Nurs fpx 4020 assessment 2 root cause analysis and safety improvement


The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern of medication administration safety based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.

Use the Root-Cause Analysis and Improvement Plan [DOCX] template to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

  • Analyze      the root cause of a patient safety issue or a specific sentinel event      pertaining to medication administration in an organization.
  • Apply      evidence-based and best-practice strategies to address the safety issue or      sentinel event pertaining to medication administration.
  • Create      a feasible, evidence-based safety improvement plan for safe medication      administration.
  • Identify      organizational resources that could be leveraged to improve your plan for      safe medication administration.
  • Communicate      in writing that is clear, logical, and professional, with correct grammar      and spelling, using current APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your Assessment 2 will focus on safe medication administration.

Additional Requirements

  • Length of      submission: Use      the provided Root-Cause Analysis and Improvement Plan template to create a      4–6 page root cause analysis and safety improvement plan pertaining to      medication administration.
  • Number of      references: Cite      a minimum of 3 sources of scholarly or professional evidence that support      your findings and considerations. Resources should be no more than 5 years      old.
  • APA formatting: Format references and      citations according to current APA style.

Healthy people discussion

See guidelines. 

NSG 4410 Fall 2020

Population Health Nursing

Instructions for the Healthy People

The purpose of this discussion is to apply research-based, public health objectives to a selected community aggregate. The documents
Healthy People 2020, and
Healthy People Midcourse Review 2010- Healthy People 2020 will be used by the students. This assignment is based on the aggregate in the community where the students did their preceptorship. The discussion is also based on the community assessment that the students completed in NSG 4411. The point distribution is listed below. The instructions on how to develop the discussion following
APA format on the next page.

Points Description

6.5 Describe the community where the aggregate lives and then describe the

aggregate using demographic data and characteristics. Discuss some

social, economic, and environmental factors determining health status.

7 Describe the leading causes of death, extent of disability, and morbidity

for this aggregate.

7 Describe the health risk factors and/or stressors facing this aggregate.

30 Discuss three
Healthy People 2020 objectives, which apply to this aggregate.

7.5 According to the
Healthy People 2010 Midcourse Review – Healthy People 2020, what, if any, progress has been made toward achievement of each
Healthy People 2020 objectives cited?

12 Identify the Healthy People 2020 objective you feel to be the most pertinent to your aggregate, identify, and discuss a strategy to promote health for this aggregate through inter-and intra-professional communication.

30 Use three peer reviewed scholarly-based articles (within last 5 years) to

validate possible interventions for improving the health status of the

assigned aggregate based on your chosen Healthy People 2020 objective.

The following websites are helpful for use in this project:


Instructions on How to Develop Following APA Format

1. The must be typed in scholarly format (Refer to the BSN Guide for Scholarly Papers) and the APA manual (7th edition):

a. no less than 5 pages and no more than 8 pages (excluding title page and reference page).

b. double-spaced, Times New Roman font, size 12 with 1” margins.

c. Do not write in first, second or third person.

d. Use of proper grammar, spelling, sentence structure, and punctuation is required.

e. Do not start sentences with numbers or acronyms.

f. A paragraph contains at least 3 sentences. Do not add a space between paragraphs.

g. Use headings. (Refer to the APA manual).

No quotes. Paraphrase in your own words.

i. Correctly cite all information. When in doubt, cite. (Refer to APA manual 7th edition).

j. Do not copy and paste from the source or from other assignments. (See syllabus regarding plagiarism).

k. References on separate page.

2. Submit under the Assignments tab through Turnitin.

NSG 4410

Population Health Nursing

Guidelines for the Healthy People

The subject of this is the AGGREGATE (vulnerable population) and the community that the aggregate lives in. For example, the aggregate could be children living in poverty, maybe in the rural community of Hurtsboro, AL. The students will be working with the aggregate population they chose during the preceptorship experience from NSG 4411. Some of the information from the NSG 4411 Community Assessment Project may be useful in writing this , however, do not cut and paste directly from the previous assignment. (See below)

The discussion has seven parts to it:

1. a. Describe the aggregate’s location using demographic data: You may pull in any

demographics you used from your Community Assessment, such as population, averages,

most common occupations, race, and education and income levels. Remember to

paraphrase the information you have previously written. You should also briefly

describe the aggregate. The idea is to give a snapshot of this aggregate and where this

aggregate lives.

A very helpful website to access is go to fast access, enter

your community (city, state) then click on “fact sheet” and “people” for details about your

community. You will need to cite this information and list in your references.

b. The environmental and economic conditions really do affect the aggregates’ health care

needs. What are some of the social, economic, and environmental factors that determines

the health status of your aggregate population?

2. Describe the leading causes of death, extent of disability, and morbidity-(illness) for this

aggregate-might not find death for children but could be adults such as heart disease for

obese children. This may be based on census data that you find on the web for this

aggregate, or your own observations of people in that community.

3. Describe the health risk factors or stressors facing this aggregate: This is based on your

own observations and research findings (such as incidence or prevalence of poverty of

children in rural areas and any health risk conditions such as lack of immunizations or

dental care).

4. Discuss three
Healthy People 2020 objectives (not topics) which apply to your aggregate:

Go to the website and you will see

a list of topics from A-Z. Each topic area will direct you to a list of objectives. List three

objectives that you identify as health risks facing your aggregate and discuss how they

apply to your aggregate. For example, if one of the topics you identify is “Access to Health

Services”, then search under the topic the objective that applies to your aggregate.

Objective AHS-3, “Increase the proportion of persons with a usual primary care provider”

because the aggregate population lives in a rural community and there are limited

healthcare providers, the nearest facility is….

5. According to the
Healthy People Midcourse Reviews 2010 and Healthy People 2020 ,

what, if any, progress has been made toward achievement of each
Healthy People

2020 objective? Go to

to find this information by clicking on
All Topic Areas and find your topic. You can then

click on the + sign to the right and expand the area to see more about the Midcourse

Review progress data specific to the objectives that you choose. (This information can also

Be accessed this from the Healthy People 2020 website by clicking on
Data Search tab.

6. Identify the one Healthy People 2020 objective
(from the 3 you chose) you feel to be

most pertinent to your aggregate, identify, and discuss a strategy to promote health for

this aggregate through inter- and intra-professional communication. You would select the

objective that
most closely applies to your aggregate and discuss a plan of action to be

optimized through communication practices that would benefit your aggregate population.

7. Using
three research-based articles from peer-reviewed Journals published within the last

five (5) years (see examples of research under APA information). Cite
three (3)

interventions for improving the health status of the residents of your assigned aggregate

based on the Healthy People 2020 objective you chose as the
most pertinent.

Example: Objective AHS-3 was the most pertinent, what interventions are being done to

improve access or reduce costs? The Healthy People 2020 website (#4) also provides some

of this information under the
Interventions & Resources tab.

Ethics week 6 discussion

  1. Watch the short video Ethics in Action – Drivers of Migration, Human Trafficking, and Modern Slavery.
  2. Post one of the basic five ethical principles listed below and how it applies to the issues in the video:
    1. Automony
    2. Justice
    3. Beneficence
    4. Non-maleficence
    5. Fidelity
  3. Your discussion should be approximately a total of 240 words.

Concept Map

Instructions: Fill in the blanks (no wrong or right answer)

1. _____________________ 2. _______________________ 3. ____________________

How can we create an equitable and effective health system?

4. _____________________ 5. _______________________ 6. ____________________


Dq on ans system organ lungs

Introduction: The ANS is the part of the nervous system that  supplies the internal organs and structures, including the blood  vessels, stomach, intestine, liver, kidneys, bladder, genitals, lungs,  pupils, heart, and sweat, salivary, and digestive glands. Two divisions  of ANS (the sympathetic and parasympathetic) have opposite functions. As  we learned, the sympathetic nervous system prepares the body for  intense physical activity and is often referred to as the  fight-or-flight response. The parasympathetic nervous system has almost  the exact opposite effect, relaxes the body, and is often referred to as  the rest-and-digest response.

For this post, you have to write at least 400 words addressing the  following 5 points. Please identify each point in your answer.

  1. Choose an organ in the body that has autonomic innervation. (LUNGS)
  2. Next, describe how the organ you have chosen is affected by one of  the two divisions of the ANS. Is it stimulated? Inhibited? Which part of  the organ is affected? Do not do both divisions of the ANS.
  3. Identify the location and neurotransmitters of the preganglionic and  postganglionic neurons that innervate the organ you chose from the  division (sympathetic or parasympathetic) you chose.
  4. Would your organ be controlled through a gray ramus communicans, splanchnic nerve, cranial nerve, or sacral spinal nerve?
  5. Describe a situation, like a car crash, that increases or decreases  the activity of your organ, and explain the effect that situation would  have on your organ. Compare that effect to normal basal levels of your  organ’s activity. Explain how the change(s) in the activity of the organ  of your choice might be perceived, if at all. Other situations could  include a job interview, relaxing on a beach, encountering a growling  dog while walking outside, jumping out of the way of an oncoming  vehicle, getting a massage, feeling unsafe while walking down a dark  street at night.

This is a first come first serve choice, so please review the  previous postings to choose your organ. If one student chooses an organ  like the eye, then only the regulation by either the sympathetic or  parasympathetic nervous system should be discussed. One organ per  student. Duplications are not allowed, and such postings will be deleted  by the instructor. If you cite a specific source, please include the  reference (APA format).

Case study 3 & 4


Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

Copyright © 2018 by Elsevier Inc. All rights reserved.

Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition

Adolescent With Diabetes Mellitus (DM)

Case Studies

The patient, a 16-year-old high-school football player, was brought to the emergency room in a

coma. His mother said that during the past month he had lost 12 pounds and experienced

excessive thirst associated with voluminous urination that often required voiding several times

during the night. There was a strong family history of diabetes mellitus (DM). The results of

physical examination were essentially negative except for sinus tachycardia and Kussmaul


Studies Results

Serum glucose test (on admission), p. 227 1100 mg/dL (normal: 60–120 mg/dL)

Arterial blood gases (ABGs) test (on admission),

p. 98

pH 7.23 (normal: 7.35–7.45)

PCO2 30 mm Hg (normal: 35–45 mm Hg)

HCO2 12 mEq/L (normal: 22–26 mEq/L)

Serum osmolality test, p. 339 440 mOsm/kg (normal: 275–300


Serum glucose test, p. 227 250 mg/dL (normal: 70–115 mg/dL)

2-hour postprandial glucose test (2-hour PPG), p.


500 mg/dL (normal: <140 mg/dL)

Glucose tolerance test (GTT), p. 234

Fasting blood glucose 150 mg/dL (normal: 70–115 mg/dL)

30 minutes 300 mg/dL (normal: <200 mg/dL)

1 hour 325 mg/dL (normal: <200 mg/dL)

2 hours 390 mg/dL (normal: <140 mg/dL)

3 hours 300 mg/dL (normal: 70–115 mg/dL)

4 hours 260 mg/dL (normal: 70–115 mg/dL)

Glycosylated hemoglobin, p. 238 9% (normal: <7%)

Diabetes mellitus autoantibody panel, p. 186

insulin autoantibody Positive titer >1/80

islet cell antibody Positive titer >1/120

glutamic acid decarboxylase antibody Positive titer >1/60

Microalbumin, p. 872 <20 mg/L

Diagnostic Analysis

The patient’s symptoms and diagnostic studies were classic for hyperglycemic ketoacidosis

associated with DM. The glycosylated hemoglobin showed that he had been hyperglycemic over

the last several months. The results of his arterial blood gases (ABGs) test on admission

indicated metabolic acidosis with some respiratory compensation. He was treated in the

Case Studies

Copyright © 2018 by Elsevier Inc. All rights reserved.


emergency room with IV regular insulin and IV fluids; however, before he received any insulin

levels, insulin antibodies were obtained and were positive, indicating a degree of insulin

resistance. His microalbumin was normal, indicating no evidence of diabetic renal disease, often

a late complication of diabetes.

During the first 72 hours of hospitalization, the patient was monitored with frequent serum

glucose determinations. Insulin was administered according to the results of these studies. His

condition was eventually stabilized on 40 units of Humulin N insulin daily. He was converted to

an insulin pump and did very well with that. Comprehensive patient instruction regarding self-

blood glucose monitoring, insulin administration, diet, exercise, foot care, and recognition of the

signs and symptoms of hyperglycemia and hypoglycemia was given.

Critical Thinking Questions

1. Why was this patient in metabolic acidosis?

2. Do you think the patient will eventually be switched to an oral hypoglycemic agent?

3. How would you anticipate this life changing diagnosis is going to affect your patient

according to his age and sex?

4. The parents of your patient seem to be confused and not knowing what to do with this

diagnoses. What would you recommend to them?

Copyright © 2018 by Elsevier Inc. All rights reserved.

Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition

Esophageal Reflux

Case Studies

A 45-year-old woman complained of heartburn and frequent regurgitation of “sour” material into

her mouth. Often while sleeping, she would be awakened by a severe cough. The results of her

physical examination were negative.

Studies Results

Routine laboratory studies Negative

Barium swallow (BS), p. 941 Hiatal hernia

Esophageal function studies (EFS), p. 624

Lower esophageal sphincter (LES)


4 mm Hg (normal: 10–20 mm Hg)

Acid reflux Positive in all positions (normal: negative)

Acid clearing Cleared to pH 5 after 20 swallows (normal:

<10 swallows)

Swallowing waves Normal amplitude and normal progression

Bernstein test Positive for pain (normal: negative)

Esophagogastroduodenoscopy (EGD), p. 547 Reddened, hyperemic, esophageal mucosa

Gastric scan, p. 743 Reflux of gastric contents to the lungs

Swallowing function, p. 1014 No aspiration during swallowing

Diagnostic Analysis

The barium swallow indicated a hiatal hernia. Although many patients with a hiatal hernia have

no reflux, this patient’s symptoms of reflux necessitated esophageal function studies. She was

found to have a hypotensive LES pressure along with severe acid reflux into her esophagus. The

abnormal acid clearing and the positive Bernstein test result indicated esophagitis caused by

severe reflux. The esophagitis was directly visualized during esophagoscopy. Her coughing and

shortness of breath at night were caused by aspiration of gastric contents while sleeping. This

was demonstrated by the gastric nuclear scan. When awake, she did not aspirate, as evident

during the swallowing function study. The patient was prescribed esomeprazole (Nexium). She

was told to avoid the use of tobacco and caffeine. Her diet was limited to small, frequent, bland

feedings. She was instructed to sleep with the head of her bed elevated at night. Because she had

only minimal relief of her symptoms after 6 weeks of medical management, she underwent a

laparoscopic surgical antireflux procedure. She had no further symptoms.

Critical Thinking Questions

1. Why would the patient be instructed to avoid tobacco and caffeine?

2. Why did the physician recommend 6 weeks of medical management?

Case Studies

Copyright © 2018 by Elsevier Inc. All rights reserved.


3. How do antacid medication work in patients with gastroesophageal reflux?

4. What would you approach the situation, if your patient decided not to take the medication

and asked you for an alternative medicine approach?