October 2019

Leading and Managing Care: Critically discuss how leadership qualities and skills contribute to effective multi-professional team work

You have a choice from 2 essay titles.

The assignment is no more than 3,000 words

Option 1: Critically discuss how leadership qualities and skills contribute to effective multi-professional team work

Define team work, define multi professional team work

Why is this important?

What makes multi-professional teams work well?

What is leadership?

What are the skills and qualities for leaders to demonstrate to be positive leaders?

Which leadership theories are you critically discussing because each theory incorporates values and actions that a leader has and acts upon

We would recommend that you critically consider 2 leadership theories

(Attach with PowerPoint of different leadership theory)

Reference that can be used:

Bach, S. & Ellis, P., (2011) “Chapter 2: Teams and Team work” from Leadership, management and team working in nursing, pp.20-36File

Leadership in health care (2012) by Jill Barr; Lesley Dowding

Leadership and Management in Healthcare (2013) by Neil Gopee; Jo Galloway

Avery G.C. (2004) Understanding Leadership London Sage Publications

• Gill R (2006) Theory and practice of Leadership London Sage Publications

• Northouse PG (2010) 5th Ed Leadership: Theory and Practice London. Sage Publications

• www.leadershipacademy.nhs.uk

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Question 1

Countries other than Australia have other significant health issues, as listed by the World Health organisation (WHO). After child and maternal health, a significant health priority area for countries to target is__________ (Select the one (1) correct answer)

a.

essential medicines, cholera and urban health.

b.

global information system on alcohol, substances and tobacco control.

c.

sexually transmitted infections, meningococcal meningitis, and influenza virology.

d.

infectious diseases for example HIV/AIDs, tuberculosis, malaria.

1 points  

Question 2

In Australia health financing is based on universal health insurance that enables access to quality, low cost health care for all citizens. When it was first introduced in the 1970s it was called ________ (Select the one (1) correct answer)

a.

public health insurance.

b.

Medibank.

c.

Medicare.

d.

health insurance scheme.

Question 3

Private health insurance organisations in Australia function in addition to the universal public financing of Medicare. A significant role of the private health insurance system is to _______ (Select the one (1) correct answer)

a.

stop people using the public system all together to ensure an entirely private system in the future.

b.

help with the cost of non–Medicare funded services and assist with avoidance of waiting lists in the public system.

c.

to pay for 75% of ancillary health costs for older people living in remote areas and to provide extra health care to eligible disabled people.

d.

to ensure that people in high tax brackets do not attend public hospitals and obtain a better tax return by ticking the private health insurance box when submitting their tax declaration.

Question 4

The historical trauma experienced by Aboriginal and Torres Strait Islander people has been identified as affecting uptakes of health programmes that were set up to support health issues for the Aboriginal and Torres Strait Islander people. Significant improvements to participation have been made since which one (1) of the following has increased?

a.

Large metropolitan hospitals have provided more health promotion services to Indigenous people in order to target their specific issues

b.

Private health insurance changes have been made over the last two decades to offer less expensive medical treatment to Aboriginal and Torres Strait Islander people.

c.

Increasing numbers of Aboriginal and Torres Strait Islander health workers and professionals employed within services for the Aboriginal and Torres Strait Islander people.

d.

The Northern Territory Intervention was introduced in 1998 and has provided targeted medical equipment to Aboriginal people living in rural areas.

1 points  

Question 5

A major historical development within perspectives of the nursing profession was a change to nurse education. Select which one (1) of the following summarises the significant changes that have occurred at the end of the last century.

a.

Education of nurses has been allocated to providers who are medical doctors to ensure complex medical knowledge base.

b.

Education of nurses has recently introduced concepts of discipline and standardisation of task completion and allocation to ensure standard practice.

c.

Education of nurses was taken out of hospital-based, vocational style and transferred to universities and vocational education providers to standardise and professionalise.

d.

Education of nurses was focused upon the use of high technology materials to modernise the profession.

Question 6

The historical development of health care in Australia allows us to understand context of current developments. Match the developments to the time frames provided.

The first universal health insurance was proposed then re-introduced based on the principle of equal access for all Australians.

The transfer or government monies via taxation, for free education, public housing, unemployment or sickness and disability care.

The first National allocation of health care responsibilities to the Commonwealth and States

The Pharmaceutical Benefits Scheme was introduced for the provision of free ‘life saving and disease preventing’ drugs.

Time frames

Developments

The declaration of the Australian constitution in 1901.

Term 1

Post second world war period based on the concept of the social wage.

Term 2

Coming into force in 1950 as a result of a 1947 Act of Parliament.

Term 3

An initial change was made in 1975 but later altered and redeveloped in the 1980’s.

Term 4

Question 7

Health Care in Australia is conducted in a range of environments with varying focusses. Match the following care environments to the services in the current models of care in which they operate in local areas as part of the Australian health care system.

Care environments

Community services nurse

Ambulatory clinic

Residential respite service

Operating theatre

Care environments

Arenas of care

Home health care

Term 1

Outpatient care

Term 2

Long-term care

Term 3

Acute hospital care

Term 4

4 points  

Question 8

Australian governments and peak health bodies have been working toward a National approach to more standards of care which were once State and Territory based. Examples of current common care standards are listed below. Match them to the description of the standards.

Standards

Palliative Care Standards

National Safety and Quality Health Service Standards

Enrolled Nurse Standards For Practice

Aged Care Accreditation Standards

Descriptions

Standards

Consisting of four (4) standards, their principles and expected outcomes to which homes must comply.

Term 1

Consisting of ten (10) standards, their intent and context, and listed criteria for items and actions that are required to meet the standard in wide variety of health services.

Term 2

Developed by the peak body, they represent a set of philosophical standards, reflecting a need to clearly articulate and promote a vision for compassionate and appropriate care

Term 3

The standards are the core to providing a framework for assessing practice and communicating expectations for practice and education.

Term 4

Question 9

The Australian health care system is complex and interdisciplinary. Match interdisciplinary team members and personnel with the roles they play within the health care system.

Interdisciplinary team member

Enrolled Nurse

Registered pharmacist

Physiotherapist

Social worker

Roles

Interdisciplinary team member

Prepares and dispenses drugs for therapeutic use

Term 1

Assists clients with psychosocial problems such as financial, housing, life skills

Term 2

Addresses the needs of the person based on a holistic assessment and following a plan of care in consultation with a registered nurse.

Term 3

Work with people with musculoskeletal problems to assess and support strength and mobility.

Term 4

Question 10

Take into account the biological, socio-cultural and social influences on health and match the impacts on health and illness for Australians to the commonly occurring outcomes (themes) of such impacts.

Impacts on health and illness

Ageing population

Obesity

Poverty

Smoking

Outcomes of health impacts

Impacts on health and illness

Increased number of people living with chronic illness for long periods of time.

Term 1

Acute and chronic illnesses, such as diabetes, that are secondary to the original health impact.

Term 2

Extensive impacts on all aspects of physiology and health, and particularly a major cause of cardiovascular and respiratory disease.

Term 3

General increase in likelihood of disease and illness states associated with poor diet, and poor preventative and general health care.

Term 4

Question 11

The health of immigrants, refugees and Aboriginal and Torres Strait Islander people can be impacted upon because of cultural barriers in society. Match the following cultural issues faced by such people to the common health impacts seen in clinical practice.

Cultural issues faced

Removal from traditional lands and family

Non-acceptance by dominant community

Belief in traditional medicine and mistrust of western medical structures

Environmental issues such as remoteness

Health impacts

Cultural issues faced

Fear, lack of knowledge and support to access services in a timely manner.

Term 1

Poor diet, inactivity, mental health issues, high level of risk taking behaviour.

Term 2

Poor local provision of or limited expertise in complex health problems.

Term 3

Late diagnosis and treatment of serious illness, if treatment is commenced at all.

Term 4

Question 12

The provision of services within the Australian health care system can be impacted by a variety of issues that can cause constraints on funding and resource availability. These issues can include social, political and economic factors. In the table below, match the three (3) correct type of issues with the statement.

A cultural issue

A political issue

Constraints on available funding

A social and economic issue

Statement

Type of issue

Clients wanting to be prescribed medication that is available overseas, but not yet in Australia, must pay full price for them because they are not yet approved for the Pharmaceutical Benefits Scheme.

Term 1

To have new drugs listed on the Pharmaceutical Benefits Scheme, they must go through rigorous cost effectiveness assessment, a safety assessment and be for a significant condition.

Term 2

People on low incomes are able to get a higher level of subsidy for approved Pharmaceutical Benefits Scheme drugs, compared to those on higher incomes.

Term 3

Question 13

Funding for public health services in Australia predominantly comes via the taxation system in the form of_________ (Select the one (1) correct answer)

a.

rebates.

b.

tax offsets.

c.

Medicare.

d.

co-payments.

Question 14

Identify the different levels in the structure of health care in Australia. (Select the one (1) correct answer)

a.

Tertiary, secondary and community levels

b.

Primary, secondary and tertiary levels

c.

Public health care and private health care

d.

Community, secondary and quaternary levels

Question 15

A brief overview of the Australian health care system’s structure including control and funding mechanisms follows. Complete the following paragraph by selecting the correct options from the box below

delivery

regional health networks

State and Territory

Australian Health Care Agreement

The States and Territories are responsible for efficient

Term 1

  of health care services. Every five (5) years the Federal government enters into a new

Term 2

  with the States and Territories. In 2011 arrangements for governance of funding and management of public hospitals changed to a National Health and Hospitals Agreement which included requirements for timely care and inclusion of local and

Term 3

.  These structures were reversed with change of government to revert to

Term 4

  management of hospitals.

Question 16

. A strength of the Australian health care system for local areas, is in __________ (Select the one (1) correct answer)

a.

health practitioners and health care facilities, no matter where they are situated are held to high standards of practice and accountability through government and professional regulatory bodies.

b.

the ability to have extensive consultations with local doctors at no additional costs, and at short notice to reduce the number of medical situations where ‘it’s too late’.

c.

provision of prescription medications in local pharmacies for all citizens at no cost if the client can prove they live in a remote area by providing an official document.

d.

provision of elective surgery in local public hospitals with little or no waiting period provided that the State Health Department has approved the premises and that Medicare has approved the prescribed drugs.

Question 17

A weakness of the Australian health care system for local areas, is that___________ (Select the one (1) correct answer)

a.

public hospitals are not required to treat individuals with private health cover.

b.

there are no services provided outside of hospitals in remote or low socio-economic areas.

c.

expensive technology is withheld from treatment options for public patients, whereas patients with private health insurance have priority access to the best technology.

d.

the breadth and variety of services available in the system are often only available in large metropolitan cities and rural and remote are neglected.

Question 18

Policies on health care are made by both Federal and State governments, which can cause a variety of problems. Other issues affecting policy development in the contemporary health environment are also varied. In the following table, match the issues impacting policy, to the most accurate description of the issue.

Issues impacting policy

Higher demand for services

Technology

Average length of stay in hospitals

Rural and remote provision of services

Descriptions

Issues impacting policy

People living longer with more chronic illnesses increases demand on services.

Term 1

The mean number of days that admitted patients stay in hospital, which impacts on costs of hospitals.

Term 2

The requirement for equitable service provision for chronic health problems in distant and sparsely populated regions.

Term 3

Techniques, instruments and medicines which are changing the nature of how procedures and treatments are conducted and their effects on people’s needs.

Term 4

Question 19

Which two (2) of the following current health issues in Australia will continue to have significant influences upon National health policy into the future?

a.

Ageing population

b.

Increased prevalence of chronic illness

c.

The misuse of reconstructive surgery to fill in demand for cosmetic surgery.

d.

Immigrant populations from third-world countries.

e.

The overuse of vaccinations in preschool children.

Question 20

An example of the impacts of health and illness factors on people is when an older person requires support to maintain their activities of daily living in their home. Select which two (2) of the following are examples of significant impacts upon them as a result of health changes

a.

Trying to navigate the complex array of services that could be used to support them to remain in the home.

b.

Paying for aids and modifications to the home to maintain safety and functionality.

c.

Attending a general practitioner for a health check every month or every week, even when travelling

d.

Reading health information on a Government brochure provided by their practice nurse at home

e.

Paying more expensive taxi fares because of the need to carry the medical equipment, e.g. walking aids.

Question 21

Health and illness factors can impact on the everyday life of a client. For young adults with insulin dependent diabetes (chronic illness), how would compliance with their maintenance regimes impact negatively in their everyday lives?

a.

They cannot drink any alcohol if they are not eating food at the same time – they blood sugar levels would be too low

b.

They can incur considerable costs for testing equipment and medications, and require regular specialist visits.

c.

They are aware of healthy diets and must visit the diabetes educator fortnightly, otherwise their insulin pump won’t be reimbursed by Medicare.

d.

They live and work within the general public at a variety of roles and activity levels.

Question 22

The principles and philosophical framework of Primary Health Care are concerned with which one (1) of the following?

a.

Providing inter-sectoral acute, chronic and rehabilitative services in tertiary health care, under a framework of emphasis on consumer involvement, universal access and affordability of health care.

b.

Providing inter-sectoral access, equity and participation in health care for all in a communitybased framework with emphasis on consumer involvement, universal access and affordability of health care.

c.

Providing health promotional, acute, surgical and rehabilitative services based in medical centres and GP clinics with emphasis on consumer involvement, universal access and affordability of health care.

d.

Providing wellbeing and disease preventative services in a framework of self-care and health focus with emphasis on consumer involvement, universal access and affordability of health care.

Question 23

The role of the Enrolled Nurse (EN) within the principles of primary health care is demonstrated by which of the following statements about the relationship with other health professionals?

a.

The EN works through direct consultation with the other health care professionals in the delivery of accessible, community driven health care.

b.

The EN works in the delivery of accessible, community driven health care.

c.

The EN works through consultation with the Registered Nurse and in collaboration with the other health care professionals in the delivery of accessible, community driven health care.

d.

The EN works in collaboration with the other health care professionals in the delivery of accessible, community driven health care.

Question 24

There are different models of health and wellness. Which one (1) of the models is reflected in the following statement? ‘This model recognises individual states of health and wellness as a position on the continuum’.

a.

Health promotion model.

b.

High-level wellness model.

c.

Health illness continuum model.

d.

Holistic health model.

Question 25

Approaches to health outside of Western based medical models often share some fundamental tenets, such as the use of natural products. Another similarity between non-western health practices is _______

a.

the need to create balance in the body, mind and spirit.

b.

the invocation of animal spirits in healing.

c.

the practice of hovering hands over the body to feel vibrational variations.

d.

the approach of testing responses on the feet to diagnose other organ or system problems.

Question 26

Promoting wellness and illness principles can be influenced by the perceptions of individuals. Match the following common perceptions to the correct principles statement.

Common perception

The emotional and social elements of a person’s life

A focus on optimising one’s health potential.

A holistic view of six (6) dimensions of one’s life of which physical health is a part, but not all that contributes to wellness.

A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.

Principles statement

Common perception

Health can be defined by each person in a different way.

Term 1

The meaning of wellness

Term 2

Some of the components of wellbeing

Term 3

The view of the dimensions of wellness.

Term 4

Question 27

In an Enrolled Nurse’s contemporary practice there is increasing likelihood that a person’s care regime will include non-western forms of medicine. The EN’s role is to apply knowledge of complementary and alternate therapies to the care of the person by_________ (Select the one (1) correct answer)

a.

informing them that all alternate therapies are dangerous and should not be used.

b.

explaining that any complementary therapies are not taken into account when they are assessed for western medicine because they make no difference.

c.

assisting the person to access more products from the internet because they are less expensive.

d.

ensuring the person is aware of potential interactions of prescribed medications and treatment with other herbs and medicines.

Question 28

Which one (1) of the following professional bodies has a function of nursing disciplinary matters and outcome decisions?

a.

Australian Health Professional Regulation Agency

b.

Nursing and Midwifery Board of Australia

c.

Australian Nursing and Midwifery Federation

d.

Australian Nursing and Midwifery Accreditation Council

Question 29

The Nursing and Midwifery Board of Australia (NMBA) is responsible for registration of nurses and midwives and development of standards, codes and guidelines for the professions. Match the following codes and guidelines to their descriptions.

NMBA codes and guidelines

Enrolled Nurse Standards For Practice

Codes of professional conduct for nurses

Codes of ethics for nurses

Descriptions

NMBA codes and guidelines

This Code outlines the nursing profession’s commitment to respect, promote, protect and uphold the fundamental rights of people who are both the recipients and providers of nursing and health care.

Term 1

Sets the minimum standards for practice a professional person is expected to uphold both within and outside of professional domains in order to ensure the ‘good standing’ of the nursing profession.

Term 2

The core practice standards that provide the framework for assessing Enrolled Nurse (EN) practice.

Term 3

Question 30

Nursing in Australia is regulated and supported by regulatory, industrial and professional bodies. An example of an industrial body in support of the profession is the Australian Nursing and Midwifery Federation. Its main function is ________

a.

advancement of the industrial, political and professional status of members.

b.

regulation all health professionals in Australia.

c.

responsibility for registration and accreditation of nurses in Australia.

d.

the peak professional nursing organisation, lobbying governed, policy analysis and development.

Question 31

A critical aspect to the nursing profession in the contemporary setting is to maintain practice within the standards of care for one’s own work role. In a palliative care setting with a distressed family, which one (1) of the following strategies would reflect that the EN is practicing within their role and standards?

a.

Speaking to the medical team and asking them to speak to the client and family.

b.

Consulting with the Registered Nurse about the family’s concerns and making a referral to support services.

c.

Speaking to the social worker or counsellor and telling them that they should contact the client and family.

d.

Setting up an appointment with the palliative care team for the client and family on the behalf of the Registered Nurse

1 points  

Question 32

A valuable resource to support your knowledge of the current health issues that will inform ongoing health policy for Australia, is the ______________ (Select the one (1) correct answer)

a.

Health care Australia managed services reports.

b.

ABC Health online website for health and wellbeing.

c.

Australian Institute of Health and Welfare report on Australia’s health.

d.

Defence Health Australia annual report on current health issues.

Question 33

Australians are, in general, able to access a wide variety of existing health services to support their current health issues. In the following tables, match the appropriate health service to the description of a health issue.

Diabetes Educators

Renal dialysis centres

Drug and alcohol rehabilitation units

Cardiac catheterisation units

Description

Health service

A person with heart disease who has had heart attacks caused by blockage of coronary arteries.

Term 1

A person with kidney failure that needs to have their blood filtered

Term 2

A person who has a long term chronic disease and is struggling to understand how to manage their diet and blood glucose levels.

Term 3

A person who is unable to function to their full potential due to overuse and misuse of substances, causing them lifestyle distress and dysfunction.

Term 4

Question 34

Florence Nightingale is often described as the founder of modern nursing. One (1) of the most significant historical contributions she made was to change the way nurses were perceived by the public, based upon which one (1) of the following innovations of the time?

a.

The introduction of formal nursing training based upon both theory knowledge and clinical experience.

b.

The use of systematic hand washing in clinical settings before changing dressings to avoid contamination

c.

That nurses should come from a religious background to ensure they are focussed on the holistic benefits to the patient

d.

The use of evidence based practice in her hospitals to avoid conflict with medical doctors and the Medical Board of England.

Question 35

Scenario 1: team meeting (Questions 35-36 refer to this scenario)

You are working as an Enrolled Nurse in a specialist, multidisciplinary service that is focussed on diabetes management. The service is due to have an audit attended by the relevant accreditation agency. You are participating in a team meeting in preparation for the audit. Because of the stress of the coming audit there is some tension within the group.

In thisscenario you need to contribute to the meeting to demonstrate your collaboration within the team, while considering your role as an enrolled nurse. Which two (2) of the following describe contributions you could make to the team meeting to support positive group dynamics?

a.

That you could take on the roles of the other team members whilst they prepare for the audit

b.

Your understanding of the situation and what your concerns are.

c.

Acknowledgement that this can be a stressful event for everyone.

d.

The fact that there is not much that you could do given your level of accountability.

e.

You could offer to act as personal assistant for your supervisor to help reduce workload

2 points  

Question 36

Scenario 1: team meeting (Questions 35-36 refer to this scenario)

You are working as an Enrolled Nurse in a specialist, multidisciplinary service that is focussed on diabetes management. The service is due to have an audit attended by the relevant accreditation agency. You are participating in a team meeting in preparation for the audit. Because of the stress of the coming audit there is some tension within the group.

Considering that the audit process is causing stress, why should you and the service participate in the process? Select the most appropriate answer from the following.

a.

Because you have to do what you are told within you role, without question.

b.

Because you are required to perform activities of audit for accreditation purposes as part of your code of ethics.

c.

Because it is a standard quality compliance activity within health services and participation is a function of professional practice and compliance with organizational procedures.

d.

Because it is solely your responsibility to maintain the accreditation standards for the service you work within.

Question 37

Both the practice of professional nursing and nursing knowledge has evolved from nursing theories. Match the theoretical concepts or frameworks that guide nursing care with the relevant theorist.

Nightingale

Abdellah

Orem

Benner

Theoretical concept or framework

Theorist

Emphasized delivery of nursing care to the whole person using a problem-solving approach the nurse formulates a plan of care to help clients meet their physical, social, intellectual and spiritual needs, via 21 nursing problems.

Term 1

Depicted the goal of nursing as helping client achieve health through self-care. Nursing is seen as a service required when individuals are unable to care for themselves, or self-care deficit.

Term 2

Viewed nursing as a development of skills and an understanding of patient care over time, thus the nurse moves from a novice to an expert

Term 3

Environmental adaptation theory, with a focus on the basic needs of humanity to survive.

Term 4

Question 38

To better support a person toward positive health outcomes for them and their family, an appropriate agency to refer to is the Immunize Australia Program. To answer the following question, you are required to access the programmer’s website using the link provided.

http://www.immunise.health.gov.au/

Identify two (2) of the six (6) sections that people can search further to find out more about the agencies and information available to them regarding immunization.

Question 39

There are times when you will need to interpret information about sources of funding for the people for whom you care, to make sense of the context they are in. Access the website’s information so that you can answer the question following.

https://www.humanservices.gov.au/customer/subjects/medicare-services

Indicate a benefit that is relevant for people who have reached a threshold of costs for health services and what the benefit means for their ongoing costs.

Question 40

There are a range of factors which commonly affect health for people. Outline three (3) common factors which affect health. In your answer briefly describe the effect on health and give an example of a group of people for which the factor is a very common risk.

An example answer is: Substance abuse is a high risk to health, which can cause serious side effects, organ failure and sudden death. It is often focussed in younger people from 15 to 30 years.

Question 41

One of the current perspectives in the profession which relates to nursing practice is Evidence Based Practice (EBP). Give a brief description of what EBP represents and how it is applied to maintain standards of nursing care.

Question 42

Health promotion is often very costly to the nation but also very important to support health, so should be evaluated for effectiveness. From the following passage, first identify a health promotion strategy that has been implemented then give a brief evaluation of what has been said about the outcomes of the strategy and the suggestion for a future approach.

‘Potentially avoidable hospitalisations (PAHs) refer to hospitalisations that may (potentially) have been avoided by providing timely and appropriate primary health care, including preventive care. Chronic diseases account for more than half of all PAHs. Widespread implementation of chronic disease management programmes, has not led to statistically significant reduction in the rates of PAH. The rates have increased in vulnerable populations (Indigenous Australians, rural/remote residents, socioeconomically disadvantaged, elderly). Effective programmes for vulnerable populations are condition- and con text-specific as many experience multiple disadvantage, including more advanced illness, comorbidities, poor health literacy and low socioeconomic status. Overall, a targeted approach that is ‘fit for purpose’ may be needed to ensure that programmes to reduce PAHs reach those most in need.’

http://www.phcris.org.au/news/newsfeed/2016/june/pir.php  (accessed 27th July 2016)

Health promotion strategy:

Evaluation:

Suggestion for a future approach:

Question 43

Scenario 2: patient load and scope of practice ( Questions 43-44 refer to this scenario)

You are a student Enrolled Nurse participating in clinical placement in a busy medical-surgical ward within an organisation that has a policy regarding nursing workloads which states; ‘Appropriate Patient AlOutcomes’.

This is your first placement on a hospital ward and you are allocated two (2) surgical clients for this shift (postoperative clients with IV therapy and wound drains) and two (2) medical patients (an Aboriginal and Torres Strait Islander person, who needs full assistance with all ADLs and a person with IV medications).

To ensure you comply with the relevant Codes of ethics, conduct and standards for practice, and in consultation with colleagues and your supervisor, you identify that this patient load is likely to be outside your scope of practice and therefore not safe.

Applying jurisdictional requirements of the organisation to the Decision Making Framework for nurses to address your scope of practice, determine whether it is appropriate or not to accept the allocation of patients. In your answer ensure you address reasons for your determination, organisational compliance and how you are working within the parameters of nursing practice relevant to your role (as per the scenario).

Question 44

Scenario 2: patient load and scope of practice (Questions 57-58 refer to this scenario)

You are a student Enrolled Nurse participating in clinical placement in a busy medical-surgical ward within an organization that has a policy regarding nursing workloads which states; ‘Appropriate Patient AlOutcomes’.

This is your first placement on a hospital ward and you are allocated two (2) surgical clients for this shift (postoperative clients with IV therapy and wound drains) and two (2) medical patients (an Aboriginal and Torres Strait Islander person, who needs full assistance with all ADLs and a person with IV medications).

To ensure you comply with the relevant Codes of ethics, conduct and standards for practice, and in consultation with colleagues and your supervisor, you identify that this patient load is likely to be outside your scope of practice and therefore not safe.

Refer to the above scenario. In adapting to the role of the EN who works in collaboration with the RN, in accordance to the EN scope of practice, organisational policy, relevant legislation, nursing standards, and principles of practice within the context of care, identify the most appropriate strategy/ies that you should take in this situation to maintain safety of the clients.

Question 45

Give an example of how nurses could incorporate the process of ‘assessment’, as described in Henderson’s nursing theory, into nursing practice on a regular basis. A brief overview of theory has been supplied below.

Henderson’s theory: Described the goal of nursing as helping people to gain independence as rapidly as possible. Identified 14 basic needs which provide the framework for nursing care.

Question 46

Give an example of a situation where you might be required to discuss funding sources and health insurance with a person or their family/carer. In your answer also discuss why it is important to the person to have the conversation in this situation.

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CM1:1. Why is Whirlpool’s share price down after 6 months of tariffs? Whirlpools share price is down because of the tariffs on aluminum and steel placed by President Trump in March. These tariffs have caused Whirlpool to have to pay more for their raw materials in order to make their products. This increase in raw materials has forced Whirlpool to increase their prices on their products. This price increase has led to lower consumer demand and millions lost in net income compared to a year ago for Whirlpool.

2. Why did Whirlpool want protection from unfair foreign competition? Whirlpool wanted protection from unfair foreign competition because companies such as LG and Samsung are selling their products cheaper in the U.S. than Whirlpool can. Even though LG and Samsung are having to pay higher shipping costs for their washing machines, they are not hurt by the higher cost of aluminum and steel like Whirlpool. Just last year, Whirlpool sought protection from South Korean products known as the safeguard law. This law, implemented by President Bush in the early 2000’s, requires U.S. companies to prove that it is suffering because of surging imports.

3. Why have prices for washers and dryers gone up? The prices for washers and dryers have gone up because of the U.S./China trade war. The increase in prices for raw materials such as aluminum and steel, from which washers and dryers are primarily made from, has caused an increase in these appliances. The increase is the steepest, according to our article, in at least twelve years. The higher price of raw materials has the direct result of causing washer and dryer prices to increase along with it. Whirlpool has no choice but to raise prices because profits are less than 4% for each washer and dryer sold. They have to make up the difference by raising prices.

4. Why will revenues, employment, and wages shrink in the US appliance market? Revenues, employment, and wages will shrink because the demand for appliances have begun to shrink in response to the rising costs of the appliances due to the higher cost of aluminum and steel. Revenues will shrink because prices on appliances will rise and consumers will not purchase them. Employment and wages will shrink because the demand for appliances will shrink. Employment will decrease with the demand, and the employees that remain will have to take a pay cut for Whirlpool to offset the lost revenue.

5. Will tariffs help Whirlpool compete more effectively in the US appliance market? Tariffs will help Whirlpool complete more effectively. Whirlpool recently sought protection for unfair dumping, which means selling below cost, from companies such as LG and Samsung. In response, LG and Samsung have begun producing their appliances in the U.S. They now must pay fair wages, and all other expenses that U.S. producers must pay in order to do business here. They no longer have an unfair advantage over Whirlpool. This will help Whirlpool to compete more effectively in the U.S. appliance market and make it fairer for them.

CM2: The reason Whirpool’s share price was down after 6 months of tariffs is due to people not being able to afford buying a new washing machine.  All the items that go into making a washing machine are imported.  The tariffs are still being employed on those items.  As long as that continues, the sales will continue to stay lower.  Whirpool wanted protection under the unfair foreign competition because of the imports coming in was causing harm to their business.  The prices for washers and dryers have went up due to the tariffs that have been imposed.  The cost of steel and aluminum continues to rise, and most of the items that go into making them come from overseas, and the tariff is making the products expensive. If the products are not made in the US we will continue to suffer.  It would not be as simple as starting a company here and making our own product.  A lot goes into that part of it.  We don’t have the resources that other countries may have.  Something like that would not happen over night.   People are now doing repairs on them instead of buying new ones due to the cost.  The revenues and wages will shrink because there will not be a demand for new washers and dryers. The demand will continue to decline.  It will put many people in jeopardy of not having a job.  In the article it talks about how one person opted not to buy some of the major appliances that they were wanting because the prices were so high for a new washer and dryer.  People will stop buying new, and learn to fix what they have in order to save money.  While the tariffs might have been good for Whirpool in the beginning, I think long term it will not be good for the company.  It is costing the US more to keep the tariffs because we are having to pay higher prices.  There will not be demand that there once was because of the expense to the consumer.  The longer we employ the tariffs, the more it will damage the US economy and will hurt our ties with China.  The cost to repair the washers and dryers will also increase due to the demand of just needing to fix the item.  Those items will still be imported and cost money.  In the article it states that they are working with other countries to try to help, but even by doing that, the manufacturing facilities that we have in the US will still suffer.  Until we lift the tariffs and make them more manageable we will continue to see negative impacts on multiple companies.  It will not just be companies that suffer, but the consumers themselves.  It will be all of us.  It is going to drive our economy into a recession.  It is turning into the domino effect.  You hit one, and it trickles down until they have all fallen.  This will continue to have a negative effect until it is changed, and then it still won’t get better over night.

CM3: 1. Whirlpool’s share price is down after six months of tariffs because they are far less profitable because of the tariffs. The tariffs are meant to protect Whirlpool from foreign manufacturers but are simply costing the company millions because of the change in cost of raw materials. The protective tariffs are not working because all of the goods that all companies use to construct appliances are built out of metals that are highly taxed when imports at the moment. This is creating a much more difficult business position for appliance manufacturers because their profit margins have been decreased severely and they already had a very slim margin for profit.

2. Whirlpool wanted protection from foreign competitors because they were able to produce and sell goods for much cheaper than Whirlpool. These tariffs only made it harder on everyone though when imposed because it did not only affect foreign companies exporting to the United States, it affected Whirlpool through higher taxes on raw materials. This did not go as planned and allow for a home advantage for Whirlpool, it rather increased difficulty when attempting to sell goods. Rather than going as planned and excluding foreign companies from profitability in the United States, the tariffs created a more difficult business environment for all involved.

3. Prices for washers and dryers have increased drastically because of the higher costs of raw materials utilized to construct these goods. The profit margins for all companies have been greatly impacted by the trade war instead of simply helping American companies as intended when the tariffs were imposed by President Trump. The only people benefiting from the tariffs at the moment are the towns where new factories are being built or set up to construct goods within the borders of the United States and exclude the need for outside goods. This is hurting the companies though because costs are so much higher than when producing goods in the past.

4. Revenues will shrink in the United States market because people have already began fixing their broken appliances rather than purchasing new ones because the costs have increased so dramatically. This would not be the case if costs for the companies producing the goods were lower but with raw materials being so high due to the tariff war with China, all companies are feeling the affects. This is working out greatly for repair companies though because they are receiving many more repair calls and are performing jobs that cost substantially more than previously when people would simply purchase new appliances. Because of the cut profit margin, employment for appliance manufacturing companies will drop dramatically because the companies will not be able to carry as much labor cost as before because of the change in materials cost.

5. I do not believe tariffs will help Whirlpool compete more effectively in the United States market because they are hindering the company more than they are helping because of the substantial rise in manufacturing costs. This will overrule any possible threat from a foreign company that has potential to outproduce Whirlpool. Dealing with substantial changes in costs is much more difficult than competing with other companies who produce the same goods.

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What circumstances cause local Haitian peanuts to be more expensive than those produced in foreign countries? Consider how operating leverage and economies of scale affect the cost per kilogram.

Krumwiede, K. R., Paik, G. H., & Walden, W. D. (2018). Can management accounting help aid associations make tough choices in Haiti? (Links to an external site.) Issues in Accounting Education, 33(1), 17–28.

Answer the following questions:

Susan Jackson recently accepted an unpaid intern, Anakin (Bongjoo) Kim, a recent accounting grad who wants to do humanitarian service before pursuing a career in international business. Susan is hoping that Anakin can use his management accounting knowledge to help HHC fulfill its mission. Specifically, she asked Anakin to address the following questions (these are the questions you are to answer in your submission):

• What circumstances cause local Haitian peanuts to be more expensive than those produced in foreign countries? Consider how operating leverage and economies of scale affect the cost per kilogram.
• How could cost-accounting information, such as break-even and target profit analysis, help Haitian farmers like Samuel Hilaire be more profitable? (Provide a minimum of three specific examples. If you cannot find the number you need, then make an assumption based on other case information.)
• Most, if not all, other aid associations buy their peanuts from lower cost, higher-quality providers, but there are good reasons for HHC to buy local peanuts even though they cost more. First, do a quantitative cost-benefit analysis of buying local peanuts rather than foreign peanuts. Next, identify other qualitative costs and benefits such as those affecting local farmers, the economic viability of the country, and HHC’s relationship with UNICEF.
• Think about HHC’s mission. What types of financial and nonfinancial information would help HHC lower its costs and still achieve its mission? How can cost accounting help HHC meet its objectives? Consider the appropriate costing system, key cost measures, and financial and nonfinancial impacts of using local peanuts.
• Many HHC donors not only want to help, but also want to know how their donations will make a difference. What kinds of financial and nonfinancial measures could HHC provide to donors to show how they are helping the people of Haiti? Consider how donations might be used, such as for new labor-saving equipment, supplementing HHC’s budget, expanding capacity, and who might benefit from the donations.
• What performance measures could HHC provide to UNICEF to help it achieve its goals and increase its purchases of RUTF made with local peanuts? Consider issues such as its mission, performance goals, food quality, and short-term versus long-term costs.
• What do you think is the best way to help the country and people of Haiti? Support your answer. Consider the macroeconomic, microeconomic, and ethical implications of your recommendation. For example, consider (1) how HHC could persuade UNICEF to think more long-term, (2) how HHC could expand its capacity to produce more Medika Mamba (MM), and (3) how to best reduce the amount of food aid provided to Haiti, and provide more nonfood aid.

Submission Requirements:

• Your Word document should be 4 pages in length (not including the required cover and references pages).
• Answer each question in order. You can number them if you would like.
• Format your submission according to APA.
• You must include a minimum of six credible academic, or professional references beyond the course text, required and recommended readings, or other course materials.

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NURS 2020:COMPLEX CARE NEEDS

Report Structure

The following grid is for your guidance and your report subtitles may vary from what has been suggested but before submitting your assignment, check against the following suggestions:

Things to include	Notes and comments	References / Suggested word count
Abstract	A brief summary of your report (what you have done/found) including the salient findings and any recommendations for practice. Write once report completed State the geographical area that will be the focus of the report	300-500 words (not included in word count)
Contents list with each section of your report referenced to page numbers	Make sure it enables the reader to locate each section, reference list, bibliography and any appendices. Write once report completed	(not included in word count) Number each appendix separately and only include what is relevant (appendix optional)
Introduction stating what you intend to do, how and why (rationale).	This is taken from the title of the report Write once report completed	300-400 words
Briefly identify any confidentiality/ consent issues	DO NOT convey any real patient/ staff/ GP or hospital names/details.	Code of Conduct, Accountability, Data protection etc.
Define your chosen Long term condition with a brief discussion of relevance to this study	if possible include more than one definition and compare and contrast different views	300-400 words
Demographic profile Introduce the demographic and epidemiological profile. Briefly and concisely (using sections) analyse the epidemiology and demography applicable to the chosen Long term condition, using data found i.e. the main features. How does the demography of the population under investigation affect prevalence of the LTC? If possible compare/contrast the data from two geographical locations and analyse - discuss the significance. May include affluence/deprivation, implications for health outcomes	Profile data can be included in appendix. Use of graphs, charts within the text may  save on the word count	600-800 words Use of Health Targets from Govt Reports, NSFs etc   Can obtain stats from - Local government council statistics, National Census, Public health observatories, Health profiles, Public Health England, Fingertips
Community Services Emphasise the importance of community services/ Multi-agency working/ facilities, how do they improve outcomes. May include a brief discussion on the role of carers, and statutory and voluntary agencies Discuss the gaps in provision and any evidence of inequalities. You DO NOT need to compare/contrast areas in this section.	May include overview of services/ facilities/ in appendix. This overview can be a list, may structure into statutory, voluntary and private agencies   Make this relevant to your patient	400-600 words Health inequalities and rationing.
Health Needs Assessment THIS IS THE MAIN PART OF THE ASSIGNMENT i.e the largest in terms of word count. Identify the theory of needs used to structure the framework of analysis, with reasons, and critical thought. Briefly discuss your assessment of the identified population group with a long term condition. Clearly identify the health needs of your chosen population within the structure of this section. Underpin the work with relevant evidence. Include the role of the nurse and possible nursing interventions	Use literature to support your assessment as appropriate, how can people/communities be empowered to self-manage long term conditions	800-1000 words   Evidenced based practice references and your chosen Theory of Needs     Include relevant legislative Influences/white papers discussion highlighting relevant changes in Nursing, Community/Acute  care, NSF targets etc
Conclusion: Summarise the assignment and identify your views on care and the findings of the report; include any recommendations		300-400 words
Overall: CHECK,CHECK, CHECK! Your assignment is a report and as such should be written in report style, avoiding the use of “I”, we”, “the author” etc. Use short statements/ sentences to make your point.	Paginate, spell check and proof read overall work including appendices (fully referenced). Title all appendices if used. Check correct referencing style, both in your text and in the reference list. A minimum of 30 references is required for this piece of work to demonstrate wide reading! Remember these should in the main be academic references	Reference list / bibliography / appendices not included in word count Include relevant legislative Influences/white papers/ NSF/ NICE guidelines etc throughout the work where appropriate; / link provision with policy

Learning Outcomes:  

Purpose of the Assignment

To allow the student the opportunity to demonstrate an understanding of the theoretical and practical links in identifying health needs of individuals or groups within populations.

The module written assessment explores learning outcomes 1, 2, 3,4,5 and 6.

Learning Outcomes	Assessment method
1. Apply the knowledge of assessment, planning, implementing and evaluating nursing interventions required for individuals with complex care needs	Written report (3000 words) 100% weighting. Minimum threshold 40%
2. Appreciate the impact that physical, social, psychological, cultural, environmental and socioeconomic factors may have on the health needs of individuals, carers, families and communities.
3. Analyse current service provision, within the mixed economy of care, for individuals, carers, families and communities with complex needs in your chosen field of practice
4. Illustrate the role of nurses in empowering individuals, carers, families and communities to self-manage their complex care needs
5. Identify and analyse the factors that promote and hinder working in partnership with others in your own field of practice.
6. Identify and discuss how individuals, carers, families and communities with complex care needs may be managed in your own field of practice

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Mrs. Adams, a 68-year-old widow who was referred to case management upon discharge from the hospital based on her physician’s recommendation that she is not able to care for herself independently. Her diagnosis is diabetes, hypertension, and breast cancer. She is 5 days’ post-op from a right sided mastectomy. Mrs. Adams apartment is located in a low income area of the city where crime is prevalent. Upon assessment by the Community Health Nurse, Mrs. Adams apartment was in disorder with minimal airflow or light. Her cloths appeared unchanged and she had no food in the apartment. The small apartment also housed 3 cats and a small dog who Mrs. Adams considers family since the death of her husband 1 year ago. Mrs. Adams complains of pain and draining from her surgical site and a broken air conditioner. Using Nightingales Environmental Theory, what actions would the nurse take upon the first assessment? What are the five essential components? What would be an appropriate plan of care be for Mrs. Adams? How would you prioritize the care plan? Apply Nightingale’s Environmental Theory to an area of your nursing practice? What patient population would benefit from this approach? Support this practice change with at least one evidenced-based article. The assignment should be completed in APA format, as an essay of between 1000 and 1500 words. The paper should include at least 3 outside references and the textbook. The paper should be in APA format with a title page, level headings, and reference page.

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What are the five stages of dying as detailed by Elisabeth Kübler-Ross? Describe each one.

Description

1. On each page: Student Name, ID Number, Course Number, Course Title, and Unit Number.
2. Responses typed, using a standard font, 12-point type size, double-spaced, with overall neatness and readability.
3. Restatement of the question and question number (exactly as stated in the Study Guide).
Writing Assignment Evaluation
1. Student used standard essay format: Introduction/Body/Conclusion.
2. Student demonstrated proper use of grammar, spelling, punctuation, citation style, etc.
3. Student demonstrated an understanding of course content and key concepts, as discussed in the text.
4. Student was able to examine, assess, evaluate, and/or analyze course content and key concepts.
5. Student provided a clear and well-developed response to the question

• Read pages 336-351 of your textbook
• Reference: Psychology for Living:
Adjustment, Growth, and Behavior Today
by Steven J. Kirsh. Karen Grover Duffy,
and Eastwood Atwater. 11th edition, 20

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Explain why PPP and IFE in theory makes derivatives unnecessary. Evaluate the differing ways in which derivatives can protect against the failings of IFE and PPP. (2,000 words;; 70%)

Module Title International Financial Management Level 7
Weighting within the
module
50%
Word
limit/presentation
criteria
3,000
Learning Outcomes
to be assessed
(from module spec.)
1. To examine the impact of such factors as exchange rates, inflation rates and
interest rates on the performance of firms and to assess their significance in
decision making in an international market/global context
2. To critically evaluate principles and practices guiding financial
management of the multinational enterprise
3. To explore factors that differentiate multinational from domestic financial
management
4. To devise a risk management strategy to measure and hedge against
variation in global financial market prices including financial crises
5. To prepare students for the high risk high return environment of
international finance
Details of the task
As specified
RKC & Salford Assignment 1
International Financial Management 2017_18
Please submit ONE word file covering the WHOLE assessment, answer
BOTH parts
a) Prepare a summary of the following article:
Barry Eichengreen and Ngaire Woods, The IMF’s Unmet
Challenges, Journal of Economic Perspectives—Volume 30,
Number 1—Winter 2015—Pages 29–52
Please read the following 7 items:
1. You must include the title of your submission which must be
“A summary of: “The IMF’s Unmet Challenges” by Barry
Eichengreen and Ngaire Woods, Journal of Economic
Perspectives—Volume 30, Number 1—Winter 2015—Pages
29–52”.
2. You are allowed an extra 26 words to cover the title.
3. This article is available via the University SOLAR> e-­journals
site.
4. Your submission should be a summary of the contents of the
paper.
5. You are not required to read or quote from any of the cited
articles in the paper. References are not required.
6. You are not required to have specialist knowledge beyond
that delivered in the module.
7. You are writing a summary of the paper – do not write an
essay based on the title of the paper.
(1,000 words;; 33 marks)
b)
i) Explain why PPP and IFE in theory makes derivatives
unnecessary.
ii) Evaluate the differing ways in which derivatives can protect
against the failings of IFE and PPP.
(2,000 words;; 70%)
Please read the following 5 items:
1. Parts b(i) and b(ii) carry equal marks but the word count
is for the whole of part b.
2. Clearly indicate which part you are answering by quoting
the EXACT titles “b(i) Explain…unnecessary” and “b(ii)
Evaluate …PPP”. Do not invent similar titles
3. The lecture slides should be used as the basis of your
answer.
4. Words that are not your own must be in inverted commas
and clearly referenced directly after the inverted commas
giving author name, year of publication and page number
of the publication. Further details should be given at the
end of your submission under the title “References”.
5. Referencing is not encouraged, your understanding of the
course material and your ability to present a well
explained argument in your own words based on the
course material is the most important consideration in
assessing your submission.
6. You are allowed 200 words over the 2,000 to cover for all
items considered as extra to the content of your answer.
(2,000 words;; 70%)
END OF ASSIGNMENT

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