Analyzing the Aggregate Strengths and Weaknesses and Risk Assessment

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Phase 3: Analyzing the Aggregate Strengths and Weaknesses

For Phase 3 of the Capstone project, analyze and describe the strengths and weaknesses of the aggregate
and the community where the aggregate resides.
Be sure to apply Mobilize, Assess, Plan, Implement, Track (MAP-IT) in your assessment process.

  • By the due date assigned, submit your response in a 1-page Microsoft Word document.
  • Support your responses with examples.
  • Cite all sources in APA format.

Phase 4: Risk Assessment

For Phase 4 of your project, you will select a family in your aggregate and complete a risk assessment in
the field using the information from chapter 18 "Community as Client: Assessment and Analysis" and
"Appendix D Friedman Family Assessment Model (Short Form)" as a guide. Describe how the family,
environment, home, and risk assessments were conducted, using your course textbook as a reference.
Describe the results of the assessments, drawing conclusions about the health risks to the aggregate as you
see them.

  • By the due date assigned, submit your response in a 2- to 3-page Microsoft Word document.
  • Support your responses with examples.
  • Cite all sources in APA format.

Submission Details:

Combine Phase 3 and Phase 4 documents into one paper. Use bold sub-headings in the paper to distinguish
Phase 3 from Phase 4.
Phase 3: Analyzing the Aggregate Strengths and Weaknesses and Phase 4: Risk Assessment


Rubric Name: NSG4075 Week 4 Project Rubric

Criteria

Student did not submit assignment.

MAP-IT is not reflected in the assessment process.

Few MAP-IT aspects applied to the assessment process.

MAP-IT applied to the assessment process with missing
elements.

Clearly applied MAP- IT in the assessment process.

Criteria

Student did not submit assignment

Lack of strengths identified.

Briefly mentioned the strengths.

Identified the strengths but without explanation.

Thoroughly described and analyzed the strengths linking with community in which aggregate lives.

Criteria

Student did not submit assignment

Lack of weaknesses
identified.

Briefly mentioned the
weaknesses.

Identified the
weaknesses but without explanation.

Thoroughly described
and analyzed the weaknesses linking with community in which aggregate lives.

Criteria

Student did not submit assignment.

Lack of description of
how the family, environment, home, and risk assessments were conducted.

Briefly mentioned how
the family, environment, home, and risk assessments were conducted.

Mentioned in detail
how the family, environment, home, and risk assessments were conducted,
using the course textbook as a reference.

Thoroughly described
how the family, environment, home, and risk assessments were conducted,
using the course textbook as a reference.

Criteria

Student did not submit assignment.

No health risks
Identified.

Identified the health
risks to the aggregate but no explanation included.

Identified the health
risks to the aggregate
and explanation
included vaguely relating to the risk assessment.

Identified the health
risks to the aggregate
and explanation
included clearly relating to the risk assessment.

Criteria

Student did not submit assignment.

Cited one source and
it was not a journal article.

Cited two sources but
they were not journal articles.

Cited one source that
was a journal article.

Cited two journal
articles.

Criteria

Student did not submit assignment

Introduction is limited or missing entirely.

The paper lacks a thesis statement.

Transitions are infrequent, illogical, or missing entirely.

Conclusion is limited or missing entirely.

Introduction is
present but incomplete or underdeveloped.

The paper is loosely organized around a thesis that may have to be inferred.

Transitions are sporadic.

Conclusion is present, but incomplete or underdeveloped.

Introduction has a
clear opening, provides background information, and states the topic.

The paper is organized around an arguable, clearly stated thesis statement.

Transitions are appropriate and help the flow of ideas.

Conclusion summarizes main argument and has a clear ending.

Introduction catches
the reader’s attention, provides compelling and appropriate background info, and clearly states the topic.

The paper is well organized around an arguable, focused thesis.

Thoughtful transitions clearly show how ideas relate.

Conclusion leaves the reader with a sense of closure and provides concluding insights.

Criteria

Student did not submit assignment.

Writing contains numerous errors in spelling, grammar, and/or sentence structure that severely interferes with
readability and comprehension

Writing contains numerous errors in spelling, grammar, and/or sentence structure that severely interferes with
readability and comprehension

Writing follows conventions of spelling and grammar
throughout. Errors are infrequent and do not interfere with
readability or comprehension

The paper is basically error free in terms of mechanics. Grammar and mechanics help establish a clear idea and aid the reader in
following the writer’s
logic.

Criteria

Student did not submit assignment

No attempt at APA format.

APA format is
attempted to paraphrase, quote, and cite, but errors are significant.

Using APA format,
accurately paraphrased, quoted, and cited in many spots throughout when appropriate or called for. Errors
present are somewhat minor.

Using APA format,
accurately paraphrased, quoted, and cited throughout the presentation when appropriate or called for. Only a few minor errors present.

Overall Score

This is a continuation from Phase 1.....I have included Phase 1's document for continuity

Inadequate Quality of Care in Nursing Homes Inadequate Quality of Care in Skilled Nursing Facilities Wendy Thompson January 4, 2018 1 Inadequate Quality of Care in Nursing Homes 1 Inadequate Quality of Care in Skilled Nursing Facilities Introduction Over the last 25 years I have worked in numerous emergency departments in various cities and states and see a reoccurring theme. The reputation of the local skilled nursing facilities has in the local emergency department. The sad state that most nursing home patients arrive to the emergency department is heart breaking and is a common occurrence around the United States. Nursing homes do not have properly trained staff nor the funds to provide optimum care to their residents. This leads to an increase of injuries, infections, and death within the nursing home requiring transport to the emergency departments. This population is the fastest growing segment with an estimated 34 million people over the age of 65 who might need placement in a nursing home or skilled nursing facility (Grade, B. 1976). 4.1% of people 65 years of age and older live in long term care facilities (El-Solh, A., etal. 2011). Population The average age of residents or patients in a skilled nursing facility is 85 years of age and older. This group accounts for approximately 52% of the residents. Thirty-five percent of the residents are 75-84 and thirteen percent are 65-74. Most of the residents have chronic illness such as congestive heart failure, chronic obstructive pulmonary disease, dementia, Alzheimer’s or cerebral vascular attack (www.caregiver.org). The residents have trouble basic self-care tasks such as feeding themselves, bathing, and ambulating due to the aging process or disease process. The residents can be long-term or short-term. The short-term residents are only there for a brief period for rehabilitation from injury or illness and then discharged home (www.ncbi.nml.nih.gov). Problem The problems that face nursing homes which affect the quality of care given to the residents is shortage of staffing and lack of training of the staff in the skilled nursing facilities. Most facilities are required only to have one registered nurse on duty at all times. The average nursing home houses approximately 80 residents which the registered nurse on duty is responsible for. The registered nurse usually holds an administrative or supervisory role also such director of nurses for the facility (Lin, H. 2014). The rest of the staffing is comprised of 3-5 licensed practical nurses whose main task is handing out of meds and 5 certified nursing aides who perform most of the hands-on care for the residents (Interview with MD). Another restraint the skilled nursing facilities face is funding. Most of their funding is received from reimbursements from private insurance companies or Medicare/Medicaid. These companies dictate the number of days a resident may stay, the plan of care based on the diagnosis, etc. If a resident is readmitted to the hospital with in thirty days of discharge, the skilled nursing facility may not get reimbursed for that month or may even have to pay money back even if it’s a Inadequate Quality of Care in Nursing Homes 1 separate diagnosis from the previous diagnosis. This decreases the amount of funds available to run the skilled nursing facility (Interview with MD). Also, the average cost of care in a skilled nursing facility setting is four times greater than that of a hospital, assisted living or adult day care facility ( www.caregiver.org). Vulnerabilities of Residents The leading cause of death of residents in a skilled nursing facility is pneumonia and the number one cause of injuries is falls. Pneumonia accounts for approximately 48 % of the infections in skilled nursing facilities followed by urinary tract infections and wound infections. The main cause for pneumonia is ineffective clearing of mucous from the respiratory tract due to cerebral vascular attack, dysphagia, decreased respiratory reserve such as chronic obstructive pulmonary disease, coronary artery disease, et. Urinary tract infections are related to poor hygiene and bladder habits. Wound infections are caused by poor hygiene and decreased mobility and circulation (El-Holh, A., et al, 2011). Falls account for 43% of hip and femur fractures. Falls occur mainly occurs when the residents do not obtain help with ambulating, toileting, etc. This comes from the resident trying to maintain independence or not getting the assistance, he requests in a timely manner. Also, the residents balance, gait and strength has decreased due to the aging process causing him to be apt to fall (El-Sohl, A., etal, 2011). Final Results Even though death is expected skilled nursing facility, preventable deaths due to falls and pneumonia is due in part to insufficient funding and staffing shortage. An increase in nursing hours has been shown to reduce urinary tract infections, pneumonias, and wound infections (Backhaus, R., etal, 2014). Injuries are preventable if adequate staffing is available to help assist the patients with activities of daily living. By preventing both infections and injuries, the need for rehospitalizations decreases which helps skilled nursing facilities obtain reimbursement from the private insurance companies or Medicare/Medicaid. Conclusion Skilled nursing facilities have a significant role in the community especially with the increasing number of the elderly population. However, there are major areas that need addressing – staffing shortage of properly trained staff and lack of funding. With improved quality of care, the elderly population can achieve a better quality of life even while residing in a skilled nursing life. Inadequate Quality of Care in Nursing Homes Reference Backhaus, R., Verbeek, H., van Rossum, E., Capezuit, E., & Hamers, Jan. Nurse Staffing Impact on Quality of Care in Nursing Home: A Systemic Review of Longitudinal Studies. Journal of American Medical Directors Association, 15(6) 383-393. Doi:dci.org/10.1016/j.jamda.2013.12.080 El-Sohl, A.A. (2011). Association Between Pneumonia and Oral Care in Nursing Home Residents. Lung, 189(3), 173-180. doi:10.1007/s00408-011-9297-0. Grade, B. L. (1976, January 1). A study of the Entry Crisis to a Nursing Home. Jones, T. S., Ghosh, T. S., Horn, K., Smith, J., & Vogt, R. L. (2011). Primary Care Physicians Perceptions and Practices Regarding Fall Prevention in Adult’s 65 Years and Over. Accident Analysis and Prevention, 431605-1609. Doi: 10.1016/j.aap.2011.03.013. Lin, H., (2014). Revisiting the Relationship Between Nurse Staffing and Quality of Care in Nursing Homes: An Instrumental Variables Approach. Journal Of Health Economics, 3713-24. doi:10.1016/j.jhealeco.2014.04.007. www.caregiver.org/selected-long-term-care-statistics www.ncbi.nlm.nih.gov/pmc/articles/PMC41911229. 1

Tutor Answer

CASIMIR
School: Carnegie Mellon University

Hey, do you have this with you?For Phase 4 of your project, y...

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Review

Anonymous
Goes above and beyond expectations !

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