Professor and class,Working for a skilled home health agency performing skilled RN visits, the management team tends to focus on re admissions rates for COPD patients. The skilled visits serve the purpose of assisting in managing disease process and providing education and resources. The goal is to adequately manage all effects of COPD at home. The article concentrates on detail discharge planning along with obtaining goals upon discharge home preventing readmission to hospital. Reducing readmission rates is a priority for the hospitals and home health agencies due to medicare reimbursements. ( Derdak, S 2017 ). This is a focal point on the nursing clinical issue accomplishing good patient outcomes in efforts to prevent hospitalization. Being hospitalized can lead to deadly infections, and even death.PICOT QuestionP – COPD patients readmission to hospitalI – Patient will receive skilled home health services C- Discharge home without formal skilled services.O- Reduction of readmission to hospital due to COPD exacerbation.T- Within 60 days certification period.Reference:Derdak, S. (2017). Prevention of COPD Readmissions: A Work in Progress. Respiratory Care, 62(1), 133-134. doi:10.4187/respcare.05350Week 3: PICOT/Evidence Appraisal Assignment (graded)Submit AssignmentDue Sunday by 11:59pm Points 200 Submitting a file uploadPICOT Worksheet GuidelinesUpdated 7/27/2017PurposeClear identification of the problem or opportunity is the first step in evidence-based nursing. This assignment offers a tool to assist in the identification of the problem, proposed intervention, and desired outcomes. Completion of the assignment will include identification of the problem or concern using the PICOT format.Course OutcomesThis assignment enables the student to meet the following Course Outcome.CO1: Examine the sources of evidence that contribute to professional nursing practice. (PO7)Due DateSubmit the completed PICOT Worksheet form (Links to an external site.)Links to an external site. by Sunday, 11:59 p.m. MT at the end of Week 3.PointsThis assignment is worth 200 points.DirectionsRead these guidelines including the grading rubrics below. Watch this video on how to complete the assignment at http://www.brainshark.com/devry/vu?pi=zHZzQomrNzHr05z0 (Links to an external site.)Links to an external site.Download the PICOT Worksheet form (Links to an external site.)Links to an external site..Consider what is the nursing problem or issue that you have uncovered. Make sure it is related to nursing, i.e., one that a nurse can solve independently. Do not select a medical problem that is dependent upon a medical professional to resolve.Download an Example (Links to an external site.)Links to an external site. of how to fill in the worksheet to help you complete your own form.Submit the completed PICOT Worksheet form.Example 1:What is the PICO(T) question?Will influenza immunization compliancy rates increase if flu clinics are provided in a Flu PODS and immunization clinics at convenient times covering all shifts?Define each element of the question below:P- (Patient, population, or problem): Hospital employees and volunteers required to have the influenza immunization annuallyI -(Intervention): Offer multiple Flu "PODS" and immunization clinics to hospital employees and volunteers making it convenient to receive the required immunization. Offer at a variety of times, available to all shiftsC- (Comparison with other treatment/current practice): Compare analytics showing employees and volunteers who received flu shot prior to 2016 when Flu PODS and immunization clinics were not offered compared to 2016 where Flu PODS and immunization clinics are offered to accommodate shifts. Track number of employees/volunteers coming at each hour time frame.O- (Desired outcome): Increase of compliance of receiving the annual mandatory flu shot by employees and volunteersExample 2:What is the PICO(T) question?For non-diabetic patients on corticosteroid therapy, does monitoring for headache, fatigue, nausea, vomiting, and blurred vision hourly vs. no observations for signs of hyperglycemia promote improvement of pulmonary complications?Define each element of the question below:P- (Patient, population, or problem): Non-diabetic patients on corticosteroid therapy.I- (Intervention): Monitoring for headache, fatigue, nausea, vomiting, and blurred visionC- (Comparison with other treatment/current practice): No observations for signs of hyperglycemiaO- (Desired outcome): Improvement of pulmonary complicationsT-(Time): 90 days**Academic Integrity Reminder**Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.Please see the grading criteria and rubrics on this page.NOTE: Please use your browser's File setting to save or print this page.RubricNR439_PICOT_WorksheetNR439_PICOT_WorksheetCriteriaRatingsPtsThis criterion is linked to a Learning OutcomePICOT questionQuestion or nursing problem is identified and is an independent nursing decision.50.0 ptsOutstanding Question or nursing problem identified that is an independent nursing decision44.0 ptsVery good Question or nursing problem is identified that is an independent nursing decision40.0 ptsCompetent Question or nursing problem is identified that is an independent nursing decision.19.0 ptsQuestion or nursing problem is identified but is not an independent nursing decision.0.0 ptsPICOT question missing.50.0 ptsThis criterion is linked to a Learning OutcomePICOT elementsPICOT elements are correctly identified. Outcomes are measurable.50.0 ptsPICOT elements are correctly identified. Outcomes are measurable.44.0 ptsOne PICOT element is not correctly identified. Outcomes are measurable.40.0 ptsTwo PICOT elements are not correctly identified. Outcomes are not measurable19.0 ptsThree or more PICOT elements are not correctly identified. Outcomes are not measurable.0.0 ptsPICOT elements are missing.50.0 ptsThis criterion is linked to a Learning OutcomePractice issue and scope of the problemPractice issue/problem is thoroughly described. The need for change is evident. Practice area is identified. Identification of the practice issue is clear. Scope of the problem is identified.50.0 ptsPractice issue/problem is thoroughly described. The need for change is evident. Practice area is identified. Identification of the practice issue is clear. Scope of the problem is identified.44.0 ptsPractice issue/problem is partially described. The need for change is evident. Practice area is identified. Identification of the practice issue is clear. Scope of the problem is identified.40.0 ptsPractice issue/problem is vaguely described. The need for change is not obvious. Practice area is identified. Identification of the practice issue is clear. Scope of the problem is identified.19.0 ptsPractice issue/problem is vaguely described. The need for change is not obvious. Practice area is not identified. Identification of the practice issue is not clear. Scope of the problem is not identified0.0 ptsNot answered.50.0 ptsThis criterion is linked to a Learning OutcomeEvidenceAppropriately identifies the types of evidences that should be gathered.20.0 ptsIdentifies and documents four types of evidence needed for review.17.0 ptsIdentifies and documents three types of evidence needed for review.16.0 ptsIdentifies and documents two types of evidence needed for review7.0 ptsIdentifies and documents one type of evidence needed for review.0.0 ptsDoes not document types of evidence.20.0 ptsThis criterion is linked to a Learning OutcomeRationale for EvidenceGives rationale for the types of evidence that is gathered.20.0 ptsThoroughly describes rationale for checked types of evidence.17.0 ptsGood description of rationale for checked types of evidence.16.0 ptsPartial description of rationale for checked types of evidence.7.0 ptsMinimal rationale for checked types of evidence.0.0 ptsRationale missing.20.0 ptsThis criterion is linked to a Learning OutcomeSearch TermsDescribes search terms that are manageable and will yield good results.5.0 ptsThoroughly describes manageable search terms.4.0 ptsGood description of manageable search terms.3.0 ptsPartially describes manageable search terms.2.0 ptsMinimally describes manageable search terms.0.0 ptsSearch terms are absent.5.0 ptsThis criterion is linked to a Learning OutcomeHow to Narrow Search in the LibraryProvides a description of how the library search will be narrowed to produce relevant returns.5.0 ptsThoroughly describes how to narrow searchFull Marks4.0 ptsGood description how to narrow search.3.0 ptsPartially describes how to narrow search.2.0 ptsMinimally describes how to narrow search.0.0 ptsNo description given.5.0 ptsTotal Points: 200.0PreviousNext

In this written assignment, you have the opportunity to share your thoughts about how to deliver client-centered culturally competent care and work collaboratively with others.The Case of Mrs. G.Mrs. G. is a 75 year old Hispanic woman who has been relatively well all of her life. She had been married for 50 years and had five children. Her children are grown with families of their own. All but one of her children live in other states. Mrs. G.'s husband passed away last year, which was devastating for her. She had been very close to him and relied upon him for everything. He was "the life of the party" she always said and was a loving and caring man. Since his passing, Mrs. G. has continued to live in the house they shared for 35 years. In the last month, Mrs. G. has fallen twice sustaining injuries, though minimal. Her home health nurse comes weekly to check in on her. Mrs. G. likes her very much and wishes she could come more often. Mrs. G.'s daughter who lives in the next town over, has been worried and decided with the urging of her siblings and the doctor to start looking for an assisted living facility for her mother. She found one last week and talked with the Director who said she would be happy to help in whatever way was best. The daughter decided to tell her mother that it was time for her to move, so she can be cared for and be safe. When she told her mother, Mrs. G. cried and said, "This will not happen ever. I plan to stay in this house of loving memories for the remainder of my life."In 3 - 4 pages answer the following questions:How would you best describe Mrs. G.'s feelings about her life, her family, her traditions, and her future?Did Mrs. G.'s response to her daughter surprise you? Please explain your answer.In what way do you believe her culture might be influencing her decision?If you were Mrs. G.'s daughter what would you say to her that shows you are caring and have compassion for her situation? What nonverbal communication would support that level of communication?Suppose Mrs. G. stands firm about not leaving her house. What resources and collaborations might be available and helpful so the daughter and other healthcare providers can keep her mother safe and make the most effective decision?

Assessment 4For this assessment, you will develop an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan to understand or implement to ensure the success of the plan.Refer to the following links to help you get started with Google Sites:G Suite Learning Center. (n.d.). Get started with Sites. Retrieved from https://gsuite.google.com/learning-center/products...Google. (n.d.). Google Sites. Retrieved from https://sites.google.comGoogle. (n.d.). Sites help. Retrieved from https://support.google.com/sites/?hl=en#topic=