Discussion 7

Frustrated with ongoing complaints from family members, Reba Sanders, the administrator of 100-bed Lakeview Skilled Care and Rehabilitation Facility, replaced the director of nursing (DON) after she had been on the job for less than 2 years. At the exit conference with Reba, the DON had remarked, “I don’t think pressure ulcers have been a problem in this facility the way it is made out to be by some families. Some patients develop the ulcers at the hospital before they come here; we try our best to take care of them, and I have explained to the families what we are doing. I think firing me is unfair, but it is your decision.” Before the new DON, James Osterwal, was hired for the job, Reba had mentioned to him that looking into the pressure ulcer problem would be his first priority. Reba arranged for James to attend meetings of the local chapter of a national quality improvement organization for nursing homes. Based on some of the information presented at the meetings, James quickly settled on making pressure ulcer elimination as his primary goal. James was quite familiar with the PDSA quality improvement cycle. He discussed it with the charge nurses, decided how data would be collected, and started a campaign asking all nursing staff to adopt the motto: “We will eliminate pressure ulcers at Lakeview.” The associates liked the motto because it gave them a specific goal to work toward. At James’ request, Reba approved hiring an RN nurse coordinator to float between the three shifts. The charge nurses asked their nursing assistants to report to them right away all cases of skin breakdown. James trained the nurses in best practice protocols to treat pressure ulcers. After 4 months, data showed little to no improvement in the prevalence (total number of cases) of pressure ulcers at Lakeview. Both Reba and James could not understand why.
Questions
1. Based on what you have learned to this point in the course, evaluate the quality improvement program as it pertains to pressure ulcers at Lakeview. Provide a specific outline of weaknesses in the overall approach.
2. Use the PDSA cycle to address the issue of pressure ulcers. Be specific. For example, how should data be collected? How would you go about identifying root causes of the problem? What interventions would you implement? What roles should the various personnel and the administrator have?

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I’m trying to learn for my Business class and I’m stuck. Can you help?

For this week’s first DQ, you will be asked to do a search for a peer-reviewed ACADEMIC article related to Foreign Direct Investment. You will be asked to find two papers. One paper that discusses FDI in the U.S. and another that discusses FDI in your selected country for your country report.

To find your paper, go to http://www.googlescholar.com a search engine of your choice.

While in googlescholar.com look in the upper right corner of the page and click on the link scholar preferences. This link will take you to a cell where you can type in your library preference. Type in Montana Tech and then go down to the bottom right of the page and click save preferences.

Now, type in Foreign Direct Investment and hit search. You will have thousands of results. If you wish to narrow your results, you can do this by refining your search. Under the search bar you will see another tab where you can limit your search to articles published since a particular year. After you have found your two articles, I want you to identify the central argument in the paper. You will typically find this in the abstract. I then want you to identify this argument and identify the points the writer is making to support their argument. Take note of what the author uses to prove their point, it is another author who wrote something about the topic. Your job while writing this DQ is you cannot use any direct quotes. NO direct quotes. Your job is to paraphrase what the writer has said. Do you agree with what they said? What questions do you have about what the author said? Does the author support their argument with evidence? Is it strong enough evidence? Any surprises?