Reference no: EM133867562

Assignment:

Methods:

A qualitative case study approach was used to examine four nursing homes. Extreme case examples-high- and low-performing nursing homes-were purposefully selected. More than 100 hr of observation, 70 formal interviews, numerous informal interviews, and document review were the primary data collection methods.

Findings:

Using select complexity science principles added richness to the analysis, highlighting the stark contrast between the high- and low-performing nursing homes. Leaders in the high-performing homes behaved congruently with the nursing home's stated and lived mission by fostering connectivity among staff, ample information flow, and the use of cognitive diversity. In contrast, leadership in low-performing homes behaved disharmoniously with the stated mission, which confused and eroded trust and relationships among staff members, contributed to poor communication, and fostered role isolation and discontinuity in resident care.

Practice Implications:

The study offers insights into the importance of mission- and values-based leadership behaviors, suggesting that an overuse of mechanistic, linear command-and-control approaches to improving care, such as punitive measures to insist on regulatory compliance, will do little to ultimately improve care. Rather, relationship-centered leadership that embraces comanagement and mutual shaping of resident care complements doing the right thing for residents from a values-based shared experience. Examples of practice implications include developing a strong, coherent organizational mission; having fewer, more flexible rules to foster creativity; and allowing lateral decision making.

Question 1. Dear authors, why are gastric ulcers more common along the lesser curve, near the pylorus of the stomach?

Question 2. What is the best time of day to administer omeprazole, and why?

Question 3. Is it safe to use the drugs omeprazole and ranitidine during pregnancy?

Question 4. Are non-steroidal anti-inflammatory drugs harmful to the stomach when taken parenterally, for example by intravenous or intramuscular routes?

Question 5. Is it safe to give a patient with a past history of bleeding peptic ulcer aspirin in an antiplatelet dose of 75-325 mg?

Question 6. Is sulpiride effective in the treatment of a peptic ulcer or gastrooesophageal reflux disease (GORD)?

Question 7. Is clopidogrel gentle on the stomach?

Question 8. Is there a drug interaction between non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs)?

Question 9. Do antacids enhance mucosal resistance in the gastric mucosa? If so, please indicate the mechanism.

Question 10. Is there a drug interaction between antacids and H2-receptor blockers?