Chamberlain College of Nursing

scano123
2017-03-06 00:21

Chamberlain College of NursingNR 451RN Capstone Course
Capstone Project Milestone 1:

Practice Issue and Evidence Summary Guidelines

Purpose

Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO #4)

• CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO #8)
Due Dates

Milestone #1 consists of the completion of two worksheets (Practice Issue Worksheet) and (Evidence Summary Worksheet). Submit the completed worksheets to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 3.

Points

Milestone #1 is worth 175 points (75 points for the Practice Issue and 100 points for the Evidence Summary).

Practice Issue Worksheet Directions

1. Practice Issue Worksheet:
a. Read the guidelines including the grading rubrics below. You will use this worksheet to document the practice issue presented and approved by your instructor in the Week 2 Discussions.
i. Your practice issue will be the same for all three Milestone assignments in this course.
b. Please type your answers directly into the worksheet.

Evidence Summary Worksheet Directions

2. Evidence Summary Worksheet:
a. Read the guidelines including the grading rubrics below. You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
b. Find a systematic review article in the Chamberlain library on your topic. Your Systematic Review Article must be peer-reviewed and include a narrative summary.
i. Go to the Chamberlain Library, click on RNBSN; NR451 Capstone course. You can find systematic reviews from many databases within the library, or by searching from the library homepage main search bar.
ii. To search, combine the phrase ‘systematic review’ with your topic using the Boolean search operator AND. For example, if you are looking for a systematic review on fall prevention, you would use this Boolean search phrase: systematic review AND fall prevention.
c. Type in your practice issue in the search tab; choose a systematic review article with a narrative summary to complete your worksheet.
d. Please type your answers directly into the worksheet.

Grading Criteria: Practice issue

Category

Points

%

Description

Practice issue statement, scope of practice, practice area

20

27%

Identifies a Practice issue statement that is an independent nursing decision.

Describes the scope of practice issues.

Example: The number of falls in your facility has been increasing, especially during shift change. What do you believe may be causing this? Are there any new interventions that could be put into place that would lessen or eliminatethe falls? This is where you begin your initial search into the problem or practice issue identified.

Identifies the practice area.

Practice issue identification, rationale for selections

35

46%

Identifies how rationale behind how the practice issue was selected as a practice issue/problem

Documents the practice issue in a logical manner.

Types of evidence to gather, rationale for selections

20

27%

Identifies and documents types of evidence that must be gathered for review of the Practice Issue.

Describes rationale for each type of evidence that is selected.

Total

75 points

100%

Grading Rubric: Practice Issue

Assignment Criteria

A (100%)

Exceptional

Outstanding or highest level of performance

B (88%)

Exceeds

Very good or high level of performance

C (80%)

Meets

Competent or satisfactory level of performance

NI (38%)

Needs Improvement

Poor or failing level of performance

F (0%)

Developing

Unsatisfactory level of performance

Practice issue statement, scope of practice, practice area

20 points

Practice issue is identified.

Practice issue is an independent nursing decision.

Scope of practice issue is fully described.

Practice area identified.

20 points ☐

Practice Issue is identified but is not clear.

Practice issue is an independent nursing decision.

Scope of practice issue is described in simple terms.

Practice area identified.

18 points ☐

Practice Issue is identified but is not clearly related to a nursing practice issue.

Practice Issue isnot an independent nursing decision.

Scope of practice issue is described but is not logical in comparison to Practice Issue described.

Practice area identified.

16 points ☐

Practice Issue is unclear.

Practice Issue is not an independent nursing decision.

Scope of practice issue is not described.

Practice area identified.

8 points ☐

Practice Issue isnot identified; practice issue is not an independent nursing decision; scope of practice issue is not described; practice area is not identified.

0 points ☐

Practice issue identification, rationale for selections

35 points

Documents how the practice issue was identified.

Rationale for responses islogical anddescribed thoroughly.

35 points ☐

Documents howthe practice issue was identified.

Rationale for responses islogical and brieflydescribed.

33 points ☐

Documents howthe practice issue was identified.

Rationale for responses issomewhat logical and vaguely described.

30 points ☐

Vaguely describes how the practice issue was identified.

Rationale for responses issomewhat logical and vaguely described.

15 points ☐

Does not document how the practice issue was identified.

Rationale is not completed.

This section of the form is blank.

0 points ☐

Types of evidence to gather, rationalefor selections

20 points

Identifies and documents what types of evidence is needed for review.

Thoroughlydescribes rationale for all checked types of evidence selected.

20 points ☐

Identifies and documents what types of evidence is needed for review.

Briefly describesrationale for all checked types of evidence selected.

18 points ☐

Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence.

16 points ☐

Does not document more than one type of evidence that is needed for reviewand does not include rationale for selected type of evidence.

8 points ☐

Does not document types of evidence orrationale.

0 points ☐

Total Points Possible = 75 points

Grading Criteria: Evidence Summary

Category

Points

%

Description

Practice Problem

10

10%

States practice problem in own words, with reference to the population, setting, and magnitude and in measurable terms.

Describes practice setting in measureable terms

Example: Consider the example given in the evidence summary above. The setting is the long term care facility where falls have been increasing and a trend has been identified that it seems to occur mainly during shift change. What do you believe may be causing this? What can be done to lessen or eliminate the falls? How does this number of falls relate to other months that have been tracked?

Source of evidence

20

20%

Identifies a source of evidence that is a nursing topic that is the subject of a systematic review article.

Identifies search terms.

Provides a complete reference for the systematic review article.

Objectives of the article/Statement of questions

20

20%

Identifies the objectives of the article.

Identifies questions being addressed by author/s.

Explains relationship to your practice issue.

Interventions/Main findings summary

30

30%

Summarizes, in own words, suggested interventions by the author/s to improve patient outcomes.

Summarizes main findings of the author/s including strength of evidence for each main outcome.

Describes the relevance to the Milestone 2 paper.

Evidence-based solutions and limitations

20

20%

Outlines evidence-based solutions to consider for the capstone project.

Discusses any limitations to the studies included in the systematic review that you believe may impact use of the evidence provided in your project.

Total

100 points

100%

Grading Rubric: Evidence Summary

Assignment Criteria

A (100%)

Exceptional

Outstanding or highest level of performance

B (88%)

Exceeds

Very good or high level of performance

C (80%)

Meets

Competent or satisfactory level of performance

NI (38%)

Needs Improvement

Poor or failing level of performance

F (0%)

Developing

Unsatisfactory level of performance

Practice Problem

10 points

-Practice problem is in own words, with reference to the population of interest.

-Setting of the problem is identified

-Magnitude of problem is discussed.

-The practice issue is stated in measurable terms.

Met all objectives as stated above

10 points ☐

-Practice problem is in own words, with reference to the population of interest.

-Setting of the problem is not discussed.

-Magnitude of problem is discussed.

-The practice issue is stated in measurable terms.

Met 3 out of 4objectives

9 points ☐

-Practice problem is in own words, with reference to the population of interest.

-Setting of the problem is not discussed.

-Magnitude of problem is not discussed.

-The practice issue is stated in measurable terms.

Met 2 out of 4objectives

8 points ☐

-Practice problem is in own words, with reference to the population of interest.

-Setting of the problem is not discussed.

-Magnitude of problem is not discussed.

-The practice issue is stated but notmeasurable.

Met only 1 out of 4 objectives

4 points ☐

-Practice problem is not in own words

-There are no references to the population of interest.

-Setting and magnitude of problem is not discussed

-The practice issue is not stated in measurable terms.

Did not meet anyobjectives

0 points ☐

Source of evidence

20 points

-Source of evidence is nursing topic.

-Source is aSystematic Review article.

-Search terms are identified.

-Complete reference is given for Systematic Review article.

Met all 4objectives as above

20 points ☐

-Source of evidence is nursing topic.

-Source is a Systematic Review article.

-Search terms are identified.

-Complete reference is not given for Systematic Review article.

Met 3 out of 4objectives

18 points ☐

-Source of evidence is nursing topic.

-Source is not aSystematic Review article.

-Search terms are identified.

-Complete reference is not given for Systematic Review article.

Met only 2 out of 2 objectives

16 points ☐

-Source of evidence is not nursing topic.

-Source is a Systematic Review article.

-Search terms arenot identified.

-Complete reference is not given for Systematic Review article.

Met only 1 out of 4 objectives

8 points ☐

-Source of evidence is not nursing topic or Systematic Review article.

-Search terms arenot identified.

-Reference is missing.

No objectives were met.

0 points ☐

Objectives of the article/ Statement of questions

20 points

-Objectives of article are identified.

-Questions being addressed by author/s are thorough.

-Relationship to your practice issue is explained.

20 points ☐

-Objectives of article are identified.

-Questions being addressed by author/s are explained but not thorough.

-Relationship to your practice issue is explained.

18 points ☐

-Objectives of article are identified.

-Questions being addressed by author/s are not thorough.

-Relationship to your practice issue is vague.

16 points ☐

-Objectives of article are identified.

-Questions being addressed by author/s is missing.

-Relationship to your practice issue is not explained.

8 points ☐

-Objectives of article are not identified.

-Questions being addressed in article and relationship toown practice is not identified.

0 points ☐

Interventions/ Main findings summary

30 points

-Thoroughly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.

-Thoroughly summarized main findings of the author/s.

-Included strength of evidence for each main outcome.

30 points ☐

-Briefly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.

-Briefly summarized main findings of the author/s.

-Included strength of evidence for each main outcome.

27 points ☐

-Vaguely summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.

-Vaguelysummarized main findings of the author/s.

-Included strength of evidence for most of main outcomes.

25 points ☐

-Summary of interventions is not in own words.

-Summarized main findings of the author/s is not apparent.

-Did not include strength of evidence for any of the main outcome.

12 points ☐

-Summary of the interventions the author(s) suggest to improve patient outcomes is missing.

-Summary of the main findings of the author is missing.

-The strength of the evidence for outcomes are missing.

0 points ☐

Evidence-based solutions and limitations

20 points

-Outline of evidence-based solutions considered for project is documented and clear.

Discussed any limitations to the studies performed.

Documents limitationsbelieved may impact use in project.

20 points ☐

-Outline of evidence-based solutions beingconsidered for project is documented but not clear.

Discussed any limitations to the studies performed.

Documents limitations believed may impact use in project.

18 points ☐

-Outline of evidence-based solutions considered for project is documented but not clear.

Discussed most limitations to the studies performed.

Documents limitations believed may impact use in project.

16 points ☐

-Outline of evidence-based solutions being considered for project is not documented.

-Discussed mostlimitations to the studies performed.

Documents limitations believed may impact use in project.

8 points ☐

-Outline of evidence-based solutions, limitations of studies and potential impact to project is missing.

0 points ☐

Total Points Possible = 100 points

NR451 W3 Milestone1 Practice Issue & Evidence Summary Guidelines 2/16/17 GH

3

This is the guidelines

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scano123
2017-03-06 00:23

Chamberlain College of NursingNR451 RN Capstone Course
Capstone Project Milestone 1:

Practice Issue and Evidence Summary Worksheets

Student Name: Date:

Directions

1. Refer to the guidelines for specific details on how to complete this assignment.
2. Type your answers directly into the worksheets below.
3. Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.
4. Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response.

Practice Issue Worksheet

What is the Practice Issue?

Define the scope of the Practice Issue:

What is the practice area?

___ Clinical

___ Education

___ Administration

___ Other (list)_________________________________

How was the practice issue identified?(check all that apply)

___ Safety/risk management concerns

___ Unsatisfactory patient outcomes

___ Wide variations in practice

___ Significant financial concerns

___ Difference between hospital and community practice

___ Clinical practice issue is a concern

___ Procedure or process is a time waster

___ Clinical practice issue has no scientific base

__ Other:

Describe the rationale for your checked selections:

What evidence must be gathered? (check all that apply)

___ Literature search

___ Guidelines

___ Expert Opinion

___ Patient Preferences

___ Clinical Expertise

___ Financial Analysis

___ Standards (Regulatory, professional, community)

___ Other

Describe the rationale for your checked selections:

Evidence Summary Worksheet

Directions: Please type your answers directly into the worksheet.

Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms:

Find a source of evidence that is a systematic review article on a nursing topic that is relevant to your practice problem. Write the complete APA reference for the systematic review article you selected:

Define the search terms for your systematic review:

Identify the objectives of the article.

Provide a statement of the questions being addressed in the work and how they relate to your practice issue:

Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome. Consider the relevance to your project proposal for the Milestone 2 project paper.

Outline evidence-based solutions that you will consider for your project.

Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project.

NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH

3

Clinical question

“The thoughtful development of a well-structured EBP question is important because the question drives the strategies used to search for evidence”. (Dearholt & Dang, 2012, p.64). My question is: Will Congestive Heart Failure patients discharged from the hospital increase the chance of not being readmitted within 30 days with follow up care that includes post discharge telephone calls for support?

P- (Patient, Population)-Congestive Heart Failure Patients

I-(Intervention)-Follow up phone call at 48 and 72 hours post discharge

C-(Comparison with current practice)-No follow up telephone calls for support.

O-(Desired outcome)-Reduce the number of Readmissions

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BYOD (Bring Your Own Device) presentation, writing homework help

I need a powerpoint of BYOD (Bring Your Own Device). In the powerpoint, it should start with agenda intro to the topic and I need examples and then talk about the disadvantage and the advantage and the policy . At least I need it to be 15 slides. Thank you

“What does bring your own device mean?

Bring your own device (BYOD)—also called bring your own technology (BYOT), bring your own phone (BYOP), and bring your own PC (BYOPC)—refers to the policy of permitting employees to bring personally owned mobile devices (laptops, tablets, and smart phones) to their workplace, and to use those devices to access …”

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Golden Package Manufacturing Co, management homework help

solve the questions in the attached pic from th casestudy also attached in pictures the pages are numbered from 1 to 5

the assignment should be 0% plagiarism





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finance questions

Describe what happens to the present value of a cash flow stream when the discount rate increases? How does this question correlate with the Fed lowering rates over the last number of years? Hint…low interest rates ..less of a reason to leave money in the Bank.

Determine the yield spread between the corporate bond and the Treasury bond.

Alternatively, you are considering a purchase of Laissez-Faure’s preferred stock. Assume that the preferred stock has a current market price of $42, a par value of $50, and dividend amount of 10% of par. Your required rate of return for investments of this type is 12.5%. Determine if you be willing to buy the firm’s preferred stock. Why or why not?

Explain why investors are more concerned with the real returns than the nominal returns on their investments.

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Abdominal Assessment

In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

Abdominal Assessment

SUBJECTIVE:

· CC: “My stomach hurts, I have diarrhea and nothing seems to help.”

· HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.

· PMH: HTN, Diabetes, hx of GI bleed 4 years ago

· Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs

· Allergies: NKDA

· FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD

· Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

OBJECTIVE:

· VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs

· Heart: RRR, no murmurs

· Lungs: CTA, chest wall symmetrical

· Skin: Intact without lesions, no urticaria

· Abd: soft, hyperctive bowel sounds, pos pain in the LLQ

· Diagnostics: None

ASSESSMENT:

· Left lower quadrant pain

· Gastroenteritis

· PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

To prepare:

With regard to the SOAP note case study provided:

· Review this week’s Learning Resources, and consider the insights they provide about the case study.

· Consider what history would be necessary to collect from the patient in the case study.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

To complete:

1. Analyze the subjective portion of the note. List additional information that should be included in the documentation.

2. Analyze the objective portion of the note. List additional information that should be included in the documentation.

3. Is the assessment supported by the subjective and objective information? Why or Why not?

4. What diagnostic tests would be appropriate for this case and how would the results be used to make a diagnosis?

Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature

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What is needed for an auditor to understand clients’ business processes, accounting homework help

    • What is needed for an auditor to understand clients’ business processes and accounting systems? What type of computer information system is used at your employer’s organization? What controls are present in the system at your organization? Are the general controls that should exist in computer information systems present in the system used by your organization? What are the application controls that exist in the system?

    • What are the six elements of a computerized information system? How do information technology general controls help ensure proper operation? 

What is generalized audit software? What are the tasks for which an auditor would use it? What are the advantages and disadvantages of using generalized audit software? Will this software be more appropriate for auditing your organization’s computer information system, or would it be necessary to develop customized audit software? Explain. What type of software works best for your work environment?

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Wells Fargo Banking Risks, business and finance homework help

. Write the next section of your risk management plan in which you discuss credit risk in relation to retail banking. Be sure to include a discussion of retail banking services and the risks associate with providing consumer credit individuals and institutions.

In this paper, please address the following questions:

  • What are the credit risks faced by retail banking?
  • How are credit risks associated with individuals different from credit risks associated with institutions?
  • What retail banking services does your bank provide to individuals?
  • What retail banking services does your bank provide to institutions?
  • How does your bank assess credit risks and does your bank have an effective plan for managing and mitigating these risks? Explain.

Requirements

  • Because this is part of a project, this section of the paper does not need an introduction.
  • Because your paper is required to be 1  pages in length, you should use subject headings to label your paper as appropriate.
  • Keep in mind that this is a research paper; and, as such, should be informed by your research articles.
  • Be sure to include APA citations to support your assertions and to inform your paper.
  • You will need to include a reference page with this section of the paper.
  • Be sure to proofread your paper to ensure that is free from all grammar and spelling errors.

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Trade Negotiation between U.S.A and Cuba , economics homework help

i want you to just re-wriite this in a good way

After your group has completed the group presentation, please read and answer the following questions. Keep your submissions to no more than a page or two maximum (or the equivalent of what would fit on one or two typed page). Put your name on your assignment!! You will get an individual grade for completing this assignment AND the answers from you and your group members will factor in to the final group presentation grade.

1) List names of all members of your group.

Lena Alzaid

Razibul Hasan

Felicia Harris

Blessing Olatimehin

2) List your group’s presentation topic.

Trade Negotiation between U.S.A and Cuba

1. Introduction

2. Historical Background of trade relation

3. Barriers of trade relations

4. Statistics of Bilateral Trade

5. Rapport building initiatives

6. Facilitating Successful Negotiations

7. Methodologies for negotiation

8. Useful ADR for this relation

9. Conclusion

3) SELF REFLECTION: From your perspective, what was your individual contribution(s) to the group’s work and the group presentation (what things did you do and help with to make your group successful)?

we met to choose the topic

wrote the outline

and talked about everyone part

and we met 3 times before the presentation

we discus about each part

What things, if any, did you NOT do as well or wish you would have done better/differently to contribute to the group’s work and project success?

for me i wanted to present more but becouse of the time we make the the presentation shorter

and for all of us we wanted to talk more and clearly about the topic but as the classmates said we were talking fast and they want to know more about the topic

4) RELFECTION ON GROUP MEMBERS: List each of the other members of your group and, from your perspective, what you think they each individually contributed (positively and negatively) to the group’s work and the group presentation.

Lena

introdaction

conclution

Hassan

did statistics and rapport building and he assembled power points and bibliography

5) What insights, take-a-ways, or points of learning will you take away from this group project experience?

__


I’m wating for more information

so please if you can work on this for now and I will send you what other members did in the next few hours

if you have any question please ask me so i can answer it



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Asthma

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.

Photo Credit: Getty Images

One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To Prepare
  • Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
  • Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
  • Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:

  • Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
  • Explain the stepwise approach to asthma treatment and management for your patient.
  • Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

 

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

  • Chapter 60, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 673–693)
  • Chapter 61, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 695–702)

5 REFERENCES NOT MORE THAN 5YEARS

ZERO PLAGIARISM

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Professional Communication Cultural Sensitivity Guide

For this assignment, consult the “Professional Communication Cultural Sensitivity Guide.”
Write a paper of 1,000-1,250 words on a specific cultural group. Use the following guidelines:
1. Select one article from a nursing journal focused on a cultural group.
2. In the introduction, state your reason for selecting the cultural group.
3. Summarize the key points of the article.
4. Apply the new information to a practice situation that demonstrates cultural sensitivity in communication, reflecting the reading in chapter 25.
5. Write a conclusion.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

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