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Diabetes and pediatric and dialysis

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Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

 

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.

Suggestions for locating qualitative and quantitative research articles from credible sources:

  1. Use a library database such as CINAHL Complete for your search.
  2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
  3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Health Care Reimbursement Training Plan

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Scenario: You are an administrator at a health care facility providing a training session for new employees.

Create a training plan using the “NUR-621 Health Care Reimbursement Training Plan” template provided that describes how Medicare, Medicaid, and private insurance reimburse health care organizations for their services.

Include two to three references, including your textbook.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

clinical topic

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The purpose of this assignment is:

To apply a change process using the ACE Star Model of Knowledge Transformation and a systematic review after identifying a clinical topic of concern and related nursing practice issue.

Identify a clinical topic and related nursing practice issue you think needs to be changed.

Locate a systematic review on your topic from the Cochrane Database of Systematic Reviews located in the Chamberlain Library. Be sure this involves nursing actions.

Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.

Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).

Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.

Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed. Paraphrasing information, rather than quoting, is expected. ****No quotes for this assignment please!

Fall Risk Tool is accurate

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T.J. is a 76-year-old man that recently lost his wife.  He lives alone now in an ALF where he has some friends that he associates with.  They are “good for his overall well-being” claims the administrators of the facility who befriended T.J. when he lost his wife six months ago.  The facility that T.J. lives in is convenient for many aspects of his life, including entertainment and even some of the healthcare associates from neighboring clinics that have partnered with the facility to allow visits with the residents.

Over the years, the associates from the neighboring clinic have grown close to some residents and have followed them during some of their crisis, both emotional and physical.  Christine, a nurse practitioner from a neighboring clinic, has followed T.J. for many years and is now assessing his fall risk through a tool called the “Hendrick Fall Risk Tool II” a popular means of assessing the fall risk that may exist for an elderly person.

An entry by the ARNP recently on T.J. demonstrated that there was enough information, recognizing previous and present knowledge to utilize the tool to give T.J. a score representing his fall risk.  the entry reads: “T.J. is a 76-year-old that is evaluated today for his fall risk. He has a MedHx of BPH, COPD, seizures, eczema, and anxiety.  He has been seen monthly and he described some episodes of nocturia that still persists.  A list of his recent mediation includes Alprazolam, Phenytoin, Dutasteride, and ibuprofen prn.  By administering the Get Up and Go Test, we find that he only had a brief episode of not being able to rise but he performed well after that completing it in 12 seconds.  He demonstrates an improvement in his depression experienced in the past exhibited for several months after the loss of his spouse.  His friends at the facility keep him busy and he is much improved in his outlook for the future.”  C. Miller ARNP

Instructions:

  1. Read the Fall Risk Assessment for Older Adults article.
  2. Complete the Hendrich II Fall Risk Model tool form completely.
    • Assign the correct scores for the Fall Risk Tool.
    • Summarize the scores derived as per fall risk.
  3. Develop a summary of the risks for T.J., so that the facility can respond to those risks and provide a safe environment.
  4. Describe the level of safety that the facility should plan to give T.J.
  5. Finally, explain whether you feel like the score from the Fall Risk Tool is accurate and if the tool is worth the effort to develop.
  6. Your paper should be:
    • One (1) page or more.
    • Use factual information from the textbook and/or appropriate articles and websites.
    • Cite your sources – type references according to the APA Style Guide.
  7. Upload your file by clicking “Browse My Computer” for Attach File.

Work Environment Assessment

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Respond to at least two of your colleagues on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

 

Main Post

Workplace civility is linked to organizational excellence and creates an environment where employees respect and value one another through cooperation, fair resolution of disputes, teamwork, and non-discriminatory behavior (Department of Veteran Affairs, 2017). Organizational leaders and managers must create an environment that is respectful and inclusive of all people (Clark, 2015; Marshall & Broome, 2017).

Work Environment Assessment

According to the Clark Healthy Workplace Inventory results, my organization is a moderately healthy environment. Why my workplace is civil? The VA understands that civility is a significant determinant not only to employee outcomes ( job satisfaction, stress levels) but also to higher level outcomes directly connected to the organizational mission (quality of patient care, operational costs, ability to retain quality workforce ). The organization continues to create a healthy work environment and measures civility annually through the All Employee Survey (Department of Veteran Affairs, 2017).

Incidence of Incivility

A physician assistant (PA) ordered Versed, and  I was not comfortable giving this medication to my patient. I asked him to explain his rationale for ordering the medication because I knew this drug was not part of the ACLS chest pain protocol and although in pain morphine was the better drug of choice.  The PA pretending to understood my concern and contacted his pharmacist friend who works in our department, but was off duty. The pharmacist became enraged and began to text me with vulgar language and statements, feeling under attack, I  stood up for myself told the pharmacist and the PA I would not be bullied into unsafe practice, and it was my responsibility to advocate appropriately. I shared the messages with the supervising physician, management, and union representative. The pharmacist and PA both issued a formal apology and suspended for two weeks.

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Department of Veteran Affairs. (2017). Civility, respect, and engagement in the workplace (crew). Retrieved from https://www.va.gov/ncod/crew.asp

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader. New York, NY: Springer Publishing Company.

nursing practice

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Use the practice problem and a quantitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center

AACN BSN Essentials

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AACN BSN Essentials and Your Future Practice (graded)

Select one of the AACN BSN Essentials and elaborate on its meaning and importance in your own future professional nursing practice. In your post intended to clearly and thoroughly address the topic of this TD, be sure to:

  • Identify the AACN BSN Essential that you have selected by name and number.
  • Clearly and thoroughly explain why you selected this Essential.
  • Clearly and thoroughly explain how this Essential will be used in your future professional nursing career.

For your response to a classmate to further develop that person’s ideas, select at least one classmate who has written about a different AACN BSN Essential than the one that you selected.

NOTE: Week 8 Discussion closes on Wednesday of Week 8. All Week 8 posts are due by Wednesday. Any posts submitted after Wednesday of Week 8 will not count towards your grade.

Hood, L. J. (2014). Leddy & Pepper’s conceptual bases of professional nursing (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

  • Chapter 7: page 171
  • Chapter 22: pp. 568–574
  • Chapter 23: pp. 600–607

Other Required Readings (located in Webliography):

  • Massachusetts Nurse of the Future Nursing Core Competencies: Review
  • AACN Essentials of Baccalaureate Education: Review

professional license renewal

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APA format is required.

The purpose of this task is to develop a working knowledge of nursing theory, nursing ethics, and professional accountability and apply these concepts to your professional clinical practice.

3. Explain the requirements for professional license renewal in your state (Florida).

a. Discuss the consequences of failure to maintain license requirements in your state (Florida).

4. Compare the differences between registered nursing license requirements in a compact state versus a non-compact state.

E. Discuss the purposes of the Nurse Practice Act in your state (Florida) and its impact on your professional practice.

1. Discuss the scope of practice for a RN in your state.

2. Discuss how your state defines delegation for the RN.

G. Identify two provisions from the American Nurses Association (ANA) Code of Ethics (see web link below).

1. Analyze how the two provisions identified in part G influence your professional nursing practice.

2. Describe a nursing error that may occur in a clinical practice (e.g., clinical setting, skills lab, or simulation).

a.  Explain how the ANA provisions identified in part G can be applied to the error discussed in part G2.

position of ethics

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS.

 

Bioethics is the the study of the position of ethics in a world of progressive technology and medicine.  Bioethics is built upon four main principles which include: respect for autonomy, nonmaleficence, beneficence, and justice. These four main principles create principlism. (Grand Canyon University, 2015). Every bioethical decision must be viewed through the light of these four principles along with the individual details of each case presented. The answers to these four principles will also be extremely different depending on the worldview of the investigator. A Christian responding to these questions would have a different approach than a Hindu. Although these principles outline an approach to solving ethical issues in medicine are they truly unbiased? Probably not.  As a Christian, we do all things and make all decisions based on the knowledge and authority of God. I would personally, as a Christian first and a nurse second, rank the importance of each of the four principles as stated below:

1. &  2. Nonmaleficence and beneficence − Do no harm and prevent harm are very similar and both rank as my number one priority. Mark 12:30-31 states one of the greatest commandments is to love your Lord with all your heart, soul, mind, and strength. The second greatest commandment is to love your neighbor as yourself. Based on these commandments is my decision to make nonmaleficence and beneficence the priority.

3. Respect for autonomy – Respecting the choices of a competent person.  The definition of competent is at times hard to assume and can become a great legal debate I believe it is a high priority.  I do not believe a Jehovah’s witness is making the best medical decision to refuse blood, but I do respect their spiritual views and feel they have the right to make this decision.  Just as I feel I have the right to practice my faith according to the Bible, I believe they have the same rights to deny blood based on their faith.  I do not want to have the right of autonomy jeopardized as Christians fall into the minority, and an oppressive society is a majority. It is a right of free will. God gives us all free will to choose Him or not.  In Genesis 2:16-17 He gave Adam and Eve both free will to eat from any tree in the garden of Eden except the tree of good and evil.

4. Justice- Requires resources be given fairly and that all cases be treated similarly regardless of status, race or religion of the patient.  Psalms state “Blessed are they who observe justice, who do righteousness at all times” (Psalms 106:3, English Standard Version). As a Christian and nurse, I believe this to be true.

In the ICU I have encountered many situations where these ethical principles are not followed.  One particular case I can think of was the treatment of a “confidential, high authority” patient.  Our hospital goes out of its way to cater to these individuals.  We had a member of the house of representatives as a patient.  Extra care was given, a one to one nurse was assigned, visitor rules were ignored, and an extra bedside sitter was ordered to be in the room while the nurse was not able to in order to avoid having to put restraints on the patient. Justice was not displayed in this case as we do not do this with all of our homeless, suicide attempts, alcoholics, or drug overdose patients, but we did for this member of Congress.

 

References

 

Grand Canyon University. (2015). Bioethics in the Christian narrative [Lecture 3]. (2015). In Ethical and Spiritual Decision Making in Healthcare. Retrieved from https://lc-ugrad3.gcu.edu/learningPlatform/user/users.html?operation=loggedIn#/learningPlatform/loudBooks/loudbooks.html?currentTopicname=Biomedical%20Ethics%20in%20the%20Christian%20Narrative&viewPage=current&operation=innerPage&topicMaterialId=97398c46-a5f4-4052-b68e-548d7f1928da&contentId=03c5c1df-8b1d-4f2d-8abe-897f0f09463f&

Meilaender, G. (2013). Bioethics: A primer for Christians (3rd ed.). Grand Rapids, MI: W.B. Eerdmans Pub. Co. Retrieved from https://viewer.gcu.edu/UXWB22.

Reilly, D. (2006). Bioethics Chrisitanity & Medicine: A plea to relevance to daily practice. Focus, 18-20. Retrieved from http://danreilly.ca/wp-content/uploads/2010/08/Bioethics_Christianity_and_Medicine-Focus-Fall-2006.pdf

 

Addressing Chronic Disease

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Addressing Chronic Disease

According to the Population Health course text, “Roughly 40 million Americans are still uninsured and 112 million Americans (almost half of the U.S. population, 45%) suffer from at least one chronic condition” in the United States, an estimated 125 million persons have at least one chronic condition, and half of these persons have multiple chronic conditions” (Fabius, and Pracilio, Nash, Clark, 2015, p. 4 ).

This week’s Learning Resources examine numerous health problems that result in a need for ongoing care. As you have explored this week, many costs are associated with chronic disease—both in terms of lives lost and socioeconomic burden. What can be done to help reduce chronic disease at the population level?

For this Discussion, you will take an in-depth look at chronic disease, and you will evaluate ways to address this issue through the application of chronic disease models and frameworks. In addition, you will consider the impact of the challenges of managing chronic disease on quality of care delivery.

To prepare:

  • Review      the application of chronic disease models as a method for managing chronic      diseases at the population level.
  • Consider      characteristics of chronic disease models and how to apply them as      presented in the Learning Resources.
  • Consult      Figure 13–7 (p. 267) in Population Health: Creating a Culture of      Wellness and consider examples of determinants and outcomes of      population health with chronic diseases in a specific subpopulation. Then,      select one chronic disease on which to focus for this Discussion.
  • Ask      yourself, “What are the challenges of managing this chronic disease? How      do these challenges limit the ability to deliver effective quality care?”      Conduct additional research using the Walden Library and credible websites      as necessary.

By tomorrow 05/01/2018 3 pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive scholarly response that addresses the following:

1) Identify your selected chronic disease (refer to attached article).

2) Describe the application of a chronic disease model to address this disease at the population level (refer to attached article). Include your rationale for selecting this particular model.

3) Discuss one or more current challenges related to the management of the chronic disease and explain how these challenges limit the ability to deliver effective quality care.

Required Readings

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.

Chapter 10, “Transitions of Care”

Chapter 10 provides a framework for understanding the challenges faced by the U.S. health care system, including the shift from acute care to chronic care and the costs associated with that shift. Emerging models of chronic care delivery are presented.

Chapter 11, “Healthcare Quality and Safety Across the Care Continuum”

Chapter 11 examines the implications for quality and safety, and the imperative to focus on these issues at the population level under the mandate of the Affordable Care Act. The Examples of population-based quality and safety initiatives are presented.

Chapter 14, “Population Health in Action: Successful Models”

Chapter 14 focuses on improvements within population health, including chronic care. The Chronic Care Model, a conceptual framework, is discussed as a method for distributing care improvement to numerous practice settings. The key characteristics of a successful chronic care model that provide access to board populations are discussed.

Easley, C., Petersen, R., & Holmes, M. (2010). The health and economic burden of chronic diseases in North Carolina. North Carolina Medical Journal, 71(1), 92–95.

This short reading presents an analysis of the economic effects of selected chronic diseases resulting in increased hospitalization, with a focus on behaviors that may be changed to prevent these diseases.

Kim, T. W., Saitz, R., Cheng, D. M., Winter, M. R., Witas, J., & Samet, J. H. (2011). Initiation and engagement in chronic disease management care for substance dependence. Drug & Alcohol Dependence, 115(1–2), 80–86.

This article presents a study on treating substance abuse as a chronic disease. The authors discuss challenges to treatment options and propose methods for more appropriately managing treatment for substance dependence as a chronic illness.

Ormond, B. A., Spillman, B. C., Waidmann, T. A., Caswell, K. J., & Tereshchenko, B. (2011). Potential national and state medical care savings from primary disease prevention. American Journal of Public Health, 101(1), 157–164.

In this article, the authors examine whether population-based primary prevention activities lead to reduced disease onset in the short run, and, consequently, to cost savings within the health care system at both the state and national levels.

Tenforde, M., Jain, A., & Hickner, J. (2011). The value of personal health records for chronic disease management: What do we know? Family Medicine, 43(5), 351–354.

This reading examines evidence related to the value of electronic personal health records (PHRs), noting that additional research is needed to evaluate this for chronic disease management.

United Nations. (2011, September 19). Non-communicable diseases deemed development challenge of ‘epidemic proportions’ in political declaration adopted during landmark general assembly summit. Retrieved from http://www.un.org/News/Press/docs/2011/ga11138.doc.htm

The United Nations met in September 2011 to collaborate on global plans to address the control and prevention of chronic diseases. This report from the general assembly notes the high cost of not managing chronic disease worldwide.

Yale School of Public Health. (2012). Chronic disease epidemiology. Retrieved from http://publichealth.yale.edu/cde/index.aspx

Yale School of Public Health sponsors this site. Explore the information presented on addressing chronic disease through epidemiology.

Florida Department of Health. (n.d.). Bureause of epidemiology: Surveillance and investigation guidance. Retrieved March 5, 2012, from http://www.floridahealth.gov/diseases-and-conditions/disease-reporting-and-management/disease-reporting-and-surveillance/surveillance-and-investigation-guidance/index.html

This Florida-based agency monitors chronic disease conditions in Florida’s population using a variety of population-based surveillance systems.

World Health Organization. (2012). Chronic diseases and health promotion: Integrated chronic disease prevention and control. Retrieved from http://www.who.int/chp/about/integrated_cd/en/

The World Health Organization monitors chronic diseases worldwide. This website provides an overview of their programs, monitoring efforts, and activities they engage in to reduce the incidence of chronic disease globally.