Use MS Word to complete “Questions to be Graded: Exercise 27” in Statistics for Nursing Research: A Workbook for Evidence-Based Practice. Submit your work in SPSS by copying the output and pasting into the Word document. In addition to the SPSS output, please include explanations of the results where appropriate.
This week’s graded topics relate to the following Course Outcomes (COs).
• CO 3: Plan prevention and population-focused interventions for vulnerable populations using professional clinical judgment and evidence-based practice. (POs 4 and 8)
• CO 5: Analyze the nursing roles in providing comprehensive care in a variety of community health settings. (PO 1)
Community health nurses practice in a variety of settings. Choose one of the following CH settings, and describe what you have learned about the setting and the role(s) of the nurse in that setting (see Nies & McEwen, 2019, Chapters 30-34).
Please do not choose occupational health nursing for this discussion because your paper is on occupational health nursing.
• Correctional nursing
• Home health nursing
• School Nursing
• Forensic nursing
• Hospice nursing
• Faith community nursing
Next study levels of prevention in this week’s lesson (primary, secondary, and tertiary). Note that the term primary is used differently than in normal conversation.
• Describe one of the levels of prevention, and discuss how a community health nurse (CHN) in the setting you discussed can implement this level of prevention.
Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.
Professor’s comment: Hello Class,
This week, we are exploring the Healthy People Objectives for Community Settings. Please take a moment to reflect on the below questions and share your thoughts.
References: American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.
Nies, M. A., & McEwen, M. (2019). Community/public health nursing: Promoting the health of populations (7 ed.). St. Louis, MO: Elsevier.
Successful completion of a doctoral dissertation requires significant amounts of independent reading on the research topic. This allows the doctoral learner/researcher to become familiar with the scope of the topic and to identify gaps or tensions within the existing literature on the topic. These gaps and tensions become the source of the dissertation research. In this assignment, you will read and annotate potential sources in your dissertation field of interest. Those demonstrating the most merit to the best of your understanding of the topic at this time should be added to your RefWorks list for potential inclusion in the literature review section of your dissertation.
General Requirements:
Use the following information to ensure successful completion of the assignment:
Dissertation topics must, at a minimum, be aligned to General Psychology in the Ph.D. program, Leadership in the Ed.D. Organizational Leadership program, Adult Instruction in the Ed.D. Teaching and Learning program, Management in the DBA program, and Counseling Practice, Counselor Education, Clinical Supervision or Advocacy/Leadership within the Counseling field in the Counselor Education Ph.D. program.
If there are questions regarding appropriate alignment of a dissertation topic to the program, the respective program chair will be the final authority for approval decisions.
Specifically, although the College prefers a learner’s topic align with the program emphasis, this alignment is not “required.” The College will remain flexible on the learner’s dissertation topic if it aligns with the degree program in which the learner is enrolled. The Ph.D. program in General Psychology does not support clinically based research.
Directions:
Read at least five empirical articles in your general dissertation field.
In the “Literature Review Resources” document, provide the following for each source:
Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.
How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?
Preterm Labor Management
Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
Her current gestational age is 30 weeks.
She is O+ and all other lab values are normal. No noted STI’s.
1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
3. What other information would you like to ask her?
4. What nursing intervention will you provide?
5. What screening tests are often obtained to help determine her risk for preterm labor.
6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
7. Please also give dose, side effects and possible result of the medication. Please answer all questions include intext citation and 3-4 references
Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.
How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?
Preterm Labor Management
Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
Her current gestational age is 30 weeks.
She is O+ and all other lab values are normal. No noted STI’s.
1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
3. What other information would you like to ask her?
4. What nursing intervention will you provide?
5. What screening tests are often obtained to help determine her risk for preterm labor.
6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
7. Please also give dose, side effects and possible result of the medication.P
Note: This is an individual assignment. Applying what you have learned thus far, develop a community teaching proposal designed to address the needs of your community.
Select one of the following as the focus for the teaching plan:
Complete the “Community Teaching Work Plan Proposal.” This will help you organize your plan and create an outline for the written assignment.
APA format is required for essays only. Solid academic writing is always expected. For all assignment delivery options, 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.
You are not required to submit this assignment to Turnitin.
FRESNO, CALIFORNIA is the community
FOLLOW ALL DIRECTIONS- OR WILL BE DISPUTED
APA, 2000 words, 3 scholarly sources
Instructions- Read Carefully
Defining the Community
Your community should be within a specifically designated geographic location.
One must clearly delineate the following dimensions before starting the process of community assessment:
• Describe the population that is being assessed?
• What is/are the race(s) of this population within the community?
• Are there boundaries of this group? If so, what are they?
• Does this community exist within a certain city or county?
• Are there general characteristics that separate this group from others?
• Education levels, birth/death rates, age of deaths, insured/uninsured?
• Where is this group located geographically…? Urban/rural?
• Why is a community assessment being performed? What purpose will it serve?
• How will information for the community assessment be collected?
Assessment
After the community has been defined, the next phase is assessment. The following items describe several resources and methods that can be used to gather and generate data. These items serve as a starting point for data collection. This is not an all-inclusive list of resources and methods that may be used when a community assessment is conducted.
The time frame for completion of the assessment may influence which methods are used. Nonetheless, these items should be reviewed to determine what information will be useful to collect about the community that is being assessed. It is not necessary to use all of these resources and methods; however, use of a variety of methods is helpful when one is exploring the needs of a community.
Data Gathering (collecting information that already exists)
Demographics of the Community
• When demographic data are collected, it is useful to collect data from a variety of levels so comparisons can be made.
• If the population that is being assessed is located within a specific setting, it may be best to contact that agency to retrieve specific information about that population.
• The following resources provide a broad overview of the demographics of a city, county, or state:
• American Fact Finder—Find population, housing, and economic and geographic data for your city based on U.S. Census data:http://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml
• State and County Quick Facts—Easy access to facts about people, business, and geography, based on U.S. Census data:https://www.census.gov/quickfacts/fact/table/US/PST045216
• Obtain information about a specific city or county on these useful websites:
www.epodunk.com and www.city-data.com
Information from Government Agencies
• Healthy People 2020—this resource is published by the U.S. Department of Health and Human Services. It identifies health improvement goals and objectives for the country to be reached by the year 2020: http://www.healthypeople.gov/
• National Center for Health Statistics—this agency is part of the Centers for Disease Control and Prevention; this website provides statistical information about the health of Americans: http://www.cdc.gov/nchs/nvss.htm
• Centers for Disease Control and Prevention (CDC)—The CDC website contains a large amount of information related to the health of the American population. The search engine within this website can be used to find relevant information: http://www.cdc.gov
• Federal agencies with statistical programs: http://www.fedstats.gov/agencies
• Every state in the United States has its own specific health improvement plan and goals that are based on the Healthy People 2020 document. This information may be available on the state health department website.
• State and local health departments provide information related to vital statistics for the community.
Other Data Sources
• America’s Health Rankings—this website provides information about various health indicators for each state: https://www.americashealthrankings.org/
• Other relevant data sources may be found by conducting an Internet search related to the topic that is being examined through the community assessment.
After data are collected from various sources, it is important to review the information and to identify assets and areas for improvement in the community by comparing local data (if available) versus state and national data. This will facilitate organization of the information that has already been obtained and will provide direction for the next step of the process.
Data Generation (data are developed that do not already exist)
Windshield Surveys
With the use of public transportation or by driving a vehicle around the community, one can observe common characteristics of the community.
Examples of key observations to make when one is assessing the community through a windshield survey include the following:
Participant Observation
Spend time observing the population that is being assessed. Through observation of interactions among group members, much can be learned about the community, including the following:
Informant Interviews
Informants could be people who are familiar with and interact with the population on a regular basis.
Examples of questions that may be asked of key informants include the following:
Focus Groups
Focus groups (usually small groups of 6-12 people) can be helpful when one is gathering information about specific areas of concern within the population. Use of a focus group involves open dialogue about the population, whereas an interview or survey yields only individual responses.
Surveys
Surveys may be used to collect data from the community. Selecting a sample of the target population may prove helpful in the collection of data that are easier to analyze. It is important to ensure that the sample is representative of the target population.
A survey should be developed that takes into consideration the developmental level of the group that is being assessed. Questions should be written at the appropriate developmental level, so they are answered in a way that makes the data useful. Surveys might include closed-ended (yes/no), multiple choice (several responses to choose from), Likert scale (Strongly Agree/Agree/Neutral/Disagree/Strongly Disagree), or open-ended (“why”/“how”) questions.
Topics that may be addressed in a survey include the following:
Examine Case Study: A Caucasian Man With Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Also include how ethical considerations might impact your treatment plan and communication with clients.
Discuss why EBP is an essential component of the practice of a BSN-prepared RN. Identify two ways in which you will continue to integrate evidence into your practice and encourage it within your work environment. What obstacles could challenge this plan, and what steps will you take to minimize their impact?
Conduct a “Windshield Survey” in a section of your community. Instructions for the survey can be found in Stanhope and Lancaster (2016) on page 416, Table 18-6. As you notice, conducting a Windshield Survey requires that you either walk around or drive around a particular section of the community and take notes about what you observe. A Windshield Survey cannot be conducted by reviewing websites or Google Earth only. It requires actually taking a look at the selected area of the community. This survey should be focused on the problem and population you have selected for your practicum project. If you choose, for example, obesity among Hispanic schoolchildren, you might want to locate a section of the community where many Hispanic children live, or you might want to conduct the Windshield Survey around where Hispanic children attend school. If Hispanic children are not found in a specific section of your community (e.g., Chinatown in San Francisco or Harlem in New York), then you may select the section of the community where you live or work but pay particular attention to your practicum population and practicum problem as you conduct a survey of the community as viewed through the eyes of the public health nurse.
Submit a 3- to 4-page paper including:
For this Assignment, review the following:
Part A: Answer each of the following questions in one or two paragraphs.
1. Code the following operative report.
Preoperative Diagnosis: Left flank soft tissue mass
Postoperative Diagnosis: Left flank soft tissues mass
Surgeon: John Doe, DO
Operations: Excision of left flank soft tissue mass with layered closure measuring 4 cm , with margins, prior to excision
Anesthesia: sedation with 1% lidocaine with epinephrine and sodium bicarbonate
Operative Indications: this is a pleasant female who come in with soft tissue lesion in the left
flank over what appeared to be a Spigelian Hernia site as well. However, it was not reducible and did not appear to be consistent with a hernia. Consequently, the procedure, risk, benefits, and alternative of excision of this lesion were discussed with the patient, and she understood and wished to proceed with the excision.
Operative Findings: Large soft tissue lesion measuring about 6 cm in greatest dimension
Operative procedure: The patient was brought into the operation room after informed consent was obtained. The patient then underwent sedation with a sterile prep and drape. We then anesthetized with 1% lidocaine with epinephrine and sodium bicarbonate, made a 4-cm incision, and used sharp dissection to dissect circumferentially around this soft tissue lesion, being careful to make sure that we were not entering any kind of hernia sac secondary to Spigelian hernia. As we continued to dissect circumferentially around it without sharp dissection, it was noted that it did go down to a muscle, but no evidence of hernia was identified. The lesion was excised in its entirety and electrocautery was used to control hemostasis. We then irrigated with saline solution and closed the subcutaneous tissue with 3-0 Vicryl interrupted and sutures. We then used 4-0 Vicryl sutures to close the skin in a subcuticular fashion. Benzoin and Steri-Strips were then applied. Blood loss was minimal. The patient tolerated the procedure well and remained in stable condition throughout the procedure.
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