Tag Archive for: nursing

Cardiovascular system

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Cardiovascular system

A 70 year old black American female who has the following preexisting conditions;

Hypertension (HTN): longterm

Heart failure (CHF) : 2 months

Coronary artery disease (CAD) : longterm

Myocardial infarction (MI) : five years ago

Ejection (EF) of 55% : 2 months ago

Socioeconomic data:

Widow, Lives alone, independent ADL’s, Nonsmoker, Nondrinker

Pharmacologic data:

Aspirin (acetylsalicylic acid, ASA)

Clopidogrel bisulfate (Plavix)

Lisinopril (Prinivil, Zestril)

Carvedilol (Coreg)

Furosemide (Lasix)

Potassium chloride (KCL)

Client Profile: 

70 year old woman originally from Alabama. She lives alone and is able to manage herself independently. She is active in her community and church. Diagnosed with heart failure 2 months age and is followed up at home with a visiting nurse every other week for to assist is managing her heart failure symptoms. She is being referred to the nurse practitioner for follow up of changes in her symptoms.

Assessment:

At the office the following subjective and objective data was supplied:

“I noticed my legs were getting a bit bigger and they are achy, too.”

She has gained 10 pounds over the last 5 days.

She gets short of breath when ambulating from one room to the other (approximately 20 feet) and must sit down to catch her breath.

Her oxygen saturation is 95% on room air. Bibasilar crackles are heard when auscultating her lung sounds.

She denies any chest, arm, or jaw pain or nausea.

She denies any back pain, stomach pain, confusion, dizziness, or a feeling faint.

She admits only to feeling a little more tired than usual.

Eats Southern Cooking when at home.

Vital signs :

T= 97.6 F (36.4C), BP 140/70, P 93, R 22.

Labs ordered:

complete blood count (CBC), basic metabolic panel (BMP), brain natriuretic peptide (B-type natriuretic peptide assay or BNP), troponin, creatine kinase (CPK), creatine kinase-MB (CKMB), and albumin. The APN also prescribes oral (PO) Furosemide and arranges an outpatient electrocardiogram (ECG, EKG), chest X-ray, and echocardiogram.

Questions

1. Which assessment findings during this visit are consistent with heart failure?

2. Why did the APN ask about back pain, stomach pain, confusion, dizziness or a feeling that she might faint?

3. Explain what the following terms indicate and include the normal values: cardiac output, stroke volume, afterload, preload, ejection fraction and central venous pressure. Is an ejection fraction of 55% significant. Provide rationale.

5. Discuss the body’s compensatory mechanisms during hear failure. Include an explanation of the Frank-Starling law in your discussion.

6. Heart failure can be classified as left or right ventricular failure, systolic versus diastolic, according to the New York Heart Association (NYHA) and using the ACC/AHA (American Heart Association) guidelines. Explain these four classification systems and the signs and symptoms that characterize each. Which Classification fits this patient?

7. Provide a rationale for why each of the following medications have been prescribed: Aspirin, Clopidogrel bisulfate (Plavix), Lisinopril(Prinivil/Zestril) , and Carvedilol (Coreg).

8. What information will each of the following tests provide: CBC, BMP, BNP, Troponin, CPK, CKMB, and albumin, EKG, CXR, and Echocardiogram

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Disorders of the Veins and Arteries

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Assignment: Disorders of the Veins and Arteries

Advanced practice nurses often treat patients with vein and artery disorders such as chronic venous insufficiency (CVI) and deep venous thrombosis (DVT). While the symptoms of both disorders are noticeable, these symptoms are sometimes mistaken for signs of other conditions, making the disorders difficult to diagnose. Nurses must examine all symptoms and rule out other potential disorders before diagnosing and prescribing treatment for patients. In this Assignment, you explore the epidemiology, pathophysiology, and clinical presentation of CVI and DVT.

To Prepare

· Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.

· Consider the patient factor of genetics and how genetics might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on genetics.

To Complete

Write a 2- to 3-page paper that addresses the following:

· Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.

· Explain how the patient factor genetics might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

· Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, treatment, diagnosis, risk factors

References to use for Assignment:

https://books.google.com/books?hl=en&lr=&id=u81BDgAAQBAJ&oi=fnd&pg=PA61&dq=genetics+impact+on+pathophysiology+of+CVI+and+DVT&ots=nDV1wpSOWv&sig=f1R8fYvZaGxp1QEJgGst9HyF7ec#v=onepage&q=genetics%20impact%20on%20pathophysiology%20of%20CVI%20and%20DVT&f=false

http://www.bloodjournal.org/content/bloodjournal/124/8/1242.full.pdf

http://nuife.org/index.php/pnap/article/view/335/315

https://link.springer.com/content/pdf/10.1007%2Fs12325-019-0885-3.pdf

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Time Travel

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Time Travel

Assume you have been given the ability to travel back in time, and you are about to set off on a trip to the nineteenth and twentieth centuries. The purpose of your trip is to visit artists in their studios and view firsthand the creation of some of their paintings and sculpture.

In your time travels, you will collect information on five different styles of nineteenth- and twentieth-century art, as represented by one artist from each style. Before you set out, decide which specific styles you would like to explore.

Select one style from each of the five categories listed below:

  • Late Nineteenth Century: Impressionism or Post Impressionism
  • Early Twentieth Century: Fauvism, Expressionism, or Futurism
  • Cubism: Analytic or Synthetic
  • Post-World War I Art: Dada or Surrealism
  • Post-World War II Art: Abstract Expressionism, Minimalism, or Pop Art

For each of your five selected styles, identify one artist who represents that style whose studio you will explore in your time travels. In your visits to each artist’s studio, plan to identify one work of art that best exemplifies the artist’s style.

When you return from your time travels, prepare a report that includes the following information for each of your five representative works of art:

  1. A photograph of the object
  2. Identifying information:
    1. Name of the artist
    2. Title of the work
    3. Date of the work
    4. Medium/materials used to create the work
  3. Identify the style of the work of art. Then, write a paragraph of 4-6 sentences that:
    1. Describes the visual characteristics that makes the object representative of its style
    2. Places the work within its social and historical context and explains why it is culturally significant

Finally, in a well-developed paragraph of 6-8 sentences, summarize what you have learned from your “time travels,” highlighting key similarities and distinctions between the artists you visited and their representative works of art.

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dvocate for Health Care Policy  

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First Steps on Becoming a Grassroots Lobbyist/Advocate for Health Care Policy

This assignment has two parts, numbered below. Write each question as a new topic area, then follow with a paragraph or two to answer the question. You may find it necessary to search for answers to the questions outside of the assigned reading. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources.

Tasks:

1.Imagine that you are going to make a visit to your representative in Congress. Develop a one-page document that supports your position on the AHCA that you would leave with your representative or his or her aide when you make your visit. This one-pager, also called a “leave behind,” should state your position clearly in bullet points and give your reasons why your position is preferred. This “leave behind” should have 1 inch margins and utilize 14-point font throughout. If you were making this visit in person, you would present your “leave behind” to the person with whom you speak during your visit. Include a second page that describes your rationale for the position in your “leave behind” page supported by at least two journal articles.

2.Write a two-page brief to describe the scenario surrounding your legislative visit. Understanding the political affiliation of your representative, include answers to the following:

•Was your member in support or in opposition to the AHCA?

•State three points that you would cover in support or opposition to your representative’s position.

•How does your nursing experience influence the advocacy position that you take on the AHCA?

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herpes simplex virus (HSV)

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Question 20

A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority?

a) order herpes simplex virus (HSV) antibody testing

b) Order a blood urea nitrogen (BUN) and creatinine STAT

c) Prescribe lidocaine 5%

d) Prescribe hydromorphone (dilaudid) 2mg

Question 21

The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months ago. The patient suddenly presents to the office with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP most likely take?

a) Increase the dose of lamotrigine (Lamictal) to 25mg twice daily

b) Ask if the pt has been taking the medication as prescribed

c) Order gabapentin, 100mg TID because lamotrigine is no longer working for this patient

d) Order a CBC to assess for an infection

Question 22

An elderly woman with a hx of alzheimer’s disease, coronary artery disease, and myocardial infarction had a fall at home 3 months ago that resulted in her receiving an open reduction internal fixation. While assessing this patient, the pmhnp is made aware that the patient continues to experience mild to moderate pain. What is the pmhnp most likely to do?

a) order an X-ray because it is possible that she dislocated her hip

b) order ibuprofen because she mayneed long term treatment and chronic pain is not uncommon

c) Order naproxen because she may havarthritis and chronic pain is not uncommon

d) Order morphine and physical therapy

Question 23

The PMHNP is assessing a 49-year-old male with a history of depression, post-traumatic stress disorder (PTSD), alcoholism with malnutrition, diabetes mellitus type 2, and hypertension. His physical assessment is unremarkable with the exception of peripheral edema bilaterally to his lower extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP?

a) Orders liver function tests

b) Educate the patient on avoiding grapefruits when taking this medication

c) Encourage this patient to keep fluids to 1500ml/day until the swelling subside

d) Order BUN/Creatinine test

Question 24

The PMHNP is evaluating a 30-year-old female patient who states that she notices pain and a drastic change in mood before the start of her menstrual cycle. The patient states that she has tried diet and lifestyle changes but nothing has worked. What will the PMHNP most likely do?

a) Prescribe estrin FE 24 birth control

b) Prescribe Ibuprofen 800mg every 8 hours as needed for pain

c) Prescribe desvenlafaxine (Pristiq) 50mg daily

d) Prescribe Risperdal 2mg TID

Question 25

A patient with chronic back pain has been prescribed a serotonin-norepinephrine reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the inhibition of pain to the patient?

a) “the SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn”

b) “the SNRI can decrease noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn”

c) “the SNRI can reduce brain atrophy by slowing the gray matter loss in the dorsolateral prefrontal cortex”

d) “the SNRI can increase neurotransmission to descending neurons”

Question 26

A patient with fibromyalgia and major depression needs to be treated for symptoms of pain. Which is the PMHNP most likely to prescribe for this patient?

a) Venlafaxine (Effexor)

b) Duloxetine (Cymbalta)

c) Clozapine (Clozaril)

d) Phenytoin (Dilantin)

Question 27

The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work?

a) It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels

b) It will induce synaptic changes, including sprouting

c) It will act on the presynaptic neuron to trigger sodium influx

d) It will Inhibit activity of dorsal horn neurons to suppress body input from reaching the brain

Question 28

Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition?

a) Venlafaxine (Effexor)

b) Armodafinil (Nuvigil)

c) Bupropion (Wellbutrin)

d) All of the above

Question 29

The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain?

a) Methylphenidate (Ritalin)

b) Viloxazine (Vivalan)

c) Imipramine (Tofranil)

d) Bupropion (Wellbutrin)

Question 30

The PMHNP is attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select?

a) Pregabalin (Lyrica)

b) Duloxetine (Cymbalta)

c) Modafinil (Provigil)

d) Atomoxetine (Strattera)

Question 31

A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe?

a) Pregabalin (Lyrica)

b) Gabapentin (Neurontin)

c) Duloxetine (Cymbalta)

d) B and C

Question 32

The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient?

a) Prescribing the patient an agent that ignores the painful symptoms by initiating a reaction known as “fibro-fog”

b) Targeting the patient’s symptoms with anticonvulsants that inhibits gray matter loss in the dorsolateral prefrontal cortex

c) Mzatching the patient’s symptoms with the malfunctioning brain circuits and neurotransimitters that might mediate those symptoms

d) None of the above

Question 33

The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP?

a) “SSRIs only increase norepinephrine levels”

b) “SSRIs only increase serotonin levels”

c) “SSRIs only increase serotonin and norepinephrine levels”

d) “SSRIs do not increase serotonin or norepinephrine levels”

Question 34

A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe?

a) Antipsychotics

b) Lithium

c) SSRI

d) Naltrexone

Question 35

Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options?

a) “Naltrexone may be an appropriate option to discuss”

b) “there are many medicine options that treat Kleptomania”

c) “Kevin may need to be prescribed antipsychotics to treat this illness”

d) “Lithium has proven effective for treating kleptomania”

Question 36

Which statement best describes a pharmacological approach to treating patients for impulsive aggression?

a) Anticonvulsant mood stabilizers can eradicate limbic irritability

b) Atypical antipsychotics can increase subcortical dopaminergic stimulation

c) Stimulants can be used to decrease frontal inhibition

d) Opioid antagonists can be used to reduce drive

Question 37

A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient?

a) It will prevent feelings of euphoria

b) It will amplify impulse control

c) It will block testosterone

d) It will redirect the patient to think about other things

Question 38

Mrs. Kenner is concerned that her teenage daughter spends too much time on the Internet. She inquires about possible treatments for her daughter’s addiction. Which response by the PMHNP demonstrates understanding of pharmacologic approaches for compulsive disorders?

a) “Compulsive internet use can be treated similarly to how we treat people with substance use disorders”

b) “internet addiction is treated with drugs that help block the tension/arousal state your daughter experiences”

c) “When it comes to internet addiction, we prefer to treat patients with pharmaceuticals rather than psychosocial methods”

d) “there are no evidence-based treatments for internet addiction, but there are behavioral therapies your daughter can try”

Question 39

Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs”, he says. Which statement best describes the neurobiological parallels between food and drug addiction?

a) There is decreased activation of the prefrontal cortex

b) There is increased sensation of the reactive reward system

c) There is reduced activation of regions that process palatability

d) There are amplified reward circuits that activate upon consumption

Question 40

The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state?

a) Histamine 2 receptor antagonist

b) Benzodiazepines

c) Stimulants

d) Caffeine

Question 41

The PMHNP is caring for a patient who experiences too much overstimulation and anxiety during daytime hours. The patient agrees to a pharmacological treatment but states, “I don’t want to feel sedated or drowsy from the medicine.” Which decision made by the PMHNP demonstrates proper knowledge of this patient’s symptoms and appropriate treatment options?

a) Avoiding prescribing the patient a drug that blocks H1 receptors

b) Prescribing the patient a drug that acts on H2 receptors

c) Stopping the patient from taking medicine that unblocks H1 receptors

d) None of the above

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Analyzing Organizational Culture

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Discussion: Analyzing Organizational Culture

A company’s culture is often buried so deeply inside rituals, assumptions, attitudes, and values that it becomes transparent to an organization’s members only when, for some reason it changes.

 

—Rob Goffee

 

Culture is embedded within every organization. Yet, because culture is woven throughout the everyday interactions and atmosphere of an organization, it can be difficult to assess and explain how the culture influences the inner workings of the organization.

As a nurse leader-manager, developing a sound understanding of an organization’s culture can help you to achieve quality improvement initiatives and identify strategies for enacting sustainable change.

For this Discussion, you analyze the culture of an organization and consider how this relates to achieving goals related to quality improvement. You may wish to focus on the same organization that you have selected for your Course Project.

 

To prepare:

 

Review the information on organizational culture in this week’s Learning Resources.

Reflect on the culture of an organization with which you are familiar. Consider the following:

What elements of the organization’s culture seem most prominent or significant to you?

What beliefs, dispositions, and/or actions seem to be most valued? Why do you think so?

What do you notice about the expectations, assumptions, and more demonstrated among people within the organization?

What artifacts provide clues about the culture?

How do these cultural elements contribute to or detract from the organization’s ability to meet prominent goals and objectives?

Consider how you, as a nurse leader-manager, could apply your knowledge of this culture to facilitate quality improvement initiatives within this organization. How would you leverage the strengths of the culture, and address limitations or obstacles that may arise within it?

 

 

Post an analysis of the culture of the organization that you selected. Explain how you think this particular culture contributes to or detracts from the organization’s ability to meet goals. Explain how you, as a nurse leader-manager, could utilize your knowledge of this culture to facilitate quality improvement initiatives within this organization.

 

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Analyze similarities and differences between your colleague’s organizational culture and the organization that you selected.

Ask a probing question, substantiated with additional background information or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Suggest leadership strategies that your colleague could use to overcome obstacles in the organization’s culture to facilitate quality improvement initiatives.

 

Required Readings

 

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.

Chapter 10, “Evaluation of Patient Care Standards, Guidelines, and Protocols” (pp. 207-226)

Chapter 12, “Evaluating Populations and Population Health” (pp. 265-280)

Chapter 10 reviews methods for using national, local, and organizational standards to evaluate the quality of health care practices. Chapter 12 examines strategies for identifying quality issues through the evaluation of populations.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

Chapter 3, “General Concepts in Quality” (pp. 45–82)

See the six aims for quality proposed by the Institute of Medicine (IOM).

Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37.

Retrieved from the Walden Library databases.

 

Bellot reviews the definition of organizational culture, methods for evaluating organizational culture, and the application of Schein’s framework to defining the culture of health care organizations.

Dixon, M. A., & Dougherty, D. S. (2010). Managing the multiple meanings of organizational culture in interdisciplinary collaboration and consulting. Journal of Business Communication, 47(1), 3–19.

Retrieved from the Walden Library databases.

 

This article demonstrates the importance of not only understanding the culture of an organization, but also how these dynamics affect workplace performance and retention of employees.

Dorgham, S. R. (2012). Relationship between organization work climate & staff nurses organizational commitment. Nature and Science, 10(5), 80–91. Retrieved from http://www.sciencepub.net/nature/ns1005/009_9000ns1005_80_91.pdf

 

The correlation between organizational climate and commitment and its effect on an organization is evaluated in this study.

Hartnell, C. A., Ou, A. Y., & Kinicki, A. (2011). Organizational culture and organizational effectiveness: A meta-analytic investigation of the competing values framework’s theoretical suppositions. Journal of Applied Psychology, 96(4), 677–694.

Retrieved from the Walden Library databases.

 

This article presents a study on the relationship between culture types and organizational effectiveness. The authors apply specific values frameworks to determine the relationships while also assessing the competing values framework.

Schein, E. H. (1996). Three cultures of management: The key to organizational learning. Sloan Management Review, 38(1), 9–20.

Retrieved from the Walden Library databases.

 

In this seminal article, Schein identifies three subcultures found within an organization and the effects of these competing cultures on an organization’s effectiveness.

Wait, S. T., & Dayman, M. A. (2012, July/August). Company culture drives business value. Value Examiner, 30–31.

Retrieved from the Walden Library databases.

 

The authors connect company culture to innovation and success.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Retrieved from https://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

 

This report briefly outlines the six aims of the IOM to improve the quality of health care.

Schein, E. H. (1997). Organizational culture & leadership. Retrieved from http://www.tnellen.com/ted/tc/schein.html

 

Edgar Schein is one of the early writers on organizational culture. In this foundational article, Schein outlines various dimensions of organizational culture, and how leaders create, transmit, and embed organizational culture.

Required Media

Laureate Education (Producer). (2013e). Organizational culture. Retrieved from https://class.waldenu.edu

 

Note:  The approximate length of this media piece is 3 minutes.

 

Dr. Carol Huston discusses the influence of organizational culture on the delivery of quality care

 

 

Accessible player

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Discussion Board Rubric.docx 

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Reflect on the role that the electoral process and government plays in one’s daily work and family life. As nurses, health policy can influence both arenas of our lives. What policy issues might drive nurses to lobby Congress and/or get involved in campaign politics? What strategies might nurses use to have their voices heard?

Discussion Board Rubric.docx

**As a reminder, all questions must be answered to receive full credit for this discussion. please include your name in the title of the discussion. Also, make sure to use scholarly sources to support your discussion. Original posts must be  a minimum of 250 words and reply posts minimum 100 words.**

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PICOT Question and Literature Search

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PICOT Question and Literature Search

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

  1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
  2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
  3. The PICOT question will provide a framework for your capstone project.
  4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Therefore, they should not be included in this assignment.

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.

You are not required to submit this assignment to LopesWrite

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Competency

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Competency

Analyze  leadership and management roles in change management.

Instructions

An effective leader must possess the  skills, emotional intelligence, and knowledge base to influence and convince the members of the organization to not only adopt, but to become advocates for the change that the leader seeks to implement.

In order for one to develop the leadership skills that are required to affect change within the organization, one must become familiar with a variety of approaches previously utilized by successful leaders and managers in organizational transformation.

For this assignment, utilize the Rasmussen Business Library resource to research a business case study of an organization going through strategic change. Then research two leadership strategies that have been used to successfully drive organizational change during the past 10 years. Once you have located these strategies, write a paper analyzing the effectiveness of each strategy, and relate how effective management strategy alone may well be challenged to achieve desired change without effective leadership. In your analysis, address the following:

  • Identify and research two leadership strategies.
  • Develop a description of the leadership strategies.
  • Formulate an overview of how the strategy is used and rate its effectiveness.
  • Argue whether the strategy is still relevant and effective in present day organizations. Why or Why not?
  • Describe how management alone will fall short of achieving desired organizational change without all levels of leadership effectively operating in their rolls.

Please identify these strategies  from references found in the Rasmussen College Library.

Assignment Requirements are as follows:

  1. The body of the paper should be 2-3 pages.
  2. The paper should include an APA formatted cover page and reference page.
  3. The paper should include at least two peer-reviewed sources, such as journal articles from the Rasmussen Library.
  4. The paper should be proofread for correct spelling, grammar, and punctuation.

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“General Appraisal Overview for All Studies,

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MODULE 2

DQ 1

Review the “General Appraisal Overview for All Studies,” available in Appendix B in the textbook. You should save this tool and use it throughout the development of the PICOT question, problem description, and literature review.

Begin the development of your PICOT question, using the following resources:

1. “Appendix A: Template for Asking Clinical Questions,” available in the textbook appendix

2. Text readings

Formulate your PICOT question and post it to the main forum. Respond to at least four other statements, providing feedback. Review the statements to see if the clinical issue is clearly defined and that all aspects are identified. Also refer to the “PICOT: Components of an Answerable, Searchable Question” table, located in chapter 2 of the text. If one PICOT statement has at least three feedback posts, move to another statement.

You will be using the feedback to make revisions to your PICOT question before using it in your “Section B: Problem Description” assignment.

Here is something to think about.

· Population/ Patient Problem: Who is your patient? (Disease or Health status, age, race, sex)

· Intervention: What do you plan to do for the patient? (Specific tests, therapies, medications)

· Comparison: What is the alternative to your plan? (ie. No treatment, different type of treatment, etc.)

· Outcome: What outcome do you seek? (Less symptoms, no symptoms, full health, etc.)

· Time:  What is the time frame? (This element is not always included.)

Example: 

Prevention:

For________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

In acute care cancer patients, does the use of scheduled pain medication regimes reduce the risk of uncontrolled pain compared with non-scheduled pain medication regimes.

DQ 2

What strategies will you use in your new practice as an advance practice nurse to review and critique literature pertinent to your practice?

As a Christian nurse will you focus on one particular genre of literature more than others. or will you be looking at specific topics related to your practice.

RESOURCES

1. Evidence-Based Practice Resources on the World Wide Web

Read “Evidence-Based Practice Resources on the World Wide Web,” by Stevens, from the Academic Center for Evidence Based Practice, located on the Wayback Machine archive website.

http://replay.waybackmachine.org/20080521225345/http://acestar.uthscsa.edu/Resources_www.htm

e-Library Resource

1. Evidence-Based Nursing

Access “Evidence-Based Nursing.” Use all issues of the journal to further explore your individual PICOT topic.

https://lopes.idm.oclc.org/login?url=http://gateway.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&NEWS=N&PAGE=toc&SEARCH=00124408-201007000-00000.kc&LINKTYPE=asBody&LINKPOS=1&D=ovft

2. Joanna Briggs Institute EBP Database

Use the Joanna Briggs Institute EBP Database to search for EBP resources related to your capstone project.

http://joannabriggs.org/jbi-approach.html#tabbed-nav=JBI-approach

Website

1. Centre for Evidence-Based Medicine

Explore the Centre for Evidence-Based Medicine (CEBM) website.

http://www.cebm.net/

2. Cochrane Database of Systematic Reviews

Access the full text of “Cochrane Database of Systematic Reviews,” located on The Cochrane Library website.

http://www.thecochranelibrary.com/view/0/index.html

3. Cochrane Library Database

Explore the Chochrane Library Database.

https://lopes.idm.oclc.org/login?url=http://www.cochranelibrary.com

4. Guide to Clinical Preventive Services

Explore the Agency for Healthcare Research and Quality website. Be sure to access the “Guide to Clinical Preventive Services,” located on the Agency for Healthcare Research and Quality website.

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