Tag Archive for: nursing

clinical environment

In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.

Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

  1. The problem, issue, suggestion, initiative, or educational need that will be the focus of the project
  2. The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
  3. A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
  4. Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
  5. Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
  6. A proposed solution to the identified project topic

reflective narratives

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

  1. New practice approaches
  2. Intraprofessional collaboration
  3. Health care delivery and clinical systems
  4. Ethical considerations in health care
  5. Population health concerns
  6. The role of technology in improving health care outcomes
  7. Health policy
  8. Leadership and economic models
  9. Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this c

client system

Assessment is a structured approach to gathering and analyzing information about the client system and their story. How is the assessment process different when the client system is an individual or family versus a community made up of individuals and families?

Assessment involves gathering the needed information in order to determine appropriate intervention. Thorough assessment allows social workers to identify the problems that need to be addressed. Complex social problems often mean that both the micro and macro level factors contribute to social work cases.

In this Discussion, you compare differences in the assessment stage at different practice levels.

Answer all 5 questions (No Plagiarism) and Post in APA Format given 3 cites from  Kirst-Ashman, K. K., & Hull, G. H., Jr. (2018). Understanding generalist practice (8th ed.) &  Graybeal, C. (2001). Strengths-based social work assessment: Transforming the dominant paradigm. Families in Society, 82(3), 233–242.

  • 1.Describe the assessment process as related to individuals and families.
  • 2. Briefly identify the types of information it is important to gather.
  • 3.Compare how assessment is similar and dissimilar at the macro level.
  • 4. Explain how you would gather the needed information at the macro level.
  • 5. Identify a situation where a client system (micro or macro) may be reluctant to engage in the assessment process.

anemia

  1. Explain why there are so many codes related to anemia (D50-64).

    Your response should be at least 75 words in length

  2. Describe resistant infections and the official guidelines for coding and reporting. Why is it important to correctly identify and code all resistant infections? Include at least one example of a resistant-infection code.Your response should be at least 75 words in length

3 Use the Encoder Pro software to assign I-10 code(s) to the following diagnosis: Pneumocystis pneumonia in patient with HIV.

4 Use the Encoder Pro software to assign I-10 code(s) to the following diagnosis: Combined spinal cord degeneration due to pernicious anemia.

5 Use the Encoder Pro software to assign I-10 code(s) to the following diagnosis: Gastroenteritis due to Norwalk virus.

6  Use the Encoder Pro software to assign I-10 code(s) to the following diagnosis: Alzheimer’s disease.

7  Use the Encoder Pro software to assign I-10 code(s) to the following diagnosis: Hypertension with end-stage renal disease.

8.

QUESTION 8

  1. History of Present Illness
    A 50-year-old disabled male is a resident of a nursing home who has been admitted because of marked congestion and respiratory distress. He is known to have mental retardation and frequent urinary tract and pulmonary infections. He has a recurrent epileptic disorder that is well controlled on Dilantin.

    Physical Examination
    On admission, vital signs include a temperature of 101° F, respiratory rate of 32 breaths per minute, heart rate of 82 beats per minute, and blood pressure of 120/70 mm Hg. Examination of the chest reveals bilateral crepitations. There is moderate redness and edema of the scrotal skin.

    Laboratory Data and Course in Hospital
    His white blood cell count is 8.5; hemoglobin, 12.9 g/dl; polymorphonuclear leukocytes, 64; bands, 19; lymphocytes, 10; monocytes, 6; and eosinophils, 1. A urinalysis shows moderate bacterial and white blood cell count. A urine culture shows mixed flora. The repeat urine culture shows Providencia stuartii sensitive to Fortaz. A sputum culture reveals the presence of methicillin-resistant Staphylococcus aureus, sensitive to vancomycin. A chest X-ray film shows bilateral pulmonary infiltrates. Arterial blood gases on room air show a PO2 of 48, PCO2 of 30, and pH of 7.50. When repeated with the patient on oxygen, PO2 is 66, PCO2 is 36, and pH is 7.45. The patient is treated with intravenous vancomycin and intravenous Fortaz. His pulmonary infiltrate decreases. His oral intake has been somewhat poor, and he has been given intravenous fluids off and on. The nursing staff at the nursing home note that his intake, in terms of eating and taking fluids, is much better. His medications at the nursing home include Dilantin, 200 mg twice a day; Tegretol, 400 mg at 8 a.m. and 4 p.m. and 200 mg at 8 p.m.; and Cipro, 500 mg twice a day; and his maintenance medications are continued. This patient is being discharged today.

    Use Encoder Pro software to assign I-10 code(s) for each of the final diagnosis statements below:

 

Final Diagnosis

  1. Acute respiratory insufficiency
  2. Bilateral pneumonia due to MRSA
  3. Providencia stuartii (gram-negative bacilli) infection
  4. Mental retardation
  5. Epilepsy
  6. UTI

Research Critiques

Prepare this assignment as a 1,500-1,600 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

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 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

healthcare policy

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

  • Review      the Resources on healthcare policy and regulatory/legislative topics      related to health and nursing informatics.
  • Consider      the role of the nurse informaticist in relation to a healthcare      organization’s compliance with various policies and regulations, such as      the Medicare Access and CHIP Reauthorization Act (MACRA).
  • Research      and select one health or nursing informatics policy (within the past 5      years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

  • Briefly      and generally explain the policy or regulation you selected.
  • Address      the impact of the policy or regulation you selected on system      implementation.
  • Address      the impact of the policy or regulation you selected on clinical care,      patient/provider interactions, and workflow.
  • Highlight      organizational policies and procedures that are/will be in place at your      healthcare organization to address the policy or regulation you selected.      Be specific.

Wake Disorders order

Discussion: Sleep/Wake Disorders order code 0070004002019BB

Subject Area

Coursework

task (TSE) A new Task-

No.of pages/Wordcount

2 page

Urgency 6 to 12 hours.

Citation Style

APA Style

Assignment Details

Discussion: Sleep/Wake Disorders
It is not uncommon to experience a night or two of disrupted sleep when there is something major going on in your life. However, sleep/wake disorders are much more than an occasional night of disrupted sleep. A recent report from the Centers for Disease Control and Prevention estimated that between 50 and 70 million American have problems with sleep/wake disorders (CDC, 2015). Although the vast majority of Americans will visit their primary care provider for treatment of these disorders, many providers will refer patients for further evaluation. For this Discussion, you consider how you might assess and treat the individuals based on the provided client factors.

Learning Objectives
Students will:
Assess client factors and history to develop personalized therapy plans for clients with sleep/wake disorders
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for sleep/wake disorders
Evaluate efficacy of treatment plans for clients presenting for sleep/wake therapy
Apply knowledge of providing care to adult and geriatric clients presenting for sleep/wake disorders
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 11, “Disorders of Sleep and Wakefulness and Their Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

For insomnia

alprazolam
amitriptyline
amoxapine
clomipramine
clonazepam
desipramine
diazepam
doxepin
flunitrazepam
flurazepam
hydroxyzine
imipramine
lorazepam
nortriptyline
ramelteon
temazepam
trazodone
triazolam
trimipramine
zaleplon
zolpidem

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: Retrieved from Walden Library databases.

Davidson, J. (2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines. British Journal of Psychiatry, 2(6), e16-e18. doi:10.1192/bjpo.bp.116.003707. Retrieved from http://bjpo.rcpsych.org/content/2/6/e16

To prepare for this Discussion:

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.

Case 1: Volume 2, Case #16: The woman who liked late-night TV

Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady

Case 3: Volume 1, Case #5: The sleepy woman with anxiety

Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

By Day 3
Post a response to the following:

Provide the case number in the subject line of the Discussion.
List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s sleep/wake therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.
Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.
Read a selection of your colleagues’ responses.

Care of a patient with prenatal complications

Write a 2-3 page APA formatted paper (not including cover sheet or reference page) utilizing a minimum of three resources based on the case scenario below. You may opt to do a power point presentation or Prezi with a minimum of 10 – 15 slides (not including cover sheet or reference slide) instead of the written paper.

Scenario: A gravida two, para-one 34 year old woman comes into the office for pre-natal care. She is 28 weeks pregnant. Her blood pressure is 160/90 with a weight of 220 lbs and a height of 5’1. Her previous blood pressure at her visit 4 weeks ago was 122/ 78. Her previous weight was 210 lbs. She reports a history of gestational diabetes. Her fasting glucose is 108 with an A1C of 6.0.

What focused assessments would you expect the practical nurse to perform? What important data would need to be communicated to her health care team?

Rubric

 

Scenario: A gravida two, para-one 34 year old woman comes into the office for pre-natal care. She is 28 weeks pregnant. Her blood pressure is 160/90 with a weight of 220 lbs and a height of 5’1. Her previous blood pressure at her visit 4 weeks ago was 122/ 78. Her previous weight was 210 lbs. She reports a history of gestational diabetes. Her fasting glucose is 150.

What focused assessments would you expect the practical nurse to perform? What important data would need to be communicated to her health care team?

                                      Scoring Rubric

 

Care of a patient with prenatal complications

 

Spelling and grammar is correct throughout   the presentation. APA format is consistently done and correct. All   information is referenced throughout the body of the presentation. Uses a   minimum of 3 credible references.

1

 

Discusses the significance of the blood   pressure. Outline what other assessments will be made by the nurse.

What will be reported based on this finding?

What condition are you assessing for? How   urgent is the reporting of this problem?

2

 

Discusses the significance of the blood glucose   finding. Outline what other assessments will be made based on this finding.

What will be reported based on this finding?

What   condition are you assessing for?

How urgent is the reporting of this problem?

2

 

Briefly discuss the common findings of   preeclampsia and nursing care and   management of this disorder.

2

 

Briefly discuss the common findings of   gestational diabetes mellitus (GDM), and nursing care and management of this disorder.

2

 

Includes SBAR report for this patient.

Myasthenia Gravis

This week, you will write a mini-systematic literature review. It is mini because you will only be reviewing two sources.
For this literature review assignment, we are going to give you a choice of three topics to choose from. Choose one for this assignment.

Myasthenia Gravis
Hodgkin’s Lymphoma
HIV/AIDS
Remember, for a systematic review, focus your analysis on the treatments, causes, diagnosis, and prognosis presented in the literature.
Next, conduct your research of scholarly articles. Use the WCU Online Library databases. You will need to choose two sources to include in this mini-literature review.
For this review, be sure to:

Select two relevant and appropriate scholarly articles that address the topic you chose.
Present a thorough literature review of both articles by summarizing, synthesizing, and evaluating the materials.
Demonstrate understanding of the content presented in the articles.
Include a critical assessment of the sources. Do not simply include a summary of what you have read.
Incorporate citations into your body paragraphs; incorporate the essential and most relevant supporting evidence eloquently and appropriately.
Present your writing in a clear, organized manner.
Provide a strong introduction and conclusion, including further questions for research.
Use proper APA format with proper citations. Review APA Citations Here
Your literature review should be 1–2 pages in length. Remember, you will need to use APA formatting in your literature review and include a title page and a reference page.

Competitiveness and Performance Effectiveness for Health Care IT Systems

Assignment 2: Competitiveness and Performance Effectiveness for Health Care IT Systems

Due Week 8 and worth 250 points

Write a six to eight (6–8) page paper in which you:

  1. Define the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Make one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Support your response with related examples of such expertise in use.
  2. Suggest two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Provide a rationale to support your response.
  3. Determine two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Provide a rationale to support your response.
  4. Suggest one (1) strategy for health care organizations to train providers in using technology in health care. Provide a rationale to support your response.
  5. Provide three (3) best practices for effective IT alignment and strategic planning initiatives. Justify your response.
  6. Use at least three (3) quality academic resources in this assignment. Note: Wikipedia and similar type websites do not qualify as academic resources.

Your assignment must follow these formatting guidelines:

  • This course requires use of new Strayer Writing Standards (SWS). The format is different than other Strayer University courses. Please take a moment to review the SWS documentation for details.
  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; references must follow SWS or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required page length.

The specific course learning outcomes associated with this assignment are:

  • Examine the impact technologies have on health care information systems.
  • Describe the basic components of a strategic information system plan.
  • Describe the major types and classifications of health care information standards and the specific organizations that develop and regulate these standards.
  • Discuss the need for, and identify methods of, accomplishing the security of information systems.
  • Evaluate the impact of strategic information system plans on organizational competitiveness and performance.
  • Use technology and information resources to research issues in health information systems.
  • Write clearly and concisely about health information systems using proper writing mechanics.

Grading for this assignment will be based on answer quality, logic / organization of the paper, and language and writing skills, using this rubric.