Tag Archive for: nursing

quantitative, peer-reviewed research

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 Turnitin. Please refer to the directions in the Student Success Center.

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Economic Impact of States Declining Medicaid Expansion

With coinciding concerns about health care costs and the imperative to improve quality of care, health care providers and others face difficult decisions in the effort to achieve an appropriate balance. Such decisions often are addressed in the policy arena. How do policymakers evaluate which health care services should be financed through government programs? How do ethics-related questions and other considerations play into this evaluation process? Is it possible to contain costs and provide accessible, high-quality care to all, or is the tension between cost and care inherent in the U.S. health care delivery system? These questions are central to health care financing decisions in the United States.

For this Discussion, you will focus on the policy decision-making process that determines what types of care are covered by public and private insurers and the ethical aspects of such financial decisions.

To prepare:

  • Read the the case study “Economic Impact of States Declining Medicaid Expansion”  page 305 of the Milstead text.
  • Review the information in the Washington Post article “Review of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debate” in the Learning Resources.
  • Consider how policy decisions currently are made about what will and will not be paid for and what changes, if any, could improve the process.
  • Reflect on how the Washington Post example illustrates the tension between cost and care.

Post your analysis and assessment of the ethical and economic challenges related to policy decisions such as those presented in the Washington Post article. How does this type of situation contribute to the tension between cost and care? Substantiate your response with at least two outside resources.

Washington Post article:

http://www.washingtonpost.com/wp-d

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Data Analysis—Small Group Discussion

Discussion: Data Analysis—Small Group Discussion

As a nurse engaged in evidence-based practice, it is important to recognize how statistics and other data analysis tools are used to generate and assess evidence. Most nurses need only a foundational understanding of statistical tools and terminology to understand the majority of research studies. As a nurse, you should be able to recognize the most commonly used statistical tests, how and when they are used, and how significance is determined.

In this Discussion, you examine different types of statistics and statistical tests, when and why these particular tests would be selected for use, and, most importantly, what the results indicate. To this end, you will be assigned to a group by Day 1 of this week. Each group will be assigned one of the five chapters listed in this week’s Learning Resources and will develop a study sheet on their chapter that will be shared with the other groups.

Review the information in your assigned chapter.( CHAPTER 19)-BOOK ATTACHED BELLOW

Look for:

The key concepts of the chapter: Focus on the basic concepts that are important for nurses to understand as they review research studies.

A description of the statistical methods covered in the chapter, 

What they measure, and under what circumstances they are used. 

Identify examples of how the statistical methods have been used in research studies.

        

An explanation of the key statistical tests and how they measure significance (if applicable).

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Windshield Survey

A. Windshield Survey

The Windshield Survey is comprised of general qualitative observations that give you a snapshot of the community that you can capture as you drive/walk through the community. The demographic data can be obtained online, through the public library, county or township administration buildings. Please address the following in a narrative format following APA guidelines:

1. Geographical description

 Boundaries, geographical, political, or economic, how is it seen.

 Housing an zoning

 Sign of decay

2. Health Resources

a. Type of services available: health department, private MD, dentist, hospital clinic,

b. pharmacy, health promotion, mental health

c. School and occupational health services

d. Official and voluntary services

e. Self help and support groups

f. Service organizations, faith-based programs

g. Stores (grocery, retail, drug, dry cleaning, etc.

h. Transportation

3. Citizen safety and protective services

a. Police and fire

b. Shelters for victims of abuse

c. Others: neighborhood watch etc.

4. Services provided by senior citizens senior centers, meals on wheels, transportation, day care, long term care.

a. Parks and recreational areas

5. Community welfare services beyond city/state aid as provisions for emergency food, shelter and clothing.

Below please see the rubric that will be used to grade your survey and due date instructions.

Assignment must be presented in an essay style using APA format in the required Arial 12 font with minimum of 1000 words.

If you are unable to comply with the due date, please contact me via e-mail at least 3 days before the due date. Extra time will not be granted after the due date has passed. This assignment will be grade based on the assignment rubric.

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Professional identity

Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #4, the MSN Essential IV, and the Nurse Practitioner Core Competencies # 7.

Program Outcome #4:  Integrate professional values through scholarship and service in health care. (Professional identity)

MSN Essential IV: Translating and Integrating Scholarship into Practice Recognize that the master’s-prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.

Nurse Practitioner Core Competencies # 7

Health Delivery System Competencies

1. Applies knowledge of organizational practices and complex systems to improve health care delivery.

2. Effects health care change using broad based skills including negotiating, consensus-building, and

partnering.

3. Minimizes risk to patients and providers at the individual and systems level.

4. Facilitates the development of health care systems that address the needs of culturally diverse

populations, providers, and other stakeholders.

5. Evaluates the impact of health care delivery on patients, providers, other stakeholders, and the

environment.

6. Analyzes organizational structure, functions and resources to improve the delivery of care.

7. Collaborates in planning for transitions across the continuum of care.

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bacteria

Answer Critical Thinking Question 2 for Chapter 7 on page 206 and Clinical Application Question 1 for Chapter 8 on page 243. Answers should be submitted in a word document with any associated references used.

Day four assignment

206 question:For each of the following bacteria, explain why is is often resistant to disinfectant

a)Mycobacteriim

b)Pseudomonas

c)Bacillus

question number one chapter 8

Ciprofloxacin erythromycin, and acyclovir are used to treat microbial infections, Ciprofloxacin inhibits DNA gyrase. Erythromycin binds in front of the A site on the 50S subunit of a ribosome Acyclovir is a guanine analog.

a) What steps in protein synthesis are inhibited by each drug?

b) Which drug is more effective against bacteria?why?

c) Which drugs will have effects on the host’s cells?why

d) Use the index to identify the disease for which acyclovir is primarily used . Why is it more effective than erythromycin for treating this diseaese

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Healthcare policy concern

Healthcare policy concern :Crosswalk safety (Community based concern)

Type of Service

Research Paper

Urgency 6 to 10 hours.

Citation Style

APA Style

No. of Pages/Wordcount

6 page(s)/1650 Words

No. of Sources/References

6

English UK/US/AU?

English US

Description

Paper is about policy concern crosswalk safety in prince georges county (maryland).

Identify community based healthcare policy concern, propose a policy change with evidenced-based foundation, (define: health care policy, role of advocacy and how it can impact healthcare policy, explain how the role of advocacy is consistent with the responsibility of an advance practice nurse. solution to the healthcare concern, positive outcome if implemented, what changes would need to occur, what measurable action will demonstrate a positive outcome, two challengess to implement the proposed solution, and how they can be avoided or resolved.

Please APA format, 6 pages, 6 research-based scholarly references with in the last past 5 years of which 2 references are mpirical evidence from state and county website data. I leave in Maryland (Prince Georges county) . propose a solution, The outcome is to improved health

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Puerto Rican Woman With Comorbid Addiction.

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. 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:

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

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Building a Health History

Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients: Chosen topic in red

· 76-year-old Black/African-American male with disabilities living in an urban setting

To prepare:

With the information presented in Chapter 1 in mind, consider the following:

· How would your communication and interview techniques for building a health history differ with each patient?

· How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

· What risk assessment instruments would be appropriate to use with each patient?

· What questions would you ask each patient to assess his or her health risks?

· Select one patient from the list above on which to focus for this Discussion.

· Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

· Select one of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.

· Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

· Include sub headings please

Write: a description of the interview and communication techniques you would use with your selected patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient

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Advocating Through Policy

Advocating Through Policy

As noted by Dr. Stanley and Dr. White in this week’s media presentation, professional nurses should be engaging in advocacy efforts to improve health and nursing practice through involvement in the policy process at the institutional, local, state, or federal levels. This array of possibilities for involvement provides opportunities for all nurses, regardless of time, or other possible constraints. Successful policy making is a collaborative effort, and one that commands mutual respect from all involved. Your involvement in policy making can lead to expanded opportunities as both a nurse leader and as a respected member of an interprofessional health care team.

Note: This Discussion provides a forum for discussing advocacy opportunities and honing your presentation skills in a small group setting.

To prepare:

  • Reflect      on the insights offered by Dr. Stanley and Dr. White on engaging in      advocacy through the policy process.
  • Identify      a practice issue that is of interest to you and that could benefit from      advocacy efforts through the policy process.
  • Consider      the stakeholders and any special interest or professional organizations      that would support your issue.
  • Develop a short, yet      persuasive PowerPoint (up to 3 slides IN APA FORMAT) as follows:

1) Identify the practice issue that would benefit from being addressed through the policy process

2) Represent the key stakeholders (i.e. use graphical images when possible)

3) Propose one strategy for how a nurse could advocate for this issue

The PowerPoint should be succinct, visually appealing, and effective.

By Tuesday 5/8/18 6pm

Post your PowerPoint presentation.

Required Readings

Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.

  • Chapter      17, “Conclusion: Tensions and Challenges”

    This chapter concludes with final thoughts on the challenge of providing      quality health care and controlling health care costs. The solution is      likely to be resolved only by a collaborative approach, involving all      health care stakeholders, and by health professionals taking the lead.

Howard, J., Levy, F., Mareiniss, D. P., Craven, C. K., McCarthy, M., Epstein-Peterson, Z. D., & et al. (2010). New legal protections for reporting patient errors under the Patient Safety and Quality Improvement Act: A review of the medical literature and analysis. Journal of Patient Safety, 6(3), 147-152.

The authors studied the dissemination of information on the Patient Safety and Quality Improvement Act (PSQIA), a federal act that affords protection to those reporting medical errors. They found medical literature to be inadequate in this regard, and as a result, medical personnel were uninformed on their legal protections. This lack of information has become a barrier to policy implementation.

Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for knowledge translation: Understanding user context. Journal of Health Services Research & Policy, 8(2), 94–99.

Lau, B., San Miguel, S., & Chow, J. (2010). Policy and clinical practice: Audit tools to measure adherence. Renal Society of Australasia Journal, 6(1), 36–40.

The authors study the compliance to renal-care policies by health care professionals. They conclude with the necessity for nurses to support evidence-based protocols as well as to obtain continuing education on new protocols.

McCracken, A. (2010). Advocacy: It is time to be the change. Journal of Gerontological Nursing, 36(3), 15-17.

The author proposes that nurses, as patient advocates, need to be more involved in the making of health care policy instead of reacting to policies that are constantly changing. The article provides a guide to help organize initial policy efforts.

Nannini, A., & Houde, S. C. (2010). Translating evidence from systematic reviews for policy makers. Journal of Gerontological Nursing, 36(6), 22–26.

The article cites geronotological nurses as examples of those who are able to translate research into policy briefs that can be clearly understood by policy makers. Geronotological nurses are in this unique position because of their clinical experience and educational background.

Paterson, B. L., Duffet-Leger, L., & Cuttenden, K. (2009). Contextual factors influencing the evolution of nurses’ roles in a primary health care clinic. Public Health Nursing, 26(5), 421-429.

This article provides details on a study conducted in a nurse-managed clinic related to the changing roles of nurses. The authors found that nurses, in response to social, political, and economic forces, became involved in advocacy for the clinic through political action, government funding issues, and media relations roles.

Sistrom, M. (2010). Oregon’s Senate bill 560: Practical policy lessons for nurse advocates. Policy, Politics, & Nursing Practice, 11(1), 29-35. doi: 10.1177/1527154410370786

The author uses the efforts by a nurse advocate in lobbying for an Oregon bill related to healthy food in public schools to illustrate nurse advocacy and policy making. The bill, developed in response to childhood obesity, did not immediately become law. The author concludes with the importance of considering the political environment when creating successful policy.

Spenceley, S. M., Reutter, L., & Allen, M. N. (2006). The road less traveled: Nursing advocacy at the policy level. Policy, Politics, & Nursing Practice, 7(3), 180-194. doi: 10.1177/1527154410370786

Nurses have always been advocates at the patient-level of care, but the authors of this article promote the need for all nurses to become advocates at the policy level as well. They discuss factors that have kept nurses from getting involved with policy making and they provide strategies to resolve these challenges.

Wyatt, E. (2009). Health policy advocacy: Oncology nurses make a difference. ONS Connect, 24(10), 12-15.

The author presents information on two nurses who have become health care policy advocates—one as a policy maker and one as an elected legislator. Both have been able to use their perspectives from their nursing careers to affect health policy.

Zomorodi, M., & Foley, B. J. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line.’ Journal of Advanced Nursing, 65(8), 1746-1752.

The authors attempt to distinguish the concepts of advocating for a patient and paternalism, or overriding a patient’s wishes. They provide clinical examples to illustrate the differences between these concepts, and they conclude with strategies to use in practice.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Advocating through policy. Baltimore: Author. 

Note: The approximate length of this media piece is 7 minutes.

In this media presentation, Dr. Joan Stanley and Dr. Kathleen White discuss how nurses can influence practice and engage in advocacy through the policy process.

Optional Resources

Birnbaum, D. (2009). North American perspectives: POA, HAC and never events. Clinical Governance: An International Journal, 14(3), 242–244.

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