Tag Archive for: nursing

Intent

Intent

In this assessment, you demonstrate that you can provide an evidence-based conclusion to an uncertain clinical situation. It requires you to search for relevant research, understand levels of evidence, consider the quality of evidence, present the summary of each article, interpret their findings, and reach a conclusion based on your reviewed evidence.

Task: You have been provided with three clinical scenarios. Each scenario indicates an area of clinical uncertainty. Select a scenario that interests you and using your evidenced based practice skills answer the question that follows.

Scenario 1:

In the course of your clinical placement in a surgical ward, you noted inconsistency in wound care. While some nurses use a sterile technique, others employ a clean dressing change technique.

Is clean wound dressing a safe option for dressing of surgical wounds?

Scenario 2:

You are working on a hospital ward where you encounter stroke patients. You notice that some doctors order compression stockings for prevention of deep venous thrombosis while others not.

Should antithrombotic stockings be routinely used for patients with stroke or not?

Scenario 3:

You are working as an RN in an emergency department. A 10-year-old child has been admitted to the department with a diagnosis of exacerbation of asthma secondary to bronchitis. The patient has been prescribed salbutamol.

What is the more effective method of delivery- a nebuliser or a spacer?

Format

Written paper with well-structured paragraphs. Headings can be used if they help structure your work.

Introduction (500 words)

Briefly describe the process you used to answer the question. i.e. how you formulated a searchable question and developed a search strategy. Justify the approach you took in accessing the evidence. Describe the rationale behind the selection of each paper (hint: level of the evidence, quality of the evidence, relevance). Both quantitative and/or qualitative articles can be used, as appropriate to the clinical scenario and question you have developed. It is not necessary to present all the evidence you found (and you have limited word count to do this). The key thing is quality not quantity – so four or five research-based articles are better than a large number of low-level papers. Provide the print screens of the abs

tracts of the papers you have chosen.

Main body of the paper (800 words)

Briefly present each paper and their main findings. What does the research show?

Conclusion (200 words)

This is where you clearly state what you think the answer to your question is and why.

gestational diabetes

Minimum of 250 words with at least 2 peer review reference in 6th edition apa style.

Ms. C is a 28-year-old Casino Floor Manager. She had gestational diabetes during her fourth pregnancy which she delivered about a year ago and during that time she was treated with NPH BID and NovoLog QID with meals. After delivery she started Metformin and then after that Pioglitazone and Sitagliptin and Glimepiride were added. She eats three meals a day. She prepares them at home. She doesn’t eat fast food or junk food and she’s pretty consistent with what she eats day-to-day. She’s very active, exercises regularly and when she sees you in the office her A1C is despite all that she is doing to control the sugars, her A1C is 8.9. What are your treatment options? Give probable diagnosis and differentials

ssues in Health Care Reform (

Assignment 1: Issues in Health Care Reform (Interview)

According to the AACN (2006), “Political activism and commitment to policy development are central elements of professional nursing practice” (p. 13). Throughout this course, you will hone the skills and competencies required for this type of involvement in policy.

Research is an essential step in the process of acquiring the skills and competencies, and interviews are one form of research that can serve as a valuable source of information. As such, this Assignment (which you will start this week, and submit by the end of Week 9) provides an opportunity for you to identify a health reform issue of interest and discuss the issue with a state or national politician (or their aide).

To prepare:

  • Identify      a state or national politician (state representative or legislator,      senator, congressman, governor, etc.), or aide, whom you would like to      interview regarding current issues in health care reform. (I live in the state of Maryland.      The 2 states senators are Chris Van Hollen since 2017 and Ben Cardin since      2007; the Governor name is Larry Hogan. You can also google any of the      information about the state of Maryland in the US)
  • As      soon as possible, contact the individual’s office to request a meeting.      Keep in mind that it may be difficult to get on their calendar, so plan      accordingly. You may conduct the interview in person or by phone.
  • In      advance of the interview, ask yourself:
    • What       health care policy issue is important to me personally?
    • What       issue do I want to bring to this person’s attention?
  • With      this in mind, develop your list of questions for the interview around your      selected health policy issue. In addition, you may wish to include      questions related to health care reform:
    • What       are your constituents most concerned about regarding health care reform?
    • What       are the trade-offs associated with recent health care reform policy?

To complete:

  • Write  a 3- to 4-page paper with at least 5 scholarly references providing a summary and analysis of the interview and the health care reform issues you discussed. Include an introduction and a conclusion.

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate (at least 5 references). Refer to the Publication Manual of the American Psychological Association to ensure that your in-text citations and reference list are correct.

This assignment is due by Thursday 04/26/18 by 10 pm.

Required Readings

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

Chapter 5, “How Health Care is Organized – I: Primary, Secondary, and Tertiary Care”

Chapter 6, “How Health Care is Organized – II: Health Delivery Systems”

McClellan, M. (2010). Accountable care organizations in the era of health care reform. American Health & Drug Benefits, 3(4), 242–244.

The PPACA of 2010 encourages the formation of accountable care organizations (ACOs) to improve the quality and efficiency of health care delivery. An ACO is a group of health care providers who coordinate care for their Medicare patients and share the financial incentives of health care improvement gains.

Moore, K. D., & Coddington, D. C. (2010). Accountable care: The journey begins. Health Care Financial Management, 64(8), 57–63.

This article provides information on the importance of health care provider organizations taking steps to become accountable care organizations (ACOs) and provides examples of systems that have historically functioned in this capacity. The authors also provide steps for developing and transitioning to an ACO structure.

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

This report discusses how nurses can and should play a fundamental role in meeting the challenges of increased demand for health care brought about by the implementation of the 2010 Affordable Care Act. In addition, it stresses the need for nurses to be partners with other health professionals and assume leadership roles in redesigning health care in the United States.

Institute of Medicine. (2010). Report brief: The future of nursing: Leading change, advancing health. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

This report brief highlights the four key recommendations from the Robert Wood Johnson and Institute of Medicine the Future of Nursing: Leading Change, Advancing Health report. The recommendations focus on nursing practice, education and training, partnerships with other healthcare professionals, and workforce planning and policymaking.

HealthCare.gov. (n.d.). Understanding the Affordable Care Act. Retrieved from http://www.hhs.gov/healthcare/rights/index.html

This website introduces the Affordable Care Act and presents the timeline for implementation of the various provisions of the Act.

HealthCare.gov. (n.d.). Understanding the Affordable Care Act: About the law. Retrieved from http://www.hhs.gov/healthcare/rights/law/index.html

Read the full Affordable Care Act law at this website. An overview of the law is also provided along with an outline of how the Affordable Care Act helps reduce health insurance costs.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Reforming health care delivery: Accountable care organizations. Baltimore: Author.

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

In this media presentation, Dr. Kathleen White explains the structure of accountable care organizations (ACO) and discusses the benefits and challenges of becoming an ACO.

Optional Resources

APRN Joint Dialogue Group Report. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & education. Retrieved from http://www.aacn.nche.edu/education-resources/APRNReport.pdf

Fisher, E. S., & Shortell, S. M. (2010). Accountable care organizations: Accountable for what, to whom, and how. JAMA: Journal of the American Medical Association, 304(15), 1715–1716.

Fisher, E. S., Staiger, D. O., Bynum, J. W., & Gottlieb, D. J. (2007). Creating accountable care organizations: The extended hospital medical staff. JHealth Affairs, 26, w44-w57. doi:10.1377/hlthaff.26.1.w44–57

McClellan, M., McKethan, A. N., Lewis, J. L., Roski, J., & Fisher, E. S. (2010). A national strategy to put accountable care into practice. Health Affairs, 29(5), 982–990.

Kaiser Health News. (2011). Accountable care organization proposed regulations: Resources. Kaiser Family Foundation. Retrieved from http://www.kaiserhealthnews.org/Stories/2011/March/31/ACO-Documents-In-The-News.aspx

MSN program.

How will you approach your studies? What types of resources are available to you, and how will you access and utilize them? Taking the opportunity to prepare these strategies, tools, and materials will help ensure you can “break ground” without incident and successfully move to the phase where you begin building your vision.

To Prepare:

  • Consider your goals for academic accomplishments while a student of the MSN program.
  • Reflect on the strategies presented in the Resources for this module.

The Assignment:

In this Assignment, you will continue developing your Academic Success and Professional Development Plan by appending the original document you began in the previous Assignment to develop the second component—academic resources and strategies. To accomplish this:

  • Identify and describe at least three academic resources or strategies that can be applied to the MSN program
  • Identify and describe at least three professional resources that can be applied to success in the nursing practice in general or your specialty in particular
  • Explain how you intend to use these resources, and how they might benefit you academically and professionally.

Intervention and Assessment Models

Week 2: Question for Discussion

Chapter 3 – The Intervention and Assessment Models
Chapter 4 – Tools of the Trade

Question(s): Case of Elizabeth.

Maria is a 48-year-old white female who is recently divorced. She is not doing well in her love life and comes to you to get some immediate help because she is depressed and thinking about suicide. She spends the first ten minutes weeping uncontrollably and has a hard time putting words together.  Of the nine intentional strategies depicted in your book, which ones are the most important ones in this situation (mention 3 in the order of priorities) and why (explain and justify your answer)?

Guidelines:The answer should be based on the knowledge obtained from reading the book, no just your opinion. If there are 2 questions in the discussion, you must answer both of them. Your grade will be an average of both questions (50% each question). First question: Mention the adequate strategy for this case scenario (50%). Second part of this question:  explain / justify your answer (50%).

Practicum Professional Development

Discussion: Practicum Professional Development

Objectives: Progress Appraisal

In Week 1, you developed your practicum professional development objectives. How have your experiences thus far in the practicum contributed to your growth as nurse leader-manager or nurse informaticist? What difficulties, if any, have you experienced, and how might this affect the achievement of your objectives?

In this Discussion, you assess your progress toward fulfilling your practicum professional development objectives and consider how you could enhance or alter your activities to achieve your aims.

To prepare:

Reflect on the practicum professional development objectives you developed and outlined in your Practicum Professional Experience Plan in Week 1.

Keeping in mind the practicum activities you have engaged in thus far, consider the following questions:

How have these activities helped to promote your professional development?

Are you satisfied with your progress toward meeting your objectives? If not, what will you do to ensure you achieve them before the end of your Practicum Experience? As a reminder, you must complete all of your practicum hours on or before Day 5 of Week 11.

What challenges or unexpected opportunities have arisen at your practicum site? How has this affected your professional development?

Think about the experiences you may have in the forthcoming weeks. Do you foresee any particular challenges on the horizon? If so, what is your plan for addressing those challenges?

Think about the time you have spent with your Preceptor. How has this time enhanced or changed your understanding of the role and functions of the nurse leader-manager or nurse informaticist?

Post an assessment of your progress toward achieving your practicum professional development objectives, including how your involvement in specific practicum activities has contributed to your development. Explain what you will do to ensure you achieve your objectives by the end of your practicum. Summarize challenges or unexpected opportunities that have arisen, as well as any challenges that you anticipate may arise. Explain how you will address those challenges. Finally, summarize what you have learned about the role and functions related to your specialization through time spent with your Preceptor.

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:

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

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

Validate an idea with your own experience and additional research.

Required Readings

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.

Cipriano, P. F., & Murphy, J. (2011). The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 286–289.

Note: Retrieved from the Walden Library databases.

 

“Technology tools will continue to revolutionize how we plan, deliver, document, review, evaluate, and derive the evidence about care” (p. 289). This article examines how nurses can use information technology to transform nursing and redesign the health care system. It focuses on the use of technology to promote quality and notes that technology can also be used to address challenges in education, research, leadership, and policy.

McKimm, J., & Swanwick, T. (2009). Setting learning objectives. British Journal of Hospital Medicine, 70(7), 406–409.

Note: Retrieved from the Walden Library databases.

 

This article clarifies the terminology associated with learning objectives and explains how learning objectives relate to professional development and the transformation from novice to expert. It also introduces common pitfalls when setting learning objectives and provides suggestions for avoiding them.

Murphy, J. (2011). The nursing informatics workforce: Who are they and what do they do? Nursing Economic$, 29(3), 150–153.

Note: Retrieved from the Walden Library databases.

 

The author examines the nursing informatics workforce, explaining that professionals in this well-established specialty area can play an integral role in transforming health care.

Sørensen, E. E., Delmar, C., & Pedersen, B. D. (2011). Leading nurses in dire straits: Head nurses’ navigation between nursing and leadership roles. Journal of Nursing Management, 19(4), 421–430.

Note: Retrieved from the Walden Library databases.

 

“Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity” (p. 421). In this article, the authors examine how individuals in key professional roles negotiate between and apply nursing and leadership skills.

Warm, D., & Thomas, B. (2011). A review of the effectiveness of the clinical informaticist role. Nursing Standard, 25(44), 35–38.

Note: Retrieved from the Walden Library databases.

 

The authors investigate the application of specialized knowledge and expertise to facilitate the appropriate use of emerging technologies in clinical settings. They argue for informaticists’ involvement in strategic development and delivery of information management and technology initiatives to promote patient-centered outcomes.

Wilkinson, J. E., Nutley, S. M., & Davies, H. T. O. (2011). An exploration of the roles of nurse managers in evidence-based practice implementation. Worldviews on Evidence-Based Nursing, 8(4), 236–246.

Note: Retrieved from the Walden Library databases.

 

In this article, the authors examine the role nurse managers should play in leading and facilitating evidence-based practice.

Armstrong, P. (2013). Bloom’s taxonomy. Retrieved from http://cft.vanderbilt.edu/teaching-guides/pedagogical/blooms-taxonomy/

 

Vanderbilt University provides this overview of Bloom’s taxonomy. This site also presents the original and updated versions of the taxonomy along with verb suggestions for each level.

Clark, D. (2013). Bloom’s taxonomy of learning domains. Retrieved from http://www.nwlink.com/~donclark/hrd/bloom.html

 

This article addresses three domains of learning: cognitive, affective, and psychomotor.

University of Central Florida, Office of Experiential Learning (n.d.). Writing SMART learning objectives, Retrieved from http://explearning.ucf.edu/registered-students/tips-for-success/writing-smart-learning-objectives/195

 

This blog post focuses on the distinction between learning outcomes and objectives. Consider this information as you develop your practicum professional development objectives this week.

The University of North Carolina at Charlotte, Center for Teaching & Learning. (2013). Writing objectives using Bloom’s taxonomy. Retrieved from http://teaching.uncc.edu/articles-books/best-practice-articles/goals-objectives/writing-objectives-using-blooms-taxonomy

 

This resource outlines elements of Bloom’s Taxonomy.

Document: Practicum Professional Experience Plan (Word Document)

 

Use this form to develop your Practicum Professional Experience Plan as outlined this week.

Document: Practicum Professional Experience Plan (Word Document)

 

Use this form to develop your Practicum Professional Experience Plan as outlined this week.

Document: Practicum Journal (Word Document)

 

During your Practicum Experience, you are  required to submit your time log and three journal entries. You will use this  form to complete your journal reflections.

Document: School of Nursing Practicum Manual: Master of Science in Nursing (MSN): Quarter-Based Programs (PDF)

 

This comprehensive manual outlines all of the requirements for the Practicum Experience.

Clinical Resources

Document: Introduction to Clinical Experiences (PowerPoint)

Document: Practicum Manual (PDF)

*deficient care

In continuing from last week’s discussion about reluctance to complain about care, discuss your thoughts on the following (pick three to discuss):

*deficient care

*inadequate staffing to meet your needs

*what would be considered a “timely response”

*”unsafe conditions”

*loss of your personal items or valuables while hospitalized

*a fatal mistake in your family member’s care

*your perception of how sick you are versus your doctor’s perception of how sick you are

*an incorrect blood transfusion administered to you

How would you know these things occurred and what would you be concerned about?

diagnosis and staging of cancer.

Write a paper (1,250-1,750 words) describing the approach to care of cancer. In addition, include the following in your paper:

  1. Describe the diagnosis and staging of cancer.
  2. Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
  3. 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 grading rubric. Instructors will be using the
rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.  response to 6 posts

Patient Protection and Affordable Care Act (PPACA

This is a discussion post, about 250 WORDS, tittle page not require In- text citation is required original work please, scholarly references are required for this assignment, website source strongly preferred.

QUESTION 2: The Patient Protection and Affordable Care Act (PPACA) of 2010

The Patient Protection and Affordable Care Act (PPACA) of 2010 (section titled “Subtitle D”) identifies requirements relating to provider compliance with fraud, waste, and abuse laws. Identify three measures that your health care organization ((or health care organizations in general) has initiated, or could initiate, to comply with these measures. Support your analysis with a minimum of two peer-reviewed articles. Support your response with a minimum of three peer-reviewed references.

quantitative and qualitative peer-reviewed research

The first step of the EBP process is to develop a question from the nursing practice problem of interest.

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

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

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

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

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

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

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

Use a library database such as CINAHL Complete for your search.
Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.
To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

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