Tag Archive for: nursing

Discussion Forum Sample

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Select two of the following discussion questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

  1. As with all disorders, it is essential to determine the root cause of endocrine disorders. What are primary, secondary, and tertiary disorders? Compare the differences among primary, secondary, and tertiary forms of hyposecretion and hypersecretion.
  2. The hypothalamic-pituitary system is the main controlling factor for normal endocrine function. What are some of the common ways for this finely balanced system to become unstable?
  3. Explain how the circadian rhythm is related to cortisol secretion from the adrenal cortex. What factors cause disturbances in this system?

at least 250 words. with reference no older than 5 years and intext citation

 Discussion Question Guidelines 

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For this discussion, you will need to address all of the questions below and be sure to participate fully by responding to your classmates as well. Citations should be used to support your analysis and references should be included in APA format. Be sure to review the Discussion Question Guidelines before you begin!

Now that you have been introduced to some advanced features in Microsoft Word, you will teach the class an advanced skill in it. In this discussion, select at least one advanced feature of Microsoft Word and, using your own words (no copying and pasting) and examples, teach your classmates this skill. Check the discussions to choose something no one else has shared yet!

  1. Summarize what this is used to accomplish and explain the steps to accomplish it. Share where you found this in the online reading or in one of the tutorials so others can review it and be specific about where you learned this. Attach a Word document demonstrating the example you explained. Name the document you share W2DQ_YourLastName. Format your document professionally using the skills you are learning.
  2. Share any challenges you had while demonstrating these techniques and/or any tips for others. Were there any tools/functions in Microsoft Word that you weren’t able to figure out or want to know more about? Share them and perhaps someone else can help.

In your discussions with your classmates:

  • See if you can follow their directions or offer any help to problems they had and upload your examples and experiences along with any tips or challenges you experienced. Attach a document with your attempt at following their directions.
  • You can also offer any help with challenges your classmates have shared.

colorectal cancer,

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What you need to do 

In preparation for your meeting with John, you are to develop a discharge and self- management plan for discussion with him. Your plan should consider:

  • The recommended follow up regimen after curative treatment for colorectal cancer, having critically reviewed the available evidence.
  • Signs and symptoms associated with colorectal cancer recurrence.
  • Strategies to prevent survivorship issues that John may experience across all domains of health (including physical, psychological, social and spiritual health) after treatment for colorectal cancer and.

health assessment

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Conduct a health assessment of a population of your choice. Explain the process and summarize the results.

Effective communication is one of the most critical skills a health care  provider can master. Nurses communicate to a variety of individuals  with a range of educational levels who come from diverse settings.

Conduct a health assessment of a population of your choice as you complete the following:

  1. Describe the key elements that make up a health assessment at each of the following levels:
    1. Community.
    2. Group.
    3. Individual.
  2. Explain the process for completing a comprehensive health assessment.
  3. Summarize the findings of the health assessment you conducted. Be  sure you include a brief description of the population you selected.

Additional Requirements

  • Format: Include a title page and reference. Use APA style and formatting.
  • Length: This assessment should be approximately 3–5 pages in length.
  • References: Cite at least three current scholarly or professional resources.
  • Font: Use double-spaced, 12-point, Times New Roman font.

Applying Measurement Tools

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Discussion: Applying Measurement Tools

One example of a measurement tool is the Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures. Review the components of HEDIS comprehensive diabetes care; then consider the following scenario.

You are a staff nurse working in a private primary care practice. It is a small practice with 2 MDs (internists), 2 nurses, 1 medical assistant, and an office staff for billing. There are approximately 1,000 patients in the practice. You have had no EHR until the last year, but all charts are manual, historically. Your physicians are starting to inquire about quality incentives, particularly regarding patients with diabetes.

By Day 3

Take on the role of the staff nurse in the scenario, and post an explanation of how you would go about finding out how many diabetics are in your practice and how many meet all components of HEDIS comprehensive diabetes care.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist).

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). (Refer to AWE Checklist, Capstone)

primary health concern

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Prepare a 4–5-page review of recent research that examines statistics on the primary health concern of a population, describes the methods and tools used in the research studies, explains the factors that affect health promotion and disease prevention for a population, and recommends a health care initiative.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence.

The ability to locate, evaluate, and apply research is an important skill for nurses to develop in order to provide evidence-based care for individuals, families, communities, and health care systems.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Explain the principles and concepts of disease prevention and health promotion for diverse and vulnerable populations.

Compare the statistics for a health concern of a vulnerable or diverse population to the statistics for the general population, including ethical, legal, economic, and cultural factors.

Explain the principles and concepts that influence health promotion and disease prevention for the identified vulnerable or diverse population.

Recommend an evidence-based health care initiative for a specific health care concern of a vulnerable or diverse population.

Competency 3: Apply basic epidemiological concepts, data analysis methods, tools, and databases to determine the effectiveness of health promotion and disease prevention initiatives for diverse and vulnerable populations.

Describe the epidemiological concepts, data analysis methods, tools, and databases used in research studies related to health concerns for a vulnerable or diverse population.

Describe health care initiatives used by organizations to address the health care concerns of vulnerable or diverse populations.

Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the health care professions.

Write content clearly and logically, with correct use of grammar, punctuation, APA formatting, and mechanics.

Your team has presented its preliminary findings to the executive leadership in your organization, but leadership has some doubts about some of the information they received. Each member of the team has been charged with doing a critical examination of recent research around each member’s area of expertise. As the team’s nursing representative, you need to look specifically at the health care concerns identified in the Windshield Survey assessment.

The first step in preparing to write a review of the research is to define your topic. For this assessment, your review will provide a comprehensive overview of the needs of the population you identified in the Windshield Survey assessment in terms of health promotion and disease prevention, the factors that contribute to health disparities for the population, and the need for the organization to improve health care delivery to the population.

In the internet,  search for current scholarly or peer-reviewed professional research articles that:

Examine the health care risks and needs of your population.

Analyze the need to improve health care delivery to the population.

Evaluate, critically, the factors that affect health promotion and disease prevention for the population.

Examine strategies to reduce health disparities for your population.

Locate at least 5–7 resources so that you can eliminate 2–3 if necessary. You may discover, for example, as you read each article more in-depth, that they may not all have the focus you need for your review.

Requirements

For this assessment, you need to develop several points around which to apply the research from the articles you located. Specifically, you need to:

Compare statistics for the primary health concern of your population to the rest of the general population in the United States. This would include frequency of occurrence, age groups most at risk, frequency of fatality, and so on.

Describe the epidemiological concepts, data analysis methods, tools, and databases used in the research studies you located. Address any flaws or biases you believe are present.

Explain the factors that affect health promotion and disease prevention for the population. (Hint: These may be things such as language barriers, cultural values, generational differences, social fear, and access to services.)

Describe the types of health care initiatives that have been tried by other organizations specifically for the primary health care concern or the population.

Recommend one health care initiative for your population, based on your research,

These should be the ideas, or points, that your review is based on. For each point, present all of the evidence you located. For this assessment, that should be at least four current research articles, although not all of the articles will typically offer evidence on all of your points.

Be sure your assessment includes:

An introduction that presents the points you will cover.

The body that presents the research on the points.

A conclusion that restates the points in your introduction.

Your assessment should be 4–5 pages in length, not including the title page and reference page. Be sure you follow APA guidelines for style and format.

Additional Requirements

Include a title page and reference page. The completed assessment should be 4–5 pages in length, not including the title page and reference page.

Reference at least four current scholarly or professional resources.

Use current APA format.

Use Times New Roman font, 12 point.

Double-space.

leadership traits

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Imagine that you manage a department in a health care organization of your choosing. The organization recently merged with another, layoffs occurred, and departments are now being consolidated. Your department now has employees whose ages span four generations, three different cultural groups are represented, and conflict is brewing between them. The conflict is affecting performance, shift scheduling, and cooperation with other departments.

Write a 700- to 1,050-word directive to address these conflicts. Do the following in your directive:

  • Assess the situation that your department is facing.
  • Create clear and reasonable expectations and goals to achieve cohesion, cooperation, and communication in your department.
  • Lay out a strategy to overcome these conflicts and improve workplace performance.
  • Explain how success will be measured based on your strategy and goals.
  • Consider using tables, matrices, or other visuals.
  • Evaluate what leadership traits you need to incorporate in order to lead your diverse department.

Nursing Diagnosi

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  1. hort term goals can usually be achieved by the end of your shift. Long term goals are usually achieved by discharge. Write one short term and one long term goal for the following nursing diagnosis.
  2. Nursing Diagnosis:  Impaired physical mobility related to ventilation-perfusion mismatch as evidenced by shortness of breath on ambulation and inability to ambulate more than 10 feet independently.
  3. Registered nurses perform interventions based on the following actions: (MEATA)
    • Monitor
    • Evaluate
    • Assess
    • Teach
    • Administer

Provide 2 RN interventions for each goal that you developed in #1. Provide rationale for each intervention being performed by an RN.

Short term goals can usually be achieved by the end of your shift. Long term goals are usually achieved by discharge. Write one short term and one long term goal for the following nursing diagnosis.
Nursing Diagnosis:  Impaired physical mobility related to ventilation-perfusion mismatch as evidenced by shortness of breath on ambulation and inability to ambulate more than 10 feet independently.
Registered nurses perform interventions based on the following actions: (MEATA)
Monitor
Evaluate
Assess
Teach
Administer
Provide 2 RN interventions for each goal that you developed in #1. Provide rationale for each intervention being performed by an RN.

AFRICAN AMERICAN CASE STUDY

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AFRICAN AMERICAN CASE STUDY #2

Mr. and Mrs. Evans are an African American couple who retired from the school system last year. Both are 65 years of age and reside on 20 acres of land in a large rural community approximately 5 miles from a Superfund site and 20 miles from two chemical plants. Their household consists of their two daughters, Anna, aged 40 years, and Dorothy, aged 42 years; their grandchildren, aged 25, 20, 19, and 18; and their 2- year-old great-grandson. Anna and Dorothy and their children all attended the university. Mr. Evans’s mother and three of his nieces and nephews live next door. Mr. Evans’s mother has brothers, sisters, other sons and daughters, grandchildren, and great-grandchildren who live across the road on 10 acres of land. Other immediate and extended family live on the 80 acres adjacent to Mr. Evans’s mother. All members of the Evans family own the land on which they live. Mrs. Evans has siblings and extended family living on 70 acres of land adjacent to Mr. Evans’s family, who live across the road. Mr. and Mrs. Evans also have family living in Chicago, Detroit, New York, San Francisco, and Houston. Once a year, the families come together for a reunion. Every other month, local family members come together for a social hour. The family believes in strict discipline with lots of love. It is common to see adult members of the family discipline the younger children, regardless of who the parents are. Mr. Evans has hypertension and diabetes. Mrs. Evans has hypertension. Both are on medication. Their daughter Dorothy is bipolar and is on medication. Within the last 5 years, Mr. Evans has had several relatives diagnosed with lung cancer and colon cancer. One of his maternal uncles died last year from lung cancer. Mrs. Evans has indicated on her driver’s license that she is an organ donor. Sources of income for Mr. and Mrs. Evans are their pensions from the school system and Social Security. Dorothy receives SSI because she is unable to work any longer. Mr. Evans and his brothers must assume responsibility for their mother’s medical bills and medication. Although she has Medicare parts A and B, many of her expenses are not covered. Mr. and Mrs. Evans, all members of their household, and all other extended family in the community attend a large Baptist church in the city. Several family members, including Mr. and Mrs. Evans, sing in the choir, are members of the usher board, teach Bible classes, and do community ministry.

Study Questions

1. Describe the organizational structure of this family and identify strengths and limitations of this family structure.

2. Describe and give examples of what you believe to be the family’s values about education.

3. Discuss this family’s views about child rearing.

4. Discuss the role that spirituality plays in this family.

5. Identify two religious or spiritual practices in which members of the Evans family may engage for treating hypertension, diabetes, and mental illness.

6. Identify and discuss cultural views that Dorothy and her parents may have about mental illness and medication.

7. To what extent are members of the Evans family at risk for illnesses associated with environmental hazards?

8. Susan has decided to become an organ donor. Describe how you think the Evans family will respond to her decision.

9. Discuss views that African Americans have about advanced directives.

10. Name two dietary health risks for African Americans.

11. Identify five characteristics to consider when assessing the skin of African Americans.

12. Describe two taboo views that African Americans may have about pregnancy.

APPALACHIAN CASE STUDY #1

William Kapp, aged 55 years, and his wife, Gloria, aged 37, have recently moved from an isolated rural area of northern Appalachia to Denver, Colorado, because of Gloria’s failing health. Mrs. Kapp has had pulmonary tuberculosis for several years. They decided to move to New Mexico because they heard that the climate was better for Mrs. Kapp’s pulmonary condition. For an unknown reason, they stayed in Denver, where William obtained employment making machine parts. The Kapp’s oldest daughter, Ruth, aged 20, Ruth’s husband, Roy, aged 24, and their daughter, Rebecca, aged 17 months, moved with them so Ruth could help care for her ailing mother. After 2 months, Roy returned to northern Appalachia because he was unable to find work in Denver. Ruth is 3 months’ pregnant. Because Mrs. Kapp has been feeling “more poorly” in the last few days, she has come to the clinic and is accompanied by her husband, William, her daughter Ruth, and her granddaughter, Rebecca. On admission, Gloria is expectorating greenish sputum, which her husband estimates to be about a teacupful each day. Gloria is 5 ft 5 in. tall and weighs 92 pounds. Her temperature is 101.4°F, her pulse is regular at 96 beats per minute, and her respirations are 30 per minute and labored. Her skin is dry and scaly with poor turgor. While the physician is examining Mrs. Kapp, the nurse is taking additional historical and demographic data from Mr. Kapp and Ruth. The nurse finds that Ruth has had no prenatal care and that her first child, Rebecca, was delivered at home with the assistance of a neighbor. Rebecca is pale and suffers from frequent bouts of diarrhea and colicky symptoms. Mr. Kapp declines to offer information regarding his health status and states that he takes care of himself. This is the first time Mrs. Kapp has seen a health-care provider since their relocation. Mr. Kapp has been treating his wife with a blood tonic he makes from soaking nails in water; a poultice he makes from turpentine and lard, which he applies to her chest each morning; and a cough medicine he makes from rock candy, whiskey, and honey, which he has her take a tablespoon of four times a day. He feels this has been more beneficial than the prescription medication given to them before they relocated. The child, Rebecca, has been taking a cup of ginseng tea for her colicky symptoms each night and a cup of red bark tea each morning for her diarrhea. Ruth’s only complaint is the “sick headache” she gets three to four times a week. She takes ginseng tea and Epsom salts for the headache. Mrs. Kapp is discharged with prescriptions for isoniazid, rifampin, and an antibiotic and with instructions to return in 1 week for follow-up based on the results of blood tests, chest radiograph, and sputum cultures. She is also told to return to the clinic or emergency department if her symptoms worsen before then. The nurse gives Ruth directions for making appointments with the prenatal clinic for herself and the pediatric well-child clinic for Rebecca.

Study Questions

1. Describe the migration patterns of Appalachians over the last 50 years.

2. Discuss issues related to autonomy in the workforce for Appalachians.

3. Identify high-risk behaviors common in the Appalachian region.

4. Describe barriers to health care for people living in Appalachia.

5. What might the nurse or physician do to encourage Mrs. Kapp to comply with her prescription regimen?

6. What would your advice be regarding each of the home remedies that Mrs. Kapp is taking? Would you encourage or discourage her from continuing them?

AFRICAN AMERICAN CASE STUDY

8. What advice would you give Ruth regarding the home remedies that she and her daughter are currently taking? Would you encourage or discourage their use?

9. Do you think Mrs. Kapp will return for her appointment next week? Why? What would you do if she did not return for her appointment?

10. Do you think that Ruth will make and keep appointments for herself and her daughter?

11. What would you do to encourage Mr. Kapp to consent to a health assessment?

12. What additional services could you suggest to assist the Kapp family at this time?

13. What additional follow-up do you consider essential for the Kapp family?

14. What advice would you give Ruth regarding her daughter’s frequent bouts of diarrhea?

importance of nursing-sensitive quality indicators.

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Prepare an 4-5 page paper on the importance of nursing-sensitive quality indicators.

As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality healthcare delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.

The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.

NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.

The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove, Gray, Jay, Jay, & Burns, 2015).

Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.

The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.

Reference

Grove, S. K., Gray, J. R., Jay, G.W., Jay, H. M., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice (6th ed.). St. Louis, MO: Elsevier.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
    • Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.
  • Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
    • Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
  • Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.
    • Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.
  • Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
    • Deliver a professional and effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
    • Follow APA style and formatting guidelines for citations and references.

Preparation

This assessment requires you to prepare a 4-5 page paper on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

  • Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system.
  • Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.
  • Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:
    • What is your experience with collecting data and entering it into a database?
    • What challenges have you experienced?
    • How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?
    • What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process

Instructions

For this assessment, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

You determine that you will cover the following topics in your audio tutorial script:

Introduction: Nursing-Sensitive Quality Indicator
  • What is the NDNQI®?
  • What are nursing-sensitive quality indicators?
  • Which particular quality indicator did you select to address in your tutorial?
  • Why is this quality indicator important to monitor?
    • Be sure to address the impact of this indicator on quality of care and patient safety.
  • Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
Collection and Distribution of Quality Indicator Data
  • According to your interview and other resources, how does your organization collect data on this quality indicator?
  • How does the organization disseminate aggregate data?
  • What role do nurses play in supporting accurate reporting and high-quality results?
    • As an example, consider the importance of accurately entering data regarding nursing interventions.
Additional Requirements
  • References: Cite a minimum of three scholarly and/or authoritative sources.
  • APA: Submit along with the recording a separate Reference page that follows APA style and formatting guidelines. For an APA refresher, consult the APA Style and Formatpage on Campus.