Posts

 Female Genitalia;male Genitalia.

Female Genitalia;male Genitalia.
   Midsagittal view of the female pelvic organs.

Summarize the ovulation cycle and identify the functions of the hormones produced.

An older woman who has stopped regular menstruation asks whether she can still become pregnant. What is the best response you can give this patient?

What is the name of the tissue that separates the anterior wall of the vagina from the bladder and urethra?

Name the four bones that form the pelvis

why it is important to teach mothers correct perineal care for their newborn infant daughters.

What possibility must you consider if in a child you observe vaginal swelling of the vulvar tissues accompanied by bruising or foul-smelling discharge?

Describe premenstrual syndrome (PMS).

Identify and explain positions other than the lithotomy in which a pelvic examination can be performed.

You are about to conduct a pelvic examination on an adolescent girl. What should you take time to do before carrying out the examination?

A 12-year-old girl is experiencing a vaginal mucus discharge. What can you tell this girl to decrease her anxiety?

A new mother is frightened by the appearance of blood-tinged mucus at her newborn daughter’s vaginal entrance. What response can alleviate this woman’s anxiety?

MC is a 28-year-old patient who presents to the urgent care for complaints of abdominal pain and cramping. Today she has noticed a yellow vaginal discharge. Her past medical history is noncontributory. She admits to having multiple sexual partners with unprotected intercourse

1-What additional questions regarding her vaginal discharge could you ask at this point?

2- Describe the stages of salpingitis.

3- What physical assessment findings on the vaginal examination and bimanual would you expect to see if the patient has salpingitis?

  Male pelvic organs
A 60-year-old man asks you whether it is still possible for him to become a father. How would you respond to this patient? What effect does aging have on male fertility?

Which part of the male genitalia is a soft, comma-shaped structure located on the posterolateral and upper aspect of the testis in 90% of males and provides for storage, maturation, and transit of sperm?

Differentiate between the external genitalia for a male and female fetus at both 8 weeks and 12 weeks of gestation.

Summarize the pros and cons of newborn circumcision.

The mother of a newborn you are examining voices concern that one of her son’s testicles has not yet “appeared.” What can you tell this mother to reassure her? What is the expected time for final descent of the testes into the scrotal sac?

Discuss how do you could effectively work with a child to evaluate the testicles.

You are performing a genital examination on a 12-year-old boy who seems noticeably embarrassed and nervous. What communication measures can be included to decrease anxiety and facilitate the examination?

A patient has an erection while you are performing a genital examination. What is the best response to decrease anxiety and embarrassment?

Describe the cremasteric reflex.

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PICOT Question Paper

PICOT Question Paper

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

  1. Evidence-based solution
  2. Nursing intervention
  3. Patient care
  4. Health care agency
  5. Nursing practice

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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

RUBRIC

Attempt Start Date: 24-Feb-2020 at 12:00:00 AM

Due Date: 01-Mar-2020 at 11:59:59 PM

Maximum Points: 60.0

health care policy

During NP clinical practicum experiences, we identify, as nurses, many health care issues that need to be addressed at the local, state, or national level. Addressing the need for change in health care policy is now an intricate part of your role as a social change agent.

 

For this Discussion, you will identify a change needed in your community (state of Mississippi) and what your nursing legacy for positive social change will be.

 

To prepare:

 

  • Consider the health care issues and deficits you have recognized in your professional practice.
  • Identify a change needed in your community (state of Mississippi) in health care policy and discuss how you could impart change during your career as an NP.
  • Consider your future as a NP and what your nursing legacy will be. How will you impart Social Change?

To complete:

 

Post 1-2 pages on:

 

A change needed in your community (state of Mississippi) and an explanation for how you will begin to implement that change.

 

Then, share with your colleagues a brief explanation of what your nursing legacy will be and how will you impart Social Change.

 

References

 

Buppert, C. (2015). Buppert, C. (2015). Lawmaking and Health Policy. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.). (423-436). Burlington, MA: Jones & Bartlett.

 

Christensen, C. M., Bohmer, R. M. J., & Kenagy, J. (2000). Will disruptive innovations cure health care? Harvard Business Review, 78(5), 102-112, 199.

 

National Conference of State Legislatures. (n.d.). Glossary of Legislative Terms. Retrieved from http://www.ncsl.org/research/about-state-legislatures/glossary-of-legislative-terms.aspx

 

You may use other scholarly resources and websites as you see fit.  

diagnostic tests

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

Photo Credit: Getty Images/Hero Images

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To Prepare

  • Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
  • By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
  • Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
  • Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
  • If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
    • Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
    • Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

Assignment (3–4 pages, not including title and reference pages):

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:

  • A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
    • What is its purpose?
    • How is it conducted?
    • What information does it gather?
  • Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

Assignment Option 2: Child Health Case:
Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

5 REFERENCES NOT MORE THAN 5 YEARS

ZERO PLAGIARISM

PLEASE PAY ATTENTION TO THE CASE STUDY

contrast changes in the eye

Compare and contrast changes in the eye associated with cataracts, diabetes mellitus, glaucoma, and chronic hypertension and discuss the effects of ear changes caused by the aging process.

Each posting requires one reference from an English titled, peer-reviewed nursing journal less than five years old. The article for the initial posting must be different than the article for the response to peer posting. The initial posting also requires a reference from the course textbook.
Students must justify the need and obtain approval from the professor prior to submitting any discussion postings or written assignments that use non-nursing journals or textbooks, or use references more than five-

Identifying a Researchable Problem

Project: Course Project: Part 1—Identifying a Researchable Problem

 

One of the most challenging aspects of EBP is to actually identify the answerable question.
—Karen Sue Davies

 

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

 

In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

 

To prepare:

 

  • Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.
  • Review the section beginning on page 75 of the course text, titled, “Developing and Refining Research Problems” in the course text,( Marquis & Huston) which focuses on analyzing the feasibility of a research problem.
  • Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem. (Refer to the PICOT question you earlier formulated for me on handwashing)
  • Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.
  • Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question? (once again refer to the PICO question you earlier formulated for me on: Does hand washing and appropriate staff dressing among the surgical ward nurses reduce cross infection during patient management)

 

Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

 

  • Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

    To complete:

    Write a  4-page paper that includes the following:

 

  • (1) A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
  • (2) The 5 questions you have generated and a description of how you analyzed them for feasibility
  • (3) Your preliminary PICOT question and a description of each PICOT variable relevant to your question
  • (4) At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections

     

    Reference:
    Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

     

    Readings

    • Polit, D. F., & Beck, C. T. (2012).  Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
      • Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice” (Review pages 27–34)
      • Chapter 5, “Literature Reviews: Finding and Critiquing Evidence”

        In this chapter, you focus on conducting a literature review. Topics include how to identify the relevant literature on a given topic and then how to critique the strengths and weaknesses of the literature that you have found. Finally, the chapter examines how to synthesize the research findings into a written literature review.

    • Houde, S. C. (2009). The systematic review of literature: A tool for evidence-based policy. Journal of Gerontological Nursing, 35(9), 9–12.
      Retrieved from the Walden Library databases.

      This article emphasizes the importance of systematic reviews of literature. The authors present an overview of resources that may assist in conducting systematic reviews.

    • Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. K. (2009). Evidence-based practice challenge: Teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journal of Nursing Education, 48(4), 186–195.
      Retrieved from the Walden Library databases.

      This article reviews the features of the TREAD Evidence-Based Practice Model. In particular, the authors of this article stress how the model emphasizes the use of standardized critical appraisal tools and Level I evidence.

    • Robeson, P., Dobbins, M., DeCorby, K., & Tirilis, D. (2010). Facilitating access to pre-processed research evidence in public health. BMC Public Health, 10, 95.
      Retrieved from the Walden Library databases.

      This article describes a hierarchy of pre-processed evidence and how it is adapted to the public health setting. The authors identify a range of resources with relevant public health content.

    • Barker, J. (n.d.) Basic search tips and advanced Boolean explained. Retrieved August 3, 2012, from
      http://www.lib.berkeley.edu/TeachingLib/Guides/Internet/Boolean.pdf

      This resource provides a graphical representation of different approaches to research and gives examples of each.

    • Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

      This article reviews the frameworks commonly used to assist in generating answerable research questions. The author recommends considering the individual elements of the frameworks as interchangeable (depending upon the situation), rather than trying to fit a situation to a specific framework.

    • Walden University Library. (2012). Levels of evidence. Retrieved from http://libraryguides.waldenu.edu/evidencepyramid

      This guide provides a listing of evidence-based clinical resources, including systematic reviews and meta-analyses, critically appraised topics, background information and expert opinions, and unfiltered resources.

    • Indiana State University. (n.d.). Database search strategies. Retrieved July 6, 2012, from
      http://libguides.indstate.edu/content.php?pid=118904&sid=1065428

      In this resource, the most common types of database searches are highlighted. It includes topics such as nesting searches, phrase searches, and using synonyms of key words in the search.

    • Library of Congress Online Catalog. (2008). Boolean searching. Retrieved from
      http://catalog.loc.gov/help/boolean.htm

      This web page provides a basic overview of Boolean searches and provides simple examples of key search terms.

    • Walden University. (n.d.b.). Searching and retrieving materials in the research databases. Retrieved August 10, 2012, from http://libraryguides.waldenu.edu/content.php?pid=162865&sid=1375878

      This resource provides tips for searching in the Walden Library. It includes a guide to keyword searches, an explanation of Boolean searches, and tips on locating specific journals or articles.

    • Document: Course Project Overview (Word document)

    Media

    • Laureate Education, Inc. (Executive Producer). (2012e). Finding resources for EBP. Baltimore, MD: Author.

      Note: The approximate length of this media piece is 6 minutes.

      In this video, Dr. Marianne Chulay identifies sources where nurses can find evidence to support their practices. She provides several examples of resources that provide specific information about best practices in health care.

    • Laureate Education, Inc. (Executive Producer). (2012f). Finding sources of evidence. Baltimore, MD: Author.

      Note: The approximate length of this media piece is 9 minutes.

      Dr. Kristen Mauk explains the process of performing a literature review in this video. She provides advice for nursing students in browsing databases and analyzing sources of evidence.

    • Laureate Education, Inc. (Executive Producer). (2012g). Hierarchy of evidence pyramid. Baltimore, MD: Author.

      This multimedia piece explains the hierarchy of evidence pyramid. The piece offers definitions and key information for each level of the pyramid.

     

     

Client Termination Summary

Assignment 1: Practicum – Client Termination Summary

Learning Objectives

Students will:

· Develop client termination summaries

To prepare:

· For guidance on writing a Client Termination Summary, review pages 693–712 of the Wheeler text in this week’s Learning Resources.

· Identify a client who may be ready to complete therapy.

The Assignment

With the client you selected in mind, address the following in a client termination summary (without violating HIPAA regulations):

· Identifying information of client (i.e., hypothetical name, age, etc.)

· Date initially contacted therapist, date therapy began, duration of therapy, and date therapy will end

· Total number of sessions, including number of missed sessions

· Termination planned or unplanned

· Presenting problem

· Major psychosocial issues

· Types of services rendered (i.e., individual, couple/family therapy, group therapy, etc.)

· Overview of treatment process

· Goal status (goals met, partially met, unmet)

· Treatment limitations (if any)

· Remaining difficulties and/or concerns

· Recommendations

· Follow-up plan (if indicated)

· Instructions for future contact

· Signatures

Foundational Pioneers in Informatics

Discussion: Foundational Pioneers in Informatics

The smartphone has become an increasingly valuable tool in the field of medicine. Because of the phone’s small size and powerful computing capabilities, doctors, nurses, and researchers use these smartphones in a wide range of areas. For example, smartphones can be used as an electrocardiogram, to perform ultrasound procedures, to track patient progress, and as a decision support tool for generating diagnoses (Ozdalga, Ozdalga & Ahuja, 2012). Like most innovative technologies, the smartphone and its applications are a result of many years of incremental research and development.

In this Discussion, you focus on those who set the stage for the field of informatics today. By Day 1, your Instructor will assign you one of the pioneers in the field of informatics to research.

To prepare:

  • Read the articles listed in the Learning Resources for your assigned informatics pioneer.
  • Conduct research in the Walden Library or on the Internet to find additional works by or information about the individual.
  • Determine his or her area of interest and affiliations in the medical world.
  • Reflect on the contributions he or she made to the field of informatics. What most interests you? What most surprises you?
  • Consider how these contributions impact the field of informatics today.
  • Assess why it is important to be familiar with the foundational documents of nursing informatics.

By tomorrow 11/30/2016 12pm

Post a minimum of 550 words essay in APA format with a minimum of 3 scholarly references (See list provided below), which addresses the level one headings below:

1)      An overview of the individual to whom you were assigned, including his or her principal areas of interest and medical affiliations.

2)      Highlight the contributions this individual made to the field of informatics, and explain how these contributions impact the field of informatics today.

3)      Comment on the importance of being familiar with the foundational documents of nursing informatics.

 

 

 

Required Readings

 

Kaplan, B., Brennan, P., Dowling, A., Friedman, C., & Peel, V. (2001). Towards an informatics research agenda: Key people and organizational issues. Journal of the American Medical Informatics Association, 8(3), 235–241.

Retrieved from the Walden Library databases.

This article highlights key areas in the field of health informatics in which additional research needs to be conducted. The authors cite organizational and social trends, and they suggest questions that need to be addressed in these areas.

 

 

Pioneers in Informatics

Harriet Werley

 

Werley, H. H., Devine, E. C., & Zorn, C. R. (1988). Nursing needs its own minimum data set. The American Journal of Nursing, 88(12), 1651–1653.

Copyright 1988 by Lippincott Williams and Wilkins, Inc. Reprinted by permission of Lippincott Williams and Wilkins, Inc. via the Copyright Clearance Center.

In this article, Werley, Devine, and Zorn describe their development of the nursing minimum data set (NMDS). They also discuss how the NMDS was used and why it was important.

 

Werley, H. H., Devine, E. C., Zorn, C. R., Ryan, P., & Westra, B. L. (1991). The nursing minimum data set: Abstraction tool for standardized, comparable, essential data. American Journal of Public Health, 81(4), 421–426.

Retrieved from the Walden Library databases.

In this article from 1991, the authors explain their usage of the nursing minimum data set to standardize collections of nursing data. The authors explore the importance of standardizing nursing data, as well as these data’s availability, reliability, and benefits at that time.

 

    Hobbs, J. (2011). Political dreams, practical boundaries: The case of the Nursing Minimum Data Set, 1983–1990. Nursing History Review: Official Journal of the American Association for The History of Nursing, 19, 127–155.

 

Retrieved from the Walden Library databases.

This article explores the development of the Nursing Minimum Data set (NMDS). The article details the contentious process that Harriet Werley utilized to identify information used in the NMDS.

 

Werley, H. (1972). Research in nursing as input to educational programs. Journal of Nursing Education, 11(4), 29-38.

Retrieved from the Walden Library databases.

In this article, Harriet Werley describes the relationship between nursing research and nursing education programs. Werley cites numerous studies that emphasize the need for additional nursing research and its integration into practice and curricula.

 

Robert Ledley and Lee B. Lusted

 

    Ledley, R. S., & Lusted, L. B. (1959). Reasoning foundations of medical diagnosis. Science, New Series, 130(3366), 9–21.

Copyright 1959 by American Association for the Advancement of Science. Reprinted by permission of American Association for the Advancement of Science via the Copyright Clearance Center.

This seminal article explores the research, observation, and risk involved in diagnosing a patient in 1959. The authors discuss the reasoning foundations behind how physicians made a medical diagnosis in their era.

 

    Ledley, R. S. (1964). High-speed automatic analysis of biomedical pictures. Science, New Series, 146(3641), 216–223.

Copyright 1964 by American Association for the Advancement of Science. Reprinted by permission of American Association for the Advancement of Science via the Copyright Clearance Center.

The authors of this article describe contemporary technologies in the nursing field of 1964. In particular, they focus on the high-speed automatic analysis of biomedical pictures.

 

Ledley, R. (2004). Editorial for computerized medical imaging and graphics. Computerized Medical Imaging and Graphics, 28(1–2), 1.

Retrieved from the Walden Library databases.

This article explains how advances in medical imaging technology have drastically changed patient care. The author also defines and explains different types of medical imaging and graphics.

 

Ledley, R. S., & Lusted, L. B. (1960). The use of electronic computers in medical data processing: Aids in diagnosis, current information retrieval, and medical record keeping. IRE Transaction on Medical Electronics, ME-7(1), 31–47.

 

Retrieved from the Walden Library databases.

In this article, the authors discuss the use of computers in medical data processing in 1960. The article explains how computers changed the abilities of physicians to make educated diagnoses and keep medical records.

 

 

  Ledley, R. S. (1987). Medical informatics: A personal view of sowing the seeds. Proceedings of ACM Conference on History of Medical Informatics, 1987, 31–41.

Retrieved from the Walden Library databases.

This 1987 article describes a personal view of medical informatics. The author relays personal experiences with early medical informatics systems.

 

MUMPS (Massachusetts General Hospital Utility Multi-Programming System) in Octo Barnett’s Laboratory of Computer Science, Neil Pappalardo, Curtis Marble, and Robert Greenes

 

    Ashenhurst, R. L., McIlroy, M. D., Gawlick, H. J., Daley, L. R., Fournier, A., Cohen, D., & … Rule, J. B. (1990). ACM Forum. Communications of the ACM, 33(5), 479–482.

Retrieved from the Walden Library databases.

 

 

 

This article includes numerous letters to the editor of Association of Computing Machinery’s (ACM) journal. The letters discuss numerous issues that were prevalent in computing and informatics at the time of publication.

 

Barnett, G. O. (1987). History of the development of medical information systems at the Laboratory of Computer Science at Massachusetts General Hospital. Proceedings of ACM Conference on History of Medical Informatics, 1987, 43–49.

 

Retrieved from the Walden Library databases.

In this article, the author explores the history of the development of medical information systems at the laboratory of computer science at the Massachusetts General Hospital. The author describes the importance of different medical information systems and how they were utilized at this particular hospital.

 

    Dezelic, G. (2007). A short review of medical informatics history. Acta Informatica Medica, 15(1), 43–48.

Retrieved from the Walden Library databases.

This article provides a summary of the history of medical informatics. The author describes key medical informatics pioneers and systems.

 

    Lincoln, T. L. (1987). An historical perspective on clinical laboratory information systems. Proceedings of ACM Conference on History of Medical Informatics, 1987, 117–121.

Retrieved from the Walden Library databases.

The author of this article discusses some of the medical information systems in use in 1987.This article provides a historical perspective on clinical laboratory information systems and how they have evolved over time.

 

Waxman, B. D. (1987). Planting the seeds. Proceedings of ACM Conference on History of Medical Informatics, 1987, 27–29.

 

Retrieved from the Walden Library databases.

This article describes the history of informatics prior to 1987. The author discusses the information gathered at the proceedings of the ACM conference and who “planted the seeds” of medical information systems.

 

Morris Collen

 

Collen, M. F. (1966). Periodic health examinations using an automated multitest laboratory. JAMA: Journal of the American Medical Association, 195(10), 830–833.

Copyright 1966 by American Medical Association.  Reprinted by permission of American Medical Association via the Copyright Clearance Center.

This article explains how automated multitest laboratories changed the way basic health examinations are performed. The article gives a brief history of health examinations, the importance of automated multitest laboratories, and the equipment used.

 

    Collen, M. F., Rubin, L., Neyman, J., Dantzig, G. B., Baer, R. M., & Siegelaub, A. B. (1964). Automated multiphasic screening and diagnosis. American Journal of Public Health and the Nations Health, 54(5), 741–750.

Copyright 1964 by American Public Health Association. Reprinted by permission of American Public Health Association via the Copyright Clearance Center.

The authors of this article provide a brief description of the current state of quantitative testing in their era. In particular, they explore the use of multiphasic screening and diagnosis at that time, and its contribution to the medical field.

 

    Oakes, T., Syme, S., Feldman, R., Friedman, G., Siegelaub, A., & Collen, M. (1973). Social factors in newly discovered elevated blood pressure. Journal of Health And Social Behavior, 14(3), 198–204.

 

Retrieved from the Walden Library databases.

 

 

 

This article explores a study that sought to determine the social factors associated with newly discovered high blood pressure. The study demonstrates how automated multiphasic health testing can effectively gather information.

 

Homer R. Warner

 

Clayton, P. D. (1995). Presentation of the Morris F. Collen Award to Homer R. Warner, MD, PhD: “Why not? Let’s do it!” Journal of the American Medical Informatics Association, 2(2), 137–142.

 

Retrieved from the Walden Library databases.

This article outlines the story of Homer Warner and his contribution to the field of medical information systems. The author describes how Dr. Warner used mathematical techniques to make technological advancements in the field of cardiology.

 

Warner, H. R. (1995). Viewpoint: Medical informatics: A real discipline? Journal of the American Medical Informatics Association, 2(4), 207–214.

 

Retrieved from the Walden Library databases.

In this article, Dr. Warner, a pioneer of medical informatics, states his views on medical informatics and how they are a necessary discipline in the medical field. Warner also discusses the history, importance, and usage of medical informatics.

 

Warner, H. R. (1959). The use of an analog computer for analysis of control mechanisms in the circulation. Proceedings of the IRE, 47(11), 1913–1916.

 

Retrieved from the Walden Library databases.

 

 

 

In this 1959 article, Dr. Warner discusses the use of an analog computer for analyzing the control mechanisms in the circulation system. Dr. Warner uses examples as well as history to show how an analog computer has contributed to the field of cardiology in his practice.

 

 Warner, H. R. (2001). Good isn’t enough. Health Management Technology, 22(6), 30–31.

 

Retrieved from the Walden Library databases.

In this article, Homer Warner examines natural language processing (NLP) technology. Warner identifies numerous areas where NLP may be applied, and he also provides predictions for its development.

 

    Warner, H. R. (1966). The role of computers in medical research. JAMA: Journal of the American Medical Association, 196(11), 944–949.

Copyright 1966 by American Medical Association. Reprinted by permission of American Medical Association via the Copyright Clearance Center.

This 1966 article explores the potential uses of computers in medical research. The author describes how computers had changed the field of medical research at the time of the article’s publication.

 

Edward Shortliffe

 

    Hickam, D. H., Shortliffe, E. H., Bischoff, M. B., Scott, A. C., & Jacobs, C. D. (1985). The treatment advice of a computer-based cancer chemotherapy protocol advisor. Annals of Internal Medicine, Part 1, 103(6), 928–936.

 

Retrieved from the Walden Library databases.

The authors of this article describe their use for ONCOCIN as a computer-based cancer chemotherapy protocol advisor. The article specifies how ONCOCIN combined formal guidelines with judgments of oncologists to determine the best route of therapy for certain cases.

 

    Shortliffe, E. H., Tang, P. C., & Deimer, D. E. (1991). Patient records and computers. Annals of Internal Medicine,115(12), 979–981.

 

Retrieved from the Walden Library databases.

This article explores improvements in clinical information-management systems using the computer technology of the early 1990s. The authors stress their concerns surrounding the use of technology to solve the problems of paper records.

 

Shortliffe, E. H. (1998). Health care and the next generation Internet. Annals of Internal Medicine,129(2), 138–140.

 

Retrieved from the Walden Library databases.

In this article, the author anticipates the future of health care from a 1998 perspective. The article focuses on the potential impacts of the next version of the Internet in health care.

 

Shortliffe, E. H. (2005). Strategic action in health information technology: Why the obvious has taken so long. Health Affairs, 24(5), 1222–1233.

Retrieved from the Walden Library databases.

 

This article describes the gradual advance toward implementations of health information technology. The author examines the challenges and the opportunities that the field of health information technology faced prior to the article’s publication.

 

    Tu, S. W., Kahn, M. G., Musen, M. A., Ferguson, J., Shortliffe, E., & Fagan, L. M. (1989). Episodic skeletal-plan refinement based on temporal data. Communications of the ACM, 32(12), 1439–1455.

 

Retrieved from the Walden Library databases.

 

This article describes a medical expert system (ONCOCIN) used in the late 1980s to create skeletal-planning techniques. The authors explain how this system proved to be innovative and beneficial to the health care field at that time.

 

Dr. Warner Slack

 

    Hicks, G. P., Gieschen, M. M., Slack, W. V., & Larson, F. C. (1966). Routine use of a small digital computer in the clinical laboratory. JAMA: Journal of the American Medical Association, 196(11), 973–978.

 

Copyright 1966 by American Medical Association. Reprinted by permission of American Medical Association via the Copyright Clearance Center.

The authors of this article describe the use of a small digital computer in an early clinical computer laboratory. The authors examine the benefits and drawbacks of using those digital computers in a clinical laboratory.

 

Slack, W. V., & Van Cura, L. J. (1968). Patient reaction to computer-based medical interviewing. Computers and Biomedical Research, 1(5), 527–531.

 

Copyright 1968 by Elsevier Science and Technology. Reprinted by permission of Elsevier Science and Technology via the Copyright Clearance Center.

In this article, the authors discuss patients’ reactions to computer-based medical interviewing. They also theorize how patients may have thought and felt about computer-based medical technology.

 

Fisher, L. A., Johnson, T., Porter, D., Bleich, H. L., & Slack, W. V. (1977). Collection of a clean voided urine specimen: A comparison among spoken, written, and computer-based Instructions.American Journal of Public Health, 67(7), 640.

 

Retrieved from the Walden Library databases.

The authors of this article describe a study that sought to determine the effectiveness of different methods of instructing patients on how to collect a urine specimen. The article has a significant focus on the effects of computer-based instructions.

 

    Safran, C. (2002). Presentation of Morris F. Collen Award to Professors Howard Bleich and Warner Slack. Journal of the American Medical Informatics Association, 9(4), 406–408.

Retrieved from the Walden Library databases.

This article describes the conferral of the Morris F. Collen award to Howard Bleich and Warner Slack. The article also provides an overview of the doctors’ accomplishments in the medical field.

 

    Safran, C., & Rind, D. M. (1995). Guidelines for management of HIV infection with computer-based patient’s record. Lancet, 346(8971), 341.

 

Retrieved from the Walden Library databases.

This article describes a trial of an electronic medical record (EMR) system that provides electronic messages to help reinforce adherence to clinical practice guidelines. The article presents findings on the effects of the EMR’s alert messages.

 

Ed Hammond

 

Hammond, W. E. (2008). eHealth interoperability. Studies in Health Technology and Informatics,134, 245–253.

 

Retrieved from the Walden Library databases.

This article explores the concept of interoperability between health information technology systems. The author outlines different types of interoperability and describes their importance.

 

Hammond, W. E., Stead, W. W., Feagin, S. J., Brantley, B. A., & Straube, M. J. (1977). Data base management system for ambulatory care. In Proceedings of the Annual Symposium on Computer Application in Medical Care, (p. 173). American Medical Informatics Association. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464520/pdf/procascamc00015-0181.

This article describes a database management system (DBMS) used for ambulatory care. The authors explain the benefits and uses of DBMSs for this type of care.

 

Hammond, W. E., II, Stead, W. W., Straube, M. J., & Hammond, W. E., III. (1983). Adapting to the day to day growth of TMR. In Proceedings of the Annual Symposium on Computer Application in Medical Care (p. 101). American Medical Informatics Association.

 

Copyright 1983 by IEEE.  Reprinted by permission of IEEE via the Copyright Clearance Center.

This article describes computer applications in medical care and computer systems in hospitals. The authors also explore the connection between medical records and quality assurance.

 

Stead, W. W., & Hammond, W. E. (1987). Demand-oriented medical records: Toward a physician work station. In Proceedings of the Annual Symposium on Computer Application in Medical Care (p. 275). American Medical Informatics Association.

 

Copyright 1987 by Institute of Electrical and Electronics Engineers.  Reprinted by permission of Institute of Electrical and Electronics Engineers via the Copyright Clearance Center.

This article provides a brief overview of the use of computer-based medical records at the time of publication. The authors also focus on using demand-oriented medical records at a physician workstation.

 

Stead, W. W., & Hammond, W. E. (1980). How to realize labor savings with a computerized medical record. In Proceedings of the Annual Symposium on Computer Application in Medical Care, 2 (p. 1200). American Medical Informatics Association.

In this article, the authors discuss concerns about computerized medical record systems increasing the cost of labor. The authors also examine how medical record systems may actually reduce labor costs.

 

Clem McDonald

 

    McDonald, C. J., & Tierney, W. M. (1986). The Medical Gopher—A microcomputer system to help find, organize and decide about patient data. Western Journal of Medicine, 145(6), 823–829.

Copyright 1986 by BMJ Publishing Group Ltd. Reprinted by permission of BMJ Publishing Group Ltd. via the Copyright Clearance Center.

 

 

 

The authors of this article describe the purpose and uses of the Medical Gopher. The Media Gopher is a computer system that helps find, organize, and provide decision support based on stored patient data.

 

    McDonald, C. J., Hui, S. L., Smith, D. M., Tierney, W. M., Cohen, S. J., Weinberger, M., & McCabe, G. P. (1984). Reminders to physicians from an introspective computer medical record. Annals Of Internal Medicine, 100(1), 130.

Retrieved from the Walden Library databases.

This article details the effects of a computerized medical record that provides reminder messages to physicians. The authors provide recommendations for similar systems in the future.

 

McDonald, C. J., & Hammond, W. E. (1989). Standard formats for electronic transfer of clinical data. Annals of Internal Medicine, 110(5), 333–335.

Retrieved from the Walden Library databases.

The authors of this article stress the need for standardizing the way clinical systems transmit data, and they describe some early attempts to create clinical data transmission standards.

 

    McDonald, C. J., Murray, R., Jeris, D., Bhargava, B., Seeger, J., & Blevins, L. (1977). A computer-based record and clinical monitoring system for ambulatory care. American Journal of Public Health, 67(3), 240–245.

Retrieved from the Walden Library databases.

This article provides an overview of the Regenstrief Medical Record system, which was first implemented in 1973. The authors explain how the record system presents a pioneering approach to storing medical records electronically.

 

Wilson, G. A., McDonald, C. J., & McCabe, G. P., Jr. (1982). The effect of immediate access to a computerized medical record on physician test ordering: A controlled clinical trial in the emergency room. American Journal of Public Health, 72(7), 698–702.

 

Retrieved from the Walden Library databases.

 

 

 

In this article, the authors describe the results of a controlled clinical trial that tested how the availability of patient computerized medical record summaries affected the rates at which physicians ordered additional testing. No significant decrease or increase in the number of tests ordered was found to have occurred.

 

Optional Websites

 

HIMSS. (2013). Retrieved February 21, 2013, from http://www.himss.org

 

ANIA. (n.d.). Retrieved February 21, 2013, from https://www.ania.org

Analyzing an Ethical Decision

Assignment 1:

Analyzing an Ethical Decision

In your role, as an advanced practice nurse, you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear cut answer of how to address the issue, but your ethical decision making must be based on evidenced based practice, and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their sociodemographic and ethnic/racial background. You must be prepared to critically analyze ethical situations, and develop an appropriate plan of action. For this Assignment, you will review the literature and discover the various ethical dilemmas advanced practice nurses encounter and how these issues are typically addressed in your state.

To prepare:

•             Review literature for moral/ethical issues encountered by advanced practice nurses in clinical practice.

•             Select an article that was published within the last five years.

By Day 7

Write a two page paper that answers the following questions:

•             Summarize the moral/ethical issue in the article (no more than 1 paragraph)

•             Describe the moral and ethical dilemmas surrounding the issue

•             Analyze the ethical issue and compare them to the State Health Laws and Regulations in your state

•             Outline the process of ethical decision making you would use to address this ethical dilemma

 

 

 

Resources

http://midlevelu.com/blog/should-providers-treat-their-friends-and-family

http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Ethical-Dilemmas-2.aspx

Alzheimer’s Disease”

Alzheimer’s Disease”

o Prepare

· Review the interactive media piece assigned by your Instructor.

· Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.

· Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.

· You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

Write a 1- to 2-page summary paper that addresses the following:

· Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.

· Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

· What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.

· Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

Interactive media piece case study below:

BACKGROUND

Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.”

Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

SUBJECTIVE

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

MENTAL STATUS EXAM

Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.

Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

RESOURCES

§ Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources.

Op

Options for Decisions below: Tips. Pick one that be a better option and answer all questions above. Need 3 x references

1. Begin Exalon 1.5 mg po bid with an increase to 3 mg po bid in two weeks( pt not feeling better).

2. Increase Exelon to 4.5mg orally bid( pt not feeling better)

3. Increase Exelon to 6mg po bid. ( Pt improved, dose could be maintained and checked in 4 wks, Namenda could also be added).

OR

1. Begin Aricept 5mg po bedtime ( pt no feeling better)

2. Increase Aricept to 10mg po ( Pt still not feeling Better NB Aricept at 5mg can be effective)

3. Continue Aricept 10 mg ( pt not any better) or ( 5mg with Namenda can be effective).

OR

1. Begin Razadyne 4 mg ( pt not feeling better)

2. Increase Razadyne to 24 mg extended release( Pt has seizures/SE)

3. Retart Razadyne ( pt has more s/e). Respidal not apprappriate.

Resource for references

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

· Chapter 10, “Basic Principles of Neuropharmacology” (pp. 73–77)

· Chapter 11, “Physiology of the Peripheral Nervous System” (pp. 79–90)

· Chapter 12, “Muscarinic Agonists and Antagonists” (pp. 91–107)

· Chapter 13, “Adrenergic Agonists” (pp. 109–119)

· Chapter 14, “Adrenergic Antagonists” (pp. 121–132)

· Chapter 15, “Indirect-Acting Antiadrenergic Agents” (pp. 133–137)

· Chapter 16, “Introduction to Nervous System Pharmacology” (pp. 139–141)

· Chapter 17, “Drugs for Parkinson Disease” (pp. 143–158)

· Chapter 18, “Drugs for Alzheimer Disease” (pp. 159–166)

· Chapter 19, “Drugs for Epilepsy” (pp. 167–189)

· Chapter 20, “Drugs for Muscle Spasm and Spasticity” (pp. 191–201)

· Chapter 57, “Drug Therapy of Rheumatoid Arthritis” (pp. 629–641)

· Chapter 58, “Drug Therapy of Gout” (pp. 643–651)

· Chapter 59, “Drugs Affecting Calcium Levels and Bone Mineralization” (pp. 653–672)

American Academy of Family Physicians. (2019). Dementia. Retrieved from http://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5

This website provides information relating to the diagnosis, treatment, and patient education of dementia. It also presents information on complications and special cases of dementia.

Learning Resources

Required Media (click to expand/reduce)

Laureate Education (Producer). (2019b). Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat Alzheimer’s disease.