Tag Archive for: nursing

Research Project

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I need it by 6 pm EST on tomorrow December 10, 2018. Please follow all instructions.

 

Research Project

Carefully read through all components (listed below) required for completion of the Research Project. In selecting your project topic, ensure that you will be able to ascertain the appropriate data/information needed to complete the project in terms of the deliverables.

Select a health care organization (local or national, large or small, public or private) and perform a needs assessment/gap analysis. You may utilize your own organization if you are employed in a health care related company. You may approach the Research Project from a (1) Human Resources, (2) Operations, or (3) Facilities perspective. You may select an organization in your own community.

  1. Human Resources: staffing, training, recruitment, retention, job function redesign, etc.
  2. Operations: delivery of service/care, access, wait times, equipment usage, process improvements, resource optimization, regulatory compliance, etc.
  3. Facilities: space planning, construction, redesign, relocation.

The components for the Research Project include the following:

  1. Title Page
  2. Executive Summary (Needs Content Criteria)
  3. Description of the organization (history, length in service/operation, how many beds? clients served? location; rural vs. urban, satellite locations, total number of staff, client usage information/demographics, etc.)
  4. Needs Assessment/Gap Analysis: What is not currently being offered? Room for improvements? Service delivery deficits? Personnel issues/shortages? Justify with supporting data and statistics.
  5. Propose an intervention (service or facility) based on the needs/gap analysis.
  6. Justify your proposed intervention by providing an analysis from:
    1. Cultural
    2. Social
    3. Legal
    4. Economics
    5. Regulatory
    6. Reimbursement
    7. Managed care
    8. Health legislation
    9. Contracts perspectives
  7. Pick a minimum of three of the elements listed above depending on the organization selected and which apply to the specific organization/situation selected.
  8. Create a plan to implement your intervention. Identify the stakeholders involved, and their role (s) in implementing the intervention. Include finance and staffing elements required to implement the intervention.
  9. Develop a marketing communication plan on how the stakeholders will be informed, kept up-to-date, etc. prior to the intervention, during the intervention, and post intervention.
  10. Develop a plan for measurement effectiveness of the intervention. What indicators will determine if the intervention is successful?
  11. Reference page.

Writing the Research Project

The Research Project:

  1. Must be 10 to 12 double-spaced pages in length, and formatted according to APA style as outlined in the Ashford Writing Center.
  2. Must include a title page with the following:
    1. Title of paper
    2. Student’s name
    3. Course name and number
    4. Instructor’s name
    5. Date submitted
  3. Must begin with an introductory paragraph that has a succinct thesis statement.
  4. Must address the topic of the paper with critical thought.
  5. Must end with a conclusion that reaffirms your thesis.
  6. Must use at least ten scholarly and /or peer-reviewed sources, published within the last 5 years.
  7. Must document all sources in APA style,
  8. Must include a separate reference page,

stroke

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Your written assignment for this module should be a 1-2 page paper (not including title page and reference page) that describes the following:

What are the signs and symptoms of a stroke?
How does the brain adapt in a patient who has had a stroke?
What are the evidence based care measures that need to be addressed to ensure quality care for this patient?
You should include a minimum of 3 references. Include a title page, in-text citations, and a reference page in APA format.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Peer Resp

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No plagiarism please.

Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations.

Peer Resp.#1

Pelvic pain can be caused by many reasons such as ovarian cysts, urinary tract infections, appendicitis, sexually transmitted infections, pelvic inflammatory disease (PID)…In this discussion, I will address PID as the cause of pelvic pain. PID is an infection or inflammation of the upper genital tract in women (Shen et al., 2016). For PID, it is considered acute if the symptoms last 30 days or less (Ferri, 2018). The condition is chronic if the symptoms last more than 30 days. PID is a sequela of sexually transmitted infections, so it is commonly diagnosed in young and sexually active women. Patients usually complain of lower abdominal pain, abnormal vaginal discharge/ bleeding, postcoital bleeding, dysuria, dyspareunia, or fever (Ferri, 2018). If a patient also complains of nausea and vomiting, we need to rule out peritonitis. Since the disease can cause infertility, ectopy pregnancy and can permanently damage other organs such as the uterus, ovaries, fallopian tubes, the patient needs to be referred to a gynecologist immediately to have a proper treatment (Shen et al., 2016). Some women may not have any symptoms, so we need to do a thorough history and physical examination, as well as offer STI screenings to avoid underdiagnosis. We can order basic labs and imaging studies such as urinalysis and urine culture, CBC, CMP, CRP, ESR, and ultrasound pelvic/transvaginal so that the patient can have them done before seeing the gynecologist. An endometrial biopsy or laparoscopy can be done by the gynecologist to confirm the diagnosis of PID (Ferri, 2018).

To write a referral to a specialist, we first need to include our information (name, address, phone, fax, email) and the specialist’s information. Second, the reason for consult/referral, the patient’s biographical data, chief complaint, history of present illness, past medical history, allergies, current medications, family history, social history, vital signs, review of system, and physical examination need to be addressed. Also, we need to include labs and imaging studies, treatment plan, diagnosis, and recommendations. After the patient has been seen and treated by the gynecologist, we are responsible for advising the patient to come back to see us for follow-ups. Since PID can be recurrent, the patient needs to be tested for gonorrhea and chlamydia three to six months after the treatment (Ferri, 2018). Her sexual partner needs to be treated as well to prevent her from being re-infected. Untreated gonorrhea and chlamydia can cause PID; therefore, it is essential for NPs to screen female patients aged less than 25 and those at increased risk for these infections to reduce the incidence of PID (Kreisel, Torrone, Bernstein, Hong, & Gorwitz, 2017). We also need to offer HIV and other STI screenings to all women with PID.

Peer Resp.#2

Endometriosis

Endometriosis is a painful disorder that results from the endometrium growing outside of the uterus. This generally involves the pelvic region, ovaries, fallopian tubes and the pelvic lining. It can affect areas outside of the pelvic region as well. Though the endometrium is displaced, it continues to act as normal by thickening, breaking down and then bleeding during menstruation. Unfortunately, there is no place for this to go and it becomes trapped. Eventually, this causes scarring and adhesion’s which cause pelvic organs to adhere together. All this together causes the pain and can lead to infertility (Mayo Clinic, 2018). I chose this subject because I had endometriosis. It is a horrible disorder and very painful. There were times that it felt like someone was stabbing my insides with a knife. I would ball up into the fetal position and cry until the pain went away. I eventually had to have a hysterectomy at the age of 29. This was horrible because we tried to have another baby, but it left me unable to have anymore. I was so bad that I had bleeding outside of my menstrual cycle and it was in my rectum. Before my surgery, I bleed for more than 2 weeks straight despite medications. He said if I did not have the surgery, I would eventually hemorrhage.

Endometriosis S/S

Dysmenorrhea
Chronic Pelvic Pain
Dyspareunia
Abdominal Pain
Menorrhagia
Backache (during menses)
Perimenstrual Tenesmus
Diarrhea
Constipation
Dyschezia
Dysuria
Hematuria
Nausea
(Youngkin, Davis, Schadewald & Juve, 2013)

Referral Process

Endometriosis generally does not require a referral. With this being said, women may become infertile with this issue (Johns Hopkins, 2018). If the woman would like to have children and has infertility issues, she can be referred to a fertility specialist. Some women require hysterectomies if the disease is severe (Johns Hopkins, 2018). In some cases, the woman may need to be referred to a physician within the practice that performs this.

Follow-up After Referral

It is known that 17-19% of women with endometriosis have spontaneous resolution of lesions. Many more women have a progression of lesions. This makes up 24-64% of the cases. Others remain stable. This is 9-59% of the cases. Follow-ups will depend on the treatment plans that are decided on. There should be, at the very least, a three-month follow-up to report any new, worsening or resolving symptoms. At the follow-up, side effects of treatment should be discussed as well. This follow-up can be used to discuss further pregnancy options if need be (Youngkin, Davis, Schadewald & Juve, 2013).

vaginal discharge

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ASSGINMENT PART 2 (Journals 4, 5 & 6)

(1). Assignment Practicum – 

Journal Entry 4 – (Vaginal Discharge).

Reflect on a patient who presented: 

1. with a vaginal discharge during your Practicum Experience. 2.

2. Describe key signs and symptoms that were consistent with a sexually transmitted infection (STI) versus a non-STI related infection. 

3. If you diagnosed the patient with an STI, describe your experience in telling the patient that she had an STI, as well as the patient’s reaction to the diagnosis. 

4. Explain how the diagnosis might impact the patient’s life short-term and long-term.

5. Include an explanation of the patient’s medical history, drug therapy and treatments, and follow-up care. If you did not have an opportunity to evaluate a patient, you may select a related case study from a reputable source.

 

(2). Assignment: Practicum –

Journal Entry 5 (Choose a TOPIC of your choice from the 3).

Reflect on a patient who presented:

1. with endometriosis, ovarian cysts, or amenorrhea during your Practicum Experience. (Choose one d/o).

2. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care.

3. Then, explain how treatment modalities differ for endometriosis, ovarian cysts, and amenorrhea, as well as the implications of these differences when diagnosing and treating patients.

4. If you did not have an opportunity to evaluate a patient, you may select a related case study from a reputable source.

(3). Assignment Practicum –

Journal Entry –  6

(Breast Condition).

Reflect on a patient who presents with:

 

1. with a breast condition during your Practicum Experience.

2. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care.

3. Then, explain your patient education strategies for patients with or at risk of breast conditions.

4. Include a description of how you might teach patients to perform breast self-examinations.

5. If you did not have an opportunity to evaluate a patient with this background during the last six weeks, you may select a related case study from a reputable source.

 

Instruction:

 There are 3 individual Journal Assignments here:

This Home Work is DUE on Monday. OCT. 9th.2017.

1. No plagiarism what so ever.

2. ALL work APA format.

3. A scholarly written work from a grad; preferably a NURSE.

4. Must address EACH number by paragraph.

5. Use 4 to 5 sources/reference on EACH journal; must be from reputable sources.

Here are some recommended sources use.

Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Burlington, MA: Jones and Bartlett Publishers.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.). Burlington, MA: Jones & Bartlett Publishers.

Centers for Disease Control and Prevention. (2012b). Women’s health. Retrieved from http://www.cdc.gov/women/

National Institutes of Health. (2012). Office of Research on Women’s Health (ORWH). Retrieved from http://orwh.od.nih.gov/

U.S. Department of Health and Human Services. (2012a). Womenshealth.gov. Retrieved from http://www.womenshealth.gov/

(3). Assignment: Practicum –

Journal Entry 6 – (Breast Condition)

 

(3). Assignment: Practicum –

Journal Entry 6 – (Breast Condition).

adhering to privacy laws.

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Create a 6–8-slide PowerPoint presentation for a group of school nurses, which addresses the role of the school nurse in managing the unique health concerns of teenagers while adhering to privacy laws.

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

· Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.

  • Explain the laws that relate to adolescent safety and health privacy in a school setting.
  • Explain how the privacy laws affect schools, students, and school nurses.

· Competency 3: Apply professional nursing ethical standards and principles to the decision-making process.

  • Describe health and wellness issues specific to the adolescent population.
  • Recommend evidence-based ethical strategies relating to health and wellness privacy communication by the school nurse.

· Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals.

  • Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.
  • Correctly format citations and references using APA style.

·

Context School nurses confront numerous legal issues in their daily work. It is important to know the standards of nursing practice specific to the state of licensure, as well as legal limitations and responsibilities of the school nurse. Role of the School Nurse It is the position of the National Association of School Nurses that the professional registered school nurse is the leader in the school community to oversee school health policies and programs. The school nurse serves in a pivotal role to provide expertise and oversight for the provision of school health services and promotion of health education. Using clinical knowledge and judgment, the school nurse provides health care to students and staff, performs health screenings, and coordinates referrals to the medical home or private health care provider. The school nurse serves as a liaison between school personnel, family, community and healthcare providers to advocate for health care and a healthy school environment (American Nurses Association & National Association of School Nurses, 2011).

Questions to Consider:

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

  • What is FERPA?
  • What is HIPAA?
  • How do FERPA and HIPAA affect school health privacy?
  • What unique health concerns might young people have      that differentiate them from adults?

·

· Assessment Instructions:

You are the parent of two teenagers and an active PTA member at their school. The principal approached you about an upcoming professional gathering for middle- and high-school nurses in your district. She asked you to make a short presentation on school health privacy and how it can affect nurse-student care within the teen population, where personal health issues and privacy concerns often collide. Preparation Research and gather information about the issues facing school nurses in your state of licensure, as well as state and federal privacy laws that govern your school health privacy information. You will also need to learn about the legal limitations and responsibilities of the school nurse.

Directions Create a 6–8-slide PowerPoint presentation that examines the privacy issues unique to nurses serving the high-school age population. Address the following:

  • Describe the types of health and wellness issues that      can affect adolescents in their high-school years. Be sure you think      beyond the usual things and really research the types of issues that are      affecting young people today.
  • Explain how privacy laws can impact the school nurse in      regard to patient safety and health outcomes for adolescents.
  • Explain how privacy laws benefit the student, the      school, and the school nurse.
  • Recommend two specific evidence-based ethical      strategies regarding health and wellness privacy communications in a      school environment.
  • Use the notes section of each slide to expand your      points and cite your supporting evidence. Also, include a title slide and      a reference slide that lists the resources you used in this assessment. Be      creative.
  • Consider your intended audience.
  • Additional Requirements :
  • Your      presentation should meet the following requirements:
  • Written communication:      Written communication should be free of errors that detract from the      overall message.
  • References:      Include a reference slide with a minimum of three references; a majority      of these should be peer-reviewed sources. All resources should have been      published within the last 5 years.
  • APA format:      Resources and citations should be formatted according to current APA style      and formatting.
  • Length:      6–8 slides.

Health Information Technology

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Using Health Information Technology as a Source of Evidence-Based Practice

 

Using Health Information Technology as a Source of Evidence-Based Practice

 

Before the digital revolution, health information technology supplied very limited support for evidence-based practice. If nurses wanted to be informed about cutting-edge research, their best bet was to either subscribe to leading journals or make periodic trips to the library. With the establishment of research databases, however, nurses became empowered to learn about and facilitate interdisciplinary and translational research. Databases are just one example of how health information technology supports evidence-based practice.

 

To prepare:

Read the following scenario from the text (McGonigle & Mastrian, 2012, p. 482):

Twelve-hour shifts are problematic for patient and nurse safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004, the Institute of Medicine (Board on Health Care Services & Institute of Medicine, 2004) published a report that referred to studies as early as 1988 that discussed the negative effects of rotating shifts on intervention accuracy. Workers with 12-hour shifts realized more fatigue than workers on 8-hour shifts. In another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu, and Aygun (2006), factors relating to increased risk for injury were age of 24 or less, less than 4 years of nursing experience, working in the surgical intensive care units, and working for more than 8 hours.

Consider how the resources identified in the scenario above could influence an organization’s practice.

Select an issue in your practice that is of concern to you (my area of practice area of concern is the nursing shortage, we often have to work short in my hospital which creates many issues). Using health information technology, locate at least three evidence-based practice resources that address your concern and that could possibly inform further action.

post a description of your practice concern. Outline how you used health information technology to locate evidence-based practices that address this concern. Cite and include insights from the resources. Analyze how health information technology supports evidence-based practice.

 

Required Resources

Readings

 

  • McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.
    • Chapter 26, “Nursing Research: Data Collection, Processing, and Analysis”

      The authors of this chapter relate nursing research to the foundation of knowledge model. The chapter assesses informatics tools for collecting data, storing information, and processing and analyzing data.

    • Chapter 27, “Translational Research: Generating Evidence for Practice”

      In this chapter, the authors differentiate evidence-based practice and translation research. They also describe models used to introduce research findings intro practice.

  • Hynes, D. M., Weddle, T., Smith, N., Whittier, E., Atkins, D., & Francis, J. (2010). Use of health information technology to advance evidence-based care: Lessons from the VA QUERI program. Journal of General Internal Medicine, 25(Suppl. 1), S44–S49.

    Retrieved from the Walden Library databases.

    This article presents a study that evaluated the role of health information technology (HIT) in the Department of Veteran Affairs’ Quality Enhancement Research Initiative. The authors convey their findings on how HIT provided data and information to aid implementation research, and how implementation research helped further HIT development. Additionally, the text details methods of overcoming common HIT barriers to implementation research.

  • Jamal, A., McKenzie, K., & Clark, M. (2009). The impact of health information technology on the quality of medical and health care: A systematic review. Health Information Management Journal, 38(3), 26–37.

    Retrieved from the Walden Library databases.

    This text details a study that reviews the published evidence concerning the impact of health information technology (HIT) on the quality of health care. The study investigated the use of HIT in medical care and allied health and preventive services. The authors primarily focus on the impact of electronic health records, computerized provider order-entry, and decision support systems.

  • Umscheid, C. A., Williams, K., & Brennan, P. (2010). Hospital-based comparative effectiveness centers: Translating research into practice to improve the quality, safety and value of patient care. JGIM: Journal of General Internal Medicine, 25(12), 1,352–1,355.

    Retrieved from the Walden Library databases.

    This article revolves around the usage of the hospital-based comparative effectiveness (CE) center model. The authors highlight the model’s benefits and the increasing usage of CE evidence. The article also reviews solutions to overcoming many of the challenges to operating hospital-based CE centers.

     

    APA format

    1 1/2  to 2 pages

diagnosis

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A 38-year-old woman presents to the office with complaints of weight

loss, fatigue, and insomnia of 3-month duration. She reports that she has

been feeling gradually more tired and staying up late at night because

she can’t sleep. She does not feel that she is doing as well in her occupation

as a secretary and states that she has trouble remembering things.

She does not go outdoors as much as she used to and cannot recall the

last time she went out with friends or enjoyed a social gathering. She

feels tired most of the week and states she feels that she wants to go to

sleep and frequently does not want to get out of bed. She denies any

recent medication, illicit drug, or alcohol use. She feels intense guilt

regarding past failed relationships because she perceives them as faults.

She states she has never thought of suicide, but has begun to feel increasingly

worthless.

Her vital signs and general physical examination are normal, although

she becomes tearful while talking. Her mental status examination is significant

for depressed mood, psychomotor retardation, and difficulty attending

to questions. Laboratory studies reveal a normal metabolic panel, normal

complete blood count, and normal thyroid functions.

➤ What is the most likely diagnosis?

➤ What is your next step?

➤ What are important considerations and potential complications of

management?

clinical inquiry.

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Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

· Develop a PICO(T) question to address the clinical issue of interest for the Assignment.

· Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level related to your research question.

· Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

· Identify and briefly describe your chosen clinical issue of interest.

· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

· Provide APA citations of the four peer-reviewed articles you selected.

· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

Subjective Data

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 The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.

Subjective Data

  • Complains of pain and heaviness in her leg.
  • States she cannot bear weight on her leg and has been in bed for 3 days.
  • Lives alone and has not had anyone to help her with meals.

Objective Data

  • Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
  • Left leg red from knee to ankle
  • Calf measurement on left 3 in > than right
  • Temperature: 38.9 degrees C
  • Height: 160 cm; Weight: 83.7 kg

Laboratory Results

  • WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
  • Wound culture: Staphylococcus aureus

Critical Thinking Questions

  1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
  2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
  3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
  4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

politics and economics

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The influence of poverty on health is a problem that transcends national borders. This week’s readings discussed some of the political, economic, and ethical issues that lead to health disparities in developed and developing countries. In addition, in this week’s first media presentation, Dr. Mancuso and Dr. Huijer shared insights on working within political systems to bring about positive changes in health care. Think about the importance of nurses in addressing these needs and in bringing about change.

To prepare for this Discussion:

  • Review the case study “Improving the Health of the Poor in Mexico.” Then, prepare your response to the following questions:
    • How do politics and economics influence health and health care?
    • What might the benefits be of awarding the mothers cash grants?
    • What social problems might be created by giving the mothers cash grants?
    • Do you think the resources were ethically distributed? (Think about stereotyping.)
    • What changes do you think should be made to the program, if any?
    • If the program were to be discontinued for any reason, what could you, as a nurse, say that might help to maintain funding?
    • Do you think a similar program might work in your community? Why or why not?

By Day 3

Post your response to the following prompts:

Explain how politics and economics may influence health and the health care system from your own perspective. Analyze whether the political and/or economic systems play a major role in your or your family’s access to health and explain why. Then, describe how government intervention might benefit a health care system. Be specific and provide examples.

Support your response with references from the professional nursing literature.

Note Initial Post: 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).