Tag Archive for: nursing

Decision Making

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Details: Collaborative Decision Making Through Shared Governance

Attend a committee meeting in your health care organization
Attend a committee meeting in your health care organization. If you are not currently employed in a health care setting, you may elect to attend a committee meeting at another company, a community center, a local school, local chamber of commerce or other professional organization.

Observe the interactions between committee members and the process used by the committee to arrive at decisions.

In 500-750 words, describe the function of the committee and the roles of those in attendance. Describe your observations of the interactions between members of the committee and determine whether the process used to arrive at decisions is a form of shared governance.

Prepare this assignment according to the APA guidelines

In addition to your textbook, “The Interprofessional Health Care Team: Leadership and Development”. A minimum of FOUR academic references from credible sources are required for this assignment.

Factors That Influence Disease

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Discussion: Factors That Influence Disease

In clinical settings, some of the most common questions that patients ask are Why do I have this? What caused this disorder? Will it ever go away? These emotional questions can be difficult to ask and to answer. However, for patients to come to terms with their diagnoses and adhere to treatment plans, they must have an understanding of factors that might have caused, or continue to impact, their disorders. As an advanced practice nurse, it is important that you are able to explain disorders, associated alterations and symptoms, and changes that might occur within your patients’ bodies.

To Prepare

  • Review this week’s media presentation with Dr. Terry Buttaro. Reflect on the importance of developing an in-depth understanding of pathophysiology.
  • Select a disorder from the following list:
    • Adrenal insufficiency (Addison’s disease)
    • Atherosclerosis
    • Cholelithiasis (gallstones)
    • Colon cancer
    • Cystic fibrosis
    • Hemophilia
    • Nephrolithiasis (kidney stones)
    • Osteoporosis
    • Parkinson’s disease
    • Tuberculosis
  • Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact your selected disorder, as well as potential associated alterations and symptoms.
  • Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur.
  • I will select osterporosis or Tuberculosis

Post a brief description of a patient scenario involving the disorder and the factor you selected. Explain how the factor might impact your selected disorder, as well as potential associated alterations and symptoms. Finally, explain the pathophysiology of the associated alterations, including changes in cellular function.

Reference:

Huether, S. E., & McCance, K. L. (2017). Understanding  pathophysiology (6th ed.). St. Louis, MO: Mosby.

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th  ed.). New York, NY: McGraw-Hill Education.

common practice

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Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.
  • Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
  • Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you used keywords to search 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.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

  • The full citation of each peer-reviewed article in APA format.
  • A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
  • A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
  • A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
  • A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

scholarly articles. 

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Module 3 DQ 1 and DQ 2

Tutor MUST have a good command of the English language

These are two discussion questions

Your DQ1 and DQ2 posts must be at least 150 words and have at least one reference cited for each question. In-text citation, please

Tutor MUST have a good command of the English language

Sources need to be journal/scholarly articles. 

Use only articles that are published between 2015-2018 (except for your theory articles which will be older as you must cite primary sources).

No textbook or direct quotes

Please separate the two DQ with their references

Topic 2 DQ 1

Provide examples of measures that APNs can collaborate with direct care nurses in implementing evidence-based changes to improve health literacy in practice..

Topic 2 DQ 2

Describe an example where a patient’s culture could impact health literacy. What measures would you employ to address the health literacy barrier? How effective is the current protocol for implementing practice changes in your institution? Examine any barriers and the facilitators for implementing an evidence-based change in your specific setting?

 Healthy People 2020 

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In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.

Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

  1. The problem, issue, suggestion, initiative, or educational need that will be the focus of the project
  2. The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
  3. A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
  4. Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
  5. Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
  6. A proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide

Politics and the Patient Protection and Affordable Care Act

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Discussion Post.. 350 words.. APA format..3 reference that are scholar writers. I Due by 12/10/19 by 7pm

 

Disussion: Politics and the Patient Protection and Affordable Care Act

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.

Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.

To Prepare:

· Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).

· Consider who benefits the most when policy is developed and in the context of policy implementation.

By Day 3 of Week 3

Post an explanation for how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).

Resources

Please Ask a Librarian if you have any questions about the links.

Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765. doi:10.1016/j.outlook.2017.10.002.

Corless, I. B., Nardi, D., Milstead, J. A., Larson, E., Nokes, K. M., Orsega, S., Kurth, A. E., … Woith, W. (2018). Expanding nursing’s role in responding to global pandemics. Nursing Outlook, 66(4), 412–415. doi:10.1016/j.outlook.2018.06.003. 

DeMarco, R., & Tufts, K. A. (2014). The mechanics of writing a policy brief. Nursing Outlook, 62(3), 219–224. doi:10.1016/j.outlook.2014.04.002

Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2017). Global action on the social determinants of health. BMJ Global Health, 3(1). doi:10.1136/bmjgh-2017-000603. 

Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267.

Institute of Medicine (US) Committee on Enhancing Environmental Health Content in Nursing Practice, Pope, A. M., Snyder, M. A., & Mood, L. H. (Eds.). (n.d.). Nursing health, & environment: Strengthening the relationship to improve the public’s health.

Kingdon, J.W. (2001). A model of agenda-setting with applications. Law Review M.S.U.-D.C.L., 2(331) 

Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055–1080. doi:10.5465/AMR.1996.9704071863

Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. doi:10.1016/j.outlook.2018.03.001 

O’Rourke, N. C., Crawford, S. L., Morris, N. S., & Pulcini, J. (2017). Political efficacy and participation of nurse practitioners. Policy, Politics, and Nursing Practice, 18(3), 135–148. doi:10.1177/1527154417728514

Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4. doi:10.2196/med20.4349.

Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017. doi:10.1111/jep.12350

Sandoval-Almazana, R., & Gil-Garcia, J. R. (2011). Are government internet portals evolving towards more interaction, participation, and collaboration? Revisiting the rhetoric of e-government among municipalities. Government Information Quarterly, 29(Suppl. 1), S72–S81. doi:10.1016/j.giq.2011.09.004

Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T. B., Ho, T., Mokuau, N., & Hedges, J. R. (2016). Leading by success: Impact of a clinical and translational research infrastructure program to address health inequities. Journal of Racial and Ethnic Health Disparities, 4(5), 983–991. doi:10.1007/s40615-016-0302-4

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003.

Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretion. Public Management Review, 16(4), 527–547. doi:10.1080/14719037.2013.841978

Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerations. Nursing Outlook, 66(4), 386–393. doi:10.1016/j.outlook.2018.05.003

politics of health legislation

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Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.

The suppliers of legislative benefits are legislators, and their primary goal is to be re-elected. Thus, legislators need to maximize their chances for re-election, which requires political support. Legislators are assumed to be rational and to make cost-benefit calculations when faced with demands for legislation. However, the legislator’s cost-benefit calculations are not the cost-benefits to society of enacting particular legislation. Instead, the benefits are the additional political support the legislator would receive from supporting legislation and the lost political support they would incur as a result of their action. When the benefit to legislators (positive political support) exceeds their costs (negative political support) they will support legislation. (page 27)

Source: Feldstein, P. (2006). The politics of health legislation: An economic perspective (3rd ed.). Chicago, IL: Health Administration Press.

To Prepare:

· Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).

· Consider who benefits the most when policy is developed and in the context of policy implementation.

By Day 3 of Week 3

Post an explanation for how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).

Diabetes

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Respond on two different days who selected different factors than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the pathophysiology of diabetes mellitus and diabetes insipidus.

Offer alternative diagnoses and prescription of treatment options for diabetes mellitus and diabetes insipidus.

Validate an idea with your own experience and additional research.

Main post

Diabetes affects millions of Americans and the cost of diabetes is a constant healthcare stressor as Insulin costs continue to rise. Diabetes mellitus is separated into three classes; Type 1, the pancreas fails to produce enough insulin to meet the body’s demand and Type 2, where the body’s cells do not respond to the insulin production and can be managed with lifestyle modifications, and gestational diabetes. Diabetes insipidus is not as common as diabetes mellitus but can have a severe effect on the human body due to the fluid imbalance that is created. It is important for the practitioner to understand the pathophysiologies and the roles behavior and ethnicity play in the diagnosis and treatment.

Pathophysiology of Diabetes Mellitus

Type 1 diabetes mellitus is an autoimmune disease that results from beta-cell destruction in pancreatic islets. Beta-cell death via virus directed or physiological mechanisms induces the release of antigens and initiation of immune responses against other beta-cells (Saberzadeh-Ardestani et al., 2018). Type 2 diabetes also has beta-cell destruction more but, more variable different degrees of beta-cell failure relative to varying degrees of insulin resistance. Kumar et al. (2018) acknowledge that insulin resistance impairs the ability of muscle cells to take up and store glucose and triglycerides, which results in high levels of glucose and triglycerides circulating in the blood. Type 2 diabetes can be managed with diet and exercise; like these, both can improve insulin resistance and delay the long-term complications associated with diabetes mellitus.

Pathophysiology of Diabetes Insipidus

Diabetes insipidus is separated into four classifications; central, nephrogenic, dipsogenic, and gestational. The results are that the body excretes an abundance of urine, causing the patient to have an unquenchable thirst. Kalra et al. (2016) describe central diabetes insipidus due to impaired secretion of arginine vasopressin could result from traumatic brain injury, surgery, or tumors whereas nephrogenic diabetes insipidus due to failure of the kidney to respond to arginine vasopressin is usually inherited.

Differences and Similarities of Hormonal Regulation

Despite sharing a name, the differences between diabetes mellitus and diabetes insipidus are great, from the pathophysiology to the treatment. Similarities between diabetes insipidus and diabetes mellitus due to hormonal changes lie within the symptoms that the patient is experiencing. Diabetes mellitus involves blood sugar levels and insulin resistance; diabetes insipidus, it isn’t blood sugar that is the problem, but blood water levels. The similarities of these diseases lie within the signs and symptoms that the patients may be present. Diabetes insipidus, excessive fatigue occurs because of an overall lack of hydration or an electrolyte imbalance. For diabetes mellitus, excessive fatigue generally occurs because blood sugar levels are too low or too high. Excessive thirst occurs in diabetes insipidus because the body senses a lack of Vasopressin, and so it demands more fluids because it thinks it needs them. For diabetes mellitus, excessive thirst occurs because of excessive glucose levels that need to be expelled from the body.

Ethnicity and Behavior’s Impact

Research by Saberzadeh-Ardestani et al. (2018) shows environmental factors include reduction in gut microbiota, obesity, early introduction to fruit or cow milk during childhood, gluten, toxins, lack of vitamins, and viruses play a role in the development of diabetes mellitus type 1; while previously most prevalent in Europeans, it is becoming more common in other ethnic groups. Diet and exercise can help delay diabetes mellitus type 2 from other disease processes related to diabetes mellitus. Diabetes insipidus is common when a traumatic brain injury (TBI) occurs, wearing seatbelts when driving and helmets when participating in cycling or sporting events can decrease the opportunity for diabetes insipidus to occur.

Conclusion

It is important for a practitioner to distinguish between the multiple types of diabetes that patients may present with, although signs and symptoms may be similar, the diagnosis and treatments are completely different. Patient education for each disease is also important because diabetes mellitus type 1 cannot be managed with diet and exercise alone. Diabetes insipidus can occur, but the underlying cause must be singled out to classify and treat. Central diabetes insipidus may require long term treatment depending on the extent of trauma, whereas gestational diabetes insipidus is usually a short term treatment, but the treatments remain the same.

References

Kalra, S., Zargar, A. H., Jain, S. M., Sethi, B., Chowdhury, S., Singh, A. K., … Malve, H. (2016). Diabetes insipidus: The other diabetes. Indian Journal of Endocrinology & Metabolism, 20(1), 9–21. https://doi-org.ezp.waldenulibrary.org/10.4103/2230-8210.172273Kumar, A. S., Maiya, A. G., Shastry, B. A., Vaishali, K., Ravishankar, N., Hazari, A., … & Jadhav, R. (2018). Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Annals of physical and rehabilitation medicine. https://doi-org.ezp.waldenulibrary.org/10.1016/j.rehab.2018.11.001Saberzadeh-Ardestani, B., Karamzadeh, R., Basiri, M., Hajizadeh-Saffar, E., Farhadi, A., Shapiro, A. M. J., … Baharvand, H. (2018). Type 1 Diabetes Mellitus: Cellular and Molecular Pathophysiology at A Glance. Cell Journal (Yakhteh), 20(3), 294–301. https://doi-org.ezp.waldenulibrary.org/10.22074/cellj.2018.5513

organization and the values

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Prepare a 10-minute presentation (10-15 slides, not including title or reference slide) on organizational culture and values.

  1. Describe how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes.
  2. Discuss how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem solving. Incorporate how system needs and the culture of health may influence the outcomes. How does this relate to health promotion and disease prevention in the larger picture?
  3. Identify a specific instance from your own professional experience in which the values of the organization and the values of the individual nurses did or did not align. Describe the impact this had on nurse engagement and patient outcomes.

While APA style format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Professor  Note:

 

This week you will create  a  PowerPoint presentation on the alignment of organizational  values  between you, the nurses, and the organization, and how  effective  communication is instrumental in problem resolution.

Please remember that your Title Slide and your  Reference
Slides  are not included in your total count.

You will create a 10-15 slide Power Point presentation  with  notes pages (at the bottom of the slide). Make sure to  provide  references for your information.

Epidemiology

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Question #1-

Choose a peer-reviewed journal article that discusses disease prevention. Review articles and secondary articles may be used but editorials are not appropriate and will receive a zero for the assignment if used.

 

Select one(1) article from the following online journal links:

American Journal of Epidemiology: http://aje.oxfordjournals.org/

The Journal of Infectious Diseases: http://jid.oxfordjournals.org/

Journal of Public Health: http://jpubhealth.oxfordjournals.org/

Clinical Infectious Diseases: http://cid.oxfordjournals.org/

You must read the full article (not just the abstract).  You may need to visit the APUS library to access the full article.  Full articles within the last year may not be available.

After reading your selected article, post the following information:

Identify the disease that is being studied and what type of prevention method is being evaluated (i.e. primary, secondary, or tertiary).

Describe what the prevention method is.  It could be a new screening method, vaccination, drugs, or other intervention.

Who was in the study population(s)/sample(s)?

What was the conclusion of the study?

Do you believe the study to  be reliable and valid?  Why or why not?

What recommendation(s) did the researcher offer for future studies?

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ALL FORUMS

Initial Response: Initial responses should be no less than 200 words in length not including your reference(s) and supported by at least two references (aside from the textbook).

Question #2-

Select ONE topic from below. Besides addressing the topic, try to include the following information (if applicable):

1. Why is this topic important to Public Health?

2. Why did you select this topic? What is its importance?

3. How can we get involved?

Essay topics (Pick 1) –

# 1. Watch the PBS Frontline video “Sick Around the World ” (link is available in your Week 6 Packet) and using your text information and other research articles of your choice, discuss some of the lessons the United States can learn from other Health Care Systems around the world. Cite your resources.

# 2. Watch the PBS Frontline video “Sick Around America ” (link is available in your Week 6 packet) and using your text information and other research articles of your choice, discuss some of the challenges faced by Americans trying to navigate through our current healthcare system and some possible solutions to the situation. Cite your resources.

# 3 The best hope for avoiding the need for health care rationing and at the same time improving quality of life for the elderly in this country is to integrate public health measure with the medical system to prevent chronic disease. Discuss some strategies to do this.

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ALL FORUMS

Initial Response: Initial responses should be no less than 200 words in length not including your reference(s) and supported by at least two references (aside from the textbook).