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Nurse’s Role in Influencing the Legislative Process

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Nurse’s Role in Influencing the Legislative Process For this week’s project, you’ll answer three questions related to your opportunity as a nurse and an advocate. The first two questions relate to influencing a bill is traveling through the legislative process. The third question refers you to the social determinants of health as described in your course textbook reading and asks you to think specifically on your role as a nurse in influencing social determinants of health.

In a brief paper (no more than 2 typed pages, 1 inch margins, 12 font Times New Roman or Courier New), answer the questions below. Write each question as a new topic area and then follow with a paragraph or two to answer the question. You may find it necessary to search for answers to the questions outside of the assigned reading. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources. Answer the following questions:

•What parts of the lawmaking process does a nurse have an opportunity to influence the final bill passage?

•List at least two ways that this influence can take place. In your opinion, would one way be preferable over the other?

•Reviewing the social determinants of health, select one to respond to this question: ◦What role can nurses play in promoting health status through policy changes directly affecting this social determinant?

Professional Development Exercises :

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Professional Development Exercises :

Read the case study presented at the end of Chapter 8 (Guido, p. 150)

The patient was to undergo a fundoplication surgery to repair an

esophageal hernia. The procedure involves the insertion of an esoph-

ageal dilator, which at this institution is performed by the anesthesia

team. In this particular instance, the dilator was to be inserted by a

nursing anesthesia student. The student introduced herself to the

patient immediately before the procedure. She used her first name

only and stated that she was a registered nurse who would be work-

ing with the nurse anesthetist and the anesthesiologist. The student

referred to the nurse anesthetist by first and last names and to the

anesthesiologist using the term doctor and his last name.

During the insertion of the dilator, the student tore the lin-

ing of the esophagus. This required an open procedure to be per-

formed, which resulted in complications for the patient. The

patient sued for lack of informed consent, inadequate supervi-

sion, and negligence. Specifically, the patient argued that he had

the right to know if a student was to perform any part of the pro-

cedure and that he had the right to refuse such participation.

The court returned a verdict in favor of the patient on the

part of inadequate supervision. As stated in the institution’s writ-

ten policies, the student was to be supervised by an anesthesiolo-

gist, not merely a nurse anesthetist.

Is the patient correct in asserting that he has a right to know the names and status of individuals who will be performing this procedure?

Does the manner in which the student introduced herself and the two other team members have relevance in this case?

Was the informed consent deficient to the degree that there was a lack of informed consent by the patient?

How would you decide this case?

A patient is admitted to your surgical center for a breast biopsy under local anesthesia. The surgeon has previously informed the patient of the procedure, risks, alternatives, desired outcomes, and possible complications. You give the surgery permit form to the patient for her signature. She readily states that she knows about the procedure and has no additional questions; she signs the form with no hesitation. Her husband, who is visiting with her, says he is worried that something may be said during the procedure to alarm his wife. What do you do at this point? Do you alert the surgeon that informed consent has not been obtained? Do you request that the surgeon revisit the patient and reinstruct her about the surgery? Since the patient has already signed the form, is there anything more you should do?

Now consider the ethical issues that such a scenario raises. Which ethical principles is the husband in this example most portraying? Which ethical principles should guide the nurse in working with this patient and family member?

Jimmy Chang, a 20- year- old college student, is admitted to your institution for additional chemotherapy. Jimmy was diagnosed with leukemia 5 years earlier and has had several courses of chemotherapy. He is currently in an acute active phase of the disease, though he had enjoyed a 14- month remission phase prior to this admission. His parents, who accompany him to the hospital, are divided as to the benefits of additional chemotherapy. His mother is adamant that she will sign the informed consent form for this course of therapy, and his father is equally adamant that he will refuse to sign the informed consent form because “Jimmy has suffered enough.”

You are his primary nurse and must assist in somehow resolving this impasse. What do you do about the informed consent form? Who signs and why? Using the MORAL model, decide the best course of action for Jimmy from an ethical perspective rather than a legal perspective. Did you come to the same conclusion using both an ethical and a legal approach

Create an APA essay with 1500-1800 words, complete the following questions using 4 scholarly sources to support your perspective. please an introduction and conclusion needed.

error that counts

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American writer Nikki Giovanni once said: “Mistakes are a fact of life. It is the response to the error that counts” (Goodreads, 2012). Whenever you make an error when writing a prescription, you must consider the ethical and legal implications of your error—no matter how seemingly insignificant it might be. You may fear the possible consequences and feel pressured not to disclose the error. Regardless, you need to consider the potential implications of non-disclosure. How you respond to the prescription error will affect you, the patient, and the health care facility where you practice. In this Assignment, you examine ethical and legal implications of disclosure and nondisclosure of personal error.

Consider the following scenario:

· You are working as an advanced practice nurse at a community health clinic. You make an error when prescribing a drug to a patient. You do not think the patient would know that you made the error, and it certainly was not intentional.

To prepare:

· Consider the ethical implications of disclosure and nondisclosure.

· Research federal and state laws for advanced practice nurses. Reflect on the legal implications of disclosure and nondisclosure for you and the health clinic.

· Consider what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error.

· Review the Institute for Safe Medication Practices website in the Learning Resources. Consider the process of writing prescriptions. Think about strategies to avoid medication errors.

Write a 2- to 3- page paper that addresses the following:

· Explain the ethical and legal implications of disclosure and nondisclosure. Be sure to reference laws specific to your state.

· Describe what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error. Provide your rationale.

· Explain the process of writing prescriptions including strategies to minimize medication errors.

– This work should have Introduction and conclusion

– This work should have at 4 to 6 current references

– Use at least 3 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

**Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

  • Chapter 1, “Issues for the           Practitioner in Drug Therapy” (pp. 3–14)
    This chapter introduces issues relating to      drug therapy such as adverse      drug events and      medication adherence. It also explores drug safety, the           practitioner’s role and responsibilities in      prescribing, and prescription      writing.
  • Chapter 59, “The Economics           of Pharmacotherapeutics” (pp. 1009-1018)
    This chapter analyzes the costs of drug      therapy to health care systems and      society      and explores practice guideline compliance and current issues in           medical care.
  • Chapter 60, “Integrative      Approaches to      Pharmacotherapy—A Look at      Complex Cases” (pp. 1021-1036)
    This chapter examines issues in individual      patient cases. It explores      concepts relating      to evaluation, drug selection, patient education, and           alternative treatment options.

**Crigger, N., & Holcomb, L. (2008). Improving nurse practitioner practice through rational prescribing. The Journal for Nurse Practitioners, 4(2), 120–125.

Note: Retrieved from the Walden Library databases.

This article explores issues relating to prescription drugs, specifically the frequency in which drugs are prescribed to patients. It also examines factors to consider before beginning drug therapy plans with patients.

**Philipsen, N. C., & Soeken, D. (2011). Preparing to blow the whistle: A survival guide for nurses. The Journal for Nurse Practitioners, 7(9), 740–746.

Note: Retrieved from the Walden Library databases.

This article examines issues that nurses encounter when reporting errors in medical settings. It also outlines the role of ethics and the responsibility of nurses to notify all individuals who are impacted by a medical error.

**American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Nursing World. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html

This article outlines ethical standards in the nursing profession and identifies nine provisions of care that must be adhered to by all nurses.

**Anderson, P., & Townsend, T. (2010). Medication errors: Don’t let them happen to you. American Nurse Today, 5(3), 23–28. Retrieved from https://americannursetoday.com/medication-errors-dont-let-them-happen-to-you/

This article examines factors that lead to medication errors as well as consequences of these errors on patients and nurses. It also recommends methods for avoiding and eliminating medication errors.

**Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by state. Retrieved from August 23, 2012, http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

**Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

**Institute for Safe Medication Practices. (2012). ISMP’s list of error-prone abbreviations, symbols, and dose designations. Retrieved from http://www.ismp.org/Tools/errorproneabbreviations.pdf

This website provides a list of prescription writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

**Byrne, W. (2011). U.S. nurse practitioner prescribing law: A state-by-state summary. Medscape Nurses. Retrieved from http://www.medscape.com/viewarticle/440315

**Drug Enforcement Administration. (n.d.). Code of federal regulations. Retrieved August 23, 2012, from http://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

Remember word count and to use one outside source

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Part one:

Discussion Question: Remember word count and to use one outside source (cited and referenced)

  • Identify a Community Health Assessment Model.  (This document from the CDC lists commonly used community assessment models: https://www.cdc.gov/stltpublichealth/cha/assessment.html )
  • What are some benefits of using a specific model to assess a community?
  • What agencies should be included with the assessment?
  • What is a reasonable time frame in which to complete a community wide assessment?
  • What is the role of the public nurse in implementation of the chosen model?

Part two:

Assignment Description: The final community assessment paper will be submitted in Module 8; therefore, there is no paper to be submitted this week for Mod 7 – only the updated cumulative hour log.  This week please just add the hours you spend completing the community assessment to your Project Hours Log and submit. The Log is all that is required this week for submission (You should have approximately 2-4 hours logged for the geriatric assessment from Mod 2 and now an additional 10-14 hours for Mod 7 portion of the community assessment.Any research that is completed or people who are interviewed should be included in the week 7 log. Please incorporate not only on-line research, but conversational/personal data, as well.

In this module, you will complete a full assessment of your own community.  (You will be using this for your Community Health II course as you plan, implement, and evaluate an education teaching project within your community designed to address an identified health concern of your chosen population.) For this week, in the Module 7 Overview there are several areas which must be assessed for a fully developed assessment. Review this section thoroughly.

  • First is to Defining the Community; answer all questions noted in this section in the Overview. Your community can be a pediatric, adolescence, young adults, adult, elderly or a combination. Or it can be a specific ethnic group or a group such as truck drivers, farmers, or campers. Be sure to define cultural context of the population, demographics such as age, race, education, birth/death rates, life expectancy, insurance status, and other pertinent details. Connect community context and demographics with Healthy People 2020 objectives and identify a health concern.I know the assignment instructions say to select a specific population, but for an easier transition into N493, remain very broad when doing your research this week. The broader, the better! Focus on your county, city or town. Having a broad community assessment will serve you better as you go into N493 (community health 2). In that course you will pick a more specific population, like children, adolescents or adults for the primary prevention project.
  • After the community has been defined, the next phase is Assessment. In the Overview section there are several resources and methods that can be used to gather and generate data. These items serve as a starting point for data collection. Please be sure to use this list to complete a comprehensive assessment of your community. These include:
    • Data Gathering (collecting information that already exists – be sure to use at least 3 agencies to pull data from) (be sure to make clear connections between data gathered and health issues found)
      • Demographics of the Community
      • Information from Government Agencies and Other Data Sources
    • Data Generation (data are developed that do not already exist – this comes from you). Choose three ways listed to generate new data. You should identify many cultural and contextual observations that impact health and be able to make in-depth comparison made to gathered data above as well as connections to health issues found.
      • Windshield Surveys
      • Participant Observation
      • Informant Interviews
      • Focus Groups
      • Surveys

biostatisticians

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By the due date assigned, submit a document describing your approved aggregate in detail.

In Phase 2 of the project, research and describe the demographics and statistics of your aggregate. Include information about the basic vital statistics of the aggregate such as the crude birth rate, infant mortality rate, life expectancy, the leading causes of death, and any other relevant statistical information related to the health of the aggregate. In addition, explain how the local clinic meets, supports, and advocates for evidence-based practice (EBP). As a part of this assignment, you will need to create a questionnaire and interview at least one person who is familiar with your selected aggregate.

Tips

One of the most effective ways to obtain this information is to interview people who are familiar with and have worked with the selected aggregate, such as biostatisticians or other social and healthcare providers of the aggregate.

A well-planned questionnaire with carefully developed questions can help you elicit adequate and relevant information from the interviewees.

Your response should be in the form of a 2- to 3-page Microsoft Word document. Use relevant charts and graphs to support the information you collected. Identify the sources of your information and describe how you went about collecting the information.

Submission Details:

Phase 2: Describing the Aggregate

  • Name your Microsoft Word document SU_NSG4075_W2_Project_LastName_FirstInitial_Phase2.doc.
  • Submit your document to the Submissions Area by the due date assigned.
  • Cite all sources in APA format.

recognizable memorandum

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You are the Chief Operating Officer of a large healthcare system, composed of acute, long term care, and community based organizations in addition to long term care managed care plans. Given your current studies in health policy and management, the Chief Executive Officer of this large healthcare system has requested that you prepare a high-level briefing for the system’s Board of Directors in which you describe: (a) factors that have contributed to dramatic growth in health care spending over the past 50 years; and (b) how health care payment and delivery models are transforming to promote greater accountability for cost and quality in the health care system. Please conclude your memo with your analysis of the most promising approaches for constraining cost growth while maintaining or improving quality, as well as the limitations or open questions that accompany new reimbursement and delivery models that are intended to promote “accountable care.”

The memo must be four pages in length. Please include references to course readings as well as any relevant outside sources that support your analysis. Citations and a references page (not included in page length) are required. **You must use a recognizable memorandum format for this exercise—and it is recommended that subject areas be segmented using sub headers.  Include your institution’s logo on the first page of the memo (fictitious).  Be creative.

time pregnancy

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No plagiarism please.

Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and Include: (3 references within years 2015-2018) with intext citations.

Pregnancy is the period of time when a fetus develops inside a woman’s uterus and ends with the birth of the infant. There are a variety of clinical laboratory tests and diagnostics typically used prior to and throughout pregnancy. The tests and diagnostics provide useful information from the time pregnancy is first considered through the initial days of the newborn’s life.

Discussion: (use headings with answers)

Discuss the most common screening test and diagnostics used throughout pregnancy and the purpose of the tests.

When during pregnancy are tests performed?

What is the protocol when an abnormal test or diagn

Conceptual System Theory

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This week you will be writing an APA paper to include a title page, level headings, and a reference page

  1. Discuss and explain King’s Conceptual System Theory.
    1. First explain the 3 systems and provide examples of each system
    2. Explain how the systems influence goal attainment
    3. How could King’s theory help define a clinical quality problem?
    4. Apply this theory to a potential practice quality improvement initiative within your clinical practice.
    5. How could a quality committee align outcomes with King’s Conceptual System Theory?
    6. What additional nursing theory from our readings could also align with an improved quality of practice initiative?

This paper should include 2 outside references and the textbook. This paper should be 1250 to 1500 words in length.

Virtues and Values

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Virtues and Values

For this assignment differentiate virtues from values. Discuss the characteristics of both.

  • How do they affect one’s character? How are they acquired? How can they be helpful in resolving health care ethical dilemmas? (Content criteria #2)
  • Identify and discuss a health-related case in which virtues and values played a part. Discuss application/and interpretation of these virtues and values in your selected case. (Content criteria #3)
  • Make sure you have an Introduction and Conclusion (Content criteria #1).

Your paper must be three to five double-spaced pages (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center. Utilize a minimum of three scholarly and/or peer-reviewed sources (not including the course textbook) that were published within the last five years. All sources must be documented in APA style, as outlined in the Ashford Writing Center.

Health History

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Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5kg.
  2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
  3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
  5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)
  5. Inhaled short-acting bronchodilator (ProAir HFA)
  6. Inhaled corticosteroid (Flovent HFA)
  7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mrs. J.
  2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
  3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
  4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
  5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
  6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
  7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to 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.