Briefly discuss the ethical problems in research (chapter three). Here are the ethical problems I took in
chapter.
1) Physical harm 2) psychological harm 3) invasion of privacy 4) Deception of participants 5)
Misrepresentation of findings 6) Balancing risk and gain.
2) Be sure to submit your response in a narrative format. All assignments must adhere to the latest
version of the APA-one typed pages.
THE NAME OF THE TEST BOOK IS RESEARCH METHOD SOCIAL WORK BY JAMES.R. DUDLEY YOU CAN
CODE THE BOOK.
Describe your experience in the utilization of nursing research in your clinical practice.
Submission Instructions:
Your post should be at least 500 words, formatted and cited in current APA style with support from at least 2 references from academic journals no older than five years.
Grading Rubric
Your assignment will be graded according to the grading rubric.
Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts
Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.
Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.
Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.
Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.
5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines
Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.
3 points
Response to Posts of Peers
Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.
Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.
Poor – 0 points
Student provided no response to a peer’s post.
Watch the short video (middle of the page) and read the short article then answer the two questions, (one paragraph each):1. Briefly describe how “consumers” can navigate the health care marketplace and how it differs from other consumer goods 2. Discuss what information consumers need and what their capacity is to get and evaluate that information. APA 7th edition citations. https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bills
2-3 pages, 3-4 referencesExplain the controversy that surrounds dissociative disorders.Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
For this Assignment, you will document information about a patient that you examined during the last 3 weeks, using the Comprehensive Psychiatric Evaluation Template provided. You will then use this note to develop and record a case presentation for this patient. Be sure to incorporate any feedback you received on your Week 3 and Week 6 case presentations into this final presentation for the course.
Review this week’s Learning Resources and consider the insights they provide. Also review the Kaltura Media resource in the Classroom Support Center area (accessed via the Help button).
Select a patient that you examined during the last 3 weeks who presented with a disorder for which you have not already conducted an evaluation in Weeks 3 or 6. (For instance, if you selected a patient with OCD in Week 6, you must choose a patient with another type of disorder for this week.) Conduct a Comprehensive Psychiatric Evaluation on this patient using the template provided in the Learning Resources. There is also a completed exemplar document in the Learning Resources so that you can see an example of the types of information a completed evaluation document should contain. All psychiatric evaluations must be signed by your Preceptor. When you submit your document, you should include the complete Comprehensive Psychiatric Evaluation as a Word document, and the completed assignment signed by your Preceptor. You must submit your document using Turn It In. Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.
Then, based on your evaluation of this patient, develop a video case presentation that includes chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis including differentials that were ruled out.
Include at least five (5) scholarly resources to support your assessment and diagnostic reasoning.
Ensure that you have the appropriate lighting and equipment to record the presentation.
Record yourself presenting the complex case for your clinical patient.
Do not sit and read your written evaluation! The video portion of the assignment is a simulation to demonstrate your ability to succinctly and effectively present a complex case to a colleague for a case consultation. The written portion of this assignment is a simulation for you to demonstrate to the faculty your ability to document the complex case as you would in an electronic medical record. The written portion of the assignment will be used as a guide for faculty to review your video to determine if you are omitting pertinent information or including non-essential information during your case staffing consultation video.
In your presentation:
Dress professionally and present yourself in a professional manner.
Display your photo ID at the start of the video when you introduce yourself.
Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).
Present the full case. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis including differentials that were ruled out.
Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.
Be succinct in your presentation, and do not exceed 8 minutes. Address the following:
Subjective: What details did the patient provide regarding their personal and medical history? What are their symptoms of concern? How long have they been experiencing them, and what is the severity? How are their symptoms impacting their functioning?
Objective: What observations did you make during the interview and review of systems?
Assessment: What were your differential diagnoses? Provide a minimum of three (3) possible diagnoses. List them from highest to lowest priority. What was your primary diagnosis, and why?
Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.
28 year old male patient coming in to the clinic with significant mood swings in the past year . Pt reports periods of feeling very erratic , where he engages in reckless behaviors like driving above speed limit because he only lives once and not sleeping because he does not need it and feels energetic either way . Pt also states periods of depression where he spends days in his room without going out . Will start patient on valproic acid 250 mg twice a day for mood stabilization . Will follow up with patient in 4 weeks .
It is estimated that more almost 7% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Institute of Mental Health, 2017). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to behavioral issues, adolescent substance abuse issues, and even physical ailments. For this Assignment, you examine a PTSD video case study and consider how you might assess and treat clients presenting with PTSD.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide about diagnosing and treating PTSD.
View the media Presentation Example: Posttraumatic Stress Disorder (PTSD) and assess the client in the case study.
For guidance on assessing the client, refer to Chapter 3 of the Wheeler text.
Note: To complete this Assignment, you must assess the client, but you are not required to submit a formal comprehensive client assessment.
THE ASSIGNMENT
Succinctly, in 1–2 pages, address the following:
Briefly explain the neurobiological basis for PTSD illness.
Discuss the DSM-5-TR diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?
Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard treatment” from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.
Support your Assignment with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
BY DAY 7
Submit your Assignment. Also attach and submit PDFs of the sources you used.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK9Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6645_Week9_Assignment_Rubric
NRNP_6645_Week9_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeSuccinctly, in 1–2 pages, address the following:• Briefly explain the neurobiological basis for PTSD illness.
15 to >13.0 pts
Excellent 90%–100%
The response includes an accurate and concise explanation of the neurobiological basis for PTSD illness.
13 to >11.0 pts
Good 80%–89%
The response includes an accurate explanation of the neurobiological basis for PTSD illness.
11 to >10.0 pts
Fair 70%–79%
The response includes a somewhat vague or inaccurate explanation of the neurobiological basis for PTSD illness.
10 to >0 pts
Poor 0%–69%
The response includes a vague or inaccurate explanation of the neurobiological basis for PTSD illness. Or, response is missing.
15 pts
This criterion is linked to a Learning Outcome• Discuss the DSM-5-TR diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?
25 to >22.0 pts
Excellent 90%–100%
The response includes an accurate and concise description of the DSM-5-TR diagnostic criteria for PTSD and an accurate explanation of how they relate to the symptomology presented in the case study…. The response includes a concise explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates strong diagnostic reasoning and critical thinking skills.
22 to >19.0 pts
Good 80%–89%
The response includes an accurate description of the DSM-5-TR diagnostic criteria for PTSD and an adequate explanation of how they relate to the symptomology presented in the case study…. The response includes an explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates adequate diagnostic reasoning and critical thinking skills.
19 to >17.0 pts
Fair 70%–79%
The response includes a somewhat vague or inaccurate description of the DSM-5-TR diagnostic criteria for PTSD and a somewhat vague or inaccurate explanation of how they relate to the symptomology presented in the case study…. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates somewhat inadequate diagnostic reasoning and critical thinking skills.
17 to >0 pts
Poor 0%–69%
The response includes a vague or inaccurate description of the DSM-5-TR diagnostic criteria for PTSD and a vague or inaccurate explanation of how they relate to the symptomology presented in the case study. Or, response is missing…. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates poor diagnostic reasoning and critical thinking skills. Or, response is missing.
25 pts
This criterion is linked to a Learning Outcome• Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard” treatment from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.
30 to >26.0 pts
Excellent 90%–100%
The response includes an accurate and concise explanation of one other psychotherapy treatment option for the client in this case study…. The response clearly and concisely explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs.
26 to >23.0 pts
Good 80%–89%
The response includes an accurate explanation of one other psychotherapy treatment option for the client in this case study…. The response adequately explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs.
23 to >20.0 pts
Fair 70%–79%
The response includes a somewhat vague or incomplete explanation of one other psychotherapy treatment option for the client in this case study…. The response provides a somewhat vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs.
20 to >0 pts
Poor 0%–69%
The response includes a vague and inaccurate explanation of one other psychotherapy treatment option for the client in this case study, or the treatment option is innappropriate. Or, response is missing…. The response provides a vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Or, response is missing.
30 pts
This criterion is linked to a Learning Outcome· Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached.
15 to >13.0 pts
Excellent 90%–100%
The response is supported by specific examples from this week’s media and at least three peer-reviewed, evidence-based sources from the literature that provide strong support for the rationale provided. PDFs are attached.
13 to >11.0 pts
Good 80%–89%
The response is supported by examples from this week’s media and three peer-reviewed, evidence-based sources from the literature that provide appropriate support for the rationale provided. PDFs are attached.
11 to >10.0 pts
Fair 70%–79%
The response is supported by examples from this week’s media and two or three peer-reviewed, evidence-based sources from the literature. Examples and resources selected may provide only weak support for the rationale provided. PDFs may not be attached.
10 to >0 pts
Poor 0%–69%
The response is supported by vague or inaccurate examples from the week’s media and/or evidence from the literature, or is missing.
15 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 to >4.0 pts
Excellent 90%–100%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineates all required criteria.
4 to >3.5 pts
Good 80%–89%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
3.5 to >3.0 pts
Fair 70%–79%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic.
3 to >0 pts
Poor 0%–69%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.... No purpose statement, introduction, or conclusion were provided.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.5 pts
Good 80%–89%
Contains 1 or 2 grammar, spelling, and punctuation errors.
3.5 to >3.0 pts
Fair 70%–79%
Contains 3 or 4 grammar, spelling, and punctuation errors.
3 to >0 pts
Poor 0%–69%
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent 90%–100%
Uses correct APA format with no errors.
4 to >3.5 pts
Good 80%–89%
Contains 1 or 2 APA format errors.
3.5 to >3.0 pts
Fair 70%–79%
Contains 3 or 4 APA format errors.
3 to >0 pts
Poor 0%–69%
Contains many (≥ 5) APA format errors.
5 pts
Total Points: 100
Trauma”usNext
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u… and Psychiatric Diagnosis”
American Psychiatric Association. (2017). Clinical practice guideline of PTSDLinks to an external site.. https://www.apa.org/ptsd-guideline
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach Download SAMHSA’s concept of trauma and guidance for a trauma-informed approach. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_T…
Credit: Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
Tye, S., Van Voorhees, E., Hu, C., & Lineberry, T. (2015). Preclinical perspectives on posttraumatic stress disorder criteria in DSM-5 Download Preclinical perspectives on posttraumatic stress disorder criteria in DSM-5. Harvard Review of Psychiatry, 23(1), 51–58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC45420…
Credit: Preclinical Perspectives on Posttraumatic Stress Disorder Criteria in DSM-5 by Susannah Tye, PhD, Elizabeth Van Voorhees, PhD, Chunling Hu, MD, PhD, and Timothy Lineberry, MD, in HARVARD REVIEW OF PSYCHIATRY, Vol. 23/Issue 1. Copyright 2015 by ROUTLEDGE. Reprinted by permission of ROUTLEDGE via the Copyright Clearance Center.
Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.Chapter 3, “Assessment and Diagnosis” (Previously read in Week 2)
Chapter 7, “Eye Movement Desensitization and Reprocessing Therapy”
Chapter 11, “Trauma Resiliency Model Therapy”
Chapter 15, “Trauma-Informed Medication Management”
Chapter 17, “Stabilization for Trauma and Dissociation”
Chapter 18, “Dialectical Behavior Therapy for Complex
Required Media
Grande, T. (2019, August 21). Presentation example: Posttraumatic stress disorder (PTSD)Links to an external site. [Video]. YouTube.
Gift from Within. (Producer). (2008). PTSD and veterans: A conversation with Dr. Frank OchbergLinks to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?u…
Know & Grow with Dr. K. (2021, July 18). Does your child suffer from post traumatic stress disorder?Links to an external site. (Strictly Medical-English Version). [Video]. YouTube.
GROUP PRESENTATION COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN
Assignment title or
task:
(You can write a
question)
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Select one from the following topics: Occupational stress and impact on employee well-being
Health risks for health workers on night shift.
The roles and responsibilities of the occupational health professionals
The role of telehealth in occupational health services
Occupational safety and health measures in Saudi Arabia
Promoting Mental Health in the Workplace
Digital Occupational Health in KSA.
The role of occupational health in the prevention of occupational
diseases
Psychosocial hazards and prevention in the workplace
Occupational health services for small-sized workplaces of less than 20
workers
Promoting Mental Health in the Workplace
Occupational Heat Exposure
Occupational Noise Exposure
Personal Protective Equipment
Prevent Falls in the workplace
Name
Student’s name and ID
Submission date:
ID
Instructor name
Dr.
Grade
… out of 10
Guidelines:
➢ Every student must send me by email with his chosen topic before 10/10/2023
➢ The presentation should be submitted on the blackboard as a PPT file.
➢ The PPT should not be more than 15 slides and not less than 10 slides.
➢ Use appropriate references as per the APA Style.
➢ The oral presentation time should be 7-10 minutes.
➢ All presenters must participate equally and help each other as needed.
➢ It will be conducted in weeks 9, 10, 11.
➢ Your presentation will be evaluated based on the implementation of
communication skills, slides, time, deadline, topic covering.
Week 9
1. ABDULLAH ALAMRI
2. Faisal Alanazi
3. HUSSEIN ALBAHER
4. SULTAN ALDAWSARI
5. MUFEED ALDHU
Week 10
Week 11
1. MUSTAFA
ALHADDAD
1. MUBARAK
ALMURAYR
2. FARIS ALJANFAWI
2. MOHAMMED
ALQARNI
3. SAAD ALKHALIFAH
4. AHMAD ALKUWAITY
5. KHALID ALMATHIBIRI
6. AQEEL ALMUJAYBIL
3. HASSAN ALRUBH
4. hani alrumaih
5. BADER ALSHAMMARI
All students must submit their
6. ABDULRAHMAN
ALSHEHRI
presentation by Monday of
All students must submit their
All students must submit their
week 9
presentation by Monday of
presentation by Monday of
week 10
week 11
6. AHMED MAJRASHI
Please follow the rank and the presentation will be in the virtual session on Wednesday of
the weeks 9,10, and11. Attendance is required for all students.
Good Luck
Consider the related Sustainable Development Goals, the 5A domains previously emphasized: Availability – Accessibility – Affordability- Appropriateness – Acceptability. Also, review the Framework (Model) of Determinants of Health in the (attached).
With the recent controversies with the overturning of Row v Wade and reproductive health, services, and rights, it has come to this point that many people and politicians view this issue as coming down to only a binary option/decision – for or against (and even more specifically, for or against abortion). This is but an endpoint. If we go ‘upstream’ with this issue – reproductive health, services, and rights – we can view these with a comprehensive population/public health lens and consider the SDGs, the 5A domains and also the Framework/model of Determinants of Health. There are many points for interventions to be implemented, to improve sexual and reproductive health and awareness, services, and rights and reduce some of the current controversial healthcare issues and concerns.
With a word count of >500 words), go ‘upstream’ and outline a few points and interventions that could be implemented to support and improve reproductive health, services, and/or rights. Also, when considering interventions, address the ‘who, what, where, when, and how’ of these interventions. Remember when the ‘cookie cutter’ approach had been mentioned (also known as ‘one size fits all’), where one intervention is used broadly and not considering differences among communities and populations? Typically, not as effective as more tailored approaches. Discuss the points in your outline, as well as potential barriers and/or limitations and any other key ‘takeway’ points.
Part 2
think about and reflect upon when and how you learned about sexual health and reproductive health – at what point in your life (age(s))? Was this formal or informal? Who taught you or where did you learn about these (school, church, friends, family, etc.)?…and any other related past related learning experiences.
Today, if you were in charge of a team to strategize community outreach to promote and improve sexual health and reproductive health within the community, for all community members, how would you envision this? Brainstorm ideas and discuss approaches you think would better promote these topics.
Write at least 3-4 substantial paragraphs for this.
Students will be given time to work on their assignments during class to identify research articles. Additional time will be required outside of class to complete the assignment.
topic: The role of naturopathic remedies in chronic disease management
• Select 2 articles to use for background research and literature review. One article would be a best practice document or government report, and the other article would be from professional journal. Seek approval for articles other than best practices, government reports or journal articles. News articles and web page blogs are not appropriate for the assignment.
Summarize the purpose of your policy issue in one or two one or two sentences.
Discuss the background to your issue. Ensure that this discussion is based on research and properly cited.
• Discuss the current situation of your policy issue ensuring that this section is based on research and properly cited.
• Use the examples discussed in class as a guide for the development of the briefing note.
• Using the research, you conducted to write out some recommendations relevant to your topic and summarize them. These would be properly cited.
• Identify next steps and submit the completed policy brief, including purpose, background, current situation, recommendations, and next steps.
Report Format:
• Date
• Purpose
• Background/ Literature review
• Current Situation
• Recommendations
• Next Steps
• References – APA format
Use 12-point Arial font and double space the document, minimum 3 pages-maximum 4 pages
• Use APA formatting.
• Please see the rubric to understand the expectations
Criteria Level 1 (Significant Improvement Needed)
1 point
Level 2 (Developing)
2 points
Level 3 (Pass)
3 points
Level 4 (Accomplished)
4 points
Level 5 (Exceptional)
5 points
Criterion Score
Purpose and explanation of the background
No purpose or background statement is provided.
The purpose and explanation contain errors of assertion or requires more detail.
The problem statement is adequate but missing clarity or detail.
Purpose and statement are mostly clearly outlined with an explanation of the background provided.
Purpose and statement are fully and clearly outlined with an explanation of the background provided.
Score of Purpose and explanation of the background,
/ 5
Current situation, Literature review
No analysis of current situation is provided.
Discussion is lacking evidence or evidence is incorrect.
Adequate discussion of current situation. The brief has some evidence of support for the arguments however it is overlooking some of the supporting argument or required components.
Mostly thoughtful, logical, well-articulated analysis of the current situations including legislation and/or past policy, best practice, research, and data. Literature review is of mostly of high quality and included in the assignment .
Thoughtful, logical, well-articulated analysis of the current situations including legislation and/or past policy, best practice, research, and data. Literature review is of high quality and included in the assignment.
Score of Current situation, Literature review,
/ 5
Policy options, recommendations, next steps
No options, recommendations, or next steps were provided.
Discussion is confusing and lacking some of the required components, or detail.
Adequate discussion of policy options, recommendations, and next steps, however, may not be clearly stated or is missing detail.
Policy options are mostly identified, and recommendations and next steps are mostly stated and appropriate to the audience.
Policy options are identified, and recommendations and next steps are clearly stated and appropriate to the audience.
Score of Policy options, recommendations, next steps,
/ 5
Use and quality of references
No references were provided.
Some references are of poor quality or required number are not utilized.
References are adequate but not all meet the quality requirements.
References are mostly of quality and meet requirements.
References are of quality and meet or exceed requirements.
Score of Use and quality of references,
/ 5
Formatting, use of headers, subheadings, grammar/punctuation and spelling, APA
No heading, subheadings are not used, grammar, punctuation, and spelling is poor, and APA is not used.
The brief is confusing, there are many grammar, punctuation, spelling and APA formatting problems.
The brief is adequate, transitions between thoughts are adequate, minor amount of grammar, punctuation, spelling and APA problems exist.
Brief provides mostly clear policy analysis, an adequate number of references, no grammar, punctuation, spelling or APA formatting errors.
Brief provides clear policy analysis, an adequate number of references, no grammar, punctuation, spelling or APA formatting errors.
Score of Formatting, use of headers, subheadings, grammar/punctuation and spelling, APA,
/ 5
You may check your Turnitin score and address any issues that are highlighted.
Consider all the readings and research you have done in this course.Discuss how your role as an APRN will have an impact on the culture of safety in your workplace.Apply quality improvement principles in care deliveryIdentify dilemmas facing nurses in healthcare and how that impacts patient safetyDescribe the factors that create a culture of safetyIdentify the role of the APRN in the quality and safety of patientsPlease be sure to validate your opinions and ideas with citations and references in APA format.
You are a senior nursing student completing your final leadership practicum. Your assignment today is to assume leadership of a small team composed of the registered nurse (RN), one licensed vocational nurse/licensed practical nurse, and one certified nursing assistant (CNA). The RN preceptor has agreed to let you take on this leadership role in her place, although she will shadow your efforts and provide support throughout the day.
Almost immediately after handoff report, a patient puts on the call light and tells you that she needs to have her sheets changed as she was incontinent in the bed. Because you are just beginning your 8:00 AM med pass and are already behind, you ask the CNA if she has time to do this task. She immediately responds, “I’m busy and you’re the student. Do it yourself! It would be a good learning experience for you.” When you try to explain your leadership role for the day, she walks away, saying that she does not have time anyway.
A few minutes after that, a physician enters the unit. He wants to talk to the nurse about his patient. When you inform him that you are the student nurse caring for his patient that day, he responds, “No—I want to talk to the real nurse.”
You feel frustrated with this emerging authority–power gap and seek out the RN to formulate a plan to make this gap smaller.
ASSIGNMENT:
Identify at least four strategies you might use to reduce the size of this authority–power gap. Would you involve the RN in your plan? Do you anticipate having similar authority–power gaps in the new graduate role? List which Learning Exercise you are solving at the start of your analysis and provide a brief summary of the case. Be sure to apply an appropriate problem-solving/decision-making model (Traditional Problem-Solving Process, Managerial Decision-Making Model, The Nursing Process, or the Integrated Ethical Problem-Solving Model) in determining what you should do. Justify your decision with supporting evidence.
Writing Expectations—3 to 4 pages, double-spaced, in length, not counting title page and references. APA format required (title page, citations in body of paper, and reference list). The steps of the problem-solving or decision-making model chosen should be used as subheadings for the paper. Each analysis should include a brief introduction and conclusion. Be sure to identify numerically which Learning Exercise is being analyzed.
Pease gimme strong paragraphs with clear ideas. I need good thoughts with concatenated ideas.
DEVELOPING A CULTURE OF EVIDENCE-BASED PRACTICE
As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.
In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
Reflect on which type of dissemination strategy you might use to communicate EBP.
BY DAY 3 OF WEEK 9
Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.
THIS IS WHAT WAS MENTIONED FROM MY PROFESSOR ON THE LAST ASSIGNMENT AND I RECEIVED A 67%, ALSO I’VE INCLOSED THE RUBIC AS WELL TO FOLLOW ALONE
You have presented a critical appraisal of four peer-reviewed articles within the Critical Appraisal Tool Worksheet Template. The review was underdeveloped and the studies not specific to the PICOT Based on your appraisal you suggested a best practice however you are making a leap with the “evidence”. These studies suggest there is a link between stress and burnout but they do not investigate the effect of a stress reduction program on decrease in burnout. The required course resources were not included.
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. … Supported by at least three current, credible sources. … Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
44 to >39 pts
Good
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. … At least 75% of post has exceptional depth and breadth. … Supported by at least three credible sources. … Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
39 to >34 pts
Fair
Responds to some of the discussion question(s). … One or two criteria are not addressed or are superficially addressed. … Is somewhat lacking reflection and critical analysis and synthesis. …Somewhat represents knowledge gained from the course readings for the module. … Post is cited with two credible sources. … Written somewhat concisely; may contain more than two spelling or grammatical errors. … Contains some APA formatting errors.
34 to >0 pts
Poor
Does not respond to the discussion question(s) adequately. … Lacks depth or superficially addresses criteria. … Lacks reflection and critical analysis and synthesis. … Does not represent knowledge gained from the course readings for the module. … Contains only one or no credible sources. … Not written clearly or concisely. …Contains more than two spelling or grammatical errors. … Does not adhere to current APA manual writing rules and style.
/ 50 pts
Main Post: Timeliness
view longer description
10 to >0 pts
Excellent
Posts main post by day 3.
0 pts
Poor
Does not post by day 3.
/ 10 pts
First Response
view longer description
18 to >16 pts
Excellent
Response exhibits synthesis, critical thinking, and application to practice settings. … Responds fully to questions posed by faculty. …Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. … Demonstrates synthesis and understanding of learning objectives. … Communication is professional and respectful to colleagues. … Responses to faculty questions are fully answered, if posed. … Response is effectively written in standard, edited English.
16 to >14 pts
Good
Response exhibits critical thinking and application to practice settings. … Communication is professional and respectful to colleagues. … Responses to faculty questions are answered, if posed. … Provides clear, concise opinions and ideas that are supported by two or more credible sources. … Response is effectively written in standard, edited English.
14 to >12 pts
Fair
Response is on topic and may have some depth. … Responses posted in the discussion may lack effective professional communication. … Responses to faculty questions are somewhat answered, if posed. … Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
12 to >0 pts
Poor
Response may not be on topic and lacks depth. … Responses posted in the discussion lack effective professional communication. … Responses to faculty questions are missing. … No credible sources are cited.
/ 18 pts
Second Response
view longer description
17 to >15 pts
Excellent
Response exhibits synthesis, critical thinking, and application to practice settings. … Responds fully to questions posed by faculty. … Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. … Demonstrates synthesis and understanding of learning objectives. … Communication is professional and respectful to colleagues. … Responses to faculty questions are fully answered, if posed. … Response is effectively written in standard, edited English.
15 to >13 pts
Good
Response exhibits critical thinking and application to practice settings. … Communication is professional and respectful to colleagues. … Responses to faculty questions are answered, if posed. … Provides clear, concise opinions and ideas that are supported by two or more credible sources. … Response is effectively written in standard, edited English.
13 to >11 pts
Fair
Response is on topic and may have some depth. … Responses posted in the discussion may lack effective professional communication. … Responses to faculty questions are somewhat answered, if posed. … Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
11 to >0 pts
Poor
Response may not be on topic and lacks depth. … Responses posted in the discussion lack effective professional communication. … Responses to faculty questions are missing. … No credible sources are cited.
/ 17 pts
Participation
view longer description
5 to >0 pts
Excellent
Meets requirements for participation by posting on three different days.
0 pts
Poor
Does not meet requirements for participation by posting on 3 different days.
/ 5 pts
Total Points: 0
FROM ANNOUCEMENTS;
Today we begin week 9 in the course, and the assignment is a discussion forum. Here is a reminder of the requirements for that forum:
By Wednesday of week 9 Postat least two dissemination strategies (for example a power-point, or podium presentation, or poster, etc) you would be most inclined to use to introduce an evidence-based practice into a workplace and give rationale for your selections.
Explain which dissemination strategies you would be least inclined to use and explain why.
Identify at least two barriers you might encounter when using the dissemination strategies, you are most inclined to use. Be specific and provide examples. For example it might be difficult to get busy nurses together for a presentation in person, how could you overcome that)
Explain how you might overcome the barriers you identified.
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Evidence-Based Practice, Step by Step:
Implementing an Evidence-Based Practice Change
Gallagher-Ford, Lynn MSN, RN, NE-BCFineout-Overholt, Ellen PhD, RN, FNAP,
FAANMelnyk, Bernadette Mazurek PhD, RN, CPNP/PMHNP, FNAP, FAANStillwell, Susan B.
DNP, RN, CNEAuthor Information
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Abstract
This is the ninth article in a series from the Arizona State University College of Nursing and Health
Innovation’s Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a
problem-solving approach to the delivery of health care that integrates the best evidence from studies and
patient care data with clinician expertise and patient preferences and values. When delivered in a context of
caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be
achieved.The purpose of this series is to give nurses the knowledge and skills they need to implement EBP
consistently, one step at a time. Articles will appear every other month to allow you time to incorporate
information as you work toward implementing EBP at your institution. Also, we’ve scheduled “Chat with the
Authors” calls every few months to provide a direct line to the experts to help you resolve questions. Details
about how to participate in the next call will be published with May’s Evidence-Based Practice, Step by Step.
In January’s evidence-based practice (EBP) article, Rebecca R., our hypothetical staff nurse,
Carlos A., her hospital’s expert EBP mentor, and Chen M., Rebecca’s nurse colleague, began to
develop their plan for implementing a rapid response team (RRT) at their institution. They
clearly identified the purpose of their RRT project, the key stakeholders, and the various
outcomes to be measured, and they learned their internal review board’s requirements for
reviewing their proposal. To determine their next steps, the team consults their EBP
Implementation Plan (see Figure 1 in “Following the Evidence: Planning for Sustainable
Change,” January). They’ll be working on items in checkpoints six and seven: specifically,
engaging the stakeholders, getting administrative support, and preparing for and conducting the
stakeholder kick-off meeting.
ENGAGING THE STAKEHOLDERS
Carlos, Rebecca, and Chen reach out to the key stakeholders to tell them about the RRT project
by meeting with them in their offices or calling them on the phone. Carlos leads the team through
a discussion of strategies to promote success in this critical step in the implementation process
(see Strategies to Engage Stakeholders). One of the strategies, connect in a collaborative way,
seems especially applicable to this project. Each team member is able to meet with a stakeholder
in person, fill them in on the RRT project, describe the purpose of an RRT, discuss their role in
the project, and answer any questions. They also tell each stakeholder about the initial project
meeting to be held in a few weeks.
Box
No caption available.In anticipation of the stakeholder kick-off meeting, Carlos and the team
discuss the fundamentals of preparing for an important meeting, such as how to set up an agenda,
draft key documents, and conduct the meeting. They begin to discuss a time and date for the
meeting. Carlos suggests that Rebecca and Chen meet with their nurse manager to update her on
the project’s progress and request her help in scheduling the meeting.
SECURING ADMINISTRATIVE SUPPORT
After Rebecca updates her manager, Pat M., on the RRT project, Pat says she’s impressed by the
team’s work to date and offers to help them move the project forward. She suggests that, since
they’ve already invited the stakeholders to the upcoming meeting, they use e-mail to
communicate the meeting’s time, date, and place. As they draft this e-mail together, Pat shares
the following tips to improve its effectiveness:
• communicate the essence and importance of the e-mail in the subject line
• write an e-mail that’s engaging, but brief and to the point
• introduce yourself
• explain the project
• welcome the recipients to the project and/or team and invite them to the meeting
• explain why their attendance is critical
• request that they read certain materials prior to the meeting (and attach those documents
to the e-mail)
• let them know whom to contact with questions
• request that they RSVP
• thank them for their participation
Box
No caption available.Before they send the e-mail (see Sample E-mail to RRT and
Stakeholders), the team wants to make sure they don’t miss anyone, so they review and include
all of the RRT members and stakeholders. They realize that it’s important to invite the manager
of each of the stakeholders and disciplines represented on the RRT and ask them to also bring a
staff representative to the meeting. In addition, they copy the administrative directors of the
stakeholder departments on the e-mail to ensure that they’re fully aware of the project.
PREPARING FOR THE KICK-OFF MEETING
The group determines that the draft documents they’ll need to prepare for the stakeholder kickoff meeting are:
• an agenda for the meeting
• the RRT protocol
• an outcomes measurement plan
• an education plan
• an implementation timeline
• a projected budget
To expedite completion of the documents, the team divides them up among themselves. Chen
volunteers to draft the RRT protocol and outcomes measurement plan. Carlos assures her that
he’ll guide her through each step. Rebecca decides to partner with her unit educator to draft the
education plan. Carlos agrees to take the lead in drafting the meeting agenda, implementation
timeline, and projected budget, but says that since this is a great learning opportunity, he wants
Rebecca and Chen to be part of the drafting process.Drafting documents. Carlos tells the team
that the purpose of a draft is to initiate discussion and give the stakeholders an opportunity to
have input into the final product. All feedback is a positive sign of the stakeholders’ involvement,
he says, and shouldn’t be perceived as criticism. Carlos also offers to look for any templates from
other EBP projects that may be helpful in drafting the documents. He tells Rebecca and Chen
that he’s confident they’ll do a great job and shares his excitement at how the team has progressed
in planning an EBP practice change.RRT protocol. Chen starts to draft the RRT protocol using
one of the hospital’s protocols as a template for the format, as well as definitions and examples of
protocols, policies, and procedures from other organizations and the literature. She returns to the
articles from the team’s original literature search (see “Critical Appraisal of the Evidence: Part I,”
July 2010) to see if there is information, previously appraised, that will be helpful in this current
step in the process. She recalls that the team had set aside some articles because they didn’t
directly answer the PICOT question about whether to implement an RRT, but they did have
valuable information on how to implement an RRT. In reviewing these articles, Chen selects one
that’s a review of the literature, though not a systematic review, that includes many examples of
RRT membership rosters and protocols used in other hospitals, and which will be helpful in
drafting her RRT protocol document.1 Chen includes this expert opinion article because the
information it contains is consistent with the higher-level evidence already being used in the
project. Using both higher and lower levels of evidence, when appropriate, allows the team to
use the best information available in formulating their RRT protocol.As she writes, Chen
discovers that their hospital’s protocols and other practice documents don’t include a section on
supporting evidence. Knowing that evidence is critically important to the RRT protocol, she
discusses this with the clinical practice council representative from her unit who advises her to
add the section to her draft document. He promises to present this issue at the next council
meeting and obtain the council’s approval to add an evidence section to all future practice
documents. Chen reviews the finished product before she submits it for the team’s review
(see RRT Protocol Draft for Review1–10).
Box
No caption available.Outcomes measurement plan. Based on the appraised evidence and the
many discussions Rebecca and Chen have had about it, Chen drafts a document that lists the
outcomes the team will measure to demonstrate the success of their project, where they’ll obtain
this information, and who will gather it (see Table 1). In drafting this plan, Chen realizes that
they don’t have all the information they need, and she’s concerned that they’re not ready to move
forward with the stakeholder kick-off meeting. But when Chen calls Carlos and shares her
concern, Carlos reminds her that the document is a draft and that the required information will be
addressed at the meeting.
Table 1. Plan for Measuring RRT Success (Draft for Discussion)
Education plan. Rebecca reaches out to Susan B., the clinical educator on her unit, and requests
her help in drafting the education plan. Susan tells Rebecca how much she enjoys the opportunity
to work collaboratively with staff nurses on education projects and how happy she is to see an
EBP project being implemented. Rebecca shares her RRT project folder (containing all the
information relative to the project) with Susan, focusing on the education about the project she
thinks the staff will need. Susan commends the team for its efforts, as a good deal of the
necessary work is already done. She asks Rebecca to clarify both the ultimate goal of the project
and what’s most important to the team about its rollout on the unit. Rebecca thoughtfully
responds that the ultimate goal is to ensure that patients receive the best care possible. What’s
most important about its rollout is that the staff sees the value of an RRT to the patients and its
positive impact on their own workload. She adds that it’s important to her that the project be
conducted in a way that feels positive to the staff as they work toward sustainable changes in
their practices.Susan and Rebecca discuss which clinicians will need education on the RRT.
They plan to use a variety of mechanisms, including in-services, e-mails, newsletters, and flyers.
From their conversation, Susan agrees to draft an education plan using a template she developed
for this purpose. The template prompts her to put in key elements for planning an education
program: learner objectives, key content, methodology, faculty, materials, time frame, and room
location. Susan fills the template with information Rebecca has given her, adding information
she knows already from her experience as an educator. When Rebecca and Susan meet to review
the plan, Rebecca is amazed to see how their earlier conversation has been transformed into a
comprehensive document (see the Education Plan for RRT
Implementation at http://links.lww.com/AJN/A19).Agenda and timeline. The team meets to
draft the meeting agenda, implementation timeline, and budget. Carlos explains the purposes of a
meeting agenda: to serve as a guide for the participants and to promote productivity and
efficiency. They draft an agenda that includes the key issues to be shared with the stakeholders
as well as time for questions, feedback, and discussion (see the Rapid Response Team Kick-off
Meeting Agenda at http://links.lww.com/AJN/A20).Carlos describes how the timeline creates a
structure to guide the project (see Table 2 at http://links.lww.com/AJN/A21). The team further
discusses how it can maintain the project’s momentum by keeping it moving forward while at the
same time accommodate unexpected delays or resistance. There are a few items on the timeline
that Carlos thinks may be underestimated—for example, the team may need more than a month
to meet with other departments because of already heavily scheduled calendars—but he decides
to let it stand as drafted, knowing that it’s a guide and can be adjusted as the need
arises.Budget. Carlos discusses the budget with the team. Rebecca shares a list of what she thinks
they’ll need for the project and the team decides to put this information into a table format so
they can more easily identify any missing information. Before they construct the table, they walk
through an imaginary RRT call to be sure they’ve thought of all the budget implications of the
project. They realize they didn’t include the cost of each employee attending an education
session, so they add that figure to the budget. They also realize that they’re missing hourly pay
rates for the different types of employees involved. Carlos tells Rebecca that he’ll work with the
Human Resources Department to obtain this information before the meeting so they can
complete the budget (see Table 3).
Table 3. RRT Project Budget Draft (Draft for Discussion)
REVIEWING THEIR WORK
The next time they meet, the EBP team reviews the agenda for the meeting and the documents
they’ll be presenting. The clerical person on Rebecca and Chen’s floor (sometimes called the unit
secretary) has kept a record of who’s attending the meeting and the team is pleased that most of
the stakeholders are coming. Carlos informs the team that he received notification that their
internal review board submission has been approved. They’re excited to check that step off on
their EBP Implementation Plan.Carlos suggests that they discuss the kick-off meeting in detail
and brainstorm how to prepare for any negative responses to their project that might occur.
Rebecca and Chen remark that they’ve never considered that someone might not like the idea of
an RRT. Carlos says he’s not surprised; often the passion that builds around an EBP project and
the hard work put into it precludes taking time to think about “why not.” The team talks about
the importance of stopping occasionally during any project to assess the environment and
participants, recognizing that people often have different perspectives and that everyone may not
support a change. Carlos reminds the team that people may simply resist changing the routine,
and that this can lead to the sabotage of a new idea. As they explore this possible resistance,
Rebecca shares her concern that with everyone in the hospital so busy, adding something new
may be too stressful for some people. Carlos tells Rebecca and Chen that helping project
participants realize they’ll be doing the same thing they’ve been doing, just in a more efficient
and effective way, is generally successful in helping them accept a new process. He reminds
them that many of the people on the RRT are the same people who currently take care of patients
if they code or are admitted to the ICU; however, with the RRT protocol, they’ll be intervening
earlier to improve patients’ outcomes. The team feels confident that, if needed, they can use this
approach at the kick-off meeting.
CONDUCTING THE KICK-OFF MEETING
Rebecca and Chen are both nervous and excited about the meeting. Carlos has made sure they’re
well prepared by helping them set up the meeting room, computer, PowerPoint presentation, and
handout packets containing the agenda and draft documents. The team is ready, and they’ve
placed themselves at the head of the table so they can be visible and accessible. As the invitees
arrive, they welcome each one individually, thanking them for participating in this important
meeting. The team makes sure that the meeting is guided by the agenda and moves along through
the presentation of information to thoughtful questions and a lively discussion.Join the EBP team
next time as they launch the RRT project and tackle the real-world issues of project
implementation.
REFERENCE
• 1. Choo CL, et al. Rapid response team: a proactive strategy in managing
haemodynamically unstable adult patients in the acute care hospitals.
ARTICLES
SUBSCRIBED
Organizational Change Strategies for EvidenceBased Practice
Newhouse, Robin P. PhD, RN, CNA, CNORDearholt, Sandi MS, RNPoe, Stephanie MScN,
RNPugh, Linda C. PhD, RNC, FAANWhite, Kathleen M. PhD, RN, CNAA,BCAuthor
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Abstract
Evidence-based practice, a crucial competency for healthcare providers and a basic force in Magnet hospitals,
results in better patient outcomes. The authors describe the strategic approach to support the maturation of The
Johns Hopkins Nursing evidence-based practice model through providing leadership, setting expectations,
establishing structure, building skills, and allocating human and material resources as well as incorporating the
model and tools into undergraduate and graduate education at the affiliated university.
Evidence-based practice (EBP) is an essential component of professional nursing,1,2 a crucial
competency for healthcare providers,3 and a basic force in Magnet hospitals4 and results in
better patient outcomes and higher levels of nursing autonomy.5 Fostering EBP within
organizations requires strong infrastructure, including nursing leadership and human and
material resources.6-10 Several organizations have reported on the use of EBP change models to
assist and mentor individual EBP project teams.11-14 One recent publication discusses the use of
a change model in the context of organizational change, highlighting the establishment of an
EBP committee that is positioned within the nursing department’s administrative
structure.15 Approaching the implementation of EBP as an organizational transformational
change frames the approach strategically.16After the creation and testing of a conceptual model
for EBP,17 a strategic plan was developed to implement the Johns Hopkins Nursing EBP model
and guidelines (JHN EBP) throughout the organization. The team knew that the implementation
of EBP would require a substantial change in nursing culture. The goal was to infuse the use of
JHN EBP into routine practice within each department. This goal required a number of strategic
objectives that included developing EBP education programs and Web-based resources,
modifying job description criteria to include behavioral outcomes for EBP, defining the origin of
potential question generation, and building nurse EBP skills and expertise (Table 1). The EBP
program was built through providing leadership, setting expectations, establishing structure,
building skills, and allocating human and material resources. The JHN EBP model and tools
were then incorporated into undergraduate and graduate education at the affiliated university.
This article describes the strategic approach to building infrastructure to support the maturation
of EBP within an academic medical center.
Table 1. Strategic Plan to Infuse The Johns Hopkins Nursing Evidence-Based Practice (EBP)
Model
Leadership
Leadership endorsement was the initial step in building the EBP program. Nurse administrators
are responsible for managing both human and material resources necessary for the successful
implementation of the EBP program. Leadership is critical to build organizational readiness for
change.16,18 This nursing department is part of a highly decentralized organization. A director
of nursing, an administrator, and a physician director lead each department with responsibility
for the service area. Because of their accountability for resources, it was essential that the
directors of nursing were committed to the EBP implementation goals. The strategic plan was
approved by leadership and the governance committees (standards of care [SOC], standards of
practice, nursing clinical quality improvement, staff education, and research committees) and
was then incorporated into the committee structure.
Establishing the Structure
To establish a structure for building and sustaining EBP, a majority of the governance
committees were charged with specific responsibilities. These governance committees include
committee chairs, SOC, standards of practice, nursing clinical quality improvement, staff
education, and research. Committee chairs consist of the chairs and cochairs for each of the
governance committees. Committee chairs drafted EBP committee goals that were aligned with
the purpose of each committee. Each committee then reviewed and revised or supported these
goals. In addition, the purpose and functions of each committee were reviewed in light of the
EBP initiative. During implementation, each committee in the governance structure had
responsibility for a specific goal (Figure 1). The SOC committee became responsible for
reporting progress and monitoring outcomes of the EBP initiatives within each department. This
structure was important because it infused the responsibility for EBP across the professional
governance committees, making nurse leaders on the committees accountable for growing and
sustaining the EBP program. To continue to enhance EBP expertise and engagement, each
department is completing at least 1 project over a 15-month period.
Figure 1
The shared governance role in the implementation of evidence-based practice (EBP).
Developing an EBP Skill Set
One of the most important steps in the plan was to develop EBP experts that would act as future
mentors. These individuals were to be the primary champions and facilitators of EBP. They were
members of the governance committees; thus, incorporating EBP goals into responsibilities as a
committee member was well aligned with moving the strategic initiative ahead.19In addition,
nurse schedules needed to accommodate time away from clinical responsibilities for initial
training and then later to complete the EBP process. The buy-in from nursing leadership was
essential to support nurse scheduling to meet the training requirements, provide the needed
encouragement, and assure that the EBP projects were focused on an important area for which
practice recommendations were needed.
Development of Material Resources
A number of resources needed to be established to foster the growth and development of the
program. These resources included the availability of the JHN EBP model, process, guidelines,
and tools in written and electronic formats. It was also important to assure that library, database,
and Web resources were accessible to each nurse.Training and mentorship were offered in each
department through the committee member mentors who had completed initial training. The
authors (core EBP group) were also available for committee members and teams. Because there
is not one strategy that is always successful, the team planned multiple strategies for training and
education.8 Our goal to develop EBP skills and competencies required that we develop a training
and education plan, using several approaches to meet the needs of the nurses and organization
through multimethod education, demonstration, mentorship, and fellowship. Examples of
strategies included rapid cycle training, a 1-and 2-day seminar approach, multidisciplinary
groups, completion of projects within the committee structure, and committee members
mentoring teams in their departments.In addition to these educational approaches, a fellowship in
EBP was developed and budgeted through the department of nursing administration. Two
fellowships were awarded through a competitive process that provided salary support for 20
hours per week for 3 months. This opportunity provided the time needed for the fellows to
develop advanced EBP skills to prepare them to lead EBP initiatives at the unit, functional unit,
and hospital levels. The first fellow focused on delirium screening and nursing interventions to
decrease the intensity, frequency, and duration of delirium. Results of her project were used to
provide education to unit nurses. She also completed her first publication.20 The team
recommended that the next fellowship be assigned by the SOC committee to better align the
fellow’s work with the needs of the organization. A protocol was selected in the ophthalmology
department, with the second fellow facilitating and supporting their EBP process.An additional
resource developed was EBP assistants who were available on an as-needed basis for unit
projects. These assistants were undergraduate nursing students from local universities. Examples
of the types of support they provided include running literature searches, retrieving requested
articles, disseminating the team’s evidence summaries, and documenting EBP team meetings.
The salary for these assistants was initially supported through a small grant from the Maryland
Health Services Cost Review Commission. After a favorable evaluation of this resource at the
end of the funding period, EBP assistants were included in subsequent nursing administration
budgets.
Setting Expectations
To incorporate EBP as an expectation of nursing practice, nursing staff job descriptions were
revised after significant input from the governance committees, staff, and managers. An example
of a revision is provided in Figure 2. It was important to construct language that was broad
enough to allow different units to apply the standard to fit their needs. All indirect care positions
are now under review for incorporating EBP expectations.
Figure 2
Job descriptions revisions to incorporate evidence-based practice (EBP) into standard: maintains
awareness of scientific basis for nursing practice.A basic Web EBP course was developed in
2005 and implemented as a required competency for RNs in 2006 to promote understanding of
the EBP program, goal, and resources. The basic competency education will move from yearly
competency to the nurse orientation curriculum for 2007. Three additional modules are in
development to address educational needs beyond basic competencies.
Collaborative Strategies: Introduction of the Model to the School of Nursing
Since the early 1990s, research utilization has been a major focus in the undergraduate research
courses at Johns Hopkins University School of Nursing (JHUSON). As the focus changed from
research utilization to EBP and the JHN EBP team began presenting their model and resources,
part of the implementation plan was to infuse EBP into the JHUSON. In fall of 2004, a pilot was
conducted with 1 section of the undergraduate research class. The class used the JHN EBP tools
and worked on a project from a problem identified by nurses at The Johns Hopkins Hospital. The
requirement for an undergraduate EBP project was revised with full implementation using the
JHN EBP model in the spring semester of 2005.At the same time, the master’s program
curriculum was being revised. Revisions were driven by the belief that the research course
should prepare advanced practice nurses to translate evidence into the best practices. A new
course was developed: Application of Research to Practice. The skills demonstrated are essential
for the EBP organizational leader. Two outcomes of this course include (1) conducting a team
EBP project and (2) demonstrating evidence critique and rating competencies in an individual
state of the sciences paper. The focus of these assignments can be clinical, administrative, or
educational nursing problems.Incorporating these changes into the JHUSON curriculum also
required faculty training in the conceptual underpinnings of the model as well as the EBP
process and available tools. Three members of the team presented a faculty training seminar,
covering the model, tools, and process. A mock critique and rating session provided the faculty
with a hands-on experience with the tools and process.
Lessons Learned
The EBP implementation and infusion described in this article occurred between 2004 and 2006.
The team learned a number of lessons, which include the importance of leadership support to
foster the strategic plan, the need for flexibility in training approaches to meet the requirements
of the staff, the necessity of strategic resource planning, the essential role of mentors, and the
need to have a model and tools available. Seeking synergistic opportunities to collaborate with
academic institutions and students provides a win-win outcome.20
Model and Tool Revisions
We have used the model and guidelines previously published21 in multiple projects within and
outside the organization. Based on this experience, we have kept the PET (practice
question, evidence, translation) process in place but have made some modifications to the tools
used for the EBP project (Figure 3) and further refined the graphic for the conceptual model
(Figure 4). Within the JHN EBP model, EBP is a problem-solving approach to making clinical,
educational, and administrative decisions that combines the best available scientific evidence
with the best available practical evidence. The process takes internal and external influences on
practice into consideration and requires the nurse to use critical thinking when applying the
evidence.17
Figure 3
Evidence-based practice tools.
Figure 4
Johns Hopkins Nursing evidence-based practice conceptual model.
Future Directions
The JHN EBP has evolved into a mature phase of development. To move to the next stage, we
need to develop and mentor additional EBP experts, expand the use of the model and tools, and
continue to make revisions based on our experiences. We have planned additional training for
staff and mentors, co
This paper is designed to help you discover what factors should every human being have access to in order to achieve optimal health and wellbeing. To complete the project, first go to: https://health.gov/healthypeople/priority-areas/social-determinants-healthLinks to an external site. and read about the 5 social determinants of health domains. Then, for each domain
Describe what it is
Why is it essential for a person’s health and wellbeing?
What can prevent or impede a person from possessing this domain?
What population is vulnerable or at risk for not having this domain?
What actions can you take as a future nurse to help ensure the individuals in your community possess the 5 social determinants of health?
Project Requirements:
APA 7 format
APA title page
1 page of content (minimum)
APA reference page
At least 3 sources that are no older than 5 years old from scientifically reputable sources
12-year-old male is seen today for psychiatric evaluation and medication management via telepsychiatry videoconferencing. The patient is accompanied by his mother. He has good eye contact patient, and his mother reports that the patient has not been on Qelbree for more than 4 months and says the patient continue top do well without medication. His appetite is good. He reports sleeping well. He does wake up at night but falls back easily. He is riding his bike for exercise. Encouraged him to talk to his mother about any questions or concerns that may come up. He verbalizes he will. Denies questions at this time. Mom and patient agree to discontinue the medication now to evaluate any changes from him discontinuing the medication while he is only in summer school. The patient and his mother report that the patient’s anxiety, ADHD symptoms, and depressive symptoms are all well-managed. Denies auditory and visual hallucinations. Denies suicidal and homicidal ideation during today’s encounter. Follow-up in three months.
Rx: Discontinue Qellbree 150 mg QHS follow-up in 3 months; if still doing well, he will be discharged.
Medication Compliance: N/A
Side Effects: no
Appetite: Good
Sleep: Good
Medications
viloxazine ER 150 mg capsule,extended release 24 hr, Take 150mg PO Daily (Edited by LAWRENCE ABAH on 14 Jun, 2023 at 03:55 PM )
viloxazine ER 150 mg capsule,extended release 24 hr, take 150mg (2 tablets) daily (Edited by LAWRENCE ABAH on 14 Mar, 2023 at 04:23 PM )
Allergies
No allergy history has been documented for this patient.
Mental/Functional
Functional Finding: able to bath self, independent with dressing, able to feed self, independent in toilet and transfer independent.
Cognitive Function Finding: oriented to person, time and place, able to use decision making strategies, memory: own age known, able to direct attention and able to read.
Objective
Mental Status Exam:Demeanor: Pleasant during interview
Orientation: Oriented to self, place, and time
Behavior: Cooperative with exam
Speech: Speech is fluent
Mood: “6/10” where 10 is feeling best
Affect: Appropriate to situation
Thought Process: Goal directed
Thought Content: Denies auditory hallucinations. Denies visual hallucination.
topic is The Covid-19 Pandemic and Food Consumption Patterns )
Unformatted Attachment Preview
PHC 241-Group presentation
This assignment is a group effort. Students will work in groups of three to five and will choose
one of these topics on nutrition and public health:
1. Protein Energy Malnutrition and Early Child Development
2. Iron Deficiency Anemia in the Kingdom of Saudi Arabia
3. Maternal Nutrition and Low Birth Weight
4. Nutrition in School-Age Children and Cognitive Development.
5. Fast Food Consumption and Obesity among University Students
6. The Nutritional Transition and Its Implications for the Developing World
7. The Covid-19 Pandemic and Food Consumption Patterns
8. Food Insecurity and Malnutrition in Developing Countries
9. Food Security in a Global Pandemic
10. Elderly Health: Nutritional Issues of Older Adults
Presentations should include the following:
An adequate description of the nutritional issue, including a general or specific case.
Discussion of preventive or treatment strategies, and any related local or national
policies.
Practical recommendations for reducing malnutrition.
Questions for class discussion.
Important guidelines for students:
Presentation should consist of no more than 15 PowerPoint slides (including one page of
class discussion questions).
The cover slide should include the following: university logo; presentation title, group
members names and students ID numbers.
Presentation time should be 10–12 minutes, followed by five minutes of class discussion.
Each group should have a maximum of five students.
Support your presentation with at least three references (APA style).
The group will be graded as per the “Presentation Marking Rubric”
Poor
0.25 pts
Fair
0.50 pts
Good
0.75 pts
Excellent
1 pts
Organization Audience cannot
understand
presentation because
there is no sequence
of information.
Audience has
difficulty
following
presentation
because
student jumps
around.
Subject
Knowledge
Student does not
have grasp of
information; student
cannot answer
questions about
subject.
Student is
uncomfortable
with
information
and is able to
answer only
rudimentary
questions.
Student
presents
information
in logical
sequence
which
audience can
follow.
Student is at
ease with
expected
answers to all
questions, but
fails to
elaborate.
Graphics
Student uses
superfluous graphics
or no graphics
Mechanics
Student’s
presentation has four
or more spelling
errors and/or
grammatical errors.
Student
occasionally
uses graphics
that rarely
support text
and
presentation.
Presentation
has three
misspellings
and/or
grammatical
errors.
Student
presents
information in
logical,
interesting
sequence which
audience can
follow.
Student
demonstrates
full knowledge
(more than
required) by
answering all
class questions
with
explanations
and elaboration.
Student’s
graphics
explain and
reinforce screen
text and
presentation.
Group
Dynamics
Multiple group
members not
participating.
Evident lack of
preparation/rehearsal.
Dependence on
slides.
Significant
controlling by
some members
with one
minimally
contributing.
Primarily
prepared but
with some
dependence on
just reading off
slides.
Student’s
graphics
relate to text
and
presentation.
Presentation
has no more
than two
misspellings
and/or
grammatical
errors.
Slight
domination of
one presenter.
Members
helped each
other.
Very well
prepared.
Presentation has
no misspellings
or grammatical
errors.
All presenters
knew the
information,
participated
equally, and
helped each
other as needed.
Total (5)
Only need to do the 5.Pricing Information part.Need some data and a general framework with some simple explanations for the discussion meeting with group members in one day.The rest of this part (detailing) can be done in the remaining time( not sure yet, might extend the time)
Unformatted Attachment Preview
Drug Evaluation for Coverage Decisions
Health Technology Assessment (HTA) – Used to Inform Decision-Making
• Systematic evaluation of
properties and impact of
health care technology.
• Includes medical, social,
ethical, and economic
concerns.
?
Non-Profit Entity
US has no national HTA!
• Studies outputs for safety,
effectiveness, and costs
• Primary purpose of HTA is to
inform decision-making on
coverage and pricing.
U.S. Formulary
Submissions
AMCP Dossier
AMCP Dossier for Formulary Submission Used with PBM
Standardized Format Utilized to Evaluate Drugs for Formulary
1.0
Executive Summary
2.0
Product Information and Disease Description
Tests
3.0
4.0
2.1
Product Description
2.2
Place of the Product in Therapy
2.3
Evidence for Companion Diagnostic
Clinical Evidence
3.1
Study Summaries
3.2
Evidence Tables
5.0 Additional Supporting Evidence
5.1 Clinical Practice Guidelines
5.2 Health Technology Assessments and Systematic
Reviews
5.3 Compendia
5.4 Other Economic or Outcomes Evidence
5.5 Impact on Quality
5.6 Other Evidence or Information
6.0 Dossier Appendices
Economic Value and Modeling Report
4.1
Modeling Overview
4.2
Cost-Effectiveness Analysis
4.3
Budget Impact Model
4.4
Modeling Report and Interactive Model
Drug manufacturers develop and submit the AMCP dossier for new
drug for evaluation by customers (i.e. PBM, Health Plan)
AMCP = Academy of Managed Care Pharmacy
Formulary Decisions: https://www.formularydecisions.com/
Group Assignment: Drug Formulary Coverage Evaluation
Your group serves as the Pharmacy & Therapeutics committee for
Trojan Health Plan.
Leqembi (lecanemab) was approved for the treatment of
Alzheimer’s disease
The P&T committee is charged with evaluating Leqembi (lecanemab)
and to make recommendations for prescription coverage of the drug.
Template for Formulary Presentation
Title Page
Team Member Names
1. Disease Description
• Brief discussion of disease state
• Focus discussion on the drug’s approved indication
2. Product Information
• Product Information (PI) – Label and Product Approval Information
• Indication and usage, dosage and administration, dosage form and strength,
contraindications, warnings and precautions, adverse reactions.
• Info found at Drugs@FDA: FDA-Approved Drugs
• https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm
• FDA Approval Letter and Product Information Labeling
• FDA Application Review Files
3. Clinical Assessment of Evidence
• Brief Review of Clinical trials. (Typically two Phase III Trials required)
• Efficacy
• Safety
• Population(s) studied
• Post-Approval studies requirements.
• Info found at Drugs@FDA: FDA-Approved Drugs
• https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm
• FDA Approval Letter and Product Information Labeling
• FDA Application Review Files
4. Place in Therapy
• Published Clinical Guidelines for Treatment of Disease
• Does drug have place in any current treatment guidelines?
• Does drug address any unmet needs?
• Availability of Other Treatments
• Are there similar treatments already covered by health plan?
(Note: For scenario, assume there are NO similar drugs covered by the health plan)
• Are there treatments for the disease that are available but not currently covered?
• Are there treatments that may become available in near term, 1-3 years (i.e.
competitor pipelines with anticipated timeframe of approvals)
5. Pricing Information
• List Price per unit (use WAC)
• Cost per month
• Cost per year
• Micromedex, REDBOOK (Subscription. Available through USC Online Library)
• https://libproxy.usc.edu/login?url=http://www.micromedexsolutions.com/home/dispatch
6. Economic Value
• Drug manufacturers develop their own economic models to include in AMCP Dossier.
• PBM/health plan may develop their own economic analysis for new drug.
• In absence of manufacturer’s AMCP dossier, we will use the ICER report for this exercise.
1.
From ICER Report, summarize key points and findings of potential budget impact
and cost-effectiveness of drug from ICER report.
2.
Also take note of ICER’s Health Benefit Price Benchmark (HBPB) assigned (i.e.
their benchmark of how drug might be priced based on its analysis
Institute for Clinical Economic Review (ICER) report (note: not always
available at drug launch)
https://icer.org/wp-content/uploads/2023/04/ICER_Alzheimers-Disease_FinalReport_For-Publication_04172023.pdf
7. Drug Coverage, Placement, and Recommendations
Based on your analysis and synthesis of data, explain your recommendations in the presentation.
1.
2.
3.
4.
5.
6.
Under which benefit (pharmacy or medical) will this drug be covered?
How will drug be covered relative to patient stage of disease, or use of other drugs?
• E.g. specific stage of disease, specific population, 1st…3rd line use relative to other treatments
• If oral drug, which tier will drug be placed?
What patient cost sharing is recommended? How much, if at all?
Will there be utilization management restrictions placed on drug coverage? Which restrictions?
• If plan will require a prior authorization, then search for existing PA guidelines or create your
own.
Patient monitoring required while on treatment?
Post-marketing surveillance needed to demonstrate safety and effectiveness?
8. Zoom Link to Video Presentation
• Provide Zoom link of group presentation here
Deliverables
1.
Slide Deck (may use template or create own)
• Every member in group must individually submit slide deck into Bb
2.
15-20 minute Video Presentation (record via Zoom).
• Cover slide should have list of all group member names
• Every member in group must have a part in video presentation.
• Add the zoom link to last slide of deck.
3.
Grading
• Organization of Slide Deck (25%)
• Planned and Organized Video Presentation (25%)
• Cohesiveness of Slide Deck and Presentation Between Team Members (25%)
• Participation based on contribution in presentation and 360 Peer Review (25%)
4.
Due 11/3/23 via Bb Assignment Tab
Review of System: The Review of Systems (ROS) is an inventory of the body systems obtained through a series of questions to identify signs and symptoms that the patient may be experiencing
Unformatted Attachment Preview
Turnitin™
This assignment will be submitted to Turnitin™.
Instructions
Understanding Review of Systems and Cultural Assessment.
Review of System: The Review of Systems (ROS) is an inventory of the body systems obtained
through a series of questions to identify signs and symptoms that the patient may be experiencing.
1. Name at least six systems that would be included in a ROS.
2. What questions would you ask your patient in the six systems you identified?
3. How would you document that data collected?
4. Do the ROS data collected considered Objective or subjective data why?
Cultural Assessment:
1. Outline specific examples of how culture, spirituality, and religion influence health practices.
2. Discuss how social assessment information obtained in a culturally competent manner can
improve the planning and implementation of health care services and address the disparities in
health care among culturally diverse groups.
3. Identify nursing diagnoses related to cultural nursing assessments.
4. What type of data is cultural assessment and why?
In a 3-4 page paper, answer the above question in paragraph form, using APA professional
format. Include at least two references, A minimum of one from an Englished titled peer-reviewed
Nursing Journal and one from your textbook.
Due on Oct 25, 2023 11:59 PM
Written Assignment – NUR3069L ADVANCED HLTH LAB ONLINE 722877 – BCOnline
10/24/23, 1:10 PM
Lab Assignment Rubric
Course: NUR3069L ADVANCED HLTH LAB ONLINE 722877
Category
Quality and Accuracy
of Information
Mechanics
Amount of Information
Timeliness
Satisfactory
Needs Improvement
Inadequate
Unsatisfactory
Criterion Score
2 points
1 point
0.5 points
0 points
/2
All criteria are
met with supporting
information.
1-2 criteria not met with
supporting information.
3-4 criteria not met with
supporting information.
>4 of the criteria is
not met and/or missing
significant supporting
information.
1 point
0.75 points
0.25 points
0 points
Paper is well organized
and consists of wellconstructed paragraphs;
no more than two (2)
spelling or grammatical
errors.
Paper is organized and
consists of wellconstructed paragraphs;
no more than four (4)
spelling or grammatical
errors.
Paper is organized and
consists of wellconstructed paragraphs;
no more than six (6)
spelling or grammatical
errors.
Paper is disorganized
with poorly constructed
paragraphs; greater than
six (6) spelling or
grammatical errors.
1 point
0.75 points
0.25 points
0 points
Adheres to H and
P guidelines for assigned
system (s).
Somewhat
adheres to H and P
guidelines for assigned
system (s).
Does not
adhereto H and P
guidelines; bu
tdoes address
assigned system covered.
Does not
adhereto H and P
guidelines, nor address
assigned system.
1 point
0.5 points
0.25 points
0 points
Submit
sassignment on or before
the electronic week
due date.
Submit sassignment
1 day after the
electronic week
due date.
Submit sassignment
2 days after the
electronic
week due date.
Submits assignment 3 or
more days after the
electronic week
due date.
/1
/1
/1
Total
/5
Overall Score
Satisfactory
Need Improvement
Inadequate
Unsatisfactory
12 points minimum
12 -15
8 points minimum
8 – 11
1.6 points minimum
2 – 7.5
0 points minimum
0 – 1.5
https://bconline.broward.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=907309&grpid=0&isprv=0&bp=0&ou=584999
Page 1 of 3
Written Assignment – NUR3069L ADVANCED HLTH LAB ONLINE 722877 – BCOnline
https://bconline.broward.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=907309&grpid=0&isprv=0&bp=0&ou=584999
10/24/23, 1:10 PM
Page 2 of 3
Written Assignment – NUR3069L ADVANCED HLTH LAB ONLINE 722877 – BCOnline
https://bconline.broward.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=907309&grpid=0&isprv=0&bp=0&ou=584999
10/24/23, 1:10 PM
Page 3 of 3
Topic is fast food consumption and obesity among university students
Unformatted Attachment Preview
PHC 241-Group presentation
This assignment is a group effort. Students will work in groups of three to five and will choose
one of these topics on nutrition and public health:
1. Protein Energy Malnutrition and Early Child Development
2. Iron Deficiency Anemia in the Kingdom of Saudi Arabia
3. Maternal Nutrition and Low Birth Weight
4. Nutrition in School-Age Children and Cognitive Development.
5. Fast Food Consumption and Obesity among University Students
6. The Nutritional Transition and Its Implications for the Developing World
7. The Covid-19 Pandemic and Food Consumption Patterns
8. Food Insecurity and Malnutrition in Developing Countries
9. Food Security in a Global Pandemic
10. Elderly Health: Nutritional Issues of Older Adults
Presentations should include the following:
An adequate description of the nutritional issue, including a general or specific case.
Discussion of preventive or treatment strategies, and any related local or national
policies.
Practical recommendations for reducing malnutrition.
Questions for class discussion.
Important guidelines for students:
Presentation should consist of no more than 15 PowerPoint slides (including one page of
class discussion questions).
The cover slide should include the following: university logo; presentation title, group
members names and students ID numbers.
Presentation time should be 10–12 minutes, followed by five minutes of class discussion.
Each group should have a maximum of five students.
Support your presentation with at least three references (APA style).
The group will be graded as per the “Presentation Marking Rubric”
Poor
0.25 pts
Fair
0.50 pts
Good
0.75 pts
Excellent
1 pts
Organization Audience cannot
understand
presentation because
there is no sequence
of information.
Audience has
difficulty
following
presentation
because
student jumps
around.
Subject
Knowledge
Student does not
have grasp of
information; student
cannot answer
questions about
subject.
Student is
uncomfortable
with
information
and is able to
answer only
rudimentary
questions.
Student
presents
information
in logical
sequence
which
audience can
follow.
Student is at
ease with
expected
answers to all
questions, but
fails to
elaborate.
Graphics
Student uses
superfluous graphics
or no graphics
Mechanics
Student’s
presentation has four
or more spelling
errors and/or
grammatical errors.
Student
occasionally
uses graphics
that rarely
support text
and
presentation.
Presentation
has three
misspellings
and/or
grammatical
errors.
Student
presents
information in
logical,
interesting
sequence which
audience can
follow.
Student
demonstrates
full knowledge
(more than
required) by
answering all
class questions
with
explanations
and elaboration.
Student’s
graphics
explain and
reinforce screen
text and
presentation.
Group
Dynamics
Multiple group
members not
participating.
Evident lack of
preparation/rehearsal.
Dependence on
slides.
Significant
controlling by
some members
with one
minimally
contributing.
Primarily
prepared but
with some
dependence on
just reading off
slides.
Student’s
graphics
relate to text
and
presentation.
Presentation
has no more
than two
misspellings
and/or
grammatical
errors.
Slight
domination of
one presenter.
Members
helped each
other.
Very well
prepared.
Presentation has
no misspellings
or grammatical
errors.
All presenters
knew the
information,
participated
equally, and
helped each
other as needed.
Total (5)
College of Health Sciences
Department of Public Health
PAPER ASSIGNMENT COVER SHEET
Course name:
Introduction to Hospital Epidemiology
Course Code:
PHC 231
CRN:
xxxxx
Assignment title or task:
(You can write a question)
Write in details about Quantitative Epidemiology
in the Healthcare Setting?
Student name:
Student ID:
Submission date:
Instructor name:
Dr. Olla Qadi
Grade:
……. Out of 10
Instructions for submission:
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Length of the write-up should be 200-500 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
College of Health Sciences
Department of Health Informatics
ASSIGNMENT COVER SHEET
Course name:
Public health outbreak and disaster management
Course number:
PHC 372
Assignment 1 Questions
– What makes Hajj different than other mass
gatherings?
– What are the risk factors associated with
Hajj?
– Then Choose only one of the following:
o Choose one potential disaster in Hajj
and propose your plan to manage it.
(Explain your disaster management
plan in each phase of the disaster
(Mitigation, Preparedness, Response,
Recovery)
Assignment
question
o Review one disaster incident that
happened in Hajj (explain the
strategies used in the 4 phases, if
possible, to manage the disaster, and
what are the lessons learned out of
that incident)
Note:
•
You can use the following resource (page 2) to review
a brief of the 4 phases of disaster.
Lindsay, B. R. (2012, November). Federal emergency
management: A brief introduction. Congressional Research
Service, Library of Congress.
https://apps.dtic.mil/sti/pdfs/AD1172029.pdf
College of Health Sciences
Department of Health Informatics
Student name:
Student ID:
CRN
Submission date:
Instructor name:
Grade:
…. Out of 10
Paper assignment guidelines
Short essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PM
•
•
•
•
•
•
•
Conduct your own research to explore further online resources to provide the conceptual
idea and avoid using advertising or commercial material.
Do not use bullet points in representing your answer.
The assignment should have the COVER PAGE with SEU logo and the details of who is
submitting and to whom is it submitted.
Assignments should be submitted through Blackboard in Word document only and not
through email.
Font should be 12 Times New Roman, color should be black and line spacing should be
1.5
Use APA referencing style. Please see below link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism.
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Introduction to Disease
Course code:
PHC271
CRN:
Assignment title or task:
Diabetes Mellitus (DM) is a common chronic disease in Saudi Arabia. Explain the
epidemiology, pathophysiology, types, risk factors, symptoms, signs, and prevention of
diabetes.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
Out of 10
Proficiency
Some Proficiency
Limited Proficiency
No Proficiency
2
1.5
1.0
0.5
Content Presentation
Criteria
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Thinking
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/ 10
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Start your writing from the next page (page 3)
•
Word limit: Minimum 600 words (3 pages)
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task (PDF is not
acceptable)
•
Submission should be before the deadline (submission after the deadline is not allowed)
College of Computing and Informatics
Project
Deadline: Tuesday 05/12/2023 @ 23:59
[Total Mark for this Project is 14]
Group Details:
CRN:
Name:
ID:
Name:
ID:
Name:
ID:
Instructions:
• You must submit two separate copies (one Word file and one PDF file) using the Assignment Template on
Blackboard via the allocated folder. These files must not be in compressed format.
• It is your responsibility to check and make sure that you have uploaded both the correct files.
• Zero mark will be given if you try to bypass the SafeAssign (e.g., misspell words, remove spaces between
words, hide characters, use different character sets, convert text into image or languages other than English
or any kind of manipulation).
• Email submission will not be accepted.
• You are advised to make your work clear and well-presented. This includes filling your information on the cover
page.
• You must use this template, failing which will result in zero mark.
• You MUST show all your work, and text must not be converted into an image, unless specified otherwise by
the question.
• Late submission will result in ZERO mark.
• The work should be your own, copying from students or other resources will result in ZERO mark.
• Use Times New Roman font for all your answers.
Project
Pg. 01
Learning Outcome(s):
CLO 1, 2, 5
1, Demonstrate an
understanding of the
concepts of decision
analysis and decision
support systems (DSS)
including probability,
modelling, decisions under
uncertainty, and real-world
problems.
2, Describe advanced
Business Intelligence,
Business Analytics, Data
Visualization, and
Dashboards.
5, Improve hands-on skills
using Excel, and Orange
for building Decision
Support Systems.
Project
14 Marks
Students can form groups consisting of three students and send their names to their
instructors before 5th October 2023. Otherwise, the instructors will form the groups
randomly and assign any datasets to the groups.
Select one dataset from the datasets provided in the bellow link.
For 28 Data Analysis Projects to Boost Your Skills [2023 Guide]:
https://www.springboard.com/blog/data-analytics/data-analysis-projects/
For more free public datasets for EDA:
https://www.tableau.com/learn/articles/free-public-data-sets
✓
After the dataset is selected (or assigned), analyze the data using Microsoft Excel
to discover the structure of data, trends, patterns, or any anomalies in the data based on
your own hypothesis.
✓
Perform the following six tasks.
✓
You should use visualization to aid your answers.
Your project will include two main parts:
1.
The final project report which must incorporate all the following 6 tasks and
written using the provided template. (10 marks distributed among the below tasks).
2.
A presentation that illustrates your 6 tasks completed in the project. (4 marks)
==========================================================
Task 1: Understand and describe the nature and structure of the selected dataset. (2
marks)
•
Describe the dataset. Your description should answer the following questions:
is it reliable? how was it collected? What its size?
Project
Pg. 02
•
Identify the features of dataset.
•
Propose hypothesis / assumptions (between 2 numerical variables) to validate.
Task 2: Check if your selected features have any of the following issues. Describe how you
conducted the tests and how you addressed the issues. Support your answers with screenshots of
the issues before and after the fixes. (1 mark)
•
Missing values (0.25 for the test, fix and screenshot)
•
Duplicate values (0.25)
•
Data outliers (0.25)
•
Any noise or irregularities (0.25)
Task 3: Provide descriptive statistics for the selected features using statistical method to
understand the dataset more and answer the following analysis questions: (2 marks)
•
Include any of the measure of central tendency such as the mean, median, and mode.
•
Describe the spread of your data. This may include the measure of variance, standard
deviation, skewness, and kurtosis.
(You are encouraged to impose other analysis questions based on any trend you notice in
the dataset).
Task 4: Validate the hypothesis in Task 1 by investigating the relationship between two
quantitative variables you have chosen using correlation, regression and R-squared with possible
conclusions. (2 marks)
Task 5: Show visual representation of your analysis (hint: use the right chart/graph for your data
analysis). (1 mark)
Task 6: Build an active Dashboard which summarizes the most crucial factors (variables) that
will help in decision-making process, and then demonstrate the effectiveness of your selection
of those factors in the decision-making process. (2 marks)
Project
Pg. 03
Project Report
College of Computing and Informatics
Project Report
Deadline: Monday 11/12/2023 @ 11:59
[Total Mark is 14 Marks]
Students Details:
CRN:
Name:
Name:
Name:
ID:
ID:
ID:
Instructions:
• This Project must be submitted on Blackboard via the allocated folder.
• Students must work as groups in which each group has up to 3 students.
• Email submission will not be accepted.
• You are advised to make your work clear and well-presented, marks will be reduced for poor
presentation. (for diagrams it is recommended to add them inside a textbox to achieve a good
management of the document layout)
• You MUST show all your work.
• Late submission will result in ZERO marks being awarded.
• Identical copy from students or other resources will result in ZERO marks for all involved
students.
• Add pages as necessary.
Description and Instructions
Pg. 01
Description and Instructions
Project Description:
This project is an opportunity for you to practice your knowledge and skills by
assessing the actual information security practice in Saudi companies/organizations
based on the information security capability maturity model (ISCMM).
•
Total Marks = 14
Project Report
Presentation
10 marks
4 marks
•
Group Size = 2- 3 members.
•
Each student must visit a chosen company/organization to interview a
cybersecurity representative (i.e., each group should have two or three filled
checklists based on the number of team members).
•
•
You should answer the questions in this research activity as a group.
One group member (group leader) should submit all files: Project Report and
Presentation Slides on Blackboard. Marks will be given based on your submission
and the quality of the content.
Project Report
•
Each Project Report will be evaluated according to the marking criteria in each
question section.
Presentation
Grading Criteria:
Complete content (Introduction, body, and conclusion)
2 mark
Effective use of time (max. 8-10 minutes)
1 mark
Voice projection and loudness/ Eye contact/ Confidence and 1 mark
attitude
Pg. 02
Description and Instructions
Information Security capability maturity (ISCMM) levels
For this project, you will use the following levels of the information security capability
maturity model (ISCMM) as guiding principles for your journey to assess the maturity
of the chosen company/organization regarding information security.
Question One
Pg. 03
Learning
Outcome(s):
4 Marks
Question One
Use the following checklist to fill out during the meeting with the chosen
company/organization cybersecurity representative. Provide the filled
CLO4: Analyze
checklists for each team member.
problems related to the
field of Security and
Information Assurance
ISCMM
Levels
Enhanced
Managed
Indicators
1.
You actively explore opportunities to enhance information
security as part of your continuous improvement program
for security
2.
Information security measures are responsive, adaptable,
efficient, robust, and benefit from strategic intent.
1.
You have mechanisms to assess and manage requirements
for protecting, sharing, and assuring information. These
mechanisms are well understood and updated as required.
2.
You have proportionate measures in place to prevent,
detect, and respond to unauthorized or inappropriate access
to information and ICT systems, including during systems
development and throughout the information lifecycle.
3.
You clearly understand where and how information
and data assets are shared with service providers.
4.
You appropriately archive or otherwise dispose of
information holdings when they are no longer required.
5.
Mobile devices and remote working solutions are managed
securely.
Information or other assets you hold are consistently
classified, marked, accessed, and handled in line with the
Saudi Government Security Classification System.
6.
7.
Your systems ensure access controls are updated when your
people change roles or leave your organization.
8.
You ensure changes made to information management
measures are consistent with your security risk profile and
wider protective security policies. Changes are promptly
communicated
9.
You periodically conduct both scheduled and
unannounced tests and audits of information
security.
10. When appropriate, your access controls enforce
Tick the
applicable
indicators
Question One
Pg. 04
segregation of duties to reduce opportunities for
unauthorized or unintentional access to or misuse of
information assets.
1.
2.
People most directly responsible for protective security
understand the information security lifecycle.
You have a certification and accreditation program in
place for new and existing ICT systems; however, it is
inconsistently followed.
3.
You have simple information security measures in place for
areas holding physical records, ICT equipment, and basic
ICT system access controls.
4.
You have pockets of good information security
awareness and practice, but standards aren’t applied
consistently across your information holdings, and
your overall compliance is poorly understood. This
may be particularly true when external suppliers
hold or manage your information.
5.
You have some security mechanisms in place for
ICT systems development.
6.
You have a limited understanding of where and
how information or data assets are shared with
service providers.
7.
You understand emerging cyber intrusions and threats and
have put in place simple information security measures to
mitigate targeted cyber intrusions.
1.
You have limited understanding of your information assets
and don’t proactively assess the information assets you most
need to protect
You have limited information security measures in place to
protect your information assets and ICT system
development
Basic
2.
3.
You do not have a certification and accreditation program in
place for new or existing ICT systems.
4.
You can’t be confident you would detect
unauthorized access to, or the compromise of,
electronic or physical information holdings
5.
You don’t usually assess whether information or
other assets require a national security
classification. You also can’t be confident that
classified resources are managed correctly
6.
You can’t be confident you implement measures for
information assets that are proportional to their
value, importance, and sensitivity
Informal
Question One
Pg. 05
7.
You have limited information security measures in place for
targeted cyber intrusions and have a reactive approach to
emerging cyber intrusions and threats
8.
You do not understand where and how your information or
data assets are shared with service providers.
Question Two
Pg. 06
Learning
Outcome(s):
CLO2: Apply
effective, proper,
and state-of-the-art
security tools and
technologies.
Question Two
4 Marks
Summarize the key findings of your participating companies/organizations in light
of ISCMM levels. (Maximum 250 words).
Question Three
Pg. 07
Learning
Outcome(s):
CLO3: Develop
security policies and put
in place an effective
security architecture
that comprises modern
hardware and software
technologies and
protocols.
Question Three
2 Marks
From your point of view, what are the main recommendations for participating
companies/organizations to upgrade their level in ISCMM.
Describe how the assigned readings, activities, assessments, and clinical experiences in this course helped you to meet Program Outcome 5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice. (Extraordinary Nursing) Provide at least two specific examples. Select one of the competencies from American Association of Colleges of Nursing (AACN) Essentials Domain 3 listed below and describe how learning in this course helped you to meet the advanced-level nursing education competency. Provide at least two specific examples. 3.1 Manage population health 3.1j Assess the efficacy of a system’s capability to serve a target sub-population’s healthcare needs. 3.1k Analyze primary and secondary population health data for multiple populations against relevant benchmarks. 3.1l Use established or evolving methods to determine population-focused priorities for care. 3.1m Develop a collaborative approach with relevant stakeholders to address population healthcare needs, including evaluation methods. 3.1n Collaborate with appropriate stakeholders to implement a sociocultural and linguistically responsive intervention plan. 3.2 Engage in effective partnerships 3.2d Ascertain collaborative opportunities for individuals and organizations to improve population health. 3.2e Challenge biases and barriers that impact population health outcomes. 3.2f Evaluate the effectiveness of partnerships for achieving health equity. 3.2g Lead partnerships to improve population health outcomes. 3.2h Assess preparation and readiness of partners to organize during natural and manmade disasters. 3.3 Consider the socioeconomic impact of the delivery of health care. 3.3c Analyze cost-benefits of selected population-based interventions. 3.3d Collaborate with partners to secure and leverage resources necessary for effective, sustainable interventions. 3.3e Advocate for interventions that maximize cost-effective, accessible, and equitable resources for populations. 3.3f Incorporate ethical principles in resource allocation in achieving equitable health. 3.4 Advance equitable population health policy 3.4f Identify opportunities to influence the policy process. 3.4g Design comprehensive advocacy strategies to support the policy process. 3.4h Engage in strategies to influence policy change. 3.4i Contribute to policy development at the system, local, regional, or national levels. 3.4j Assess the impact of policy changes. 3.4k Evaluate the ability of policy to address disparities and inequities within segments of the population. 3.4l Evaluate the risks to population health associated with globalization. 3.5 Demonstrate advocacy strategies 3.5f Appraise advocacy priorities for a population. 3.5g Strategize with an interdisciplinary group and others to develop effective advocacy approaches. 3.5h Engage in relationship-building activities with stakeholders at any level of influence, including system, local, state, national, and/or global. 3.5i Demonstrate leadership skills to promote advocacy efforts that include principles of social justice, diversity, equity, and inclusion. 3.6 Advance preparedness to protect population health during disasters and public health emergencies 3.6f Collaboratively initiate rapid response activities to protect population health. 3.6g Participate in ethical decision making that includes diversity, equity, and inclusion in advanced preparedness to protect populations. 3.6h Collaborate with interdisciplinary teams to lead preparedness and mitigation efforts to protect population health with attention to the most vulnerable populations. 3.6i Coordinate the implementation of evidence-based infection control measures and proper use of personal protective equipment. 3.6j Contribute to system-level planning, decision making, and evaluation for disasters and public health emergencies. Select one of the competencies from the National Organization of Nurse Practitioner Faculties (NONPF) Core Competency Domain 5: Quality and SafetyLinks to an external site. listed below and describe how learning in this course helped you to meet the competency. Provide at least two specific examples. NP Domain 5: Quality and Safety The nurse practitioner utilizes knowledge and principles of translational and improvement science methodologies to improve quality and safety for providers, patients, populations, and systems of care. NP 5.1 Apply quality improvement principles in care delivery. NP 5.1p: Systematically evaluate quality and outcomes of care using quality improvement principles. NP 5.1q: Evaluate the relationships and influence of access, populations, cost, quality, and safety on healthcare.NP 5.1r: Evaluate the impact of organizational systems in healthcare to include care processes, financing, marketing, and policy.NP 5.2 Contribute to a culture of patient safety.NP 5.2k: Build a culture of safety through quality improvement methods and evidence-based interventions. NP 5.3 Contribute to a culture of provider and work environment safety.Submit the assignment using correct grammar mechanics and APA style standards. Writing is free of grammar, syntax, spelling, and punctuation errors A title page is included in APA format Document is double-spaced A reference page is included if references were cited. If a reference page is included, use APA format.
College of Health Sciences
Department of Health Informatics
ASSIGNMENT COVER SHEET
Course name:
Public health outbreak and disaster management
Course number:
PHC 372
Assignment 1 Questions
– What makes Hajj different than other mass
gatherings?
– What are the risk factors associated with
Hajj?
– Then Choose only one of the following:
o Choose one potential disaster in Hajj
and propose your plan to manage it.
(Explain your disaster management
plan in each phase of the disaster
(Mitigation, Preparedness, Response,
Recovery)
Assignment
question
o Review one disaster incident that
happened in Hajj (explain the
strategies used in the 4 phases, if
possible, to manage the disaster, and
what are the lessons learned out of
that incident)
Note:
•
You can use the following resource (page 2) to review
a brief of the 4 phases of disaster.
Lindsay, B. R. (2012, November). Federal emergency
management: A brief introduction. Congressional Research
Service, Library of Congress.
https://apps.dtic.mil/sti/pdfs/AD1172029.pdf
College of Health Sciences
Department of Health Informatics
Student name:
Student ID:
CRN
Submission date:
Instructor name:
Grade:
…. Out of 10
Paper assignment guidelines
Short essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PM
•
•
•
•
•
•
•
Conduct your own research to explore further online resources to provide the conceptual
idea and avoid using advertising or commercial material.
Do not use bullet points in representing your answer.
The assignment should have the COVER PAGE with SEU logo and the details of who is
submitting and to whom is it submitted.
Assignments should be submitted through Blackboard in Word document only and not
through email.
Font should be 12 Times New Roman, color should be black and line spacing should be
1.5
Use APA referencing style. Please see below link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism.
You can review different theories to determine which theories you may apply to create a conceptual framework here: https://nurseslabs.com/nursing-theories/ (PLEASE USE THE TEMPLET)
Exercise ContentSelect a nursing theory used in nursing leadership and explain its importance in healthcare system. Guidelines: APA Format MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.Research paper must be 500 words 3 or more scholarly sources must be utilizedSources must be within the last 5 years Must have a minimum of 3 Sources All article sources must be cited by including them in reference sheet (separate).
Exercise ContentSelect a nursing theorist of choice and research him/her. Include a summary of your research and how it correlates to a community health issue. Identify their key contribution to nursing and explain its importance in healthcare. Guidelines: APA Format MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.Research paper must be 500 words. 3 or more scholarly sources must be utilizedSources must be within the last 5 years Must have a minimum of 3 Sources All article sources must be cited by including them in reference sheet (separate).
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases OR non-infectious disease and
explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet. (DO
NOT include the assignment instructions)
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing (2).
• AVOID PLAGIARISM
• References must be in APA format (use in-text citation and reference page)
at least 3 references should be used.
• The due date is 29/10/2023 at 11:59 PM
You can use the following link to guide you how to use APA style
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/ge
neral_format.html
Best of Luck
Module 09: Discussion Module 09: DiscussionResearch the National Committee of BioEthics (NCBE) Implementing Regulations of the Law of Ethics of Research on Living Creatures in Saudi Arabia. National Committee of BioEthics (NCBE) Implementing Regulations of the Law of Ethics of Research on Living Creatures in Saudi Arabia. – Alternative FormatsSelect any of the many articles related to your profession or resonate with your student research topic. How could these guidelines be integrated to ensure the researcher’s adherence to these research regulations and protocols?Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
Unformatted Attachment Preview
1
Annotated Bibliography on Patient Safety Culture
Name of Student
Institutional Affiliation
Course
Date
2
Annotated Bibliography on Patient Safety Culture
Al‐Shaya, S., Al‐Reshidi, A., Farajat, M., & Elnefiely, A. (2021). The COVID‐19
outbreak in Saudi Arabia and the impact on patient safety incident reports: an
empirical study among the medical facilities of Qassim health cluster. Journal
of Healthcare Risk Management, 41(2), 4045. https://doi.org/10.1002/jhrm.21464
– The influence of COVID-19 on patient safety incident reporting at Saudi
Arabia’s Qassim Health Cluster is investigated in this study. Inpatient
admissions fell by 25% during the pandemic, which resulted in more incident
reports (30.6/100 inpatients). Medication, patient care, infection control, staff,
and facility upkeep are frequently cited problems. Curiously, the analysis
discovers no association between incidence volume and facility size.
-This study provides insightful information about COVID-19’s impact on
patient safety culture. It effectively highlights higher incident reporting rates
during the pandemic using empirical data, highlighting the significance of
active reporting cultures. However, because it needs to examine the underlying
causes thoroughly, healthcare organizations hoping to improve patient safety
in emergencies may find that it has limited practical implications.
Al-Surimi, K., Najjar, S., Al Quidaihi, A., & Masuadi, E. (2021). The impact of a
national accreditation program on patient safety culture in a tertiary hospital:
pre-and post-evaluation study. Global Journal on Quality and Safety in
Healthcare, 4(1), 18-26. https://doi.org/10.36401/JQSH-20-30
– This study examines how a significant public hospital’s patient safety culture
has changed due to Saudi Arabia’s national accrediting program. Three
hundred healthcare professionals participated in surveys performed before and
3
after accreditation using a pre-and-post evaluation design. After accreditation,
improvements were seen in hospital handoffs, error communication, and
cooperation. The Patient Safety Culture’s Hospital Survey was used in the
study, which showed improvements in staff awareness and general perceptions
of safety.
-The study uses rigorous statistical analysis, a proven tool, and a careful
research technique. The high reaction rate enhances its dependability. The
single hospital emphasis could limit generalizability, and there are potential
limitations due to the need for long-term data. Despite these drawbacks, the
study contributes to understanding how accreditation affects patient safety
culture, highlighting its critical role in improving patient safety and healthcare
quality.
Ellis, L. A., Churruca, K., Tran, Y., Long, J. C., Pomare, C., & Braithwaite, J. (2020).
An empirical application of “broken windows” and related theories in
healthcare: examining disorder, patient safety, staff outcomes, and collective
efficacy in hospitals. BMC health services research, 20(1), 112. https://doi.org/10.1186/s12913-020-05974-0
– This study explores the use of the Broken Windows Theory in hospitals,
examining how chaos affects staff and patient outcomes. The Disorder and
Collective Efficacy Survey (DaCEs), used in this study’s Australian hospital
settings, is used to gauge disorder and collective efficacy. Findings show a
favorable relationship between staff burnout and social and physical disorder
but a negative relationship between job satisfaction and patient safety.
-This ground-breaking study applies BWT in a novel way to the healthcare
field, using a customized survey method and emphasizing the mediating role
4
of collective efficacy. The research offers crucial insights into the complex
dynamics of disorder in hospital settings, notwithstanding its regional focus
and potential difficulties in theoretical translation. This study establishes a
crucial basis for improving patient safety culture and staff satisfaction in
hospitals worldwide by linking theory and healthcare practice.
Garcia, C. D. L., Abreu, L. C. D., Ramos, J. L. S., Castro, C. F. D. D., Smiderle, F. R.
N., Santos, J. A. D., & Bezerra, I. M. P. (2019). Influence of burnout on
patient safety: systematic review and meta-analysis. Medicina, 55(9),
553. https://doi.org/10.3390/medicina55090553
– This comprehensive research and meta-analysis examines the connection
between patient safety and burnout. The analysis of 21 research in the study,
which was done using the PubMed and Web of Science databases, revealed a
clear correlation between high levels of burnout and declining patient safety.
Burnout among health professionals is influenced by things like workload,
long hours, and dysfunctional interpersonal interactions. The meta-analysis
results show a strong correlation, highlighting the negative effects of burnout
on patient safety.
-This study, which uses reliable systematic review techniques, illuminates the
connection between burnout and patient safety, a crucial issue in healthcare. In
order to improve patient safety, it recognizes extrinsic variables that can
contribute to burnout, such as workload, and emphasizes the significance of
resolving professional tiredness. Although the meta-analysis shows a strong
association, the complexity of this relationship is highlighted by noting the
diverse results in the different research.
5
Hata, T., Murao, H., Nakagami-Yamaguchi, E., Yamaguchi, Y., Eguchi, H.,
Nishihara, M., … & Katsumata, T. (2022). Factors affecting patient safety
culture in a university hospital under the universal health insurance system: A
cross-sectional study from
Japan. Medicine, 101(45). https://doi.org/10.1097%2FMD.0000000000031603
– This cross-sectional study explores the culture of patient safety in university
hospitals operating under a system of widespread health insurance. The two
topics that received the highest percentage of affirmative votes were
“Teamwork within units” (81%) and “Supervisor/manager expectations
promoting patient safety” (80%), while “Staffing” received the lowest
percentage of votes (36%).
-This study uses rigorous techniques, such as confirmatory factor analysis, to
gain an important understanding of patient safety culture. However, its
exclusive application to a single hospital might make it less generalizable. The
study’s findings highlight the critical link between workload, staffing, and
patient safety culture in the absence of worldwide comparisons, and they offer
crucial advice for healthcare professionals and politicians in universal health
insurance systems.
Haugen, A. S., Sevdalis, N., & Søfteland, E. (2019). Impact of the World Health
Organization surgical safety checklist on patient
safety. Anesthesiology, 131(2), 420425. https://doi.org/10.1097/ALN.0000000000002674
– The surgical safety checklist of WHO is implemented in this article, and its
effects on surgical complications and patient outcomes are investigated. It
highlights the challenges of checklist adoption in actual medical practices and
6
emphasizes the requirement of thorough checklist usage and personalized
implementation tactics to improve patient safety in operating rooms.
-The study evaluates surgical safety checklists severely while admitting their
potential to lower mortality and complication rates. It underlines the value of
concentrated implementation efforts and the necessity of a safety-oriented
culture in healthcare settings. The assessment acknowledges achievements and
concerns, providing a balanced viewpoint on using checklist adoption in
raising the safety of patient.
Hessels, A. J., Paliwal, M., Weaver, S. H., Siddiqui, D., & Wurmser, T. A. (2019).
Impact of patient safety culture on missed nursing care and adverse patient
events. Journal of nursing care quality, 34(4), 287294. https://doi.org/10.1097%2FNCQ.0000000000000378
– This cross-sectional study investigates the connection between adverse
patient events, missing nurse care, and hospital patient safety culture (PSC).
The study, which involved 311 nurses in 29 units across five hospitals, found
that certain PSC dimensions substantially impact missing nursing care
associated with falls and adverse outcomes. The findings highlight the critical
link between organizational culture and patient safety and the urgent need to
improve PSC to reduce missed nurse care.
-The cross-sectional methodology of this study restricts the ability to draw
causal conclusions, even if it provides essential insights into the dynamics of
patient safety culture and its effect on patient outcomes. The study’s
dependence on self-reporting by nurses raises the possibility of bias.
Additionally, the study’s overall robustness is compromised by the absence of
thorough adjustment for relevant confounders.
7
Hunt, J., Gammon, J., Williams, S., Daniel, S., Rees, S., & Matthewson, S. (2022).
Patient safety culture as a space of social struggle: understanding infection
prevention practice and patient safety culture within hospital isolation settingsa qualitative study. BMC Health Services Research, 22(1),
1446. https://doi.org/10.1186/s12913-022-08703-x
– This study examines the relationship between infection prevention in
isolation settings and patient safety culture within NHS hospitals. It examines
how the culture of patient safety is impacted by healthcare professionals’
participation in infection prevention procedures through Bourdieu’s lens.
Focus group interviews in two hospitals reveal various safety cultures amid
healthcare reform, illuminating the challenges of implementing efficient
isolation methods while protecting patient safety.
-This article explores infection control and patient safety culture using
Bourdieu’s theory to provide a new perspective. It adds depth to current
conversations by placing patient safety in social, cultural, and political
contexts. Focusing on isolated environments offers novel insights into a
critical but challenging element of healthcare. Focus group interviews, used in
the study’s qualitative methodology, deepen the analysis. However, the study’s
concentration on a particular geographic region poses a drawback regarding
the generalizability of findings.
Lee, S. E., Scott, L. D., Dahinten, V. S., Vincent, C., Lopez, K. D., & Park, C. G.
(2019). Safety culture, patient safety, and quality of care outcomes: a literature
review. Western journal of nursing research, 41(2), 279304. https://doi.org/10.1177/0193945917747416
8
– This comprehensive literature analysis analyzes 17 papers from six databases
to explore the relationship between hospital safety culture and patient
outcomes. The analysis reveals inconsistencies, a need for more theoretical
frameworks, and methodological diversity. Surprisingly, many studies show
weak and erratic relationships between patient outcomes and safety culture,
highlighting the need for reliable frameworks and better research techniques to
further knowledge in this important domain.
-This study is a critical critique, calling for increased precision while
highlighting semantic discrepancies and methodological problems in earlier
research. Its analysis of erratic interactions emphasizes the need for robust
theoretical underpinnings and meticulous research methodologies. By
highlighting flaws, this evaluation transforms into a priceless tool that directs
future researchers toward more thorough studies and guarantees the growth of
patient safety culture studies.
Olsen, E., & Leonardsen, A. C. L. (2021). Use of the Hospital Survey of Patient
Safety Culture in Norwegian hospitals: A systematic review. International
Journal of Environmental Research and Public Health, 18(12),
6518. https://doi.org/10.3390/ijerph18126518
– This analysis of 20 HSOPSC-based research from Norway demonstrates the
difficulties in improving patient safety culture while highlighting HSOPSC
characteristics’ consistency over time. An important study showed that
comprehensive, long-term plans are necessary for successful changes.
Confirmatory factor analysis (CFA) and meticulous criterion-related validity
testing are encouraged by the necessity for methodological rigor. New
9
HSOPSC variants that are adapted for various settings and place an emphasis
on strategic, nuanced interventions are suggested by the review.
-The research highlights the need for comprehensive, systemic reforms and
offers useful insights into the intricacies of the patient safety culture in
Norwegian hospitals. Methodological critiques guide upcoming research,
highlighting the value of thorough analysis methods. The review has greater
practical importance now that context-specific HSOPSC versions have been
found. However, the narrow scope raises concerns regarding generalizability,
highlighting the requirement for comparative research beyond Norway’s
healthcare system.
10
References
11
1
Vaccines: COVID-19 Vaccines and their Effects on Different Trial Groups globally
Annotated Bibliography
Ghady Alayad
Colorado State University – Global Campus, and Saudi Electronic University
HCM 505: Research Methodology in Health Care Management
Dr. Mary Moor
13 October, 2023
2
Vaccines: COVID-19 Vaccines and their Effects on Different Trial Groups globally
Annotated Bibliography
Chemaitelly, H., AlMukdad, S., Ayoub, H. H., Altarawneh, H. N., Coyle, P., Tang, P., Yassine,
H. M., Al-Khatib, H. A., Smatti, M. K., Hasan, M. R., Al-Kanaani, Z., Al-Kuwari, E.,
Jeremijenko, A., Kaleeckal, A. H., Latif, A. N., Shaik, R. M., Abdul-Rahim, H. F.,
Nasrallah, G. K., Al-Kuwari, M. G., & Al-Romaihi, H. E. (2022). Covid-19 Vaccine
Protection among Children and Adolescents in Qatar. New England Journal of Medicine,
387(20), 1865–1876. https://doi.org/10.1056/nejmoa2210058
The authors of this study used three groups of retrospectives, and target-trial
methods to collect data, to compare the prevalence of COVID-19 in the vaccinated group
and the unvaccinated group in Qatar. The aim of this research study is to assess the
effectiveness of the BNT162b2 vaccine against Covid 19 in children 5 to 11 years old
and adolescents 12 to 17 years old. In the research, the first group was children 5 to 11
years old after the B.1.1.529 (omicron) variant spread. The second group is adolescents
12 to 17 years of age before the spread of the omicron variant, and the third group is
adolescents 12 to 17 years of age after the spread of the omicron variant. The vaccinated
group received a 10-μg dose of the BNT162b2 vaccine among children and a 30-μg dose
of the BNT162b2 vaccine among adolescents. The Cox proportional-hazards regression
model was used to compare percentages and statistics among the three trial groups.
Chin, E. T., Leidner, D., Lamson, L., Lucas, K., Studdert, D. M., Goldhaber-Fiebert, J. D.,
Andrews, J. R., & Salomon, J. A. (2022). Protection against Omicron from Vaccination
and Previous Infection in a Prison System. New England Journal of Medicine, 387(19),
1770–1782. https://doi.org/10.1056/nejmoa2207082
3
The authors of this paper used a retrospective cohort design research to conduct
their study by collecting data from December 24, 2021, through April 14, 2022, which is
the period of the omicron outbreak. The research was focused on two high-risk groups:
the staff and residents of California State Prison. The aim of this study is to evaluate the
protection level by vaccination and previous infection against the omicron variant of
COVID-19. The Weighted Cox models were used to compare the effectiveness of
protection between the group who had a previous infection, secondly, the group who was
vaccinated before with two doses, and lastly the group who was vaccinated with a third
booster dose. Also, a rolling matched-cohort design was used as a secondary analysis
method to compare the effectiveness of two, and three doses of vaccination.
Dai, L., Gao, L., Tao, L., Hadinegoro, S. R., Erkin, M., Ying, Z., He, P., Girsang, R. T., Vergara,
H., Akram, J., Satari, H. I., Khaliq, T., Sughra, U., Celi, A. P., Li, F., Li, Y., Jiang, Z.,
Dalimova, D., Tuychiev, J., & Turdikulova, S. (2022). Efficacy and Safety of the RBDDimer–Based Covid-19 Vaccine ZF2001 in Adults. New England Journal of Medicine.
https://doi.org/10.1056/nejmoa2202261
The method used by researchers in this study was a randomized, double-blind,
placebo-controlled, phase 3 trial to investigate the efficacy and safety of the ZF2001
vaccine against COVID-19. The research was conducted at 31 clinical centers across
Uzbekistan, Indonesia, Pakistan, and Ecuador, and additionally, a center in China was
included in the safety analysis only. A random allocation of three 25 g doses, 30 days
apart from ZF2001 or placebo, was given to adult participants 18 years of age or older in
a 1:1 ratio. Symptomatic symptoms of the Covid19 that were confirmed in a polymerase
chain reaction assay not less than 7 days after initiation of 3 doses, were an important
4
endpoint. Serious to critical COVID-19 events at least seven days after administration of
the 3rd dose were a crucial second efficacy endpoint.
Halasa, N. B., Olson, S. M., Staat, M. A., Newhams, M. M., Price, A. M., Pannaraj, P. S., Boom,
J. A., Sahni, L. C., Chiotos, K., Cameron, M. A., Bline, K. E., Hobbs, C. V., Maddux, A.
B., Coates, B. M., Michelson, K. N., Heidemann, S. M., Irby, K., Nofziger, R. A., Mack,
E. H., & Smallcomb, L. (2022). Maternal Vaccination and Risk of Hospitalization for
Covid-19 among Infants. New England Journal of Medicine.
https://doi.org/10.1056/nejmoa2204399
The method used by researchers in this study is a case-control test-negative design
to assess the effectiveness of maternal vaccination in pregnancy against hospitalization
for COVID-19 among infants aged less than 6 months; as they are considered at high risk
for Covid 19 and not eligible for vaccination. Researchers are trying to test if the
transplacental transfer of antibodies in vaccinated pregnant ladies can offer protection
against COVID-19 for infants. Researchers included infants hospitalized for COVID-19
(case infants) and infants hospitalized without COVID-19 (control infants) at 30 hospitals
in 22 states between July 1, 2021, and March 8, 2022. Researchers calculated vaccine
efficiency by comparing the likelihood of full maternal immunization (two doses of
mRNA vaccine) among case and control newborns during the B.1.617.2 (delta) and
B.1.1.529 (omicron) variants’ circulation.
Muñoz, F. M., Sher, L. D., Sabharwal, C., Gurtman, A., Xu, X., Kitchin, N., Lockhart, S.,
Riesenberg, R., Sexter, J. M., Czajka, H., Paulsen, G. C., Maldonado, Y., Walter, E. B.,
Talaat, K. R., Englund, J. A., Sarwar, U. N., Hansen, C., Iwamoto, M., Webber, C., &
Cunliffe, L. (2023). Evaluation of BNT162b2 Covid-19 Vaccine in Children Younger
5
than 5 Years of Age. New England Journal of Medicine, 388(7), 621–634.
https://doi.org/10.1056/nejmoa2211031
The method used by researchers in this study is an ongoing phase 2-3,
randomized, placebo-controlled trial to investigate the efficacy, safety, and
immunogenicity of the BNT162b2 vaccination in children aged 6 months to 4 years. The
BNT 162b2 vaccine (three dosages, 3 μg) was given as 2:1 ratio to give two injections,
21 days apart, to 1776 children aged 6 months to 2 years and 2750 children aged 2 to 4
years. A third dose was given at or after 60 days from the second dose. To check the
effectiveness of the vaccine, the ratio of the geometric mean titer (GMT) of neutralizing
antibodies against COVID-19 was used to compare children at 1 month after the third
vaccine dosage as opposed to the GMT at 1 month after the second dose of 30 μg for
people aged 16 to 25.
Pavord, S., Scully, M., Hunt, B. J., Lester, W., Bagot, C., Craven, B., Rampotas, A., Ambler, G.,
& Makris, M. (2021). Clinical Features of Vaccine-Induced Immune Thrombocytopenia
and Thrombosis. The New England Journal of Medicine.
https://doi.org/10.1056/NEJMoa2109908
The method used by researchers in this paper is a prospective cohort study. An
anonymous electronic method was used to collect data from hospitals in the United
Kingdom between March 22 and June 6, 2021. The aim of this research is to provide risk
factors, indicators, course of treatment, and information about the prognosis of VaccineInduced Immune Thrombocytopenia and Thrombosis (VITT) which is a new syndrome
associated with the Oxford-AstraZeneca Covid19 vaccine. Based on predetermined
criteria, incidents were classified as either definite or probable VITT. Researchers found
6
170 definite and 50 probable cases of VITT among the 294 individuals that were
assessed. All of the patients showed up 5 to 48 days (median, 14) after receiving the first
dose of the ChAdOx1 nCoV-19 vaccine. There was no sex predominance and no clearcut medical risk factors, and the age range was 18 to 79 years (median, 48).
Pittet, L. F., Messina, N. L., Orsini, F., Moore, C. L., Abruzzo, V., Barry, S., Bonnici, R.,
Bonten, M., Campbell, J., Croda, J., Dalcolmo, M., Gardiner, K., Gell, G., Germano, S.,
Gomes-Silva, A., Goodall, C., Gwee, A., Jamieson, T., Jardim, B., & Kollmann, T. R.
(2023). Randomized Trial of BCG Vaccine to Protect against Covid-19 in Health Care
Workers. New England Journal of Medicine, 388(17), 1582–1596.
https://doi.org/10.1056/nejmoa2212616
In this publication, the researchers’ method that was used is a multinational,
double-blind, randomized, placebo-controlled trial to assess the efficacy of the BCG
Denmark Vaccine against COVID-19 in Health Care Workers. A total of 3988
individuals were randomly assigned of which 1703 were in the BCG group and 1683
were in the placebo group. These healthcare workers have never tested positive for
COVID-19 and were assigned to receive a (0.1 ml) of BCG Denmark Vaccine
intradermally, be assessed after 6 months, and followed for 12 months.
Polack, F. P., Thomas, S. J., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J. L.,
Pérez Marc, G., Moreira, E. D., Zerbini, C., Bailey, R., Swanson, K. A., Roychoudhury,
S., Koury, K., Li, P., Kalina, W. V., Cooper, D., Frenck, R. W., Hammitt, L. L., &
Türeci, Ö. (2020). Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. New
England Journal of Medicine, 383(27), 2603–2615.
https://doi.org/10.1056/nejmoa2034577
7
The method used by researchers in this study is a multinational, placebocontrolled, observer-blinded, pivotal efficacy, randomized trial, in which people 16 years
of age or older were assigned in a 1:1 ratio to receive two doses, 21 days apart, of either
placebo or the BNT162b2 vaccine (30 μg per dose). There were 43,448 participants who
received intramuscular injections: 21,720 with BNT162b2 and 21,728 with placebo and
were followed for around 2 months to assess the efficacy of the vaccine.
Tan, S. H. X., Cook, A. R., Heng, D., Ong, B., Lye, D. C., & Tan, K. B. (2022). Effectiveness of
BNT162b2 Vaccine against Omicron in Children 5 to 11 Years of Age. New England
Journal of Medicine, 387(6), 525–532. https://doi.org/10.1056/nejmoa2203209
The method conducted by researchers in this study is data analysis from January
21, 2022, through April 8, 2022, for 255,936 children who were between the ages of 5 to
11 in Singapore during an outbreak of the omicron strain. The objective of this study is to
report on the efficacy of the BNT162b2 messenger RNA (mRNA) vaccine (PfizerBioNTech) against COVID-19 in 5 to 11-year-old children. Data were collected and
assessed among all, unvaccinated children, partially vaccinated, and fully vaccinated
children. From the incidence rate ratio of outcomes, the Poisson regression model was
utilized to evaluate vaccine effectiveness.
Winokur, P., Gayed, J., Fitz-Patrick, D., Thomas, S. J., Diya, O., Lockhart, S., Xu, X., Zhang,
Y., Bangad, V., Schwartz, H. I., Denham, D., Cardona, J. F., Usdan, L., Ginis, J., Mensa,
F. J., Zou, J., Xie, X., Shi, P.-Y., Lu, C., & Buitrago, S. (2023). Bivalent Omicron BA.1–
Adapted BNT162b2 Booster in Adults Older than 55 Years. New England Journal of
Medicine, 388(3), 214–227. https://doi.org/10.1056/nejmoa2213082
8
The method used in this research is phase 3, a randomized trial to evaluate the
effectiveness of different sequences of BNT162b2 Booster vaccine against Omicron
BA.1 in Adults Older than 55 Years. 1846 participants were assigned to six treatment
groups to receive their fourth dose, and all participants had previously received three 30μg doses of the BNT162b2 vaccine. The six groups will receive the fourth dose as follow:
either 30 μg or 60 μg of BNT162b2, 30 μg or 60 μg of (monovalent BA.1 which is a new
adaptive vaccine), 30 μg or 60 μg of (bivalent BA.1 which is also new and adaptive
vaccine).
Evaluate various technologies, systems, and applications needed to achieve optimal clinical and business performance outcomes.
Scenario
A director within a large integrated health network has expressed interest for a mHealth solution for her community-based patient population. She wants to ensure this solution could integrate with other health systems in the network. Her team wants to collect blood pressure data for newly diagnosed hypertensive patients requiring daily monitoring. A mHealth solution could reduce resource costs for the number of face-to-face visits required by nurses and improve patient outcomes with continuous monitoring. As a new intern at this health network, investigate one mHealth solution that could meet the director’s needs. Use the module readings, lectures and your own research to select the solution and provide support for the analysis. The director requests your results in the form of a SWOT analysis with discussion on how it will achieve improved clinical and business performance outcomes.
Instructions
Create a SWOT Analysis that includes:
Description of a selected mHealth solution including why it was chosen for this patient population.
SWOT Analysis Model that bullets the items to be included in the subsequent analysis and discussions.
Discussion of the outcome analysis of the strengths and opportunities for having this type of clinical data collected from a patient in the community.
Discussion of the outcomes analysis of the threats/weaknesses on integrating community-based data into large integrated health network systems (e.g., clinical, financial, administrative).
Reference page of resources utilized.
Grading criterion
Comprehensive description of a selected mHealth solution including why it was chosen for this patient population, including multiple examples and supporting details.
Clear and thorough SWOT Analysis Model that bullets the items to be included in the subsequent analysis and discussions.
Clear and thorough discussion of the outcome analysis of the strengths and opportunities for having this kind of clinical data collected from a patient in the community including multiple examples and supporting details.
Clear and thorough discussion of the outcome analysis of the threats/weaknesses on integrating community-based data into large integrated health network systems, including multiple examples and supporting details.
Reference page contains almost no formatting errors and all sources are scholarly and academic.
Go to the literature available through the library data bases (i.e., CINAHL, MEDLINE EBSCO, Nursing and Allied Health Database, etc.) and
– research at least three peer-reviewed articles that address a healthcare technology leader role such as CIO/CNIO/CMIO/Nursing Informaticist/IT Analyst/Data Base Analyst. –
The selected articles should have been published within the last five years.
Use the information and knowledge gained from your article readings,
and summarize what you have found in no more than 5 PowerPoint Slides. using the following:
The role that you were interested in learning about: Does that role exist in your own organization? If the role is present in your organization, how long has that role been part of the complement of the health care IT team?
What are the major job responsibilities?
What type of education/degree/certification does the role require?
What are/or might be the major initiatives in which a person in the role would typically be involved?
How will individuals who take this role influence the future of Healthcare Informatics and the future of healthcare delivery? Why are they important based on the websites containing the quality data that you have now seen for the local healthcare institutions on the websites that you viewed?
Please include a Title and Reference slide, these DO NOT count toward the total slides in the presentation.
Click here for the ONS Voice article
Click here for the HIMSS job description
Click here for the Hospital Compare website
Click here for the Leapfrog Group website Click on these link as additional materials
Directions: Based on your synthesis of the evidence, you will present your findings in a professional format. Using all the work products from previous parts, you will create a slide presentation of your work. See the grading rubric embedded in Brightspace.
Instructions:
Create a PowerPoint presentation of no more than 10 slides. Design should be professional, clean, organized, and readable from a distance (use graphics and tables; keep words to a minimum!).
In the notes section of each slide, write your narrative, i.e. what you would say for an oral presentation.
At a minimum, slides and your presentation should demonstrate:
PowerPoint Narrative in your presentation
Introductory title slide (grabs attention with title, includes your name and credentials) Short introduction of yourself and purpose of presentation
Final PICO Question Explanation of the question and your inspiration for choosing it (Use Part 1 for your inspiration; be sure to include your FINAL PICO question from Part 3 or beyond).
Short description of the final intervention—based on the evidence!–you are proposing to fulfill the outcome in your PICO. Explain the intervention. It can be a combination of high-quality interventions—based on the evidence!—across multiple articles.
Synthesis of consistency and findings for each level of evidence (use Parts 5 and 6) to support (or not support) the intervention. Include the # of studies for each level. Explain the consistency (or inconsistency) of findings across each level.
Applicability of the intervention to the population and agency resources. Explain this.
Recommendation for practice change or future work Explain the rationale for the recommendation.
Final slide should include a complete reference list in APA format. No narrative.
Unformatted Attachment Preview
EBP Project, Part 3: Executing Your Search
Final PICO Question used for this assignment:
In hospitalized patients would a multifactorial approach be the best impact to prevent falls when
compared to the usual falls prevention interventions in reducing incidence of falls.
Search terms tried/used:
-patient safety
– best practices
-guidelines
-fall prevention
Rationale for choosing Article 1:
According to this article, using a system is the greatest approach to prevent falling. This system
includes a program that helps patients prevent additional harm. The purpose of this program is to
guard against falls in nursing homes. This program is utilized at the bedside and aids in reducing
the likelihood of falls significantly following use.
Rationale for choosing Article 2:
The actions described in this article will reduce hospital-related falls. It focuses on a project that
is built around educating the workers and guaranteeing the right education to reduce the
likelihood of a fall occurring. Patients won’t be at risk if the scale is properly trained for use and
implemented.
Rationale for choosing Article 3:
Interventions in this article include messaging. According to this article, nurses who do not have
penalties will not give a patient’s fall as much attention. Nurses worry that consequences will
ultimately prevent few or no falls from happening.
Rationale for choosing Article 4:
This article handles the intervention by giving the right information and resources to understand
why it is crucial to prevent a fall. These papers explain why it is crucial for neither party that
there be any falls. This will instruct the nurse on appropriate safety measures.
Reflect:
Finding the articles I included in this project made me happy. I think these articles have taught
me a lot about interventions, and they will help me obtain useful, accurate information. I’m glad
to see that there is a lot of research on the subject of my interest and that it is acknowledged as a
problem.
1
EBP Project, Part 4: Levels of Evidence
Author/Year
Journal Title/Peer
Review?
Journal of nursing care
quality (Peer reviewed)
Category
Mozingo (2023)
The University of
Arizona (Doctoral
dissertation)
Primary-Quantitative
King, (2018)
The Gerontologist (Peer Primary-Quantitative
reviewed)
Schoberer (2022)
Worldviews on
Evidence‐Based
Nursing (Peer
reviewed)
Other-CPG
National Institute for
Health and Care
Excellence (2014)
National Institute for
Health and Care
Excellence (Peer
reviewed)
Other-CPG
Tzeng (2021)
Primary-Quantitative
Rationale for
Category
Follows IMRaD, uses
human participants,
results are mainly
numbers and stats, and
there’s an intervention
Follows IMRaD, uses
human participants,
results are mainly
numbers and stats, and
there’s an intervention
Follows IMRaD, uses
human participants,
results are mainly
numbers and stats, and
there’s an intervention
Does not follow
IMRaD but does make
recommendations on
the care of patient
populations
Does not follow
IMRaD but does make
recommendations on
the care of patient
populations
Reflection on the body of evidence as a whole to answer your research question.
Level of Evidence
Level 3
Level 3
Level 3
Level 1
Level 1
2
My research question is answered by the entire body of evidence. A clinical practice guideline (CPG) with the highest level of
evidence gives me the latest fall prevention advice for hospitals and nursing homes. The key quantitative research also support fall
prevention measures. I’m certain I can create a thorough, evidence-based fall prevention program for my organization using the CPG
and primary quantitative studies.
EBP Project, Part 5: Evidence Table
First author/year
Level of Evidence
Population and
Setting
Intervention
Description
Tzeng et al. (2021)
Level 3: PrimaryExperimental
Quantitative
Older adults in a
nursing home
Adopting the Fall
Tailoring
Interventions for
Patient Safety (TIPS)
program
Outcomes
Measured (include
only those that
relate to the “O” in
the PICO)
Number of falls and
fall-related injuries
Relevant findings (or
recommendations for CPGs)
that help answer the PICO
question
The TIPS program was
associated with a significant
reduction in the number of
falls and fall-related injuries.
At this point, do you feel the study is relevant to the clinical question? Why or why not?
Yes, this study is relevant to the clinical question because it evaluates the effectiveness of a fall prevention intervention in older adults in
a nursing home setting.
Mozingo (2023)
Level 5: Primary
Qualitative
Older adults in a
nursing home
Use of the Morse
Fall Scale
Perceptions of the
Morse Fall Scale and
fall prevention
Participants found the Morse
Fall Scale to be a helpful tool
for identifying and
addressing fall risks.
At this point, do you feel the study is relevant to the clinical question? Why or why not?
Yes, this study is relevant to the clinical question because it provides insights into the experiences of older adults in nursing homes with
the Morse Fall Scale, which is a tool used to identify and assess fall risk.
King et al. (2018)
Level 3: PrimaryExperimental
Quantitative
Nurses in a nursing
home
Fall prevention
education and
training
Perceptions of fall
prevention and
knowledge of fall
prevention
strategies
At this point, do you feel the study is relevant to the clinical question? Why or why not?
Nurses’ knowledge of fall
prevention strategies
increased significantly after
the intervention. Nurses also
reported feeling more
confident in their ability to
implement fall prevention
strategies.
First author/year
Level of Evidence
Population and
Setting
Intervention
Description
Outcomes
Measured (include
only those that
relate to the “O” in
the PICO)
Relevant findings (or
recommendations for CPGs)
that help answer the PICO
question
Yes, this study is relevant to the clinical question because it evaluates the effectiveness of fall prevention education and training for
nurses in a nursing home setting.
Schoberer et al.
(2022)
Level 1: Other-CPG
Older adults in
hospitals and nursing
homes
Multifactorial fall
prevention
interventions
Number of falls and
fall-related injuries
Multifactorial fall prevention
interventions are effective in
reducing the number of falls
and fall-related injuries in
older adults.
At this point, do you feel the study is relevant to the clinical question? Why or why not?
Yes, this study is relevant to the clinical question because it provides evidence for the effectiveness of multifactorial fall prevention
interventions in older adults in nursing homes.
National Institute for
Health and Care
Excellence (2013)
Level 1: Other-CPG
Older adults in the
community
Comprehensive fall
prevention
interventions
Number of falls and
fall-related injuries
Comprehensive fall
prevention interventions are
effective in reducing the
number of falls and fallrelated injuries in older
adults in the community.
At this point, do you feel the study is relevant to the clinical question? Why or why not?
This study is relevant to the clinical question because it provides evidence for the effectiveness of comprehensive fall prevention
interventions in older adults. However, it is important to note that the study was conducted in a community setting, not a nursing home
setting.
EBP Project, Part 6: Synthesis Table
Level of Evidence
Level 1
# of Sources
1
Level 2
1
Level 3
2
Level 4
Level 5
0
1
Level 6
1
Consistency
Findings are very
consistent and come
to the same
conclusion.
Findings are
consistent and come
to the same
conclusion.
Findings
Implementation of an evidence-based patient safety team to
prevent falls in inpatient medical units. The study discusses
the effectiveness of a patient safety team in preventing falls
in inpatient medical units.
A systematic review suggests that falls in hospitals can be
prevented effectively using specific strategies. Prevention of
Falls by Appropriate Use of the Morse Fall Scale. This
dissertation explores the use of the Morse Fall Scale as a
tool for fall prevention (Mozingo, 2023).
Impact of fall prevention on nurses and care of fall risk
patients. Fall prevention in hospitals and nursing homes:
Clinical practice guideline.
No relevant sources at this level.
Qualitative research suggests that falls in hospitals can be
prevented effectively using a multidisciplinary evidencebased patient safety team approach (Godlock, Christiansen,
& Feider, 2016).
Clinical practice guidelines recommend specific approaches
to fall prevention in hospitals and nursing homes,
highlighting the importance of evidence-based strategies
(Schoberer et al., 2022).
Fit/Applicability
The evidence from the new articles is relevant to the population in my PICO question, which is hospital falls. Articles 2, 3, 4, and 6
on hospital fall prevention are most pertinent to my PICO question.
Recommendation Option
Level of Evidence
# of Sources
Consistency
Findings
Option 2: good evidence, consistent results, moderate to high applicability: Consider pilot of change or further investigation.
Recommendation Option: The evidence suggests developing evidence-based patient safety teams for fall prevention (Option 3) and
following clinical practice standards in hospitals and nursing homes.
Recommendation Rationale
Option 2 is relevant since it analyzes good evidence and consistent findings from sources, notably for hospital fall prevention. These
techniques must be tailored to the hospital’s needs and challenges through more research or a pilot of change. In Article 4, a
systematic review adds weight to the evidence supporting hospital fall prevention practices.
Previously, there was a video link here that was requiring payment. Don’t pay for anything!! Instead, do this:
Write about the most interesting thing you’ve learned so far in the semester, and tell me three things I should change about the course in future semesters! 🙂
Each week I will be posting a mini podcast/video/ mini lecture. You are required to view the weekly videos that I post and submit a 250 word reflection. You are to reflect on any specific questions that I may ask as well as the content of the video itself. It is important that you integrate evidence and information from the textbook and readings to support the ideas in your reflection. Reflections are due every Sunday evening by 11:59 p.m. Late submissions will be deducted by half. You will be graded based on the quality of your reflection, including appropriate content, proper grammar and spelling and thoughtful consideration of the ideas and concepts.
Rubric
Read: Chapter 6 Summary and Outline and Chapter 6 PowerPoint
View Videos:
American Family with Five Autistic ChildrenLinks to an external site. (5:36)
Autism Diagnosis in ChildrenLinks to an external site. (4:12)
Autism GenesLinks to an external site. (2:19)
Under-Diagnosed Autism in GirlsLinks to an external site. (9:3
The eye-of-the-storm technique is an experiential, teaching technique heralded by Jane Elliot, and used to enlighten youngsters on the impact of overt racism and discrimination.
Micro-assaults are covert or subtle acts of discrimination that plague minority, dis-empowered or disenfranchised groups in our contemporary world.
Watch the following video on the Eye of the Storm technique. Then, reflect upon applying this pedagogical exercise to microaggressions.
Identify a current social cause (example: gender discrimination) and write a paper describing how you would implement an eye-of-the-storm teaching technique/demonstration to highlight micro-assaults plaguing a group.
Please identify the social cause (e.g., gender discrimination), the social group (e.g., women), the micro-assaults you want to expose your “class” to, and the strategy(-ies) you will use to induce the eye-of-the-storm technique (i.e., what will you do). Please be creative and concise.
Post must be complete sentences and thought out. Please separate your answers per section. Each section should be 150-250 words. Make sure to cite or give credit if you are referencing someone else’s work.
More specifically, please address the following points in your paper:
Explain micro-aggressions/assaults/invalidations, (2 points)
Explain prejudice, discrimination, stereotype, and racism, as well as how these concepts specifically relate to modern prejudice (e.g., microaggressions (2 points)
Describe the social cause, the social group affected, and the micro-assaults you want to expose your “class” to; i.e., describe to whom and how you will do “eye of the storm” (3 points)
Describe strategies you will use to induce the eye-of-the-storm technique (3 points)
Additionally, please review the general grading rubric for assignments 1-8.
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Introduction to Disease
Course code:
PHC271
CRN:
Assignment title or task:
Diabetes Mellitus (DM) is a common chronic disease in Saudi Arabia. Explain the
epidemiology, pathophysiology, types, risk factors, symptoms, signs, and prevention of
diabetes.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
Out of 10
Proficiency
Some Proficiency
Limited Proficiency
No Proficiency
2
1.5
1.0
0.5
Content Presentation
Criteria
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Thinking
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/ 10
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Start your writing from the next page (page 3)
•
Word limit: Minimum 600 words (3 pages)
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task (PDF is not
acceptable)
•
Submission should be before the deadline (submission after the deadline is not allowed)
Details are provided in attachments. Complete goal writing case 1 and case 2.
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Student: __________________________
SPA 6410
Goal Writing: Grading Rubric
PARAMETER
•
•
•
•
•
•
•
•
SCORE
CASE 1
Identifies performer of goal
Clearly states behavior
Describes conditions
Specifies measurement
Mentions timeline
Added context appropriate to case
Goal is appropriate for case
Clarity/Organization/Writing Style
_____________/1
_____________/1
_____________/1
_____________/1
_____________/1
_____________/1
_____________/2
_____________/2
Total Case 1
•
•
•
•
•
•
•
•
_____________/10
CASE 2
Identifies performer of goal
Clearly states behavior
Describes conditions
Specifies measurement
Mentions timeline
Added context appropriate to case
Goal is appropriate for case
Clarity/Organization/Writing Style
_____________/1
_____________/1
_____________/1
_____________/1
_____________/1
_____________/1
_____________/2
_____________/2
Total Case 2
TOTAL POINTS ACCUMULATED
_____________/10
______________ /20
Goal
Writing
APHASIA
Long term goals
What are the main overall goals you want to accomplish with your client?
You determine these by completing all steps of the evaluation so you have
the complete picture of the client’s strengths, areas for growth, and
functional communication needs.
You work with the client to determine what these long term goals might be.
◦ Examples
◦ In order to communicate effectively at work . . .
◦ In order to answer an email from his grandson . . .
◦ In order to tell her husband if she is feeling pain . . .
1. Who? – name the person(s) who will
complete the goal
2. What? – behavior that can be observed
as a step toward the long-term goal (verb)
Components to
short term goals
3. Where, when, how, with whom? – tools
involved, cue, models, conditions. or locations
4. How well? – quantity, quality, speed,
accuracy level
5. When? – number of sessions, days, or
weeks
IN ORDER TO {LTG} {WHO} WILL {WHAT}
{HOW/WHERE} {HOW WELL} FOR {HOW LONG}
IN ORDER TO USE EXPRESSIVE COMMUNICATION
WITH HER HUSBAND AND DAUGHTERS
Combine LTG
with STG
SUSAN WILL USE 10 SIGNS/GESTURES/WORD
APPROXIMATIONS
TO ANSWER YES/NO QUESTIONS 80% OF
OPPORTUNITIES THAT OCCUR IN 2/3
CONSECUTIVE SESSIONS.
Setting Goals
Goals that are not functional for the individual clients are not
worth addressing.
Set goals that will improve the patient’s quality of life (QOL).
Start by determining LTG(s).
Then work backwards by breaking that into smaller steps.
Depending on where you work (university clinic, medical or school
setting) – goals can be written differently.
Our version involves a non-detailed LTG but in many facilities you
will write them with allof the components we covered for STGs.
Client 1:
Mr. Booth presents with a moderate Broca’s aphasia characterized by non-fluent,
telegraphic, agrammatic speech with some difficulty recognizing errors of grammar,
significant word finding difficulty, and. poor repetition.
Add three sentences to the above case description. What you add should be different than
what is there but should also fit the DX of this client.
1. Please write three goals for your client.
One goal should address part of the information provided by your
instructor.
Two goals should address the portions you added.
2. Please explain as if to me (or to another speech pathologist) the reason for each
goal. (1-2 sentences)
3. Please explain as if to your client the reason for each goal. (1-2 sentences)
4. For one goal, write three more goals that raise the level of difficulty for your
client in a three different ways.
Goal Assignment #2
DJ is a 65 year old client, 10 years post CVA, who currently presents with moderately
severe Wernicke’s aphasia. His primary concerns, and those of his wife and children, are
his difficulties understanding conversation and his lack of awareness of his own speech
production errors.
Add three sentences to the above case description. What you add should be different than
what is there but should also fit the DX of this client.
1. Please write three goals for your client.
One goal should address part of the information provided by your
instructor.
Two goals should address the portions you added.
2. Please explain as if to me (or to another speech pathologist) the reason for each
goal. (1-2 sentences)
3. Please explain as if to your client the reason for each goal. (1-2 sentences)
4. For one goal, write three more goals that raise the level of difficulty for your
client in three different ways.
Discussion Board #588 unread replies.88 replies.What is the impact on the families of children with autism? Compared to other mental disabilities, are there any characteristics of autism that make it uniquely difficult for families to cope? (For an article on this issue, see Conan, N. (2003). Analysis: Effects of autism on families. Talk of the Nation (NPR).)It is required that you post at least 2 times per discussion (initial post and response to at least 1 peer) over the two week period (on two different days) to encourage a lively discussion. Your first post must be submitted during the first week that the question is posted. Your initial response must contain an in-text citation, referencing material from your textbook and/or other academic sources. Your second response, which is your follow-up response to another student, can be posted during either the first or second week that the discussion board is open. Your initial response needs to use in-text citations and must contain an academic reference at the end of your post. This is an upper-level psychology course, so APA style is mandated for the discussion board. Failure to use proper APA style in-text citations and references will result in point loss. Please consult Purdue’s OWL Resources (Links to an external site.)Links to an external site. for APA format.Each of your required two responses should be a minimum of 225 words and should meet the content requirements stated in the syllabus. However, your initial response will probably be longer. Two postings per discussion module (a two week period) is the minimum number of postings per discussion and will yield a minimum grade. Proper grammar and spelling are required and points will be deducted for errors.Search entries or author
For this assignment, write a 750- to 1000-word paper that covers the following components:
1. Review the data in the two tables below.
2. Conduct a ratio analysis (for each of the 2 years reflected on the financial statements) using 1. two liquidity ratios, 2. two activity ratios, 3. two profitability ratios, and 4. two capital structure ratios.
3. Provide a detailed comparative analysis of the organization’s financial performance for each
of the 2 years.
4. Summarize your findings to include how to accomplish financial success and which financial
performance indicators would the CFO use to measure the success and explain why they are
important.
Learning styles represent the different approaches to learning based on preferences, weaknesses, and strengths. For learners to best achieve the desired educational outcome, learning styles must be considered when creating a plan. Complete “The VARK Questionnaire,” located on the VARK website, and then complete the following:
Click “OK” to receive your questionnaire scores.
Once you have determined your preferred learning style, review the corresponding link to view your learning preference.
Review the other learning styles: visual, aural, read/write, kinesthetic, and multimodal (listed on the VARK Questionnaire Results page).
Compare your current preferred learning strategies to the identified strategies for your preferred learning style.
Examine how awareness of learning styles has influenced your perceptions of teaching and learning.
In a paper (750-1,000 words), summarize your analysis of this exercise and discuss the overall value of learning styles. Include the following:
Provide a summary of your learning style according the VARK questionnaire.
Describe your preferred learning strategies. Compare your current preferred learning strategies to the identified strategies for your preferred learning style.
Describe how individual learning styles affect the degree to which a learner can understand or perform educational activities. Discuss the importance of an educator identifying individual learning styles and preferences when working with learners.
Discuss why understanding the learning styles of individuals participating in health promotion is important to achieving the desired outcome. How do learning styles ultimately affect the possibility for a behavioral change? How would different learning styles be accommodated in health promotion?
Cite to at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.
Prepare this assignment according to the guidelines 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.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance.
VARK Questionnaire: How do you learn best? (vark-learn.com)
All Experiments are attached below. Please answer each one in its file and send them back, DO NOT MIX THEM, BECAUSE EACH EXPERIMENT HAS A DIFFERENT DROPBOX TO SUBMIT.Please, if there are any questions, let me know. Do not hesitate yourself by asking me. I hope everything is clear for you in the attached files.
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Lab 6: Effects of Acid on Bone
Post-Lab Questions
1. Which group of bones is more flexible? Why is this so?
2. What was damaged in the bones placed in vinegar?
3. How might the experiment results vary if the same procedure was performed using
bones that had not been regurgitated in an owl pellet (such as raw chicken bones)?
Some people suffer from a disease called rickets, in which their bones have not been
adequately calcified. Which group of bones is most similar to that of a patient with rickets?
Why?
Post-Lab Questions
1. What are the three components of the axial skeleton? Describe the function of each.
1. Identify the labeled components on the skull below.
A ________________
B ________________
C ________________
D ________________
E ________________
F ________________
2. Indicate whether the following bones are cranial or facial bones, and give their location.
Bone
Facial or Cranial Location
Temporal Bones
Mandible
Vomer
Zygomatic Bones
Parietal Bones
Ethmoid Bone
Sphenoid Bone
Lacrimal Bones
3. What are the three regions of the vertebral column? Describe the general shape and size of the
vertebrae in each region.
4. What are the atlas and axis? What are their functions?
5. Identify the vertebral structures on the images below.
A ________________
B ________________
C ________________
D ________________
E ________________
6. What is the purpose of the thoracic cage?
7. Describe the three components of the sternum.
8. Describe the difference between true ribs, false ribs, and floating ribs.
VIRTUAL MODEL – THE AXIAL SKELETON
Post-Lab Questions
1. What features are located inferior to the cranium and superior to the mandible? Identify the
category here. How many individual items are included in this category? (Hint: the answer is not
a bone.)
1. Why aren’t teeth considered bones?
2. Identify the two major bones that comprise the head.
3. To what bones does the right scapula attach?
4. Is the left clavicle superior or inferior to the right scapula?
ARTICULATIONS
Post-Lab Questions
1. In what two ways can joints be classified? What are the three classifications of each type?
1. Fibrous joints are either sutures or syndesmoses. What is the difference between the two? Give
examples of each type.
2. Symphyses and synchondroses are two classifications of what type of joint? What are the
differences between the two classifications?
3. What allows synovial joints to be diarthrotic?
4. Fill in the table below:
Joint
Elbow
Knee
Hip
Ankle
Wrist
Articulating Bones
Type of Synovial Joint
Movement
PHYSICAL SKELETON – THE APPENDICULAR SKELETON
Post-Lab Questions
1. What are the four parts of the upper extremity and the lower extremity of the appendicular
skeleton?
1. Compare and contrast the size and function of the upper and lower extremities of the
appendicular skeleton.
2. What are the three fused bones that make up the coxae of the pelvic girdle? What is their
location in relationship to one another?
NO PLAGARISM PLEASE. THE FILE THAT SAYS “Literature Synthesis (Literature Review and Synthesis Matrix)” IS FOR THIS ASSIGNMENT. please read the instructions for this essay and write accordingly. all the formatting and EVERYTHING REGARDING THIS PAPER IS ATTACHED THE INSTRUCTIONS FOR THIS ESSAY , ALSO MENTIONS TO LAST ESSAY WHICH I HAVE SUBITTED BELOW AND ITS CALLED ” DINA RESEARCH TOPIC” I’VE SUBMITTED THE INSTRUCTIONS AND THE ESSAY THAT I WROTE FOR LAST PAPER. LET ME KNOW IF YOU HAVE ANY QUESTIONS PLEASE 🙂
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Public Health 122 – Research Topic and Problem Statement (Rubric)
During the quarter you will write a health policy analysis paper. The research topic and problem statement assignment is one of the tools
necessary to analyze a policy problem. This assignment helps you gain an understanding of how to select a topic and write a problem statement.
Finally, it will help you conduct a literature synthesis, write the Bardach Policy Memo and the Final Health Polich Analysis Paper.
The assignment will be in Times New Roman 12 pt. font with 1-inch margins, single space or double space, minimum (1 full page), maximum 2
pages (do not exceed two pages), not including the Cover/Title Page, to be submitted as one Word file (PDFs, Pages or Google Doc files will not
be accepted). A minimum of 1 reference required and 1 in-text citation. A minimum of 3 sentences required for the problem statement. Headers
and subheaders are required. You will include the specific section headers (which will be provided) for this assignment (refer to the rubric
below). This assignment will be submitted via Canvas and is Due Wednesday, October 18, at 10:55 p.m. NO EXCEPTIONS. LATE SUBMISSIONS
WILL NOT BE ACCEPTED. UNDER NO CIRCUMSTANCES WILL SUBMISSIONS BE ACCEPTED VIA EMAIL OR THE CANVAS “COMMENT BOX” OR
COMMENT INBOX MESSAGES. All ASSIGNMENTS MUST BE SUBMITTED VIA CANVAS. DO NOT USE EMAIL OR THE CANVAS “COMMENT BOX”
OR CANVAS INBOX MESSAGES TO SUBMIT YOUR ASSIGNMENTS; IT WILL NOT BE READ/GRADED.
Follow these steps to effectively write about your research topic and problem statement (headers and subheaders are required in this
paper/assignment):
1. Provide a working title of your paper (your paper title may change until you submit your final paper), your name and course information.
See example below (this is on a separate page):
Research Topic and Problem Statement
Your Name Here
Provide a Title Here
Name of your possible Client Here (i.e., Drug Free America Foundation, Inc.)
Targeted for Politicians (Name of Stakeholder(s) (i.e., Identify your audience here: A pharmaceutical company, lobbyists, NRA, AARP,
AMA, an advocacy group, CMS, healthcare providers, employees, insurance companies, patients, a politician or politicians, etc.)
PH122 Fall 2023
University of California, Irvine
What should be included in the research topic and problem statement assignment (single space or double space is fine) and no longer than 2
pages max. Be sure to cite your reference(s) immediately below the problem statement and provide an in-text citation:
2. Research Topic (Header)
Why: (Subheader)
Who: (Subheader)
What: (Subheader)
Where: (Subheader)
1
When: (Subheader)
Possible Topic: (Subheader)
Problem Identification: (Subheader)
3. Problem Statement (Header)
4. Reference(s) (Header)
1. Your reference goes here
Helpful Hints (respond to the seven steps):
Respond to the seven steps below. Start by responding to the following questions/steps below in an effort to refine and narrow down your
topic. Do some research to start narrowing down your topic (i.e., use the library resources, search engines). And finally, be sure to select a topic
that interests you, and research can be located on the topic selected.
Research Topic (Header) (single space or double space)
1. WHY did you choose the topic? What interests you about it? Do you have an opinion about the issues involved?
2. WHO are the information providers on this topic? Who might publish information about it? Who is affected by the topic? Do you know of
organizations or institutions affiliated with the topic?
3. WHAT are the major questions for this topic? Is there a debate about the topic? Are there a range of issues and viewpoints to consider?
4. WHERE is your topic important: at the local, national or international level? Are there specific places and/or populations affected by the topic?
5. WHEN is/was your topic important? Is it a current event or a historical issue? Do you want to compare your topic by time periods?
6. Identify your possible topic (identify as a short sentence).
7. Identify the question/problem identification (i.e., turn your topic into a question). This is your problem identification written as one sentence.
You only need to provide one problem identification. (It should be posed as a question and this question may be used in your problem
statement).
In your submission, provide your response to the following: Why, Who, What, Where, When, Possible Topic, and Problem Identification as a
Word document (single space or double space).
An example below focusing on global warming (content reproduced):
Research Topic (header)
1. Why: I am interested in environmental issues, and I am interested in how technology can be used to improve things in the future.
2. Who: Many environmental journals have published research on this topic. Also, organizations such as the Intergovernmental Panel on Climate
Change (IPCC) and the United Nations Environment Programme publish reports on the topic.
2
3. What: The main questions in this topic are as follows: A) Which types of energy sources are best for the environment?, B) Are they feasible?,
C) How much will they cost?, D) What are the potential positive or negative effects?, and E) There are many debates about this topic and climate
change can be a controversial issue.
4. Where: This issue is important for everyone, both on the local levels and on a global level.
5. When: This is a current issue; it is very important today and for the future. I would like this paper to be more future-focused.
6. Identify your possible topic (identify as a short sentence): From these answers, I came up with possible topics, such as ‘the causes of global
warming’ ‘technological solutions to global warming’, or ‘what effect does global warming have on business?’ or ‘scientific debate about global
warming’
7. Problem Identification: Turn topic into a question – ‘Can alternative energy sources help stop global warming?’
(Content reproduced from MIT.edu under a Creative Commons Attribution Non-Commercial License)
For the Problem Identification, please be sure to Read Ch. 14 (including pages 342-344 – Problem Identification).
Additional hints for the problem identification: A) Is my problem written as one sentence in the form of a question? B) Can I identify the focus of
my problem?, and C) Can I identify several options (but not too many) for solving the problem?
The problem needs to be very focused. If the problem is too big or too vague, it will be difficult to analyze and determine a resolution to the
issue. Problem identification should define a specific problem; it should not indicate how that problem should be solved. Once you have written
your concise and precise problem identification, you have set the framework for your analysis. Every other section of the analysis should relate
directly to the problem you identified.
Examples of problem identification (Chapter 14 – EHPL book):
Problem identification Ex. 1:
What type of tax credit, if any, should the president include in the next budget proposal?
Problem identification Ex. 2:
What type and size of health insurance tax credit should the president include in the next budget proposal?
Problem identification Ex. 1:
Which health issue should be the governor’s top priority?
Problem identification Ex. 2:
Should the governor’s priority of reducing the number of obese residents be accomplished by relying on currently existing programs?
An acceptable way to identify the problem for the pharmaceutical lobbying firm:
Ex. How can this firm help improve medical care quality in the United States by reducing the importation of dangerous prescription drugs from
Canada?
An acceptable way to identify the problem for the elder rights association:
Ex. How can this association help seniors obtain low-priced prescription drugs from Canada?
3
Neutral problem identification:
Ex. What action should [the client] take in response to recent congressional proposals relating to importing prescription drugs from Canada?
Reflect on the following examples. They both may be acceptable problem identifications, depending on the needs of your client.
A broad problem identification:
Ex. What action should the U.S. Department of Health and Human Services take to avoid another flu vaccine shortage?
A narrow problem identification:
Ex. How can the U.S. Department of Health and Human Services create incentives for additional manufacturers to supply flu vaccine to the
United States?
A manageable problem identification:
Ex. What preventive health issue should be the top priority for the Centers for Disease Control and Prevention next year?
Helpful Hints for the Problem Statement:
Problem Statement (header) (single space or double space)
For the problem statement (ex. Refer to Bardach as well), think in terms of excess or deficit (too much or too little). Include quantitative data. Be
sure include a population of interest. Provide a minimum of three sentences. And provide a minimum of 1 reference and 1 in-text citation (3
maximum references) in AMA format. Do not include the solution in the problem statement. Do not exceed 250 words for the problem
statement. The problem statement needs to be very concise.
Examples of problem statement with AMA formatting:
Problem Statement
The 1996 Family Medical Leave Act (FMLA) provides up to 12 weeks of unpaid, job-protected leave per 12-month period for specified family and
medical reasons to nearly 60% of employees in the United States (U.S.).1 However, many Americans are not covered under the FMLA; or do not
use it because of the financial implications of unpaid leave. What could Kentucky Senator McConnell do to address this issue, FMLA, in his state?
Reference(s)
1. Breidenbach, M. A family impact analysis of the Family and Medical Leave Act of 1993. (Wisconsin Family Impact Analysis Series). Madison,
WI: University of Wisconsin Center for Excellence in Family Studies; 2003.
4
Problem Statement
About 5% of children in Pennsylvania do not have health insurance because of their immigration or refugee status. As of 2019, an estimated
24,000 Pennsylvania children are undocumented and uninsured and do not qualify for CHIP, Medicaid, ACA Marketplace coverage or
Pennsylvania’s Cover All Kids program.1 What options are available to the Governor (Shapiro) to support health coverage for these children?
Reference(s)
1. Pennsylvania Immigration and Citizenship Coalition (PCCY). Fulfilling Pennsylvania’s Promise to Cover All Kids.
https://paimmigrant.org/toolbox/report-fulfilling-pennsylvanias-promise-to-cover-all-kids/. Updated September 8, 2019. Accessed August 5,
2023.
Problem Statement
Motor vehicle crashes are the leading cause of death for the United States (U.S.) teens. According to the Centers for Disease Control (CDC),
about eight teens ages 13-19 die every day from motor vehicle crash injuries.1 Per mile driven, teen drivers ages 16-19 have a fatal crash rate
almost three times as high as drivers ages 20 and older.1 The state of Michigan is the most dangerous state for teen drivers. There were 473,443
licensed drivers ages 15-20 who represented 6.7% of Michigan’s driving population in 2020.2 The drivers in this age group represented 10.3%
(41,685) of drivers in all crashes and 7.7% (126) of drivers in fatal crashes.2 What can Michigan do to prevent teen motor vehicle fatalities and
injuries?
References(s)
1. Centers for Disease Control. Teen Driver and Passenger Safety.
https://www.cdc.gov/transportationsafety/teen_drivers/index.html#:~:text=Motor%20vehicle%20crashes%20are%20th,drivers%20ages%2020
%20and%20older. Updated November 21, 2022. Accessed August 5, 2023.
2. Michigan Office of Highway Safety Planning. Michigan Traffic Crash Facts. Teens/Young Adults Ages 15-20.
https://publications.michigantrafficcrashfacts.org/2020/2020TeensYoungAdultsAges15-20.pdf. Accessed August 5, 2023.
A. You will need to provide an in-text citation in this assignment. Please do not forget to cite your source(s). You will lose points if they are not
provided.
B. Do not use quotes in your paper as well as footnotes, endnote or footers.
Formatting:
o About 1 to 2-pages, double space or single space, not including the Cover/Title Page, to be submitted as one Word file.
o Do not go beyond 2 pages
5
o
o
o
o
o
o
o
o
o
Times New Roman 12 pt. font, 1-inch margins
Save your paper with your first and last name in Word identifying your paper assignment (i.e., Ann Smith_research topic problem
statement OR RTPS)
Use 1-inch margins, 10 pt. font (Times Roman) with your name and RTPS in the upper left-hand corner of each page as a header if you
can (if you are comfortable with Word you can omit your name and page number on the title page and start it on the second page). You
will not be penalized if your name is presented twice on the Cover/Title page.
Cover/Title page (on a separate page)
Provide In-text citation(s)
Minimum of 1 reference in AMA formatting immediately below the problem statement
Minimum of 1 in-text citation
Do not provide more than 3 references
In-text citation(s) and Reference(s) must be in AMA format (AMA resources):
AMA format: http://library.stkate.edu/assets/library-uploads/files/citeAMA.pdf
AMA format: https://owl.purdue.edu/owl/research_and_citation/ama_style/index.html
AMA format: https://guides.lib.uw.edu/hsl/ama/intext
AMA format: https://guides.lib.uw.edu/hsl/ama/print
AMA format: https://guides.lib.uw.edu/hsl/ama/electronic
AMA format: https://libguides.limestone.edu/citation/amastyle
Do not use Google Docs or Google Sheets or Pages to write your paper. It is more difficult to format when using Google Docs, Google
Sheets or Pages. Please contact UCI OIT to receive a free copy of Word for use. And try not to write your assignment on your phone.
Paper Submission/Due date (Late papers/assignments will not be accepted, or read/graded). Please submit your assignment as a
Word file by 10:55 p.m. on Wednesday, October 18. The RTPS must be submitted online via Canvas by 10:55 p.m. on the specified due
date. Please be on time when submitting your assignment. You can submit your assignment multiple times via Canvas before the
deadline/due date. Do not wait until the last minute to make a submission. Canvas will close at around 10:54 p.m.
Rubric and Organization:
• Key Info: 50 points possible
• Headers: Research Topic, Problem Statement, and Reference(s)
• Subheaders: Why, Who, What, Where, When, Possible Topic, and Problem Identification
• Probably 1 to 1½ pages, 2 pages maximum in length not including the Cover/Title Page
• To be submitted: Cover/Title page, and Research Topic and Problem Statement, Reference(s. List reference(s) immediately below the
Problem Statement
6
Research Topic and Problem Statement (Rubric)
Possible Points to be Received
Criteria
Title Page
Unacceptable
0 points
Missing/Completely missing
title page.
Needs Work
1 points
Missing required
component(s). Title is not
relevant or clear.
Good
2 points
Missing required
component (s). Title is
present.
Research Topic
(Includes the
seven steps,
responses)
0 points
Fails to identify a relevant
research topic or is not
clearly defined. Seven
steps/responses are
missing.
10 points
Identifies a research topic,
but may be too broad in
scope and/or needs to be
developed further. Some of
the seven steps/responses
are missing and/or needs
further development.
Weak.
15 points
Identifies a relevant
research topic with
some degree of interest
for the reader. All the
seven steps/responses
are present. The
problem identification is
present.
Problem
Statement
(Minimum of 3
sentences and
quantitative
data included).
0 points
Problem statement missing.
Organization
0 points
Paper/assignment lacks
logical organization and
impedes readers’
comprehension of ideas.
Central position is rarely
evident and/or the
paper/assignment is missing
5 points
Demonstrates general
understanding of
developing a problem
statement. Problem
Identification may be
missing or not clear.
Quantitative data is
somewhat presented or
weak. Population not clear.
2 points
Paper/assignment is
somewhat organized,
although occasionally ideas
from section to section
may not flow well and/or
connect to the central
position or be clear as a
whole. May be missing a
10 points
Demonstrates an
understanding of
developing a problem
statement. Includes the
Problem Identification
and provides
quantitative data.
Presents a population
that may be affected.
3 points
Paper/assignment is
adequately organized.
Ideas are arranged
reasonably with a
progression of thought
from section to section
connecting to the
central position.
Excellent
3 points
Meets the requirements.
Good development of a title,
course information is there,
etc.
25 points
Identifies a relevant research
topic that will provide
direction for the final paper
and is engaging and thought
provoking. Fully responds to
the seven steps. The seven
steps/responses are clear
and concise. The problem
identification is very succinct.
15 points
Demonstrates a sophisticated
understanding of developing
a problem statement.
Includes the Problem
Identification and provides
very good quantitative data.
Presents a very specific
population that may be
affected.
5 points
Paper/assignment is
effectively organized. Ideas
are arranged logically, flow
smoothly, with a strong
progression of thought from
section to section connecting
to the central position.
Includes all required
Total
/3
/25
/15
/5
7
multiple required
components.
required component
and/or components may
be less than complete.
Seems rushed or put
together at the very last
minute.
Includes required
components (research topic
components (research
and seven steps, problem
topic and seven steps,
statement, reference and inproblem statement,
text citation, and quantitative
reference and in-text
data).
citation, and
quantitative data) for
the most part.
Reference(s)
0 points
2 points
/2
and In-text
Missing requirements
Provide a minimum of 1 reference (1 pt).
citation(s)
completely.
Provide a minimum of 1 in-text citation (1 pt).
See below in the section pertaining to (Grammar, Formatting, References – Deductions
of the Paper).
TOTAL POINTS (sum of 50 Criteria)
/50
Grammar/Formatting/References Deductions of the paper:
▪ Incorrect grammar/spelling errors -1
▪ Incorrect punctuation/errors -1
▪ Informal, non-academic language -1
▪ Incorrect formatting of the paper itself -1
▪ (Section) Headers missing -2
▪ Subheaders missing -2
▪ If body of the paper/assignment is less than 1 page -1
▪ If body of the paper/assignment is more than 2 pages -1
▪ If provides more than 3 references -1
▪ Poor sources/citations utilized (i.e., blog, lacks evidence-based research, etc.) -1
▪ Source/citations older than 10 years old -1 (Request permission to use a citation older than 10 years from professor)
▪ If Cover/Title Page is not on a separate page -1
▪ **If paper/assignment is confusing, unorganized, or poorly constructed; repetitive; meaning we cannot hear your voice -5
▪ **If the paper/assignment was written very poorly and reads like it was cut and pasted -5
▪ Reference/missing (worth 1 pt. each) -1
▪ If in-text citation(s) are completely missing in the body of the assignment -1
▪ If only hyperlinks provided for the reference(s) -1 for each hyperlink
▪ If only hyperlinks provided for in-text citation(s) -1
▪ If links or references, including in-text citation(s) are in blue font -1
▪ If Problem Statement is less than 3 sentences -1
**NOTE: If any plagiarism is present you will receive a “0” for the entire paper/assignment (try not to use Chat GPT to write your assignment)
(You will not be penalized if citations are not correctly formatted in AMA, but do your best and try to do it)
8
Public Health 122 – Literature Synthesis (Literature Review and Synthesis Matrix) (Rubric)
For this assignment you will conduct a Literature Synthesis, a Literature Review with a Synthesis Matrix (a chart), on the same topic presented
from your Research Topic and Problem Statement assignment. A literature view requires a synthesis of different subtopics to come to a greater
understanding of the state of knowledge on a larger issue. The individual pieces (arguments) must be put together to reveal the whole (state of
knowledge). Through this assignment, it will help you develop your arguments and find evidence. It will also show where there are gaps in the
literature. This assignment is not a summary of articles, but presenting a summary of each source by first developing criteria (i.e., Main Idea)
with the use of the Synthesis Matrix (chart) that will guide the selection of the articles to be included in the literature synthesis/review. Second,
you will summarize the literature (i.e., identify patterns which will guide your writing). You will show where there is agreement and
disagreement, and show the gaps in the literature. Third, you will also include in your submission the developed Synthesis Matrix (chart), with
the main ideas and sources (i.e., author), etc. Present a minimum of 5 main ideas and 5 sources (i.e., 5 main ideas X 5 sources) in the Synthesis
Matrix as a chart and formatted in landscape (due to space constraints) with in-text citations. You will cite the sources utilized directly below the
Synthesis Matrix. And fourth, you will include a minimum of 10 references (maximum 12) on a separate page which need to be cited (as in-text
citations) within your literature synthesis/review in AMA format. The 5 sources in your Synthesis Matrix do need to be part of the 10 references
you provide in the reference section. (Note: You only need to include 5 out of the 10 sources/references researched for the written Literature
Synthesis within the Synthesis Matrix). Also, be sure to keep your population of interest in mind when you conduct your research and mention it
in your Literature Synthesis (Literature Review and Synthesis Matrix). Headers and subheaders are required. You will include the specific section
headers (which will be provided) for this assignment (refer to the rubric below). This assignment will be submitted via Canvas and is Due
Wednesday, October 25, at 10:55 p.m. NO EXCEPTIONS. LATE SUBMISSIONS WILL NOT BE ACCEPTED. UNDER NO CIRCUMSTANCES WILL
SUBMISSIONS BE ACCEPTED VIA EMAIL OR THE CANVAS “COMMENT BOX” OR COMMENT INBOX MESSAGES. All ASSIGNMENTS MUST BE
SUBMITTED VIA CANVAS. DO NOT USE EMAIL OR THE CANVAS “COMMENT BOX” OR CANVAS INBOX MESSAGES TO SUBMIT YOUR
ASSIGNMENTS; IT WILL NOT BE READ/GRADED.
Follow these steps to effectively write the Literature Synthesis (Literature Review and Synthesis Matrix) (headers are required in this
paper/assignment):
1. Provide a Cover/Title Page with the following.
See example below (this is on a separate page):
Literature Synthesis (Literature Review and Synthesis Matrix)
Title of your Literature Synthesis/Review (It can be the same as your previous assignment or differ)
Your Name Here
PH122 Fall 2023
University of California, Irvine
What should be included in the Literature Synthesis (Literature Review and Synthesis Matrix assignment), double space, no longer than 5½ pages
maximum (the body), the Literature Synthesis, References, and Synthesis Matrix (chart, no page limit). Be sure to cite your references on
separate page, provide in-text citations (in both the literature synthesis/review and synthesis matrix), and provide the Synthesis Matrix as last
(on a separate page) in a chart format. Listed below is the order for your submission:
1
2. Literature Synthesis/Review (Header)
Provide a short title or topic of your paper (Subheader) (It can be the same as your previous assignment or differ)
3. References (Header)
4. Synthesis Matrix (Header) (This is your chart)
Topic: (Insert Topic Here) (Subheader) (It can be the same as your previous assignment or differ)
References/Sources for Matrix (Header) (Provide directly below the chart)
Helpful Hints: Creating your Synthesis Matrix (Content adapted from NC State University Writing and Speaking Tutorial Service Tutors, 2006 Writing a literature review and using a synthesis matrix):
My professor says I have to write a literature review, what do I do?
Well, to begin, you have to know that when writing a literature review, the goal of the researcher is to determine the current state of knowledge
about a particular topic by asking, “What do we know or not know about this issue?” In conducting this type of research, it is imperative to
examine several different sources to determine where the knowledge overlaps and where it falls short. A literature review requires a synthesis
of different subtopics to come to a greater understanding of the state of knowledge on a larger issue. It works very much like a jigsaw puzzle.
The individual pieces (arguments) must be put together in order to reveal the whole (state of knowledge).
So basically, I just read the articles and summarize each one separately?
No, a literature review is not a summary. Rather than merely presenting a summary of each source, a literature review should be organized
according to each subtopic discussed about the larger topic. For example, one section of a literature review might read “Researcher A suggests
that X is true. Researcher B also argues that X is true, but points out that the effects of X may be different from those suggested by Researcher
A.” It is clear that subtopic X is the main idea covered in these sentences. Researchers A and B agree that X is true, but they disagree on X’s
effects. There is both agreement and disagreement, but what links the two arguments is the fact that they both concern X.
This sounds like a lot of information; how can I keep it organized?
And because a literature review is NOT a summary of these different sources, it can be very difficult to keep your research organized. It is
especially difficult to organize the information in a way that makes the writing process simpler. One way that seems particularly helpful in
organizing literature reviews is the Synthesis Matrix. The Synthesis Matrix is a chart that allows a researcher to sort and categorize the different
arguments presented on an issue. Across the top of the chart are the spaces to record sources, and along the side of the chart are the spaces to
record the main points of argument on the topic at hand. As you examine your first source, you will work vertically in the column belonging to
that source, recording as much information as possible about each significant idea presented in the work. Follow a similar pattern for your
following sources. As you find information that relates to your already identified main points, put it in the pertaining row. In your new sources,
you will also probably find new main ideas that you need to add to your list at the left. You now have a completed matrix! As you write your
review, you will work horizontally in the row belonging to each point discussed. As you combine the information presented in each row, you will
2
begin to see each section of your paper taking shape. Remember, some of the sources may not cover all of the main ideas listed on the left, but
that can be useful also. The gaps on your chart could provide clues about the gaps in the current state of knowledge on your topic. It is probably
best to begin your chart by labeling the columns both horizontally and vertically. The sample chart below illustrates how to do this. Be sure to
provide a minimum of 5 main ideas and 5 references (5 X 5 chart), provide references, and in-text citations in AMA format in the chart:
Synthesis Matrix
Topic: Women in WWII
Topic/Main Idea
Source 1
(Author, Date)
Source 2
(Author, Date)
Source 3
(Author, Date)
Source 4
(Author, Date)
Source 5
(Author, Date)
Cornelsen, 2005
Stewart, 2000
Bruley, 2003
Scott, 1984
Name, year
– WAAC (Women’s
Army Auxiliary Corp)
was 1st chance for
women to serve in
army, given full
army status in 1943
as WAC2(p28)
– Needs of the war
were so great that
women’s traditional
social roles were
ignored2(p30)
– Military women
paid well for the
time period and
given benefits if
they became
pregnant2(p32)
– The 1940’s brought
more opportunities
to women than ever
before2(p26)
– Women in the
military given
extensive physical
-Women given equal
opportunities3(p223)
– Women joined
workforce as a break
from the ordinary to
help the war3(p220)
– Unconscious decision
to cross into maledominated roles3(p221)
– Seized these new
opportunities to bring
about change3(p230)
– Women born in the
1920’s found new
doors open to them
where they once would
have encountered brick
walls4(p526)
-Even women not
directly involved in the
war were changing
mentally by being
challenged to expand
their horizons because
of the changing world
around them4(p562)
– War also brought
intellectual expansion
to many people4(p557)
– Women given
unskilled labor
positions by
NONE
1.
Alteration
of women’s
roles
because of
WWII
– Women accredited the
WASP program for
opening new doors,
challenging stereotypes,
and proving that women
were as capable as
men1(p113)
– Women could compete
with men as equals in
the sky because of their
exemplary
performance1(p116)
– WASP created
opportunities for
women that had never
previously existed1(p 112)
– Women’s success at
flying aircrafts “marked
a pivotal step towards
breaking the existing
gender barrier”1(p112)
2.
Hardships
and
oppositions
– “From the outset male
pilots resented women’s
presence in a
3
women
faced
traditionally male
military setting”1(p113-4)
– “The WASP were
routinely assigned
inferior planes that
were later found to
have been improperly
maintained”1(p114)
– discrimination against
WASP at every level of
military service, women
were only paid 2/3 of
what men were for
doing identical
tasks1(p114)
– “In the belief that
women were
emotionally and
physically fragile, the
military questioned
women’s capabilities to
fly an aircraft”1(p114-5)
regardless of their
training or aptitude WASP’s not granted
veteran status until
19791(p115)
and mental tests,
but still
discriminated
against, ridiculed,
and considered
inferior to men2(p29)
government because
only seen as temporary
workers, therefore no
reason to train
them3(p221-2)
– Women given less
significant work and
viewed as less
intelligent and
physically able3(p224)
-“The Church-Bliss
diary reveals how
dilution
arrangements…ensure
d that women working
in male preserves were
prevented from
achieving any sort of
equality”3(p230)
– more traditionally
male jobs resisted the
integration of women
workers, while other
industries were less
resistant… but in most
all cases women were
considered temporary
workers3(p221)
– Equal pay rarely given
to women, even
though women did the
same work3(p221)
– Women occasionally
found their way to
positions of
importance, but were
always treated as
inferior3(p226-8)
4
3.
Opposition:
WWII did
NOT
influence
women
NONE
– Women put in
untraditional roles
during/because of
the war, but back to
previous
subservient roles
after the war2(p35)
– After the war, women
were the first to be let
go because of their
temporary status3(p230)
– Women in the
workforce also faced
discrimination from
labor unions3(p226)
– Women were not
affected
because they still
remained in
subordinate positions
after the
war3(p217)
NONE
4.
5.
SOURCE: NC State University Writing and Speaking Tutorial Service, 2006
References/Sources for Matrix
1. Cornelsen, K. Women Airforce Service Pilots of World War II: Exploring Military Aviation, Encountering Discrimination, and Exchanging
Traditional Roles in Service to America. J of Women’s History. 2005;17(4):111-119. doi:10.1353/jowh.2005.0046
2. Stewart, JN. Wacky Times: An Analysis of the WAC in World War II and its Effects on Women. Int Social Science Review. 2000;75(1):26-37.
doi:10.2307/41887024.
3. Bruley, S. A New Perspective on Women Workers in the Second World War: The Industrial Diary of Kathleen Church-Bliss and Elsie Whiteman.
Labour History Review. 2003;68, 217-234.
4. Scott, AF. One Woman’s Experience of World War II. J of American History. 1990;77(2), 556-562. doi:10.2307/2079184
5.
Example of Writing the Literature Synthesis/Review:
After your chart is complete, you will notice patterns of information. You may find that your sources, at times, discuss very similar material, or
that they sometimes deal with completely different aspects of your topic. These patterns can be useful in creating an overarching thesis that can
guide your writing and keep you focused as you begin your draft (remember by this point you have already identified a problem and a problem
statement in the previous assignment – Research Topic and Problem Statement).
Here is an example a literature synthesis/literature review – This excerpt synthesizes information without summarizing:
5
Literatur
THE ASSIGNMENTSuccinctly, in 1–2 pages, address the following:Briefly explain the neurobiological basis for PTSD illness.Discuss the DSM-5-TR diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard treatment” from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.Support your Assignment with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
Health Organization Evaluation
View Rubric
Assessment TraitsRequires Lopeswrite
Assessment Description
Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.
Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:
Describe the health care organization or network.
Describe the organization’s overall readiness based on your findings.
Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment 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.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Unformatted Attachment Preview
Rubric Criteria
Collapse All Rubric CriteriaCollapse All
Health Care Organization or Network
27 points
Criteria Description
Health Care Organization or Network
5. Excellent
27 points
Health care organization or network is clearly and accurately described.
4. Good
22.95 points
Health care organization or network is described. Some detail is needed for clarity.
3. Satisfactory
20.25 points
Health care organization or network is summarized. Some information is needed. There are minor
inaccuracies related to the representation of the organization or network.
2. Less Than Satisfactory
17.55 points
Health care organization or network is partially presented. There are significant omissions and
inaccuracies.
1. Unsatisfactory
0 points
Health care organization or network is not described.
Assessment of Overall Organizational Readiness
27 points
Criteria Description
Assessment of Overall Organizational Readiness
5. Excellent
27 points
Assessment of overall organizational readiness is described in detail. Degree of organizational
readiness is established. Strong evidence and rationale support the assessment.
4. Good
22.95 points
Assessment of overall organizational readiness is described. Degree of organizational readiness is
generally established. Some evidence or rationale is needed for support.
3. Satisfactory
20.25 points
Assessment of overall organizational readiness is summarized. Degree of organizational readiness is
partially established. More information, rationale, and support are needed.
2. Less Than Satisfactory
17.55 points
Assessment of overall organizational readiness is partially presented. There are significant omissions.
Degree of organizational readiness is not established.
1. Unsatisfactory
0 points
Assessment of overall organizational readiness is omitted.
Strategic Plan
36 points
Criteria Description
Strategic Plan
5. Excellent
36 points
The strategic plan is well developed. Network growth, nurse staffing, resource management, and
patient satisfaction are addressed in detail. The plan is supported with strong evidence and rationale.
4. Good
30.6 points
The strategic plan addresses network growth, nurse staffing, resource management, and patient
satisfaction. Some evidence or rationale is needed for support.
3. Satisfactory
27 points
The strategic plan generally addresses network growth, nurse staffing, resource management, and
patient satisfaction. More information, rationale, and support are needed.
2. Less Than Satisfactory
23.4 points
Strategic plan is partially presented. Plan contains major omissions. The plan fails to address issues
outlined in the assignment criteria.
1. Unsatisfactory
0 points
Strategic plan is omitted.
Identification of Issues in Organizational Culture
27 points
Criteria Description
Identification of Current or Potential Issues in Organizational Culture and Impact of These to Strategic
Plan
5. Excellent
27 points
Current or potential issues in the organizational culture are clearly identified. The potential impact of
these on the strategic plan is thoroughly described and supported with evidence and rationale.
4. Good
22.95 points
Current or potential issues in the organizational culture and the potential impact of these on the
strategic plan are discussed. Some evidence or rationale is needed.
3. Satisfactory
20.25 points
Current or potential issues in the organizational culture are generally discussed. The impact of these
on the strategic plan is summarized. Evidence and rationale are needed to support claims.
2. Less Than Satisfactory
17.55 points
Current or potential issues in the organizational culture are partially summarized. The potential
impact of these on the strategic plan is unclear. There are omissions and inaccuracies throughout.
1. Unsatisfactory
0 points
Current or potential issues in the organizational culture and the impact of these to strategic plan are
omitted.
Theory or Model to Support Implementation of Strategic Plan
27 points
Criteria Description
Theory or Model to Support Implementation of Strategic Plan
5. Excellent
27 points
Theory or model to support strategic plan implementation is proposed. The theory or model
demonstrates strong support for implementation of the strategic plan for the organization.
Compelling rationale supports why the theory or model is the best choice.
4. Good
22.95 points
Theory or model to support strategic plan implementation is proposed. The theory or model
demonstrates support for implementation of the strategic plan for the organization. General rationale
is provided for why the theory or model is the best choice.
3. Satisfactory
20.25 points
Theory or model to support strategic plan implementation is proposed. The theory or model
demonstrates some support for implementation of the strategic plan for the organization. It is unclear
why this theory or model is the best choice. More information is needed.
2. Less Than Satisfactory
17.55 points
Theory or model to support strategic plan implementation is partially described. It is unclear how the
theory or model would support implementation of strategic plan for the organization.
1. Unsatisfactory
0 points
Theory or model to support strategic plan implementation is omitted.
Thesis Development and Purpose
9 points
Criteria Description
Thesis Development and Purpose
5. Excellent
9 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose
of the paper clear.
4. Good
7.65 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the
arguments and appropriate to the purpose.
3. Satisfactory
6.75 points
Thesis is apparent and appropriate to purpose.
2. Less Than Satisfactory
5.85 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Argument Logic and Construction
9 points
Criteria Description
Argument Logic and Construction
5. Excellent
9 points
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner.
All sources are authoritative.
4. Good
7.65 points
Argument shows logical progression. Techniques of argumentation are evident. There is a smooth
progression of claims from introduction to conclusion. Most sources are authoritative.
3. Satisfactory
6.75 points
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification
of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible.
Introduction and conclusion bracket the thesis.
2. Less Than Satisfactory
5.85 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in
the logic. Some sources have questionable credibility.
1. Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim
made. Argument is incoherent and uses noncredible sources.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
9 points
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
9 points
Writer is clearly in command of standard, written, academic English.
4. Good
7.65 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of
effective sentence structures and figures of speech.
3. Satisfactory
6.75 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct
and varied sentence structure and audience-appropriate language are employed.
2. Less Than Satisfactory
5.85 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice
(register) or word choice are present. Sentence structure is correct but not varied.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate
word choice or sentence construction is used.
Paper Format (use of appropriate style for the major and assignment)
3.6 points
Criteria Description
Paper Format (use of appropriate style for the major and assignment)
5. Excellent
3.6 points
All format elements are correct.
4. Good
3.06 points
Appropriate template is fully used. There are virtually no errors in formatting style.
3. Satisfactory
2.7 points
Appropriate template is used. Formatting is correct, although some minor errors may be present.
2. Less Than Satisfactory
2.34 points
Appropriate template is used, but some elements are missing or mistaken. A lack of control with
formatting is apparent.
1. Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
Documentation of Sources
5.4 points
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to
assignment and style)
5. Excellent
5.4 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format
is free of error.
4. Good
4.59 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. Satisfactory
4.05 points
Sources are documented, as appropriate to assignment and style, although some formatting errors
may be present.
2. Less Than Satisfactory
3.51 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with
numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
The early conceptualizations of nursing by Weidenbach, Henderson, and Hall (Chapters 4, 5, and 6) give a unique twist to the evolution of nursing theory.
For the initial post students will be assigned one theorist. Post the response to an unassigned theorist.
Locate one media clip or weblink related to one of the theorists that helps understand how the theory was implemented in practice to improve outcomes
Describe one (1) concept from the assigned theory that changed the evolution of nursing theory and research in the 21 first century
Activity Criteria:
Students must include the following criteria for each individual activity:
Include one scholarly peer-reviewed reference for the initial posting.
2. Minimum of one response to other students by Sunday at 11:59 PM/EST.
Include one scholarly peer-reviewed reference for response postings.
3. All posts need to be on two separate days.
4. The textbook assigned to the course may be used in addition to the required references for posting.
Name: S.K ( PLS refer to patient using her intials
Age: 25
Gender: Female
Occupation: College Student
Marital Status: Single
Presenting Problem: Sarah was referred to a mental health clinic by her college counselor. She presented with concerns about her eating habits and self-esteem. Her primary complaint was binge eating followed by inappropriate compensatory behaviors.
Background: Sarah had always been a high-achieving student with a strong desire to excel. She came from a supportive family, but her parents had high expectations, which she felt pressured to meet. She described feeling inadequate and believed that she needed to be perfect to be loved.
Diagnostic Assessment: A comprehensive assessment revealed that Sarah met the criteria for Bulimia Nervosa based on the DSM-5. Her symptoms included:
Recurrent episodes of binge eating, characterized by consuming an excessive amount of food in a discrete period while feeling a lack of control.
Inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, laxative use, and excessive exercise.
Binge eating and compensatory behaviors occurred at least once a week for three months.
Self-evaluation was unduly influenced by body shape and weight.
Body mass index (BMI) was within the normal range, but Sarah expressed intense fear of gaining weight and a preoccupation with body size and shape.
Treatment Plan: Given the severity of Sarah’s symptoms and their impact on her physical and emotional well-being, a comprehensive treatment plan was developed. This plan included:
Psychotherapy: Sarah was engaged in individual cognitive-behavioral therapy (CBT). The focus was on addressing her distorted body image, perfectionism, and core beliefs that contributed to her bulimic behaviors.
Nutritional Counseling: Sarah met with a registered dietitian to establish a balanced and healthy eating plan. Education about portion control and the importance of regular meals was emphasized.
Medication: In some cases, medication may be considered. Sarah was prescribed an antidepressant (selective serotonin reuptake inhibitor – SSRI) to help manage her anxiety and depression, which were closely related to her eating disorder.
Support System: Family therapy was recommended to address family dynamics, communication, and support. This was aimed at reducing familial pressure and fostering a more nurturing environment.
Regular Monitoring: Frequent follow-up sessions were scheduled to track progress, assess the effectiveness of interventions, and make necessary adjustments to the treatment plan.
Progress and Outcome: Over the course of treatment, Sarah made substantial progress. She began to recognize her unrealistic standards and her need for perfection. With the help of CBT, she developed healthier coping strategies for dealing with stress and self-esteem issues. Her binge-eating episodes decreased in frequency, and she reduced her reliance on compensatory behaviors.
Sarah’s relationship with her family improved after family therapy sessions, and she reported feeling more supported and less pressured.
Follow-Up: It is crucial for Sarah to continue her treatment and follow-up care to maintain her progress. She has been advised to maintain a healthy lifestyle, keep in touch with her therapist, dietitian, and psychiatrist, and reach out for support when needed.
This case study of Sarah, a patient with Bulimia Nervosa, highlights the importance of early diagnosis and a multidisciplinary treatment approach to address the physical and psychological aspects of the disorder. With appropriate care, individuals like Sarah can make significant strides towards recovery and improved well-being
Instructions:What screening tools can be used to affirm your initial diagnosis that a patient may meet the diagnostic criteria for a sleep disorder?Describe the pharmacological actions of non-z sleep medications?What problems can occur when benzodiazepines are used to help with sleep?Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.Please review the rubric to ensure that your response meets the criteria.
Critically appraise a qualitative and quantitative research design.Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
My change project enlightened me to the complexity of designing and attempting to implement a large-scale coordinative effort in the benefit of a process improvement methodology that builds upon existing bodies of knowledge. I did not consider the incredible number of moving parts involved, but glad to have gone through the process. Previously, I was not aware of just how many facets of such an endeavor must be covered in terms of a combination of clinically appropriate approaches, mechanisms to ensure equity, and the understanding that there is a lot of bridging between the actual patient and the proposed change of practices. I increased my awareness through the utilization of frameworks, which is my favorite methodology of addressing needs and research. Montano (2020) discusses the utilization of the Neuman systems model for various applications, specifically the use for APRN led interprofessional efforts and delineates methodologies for the utilization of theoretical frameworks as the basic recipe or do to list behind any complex action. The use of this method simplifies any process, or at the very least manages to break it down sufficiently enough where important details are less likely to be left out. In the same token I adopted these methodologies to tackle and keep track of any necessary actions and ascertain the needs of not only the patient, but also the project’s processes.
In terms of current practices, the process of learning and developing this change project gave me much to work with when engaging in administrative functions that require massive amounts of coordination. The understanding of an effective means of communicating with individuals from other disciplines in the purpose of coordinating complex patient care functions makes for a vast difference. To me, this means that when there is a well-developed method of implementing any complex methodology that involves patient care, the outcomes associated with the presence of protocols creates a unified means of addressing needs, coupled with the use of a strong theoretical framework, the protocols also cover variables to ensure all needs are indeed covered.
Referece:
Montano, A.-R. (2020). Neuman systems model with nurse-led Interprofessional Collaborative Practice. Nursing Science Quarterly, 34(1), 45–53. https://doi.org/10.1177/0894318420965219
Post 2
The change project allowed me to recognize the critical importance of addressing issues related to insufficient patient education and inadequate time management, particularly in urgent care and primary care settings. It highlighted the impact of these issues on patient outcomes and satisfaction, emphasizing the need for patient-centered care.
Through the project, I learned that time management strategies can significantly enhance patient-provider interactions, leading to better patient understanding and trust. Moreover, providing cost-effective printed educational materials can bridge knowledge gaps among diverse patient populations, contributing to improved health outcomes (Harris et al., 2018).
My self-awareness of the values and attitudes influencing the role of an APRN in clinical practice has been heightened. I have come to appreciate the value of patient-centered care and the role of education in improving patient outcomes. Additionally, I’ve recognized the importance of advocating for adequate resources to support patient education and enhance time management in healthcare settings.
My classmates’ presentations provided valuable insights into different aspects of healthcare change projects. It was enlightening to see the diverse approaches and interventions employed to address various healthcare challenges. These presentations reinforced the idea of patient-centered care.
The foundations of my past and current knowledge have been reinforced through this project. I’ve gained a deeper understanding of the significance of time management in patient care and how education can bridge knowledge gaps. This knowledge will enhance my practice processes and contribute to better patient outcomes.
The change project has strengthened my understanding of developing and evaluating interventions that promote population health and prevent disease in community settings. It highlighted the need for personalized and culturally sensitive approaches to patient education, reinforcing the importance of considering diverse patient demographics and characteristics in healthcare interventions (Harris et al., 2018).
In conclusion, the change project has been an eye-opening experience that emphasized the critical role of addressing insufficient patient education and time management in healthcare. It has increased my self-awareness of the values and attitudes influencing my role as an APRN, reinforced my knowledge, and provided valuable insights from my peers’ projects. This project has deepened my understanding of the importance of patient-centered care and the significance of education in improving patient outcomes.
Reference
Harris, J. L., Roussel, L. A., Dearman, C., & Thomas, P. L. (2018). Project Planning and Management: A Guide for Nurses and Interprofessional Teams: A Guide for Nurses and Interprofessional Teams. Jones & Bartlett Learning.
Discuss how you would apply coaching in the healthcare work environment. How might a coaching leadership style apply to your current work role? What are the advantages and disadvantages of this style in the context of health care? Consider the implications for employee motivation, satisfaction, and productivity as well as patient satisfaction, quality of care, and patient safety.In developing your initial response, be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, you are encouraged to examine their opinions, offering supporting and/or opposing views.
Based on Module 2: Lecture Materials & Resources and experience, please answer the following questions:Describe dermatitis, diagnostic criteria, and treatment modalitiesDescribe the drug therapy for Conjunctivitis and Otitis Media Discuss Herpes Virus infections, patient presentation, and treatmentDescribe the most common primary bacterial skin infections and the treatment of choice. Submission Instructions:Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.Each question must be answered individually as in bullet points. Not in an essay format. Example: Question 1, followed by the answer to question 1; Question 2, followed by the answer to question 2; and so forth.
Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.Use the Rubric listed below ,50% of the SOAP Note is completed.
Unformatted Attachment Preview
Comprehensive Women’s Health History and Physical SOAP Note
Encounter Date: 10/19/23
Preceptor/s Name:
Student Name
Faculty Name: St. Thomas University
Course Number: NUR 514CL – Advanced FNP: Clinical II – 2023 Fall 2
Patient Demographics:
Gender: Female
Race: African American
Age Range: 27 years
Ethnicity: Black
Reason for Seeking Health Care: Follow-Up- Routine. “I am having terrible menstrual cramps and heavy
bleeding.”
HPI: F.D. is a pleasant 27-year-old African-American female. Good historian, AOX 3. She
came into the clinic complaining of dysmenorrhea and heavy bleeding. The patient complains of
dysmenorrhea for a few years. The patient states the pain is a 10 out of 10 during menstruation.
The patient states she tries Tylenol Extra Strength and Midol for menstrual pain. The OTC
medication does not help alleviate the pain. Pain occurs during the menstrual cycle. It becomes
worse when the patient consumes cold beverages. Pain is currently a 0 out of 10 due to patient’s
menstrual cycle was October 8th, 2023. She is currently sexually active with only one partner, her
boyfriend. Treatment options are discussed at bedside. Labs were drawn, and the patient will be
informed of the results when available.
Allergies (Drug/Food/Latex/Environmental/Herbal): No known allergies.
Current perception of Health: Good.
Menstrual History
Age at Menarche: 12 years old
Last menstrual period: October 8th, 2023
Menstrual Pattern: Regular
1
Cycle Length: 28 days
Duration of Flow: 4- 5 days
Amount of Flow : 5 pads a day
Bleeding Pattern: Heavy
Break through Bleeding: Denies
Gynecologic History
History of breast disease, breast feeding, use of self-breast exam, last mammogram (if
applicable): Not applicable
Previous GYN surgery (may include that in surgical history) : Denies
History of infertility: Not Applicable
History of diethylstilbestrol (DES) use by patient’s mother: Not applicable
Last pap smear, history of abnormal pap: July 2023- Normal Pap Smear
Pre-menopause/menopause
Vasomotor symptoms: Not applicable
Hormone Replacement Therapy: Not applicable
Sexual and Contraceptive History
Current method of contraception: Birth control
Sexually active: Yes
Number of sexual partners: 1
New partners in the 3-6 months: 1
Condom use : No
History of sexual abuse: No
History of sexually transmitted infections (STIs): No
Obstetric History (including complications)
2
Past Medical History
• Major/Chronic Illnesses: Iron deficiency anemia
• Trauma/Injury: No falls or injury
• Hospitalizations: Bone marrow biopsy in 2021
Past Surgical History: Bone marrow Biopsy
Family History: Father: Colon cancer diagnosed at age 59. Mother: Pre-diabetic, Paternal
Grandmother- Breast Cancer at age 64. Paternal Grandfather: Prostate cancer
Medications: Junel FE (28)Take one tablet a day, Ferrex 150mg, Take one capsule by mouth
daily.
Social History:
Lives: House
Marital Status: Single
Employment Status: Employed
Current/Previous occupation type: Registered Nurse
Exposure to: Sun
Recreational Drug Use: No
Sexual orientation: Homosexual
Sexual Activity: Straight
Contraception Use: Condoms
Family Composition: Family
Health Maintenance
3
Exposures: the sun.
Immunization H.X.: Up to date.
Screening Tests (Mammogram et al., etc.): Pap Smear- Negative July 2023
Review of Systems:
General: Alert and Oriented x 3. Denies any recent fever or chills. Denies any fatigue.
HEENT: Head Normal, no mass or lesions noted.
Eyes: Pupils are round and reactive. Ears: No inflammation noted. Ears symmetrical to head.
Conjunctiva White. No changes in vision.
Nose: Septum midline. Throat: No redness noted. Trachea midline
Neck: Symmetrical. No mass or swollen lymph nodes were noted. No neck tenderness noted
Lungs: Symmetrical. No mass was noted.
Cardiovascular: S1 and S2 noted—capillary Refill less than 3 seconds. No Murmur heard
Breast: No lymph or swelling. No nipple discharge
G.I.: Active Bowel sounds. Non-tender, soft abdomen. No hernia noted
Female genital: No lesions, inflammation, discharge or tenderness noted
GU: Normal urine output and color.
Neuro: No tremors, vertigo, or dizziness were noted. Denies any weakness
Musculoskeletal: Denies joint pain or swelling. No edema noted. Full movement noted on the
Upper and lower extremities. Normal gait.
Activity & Exercise: Physically active. Workout 3 times a month
Psychosocial: No mental illness. Normal affect and mood.
Derm: Warm, dry skin. No lesion or discoloration noted. Appropriate skin color for race
4
Endocrine: Denies polyuria, polydipsia, and polyphagia. denies weight loss
Hematologic/Lymphatic: Iron deficiency anemia, History of Iron transfusion, denies history
of blood transfusions
LMP: October 8th, 2023
STI Hx: No STI reported.
Physical Exam
B.P.: 96/58 Right arm, sitting TPR: 98.4 F Oral H.R.: 70 R.R.: 17 Ht.: 5 ft 6 inch
Wt.: 69.1 kg . BMI (percentile): 23.9 Pain: 0
General: Alert and Oriented x 3. Denies any recent fever or chills. Denies any fatigue.
HEENT: Head Normal, no mass or lesions noted.
Eyes: Pupils are round and reactive. Ears: No inflammation noted. Ears symmetrical to head.
Conjunctiva White.
Nose: Septum midline. Throat: Trachea midline.
Neck: Symmetrical. No mass or swollen lymph nodes.
Pulmonary: Lungs clear bilaterally.
Cardiovascular: Normal S1 and S2 sounds. Capillary refill less than 3 seconds. No Murmur
Breast: No lymph or swelling. No nipple discharge
G.I.: Active Bowel sounds. Non-tender, soft abdomen. No hernia was noted.
Female genital: No lesions, inflammation, discharge, or tenderness noted
GU: Normal urine output and color.
Neuro: No tremors, vertigo, or dizziness were noted. Denies any weakness
5
Musculoskeletal: Denies joint pain or swelling. No edema noted. Full movement noted on the
upper and lower extremities. Normal gait.
Derm: Warm, dry skin. No lesion or discoloration was noted. Appropriate skin color for race
Endocrine: Denies polyuria, polydipsia, and polyphagia. denies weight loss
Hematologic/Lymphatic: Iron deficiency anemia, History of Iron transfusion, denies history
of blood transfusions
Significant Data/Contributing.: Glucose: 101, BUN 10, Creatinine 0.89, Sodium 143,
Potassium 3.5, Chloride 102, CO2 25, Calcium 9.6, HGB 12.1, HCT 32.6, Platelet Count 242,
WBC 3.3,
Assessment
Differential Diagnoses (3 minimum)
Primary Diagnoses
Plan (For each primary diagnosis, include laboratory/diagnostic tests, therapeutic/pharmacological
therapy, referrals, and follow-up ordered and patient education done for this visit)
Diagnoses
Laboratory/Diagnostic Studies
Therapeutic (Non-pharmacological interventions)
Pharmacological Therapy
Patient Education/Anticipatory Guidance
Referrals
Follow up
DEA#: 101010101
Tel: (000) 555-1234
STU Clinic
LIC# 10000000
FAX: (000) 555-12222
6
Patient Name: (Initials)______________________________
Age ___________
Date: _______________
RX ______________________________________
SIG:
Dispense: ___________
Refill: _________________
No Substitution
Signature: ____________________________________________________________
Signature (with appropriate credentials): __________________________________________
References (must use current evidence-based guidelines used to guide the care [Mandatory])
7
Distinguised
Excellent
Fair
Poor
Includes a direct quote from patient about
presenting problem
Includes a direct quote from patient and other
unrelated information
Includes information but information is NOT a
direct quote
Information is completely missing
4 Points
Begins with patient initials, age, race,
ethnicity and gender (5 demographics)
3 Points
Begins with 4 of the 5 patient demographics
(patient initials, age, race, ethnicity and gender)
2 Points
Begins with 3 or less patient demographics
(patient initials, age, race, ethnicity and gender)
Information is completely missing
2 Points
1.5 Points
1 Points
0 Points
Includes the presenting problem and the 8
dimensions of the problem (OLD CARTS –
Onset, Location, Duration, Character,
Aggravating factors, Relieving factors,
Timing and Severity)
Includes the presenting problem and 7 of the 8
dimensions of the problem (OLD CARTS –
Onset, Location, Duration, Character,
Aggravating factors, Relieving factors, Timing
and Severity)
Includes the presenting problem and 6 of the 8
dimensions of the problem (OLD CARTS –
Onset, Location, Duration, Character,
Aggravating factors, Relieving factors, Timing
and Severity)
Information is completely missing
5 Points
3 Points
2 Points
0 Points
If allergies are present, students lists only the
type of allergy name
Information is completely missing
1 Points
0 Points
Subjective
Chief Complaint (Reason for seeking
health care)
Demographics
History of the Present Illness (HPI)
Allergies
Includes NKA (including = Drug,
If allergies are present, students lists type Drug,
Environemental, Food, Herbal, and/or Latex
environemtal factor, herbal, food, latex name and
or if allergies are present (reports for each
includes severity of allergy OR description of
severity of allergy AND description of
allergy
allergy)
2 Points
Review of Systems (ROS)
1.5 Points
Includes 3 or fewer assessments for each body
Includes 3 or fewer assessments for each body
Includes a minimum of 3 assessments for
each body system and assesses at least 9 system and assesses 5-8 body systems directed to system and assesses less than 5 body systems
chief complaint AND uses the words “admits” directed to chief complaint OR student does not
body systems directed to chief complaint
use the words “admits” and “denies”
and “denies”
AND uses the words “admits” and “denies”
12 Points
6 Points
3 Points
0 Points
Information is completely missing
0 Points
Objective
Vital Signs
Includes all 8 vital signs, (BP (with patient
Includes 7 vital signs, (BP (with patient position), Includes 6 or less vital signs, (BP (with patient
position), HR, RR, temperature (with
HR, RR, temperature (with Fahrenheit or Celsius position), HR, RR, temperature (with Fahrenheit
Fahrenheit or Celsius and route of
and route of temperature collection), weight,
or Celsius and route of temperature collection), Information is completely missing
temperature collection), weight, height, BMI
height, BMI (or percentiles for pediatric
weight, height, BMI (or percentiles for pediatric
(or percentiles for pediatric population) and
population) and pain.)
population) and pain.)
pain.)
2 Points
Labs
Medications
Includes a list of the labs reviewed at the
visit, values of lab results and highlights
abnormal values OR acknowledges no
labs/diagnostic tests were reviewed.
3 Points
Includes a list of all of the patient reported
medications and the medical diagnosis for
the medication (including name, dose, route,
frequency)
1.5 Points
Includes a list of the labs reviewed at the visit,
values of lab results but does not highlight
abnormal values.
1 Points
0 Points
Includes a list of the labs reviewed at the visit but
does not include the values of lab results or
Information is completely missing
highlight abnormal values.
2 Points
1 Points
Includes a list of all of the patient reported
medications and the medical diagnosis for the
medication (including 3 of the 4: name, dose,
medications route, frequency)
Includes a list of all of the patient reported
medications (including 2 of the 4: name, dose,
route, frequency)
0 Points
Information is completely missing
Screenings
Past Medical History
4 Points
Includes an assessment of at least 5
screening tests
2 Points
Includes an assessment of at least 4 screening
tests
3 Points
2 Points
Includes (Major/Chronic, Trauma,
Includes (Major/Chronic, Trauma,
Hospitaliztions), for each medical diagnosis,
Hospitaliztions), for each medical diagnosis,
year of diagnosis and whether the diagnosis either year of diagnosis OR whether the diagnosis
is active or current
is active or current
3 Points
Past Surgical History
Family History
Social History
0 Points
Information is completely missing
1 Points
0 Points
Includes each medical diagnosis but does not
include year of diagnosis or whether the
diagnosis is active or current
Information is completely missing
1 Points
0 Points
Includes, for each surgical procedure, the
Includes, for each surgical procedure, the year of Includes, for each surgical procedure but not the
year of procedure and the indication for the
procedure OR indication of the procedure
year of procedure or indication of the procedure Information is completely missing
procedure
3 Points
Includes an assessment of at least 4 family
members regarding, at a minimum, genetic
disorders, diabetes, heart disease and
cancer.
3 Points
Includes all of the following: tobacco use,
drug use, alcohol use, marital status,
employment status, current/previous
occupation, sexual orientation, sexually
active, contraceptive use, and living
situation.
3 Points
Physical Examination
2 Points
1 Points
Includes an assessment of at least 3 screening
tests
Includes a minimum of 4 assessments for
each body system and assesses at least 5
body systems directed to chief complaint
12 Points
2 Points
1 Points
0 Points
Includes an assessment of at least 3 family
members regarding, at a minimum, genetic
disorders, diabetes, heart disease and cancer.
Includes an assessment of at least 2 family
members regarding, at a minimum, genetic
disorders, diabetes, heart disease and cancer.
Information is completely missing
2 Points
1 Points
0 Points
Includes 10 of the 11 following: tobacco use,
Includes 9 or less of the following: tobacco use,
drug use, alcohol use, marital status, employment drug use, alcohol use, marital status, employment
status, current/previous occupation, sexual
status, current/previous occupation, sexual
Information is completely missing
orientation, sexually active, contraceptive use,
orientation, sexually active, contraceptive use,
and living situation.
and living situation.
2 Points
1 Points
0 Points
Includes a minimum of 3 assessments for each
Includes a minimum of 2 assessments for each
body system and assesses at least 4 body systems body system and assesses at least 4 body systems Information is completely missing
directed to chief complaint
directed to chief complaint
6 Points
3 Points
0 Points
Assessment
Diagnosis
Includes a clear outline of the accurate
Includes a clear outline of the accurate diagnoses
principal diagnosis AND lists the remaining
Includes an inaccurate diagnosis as the principal
addressed at the visit but does not list the
Information is completely missing
diagnoses addressed at the visit (in
diagnosis
diagnoses in descending order of priority
descending priority)
5 Points
Differential Diagnosis
3 Points
2 Points
0 Points
Includes at least 3 differential diagnoses for Includes 2 differential diagnoses for the principal Includes 1 differential diagnosis for the principal
Information is completely missing
the principal diagnosis
diagnosis
diagnosis
5 Points
3 Points
Plan
2 Points
0 Points
Pharmacologic treatment plan
Diagnostic/Lab Testing
Education
Anticipatory Guidance
Follow up plan
Includes a detailed pharmacologic treatment
Includes a detailed pharmacologic treatment plan
Includes a detailed pharmacologic treatment plan
plan for each of the diagnoses listed under
for each of the diagnoses listed under
for each of the diagnoses listed under
“assessment”. The plan includes ALL of
“assessment”. The plan includes less than 4 of
“assessment”. The plan includes 4 of the
the following: drug name, dose, route,
the following: the drug name, dose, route,
following 7: the drug name, dose, route,
frequency, duration and cost as well as education
frequency, duration and cost as well as
frequency, duration and cost as well as education
education related to pharmacologic agent. If
related to pharmacologic agent. If the diagnosis
related to pharmacologic agent. If the diagnosis is
the diagnosis is a chronic problem, student
is a chronic problem, student includes
a chronic problem, student includes instructions
includes instructions on currently prescribed
instructions on currently prescribed medications
on currently prescribed medications as above.
medications as above.
as above.
Information is completely missing
5 Points
Includes appropriate diagnostic/lab testing
100% of the time OR acknowledges “no
diagnostic testing clinically required at this
time”
5 Points
3 Points
2 Points
0 Points
Includes appropriate diagnostic/lab testing 50%
of the time OR acknowledges “no diagnostic
testing clinically required at this time”
Includes appropriate diagnostic testing less than
50% of the time.
Information is completely missing
3 Points
2 Points
0 Points
Includes at least 3 strategies to promote and
develop skills for managing their illness and
at least 3 self-management methods on how
to incorporate healthy behaviors into their
lives.
Includes at least 2 strategies to promote and
develop skills for managing their illness and at
least 2 self-management methods on how to
incorporate healthy behaviors into their lives.
Includes at least 1 strategies to promote and
develop skills for managing their illness and at
least 1 self-management methods on how to
incorporate healthy behaviors into their lives.
Information is completely missing
5 Points
3 Points
2 Points
0 Points
Includes at least 3 primary prevention
strategies (related to age/condition (i.e.
immunizations, pediatric and pre-natal
milestone anticipatory guidance)) and at
least 2 secondary prevention strategies
(related to age/condition (i.e. screening))
Includes at least 2 primary prevention strategies
(related to age/condition (i.e. immunizations,
pediatric and pre-natal milestone anticipatory
guidance)) and at least 2 secondary prevention
strategies (related to age/condition (i.e.
screening))
Includes at least 1 primary prevention strategies
(related to age/condition (i.e. immunizations,
pediatric and pre-natal milestone anticipatory
guidance)) and at least 1 secondary prevention
strategies (related to age/condition (i.e.
screening))
Information is completely missing
4 Points
Includes recommendation for follow up,
including time frame (i.e. x # of
days/weeks/months)
4 Points
2 Points
Includes recommendation for follow up, but does
not include time frame (i.e. x # of
days/weeks/months)
2 Points
1 Points
0 Points
Does not include follow up plan
0 Points
0 Points
Moderate level of APA precision
Incorrect APA style
Information is completely missing
3 Points
2 Points
1 Points
0 Points
Free of grammar and spelling errors
Writing mechanics need more precision and
attention to detail
Writing mechanics need serious attention
3 Points
2 Points
0 Points
Writing
References
Grammar
High level of APA precision
0 Points
topic is future directions of Occupational health)
Unformatted Attachment Preview
GROUP PRESENTATION COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN
Assignment title or
task:
(You can write a
question)
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Select one from the following topics: Occupational stress and impact on employee well-being
Health risks for health workers on night shift.
The roles and responsibilities of the occupational health professionals
The role of telehealth in occupational health services
Occupational safety and health measures in Saudi Arabia
Promoting Mental Health in the Workplace
Digital Occupational Health in KSA.
The role of occupational health in the prevention of occupational
diseases
Psychosocial hazards and prevention in the workplace
Occupational health services for small-sized workplaces of less than 20
workers
Promoting Mental Health in the Workplace
Occupational Heat Exposure
Occupational Noise Exposure
Personal Protective Equipment
Prevent Falls in the workplace
Name
Student’s name and ID
Submission date:
ID
Instructor name
Dr.
Grade
… out of 10
Guidelines:
➢ Every student must send me by email with his chosen topic before 10/10/2023
➢ The presentation should be submitted on the blackboard as a PPT file.
➢ The PPT should not be more than 15 slides and not less than 10 slides.
➢ Use appropriate references as per the APA Style.
➢ The oral presentation time should be 7-10 minutes.
➢ All presenters must participate equally and help each other as needed.
➢ It will be conducted in weeks 9, 10, 11.
➢ Your presentation will be evaluated based on the implementation of
communication skills, slides, time, deadline, topic covering.
Week 9
1. ABDULLAH ALAMRI
2. Faisal Alanazi
3. HUSSEIN ALBAHER
4. SULTAN ALDAWSARI
5. MUFEED ALDHU
Week 10
Week 11
1. MUSTAFA
ALHADDAD
1. MUBARAK
ALMURAYR
2. FARIS ALJANFAWI
2. MOHAMMED
ALQARNI
3. SAAD ALKHALIFAH
4. AHMAD ALKUWAITY
5. KHALID ALMATHIBIRI
6. AQEEL ALMUJAYBIL
3. HASSAN ALRUBH
4. hani alrumaih
5. BADER ALSHAMMARI
All students must submit their
6. ABDULRAHMAN
ALSHEHRI
presentation by Monday of
All students must submit their
All students must submit their
week 9
presentation by Monday of
presentation by Monday of
week 10
week 11
6. AHMED MAJRASHI
Please follow the rank and the presentation will be in the virtual session on Wednesday of
the weeks 9,10, and11. Attendance is required for all students.
Good Luck
Describe your clinical experience for this week in a women’s health primary care clinic. Did you face any challenges, any success? If so, what were they?Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.Mention the health promotion intervention for this patient.What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?Support your plan of care with the current peer-reviewed research guideline.Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources
Write a 3-4 page paper in APA format with a minimum of 3 references.
Address the following Areas:
Project Objectives
The objectives are something you hope to achieve from doing the project
Strategies
Strategies are the method you will use to reach the objectives you have set for your project
Background Analysis
This may also be called a situation analysis. This section you will need to discuss what is happening that made you decided to do your capstone project.
For example, the nurses at a facility are making a many medication errors. For your capstone project you decide you will try to reduce the number of medication errors from 10 every week to three a week. You will have to analyze why the errors are taking place. Maybe the lighting in the medication room is poor or maybe the nurses are working 70 hours every week.
You will also need to locate peer review articles that support you analysis.
Unformatted Attachment Preview
1
Objectives, Strategies, and Background
Student Name
College
Course Number & Name
Instructor’s full name and credentials
Date assignment is due
2
Objectives, Strategies, and Background
[The introduction to the paper at least 5 sentences with 1 in-text citation and a fully stated
purpose and PICOT question.]
Objectives
[Introduce the objectives using SMART objectives (Specific, measurable, attainable,
realistic and timeframe. This should be at least 1 fully formed paragraph with 3-5 SMART
objectives (at least 5 sentences in length for each paragraph) with at least 1 in-text citation.]
Strategies
[Provide 2 strategies for each objective. What will you do to address the objectives?
What will you do to create “improved outcomes”? Provide at least 3 fully formed paragraphs (at
least 5 sentences in length for each paragraph) with in-text citations.]
Background
[Describe the problem or need. What do you hope to achieve by addressing this issue?
Give a background of the problem supported by at least 2 in-text citations in a minimum of 3
fully formed paragraphs (at least 5 sentences).]
Conclusion
[The conclusion to the paper is at least 5 sentences, summarizes at least 3 key points, and
has 1 citation.]
3
References
(All references in alphabetical order, most within the last 5 years, at least 3 peer-reviewed
references)
Author, A. A., & Author, B. B. (Year). Title of the article. Name of the Periodical,
volume(issue), #–#. https://doi.org/xxxx
Author, A. A., & Author, B. B. (Copyright Year). Title of the book (7th ed.). Publisher. DOI or
URL
Nursing Philosophy/QEP Writing Assignment The personal philosophy must include the following domains: Nursing, Environment, Health and Person. You should include your personal definition of each domain and how these fit into your philosophy of nursing. In preparing your philosophy the faculty require that you review the philosophies of Miami Dade College, Benjamin Leon School of Nursing and at least one hospital. A limit of 2 to 3 pages is acceptable in APA format. The guidance of the assignment rubric should be utilized to achieve maximum points. QEP guidelines/prompt will be in a separate document and adherence is REQUIRED to achieve a passing score.
NUR 2811L (Professional Nursing Leadership NUR2811C)
For this course, you will write a scholarly paper on Nursing Philosophy. Utilizing the four
domains within the nursing metaparadigm you will include the following:
• A definition of the four domains: Nursing, Environment, Health and Person
• Your personal definition of each domain and how these fit into your philosophy of
nursing.
• Compare and contrast the philosophies of Miami Dade College Benjamin Leon School of
Nursing and at least one hospital (JACKSON SOUTH COMMUNITY HOSPITAL, MIAMI, FL)
• Conclude by summarizing and reflecting on what was learned from the assignment and
how it will impact your practice in the future.
NUR 2811C Domains
1. Nursing
2. Environment
3. Health
4. Person
Requirements:
o Your paper must be APA format and at least 750 words not to exceed 1000 words.
o Double space your paper and use Times New Roman standard 12-point font.
o Proofread your paper; visit and present proof of seeing a writing tutor before submitting
your paper to “Turn-it-in”.
o A minimum of two (2) scholarly references (ex. journal articles) must be used. APA
format must be used in citing and referencing sources.
VIDEO INSTRUCTIONS: https://us-lti.bbcollab.com/collab/ui/session/play…
Unformatted Attachment Preview
Associate of Science in Nursing
STUDENT HANDBOOK
The guidelines noted in this document are utilized in conjunction with guidelines
in the current MDC Student’s Rights and Responsibilities handbook. Students
will be notified in writing of any changes 30 days prior to implementation.
Revised December 2021
Associate of Science in Nursing Student Handbook 1
MISSION
The mission of Miami Dade College Benjamin Leon School of Nursing (BLSON) is to change lives through accessible,
high-quality, evidence-based education. The BLSON embraces its responsibility to serve as a diverse, civic, and
healthcare leader for the advancement of our community.
VISION/VALUES
The Benjamin Leon School of Nursing aspires to be nationally recognized as a leader in nursing education,
innovation and strives to improve health outcomes in our diverse community.
A commitment to:
An environment of inquiry where faculty support and facilitate academic growth to meet lifelong learning goals.
Civic engagement that fosters an understanding and appreciation of a multi-cultural environment.
Personal integrity which results in sound clinical judgment.
Optimizing educational quality through technology and innovation while emphasizing evidence-based decision making.
An exceptional work environment which engages an outstanding and diverse nursing faculty.
Collaborative partnerships which foster workforce development in the community.
Cultural awareness, initiatives, and responsiveness that capture the multicultural environment of the community
and the nursing profession.
Promoting a healthy community through environmental awareness and intentional sustainability practices which
impact health.
2 Associate of Science in Nursing Student Handbook
Dear Students:
Congratulations! Welcome to Miami Dade College (MDC), School of Nursing. You have
made the ultimate lifelong learning decision by entering one of the most trusted
professions in the world – Nursing!
We are honored that you have chosen MDC- Benjamín León School of Nursing to begin your
nursing career. We hope your educational experiences and journey will be exciting and
successful. The faculty, staff and leadership team in the Benjamín León School of Nursing are
committed to preparing you for a career in nursing, which offers meaningful rewards derived
from providing service to others. Healthcare is ever changing, therefore, as patient acuity
increases and the populations become increasingly diverse, nurses will be challenged
to respond with greater knowledge, technological proficiency, critical thinking skills, and
competence to provide safe and effective patient-centered nursing care. The conceptual
framework your program focuses on is the continuum of novice to expert, culturally competent
care, and safe ethical practice.
We, in the Benjamín León School of Nursing, are looking forward to having you and eager to
assist you in exploring creative, innovative, and transformative ways for you to become a
competent, safe practitioner, as you enter the professional world of service. Please remember
we are here for you as you strive for excellence and success in your nursing career!
Dean
Chairpersons
Faculty
Miami Dade College – Medical Campus
Benjamín León School of Nursing
Associate of Science in Nursing Student Handbook 3
TABLE OF CONTENTS
ITEM
PAGE NUMBER
Section 1: Administrative Guidelines …………………………………………………………………………………………………………….5
Statement of Expectations ……………………………………………………………………………………………………………………………5
Miami Dade College Learning Outcomes ………………………………………………………………………………………………………….. 6
Benjamín León School of Nursing Student Learning Outcomes (Terminal Objectives) ………………………………………. 6
Nursing Program Descriptions ……………………………………………………………………………………………………………………..7
Associate of Science in Nursing Program Philosophy ……………………………………………………………………………………… 8
Associate of Science in Nursing Program Conceptual Framework……………………………………………………………………. 9
Associate of Science in Nursing Program Definitions of Core Components ………………………………………………….. 10
Associate of Science in Nursing Curriculum by Program ……………………………………………………………………………….. 11
Associate of Science in Nursing Program Paradigm ……………………………………………………………………………………….. 12
Section 2: Attendance ………………………………………………………………………………………………………………………………… 13
Section 3: Assignments and Tests ………………………………………………………………………………………………………………….. 14
Section 4: Classroom Testing Procedures …………………………………………………………………………………………………… 14-18
Section 5: Test Review and Re-Test Policy ………………………………………………………………………………………………………..18
Section 6: Grading and Course Completion …………………………………………………………………………………………………. 19
Section 7: Program Progression, Course Repetition, Nursing SMART Action Plan for Remediation………………. 20-21
Section 8: Student Exception Committee………………………………………………………………………………………………….22-23
Section 9: External Transfer …………………………………………………………………………………………………………………………… 24
Section 10: Dress Code/Required Equipment …………………………………………………………………………………………….24-25
Section 11: Advisement, Counseling and Tutorials …………………………………………………………………………………………. 26
Section 12: Chain-of-Command ……………………………………………………………………………………………………………………… 26
Section 13: Conduct ………………………………………………………………………………………………………………………………………. 27
Section 14: Disciplinary Process ……………………………………………………………………………………………………………………. 28
Section 15: Required Program Documentation …………………………………………………………………………………………….. 29
Section 16: Exposure Procedure ……………………………………………………………………………………………………………………..29
Section 17: Clinical Pre-Assignments/Rotations……………………………………………………………………………………………30
Section 18: Chemically Impaired Nursing Student ………………………………………………………………………………………. 31
Section 19: Student Affective Behaviors …………………………………………………………………………………………………….. 32-33
Section 20: Code of Academic and Clinical Conduct ………………………………………………………………………………………. 34
Section 21: Professional Behaviors ………………………………………………………………………………………………………………… 34
Section 22: Benjamín León School of Nursing Student Agreement ………………………………………………………….. 35-36
Change in Clinical Site Student Signature Page ……………………………………………………………………………………………… 37
Student Confidentiality Statement Signature Page …………………………………………………………………………………………. 38
Student Achievement Data …………………………………………………………………………………………………………………………….. 39
4 Associate of Science in Nursing Student Handbook
SECTION 1: ADMINISTRATIVE GUIDELINES
INTRODUCTION: STATEMENT OF EXPECTATIONS
As indicated in the MDC Students’ Rights and Responsibilities Handbook, Miami Dade College and the Benjamín León School
of Nursing takes great pride in offering a high quality and challenging learning environment that will expose you to
a myriad
of opportunities for discovery and growth. Students can expect:
a. Excellence in teaching
b. Encouragement of innovation and creativity
c. A free exchange of ideas
d. Respect for cultural diversity
e. A comprehensive array of services to maximize your academic success
As a student, you play a central role in fostering and maintaining a quality environment for yourself and others. Consequently, Students
are expected to:
1. Attend classes regularly and on time.
2. Succeed and do well in your classes.
3. Strive for personal excellence.
4. Treat others with courtesy and respect.
5. Contribute to the marketplace of ideas at the College.
6. Demonstrate personal and academic integrity in your dealings with others.
7. Make a positive contribution to the multicultural, multiracial environment at the College.
8. Share responsibility for maintaining the integrity of the physical surroundings.
To assist students enrolled in any of the Nursing options, sections of the Benjamín León School of Nursing Student Handbook
are linked to specific portions of the Statement of Expectations (Statement of Expectations a-e and/or Statement of
Expectations 1-8). Students enrolled in any of the NUR courses are expected to abide by the “Statement of Expectations” indicated in
the MDC Students’ Rights and Responsibilities Handbook.
Associate of Science in Nursing Student Handbook 5
MIAMI DADE COLLEGE LEARNING OUTCOMES
Miami Dade College has adopted the Learning Outcomes listed below. Upon completion of a program of study at the Medical
Center Campus, graduates from Miami Dade College should emulate these outcomes.
1. Communicate effectively using listening, speaking, reading and writing skills.
2. Use quantitative analytical skills to evaluate and process numerical data.
3. Solve problem using critical and creative thinking and scientific reasoning.
4. Formulate strategies to locate, evaluate, and apply information.
5. Demonstrate knowledge of diverse cultures, including global and historical perspectives.
6. Create strategies that can be used to fulfill personal, civic, and social responsibilities.
7. Demonstrate knowledge of ethical thinking and its application to issues in society.
8. Use computer and emerging technologies effectively.
9. Demonstrate an appreciation for aesthetics and creative activities.
10. Describe how natural systems function and recognize the impact of humans on the environment.
Through a collaborative effort, the School of Nursing has identified which of the ten outcomes correlate with each nursing course.
The specific outcomes will be identified in the course syllabi with information on the intentional activities utilized to meet
the outcome and the manner of authentic assessment employed.
SCHOOL OF NURSING LEARNING OUTCOMES (TERMINAL OUTCOMES)
1.
2.
3.
4.
5.
Develop a professional identity that demonstrates teamwork, collaboration, effective communication and adhere to standards of
practice for nursing. (MDC Learning Outcomes 1,6) (NLN Competency 3)
Implement safety and quality initiatives in the delivery of holistic patient-centered care. (MDC Learning Outcomes 3) (NLN
Competency 2, 4)
Utilize technological resources to effectively deliver care which enhances positive patient outcomes. (MDC Learning Outcomes
4,8,9) (NLN Competency 2)
Demonstrate nursing clinical judgment while delivering compassionate care to diverse populations with respect to individuality
and clients’ needs. (MDC Learning Outcomes 1, & 2) (NLN Competency 1, 2)
Use relevant evidence to improve clients’ outcomes within a dynamic environment. (MDC Learning Outcomes 2,4,9,10) (NLN
Competency 2, 4)
6 Associate of Science in Nursing Student Handbook
NURSING PROGRAM DESCRIPTIONS
The Associate of Science in Nursing Program (ASN) offers a sequence of courses that provides coherent and rigorous content aligned
with challenging academic standards and relevant technical knowledge and skills needed to prepare for further education and
careers in the Health Science career cluster; provides technical skill proficiency, and includes competency-based applied learning that
contributes to the academic knowledge, higher-order reasoning and problem-solving skills, work attitudes, general employability skills,
technical skills, occupation-specific skills, and knowledge of all aspects of the Health Science career cluster.
The ASN Program is approved by the Florida Board of Nursing and accredited by the Accreditation Commission for Education in Nursing.
Miami Dade College is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools (SACS).
The program content includes, but is not limited to: theoretical instruction and clinical experience in medical-surgical,
obstetric, pediatric, psychiatric and geriatric nursing; theoretical instruction and clinical experience in acute, care,
long-term care and community settings; theoretical instruction and clinical application of the registered nurse role and
function; personal, family and community health concepts; nutrition; human growth and development over the lifespan;
body structure and function; interpersonal relationship skills, mental health concepts; pharmacology and administration
of medications; legal aspects of practice; and current issues in nursing. Clinical experience makes up at least 50% of
the total program. Clinical simulation may be used for no more than 50% of the total clinical experience.
This program focuses on broad, transferable skills and stresses understanding and demonstration of the following
elements of the healthcare industry: planning, management, and community issues and health, safety, and
environmental issues.
The location of the ASN program within the state college setting provides an appropriate academic environment for instruction in the
biological, physical, social, and behavioral sciences. The state college setting further provides instruction in the communication skills
basic to the successful performance of the ASN graduate in the work setting. This body of knowledge supports concepts specific to the
practice of nursing. The purpose of this program is to prepare students for employment as a registered nurse. Associate of Science in
nursing graduates are prepared to provide care to clients in a variety of settings.
Supporting the mission of the College, the nursing faculty believes that nursing education should be accessible,
affordable and of high quality by keeping the learner’s needs at the center of decision making and working in
partnership with its dynamic, multi-cultural community. The Benjamín León School of Nursing provides access to
programs, which educate students to become healthcare professionals. Educational offerings include opportunities for
entry at various levels of nursing practice including Associate of Science in Nursing and RN to Bachelors of Science in
Nursing degrees.
The faculty supports the mission of the College and believes that nursing education should be accessible, affordable,
and of high quality by keeping the learner’s needs at the center of decision-making and working in partnership with
its dynamic, multi-cultural community. Miami Dade College provides avenues of practice to support the needs of the
student and the community.
Associate of Science in Nursing Student Handbook 7
ASSOCIATE OF SCIENCE IN NURSING PROGRAM PHILOSOPHY
We believe Nursing is a professional discipline which applies nursing knowledge to clinical practice. Nursing Education is
based on a strong foundation of nursing standards, principles, and ethics. Nurses strive to provide holistic, client centered care in an
evolving environment which promotes human flourishing. Health is defined by the client(s), as the holistic well-being of the individual
or community. Health care delivery focuses on prevention, wellness, and management of chronic conditions. As the focus of nursing
care shifts, nursing education must include the concepts of cultural responsiveness, quality and safety, evidence-based practices,
informatics, genomics, critical thinking, and clinical judgement.
We believe in fostering a spirit of inquiry and utilizing evidence-based approaches to nursing. The nurse, in collaboration
with the client and the interdisciplinary team members, must manage a culture of safety, client care, resource availability, fiscal
accountability, as well as professional and personal integrity utilizing current available evidence.
We believe Nursing Education is fundamental and must prepare students to assess, analyze, plan, apply, and evaluate
nursing care and patient outcomes. The relationship between the nurse educator and the student is based on establishing a
professional identity and a spirit of inquiry. The student is responsible for their own learning, with the facilitation and support of the
faculty. The educational learning experience is enhanced through use of multiple learning modalities and a spirit of inquiry. The
student’s professional identity is formed through the lived experiences of nursing. The concept of life-long learning is integral to
maintaining the student’s ability to stay current within the dynamic practice of healthcare and nursing.
We believe Nursing Education emphasizes the use of the nursing process and critical thinking which will result in sound clinical
nursing judgement. Individuals and groups function in complex, constantly changing environments where responses to health states
are dynamic. The nursing student cares for individuals and groups in a diverse multi-cultural environment.
We believe caring is integral in the role of the Nurse and the Student which is provided in a variety of healthcare settings.
These settings include long term care facilities, acute care institutions, rehabilitation centers, and varying community organizations.
Collaboration with individuals and groups, including the interdisciplinary team and community agencies, assist the student in meeting
their educational goals.
We believe learning experiences will assist in imprinting the student with the standards of nursing practice. As the student
manages care for individuals and groups throughout the lifespan they apply the principle of maintaining their practice within the legal
and ethical framework of nursing. This is crucial to the wellbeing of the client, as well as maintaining the integrity of nursing and health
care.
We believe in the advancement of the nurse through continuing academic education. Therefore, baccalaureate preparation
of the professional nurse is essential to fostering leadership and advocacy with advanced knowledge and skills.
We believe the professional nurse is a leader who:
• must be willing to take risks and serve as a client advocate to create innovative, planned changes that contribute to the
improvement of the quality of health care and fiscally responsible outcomes.
• functions autonomously and in collaboration with other health care providers.
• utilizes current theoretical and scientific knowledge to provide quality health care for unique human beings in a multi-cultural
global environment.
8 Associate of Science in Nursing Student Handbook
ASSOCIATE OF SCIENCE IN NURSING PROGRAM CONCEPTUAL FRAMEWORK
The Associate of Science in Nursing (ASN) curriculum is based on an eclectic approach deeply rooted in the mission, vision,
and philosophy of the BLSON, which in turn aligns with the mission and vision of MDC. The nursing faculty have chosen to use the
National League for Nursing (NLN) Graduate Associate Degree Competencies, Quality and Safety Education for Nurses (QSEN)
Competencies, and American Nurses Association (ANA) Scope and Standards of Practice to create the end of program student learning
outcomes and to provide the foundation for the curriculum. The conceptual framework facilitates the course sequencing and the
progression of concepts within the curriculum.
Nursing knowledge is built on a strong liberal arts and science foundation. The nursing curriculum is designed to provide the
education and skills needed to work in the healthcare field as a registered nurse. The student progresses through the curriculum, going
from novice to competent graduate, using simple to complex nursing concepts and skills. This prepares the student for nursing practice
and to enter a baccalaureate program to further advance as a proficient/expert nurse (Benner, 2001). Through this process, the student
becomes adept in caring for individuals, families, and communities living within the health, wellness, illness continuum.
Caring behaviors, quality, safety, and the nursing process are woven into each course of the curriculum (NLN, 2010, QSEN,
2021, ANA, 2021). These concepts guide the student to provide culturally responsive care in a diverse, multicultural population that
facilitates human flourishing (NLN, 2010). The student’s professional identity is cultivated by the demonstration of caring behaviors
such as compassion, integrity, and ethical principles by faculty in the classroom and clinical setting (NLN, 2010). The nursing process
guides the student to demonstrate critical thinking skills, clinical reasoning, and decision making which fosters the use of evidencebased practice (NLN, 2010, QSEN, 2021, & ANA, 2021). Interdisciplinary teamwork and collaborative practice allow the student to
incorporate clinical judgement to ensure safe, high-quality, client-centered healthcare (QSEN, 2021, & ANA, 2021). The progression of
student’s foundational knowledge fosters a spirit of inquiry that leads to client centered care along with the application of technology
and informatics (NLN, 2010). These concepts steer the student toward resource utilization which facilitates life-long learning and thus
improved client outcomes.
Local and national trends, in healthcare settings, guide curriculum and nursing practice. Nursing exists in an evolving
environment and the curriculum requires the flexibility to adapt to those changes. The faculty of the Benjamin Leon School of Nursing
at Miami Dade College has pledged to identify these changing trends in practice and continuously revise the curriculum to ensure high
quality, safe ASN graduates.
Associate of Science in Nursing Student Handbook 9
ASSOCIATE OF SCIENCE IN NURSING PROGRAM DEFINITIONS OF GRADUATE COMPETENCIES
1. Human
Flourishing
Advocate for patients and families in ways that promote their selfdetermination, integrity, and ongoing growth as human beings. (NLN,
2010)
2. Nursing
Judgment
Make judgments in practice, substantiated with evidence, that integrate
nursing science in the provision of safe, quality care and promote the
health of patients within a family and community context. (NLN, 2010)
3. Professional
Identity
Implement one’s role as a nurse in ways that reflect integrity,
responsibility, ethical practices, and an evolving identity as a nurse
committed to evidence-based practice, caring, advocacy, and safe,
quality care for diverse patients within a family and community context.
(NLN, 2010)
4. Spirit of
Inquiry
Examine the evidence that underlies clinical nursing practice to
challenge the status quo, question underlying assumptions, and offer
new insights to improve the quality of care for patients, families, and
communities. (NLN, 2010)
10 Associate of Science in Nursing Student Handbook
ASSOCIATE OF SCIENCE IN NURSING CURRICULUM BY PROGRAM
Associate of Science in Nursing Curriculum by program
Program
Credits/Semester
Generic Full Time
Spring
Semester 1
12
NUR 1025
NUR 1025L
NUR 1025C
NUR 1060C
NUR XXXX**
(Pharmacology)
Semester 2
9
NUR XXXX**
(Med.-Surg I)
NUR XXXX L **
(Med.Surg I Lab)
NUR 1214C
NUR 2310
NUR 2310 L
Semester 3
11
NUR 2420
NUR 2420L
NUR 2520
NUR 2520L
NUR XXXX**
(Med.Surg II)
NURXXXX L**
(Med.Surg II
Lab)
Semester 4
10
NUR XXXX**
(Med.Surg
III)
NURXXXXL**
(Med.Surg III
Lab)
NUR2811C
NURXXXX **
(Leadership
Senior
Seminar)
Semester 5
Semester 6
Semester 7
6
NUR 2310
NUR 2310L
NUR 2420
NUR 2420L
5
NURXXXX **
(Med.Surg II)
6
NUR 2520
NUR 2520 L
NURXXXX**
(Med.SurgIII)
7
NURXXX L**
(Med.Surg III
Lab)
Semester 8
NUR 2680L
Credits/Semester
Generic Part-Time
Spring
6
NUR 1025
NUR XXXX**
(pharmacology)
6
NUR 1060C
NUR 1025C
NUR 1025L
6
NURXXXX **
(Med.Surg I)
NURXXXXL**
(Med.Surg I
Lab)
NURXXXXL**
(Med.Surg II
Lab)
NUR 1214C
NUR 2680L
Credits/Semester
Accelerated Option
Spring
18
NUR 1025
NUR 1025L
NUR 1025C
NURXXXX**
(pharmacology)
NUR 1060C
NURXXXX**
(Med.Surg I)
11
NUR XXXX**
(Med.Surg II)
NURXXXXL**
(Med.Surg II Lab)
NUR 2310
NUR 2310L
NUR 2420
NUR 2420L
NUR 2680L
NURXXXXL**
(Med.Surg III Lab)
NUR 1214C
Credits/Semester
Transitional/Bridge
(Full Time and
Online)
Spring
12
NUR 1002
NUR XXXX**
(Trans.To Med/Surg I)
NURXXXX I L**
(Trans.to Med/surg I
Lab)
NURXXXX**
(pharmacology)
10
NUR 2520
NUR 2520L
NUR 2310
NUR 2310L
NUR 2420
NUR 2420L
NUR 2680L
NUR2811C
NURXXXX**
(Leadership
Senior
Seminar)
13
NUR 2520
NUR 2520L
NURXXXX**
(Med.SurgIII)
NURXXXX L**
(Med.Surg III
Lab)
NUR2811C
NURXXXX **
(Leadership
Senior
Seminar)
10
NUR XXXX**
(Med. Surg III)
NURXXXX L**
(Med.Surg III
Lab)
NUR2811C
NUR XXXX**
(Leadership
Senior
Seminar)
Associate of Science in Nursing Student Handbook 11
Course
Number
Course Title
Course
Semester
Credits
NUR 1002
NUR 1002L
Transition to Professional Nursing
Transition to Medical-Surgical Nursing I
Nursing Clinical Lab
2
5
NUR XXXXL**
Transition to Medical-Surgical Nursing I Clinical Lab
2
NUR 1025
NUR 1025L
Fundamentals of Nursing
Fundamentals of Nursing Clinical Lab
NUR 1025C
NUR 1060C
Course
Number
Course Title
Course
Semester
Credits
NUR 2310
NUR 2310L
Pediatric Nursing
Pediatric Nursing Clinical Lab
2
1
3
2
NUR 2420
NUR 2420L
Obstetrical Nursing
Obstetrical Nursing Clinical Lab
2
1
Fundamentals of Nursing Skills Lab
Adult Health Assessment
1
3
NUR 2520
NUR 2520 L
Psychiatric Nursing
Psychiatric Nursing Clinical Lab
2
1
NUR XXXX**
Introduction to Nursing
Math/Pharmacology
3
NUR 2680L
Community Health Nursing
Clinical Lab
1
NUR XXXXX**
NUR XXXXX**
Medical Surgical Nursing 1
Medical Surgical Nursing 1 Clinical Lab
3
2
NUR 2811C
Professional Nursing Leadership
4
NUR XXXXX**
Medical Surgical Nursing II
3
NURXXXX**
Senior Seminar
1
NUR XXXXX**
Medical Surgical Nursing II Clinical Lab
1
NUR XXXXX**
Medical Surgical Nursing III
3
NUR XXXXX**
Medical Surgical Nursing III Clinical Lab
2
**Course numbers will be updated once provided by the State to MDC
12 Associate of Science in Nursing Student Handbook
SECTION 2: ATTENDANCE
Clinicals are MANDATORY. Students are expected to have 100% attendance for all clinical rotations.
1. In the event of an emergency or illness, the student must notify the faculty member of the absence as soon as
possible but no later than one hour prior to starting the clinical and consideration regarding alternative
assignments/experiences will be made at the discretion of the faculty member. Students missing more than one
clinical day related to an illness must have medical provider approved clearance prior to returning to clinical
2. In the event of an absence, the faculty must document on the anecdotal form the unmet objectives and the clinical
day missed. Documentation on the anecdotal form must include: reason for absence and supporting documentation
(medical, bereavement, etc.).
3. Faculty members must develop a plan of how the student will meet the objectives missed within the time frame
specified. Decisions as to the need for alternative assignments/experiences are based on the student’s progress in
meeting the course objectives. If a student does not meet course objectives within the course time frame, the course
will need to be repeated.
4. An alternative assignment to assist the student in meeting the course objectives may be assigned by the faculty
member. However; a student cannot attend another clinical group to make up for missed days.
5. Despite the circumstance, a student is not allowed to miss more than 1 day for a clinical rotation of less than
or equal to 6 weeks, or 2 days for a clinical rotation greater than 6 weeks. Exceeding these criteria will automatically result
in an unsatisfactory grade for the clinical course.
6. The student is considered to be tardy if he or she arrives after the designated start time. Tardiness may result in an
unexcused clinical absence.
7. It is the students’ responsibility to disclose any changes in medical, psychiatric, and other conditions that may impact
clinical attendance/performance and/or the safety of self or others. Written medical clearance must be provided to the
faculty member and the School of Nursing before the next experience.
Approved by Benjamín León School of Nursing Faculty April 28, 2014
Associate of Science in Nursing Student Handbook 13
SECTION 3: ASSIGNMENTS AND TESTS IN NURSING
(Reference Statement of Expectations 2, 3)
1. There are no makeup tests/exams for program courses. Students are expected to take all tests and/or exams when they are
scheduled.
2. Faculty should be notified beforehand if there is a problem. If a student is unable to attend class the day a test is scheduled, the
weight of the Midterm or Final exam will be increased by the weight of the missed test.
3. Students who enter the classroom late, while a quiz/test/exam is in progress will be allowed only the remaining testing time to
complete the quiz/test/exam.
4. At a designated time during the semester, the student will take a proctored standardized test. The results of the practice proctored
test will provide a comprehensive remediation. The student will be required to complete the remediation prior to taking the end- ofcourse final exam.
The End-of-Course proctored standardized test is mandatory and it is given towards the end of the course (Fundamentals,
Pharmacology, Obstetrics Pediatrics, Psychiatrics, Medical Surgical, and Advanced Medical Surgical).
During the final semester of the nursing program students will take the Comprehensive Predictor exam. Students will prepare for this
exam utilizing the online practice items related to the course and other related content. The analysis obtained from this exam will
facilitate student success in NUR 2811C.
Course syllabus will explain grading scale and score distributions.
SECTION 4: CLASSROOM TESTING PROCEDURES
Testing is a means of providing the student with an opportunity to demonstrate his/her knowledge of course content. Sharing
of information related to test items is a violation of the Student Code of Conduct, College Procedure 4035, and is considered Academic
Dishonesty as described in Student’s Rights and Responsibilities in the section Code of Conduct. For detailed information about
academic dishonesty please refer to College Procedure 4035 in Student’s Rights and Responsibilities, Academic Dishonesty.
The following guidelines for test taking are to be observed by all nursing students. Special guidelines, referring only to laboratory
(performance) testing, classroom (paper and pencil) testing or computerized testing are given below.
14 Associate of Science in Nursing Student Handbook
1. FOR ALL TESTING SITUATIONS:
a. Be on time for all testing situations. No additional time beyond the scheduled testing time will be given
for students who arrive late.
b. Place all books and personal belongings in the front of the room or out of the testing area. Keep
personal items to a minimum.
c. Do not talk to or look at other students while they are anywhere in the testing area.
d. If assistance from the proctor is needed remain seated and raise your hand. Do not move or stand up
during the testing session unless requested to do so by the proctor.
e. Leaving and re-entering the testing room during the testing session will be permitted with the
student being accompan
This week, the final paper on organizational change through leadership is due. Revise the rough draft based on your instructor’s feedback and submit the final paper.The final paper should be of 10-12 pages, providing the following:A detailed and in-depth description of the problem. Your description should include actual evidence supporting that the issue exists.A detailed description of all interventions utilized till date to resolve the challenge the organization is experiencing. Your description should include actual evidence supporting that the interventions mentioned have been implemented by the organization.A proposal to correct the issue. Your proposal should be based on evidence from current literature that supports your idea. Include a minimum of ten credible citations from current literature.A reference list citing all sources in APA format.PLEASE NOTE PROFESSOR RECOMENDATIONS IN RED ALSO FROM MY INSTRUCTOR Sabina, the paper does not really meet the assignment criteria of leader directed change. The assignment uses the weekly topics about leader development to identify a problem and apply leader attributes to plan a change in an organization. Financial topic would work for a business course rather than a nursing leadership course. As a future DNP leader, learning about application of change theory is to help you prepare for the practicum project which is implementation of a change to resolve a nursing problem.
Unformatted Attachment Preview
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Addressing Financial Strain at Ouachita Medical Center-great title
Sabina Thomas MSN, APRN, FNP-C
South University
NSG 7000
Dr. Mary
10/15/2023-date format not correct
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Addressing Financial Strain at Ouachita Medical Center
The American healthcare system faces-conversational numerous challenges and many
healthcare organizations struggle to remain in the industry amidst financial and other challengescitation. The COVID-19 pandemic worsened what has been a tough-conversational decade for
many hospitals and especially small and rural hospitals have faced significant-conversational
challenges. Healthcare leadership can be used to assist such hospitals in regaining their-remove
or replace with specific noun stance-conversational and stabilizing to continue providing safe
and quality care to the population. Healthcare organizations across the country have been facing
financial challenges and this which has affected many small and rural hospitals-citation. With the
numerous challenges facing healthcare organizations, managerial decisions have to be made to
meet the demands of care while addressing the main challenges.
The healthcare industry has been facing challenges and it has been fragile in the last few
years. More than 600 rural hospitals have been on the brink of closure in the last three years due
to financial challenges and many clinics and rural health centers have been closed (Robertson,
2023). All across the nation, small hospitals have been facing a cash flow problem with reducing
revenues and increasing costs. This has significantly reduced the operating revenues with many
hospitals operating at losses. This financial problem is not only an organization-level problem
but also an industry-wide challenge. This paper focuses on Ouachita Medical Center in Arkansas
as a case study of the financial challenges rural hospitals have been facing, solutions
implemented, and recommendations to deal with the problem. Financial topic is a business
topic; a better choice of a topic for nursing leadership NSG7000 course would be an employee
problem-employee burnout, employee morale, hand washing, communication
Financial Challenges at Ouachita County Medical Center
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Ouachita County Medical Center (OCMC) is a healthcare organization in Camden,
Arkansas and serves the people of Ouachita County. It is an independent 80-bed rural hospital
located in the county seat and one of the major healthcare organizations in the state (OCMC,
n.d.). The healthcare organization is committed to providing a host of services to the residents of
the county and has been offering services for more than three decades. The services provided at
OCMC include ambulance, cardiopulmonary, gastrointestinal, laboratory, physical therapy,
nutrition, nursing, pharmacy, sleep care, and wound care (OCMC, n.d.). The main branch is in
Camden but the hospital operates other clinics throughout the county. The healthcare
organization has been facing financial challenges since the 2010s and is in a dire crisis with the
risk of hospital closures.
Rural healthcare organizations have faced a reduction in revenue and increase in costs in
the past few years. The unique challenge of rural healthcare hospitals is that they often have
small operating margins due to the people they serve. Many rural hospitals have a relatively
smaller target population and hence lower reimbursements compared to urban hospitals.
Additionally, in the last few years, there has been high inflation rates leading to poor
compensation and increased operating revenues (Eti et al., 2023). This has made it challenging
for many healthcare organizations to provide adequate services while maintaining the budgets on
which they have worked before. These income and revenue problems make it challenging for
smaller hospitals to maintain services as needed.
Other than inflation, the COVID-19 pandemic worsened the financial challenges of rural
hospitals. With the COVID-19 pandemic, the influx of patients, demand for services, and
operating environment were worsened. Sicker patients meant more utilization of healthcare
services, longer hospital stays, and high acuity, demanding healthcare services in the hospitals.
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Expenses have also been rising across the board with increased labor and drug costs and
increased demand for personal protective equipment (PPEs). Therefore, operating costs of
hospitals have been increasing during the pandemic. Also, with many healthcare personnel
affected, the capacity to provide quality care also reduced as healthcare workers were in the
frontline and they themselves were patients too (Ardebili et al., 2021). The COVID-19 worsened
a problem that was already in existence and for hospitals that were already facing financial
instability, this was a huge blow.
OCMC has been facing financial challenges even before COVID-19 and they continue in
2023. In 2022, the hospital reported a loss of $1 million (Garza, 2023). According to the
president Peggy Abbott, the hospital has been operating in the ‘red’ for more than five years due
to increasing costs and that do not match revenue increases. This challenge was worsened during
the COVID-19 pandemic. In 2022, the hospital experienced a 4% decrease in year-to-year
revenue (Garza, 2023). This was largely due to a result of the COVID-19 pandemic impact on
the income and compensation for hospitals. In the year 2021-2022, the hospital also reported a
loss. This healthcare organization has been reporting losses like 600 other rural hospitals and is
at risk of closure.
Moreover, the hospital is experiencing increases in costs. In 2022, the hospitals in
Arkansas also experienced an increase in costs. By one report, there was a 20% increase in
supplies costs, 20% in pharmaceutical, and over 30% in labor costs in Arkansas hospitals (Garza,
2023). In OCMC, 12% increase in labor costs were reported despite the 4% decrease in revenue
(Garza, 2023). These changes have created financial constraints for the healthcare organization
and many other healthcare organizations similar to OCMC. The increase in costs and reduction
5
in revenue are attributed to the labor market, COVID-19, and the costs of healthcare supplies in
the United States.
In addition to financial losses and reduction in revenue, OCMC has been facing a staffing
challenge which exacerbates the financial problem. Staffing shortage in the healthcare industry
has been affecting numerous healthcare organizations including OCMC. The staff shortages have
led to high labor costs due to the compensation of part-time employees and seeking other staffing
solutions. This has also led to increased operations costs due to the costs of hiring new staff. This
staffing crisis further worsens the situation through poorer health outcomes, increased cuts due to
penalties by the Centers for Medicare and Medicaid Services (CMS), and increased labor costs
due to high demand (Buerhaus, 2021). The staffing shortage goes hand in hand with the financial
challenges in the healthcare organization specifically because they are partly caused by poor
financing and also worsen the current situation. Staffing and financing, therefore, are the major
challenges facing OCMC and other rural hospitals.
The highlight of OCMC problems has had a huge impact on the hospital and the people
served. First, the hospital faces a challenge offering high quality services. According to Abbott,
the hospital has been operating on a week by week budget and this leads to a huge variation in
the services offered (Muoio, 2022). The impact is that the quality of care must be lower due to
insufficient support to provide high quality and safe care. Secondly, the organizational culture is
also significantly affected by the financial challenges and staffing shortage. The shortage leads to
poor morale in the healthcare organization and consequently low motivation to achieve the
desired quality of services. Employees are poorly compensated, have inadequate access to
facilities and resources needed to provide care, and experience high levels of burnout due to
staffing shortages and financial challenges (Muoio, 2022). A financially-struggling healthcare
6
organization automatically leads to struggling healthcare staff. These adverse outcomes and other
problems in the organization can be solved by solving the financial and staffing problem at
OCMC.
Missing leader attributes, the organizational change through leadership assignment is
about leader directed change.
Interventions Implemented to Solve the Problem
One of the interventions implemented to help OCMC is the use of relief funds to address
the financial challenge. After COVID-19 pandemic and as part of the recovery, the Biden
government has allocated funds to hospitals to help in their financial recovery. OCMC received
$6 million in September 2022 as part of the American Rescue Plan funds targeting rural hospitals
to prevent closure (Garza, 2023). Abbott confirmed that the funding did help in alleviating the
problem but this was a drop in the ocean as it was a temporary solution to a chronic problem.
The allocation of funding to the hospital helped reduce the risk of closure and gave the hospital a
lifeline in the backdrop of COVID-19 challenges and recovery.
Additionally, the closure of some clinics operated by the healthcare organization was a
challenging but seemingly necessary decision for OCMC. Early in 2023, OCMC ceased
providing services in two of its rural clinics: an urgent care clinic and a primary care facility
(Garza, 2023). The decision behind ceasing services was a strategic one in reducing the operating
costs of the healthcare organization. By stopping services in these clinics, the organization was
able to reduce operating costs and maintain revenue. However, stoppage of healthcare services is
not a permanent solution to the financial challenges. It is indeed a negative outcome because it
reduces access to care. Rural health clinics and hospitals often provide care to low-income and
7
underinsured residents. The closure of rural clinics leads to poorer access to care and potentially
causes poorer health outcomes in the community. This was a heart-wrenching but necessary step
to reduce operating costs.
Another intervention used by the hospital is reduction in wages through pat cuts. Pay cuts
are meant to reduce labor costs and hence save money through a shrunk budget. As a means of
cutting costs, Abbott reported that the healthcare organization staff have had to resort to
voluntary pay cuts and reduced working hours (Muoio, 2022). Pay cuts have been used across
the board but especially among executive employees and managers to reduce the labor costs that
the organization has had to endure. These pay cuts and hours reduction are of course voluntary
but also present a larger challenge. When employees are expected to take pay cuts, this may
affect their morale and motivation to provide quality services. Also, pay cuts cannot be sustained
in the long-term and are essentially a temporary fix to a larger scope problem. Overall, the pay
cuts and reduced hours have been temporary measures to reduce costs but cannot fix the revenue
and costs issue permanently.
In addition to pay cuts, OCMC has been laying off staff and consolidating services, a
strategic decision to reduce the organization’s operating costs. In the past one year, the
organization has been shrinking the workforce. This is especially through a strategy to reduce
labor costs through a leaner and more efficient way of operating its facilities. Other than layoffs,
the organization has also been consolidating services. For instance, some services are now only
available in specific locations and not in others (Garza, 2023). This consolidation seeks to reduce
operating costs and shrinking the budget. On the one hand, consolidation and layoffs may reduce
the organization’s budget and reduce the loss margins. This is through lower spending to match
the revenue. On the other hand, layoffs mean the loss of jobs to healthcare organization staff and
8
consolidation leads to lower accessibility of services (Garza, 2023). Consolidation and layoffs
are essentially a temporary solution, similar to the pay cuts instituted in the organization. OCMC
will need adequate staffing and resources to provide high quality services without compromising
on quality and accessibility of services.
As a general assessment, the interventions implemented by OCMC have been crisisdriven but have not entirely solved the financial problems facing the organization. Closures, pay
cuts, and reduction in services offered all reduce operating costs. However, they are not
sustainable solutions to the recurrent financial problems affecting the hospital and many others
from even before the COVID-19 pandemic. Relief funds provided temporary relief for a hospital
that was on the brink of closure. However, it can no longer survive on relief emergency funding
and a more permanent and sustainable solution is needed. The next section outlines the proposed
approaches that OCMC and other similar organizations can use to address financial challenges.
Missing application of leader attributes to identify the problem and critique the past
solutions
Proposed Solutions
In the context of increasing operating costs and lower revenue, OCMC must consider
virtual and telehealth care as a possible solution to maintain high quality care. Virtual and
telehealth care are not going to solve the financial problems. However, they can strive to use
these technologies to maintain services to those populations affected by a shrinking budget and
closures. Telehealth solutions have been used and deemed effective in providing care access
especially in rural areas (Lum et al., 2020). In areas where primary and urgent care clinics have
been closed, OCMC can use virtual care options to ensure that the population maintains access to
healthcare services. This technology can also reduce the in-person visits and hence ensure
9
adequate care provision even with staffing shortages (Baum et al., 2021). Telehealth is effective
in reducing the care gap by ensuring care provision even in the context of insufficient staffing.
The initial costs of telehealth are high but the long-term effects justify this high initial cost.
Investing in an evidence-based telehealth program can help reduce staffing costs and costs of
care while maintaining services access through remote consultations.
Another solution to the financial problems is using a creative health management
software to enhance efficiency while maintaining high quality services to the patients. A health
management software is used for administrative work and can reduce costs and increase
efficiency. According to Urbich et al. (2020), the high operating costs of many hospitals can
partly be blamed on administrative costs inefficiencies and hence an improvement in
administrative work can necessarily lead to cost savings. A healthcare management software can
achieve this goal and help OCMC in further cutting operation costs. First, the software can
expedite Medicare and Medicaid reimbursement and reduce claims denials (Powers et al., 2020).
This can increase cash flow and hence promote the organization’s efficiency. Secondly, the
software can increase point-of-service collections. A health management software increases
visibility in the healthcare processes and hence can enhance collections. Lastly, the software can
provide tools for non-clinical staff to work remotely. Remote working can help reduce operating
costs in the healthcare facilities while promoting care access.
Another approach to reducing the financial strife is increasing income for the healthcare
organization. OCMC is a healthcare organization whose revenue only comes from
reimbursement and financial allocations for hospitals to provide affordable care. The hospital can
increase income by investing in other opportunities for interest and capital gains generation
(Jeurissen & Maarse, 2020). The current model for for-profit hospitals depends on the payments
10
made by patients and insurance organizations as the main source of income. However, hospitals
do invest in other businesses and opportunities either within or outside the healthcare industry.
This investment is a way of diversifying the revenue sources for the healthcare organization and
providing stability in the long-term. Revenue diversification and investments in other business
opportunities can help cover the losses for OCMC and provide operating incomes for business
stability and reducing the risk of closures.
Still on the issue of income increase renegotiation of reimbursement contracts is also
necessary for OCMC. Inflation and increasing industry costs have led to increased cost of
providing care to patients. The increasing costs within the last few years must be accounted for
in the reimbursement agreements with payers. Compensation agreements made before COVID19 can no longer sustain services in the post-COVID era and renegotiation of contracts can help
the organization inch reimbursements higher (Khullar et al., 2020). For instance, a service that
used to cost healthcare organizations $100 to provide in 2019 does not cost the same in 2023.
Therefore, reimbursements using 2019 rates hurt the healthcare organization. An increase in
reimbursements can be achieved through contract renegotiations with payers who may in turn
increase insurance premiums. Negotiating new contracts will increase OCMC income through
better and fairer compensation terms.
Moreover, cost-reduction strategies can be implemented through standardization and
bundling contracts in the hospital. There is currently an increase in market consolidation specific
to healthcare organizations and this produces an opportunity for standardization. According to
Borowska et al. (2020), outsourcing some of the services such as laboratory, IT, pharmacies, and
human resource management can reduce overhead costs for healthcare organizations. However,
having too many vendors for each of the outsourced services increases costs and is likely to
11
reduce the quality of services provided. The solution, therefore, is standardizing and
consolidating these services under a single partner (Borowska et al., 2020). A partner that aligns
operationally and culturally with OCMC can be sought to provide a solid administrative and
governance model for the organization. By outsourcing standardized and consolidated services,
the healthcare organization can reduce costs in the long-term and hence alleviate the financial
challenges.
Another cost-reduction strategy is through optimizing scheduling and staffing. OCMC
especially struggles with labor costs and this can be alleviated through smart and responsive
scheduling and staffing approaches. A system audit is needed to identify the busiest and slowest
hours and months in the hospital. After identifying these fluctuations, digital smart solutions for
scheduling can be used to ensure that scheduling matches the demand and supply cycles in the
organization (Khodabandeh et al., 2021). Using this system, OCMC can ensure that staffing is
just adequate for patient flow in a true lean management approach. Matching scheduling and
staffing needs can help reduce labor costs while maintaining high quality services.
Lastly, OCMC can reduce costs through reduced utility costs in the hospital facilities.
There are many ways of reducing utility costs and one is through energy costs savings and
facility costs reduction. Energy costs make up a huge percentage of the healthcare organization’s
bills and costs for services provision. As such, saving on energy costs can help save costs and
reduce operating costs. To lower energy consumption, the healthcare organization can implement
more power-efficient appliances and utilities such as energy-saving lighting bulbs, automatic
temperature-adjusting thermostats, motion sensor lighting, and more effective heating,
ventilation, and air conditioning (HVAC) systems (Montiel-Santiago et al., 2020). Routine
inspection of all energy utilities and power audit can also help to significantly reduce costs
12
associated with running the facility. Generally, reduced waste in terms of energy and utilities
such as offices can help cut costs beyond the simplistic pay cuts.
Missing leader directed plan of change, selection and application of change theory,
Conclusion
OCMC has been facing financial challenges and more sustainable income-increasing and
cost-reduction approaches should be applied in the organization. The rural hospital has been
struggling with financial challenges since before COVID-19 and the pandemic worsened the
situation. Interventions implemented include pay cuts, closures, lay-offs, and bailing out using
relief funds. The proposed approaches, however, include more sustainable cost-cutting
approaches such as IT solutions and better scheduling and income increase through diversified
investment portfolio. OCMC is not the only hospital facing this challenge and its case study can
be used by other small and rural hospitals to reduce the financial challenges and avoid closures
and maintain safe and high quality care provision.
The paper does not really meet the assignment criteria of leader directed change. Let’s
plan to talk by phone before you revise the assignment
13
References
Ardebili, M. E., Naserbakht, M., Bernstein, C., Alazmani-Noodeh, F., Hakimi, H., & Ranjbar, H.
(2021). Healthcare providers experience of working during the COVID-19 pandemic: A
qualitative study. American Journal of Infection Control, 49(5), 547-554.
https://doi.org/10.1016/j.ajic.2020.10.001
Baum, A., Kaboli, P. J., & Schwartz, M. D. (2021). Reduced in-person and increased telehealth
outpatient visits during the COVID-19 pandemic. Annals of Internal Medicine, 174(1),
129-131. https://doi.org/10.7326/M20-3026
Borowska, M., Augustynowicz, A., Bobiński, K., Waszkiewicz, M., & Czerw, A. (2020).
Selected factors determining outsourcing of basic operations in healthcare entities in
Poland. Health Policy, 124(4), 486-490. https://doi.org/10.1016/j.healthpol.2020.01.010
Buerhaus, P. I. (2021). Current nursing shortages could have long-lasting consequences: Time to
change our present course. Nursing Economics, 39(5), 247-250.
Eti, S., Dinçer, H., Gökalp, Y., Yüksel, S., & Kararoğlu, D. (2023). Identifying key issues to
handle the inflation problem in the healthcare industry caused by energy prices: An
evaluation with decision-making models. Managing Inflation and Supply Chain
Disruptions in the Global Economy, 162-178. https://doi.org/10.4018/978-1-6684-58761.ch011
Garza, J. (2023, Mar. 29). Arkansas hospitals hurting financially, several face closure.
https://www.thv11.com/article/news/local/arkansas-hospitals-hurting-financially/912bd727fb-998e-49e2-828c-5489138d8fae
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Jeurissen, P., & Maarse, H. (2020). Hospital care: Private assets for-a-Profit?. Understanding
Hospitals in Changing Health Systems, 103-119. https://doi.org/10.1007/978-3-03028172-4_5
Khodabandeh, P., Kayvanfar, V., Rafiee, M., & Werner, F. (2021). A bi-objective home health
care routing and scheduling model with considering nurse downgrading
costs. International Journal of Environmental Research and Public Health, 18(3), 900.
https://doi.org/10.3390/ijerph18030900
Khullar, D., Bond, A. M., & Schpero, W. L. (2020). COVID-19 and the financial health of US
hospitals. Jama, 323(21), 2127-2128. https://doi.org/10.1001/jama.2020.6269
Lum, H. D., Nearing, K., Pimentel, C. B., Levy, C. R., & Hung, W. W. (2020). Anywhere to
anywhere: use of telehealth to increase health care access for older, rural veterans. Public
Policy & Aging Report, 30(1), 12-18. https://doi.org/10.1093/ppar/prz030
Montiel-Santiago, F. J., Hermoso-Orzáez, M. J., & Terrados-Cepeda, J. (2020). Sustainability
and energy efficiency: BIM 6D. Study of the BIM methodology applied to hospital
buildings. Value of interior lighting and daylight in energy
simulation. Sustainability, 12(14), 5731. https://doi.org/10.3390/su12145731
Muoio, D. (2022, Sep. 16). ‘Unsustainable’ losses are forcing hospitals to make ‘heart-wrenching’
cuts and closures, leaders warn. Fierce Healthcare.
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Ouachita County Medical Center. (n.d.). About us. https://www.ouachitamedcenter.com/about-us
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Powers, B. W., Modarai, F., Palakodeti, S., Sharma, M., Mehta, N., Jain, S. H., & Garg, V.
(2020). Impact of complex care management on spending and utilization for high-need,
high-cost Medicaid patients. Am J Manag Care, 26(2), e57-e63.
Robertson, M. (2023, Jan. 6). 631 hospitals at risk of closure, state by state. Becker Hospital
Review. https://www.beckershospitalreview.com/finance/631-hospitals-at-risk-of-closurestate-by-state.html
Urbich, M., Globe, G., Pantiri, K., Heisen, M., Bennison, C., Wirtz, H. S., & Di Tanna, G. L.
(2020). A systematic review of medical costs associated with heart failure in the USA
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Instructions: To create a focused/episodic note, you must make up information for all aspects. I strongly encourage you to review previous feedback. In some cases, there are notes still being submitted that do no incorporate feedback. For example, your HPI should capture all aspects of the LOCATES mnemonic. Medical conditions listed for the past medical history should reflect the year of the diagnosis – not age. Calculate the year of the diagnosis. How is the condition managed? There are four categories for allergies – food, drugs, environmental, and latex. Seasonal is not a fifth category. It should be listed under environmental. Personal/Social, Sexual/Reproductive, and Health Maintenance should be robust and written in narrative format. With regard to the case study you were assigned: Review this week’s Learning Resources, and consider the insights they provide about the case study.Consider what history would be necessary to collect from the patient in the case study you were assigned.Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. If your assignment is focused, then you are expected to select systems pertinent to the chief complaint. THE CASE STUDY ASSIGNMENT Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the attached episodic/focused note template. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each using current both classroom and outside resources. The Case study: A 48 year old male with a history of diabetes mellitus type 2 complains of not being able to feel his toes in the left foot. He also complains of numbness in the heel of the right foot and a tingling sensation. Required Readings Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.Chapter 7, “Mental Status” This chapter revolves around the mental status evaluation of an individual’s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.Chapter 23, “Neurologic System” The authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.Chapter 2, “The Comprehensive History and Physical Exam” (“Cranial Nerves and Their Function” and “Grading Reflexes”) (Previously read in Weeks 1, 2, 3, and 5) O’Caoimh, R., & Molloy, D. W. (2019). Comparing the diagnostic accuracy of two cognitive screening instruments in different dementia subtypes and clinical depression.Links to an external site. Diagnostics, 9(3), 93. https://doi.org/10.3390/diagnostics9030093 Shadow Health Support and Orientation Resources Use the following resources to guide you through your Shadow Health orientation as well as other support resources: Shadow Health. (2021). Welcome to your introduction to Shadow Health.Links to an external site. https://link.shadowhealth.com/Student-Orientation-…Shadow Health. (n.d.). Shadow Health help desk.Links to an external site.Retrieved from https://support.shadowhealth.com/hc/en-usShadow Health. (2021). Walden University quick start guide: NURS 6512 NP students. Download Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Stu…Document: DCE (Shadow Health) Documentation Template for Comprehensive (Head-to-Toe) Physical Assessment (Word document)Download DCE (Shadow Health) Documentation Template for Comprehensive (Head-to-Toe) Physical Assessment (Word document) Use this template to complete your Assignment 3 for this week. Required Media Neurologic System – Week 9 (16m) Online media for Seidel’s Guide to Physical Examination It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 7 and 23 that relate to the assessment of cognition and the neurologic system. Refer to the Week 4 Learning Resources area for access instructions on https://evolve.elsevier.com/Links to an external site. Optional Resources LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.Chapter 14, “The Neurologic Examination” This chapter provides an overview of the nervous system. The authors also explain the basics of neurological exams.Chapter 15, “Mental Status, Psychiatric, and Social Evaluations” In this chapter, the authors provide a list of common psychiatric syndromes. The authors also explain the mental, psychiatric, and social evaluation process.Kim, H., Lee, S., Ku, B. D., Ham, S. G., & Park, W. (2019). Associated factors for cognitive impairment in the rural highly elderly.Links to an external site. Brain and Behavior, 9(5), e01203. https://doi.org/10.1002/brb3.1203 Lee, K., Puga, F., Pickering, C. E., Masoud, S. S., & White, C. L. (2019). Transitioning into the caregiver role following a diagnosis of Alzheimer’s disease or related dementia: A scoping review.Links to an external site. International Journal of Nursing Studies, 96, 119–131. https://doi.org/10.1016/j.ijnurstu.2019.02.007
Research the National Committee of BioEthics (NCBE) Implementing Regulations of the Law of Ethics of Research on Living Creatures in Saudi Arabia.
Select any of the many articles related to your profession or resonate with your student research topic. How could these guidelines be integrated to ensure the researcher’s adherence to these research regulations and protocols?
Choose 1 of your 10 articles you selected and completed the Annotated Bibliography on. Identify information pertaining to ethical assurances or compliance by the researchers in that specific study. This will commonly be located in Chapter 3 Methodology sections regarding Sampling, Data Collection Procedures, Data Analysis Procedures, Ethical Assurances, or Informed Consent.
*If your article is missing any of the ethical standards commonly associated with human subjects research, please identify them in your post!
Common ethical requirements:
1. Right to participation autonomy – participants can quit research participation at any time wiithout repercussion or consequence.
2. Right to privacy – particpants will NOT be identified by name or other personal health information (pseudonyms or numerical coding will preserve the anonymity of participants).
3. Right to be protected from harm (non-maleficence) – researchers take precautions to minimize mental or physical injury or harms and provide contact information to professionals in the case injury does occur.
4. Right to beneficence – assurances that participation in the research will most likely generate benefits (health improvements).
5. Right to be notified of researcher affiliations – notifications of grant funding or business/organization support for the research which could be biasing.
6. Right to know why the participant is being selected for the study.
7. Right to know if the participant is being reimbursed or provided some type of reward for participation.
8. Right to know possible risks or harms from participating in the research study.
9. Right to ask questions before, during, or after participation in the research study with contact information provided.
10. Right to not be tricked or deceived by the researcher.
There are plenty of other ethical considerations, but this should give you a start of things to look for, Dr. Eric
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Annotated Bibliography on Antibiotic Use
Name
Institutional Affiliation
Date
2
Annotated Bibliography on Antibiotic Use
Bezruk, V. V., Ivanov, D. D., & Shkrobanets, I. D. (2023). Monitoring and features of
antibiotic resistance during the COVID-19 pandemic. KIDNEYS, 12(1), 26-32.
https://doi.org/10.22141/2307-1257.12.1.2023.391
-This study compares the data from a study conducted from 2014 to 2016 to examine
trends of antibiotic resistance among the bacteria that cause pediatric urinary tract
infections during the COVID-19 pandemic. Six hundred fifty-seven youngsters (0-17
years old) had urine samples that were examined. The findings revealed wave-like
changes in penicillin and cephalosporin resistance, while fluoroquinolone and
tetracycline resistance rose. The findings underline the importance of upholding
medical care standards and emphasize the need for pediatric practitioners to prescribe
antibiotics expressly, notably carbapenems.
-This study offers important new information about the changing pattern of antibiotic
resistance during the COVID-19 pandemic among pediatric UTI cases. Its authority is
increased by thoroughly examining the patterns of resistance it provides. In order to
support localized healthcare practices, the study’s emphasis on area data provides
specificity. However, the study needs a global perspective and comprehensive
demographic data. Furthermore, the short time range can miss long-term patterns.
Blackburn, J., Barrowman, N., Bowes, J., Tsampalieros, A., & Le Saux, N. (2021).
Establishing benchmarks for antimicrobial use in Canadian children’s hospitals:
results from 2 national point prevalence surveys. The Pediatric Infectious Disease
Journal, 40(10), 899-905. https://doi.org/10.1097/INF.0000000000003170
– Through two one-day Point Prevalence Surveys (PPS), this study evaluates the use
of antibiotics in 15 pediatric hospitals in Canada in 2018–19. Findings show that a
sizable percentage of broader-spectrum antibiotics were given out, even in cases of
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community-acquired pneumonia. The study emphasizes the viability of PPS for
monitoring antibiotic use and raises the possibility of setting objectives to lower total
and Watch group antibiotic prescriptions.
-This study used PPS across various pediatric hospitals and provides insightful
information about Canadian antibiotic usage trends. Its methodology, which focuses
on a single-day snapshot, summarizes the most common themes. The addition of
neonatal critical care units increases the study’s breadth. The study, however, needs
more precise patient-specific data, which may prevent a thorough review. The report
also highlights the widespread use of broad-spectrum antibiotics as a possible area for
policy development and action.
Blaser, M. J., Melby, M. K., Lock, M., & Nichter, M. (2021). Accounting for variation in and
overuse of antibiotics among humans. Bioessays, 43(2), 2000163.
https://doi.org/10.1002/bies.202000163
– The global problem of rising antibiotic use that is made worse by over-the-counter
and online sales is discussed in this study. Several reasons, including expectations of
healthcare providers and patients, institutional rules, business practices of the
pharmaceutical sector, and cultural influences, cause regional differences in antibiotic
use. The study investigates these factors systematically, highlighting the demand for
better antibiotic stewardship. Some recommendations include increased practitioner
accountability for prescribing and the exploration of antibiotic substitutes.
-This article explores the intricate causes of antibiotic usage from a comprehensive
angle. It offers depth in its examination of the complete therapeutic ecology.
However, it lacks details on how to apply these broad remedies, such as practitioner
responsibility and improved communication. Further research is necessary to address
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the call for caregivers to serve as diagnosticians. Additionally, despite suggesting
fewer economic effects, it has yet to offer concrete suggestions for how to do so.
Lampi, E., Carlsson, F., Sundvall, P. D., Torres, M. J., Ulleryd, P., Åhrén, C., & Jacobsson,
G. (2020). Interventions for prudent antibiotic use in primary healthcare: An
econometric analysis. BMC Health Services Research, 20(1), 1-11.
https://doi.org/10.1186/s12913-020-05732-2
– In the fight against antibiotic resistance, rational antibiotic prescription is essential.
Utilizing data from 2011 to 2014 in western Sweden, this study examines the effects
of two interventions—an informational visit and a self-evaluation meeting—on
antibiotic prescription rates in primary healthcare facilities. The educational
intervention briefly decreased prescriptions in public healthcare facilities, but the selfevaluation meeting did not reveal any appreciable effects. The findings indicate the
need for diverse strategies to successfully reduce antibiotic usage in primary
healthcare and draw attention to the shortcomings of single educational programs.
-This study highlights the need to use multiple tactics when prescribing antibiotics
and offers insightful information. Its retrospective study offers a thorough breakdown
of the interventions’ efficacy. The study’s lack of precise qualitative data, however,
restricts the scope of the investigation. Also unknown are the precise causes of the
educational intervention’s transient effects. Despite these drawbacks, the study
emphasizes the difficulty of behavioural change in healthcare practices.
Luo, Y., Guo, Z., Li, Y., Ouyang, H., Huang, S., Chen, Y., … & Liu, X. (2023).
Appropriateness of Empirical Antibiotic Therapy in Hospitalized Patients with
Bacterial Infection: A Retrospective Cohort Study. Infection and Drug Resistance,
4555-4568. https://doi.org/10.2147/IDR.S402172
5
– This study analyzes empirical antibiotic therapy (EAT) in hospitalized patients with
bacterial illnesses, concentrating on inappropriate and excessive antibiotic use. The
research demonstrates the widespread frequency of improper and excessively broadspectrum antibiotic prescriptions, with almost half of the patients receiving improper
EAT and more than half of those receiving unnecessarily broad-spectrum antibiotics.
Infection with Multidrug-Resistant Organisms was related to IEAT and unnecessary
broad-spectrum antibiotics. The study stresses the necessity for prudent antibiotic
choices based on patient variables, suspected infection site, pathogen susceptibility,
and local resistance patterns.
-This study provides a detailed examination of empirical antibiotic use, shedding light
on the occurrence and effects of improper and excessive prescriptions. The research
offers valuable insights into factors influencing antibiotic selections, highlighting the
influence of MDROs and underlining the need for judicious judgments based on
numerous considerations. However, the study’s shortcomings, particularly its singlecentre emphasis and potential biases in patient selection, need consideration.
Nepal, P., Subedee, A., Shakya, H., Poudel, S., Joshi, S., Karki, K., … & Acharya, Y. (2023).
Protocol for a randomized controlled trial on community education and surveillance
on antibiotics use among young children in Nepal. Contemporary Clinical Trials
Communications, 101177. https://doi.org/10.1016/j.conctc.2023.101177
– This study tackles antimicrobial resistance in low and middle-income countries,
focusing on non-prescribed antibiotic usage among young children in Nepal. The
project intends to examine the impact of an educational intervention for parents given
by community nurses through videos, text messages, and brochures. Additionally, the
study tracks antibiotic use using a smartphone-based application. This method,
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focusing on modifying patient behaviour, corresponds with Nepal’s Antimicrobial
Resistance Containment Action Plan.
-This revolutionary work addresses a significant issue, adopting creative approaches
to prevent AMR. Focusing on the demand side, particularly influencing patient
attitudes, is innovative and vital. Using smartphone applications coincides with
Nepal’s digital landscape, improving the study’s relevance. However, the study’s
location in Kathmandu Valley might limit generalizability to other areas of Nepal.
The self-reported nature of data presents potential biases, although attempts to involve
research arms and monthly incentives offset this. The study’s emphasis on identifying
population-specific impacts enables future scalability.
Silfwerbrand, E., Verma, S., Sjökvist, C., Stålsby Lundborg, C., & Sharma, M. (2019).
Diagnose-specific antibiotic prescribing patterns at otorhinolaryngology inpatient
departments of two private sector healthcare facilities in Central India: a five-year
observational study. International Journal of Environmental Research and Public
Health, 16(21), 4074. https://doi.org/10.3390/ijerph16214074
– This study looked at the five-year trends in antibiotic prescriptions in the ENT
inpatient units of two private Indian hospitals. The study focused on detecting
particular antibiotic diagnoses for individuals older than 15. It examined patterns in
antibiotic use for various diagnostic groups, including non-surgical, surgical, and
chronic suppurative otitis media. Most prescriptions were long-term empirical, with
little reliance on microbiology research.
-One benefit of the study is that it focuses on private healthcare facilities serving a
substantial section of the Indian population. The authors admit that assessing the
results without perioperative remarks might have been more challenging. The huge
sample size and rigorous monitoring limit the harm even if there is a risk of human
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mistakes during data collection. The study emphasizes the inadequacy of applying
international standards without considering local context and data, underscoring the
need for tailored antibiotic prescribing guidelines.
Vieira Filho, J. F., Ribeiro, V. N., do Nascimento, Á. M. A., & Maria Alves de Melo, M.
(2023). Infections in Children with Cancer Admitted in an Oncology Reference
Hospital: A Cross-sectional Study. Current Microbiology, 80(9), 315.
https://doi.org/10.1007/s00284-023-03420-y
– With a focus on 168 infection occurrences involving 96 patients from 2018 to 2021,
this paper examines the infection profile of pediatric oncology patients in a Brazilian
hospital. It demonstrates that hematological malignancies, primarily acute lymphoid
leukemia, were present in 62.4% of infected patients. Escherichia coli (31.9%) was
the most common bacteria, and 52% was multidrug resistant. The report underscores
how crucial epidemiological research is to setting up guidelines and preventing
infections in pediatric oncology.
-This study offers important information on infections in immunocompromised
pediatric oncology patients that is essential for healthcare planning. The research’s
strength is its thorough examination of antibiotic resistance and illness patterns. Its
main drawback is the study’s single-centre focus, which may need to be sufficiently
generalizable. The results do, however, underline the critical need for targeted
antibiotic regimes and the difficulties multidrug-resistant pathogens present in
pediatric oncology settings.
Wei, J., Wang, Y., Chen, C., & Lin, J. (2022). Risk factors associated with methicillin
resistance in hospitalized newborn infants with Staphylococcus aureus
infection. Infection and Drug Resistance, 2921-2928.
https://doi.org/10.2147/IDR.S367912
8
– This study examines methicillin-resistant Staphylococcus aureus infections in
hospitalized newborns to identify risk variables and recommend empirical antibiotics.
Findings show that breastfeeding exclusively protects against MRSA, while prior
antibiotic treatment lasting more than 48 hours considerably increases the risk.
Neonatal MRSA infection increases the need for prudent antibiotic administration and
supports breastfeeding in neonatal care, resulting in lengthier hospitalization and
higher costs.
-This study in a renowned Chinese pediatric facility provides crucial new information
about neonatal MRSA infections. Its key strength is pinpointing essential risk factors,
such as the duration of antibiotic use and the effects of nursing on MRSA
susceptibility. Future multi-center investigations are likely required due to the study’s
limitations, which include its single-center nature and sample size. However, the
study emphasizes reducing antibiotic misuse and encouraging breastfeeding in
newborns, guiding focused measures to lower MRSA infections and healthcare
expenses.
Willems, J., Hermans, E., Schelstraete, P., Depuydt, P., & De Cock, P. (2021). Optimizing
the use of antibiotic agents in the pediatric intensive care unit: a narrative
review. Pediatric Drugs, 23(1), 39-53. https://doi.org/10.1007/s40272-020-00426-y
– To prevent resistance and ensure effective treatment, this article examines the
difficulties associated with the correct antibiotic prescription in critically ill children.
The review talks about how difficult it can be to interpret diagnostic data and
emphasizes how crucial it is to tell bacterial infections from inflammatory disorders.
New biomarker research, a review of dosage regimens, and incorporating safe
prescribing practices into outreach initiatives are all encouraged, particularly in
settings with limited resources.
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-The authors emphasize the complexity of interpreting diagnostic data and separating
infections from inflammatory diseases as they analyze the challenges of adopting
accurate antibiotic regimens for critically unwell infants. The article calls for more
investigation into biomarkers, dosage effects on seriously ill patients, and behavioral
elements of prescribing, which are its most vital points. The absence of specific
studies listed is one of the drawbacks; hence, more research will be needed to
transform theoretical concepts into real-world, therapeutically valuable results.
10
References
11
12
1
Annotated Bibliography on Artificial Intelligence
Name of Student
Institutional Affiliation
Course
Date
2
Annotated Bibliography on Artificial Intelligence
Clement, J., & Maldonado, A. Q. (2021). Augmenting the transplant team with artificial
intelligence: Toward meaningful AI use in solid organ transplant. Frontiers in
immunology, 12, 694222. https://doi.org/10.3389/fimmu.2021.694222
-The article addresses how artificial intelligence (AI) might be used in the transplant
industry. By foreseeing patient-specific outcomes and overcoming human biases, it
investigates how AI might improve decision-making procedures. In creating
Transplant AI teams, the authors stress the importance of interdisciplinary
collaboration between clinicians, administrators, AI specialists, and ethicists.
Additionally, the article raises important issues on the need for ethical disclosure,
assessing AI’s efficacy, and including AI in shared decision-making models.
-The essay thoroughly analyses AI applications in transplantation, covering its
strengths and weaknesses. The suggested multidisciplinary strategy for Transplant AI
teams increases the article’s legitimacy. However, the depth of its appraisal is
constrained by the absence of concrete instances or case studies. Despite this, the
study is a valuable tool for academics and medical professionals, sparking vital
discussions on the integration of AI, standards for evaluation, and moral issues related
to transplantation.
Dolgikh, S. (2021). A collaborative model for integration of artificial intelligence in primary
care. Journal of Human, Earth, and Future, 2(4), 395-403.
https://doi.org/10.28991/HEF-2021-02-04-07
– The article analyzes the possibility of incorporating Artificial Intelligence (AI)
techniques into primary care while discussing the rising expenses of healthcare caused
by diagnostic mistakes. It draws attention to the difficulties that arise when human
variables, including stress and exhaustion, play a role in misdiagnosis. The paper
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suggests a strategy to increase diagnosis accuracy without sacrificing control and
safety by fusing human expertise and AI technology. It highlights the requirement for
AI system confidence and promotes strong validation and explainability.
-This study promotes a hybrid strategy that uses AI in primary care while seriously
addressing the difficulties of misdiagnosis. The study’s strength is in its ability to
acknowledge the difficulties posed by human elements while using AI’s reliable
performance. The article is theoretical and it needs concrete examples or case studies.
It provides insightful information about the application of AI in healthcare,
highlighting the significance of safety and trust.
Fdez-Olivares, J., Onaindia, E., Castillo, L., Jordán, J., & Cózar, J. (2019). Personalized
conciliation of clinical guidelines for comorbid patients through multi-agent
planning. Artificial intelligence in medicine, 96, 167-186.
https://doi.org/10.1016/j.artmed.2018.11.003
– This article suggests the Multi-Agent Planning (MAP) framework to reconcile
clinical recommendations in comorbid patients while including patient preferences.
Individual disease criteria, managing interactions, and preferences through
computerized planning processes are all included in the strategy. Qualitative and
quantitative patient preferences are introduced in the study, and preference disputes
are addressed through guideline conciliation. The approach uses temporal
Hierarchical Task Network (HTN) planning and agent coordination to create
individualized, flexible treatment plans that guarantee openness and transparency.
– The study offers a solid framework that uses MAP and HTN planning to manage
complicated relationships and patient preferences in comorbidity. The approach offers
valuable insights for research on antibiotic usage among children in healthcare
because of its transparent decision-making process and potential for interactive
4
additions, which boost its application in individualized healthcare settings. For a
thorough practical application, more research into the plan execution and patient
interface components is necessary.
Giordano, C., Brennan, M., Mohamed, B., Rashidi, P., Modave, F., & Tighe, P. (2021).
Accessing artificial intelligence for clinical decision-making. Frontiers in digital
health, 3, 645232. https://doi.org/10.3389/fdgth.2021.645232
-This article examines how healthcare systems using electronic health record (EHR)
data can incorporate artificial intelligence (AI), particularly machine learning and
deep learning. It discusses how EHR systems are widely used and how AI could be
applied. The paper focuses on applying AI in risk stratification, patient outcome
optimization, and complex healthcare decision-making. It draws attention to the
difficulties with interpretability, bias, and ethical issues surrounding the use of AI in
healthcare.
-The article thoroughly analyzes AI’s effect on healthcare, highlighting its
opportunities and difficulties. Its assessment of how well AI has been incorporated
into medical practice provides insightful information. However, the article’s practical
usefulness may be constrained by the need for more specific examples or case studies
to support its arguments. The issue of bias and interpretability is essential because it
highlights the necessity of continual medical education.
Hryciw, B. N., Fortin, Z., Ghossein, J., & Kyeremanteng, K. (2023). Doctor-patient
interactions in the age of AI: navigating innovation and expertise. Frontiers in
Medicine, 10. https://doi.org/10.3389%2Ffmed.2023.1241508
-Besides examining patient empowerment and the ethical issues raised by AI adoption
in healthcare, this article looks into the challenges of incorporating AI-generated
medical views into doctor-patient relationships. It discusses how the relationship
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between doctors and patients changes and emphasizes the importance of open
communication and teamwork. To ensure responsible AI integration in healthcare, the
authors emphasize the significance of patient-centred care models and training
healthcare practitioners and patients.
-The paper thoroughly investigates the issues raised by AI integration in healthcare,
including insightful information on patient empowerment and moral conundrums. It
assesses the possibilities of AI while emphasizing communication and cooperation
between doctors and patients. However, it draws attention to worries about false
information, prejudices, and the requirement for effective training programs. The
authors support open communication to uphold confidence and promote responsible
AI use in healthcare settings. They also call for a careful balance between AI and
human expertise.
Johnson, E. A., Dudding, K. M., & Carrington, J. M. (2023). When to err is inhuman: An
examination of the influence of artificial intelligence‐driven nursing care on patient
safety. Nursing Inquiry, e12583. https://doi.org/10.1111/nin.12583
-This article explores the use of artificial intelligence (AI) in nursing care,
emphasizing how it affects patient security and professional judgment. It addresses
how the rapidly advancing use of technologies like sensors, wearables, and robotics
has blurred the distinctions between human-driven and AI-driven care. While
highlighting the indispensable nature of human judgment and compassionate care, it
discusses the potential effects of AI in enhancing nursing practices.
-The paper analyzes the changing nature of nursing care in light of AI integration,
recognizing the possible advantages while highlighting the lasting value of human
discretion and compassion. It highlights the current inadequacies in regulatory
frameworks and the urgent need for nurse involvement in developing AI rules and
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models. The topic of transhumanism offers a distinct viewpoint and invites readers to
consider the moral implications of healthcare that incorporate AI, which makes it an
essential contribution to the conversation about AI in nursing practice.
Lynn, L. A. (2019). Artificial intelligence systems for complex decision-making in acute care
medicine: a review. Patient safety in Surgery, 13(1), 6.
https://doi.org/10.1186/s13037-019-0188-2
-This article analyzes the advantages and potential drawbacks of integrating artificial
intelligence (AI) into acute care settings. It highlights the necessity of proactive
measures to keep human oversight in patient care, even with AI aid. It also analyzes
the shortcomings of current hospital standards. It emphasizes the significance of open
communication between AI systems and healthcare practitioners during patient
handoffs.
-The study thoroughly examines the difficulties associated with AI integration in
acute care, emphasizing the importance of open communication between AI and
physicians. It highlights the various intricacies of medical practice that AI may not
fully understand while acknowledging the potential benefits of AI in medical
decision-making while also raising serious concerns about the risks associated with it.
The suggested steps for medical education adoption show a careful approach to
educating medical professionals for the future, ensuring they can work well with AI
systems while upholding patient safety and high standards of care.
Saleh Ibrahim, Y., Khalid Al-Azzawi, W., Hamad Mohamad, A. A., Nouri Hassan, A., &
Meraf, Z. (2022). Perception of the Impact of Artificial Intelligence in the DecisionMaking Processes of Public Healthcare Professionals. Journal of Environmental and
Public Health, 2022. https://doi.org/10.1155/2022/8028275
7
-This article examines how artificial intelligence (AI) is affecting how doctors of
optometry and dentists make decisions in the medical field. The study assesses the
technology employed and the advantages, difficulties, and views on the effects of AI.
Diagnoses are aided in ophthalmology by technologies like fundus photography and
optical coherence tomography, which are widely used.
-The integration of AI in ophthalmology and dentistry is thoroughly analyzed in this
study, highlighting major innovations and practical uses. The paper does an excellent
job of highlighting advantages, including better patient satisfaction and diagnoses.
The examination is made more thorough by including issues like cost and credibility.
However, the study recognizes the value of human participation and highlights the
indispensable nature of healthcare workers in patient care. The thoughtful approach
shown in the recommendations for additional research demonstrates the study’s
applicability to experts, programmers, and decision-makers in the developing field of
AI-driven healthcare.
Saqib, M., Iftikhar, M., Neha, F., Karishma, F., & Mumtaz, H. (2023). Artificial intelligence
in critical illness and its impact on patient care: a comprehensive review. Frontiers in
Medicine, 10, 1176192. https://doi.org/10.3389/fmed.2023.1176192
-The possible uses of artificial intelligence (AI) in critical care are examined in this
article, focusing on how these technologies can improve patient outcomes by
recognizing diseases and foreseeing pathological changes. It also focuses on assisting
clinicians in making decisions, and providing recommendations that can be easily
understood. The report emphasizes the rising body of top-notch research in the area
while highlighting the potential of AI in tackling the difficulties of critical care
despite its limitations.
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-The paper thoroughly reviews AI’s potential in critical care, highlighting its
numerous applications from disease diagnosis to individualized patient care. The
report needs to, however, go into great detail on the unique restrictions and difficulties
faced by AI in critical care. Nevertheless, the essay is helpful because it sheds light on
the constantly changing environment of AI applications in healthcare while
emphasizing the necessity for continued study and ethical issues.
Thavanesan, N., Vigneswaran, G., Bodala, I., & Underwood, T. J. (2023). The Oesophageal
Cancer Multidisciplinary Team: Can Machine Learning Assist DecisionMaking?. Journal of Gastrointestinal Surgery, 27(4), 807-822.
https://doi.org/10.1007/s11605-022-05575-8
-This study investigates how the Upper Gastrointestinal Multidisciplinary Team for
patients with oesophageal cancer might include machine learning (ML) methods in
their decision-making procedures. The study, which focuses on predictive tools to
improve patient outcomes, highlights the promise of ML in automating workflow,
extracting insights from imaging data, and improving complex decision-making in
treating oesophageal cancer. It also tackles difficulties such as data noise.
-The paper presents a distinctive viewpoint on how machine learning (ML) might be
used to inform decisions on how to treat oesophageal cancer. Its merits are a
comprehensive examination of the literature and articulating the Multidisciplinary
Team’s difficulties. It is a valuable tool that emphasizes the significance of datadriven tools in intricate healthcare contexts. It is pertinent to the research focus on
pediatric antibiotic use, needing more comparative analysis and in-depth answers to
problems.
9
References
10
Library Assignment Instructions for Nursing Students
Purpose:
The purpose of this library assignment is to help nursing students to develop their research skills and to become familiar with different credible data sources available through the Library page at the FNU.edu website. In addition, this assignment will help students to apply the PICOT (Population, Intervention, Comparison, Outcome, and Time) question format to develop a research question and to locate and evaluate scholarly sources.
Instructions:
Topic Selection: Select a topic that interests you and that is relevant to nursing Psychiatric practice. Your topic should be broad enough to allow for an in-depth exploration but narrow enough to be manageable within the scope of an 850-1000-word research paper. You may select a topic related to patient care, nursing education, health promotion, or any other area of nursing practice that interests you.
Searching for Literature: Use the Library page at the FNU.edu website to search for scholarly sources related to your topic. You must utilize at least 3 scholarly sources that have been published within the last 5 years. You may use databases such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Be sure to use appropriate keywords and to apply search filters to limit your search to scholarly, peer-reviewed articles.
Evaluating Sources: Once you have identified potential sources, use the CRAAP test (Currency, Relevance, Authority, Accuracy, and Purpose) to evaluate their credibility and relevance to your research question. Be sure to select sources that are relevant to your topic, written by credible authors, and based on rigorous research methods.
Writing the Paper: Your research paper should follow APA 7 guidelines and include the following sections: Introduction, Literature Review, Methodology, Results, Discussion, and Conclusion. Be sure to use in-text citations and to include a reference list at the end of your paper.
Please keep in mind that the paper will be checked for plagiarism, and similarity above 25% will not be accepted for submission.
Grading Criteria:
Your research paper will be graded based on the following criteria:
PICOT question format (10 points)
Use of at least 3 scholarly sources published within the last 5 years (10 points)
Credibility and relevance of sources (10 points)
APA 7 formatting, including in-text citations and reference list (10 points)
Introduction (10 points)
Literature Review (20 points)
Methodology (20 points)
Results (10 points)
Discussion (10 points)
Conclusion (10 points)
Evaluate one of the ICT challenges identified by the Ministry of Health listed below. Describe the eHealth ICT challenge you select and research the leadership required to achieve Vision 2030 objectives that will deliver good health and well-being. Technology challenges include the availability of services and support, the different levels of eHealth maturity, standardization, connectivity, and clinical collaboration. The MOH developed the vision for eHealth by supporting care for patients, connecting providers at all levels, and measuring medical error reporting and patient experience reporting in the MOH effort to transform the Saudi health system. The MOH states that the eHealth /ICT strategy is to achieve “A safe, quality health system, based on patient-centric care guided by standards, enabled by eHealth”(Alymeni, 2013).
* Consistency and quality in health care services and facilities
* Availability and continuity of services across a very broad and diverse geography
* Access to current, comprehensive, and accurate patient information at the point of care
* Standard reporting from regions and facilities to plan, manage, and detect trends
* Collaboration with other sectors that provide Health Services to patients
* Recruiting, training, and retaining professionals and top talent
* Managing and planning health services for an increasing number of visitors, and managing the risk of infectious disease during the Hajj (and Umrah)
* Addressing issues faced by our health system and care providers such as increasing motor vehicle accidents and chronic disease
Outline for the written assignment:
* Introduction
* HIS Innovations in Saudi Arabia
* Equitable care standards
* Governance and accountability
* Quality and performance
* Drivers of ICT Success
* Conclusion
Requirements:
* Your paper should be four to five pages in length, not including the title and reference pages.
* You must include a minimum of four credible sources. Use the Saudi Electronic Digital Library to find your resources.
* Your paper must follow Saudi Electronic University academic writing standards and APA style guidelines, as appropriate.
* You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
Review the interactive media under Required Media: Branching exercise. This is provided in the Learning Resources.
Review the information provided in the case (patient presentation, vital signs, pmh, home meds, results of labs and diagnostics. With this information, critically think about what is happening with the patient.
Use your critical thinking skills and current guidelines to develop orders. Include additional labs/diagnostics, what needs repeated and followed up on. Medications that need to be ordered or changed.
The Assignment:
Using the required admission orders template found under the Learning Resources: Required Reading.
Develop a set of orders as the admitting provider.
Be sure to address each aspect of the order template
Write the orders as you would in the patient’s chart. Be specific. Do not leave room for the nurse to interpret your orders.
Do not assume anything has already been done/order. Use the information given. Example: If the case does not mention fluids were given, the patient did not receive fluids. You may have to start from scratch as if you are working in the ER. And you must provide orders if the patient needs to be admitted.
Make sure the order is complete and applicable to the patient.
Make sure you provide rationales for your labs and diagnostics and anything else you feel the need to explain. This should be done at the end of the order set – not included with the order.
Please do not write per protocol. We do not know what your protocol is and you need to demonstrate what is the appropriate standard of care for this patient.
A minimum of three current (within the last 5 years), evidenced based references are required.
Required Media: Branching exercise:
BACKGROUND
A 68-year-old female is brought to the hospital from the acute rehabilitation facility with complaints of shortness of breath and productive cough for 1 week. She was started on ciprofloxin 3 days ago, but her symptoms have continued to worsen. Her past medical history includes hypertension, hypothyroidism. She underwent a right knee replacement 2 weeks ago. Current medications include lisinopril 10mg, levothyroxine 75mcg, rivaroxaban 10mg daily and ciprofloxacin 500mg Q12. Her current symptoms include fever, chills, productive cough with purulent green sputum, and worsening shortness of breath. She is allergic to morphine. The patient is a full code. EXAM
Current vital signs T 102.6 HR 92. RR 22 BP 128/82. O2 saturation is 96% on 4L of O2
Chest x-ray shows consolidation in the right lower lobe.
CBC and CMP are all within normal limits.
This patient meets the criteria for hospital acquired pneumonia (HAP) due to her surgery 2 weeks ago and inpatient stay at the rehabilitation facility. She is at risk of drug resistant bacteria and MRSA. . A three-drug combination for broad spectrum coverage is indicated until culture and sensitivity report on her sputum is available and antibiotic de-escalation can occur. The patient’s culture and sensitivity report for sputum and blood culture is now available. Staph aureus grew from the sputum culture. Utilizing this information, what adjustments to the patients’ antibiotics would you make for admission?
The sensitivity report indicates that the bacteria in the sputum and blood is sensitive to piperacillin/tazobactam. Continuing it and discontinuing the other antibiotics will still provide good coverage for this infection.
The patient requires oxygen to maintain her O2 saturation at the low normal range. The safest option for the patient is to admit her to make sure her oxygen requirements do not need increasing with further intervention. A PICC can be placed for antibiotic therapy.
Unformatted Attachment Preview
Admission Orders Template
Primary Diagnosis:
Status/Condition (Critical, Guarded, Stable, etc.):
Code Status:
Allergies:
Admit to Unit:
Activity Level:
Diet:
IV Fluids:
•
Critical Drips (If ordered, include type and rate. Do not defer to ICU protocol.):
Respiratory: Oxygen (If ordered, include type and rate.), pulmonary toilet needs, ventilator settings:
Medications (include ALL, tx of primary condition, underlying conditions, pain, comfort needs, etc., dose and route):
Nursing Orders (vital signs, skin care, toileting, ambulation, etc.):
Follow-Up Lab Tests:
•
Diagnostic testing (CXR, US, 2D Echo, etc.):
Consults:
NOTE: (Do not defer management to a specialist. As an ACNP, you must manage the patient’s acute needs for at least a
24-hour period]. Include indication for consult. For example: “Cardiology consult for evaluation of new-onset atrial
fibrillation,” or “Nutrition consult for TPN recommendations.”
Patient Education and Health Promotion (address age-appropriate patient education. if applicable):
Discharge Planning and Required Follow-Up Care:
References (minimum of three timely references that prove this plan follows current standards of care):
This assignment is for 2 discussions please include 250- 300 words and 1reference per discusion. Each discussion will need 2 peer responses. Each one should include 150 words and 1 references. Discussion 1Describe how the educational level achieved by a nurse or the entry point into professional nursing practice affects the quality and competence of a nurse’s participation in policy making. Why it is important for registered nurses to influence the regulatory process? Does the nurses education have influence on their ability to make an impact? Discussion 2Reflect on what you have learned in this course. What were your major takeaways? Surprises? How will you apply what you have learned to your career?
IRB is an important step in the research process. State the required components one should look for in a project to determine if IRB submission is needed. Discuss an example of a research study in one of your literature review articles that needed IRB approval, and describe why IRB approval was needed in this instance.
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeInitial Response Timing
1 to >0.0 pts
Proficient
On time (posted by Wednesday, 11:59 p.m. of the week in which assigned)
0 pts
Acceptable
n/a You will either receive 100 or 0.
0 pts
Needs Improvement
n/a You will either receive 100 or 0.
0 pts
Unsatisfactory
Late (did not submit by Wednesday, 11:59 p.m. of the week in which assigned)
1 pts
This criterion is linked to a Learning OutcomeEvidence of Critical Thinking: Initial Responses to Discussion Prompt(s)
3 to >2.76 pts
Proficient
Applies course content sufficiently by expanding on the main points of the prompt. Responses exhibit critical thinking and analysis. There is a significant correlation to course materials, national guidelines, and evidence-based research.
2.76 to >2.46 pts
Acceptable
Content knowledge is exhibited by identification of the main topics. There is some evidence of critical thinking and analysis. Responses may be insufficient or lacking in detail.
2.46 to >2.25 pts
Needs Improvement
An understanding of content knowledge is poorly exhibited and insufficient in critical thinking, analysis, and detail. Some main discussion topics are not covered, or they significantly digress from the topic at hand.
2.25 to >0 pts
Unsatisfactory
An initial response is missing or provides no indication of understanding. Main topics are not covered.
3 pts
This criterion is linked to a Learning OutcomeWord Count Initial Post
0.5 to >0.0 pts
Proficient
The initial post is 300 words or more.
0 pts
Acceptable
n/a You will either receive 100 or 0.
0 pts
Needs Improvement
n/a You will either receive 100 or 0.
0 pts
Unsatisfactory
The initial post has fewer than 300 words.
0.5 pts
This criterion is linked to a Learning OutcomeFrequency of Participation and Minimum Posting Requirements
1 to >0.0 pts
Proficient
Responses to peers’ initial posts occur throughout the week with replies to peers and/or instructors present on two or more days. A minimum of 2 replies on 2 separate days per weekly prompt is evident.
0 pts
Acceptable
Responses to peers’ initial posts do not occur throughout the week with replies to peers and/or instructors present on two or more days. Less than a minimum of 2 replies on 2 separate days per weekly prompt is evident.
0 pts
Needs Improvement
n/a You will either receive 100 or 0.
0 pts
Unsatisfactory
n/a You will either receive 100 or 0.
1 pts
This criterion is linked to a Learning OutcomeEvidence of Critical Thinking: Responses to Peers and/or Instructors
3 to >2.76 pts
Proficient
Well-developed and insightful replies provide an opportunity for response. Responses promote discussion either by sharing prior knowledge and experiences, making meaningful connections with course content, asking meaningful questions, or challenging viewpoints. There is a significant correlation of student ideas to course materials, national guidelines, and evidence-based research.
2.76 to >2.46 pts
Acceptable
Somewhat developed replies provide some opportunity for response. Responses contribute to the discussion either by sharing prior knowledge and experiences, making connections with course content, or asking questions.
2.46 to >2.25 pts
Needs Improvement
Poorly developed replies provide little or no opportunity for response. Responses do little to contribute to the discussion.
2.25 to >0 pts
Unsatisfactory
Responses are severely limited; no critical thought is present.
3 pts
This criterion is linked to a Learning OutcomeWriting Mechanics
1.5 to >1.38 pts
Proficient
The writing is clear, concise, formal, and organized. Responses contain a maximum of 2 errors in spelling and grammar. Sources are paraphrased, referenced, and cited correctly in current APA style in all but 1 or 2 instances.
1.38 to >1.23 pts
Acceptable
The writing is generally clear and organized but is not concise or formal in language. Responses contain 3- to 5 errors in spelling and grammar with minor interference with readability or comprehension. Sources are paraphrased, referenced, and cited correctly in current APA in all but 3 or 4 instances.
1.23 to >1.13 pts
Needs Improvement
The writing is unclear and unorganized. Responses contain more than 5 errors in spelling and grammar that detract from the readability of the paper. Sources are missing or they are improperly cited; APA style is barely evident.
1.13 to >0 pts
Unsatisfactory
Extensive errors in spelling and grammar detract from readability and comprehension, and/or the writing includes slang or is inappropriate for academic discourse. APA style is not evident.
Public health nurses play an important role in addressing the health needs identified during the assessment process. Only by close examination of health data can health professionals identify health disparities and take steps to address them. Numerous sources of community-level health data are available to guide public health nurses as they partner with communities in the pursuit of health for all. It is vital that all public health professionals have an understanding of the health status of their city, county, region, state, and nation, as well as global health issues of concern. This week, you will analyze health indicators for your own community, identify potential health disparities seen in your own area, and then compare your findings with your classmates from across other localities.
To Prepare
Take the Health Equity Quiz found on the Unnatural Causes website.https://unnaturalcauses.org/interactivities_01-1.p…
Research health indicators (outcomes) for your state, city, and/or county.
Research a state other than your own that is similar demographically with higher health indicators.
assisgnment
Post a health indicator for which your state ranks high and explain why you think your state ranks high on this indicator. Then, identify a health indicator for which your state ranks low and explain why you think your state ranks low on this indicator. (washington DC)
Compare your findings to a state that is similar to yours demographically but has higher indicators. Explain why you think this state is achieving higher health indicators than yours.
USW1_NURS_6710_Week09_Discussion_Rubric
Criteria Ratings Pts
Main Posting
50 to >44.0 pts
Excellent
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
44 to >39.0 pts
Good
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
39 to >34.0 pts
Fair
Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.
34 to >0 pts
Poor
Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
For this assignment, create a fictitious patient within the population you selected for the assignment in Topic 4 and complete the three parts of the assignment for your patient, as outlined below
Population- Hypertension
Part 1: Risk Factors, Quality Indicators, and CAM:
Identify the following regarding the health of your fictitious patient:
Risk factors associated with the patient’s demographics.
Complementary and alternative medicines (CAM).
Quality indicators specific to the patient.
Part 2: History and Physical
Develop a history and physical (H&P) examination for the fictitious patient chosen. In previous courses in the program, you have used this subjective, objective, assessment, and plan format to document H&P examinations. Refer to the “History and Physical Note” template to complete this assignment.
Part 3: Model or Plan of Care
Develop a model or plan of care for the patient population pertinent to the above-mentioned patient. This could include community or health system programs as an approach or what seems appropriate. Incorporate the 6 components of the chronic care model in your model or plan of care.
Self-management support
Community resources
Health system
Delivery system design
Decision support
Clinical information systems
General Requirements
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines,
This assignment comes in 2 parts. For part 1 you will use 250-300 words and 1 reference. This part also will need 2 peer responses, each one of 150 words and 1 reference.
PART 1: Week 8 Discussion Forum
Select one of the future issues presented this week. ( topic selected is Changes in healthcare employnment settings) Examine the issue in terms of cultural diversity, health promotion, and communication methods. Discuss in detail how this issue affects healthcare delivery and advanced nursing.Philosophy of Nursing Part 2 Paper-, worth 100 points.
PART 2: As you finish this course, your philosophy of nursing has probably changed. As a final review, polish your philosophy of nursing based on your newly acquired knowledge. For this paper, you will be using the Philosophy paper you turned in in week 1. (I will be attaching paper)
Then, after the Reference page, simply write out each numbered question and briefly answer it.
As an art and as a science, how has your personal nursing philosophy unfolded?
Have there been ideas that have challenged your personal values or assumptions?
Have there been ideas that have caused you personal conflict and may lead to deconstructing those dispositions in a critical manner?
What actions do you take that illustrate your personal nursing philosophy?
Describe your own definition of the concepts involving the metaparadigm of nursing
Has your first written philosophy of nursing changed? In what ways?
Attach these Q/A (questions and answers) to the end of your Philosophy Paper and submit in the appropriate place in week 8.
Also, write a summary reflection answering the following questions based on the readings and discussions throughout the course:
As an art and a science, how has your personal nursing philosophy unfolded?
Have there been ideas that have challenged your personal values or assumptions?
Have there been ideas that have caused you personal conflict and may lead to deconstructing those dispositions in a critical manner?
What actions have you taken that illustrate your personal nursing philosophy?
Describe your own definition of the concepts involving the meta-paradigm of nursing.
Has your first written philosophy of nursing changed? In what ways?
Your paper that includes both your philosophy and reflection together should be 2–3 pages in length, in APA format, typed in Times New Roman with 12-point font, and double-spaced with 1″ margins. If outside sources are used, they must be cited appropriately.
NURS_500_DE – Philosophy Part II Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
50 to >41.0 pts
Meets Expectations
The writer clearly and effectively responds to the assignment, sharing his/her own nursing philosophy, which has changed over the course from the draft in week 1. A summary reflection is included that answers the following questions: • As an art and as a science, how has your personal nursing philosophy unfolded? • Have there been ideas that have challenged your personal values or assumptions? • Have there been ideas that have caused you personal conflict and may lead to deconstructing those dispositions in a critical manner? • What actions do you take that illustrate your personal nursing philosophy? • Describe your own definition of the concepts involving the metaparadigm of nursing • Has your first written philosophy of nursing changed? In what ways?
41 to >37.5 pts
Approaches Expectations
The response to the assignment is generally adequate, but may not answer all reflective questions posed.
37.5 to >0 pts
Does Not Meet Expectations
The writer does not respond to the assignment.
50 pts
This criterion is linked to a Learning OutcomeFocus and Detail
25 to >20.5 pts
Meets Expectations
There is a clear, well- focused topic (philosophy and concepts of the metaparadigm of nursing). Main ideas are clear and are well supported by detailed and accurate information.
20.5 to >18.75 pts
Approaches Expectations
There is one clear, well- focused topic. Main ideas are clear but are not well supported by detailed information.
18.75 to >0 pts
Does Not Meet Expectations
The topic and main ideas are not clear.
25 pts
This criterion is linked to a Learning OutcomeOrganization
15 to >12.3 pts
Meets Expectations
The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong.
12.3 to >11.25 pts
Approaches Expectations
The introduction states the main topic and provides an overview of the paper. A conclusion is included.
11.25 to >0 pts
Does Not Meet Expectations
There is no clear introduction, structure, or conclusion.
15 pts
This criterion is linked to a Learning OutcomeMechanics and APA
10 to >8.2 pts
Meets Expectations
The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.
8.2 to >7.5 pts
Approaches Expectations
The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly.
7.5 to >0 pts
Does Not Meet Expectations
The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are cited and referenced incorrectly, or citations and references are missing.
10 pts
Total Points: 100
Unformatted Attachment Preview
1
Florence Nightingale
Yenisleidy Gonzalez
West Coast University
NURS 500 Theoretical Foundations of Nursing Practice
Dr Jodi Lynn Kendrick
September 22, 2023
2
Florence Nightingale
Introduction
I chose the video about Nurse Florence Nightingale because she is considered to have
pioneered modern nursing. Even though there have been lots of changes over time, the proposals
she made and the observations she made have been very influential in modern healthcare. For
instance, she made nursing a professional area that was not only for peasants but also for the high
class. She also introduced the environmental theory that focuses on the nurses’ role in
manipulating the environments to ensure proper hygiene and lighting to improve patient
outcomes. Nightingale also encouraged data usage to track changes in healthcare through her
research and data collection and analysis to determine the health issues that impacted British
soldiers in the Crimean War. She also broke the bounds that prevented women from her class
from participating in their societies.
Agree or Disagree with Theorist
My philosophy is that nursing is a career that requires professionals to apply scientific
knowledge and liberal arts to help patients recover. Therefore, nurses establish conducive
internal and external environments for healing. The philosophy agrees with Nightingale’s
environmental theory. It was inspired by Nightingale and her life as a nurse and scholar.
Applying scientific information involves using empirical evidence to guide decisions. As
Nightingale said, hygiene, lighting, and temperature are important. In modern practice, nurses
perform more roles than outlined by Nightingale. However, their primary role remains ensuring
that patients receive the care they require to improve their conditions. Therefore, apart from
3
Nightingale’s theory, my philosophy is also based on my experiences and readings of other
theories that came after Nightingale’s theory was developed.
Surprised
I found it surprising that Florance Nightingale was from a very wealthy family and that
she would have chosen something else that was simpler but still chose to nurse. What shocks me
more is that she chose the path when society and her parents had different plans and negative
views about her work. Her struggle to change healthcare and nursing caused friction with her
family, but she still pursued it. In the 19th century, women of her class were supposed to find
husbands in high society events and marry and remain inactive. Her choice is shocking because
she did not have to struggle as much as she did when she would have chosen other, more fun
things to do that would align with the society of the time. Her mother had different plans for her.
However, Nightingale believed in her calling and did not hesitate to follow it even when it
seemed hard.
Recommendation
I found the video very helpful and insightful for any aspiring nurse. Hence, I would
recommend it to any nurse. It is generally accepted that Nightingale recommended practices that
are now commonplace in nursing. For instance, she used her influence to advocate for change.
An example is that she collected data during the Crimean War that showed that the many deaths
of soldiers due to preventable illnesses were preventable. She also advocated for changes that
improved people’s welfare and showed stakeholders at the time how they should improve
people’s lives. She used her name and knowledge to reach the important stakeholders and call for
the necessary changes. She also showed the necessity of formal training for nurses. Even though
4
she had a calling, she also sought formal training and research to better understand people’s
needs.
Conclusion
In conclusion, Florence Nightingale is among the most memorable and significant people
in nursing. Her work in the 19th century caused important changes in nursing that have enabled
the field to grow to its current heights. She made nursing a respectable career. Her environmental
theory showed the importance of the environment in people’s health outcomes and how nurses
can use it to optimize people’s outcomes. I chose the video because of its impact on me and my
personal philosophy. Therefore, I would recommend other students revise the video to
understand the profession’s history and appreciate the changes that have happened over time to
enable them to practice as they do now.
1
Florence Nightingale
Student name
West Coast University
NURS 500 Theoretical Foundations of Nursing Practice
Instructor name
September 22, 2023
2
Florence Nightingale
Introduction
I chose the video about Nurse Florence Nightingale because she is considered to have
pioneered modern nursing. Even though there have been lots of changes over time, the proposals
she made and the observations she made have been very influential in modern healthcare. For
instance, she made nursing a professional area that was not only for peasants but also for the high
class. She also introduced the environmental theory that focuses on the nurses’ role in
manipulating the environments to ensure proper hygiene and lighting to improve patient
outcomes. Nightingale also encouraged data usage to track changes in healthcare through her
research and data collection and analysis to determine the health issues that impacted British
soldiers in the Crimean War. She also broke the bounds that prevented women from her class
from participating in their societies.
Agree or Disagree with Theorist
My philosophy is that nursing is a career that requires professionals to apply scientific
knowledge and liberal arts to help patients recover. Therefore, nurses establish conducive
internal and external environments for healing. The philosophy agrees with Nightingale’s
environmental theory. It was inspired by Nightingale and her life as a nurse and scholar.
Applying scientific information involves using empirical evidence to guide decisions. As
Nightingale said, hygiene, lighting, and temperature are important. In modern practice, nurses
perform more roles than outlined by Nightingale. However, their primary role remains ensuring
that patients receive the care they require to improve their conditions. Therefore, apart from
3
Nightingale’s theory, my philosophy is also based on my experiences and readings of other
theories that came after Nightingale’s theory was developed.
Surprised
I found it surprising that Florance Nightingale was from a very wealthy family and that
she would have chosen something else that was simpler but still chose to nurse. What shocks me
more is that she chose the path when society and her parents had different plans and negative
views about her work. Her struggle to change healthcare and nursing caused friction with her
family, but she still pursued it. In the 19th century, women of her class were supposed to find
husbands in high society events and marry and remain inactive. Her choice is shocking because
she did not have to struggle as much as she did when she would have chosen other, more fun
things to do that would align with the society of the time. Her mother had different plans for her.
However, Nightingale believed in her calling and did not hesitate to follow it even when it
seemed hard.
Recommendation
I found the video very helpful and insightful for any aspiring nurse. Hence, I would
recommend it to any nurse. It is generally accepted that Nightingale recommended practices that
are now commonplace in nursing. For instance, she used her influence to advocate for change.
An example is that she collected data during the Crimean War that showed that the many deaths
of soldiers due to preventable illnesses were preventable. She also advocated for changes that
improved people’s welfare and showed stakeholders at the time how they should improve
people’s lives. She used her name and knowledge to reach the important stakeholders and call for
the necessary changes. She also showed the necessity of formal training for nurses. Even though
4
she had a calling, she also sought formal training and research to better understand people’s
needs.
Conclusion
In conclusion, Florence Nightingale is among the most memorable and significant people
in nursing. Her work in the 19th century caused important changes in nursing that have enabled
the field to grow to its current heights. She made nursing a respectable career. Her environmental
theory showed the importance of the environment in people’s health outcomes and how nurses
can use it to optimize people’s outcomes. I chose the video because of its impact on me and my
personal philosophy. Therefore, I would recommend other students revise the video to
understand the profession’s history and appreciate the changes that have happened over time to
enable them to practice as they do now.
College of Health Sciences
Department of Public Health
PAPER ASSIGNMENT COVER SHEET
Course name:
Introduction to Hospital Epidemiology
Course Code:
PHC 231
CRN:
14631
Assignment title or task:
(You can write a question)
Write in details about Quantitative Epidemiology
in the Healthcare Setting?
Student name:
Student ID:
Submission date:
Instructor name:
Mustafa Mohammed
Grade:
……. Out of 10
Instructions for submission:
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Length of the write-up should be 200-500 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Guidelines:Write the appropriate references using APA style, at least 3 references.Avoid plagiarism.Attach the power point file as a PPT and as PDF file.8-10 slides excluding the first (title slide), last slide (thank you slide), and references slide(s).
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
GROUP PRESENTATION COVER SHEET
Course name:
Chronic Disease Epidemiology
Course number:
PHC 331
CRN
12648
•
Title of group presentation Topic
Assignment title or task:
(You can write a question)
sickle cell Anemia
Name
ID
1.
Students name and ID
2.
3.
4.
5.
Submission date:
Instructor name
Ahmed Al Rasasi
Grade
… out of 5
Guidelines:
•
Write the appropriate references using APA style, at least 3 references.
•
Avoid plagiarism.
•
Attach the power point file as a PPT and as PDF file.
•
8-10 slides excluding the first (title slide), last slide (thank you slide), and references
slide(s).
Grading Criteria for the group presentation
Poor
1 pts
Organization Audience
cannot
understand
presentation because
there is no sequence
of information.
Subject
Student does not
Knowledge
have
grasp
of
information; student
cannot
answer
questions
about
subject.
Graphics
Student
uses
superfluous graphics
or no graphics
Mechanics
Student’s
presentation has four
or more spelling
errors
and/or
grammatical errors.
Group
Dynamics
Multiple
group
members
not
participating.
Evident
lack
of
preparation/rehearsal.
Dependence
on
slides.
Fair
2 pts
Audience has difficulty
following
presentation
because student jumps
around.
Good
3 pts
Student presents
information
in
logical sequence
which audience
can follow.
Student is uncomfortable Student is at ease
with information and can with
expected
answer only rudimentary answers to all
questions.
questions but fails
to elaborate.
Excellent
4 pts
Student
presents
information in logical,
interesting sequence which
audience can follow.
Student demonstrates full
knowledge (more than
required) by answering all
class
questions
with
explanations
and
elaboration.
Student occasionally uses Student’s graphics Student’s graphics explain
graphics
that
rarely relate to text and and reinforce screen text
support
text
and presentation.
and presentation.
presentation.
Presentation has three Presentation has Presentation
has
no
misspellings
and/or no more than two misspellings
or
grammatical errors.
misspellings
grammatical errors.
and/or
grammatical
errors.
Significant controlling by Slight domination All presenters knew the
some members with one of one presenter. information, participated
minimally contributing.
Members helped equally, and helped each
Primarily prepared but each other.
other as needed.
with some dependence on Very
well
just reading off slides.
prepared.
Total
(20)
Use this Word Document. Fill in students’ information on the first page of this document.Font should be 12 Times New RomanHeadings should be Bold Color should be BlackLine spacing should be 1.5Use reliable references (APA format)AVOID PLAGIARISM (you will get ZERO when there is plagiarism)You should use at least 2 referencesSubmit this WORD Document when you complete the required taskSubmission should be before the deadline (submission after the deadline is not allowed)For more resources, you can review appendix A and appendix B in Schiavo, R. (2014).
Unformatted Attachment Preview
PHC 312 Group Assignment Paper
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Health Communications
Course code:
PHC312
CRN:
Assignment title or task:
Students enrolled in PHC 312 in First term 2023 will be divided into groups (4-5 students per group). The first
section will be designed to gain general information about the communication program.
The second section will be designed to assess the student’s ability to draft a health communication plan. The
group has 5 points to cover under the general program information section. The main communication program
characteristics section will be designed to assess the group’s ability to provide basic information about the health
communication planning process.
The written health communication program plan must be completed and submitted to the instructor no later than
11:59 PM on (October 07, 2023).
General program information
1.
Name of the program.
2.
Country and region (if applicable) where the program is based.
3.
Time period (start and end dates).
4.
Funding sources.
5.
Give a short description of the program (maximum of about 250 words).
Main communication program characteristics
1.
Describe the overall goal of the program.
2.
List the SMART objectives of the program.
3.
Describe the target audience(s) of the program (primary and secondary audiences).
✓ Indicate the demographic and socioeconomic factors of the target population that have been measured. E.g.
age, gender, income/socioeconomic status, education, occupation…etc.
4.
Literature review: basing the communication program on current scientific knowledge and/or theoretical
models and/or previous experience from other projects? One or two paragraphs about the problem. (300-500
words).
5.
Describe the settings and communication channels.
6.
Describe the development process of messages.
7.
Describe the activities and timeline.
8.
Describe the process/impact/outcome evaluation of the communication program that will be measured.
Points that can be added as a bonus (NOT REQUIRED):
• Describe the needs assessment that has been carried out.
• Describe the environmental factors (i.e. factors beyond individual control) that the communication program
addresses, if any.
PHC 312 Group Assignment Paper
• Does the communication plan have a special focus on vulnerable groups (socioeconomically disadvantaged
people, ethnic minorities, children, elderly people, etc.)? if yes, specify the vulnerable groups.
• Provide details of the pilot study if a pilot study has been performed.
• Describe which stakeholders are going to be involved in the implementation and describe their roles.
Group Number:
Student name & ID #
Submission date:
Instructor name:
…. Out of 10
Grade:
The written report will be assessed for clarity and succinctness in providing the required information using a rubric of 0
(undeveloped/inadequate) to 3 (outstanding/exceptional), as illustrated below:
Inadequat
e
Objective/Element
Report clearly and succinctly defines program goals
2.
Report clearly and succinctly defines program SMART objectives.
3.
SMART objectives are:
a. Specific: objectives should clearly specify what is to be achieved.
b. Measurable: objectives should be phrased in a way that achievement can
be measured.
c. Achievable: objectives should refer to something that the program can
actually influence and change.
d. Realistic: objectives should be realistically attainable within the given
time frame and with the available resources (human and financial
resources and capacity).
e. Time-bound: objectives should relate to a clearly stated time frame.
Proficient Outstanding
Partially
Meets
Exceeds
Fails to
meets
expectation Expectations
meet
expectations
s
3
expectation
1
2
s
0
1.
Adequate
PHC 312 Group Assignment Paper
4.
Report clearly and succinctly describes the target audiences (primary &
secondary audiences).
✓ Indicate the demographic and socioeconomic factors of the target population
that have been measured. E.g. age, gender, income/socioeconomic status,
education, occupation…etc.
5.
Report provides a brief background that includes:
✓ Literature review.
Report clearly and succinctly describes settings and communication
channels
Report clearly and succinctly describes the development process of
messages.
6.
7.
8.
Report clearly and succinctly describes the activities and timeline.
9.
Report clearly and succinctly describes how the process/impact/outcome
evaluation of the communication program will be measured.
Total
This assignment is worth 10% of the total possible points earned for the course.
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task
•
Submission should be before the deadline (submission after the deadline is not allowed)
•
For more resources, you can review appendix A and appendix B in Schiavo, R. (2014).
For this assignment, I will need an initial response with 250-300 words and 1 reference. I will also need 2 peer responses with 100 words each and 1 reference.
Select one of the future issues presented this week (Issue selected: Demographic changes). Examine the issue in terms of cultural diversity, health promotion, and communication methods. Discuss in detail how this issue affects healthcare delivery and advanced nursing.
Part 2 NUR 500 Assignment
Personal Nursing Philosophy, Part 2
As you finish this course, your philosophy of nursing has probably changed. As a final review, polish your philosophy of nursing based on your newly acquired knowledge.
Also, write a summary reflection answering the following questions based on the readings and discussions throughout the course:
Philosophy of Nursing Part 2 Paper-, worth 100 points.
For this paper, you will be using the Philosophy paper you turned in in week 1 (Please find paper from week 1 attached).
Then, after the Reference page, simply write out each numbered question and briefly answer it.
As an art and as a science, how has your personal nursing philosophy unfolded?
Have there been ideas that have challenged your personal values or assumptions?
Have there been ideas that have caused you personal conflict and may lead to deconstructing those dispositions in a critical manner?
What actions do you take that illustrate your personal nursing philosophy?
Describe your own definition of the concepts involving the metaparadigm of nursing
Has your first written philosophy of nursing changed? In what ways?
Attach these Q/A (questions and answers) to the end of your Philosophy Paper and submit in the appropriate place in week 8.
Your paper that includes both your philosophy and reflection together should be 2–3 pages in length, in APA format, typed in Times New Roman with 12-point font, and double-spaced with 1″ margins. If outside sources are used, they must be cited appropriately.
Due: Sunday, 11:59 p.m. (Pacific time)
Points Possible: 100
NURS_500_DE – Philosophy Part II Rubric
NURS_500_DE – Philosophy Part II Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
50 to >41.0 pts
Meets Expectations
The writer clearly and effectively responds to the assignment, sharing his/her own nursing philosophy, which has changed over the course from the draft in week 1. A summary reflection is included that answers the following questions: • As an art and as a science, how has your personal nursing philosophy unfolded? • Have there been ideas that have challenged your personal values or assumptions? • Have there been ideas that have caused you personal conflict and may lead to deconstructing those dispositions in a critical manner? • What actions do you take that illustrate your personal nursing philosophy? • Describe your own definition of the concepts involving the metaparadigm of nursing • Has your first written philosophy of nursing changed? In what ways?
41 to >37.5 pts
Approaches Expectations
The response to the assignment is generally adequate, but may not answer all reflective questions posed.
37.5 to >0 pts
Does Not Meet Expectations
The writer does not respond to the assignment.
50 pts
This criterion is linked to a Learning OutcomeFocus and Detail
25 to >20.5 pts
Meets Expectations
There is a clear, well- focused topic (philosophy and concepts of the metaparadigm of nursing). Main ideas are clear and are well supported by detailed and accurate information.
20.5 to >18.75 pts
Approaches Expectations
There is one clear, well- focused topic. Main ideas are clear but are not well supported by detailed information.
18.75 to >0 pts
Does Not Meet Expectations
The topic and main ideas are not clear.
25 pts
This criterion is linked to a Learning OutcomeOrganization
15 to >12.3 pts
Meets Expectations
The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong.
12.3 to >11.25 pts
Approaches Expectations
The introduction states the main topic and provides an overview of the paper. A conclusion is included.
11.25 to >0 pts
Does Not Meet Expectations
There is no clear introduction, structure, or conclusion.
15 pts
This criterion is linked to a Learning OutcomeMechanics and APA
10 to >8.2 pts
Meets Expectations
The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.
8.2 to >7.5 pts
Approaches Expectations
The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly.
7.5 to >0 pts
Does Not Meet Expectations
The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are cited and referenced incorrectly, or citations and references are missing.
10 pts
Total Points: 100
Part 3 NUR 510 Discussion 1 For this assignment, I will need an initial response with 250-300 words and 1 reference. I will also need 2 peer responses with 100 words each and 1 reference.
Describe how the educational level achieved by a nurse or the entry point into professional nursing practice affects the quality and competence of a nurse’s participation in policy making. Why it is important for registered nurses to influence the regulatory process? Does the nurses education have influence on their ability to make an impact?
Part 4 NUR 510 Discussion 2 For this assignment, I will need an initial response with 250-300 words and 1 reference. I will also need 2 peer responses with 100 words each and 1 reference.
Reflect on what you have learned in this course. What were your major takeaways? Surprises? How will you apply what you have learned to your career? Name of the course: Policy Organization and Financial Healthcare
The purpose of this paper is for you to articulate your beginning philosophy of nursing.1.In your own words, state your personal philosophy of nursing which must include the nursing
metaparadigm concepts: nursing, health, person, and environment 2.Clearly write your own definitions of these concepts using professional nursing references to
support your definitions.3.Choose one concept AND one process from the list below that significantly influences your personal
philosophy, define your chosen process and concept, and then discuss the reasons for your choices. Concepts: Accountability, Caring , Culture, Ethics , Clinical competence , Legal considerations ,Human dignity. Processes:
Communication, Health continuum , Health prevention , Continuity of care , Nursing process , Scientific inquiry, End of life careUtilize correct APA format overall: opening and closing paragraph, title page, correct grammar, spelling,
sentence structure, citations, reference page, etc. Page limit for paper, 8 pages not including title page
and reference page. **A minimum of 2 professional nursing citations from peer reviewed nursing journals published within
the past 7 years are required**
DISCUSSION BOARD 3
As mentioned last week, the TIGER Nursing Informatics Competencies
Model consists of three parts: Basic Computer Competencies,
Information Literacy, and Information Management. This week we will
focus on information management and security. As a nurse, you must
chart all patient care activities with a high level of efficiency and
accuracy. All activities in the electronic health record (EHR) are
electronically captured via an audit trail.
For this week’s discussion response, please address each of the
following prompts:
•
What measures should be taken to ensure adherence to ethical
charting?
•
What security measures should be taken to protect patients’
healthcare data?
•
How can you ensure that you are effectively documenting in the
electronic health record and that your documentation would hold
up to scrutiny in a court of law?
•
Please support your response with a scholarly source. Please be
sure to respond to at least two peers each week.
This activity aligns with course outcome:
•
Explain the ethical implications associated with the management
of healthcare data and the patient’s personal health record.
(Essential IV.2. IV.3, IV. 6, IV. 8, IV.11, and IV.12)
DISCUSSION BOARD 4
During this week, we focused on eHealth Literacy. This discussion will help
you to improve your personal perception of health literacy and what to do to
improve the literacy of patients. In your discussion response this week, please
address each of the following prompts:
•
•
•
•
Reflect on instances when you suspected that a patient might have low
literacy? What were the signs?
What can you do as a nurse to make it easier for patients with low literacy to
understand services and information?
Consider the entire process of patient visits, from scheduling an appointment
to check-out, and describe what strategies could all of us adopt to minimize
barriers and misunderstanding for low literacy patients?
Please support your response with a scholarly source. Please be sure to
respond to at least two peers each week.
This activity aligns with Course Outcome:
•
Create a health literacy plan that incorporates patient and provider-to-patient
communication needs. (Essential IV.1, IV.4. IV. 5, and IV. 7)
Mr. Robert McClelland, an 81-year-old man, is a new admission from the local hospital to your long-term care facility. After Mr. McClelland’s last bout with pneumonia and congestive heart failure, his wife of 59 years has decided she is no longer able to care for him alone. Mrs. McClelland states, “He has just gotten too weak and can’t help me care for him. I am so afraid he will fall and hurt himself. I am so worn out trying to care for him myself. I have to bathe him and remind him to eat; sometimes, I’ve had to feed him myself, or he won’t eat. He can be so forgetful.” Given this information, there are two options that Mrs. McClelland is considering. 1. Hire an in-home nurse to care for her husband. 2. Place her husband in a nursing home. You are Mr. McClelland’s nurse. You are tasked with providing the information for both assisted health care options. Based on your assessment of Mr. McClelland’s symptoms and his wife’s concerns, draft a response to help them make the best decision for their situation. Find at least one resource to support your argument. Be sure to use APA (7th ed.) when citing this resource. Additionally, share your opinion about which option you believe is the best for Mr. and Mrs. McClelland’s situation, and explain why.
Paper assignment guidelinesShort essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PM• Conduct your own research to explore further online resources to provide the conceptual idea and avoid using advertising or commercial material. • Do not use bullet points in representing your answer. • The assignment should have the COVER PAGE with SEU logo and the details of who is submitting and to whom is it submitted. • Assignments should be submitted through Blackboard in Word document only and not through email.• Font should be 12 Times New Roman, color should be black and line spacing should be 1.5• Use APA referencing style. Please see below link about how to cite APA reference style. https://guides.libraries.psu.edu/apaquickguide/int… • Do proper paraphrasing to avoid plagiarism.
Unformatted Attachment Preview
Federal Emergency Management: A Brief
Introduction
November 30, 2012
Congressional Research Service
https://crsreports.congress.gov
R42845
Federal Emergency Management: An Introduction
Summary
The federal government plays a significant role in emergency management, which generally
refers to activities associated with avoiding and responding to natural and human-caused hazards.
Emergency management in the United States is highly decentralized and contextual in nature:
activities often involve multiple jurisdictions as well as a vast number of agencies,
nongovernmental organizations, and private sector entities. In addition, the number and type of
actors involved in an incident will vary tremendously depending on the context and severity of
the event. Similarly, the legal framework through which emergency management functions and
activities are authorized is also decentralized and stems from multiple authorities.
Congress annually appropriates funds for a wide range of activities and efforts related to
emergency management. For example, between 2005 and 2011 Congress provided an average of
$12 billion annually to the Federal Emergency Management Agency, the lead federal agency
responsible for disaster relief through regular and supplemental appropriations. Congress has also
invested over $120 billion through various federal agencies to help the Gulf Coast Region recover
from the hurricanes that hit the Gulf Coast in 2005 and 2008.
In recent years congressional interest in emergency management has focused on funding,
program administration, and program coordination—both among federal agencies and state
emergency management agencies. This report provides an introduction to the principles and
foundations of federal emergency management in the United States and a description of the
activities of the federal agencies that provide assistance, focusing primarily on the Federal
Emergency Management Agency, but also including information on the National Guard,
Department of Agriculture, Department of Defense, Army Corps of Engineers, Department of
Health and Human Services, Department of Housing and Urban Development, Department of
Transportation, Environmental Protection Agency, Forest Service, and Small Business
Administration.
This report is designed to provide Members of Congress and congressional staff with a general
overview of principles and foundations of federal emergency management in the United States as
well as the types of activities provided by various federal agencies. The report begins with a
description of the four phases of emergency management: (1) mitigation, (2) preparedness, (3)
response, and (4) recovery, and includes examples of some of the activities that take place in each
of these phases. The report then discusses a recent movement at the federal level to carry out
these phases of emergency management through a system of frameworks. The frameworks
include (1) the National Prevention Framework, (2) the National Protection Framework, (3) the
National Mitigation Framework, (4) the National Response Framework, and (5) the National
Disaster Recovery Framework. The frameworks are used to designate roles and responsibilities
and coordinate various activities.
Next, this report describes the process for requesting federal assistance for major disasters,
emergencies, and fire suppression. The declaration section also includes brief summaries of the
types of assistance provided through each type of declaration. This discussion is followed by
description of federal-to-state cost shares, how federal assistance is funded, and the process
through which FEMA requests assistance from other federal entities. The section then provides a
description of the close-out process—the process in which FEMA terminates its recovery efforts.
The report includes a discussion of key federal laws and policies that influence federal emergency
management, and concludes by highlighting some of the federal activities that take place in
response to emergencies and disasters.
Congressional Research Service
Federal Emergency Management: An Introduction
Contents
Introduction ……………………………………………………………………………………………………………………. 1
Key Concepts and Approaches in Emergency Management ………………………………………………….. 1
All-Hazards Model …………………………………………………………………………………………………….. 1
NIMS and ICS …………………………………………………………………………………………………………… 2
Phases of Emergency Management ………………………………………………………………………………. 2
Mitigation……………………………………………………………………………………………………………. 2
Preparedness ……………………………………………………………………………………………………….. 3
Response …………………………………………………………………………………………………………….. 3
Recovery …………………………………………………………………………………………………………….. 3
The Framework Approach…………………………………………………………………………………………… 4
National Prevention Framework …………………………………………………………………………….. 4
National Protection Framework ……………………………………………………………………………… 5
National Mitigation Framework …………………………………………………………………………….. 5
National Response Framework ………………………………………………………………………………. 5
National Disaster Recovery Framework ………………………………………………………………….. 6
Federal Assistance Through Stafford Declarations ………………………………………………………………. 6
Major Disaster Declarations ………………………………………………………………………………………… 7
Assistance Provided Under Major Disaster Declarations …………………………………………… 7
Emergency Declarations …………………………………………………………………………………………….. 8
Assistance Provided Under Emergency Declarations ………………………………………………… 8
Fire Management Assistance Grant Declarations …………………………………………………………… 9
Assistance Provided under Fire Management Assistance Grants ………………………………… 9
Cost-Shares …………………………………………………………………………………………………………………….. 9
Disaster Relief Fund ………………………………………………………………………………………………………. 10
Closeout ……………………………………………………………………………………………………………………….. 10
Other Types of Federal Declarations …………………………………………………………………………….11
Federal to Federal Support ……………………………………………………………………………………………… 12
Stafford Act Incidents and Mission Assignments………………………………………………………….. 12
Non-Stafford Act Incidents ……………………………………………………………………………………….. 13
Other Key Federal Laws and Policies ………………………………………………………………………………. 13
Disaster Mitigation Act of 2000 …………………………………………………………………………………. 13
Post Katrina Emergency Management Reform Act ………………………………………………………. 13
Homeland Security Presidential Directives………………………………………………………………….. 14
Homeland Security Act …………………………………………………………………………………………….. 14
National Oil and Hazardous Substances Pollution Contingency Plan ……………………………… 15
Key Federal Assistance for Disaster Response and Recovery ……………………………………………… 16
National Guard ………………………………………………………………………………………………………… 17
Department of Agriculture ………………………………………………………………………………………… 17
Department of Defense …………………………………………………………………………………………….. 18
Immediate Response …………………………………………………………………………………………… 18
Requests for Assistance……………………………………………………………………………………….. 18
Army Corps of Engineers………………………………………………………………………………………….. 19
Department of Health and Human Services …………………………………………………………………. 20
Department of Housing and Urban Development …………………………………………………………. 20
Community Development Block Grants ………………………………………………………………… 20
Congressional Research Service
Federal Emergency Management: An Introduction
Department of Transportation ……………………………………………………………………………………. 21
Federal Highway Administration ………………………………………………………………………….. 21
Environmental Protection Agency ……………………………………………………………………………… 22
Forest Service ………………………………………………………………………………………………………….. 23
Small Business Administration ………………………………………………………………………………….. 24
Tables
Table 1. Other Types of Federal Declarations ……………………………………………………………………..11
Contacts
Author Information………………………………………………………………………………………………………… 25
Key CRS Policy Experts ………………………………………………………………………………………………… 25
Congressional Research Service
Federal Emergency Management: An Introduction
Introduction
Emergency management generally refers to activities associated with avoiding and responding to
natural and human-caused hazards. Emergency management in the United States is highly
decentralized and contextual in nature. Multiple jurisdictions as well as a vast number of
agencies, nongovernmental organizations, and private sector entities are often involved. In
general, emergency management begins locally, but the federal government plays an important
role when a state requests assistance. Consequently, the number and type of actors involved in an
incident vary tremendously depending on the context and severity of the event. Similarly, the
legal framework through which emergency management functions and activities are authorized is
also decentralized and stems from multiple authorities. This report provides Members of
Congress and their staffs with an introduction to the principles and foundations of federal
emergency management in the United States. It examines the activities of several federal
agencies, including the Federal Emergency Management Agency (FEMA), the National Guard,
Department of Agriculture, Department of Defense, Army Corps of Engineers, Department of
Health and Human Services, Department of Housing and Urban Development, Department of
Transportation, Environmental Protection Agency, Forest Service, and Small Business
Administration.
In addition, this report discusses the four phases of emergency management: (1) mitigation, (2)
preparedness, (3) response, and (4) recovery; the process for requesting federal assistance for
major disasters, emergencies, and fires; and the types of assistance provided through each type of
Stafford Act declaration. This report also includes a description of federal-to-state cost shares
under the Stafford Act, a discussion on how federal assistance is funded, and the process through
which FEMA requests assistance from other federal entities.
This report also outlines the frameworks that guide various emergency management activities at
the federal and state level, and discusses some of the key federal laws and policies influencing
federal emergency management and highlights federal entities that provide assistance to states
and localities.
Related CRS products examining these issues more in-depth are footnoted in this report.
Key Concepts and Approaches in Emergency
Management
The following sections describe key concepts that undergird federal emergency management.
Many of these concepts originated at the state level and are still being put to use by states and
localities. Some concepts developed by the states have been modified and/or adopted by the
federal government as a national standard.
All-Hazards Model
The all-hazards model is based on the idea that there are generic processes and capabilities
needed to address most kinds of emergencies and disasters. For example, preparing and
responding to an earthquake entails similar activities and capabilities for preparing and
responding to an explosion or terrorist bombing. Thus emergency managers can conduct
emergency management activities in a more flexible and cost-effective manner than using a
standalone, emergency, or disaster-specific program. Another benefit is that carrying out
emergency management functions generally involves adaptation, which is a guiding principle of
Congressional Research Service
1
Federal Emergency Management: An Introduction
the all-hazards model.1 Thus preparations and lessons learned associated with one type of event,
can often be applied to another type of emergency or disaster scenario.
NIMS and ICS
Emergency management functions are managed according to the principles of the National
Incident Management System (NIMS). Authorized by Homeland Security Presidential Directive 5
(HSPD-5), NIMS is a preparedness and response management model based on the Incident
Command System (ICS).2 ICS is a command and control model developed by firefighters after
the 1970 fires in southern California. The response to the fires was hindered due to duplication of
efforts, lack of coordination, and communication problems. ICS standardizes response operations
by using similar terminology, communication systems, and organizational structure to eliminate
or reduce confusion during a unified response.3 NIMS uses ICS concepts to establish a response
structure that is scalable (capable of growing as more organizations come together to respond to
the incident) that can be used by all jurisdictions, agencies, and organizations to ensure a unified
response to complex events. State and local governments must be NIMS compliant to be eligible
for certain preparedness grants.
Phases of Emergency Management
Emergency management functions are generally grouped into four phases: (1) Mitigation,
(2) Preparedness, (3) Response, and (4) Recovery. The grouping of emergency management
functions is useful for classifying and conceptualizing activities. Use of the four phases at the
state level is not, however, a requirement for grant funding. As discussed later, the federal
government uses a framework approach that differs somewhat from the four phases. The
following sections provide examples of the types of activities that take place in each phase.4
While conceptually useful for targeting efforts and resources, the phases of emergency
management are not distinct—activities in each phase often overlap. For example, recovery
projects often include elements of mitigation (for example, rebuilding structures using current
building codes) and response often includes recovery measures (immediate debris removal). The
phases are also cyclical in nature—lessons learned from an incident might be applied in
preparedness efforts for future emergencies and major disasters.
Mitigation
Mitigation activities entail identifying risks and hazards to either substantially reduce or eliminate
the impact of an incident usually through structural measures. Mitigation activities often have a
long-term or sustained effect and may have an impact on insurance premiums. In many cases,
1 William L. Waugh, Jr., Living with Hazards, Dealing with Disasters An Introduction to Emergency Management
(Armonk, NY: M.E. Sharpe, 2000).
2 Homeland Security Presidential Directive 5: Management of Domestic Incidents, http://www.dhs.gov/xabout/laws/
gc_1214592333605.shtm.
3 For example, prior to ICS police and fire departments responding to the same incident might use different radio
frequencies and communicate with different terms. A “code blue” for one department might mean something else for
another. The organization structure might also be different. A commander in one department might have a different role
and responsibility in another. ICS (and NIMS) is therefore an attempt to eliminate potential confusion caused by these
differences.
4 A glossary of emergency and disaster related terms can be located at http://www.fema.gov/glossary.
Congressional Research Service
2
Federal Emergency Management: An Introduction
mitigation activities occur in the recovery stage of a major disaster. Some examples of mitigation
include:
building codes that address risks such as fires, high winds, or earthquakes;
zoning rules that restrict construction in floodplains;
rebuilding damaged structures with more resilient materials;
flood mapping to identify low lying areas and relocating homes and structures
located in floodplains and flood prone areas; and
dams and levees that help prevent flooding.
Preparedness
Preparedness is distinct from mitigation because rather than focusing on eliminating or reducing
risks, the general focus of preparedness is to enhance the capacity to respond to an incident by
taking steps to ensure personnel and entities are capable of responding to a wide range of
potential incidents. Preparedness activities may include:
training;
planning;
procuring resources, such as food, water, and medication stockpiles;
intelligence and surveillance activities to identify potential threats; and
exercising to assure the adequacy of planning efforts and the use of after-action
reports to improve emergency response plans.
Response
Response activities are comprised of the immediate actions to save lives, protect property and the
environment, and meet basic human needs. Response involves the execution of emergency plans
and related actions, and may include:
evacuating victims;
deployment of response teams, medical stockpiles, and other assets; and
establishment of incident command operations.
Recovery
Recovery activities are intended to restore essential services and repair damages caused by the
event. Recovery activities may include:
the reconstitution of government operations and services (e.g., emergency
services, public safety, and schools);
housing and services for displaced families and individuals; and
replenishment of stockpiles.
Congressional Research Service
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Federal Emergency Management: An Introduction
The Framework Approach
On March 30, 2011, President Barack Obama issued Presidential Policy Directive 8: National
Preparedness (hereinafter PPD-8).5 PPD-8 superseded Homeland Security Presidential Directive 8
(HSPD-8), which was signed by President George W. Bush on December 17, 2003.6 Similar to its
predecessor, PPD-8 provides a guide as to how the nation, from the federal level to private
citizens, can “prevent, protect against, mitigate the effects of, respond to, and recover from those
threats that pose the greatest risk to the security of the Nation” including acts of terrorism and
other human caused incidents (such as oil spills) as natural disasters.7 PPD-8 is also intended to
meet several “comprehensive preparedness system” requirements in Subtitle C of the PostKatrina Act.8
PPD-8 establishes that preparedness objectives are to be accomplished by subdividing emergency
management components into a system of integrated, national planning frameworks according to
functionality—prevention, protection, mitigation, response, and recovery.9 The frameworks are
intended to assign roles and responsibilities to various federal agencies with mission areas
involved with aspects of federal emergency management.10
These frameworks either exist in various stages of development or have been implemented. The
following sections provide brief descriptions of each framework.11
National Prevention Framework
While the other planning frameworks address natural hazards and disasters as well as humancaused incidents, the focus of the National Prevention Framework is mainly on preventing
imminent terrorist threats. As such, upon issue, the National Prevention Framework is to assign
roles and responsibilities and coordinate federal agencies involved with intelligence and
information sharing, surveillance, providing public information and warnings, as well as other
elements that help the federal government identify, discover, or locate terrorist threats.12
5 For further analysis on PPD-8 see CRS Report R42073, Presidential Policy Directive 8 and the National
Preparedness System: Background and Issues for Congress, by Jared T. Brown.
6 HSPD-8 gave the Secretary of the Department of Homeland Security broad authority to improve preparedness,
prevention, response, and recovery operations among others. HSPD-8 also required the creation of a National
Preparedness Goal and the implementation of a National Preparedness System. HSPD-8 fulfilled many of the
requirements later set forth in the Post Katrina Emergency Management Reform Act of 2006 (Title VI of the
Department of Homeland Security Appropriations Act, 2007—hereinafter the Post-Katrina Act) such as actions to
approach all hazards within a risk-based framework, and the use of metrics to measure levels of preparedness. Many
such requirements, however, were not implemented.
7 The White House, Presidential Policy Directive/PPD-8, March 30, 2011, p. 1, at http://www.dhs.gov/xlibrary/assets/
presidential-policy-directive-8-national-preparedness.pdf.
8 P.L. 109-295, 6 U.S.C. §741- 764, 120 STAT. 1424-1433.
9 The White House, Presidential Policy Directive/PPD-8, March 30, 2011, p. 3, athttp://www.dhs.gov/xlibrary/assets/
presidential-policy-directive-8-national-preparedness.pdf.
10 Ibid, p. 3.
11 These descriptions should not be viewed as definitive. Some of the planning frameworks are being updated or still in
draft form. They could conceivably change in form or content before being implemented.
12 Federal Emergency Management Agency, Presidential Policy Directive 8: National Preparedness: Working Drafts
of the National Planning Frameworks – Prevention Framework, p. 9.
Congressional Research Service
4
Federal Emergency Management: An Introduction
National Protection Framework
The National Protection Framework, upon issue, would assign roles and responsibilities and
coordinate agencies on a wide range of emergency management and homeland security areas,
encompassing cyber security, border security, transportation security, and agriculture and food
security, among others. In addition, the working draft of the National Protection Framework
proposes the use of academic and research centers to develop new protection technologies and
establish protection-related curricula and degree programs.13
National Mitigation Framework
The National Mitigation Framework, upon issue, would address capabilities that reduce the loss
of life and property by lessening the impact of disasters.14 The National Mitigation Framework is
distinct from the other planning frameworks because most mitigation activities take place at the
local level; the role of the federal government in the National Mitigation Framework is not as
prominent as with the other planning frameworks.15
National Response Framework
Issued in January 2008, the National Response Framework (NRF) is the successor of two
previous response documents, the Federal Response Plan, which was thought to be too narrow in
scope, and the National Response Plan, which was found to be problematic for a variety of
reasons, including unclear designations and confusing language and jargon.16 The NRF guides the
federal response to natural and human-caused incidents. However, the NRF is not an “operational
plan.” Rather, it articulates the overarching emergency management principles used to coordinate
and conduct a multi-agency and multijurisdictional response to all types of incidents. The NRF is
executed through the use of three supplemental annexes consisting of the (1) Emergency Support
Functions Annex, (2) Support Annexes, and (3) Incident Annexes.
Emergency Support Functions Annexes
There are 15 Emergency Support Function (ESF) Annexes. ESFs group federal departments and
agencies by matching their resources and capabilities with a particular incident.17 For example,
federal entities with a role in responding to an oil spill are listed in ESF #10—the Oil and
Hazardous Materials Response Annex. ESFs also designate which federal entities have
management oversight responsibility and which entities have a support role.
13 Ibid., p. 10.
14 Ibid., p. 1.
15 Ibid, p. 12.
16 For further information on the NRF see CRS Report RL34758, The National Response Framework: Overview and
Possible Issues for Congress, by Bruce R. Lindsay.
17 U.S. Federal Emergency Management Agency, ESF Annexes Introduction, January 2008, at http://www.fema.gov/
pdf/emergency/nrf/nrf-esf-intro.pdf.
Congressional Research Service
5
Federal Emergency Management: An Introduction
Support Annexes
There are eight Support Annexes that group federal, state, local, private sector, and
nongovernmental organizations that execute functional processes and administrative functions.
The Support Annexes also designate roles and responsibilities.18
Incident Annexes
There are eight Incident Annexes that explain the authorities and policies relevant to a particular
incident, describe the incident situation, and make planning assumptions for the incident. An
Incident Annex also identifies the “coordinating and cooperating” agencies involved with
response to the incident.19
National Disaster Recovery Framework
Issued in September 2011, the National Disaster Recovery Framework (NDRF) coordinates and
assigns roles and responsibilities to entities involved in disaster recovery. The focus of the NDRF
is to “restore, redevelop and revitalize the health, social, economic, natural and environmental”
aspects of disaster-impacted states and local jurisdictions.20 The NDRF has six Recovery Support
Functions (RSF): (1) Community Planning and Capacity Building, (2) Economic, (3) Health and
Social Services, (4) Housing, (5) Infrastructure Systems, and (6) Natural and Cultural Resources.
Federal Assistance Through Stafford Declarations
The system of emergency management in the United States is scalable. This means that local
governments request assistance from the state if responding or recovering from the incident is
beyond their capacity. In cases when a state is overwhelmed by the incident, the state governor
may elect to request assistance from the federal government.
Scalability makes emergency management response more practical, but it also contains a political
element because it is embedded within the federalist system of governance aimed at the
preservation of state autonomy. The state-initiated request may also alleviate concern that the
federal government might assume leadership of response and recovery operations. The Robert T.
Stafford Disaster Relief and Emergency Assistance Act (hereinafter the Stafford Act)21 does
provide the President authority to issue an emergency declaration in the absence of a
gubernatorial request if the President determines the incident involves a subject area under the
Constitution or laws of the United States, in which the United States exercises preeminent
responsibility and authority of the incident.22 Such cases, however, are rare. The majority of
18 U.S. Federal Emergency Management Agency, Support Annexes: Introduction, January 2008, at
http://www.fema.gov/pdf/emergency/nrf/nrf-support-intro.pdf.
19 U.S. Federal Emergency Management Agency, Incident Annexes Introduction: National Response Plan, December
2004, pp. INC-i, at http://www.learningservices.us/pdf/emergency/nrf/nrp_incidentannexintroduction.pdf.
20 Federal Emergency Management Agency, National Disaster Recovery Framework: Strengthening Disaster Recovery
for the Nation, September 2011, p. 1,at http://www.fema.gov/pdf/recoveryframework/ndrf.pdf.
21 Codified at 42 U.S.C. §5121 et seq. For further analysis on the Stafford Act see CRS Report RL33053, Federal
Stafford Act Disaster Assistance: Presidential Declarations, Eligible Activities, and Funding, by Francis X. McCarthy.
22 P.L. 93-288, 42 U.S.C. §5191(b). The President is required to consult with the state governor when practical.
Examples of these declarations include the April 19, 1995, bombing of the Alfred P. Murrah Building in Oklahoma
City, and the September 11, 2001, attack on the Pentagon in Virginia.
Congressional Research Service
6
Federal Emergency Management: An Introduction
federal disaster assistance is released only after a presidential declaration is issued in response to
a gubernatorial request for federal assistance.
The Stafford Act authorizes federal assistance through three types of declarations: (1) major
disaster declarations, (2) emergency declarations, and (3) Fire Management Assistance Grant
declarations (FMAG).23 However, FMAG declarations are typically declared through the Federal
Emergency Management Agency (FEMA) Regional Director.24 Emergency and major disaster
declarations can only be issued by the President. Each of these declarations are described in more
detail in the following sections.
Major Disaster Declarations
The Stafford Act defines a major disaster as:
any natural catastrophe (including any hurricane, tornado, storm, high water, wind-driven
water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm,
or drought), or, regardless of cause, any fire, flood, or explosion, in any part of the United
States, which in the determination of the President causes damage of sufficient severity
and magnitude to warrant major disaster assistance under this chapter to supplement the
efforts and available resources of states, local governments, and disaster relief
organizations in alleviating the damage, loss, hardship, or suffering caused thereby.25
When a governor submits a request for a major disaster declaration FEMA meets with state
representatives to develop preliminary damage assessments. In general, FEMA will make a
recommendation to the President to declare a major disaster if the state’s preliminary damage
assessment exceeds certain thresholds established in regulation.26 The President in turn may or
may not act on the recommendation.
Assistance Provided Under Major Disaster Declarations
Under the Stafford Act three main types of assistance can be provided and administered through
FEMA when the President issues a major disaster declaration: (1) the Public Assistance (PA)
Grant Program, (2) the Individual Assistance (IA) program, and (3) the Hazard Mitigation Grant
Program (HMGP). Under the Stafford Act, the President may issue a major disaster declaration
that provides only PA if damage to dwellings is not severe enough to warrant IA, or if there is
sufficient damage, both PA and IA may be provided.
The PA program provides assistance to state and local governments and certain nonprofit
organizations and includes emergency protective measures, debris removal, and the repair,
replacement, or restoration of eligible facilities.27 Hazard mitigation measures during the re
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need apa references Question 1 How can healthcare systems overcome the challenges and limitations of implementing healthcare-based interventions to effectively address social determinants of health? Share real-world examples or case studies of healthcare organizations that have successfully collaborated with community-based organizations to navigate these obstacles and achieve positive health outcomes, illustrating such interventions’ potential benefits. Question 2 Compare and contrast research and translation of evidence in relation to ethical considerations. Question 3 What are the three levels of IRB review and which level is usually applied to quality improvement projects?
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Topic
Use of prednisone in childhood severe asthma.
Metformin and lactic acidosis.
Congestive heart failure therapy with a diuretic medication.
Immunization schedule/catch-up vaccination in childhood -until 12 years old.
Type 2 diabetes mellitus and bile acid sequestrant.
Urge incontinence or overactive bladder diagnoses and management.
Dosing regimen principles in a pediatric population.
Testing for type 2 diabetes in all adults.
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Week 4 Assignment – Health Care Human Resources Manageme…
Due: Mon Oct 30, 2023 9:00amDue: Mon Oct 30, 2023 9:00amUngraded, 180 Possible Points180 Possible Points
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Overview
Company mergers are very busy and challenging times for corporate leadership. The role that HR plays during a merger is often complex and far-reaching. In this assignment, you write an executive brief that considers aspects of how an HR department might prioritize and operate to support the union of two companies.
Preparation
How to Brief an Executive
There is no single correct way to brief an executive or other stakeholder. The final deliverable is your choice, but effective briefs have common elements; they should be clear, concise, relevant, well-structured, and provide decision-making information. Here are a couple of resources you may use to get started:
How to Brief an ExecutiveLinks to an external site.: A podcast from the Communications Guys.
How to Write a Formal Business Report (With Examples)Links to an external site.: Hints from Indeed.
Scenario
Imagine that Anchor Hospital, a 250-bed medical center, is merging with the similar-sized Saint Mary’s Hospital to better serve the needs of its metropolitan community. An administrative board has been formed to guide all aspects of the merger. They have asked all departments to submit an executive brief that states their roles, intended model of operations, and initial steps to build interdepartmental relationships.
The board’s primary concern for HR is how it will manage the merging of the workforce into a single, cohesive, and effective team. They want to understand HR’s primary role, guiding principles, and application of current practice. Specifically, they want your vision for the following:
A merger-related current best practice or trend that is being successfully employed by HR departments.
HR’s primary role in assimilating the workforces for the two hospitals.
The HR management model is to be followed.
How to foster relationships between HR and department managers.
Instructions
Write a 3-4-page executive brief that addresses the following merger-related items:
Recommend a relevant HR trend or practice that would be useful to consider as part of this merger. Justify your recommendation.
Analyze HR’s primary role(s) as a strategic corporate partner in merging the workforces of the organizations.
Recommend an HRM model that would effectively steer the joining of each organization’s employees into a single, cohesive workforce. Justify your recommendation.
Recommend two initial steps that HR should initiate to develop an effective relationship between HR and management. Justify your recommendation.
Additional Requirements
Resources: Use four sources to support your writing. Choose sources that are credible, relevant, and appropriate. Cite each source listed on your source page at least one time within your assignment. For help with research, writing, and citation, access the library or review library guides.
SWS: This course requires the use of Strayer Writing Standards (SWS). The library is your home for SWS assistance, including citations and formatting. Please refer to the Library site for all support. Check with your professor for any additional instructions.
The specific course learning outcome associated with this assignment is:
Determine strategies for HR operations including defining organizational roles and relations with leadership.
View Rubric
Week 4 Assignment – Health Care Human Resources Management
Week 4 Assignment – Health Care Human Resources Management
Criteria Ratings Pts
Recommend a relevant HR trend or practice that would be useful to consider as part of a merger. Justify your recommendation.
view longer description
36 to >32.4 pts
Exemplary
Thoroughly recommended a relevant HR trend or practice that would be useful to consider as part of a merger. Thoroughly justified recommendation.
32.4 to >28.8 pts
Competent
Satisfactorily recommended a relevant HR trend or practice that would be useful to consider as part of a merger. Satisfactorily justified recommendation.
28.8 to >25.2 pts
Needs Improvement
Partially recommended a relevant HR trend or practice that would be useful to consider as part of a merger. Partially justified recommendation.
25.2 to >0 pts
Unacceptable
Did not submit or did not recommend a relevant HR trend or practice that would be useful to consider as part of a merger.
/ 36 pts
Analyze HR’s primary role(s) as a strategic corporate partner in merging the workforces of the organizations.
view longer description
36 to >32.4 pts
Exemplary
Thoroughly analyzed HR’s primary role(s) as a strategic corporate partner in merging the workforces of the organizations.
32.4 to >28.8 pts
Competent
Satisfactorily analyzed HR’s primary role(s) as a strategic corporate partner in merging the workforces of the organizations.
28.8 to >25.2 pts
Needs Improvement
Partially analyzed HR’s primary role(s) as a strategic corporate partner in merging the workforces of the organizations.
25.2 to >0 pts
Unacceptable
Did not submit or did not analyze HR’s primary role(s) as a strategic corporate partner in merging the workforces of the organizations.
/ 36 pts
Recommend an HRM model that would effectively steer the joining of each organization’s employees into a single, cohesive workforce. Justify your recommendation.
view longer description
36 to >32.4 pts
Exemplary
Thoroughly recommends an HRM model that would effectively steer the joining of each organization’s employees into a single, cohesive workforce. Thoroughly justifies your recommendation.
32.4 to >28.8 pts
Competent
Satisfactorily recommends an HRM model that would effectively steer the joining of each organization’s employees into a single, cohesive workforce. Satisfactorily justifies your recommendation.
28.8 to >25.2 pts
Needs Improvement
Partially recommends an HRM model that would effectively steer the joining of each organization’s employees into a single, cohesive workforce. Partially justifies your recommendation.
25.2 to >0 pts
Unacceptable
Did not submit or did not recommend an HRM model that would effectively steer the joining of each organization’s employees into a single, cohesive workforce.
/ 36 pts
Recommend two initial steps that HR should initiate to develop an effective relationship between HR and management. Justify your recommendation.
view longer description
45 to >40.5 pts
Exemplary
Thoroughly recommended two initial steps that HR should initiate to develop an effective relationship between HR and management. Thoroughly justified recommendation.
40.5 to >36 pts
Competent
Satisfactorily recommended two initial steps that HR should initiate to develop an effective relationship between HR and management. Satisfactorily justified recommendation.
36 to >31.5 pts
Needs Improvement
Partially recommended two initial steps that HR should initiate to develop an effective relationship between HR and management. Partially justified recommendation.
31.5 to >0 pts
Unacceptable
Did not submit or did not recommend two initial steps that HR should initiate to develop an effective relationship between HR and management.
/ 45 pts
Four references.
view longer description
9 to >8.1 pts
Exemplary
Meets number of required references; all references high quality choices.
8.1 to >7.2 pts
Competent
Meets number of required references.
7.2 to >6.3 pts
Needs Improvement
Does not meet the required number of references; some or all references poor quality choices.
6.3 to >0 pts
Unacceptable
No references provided.
/ 9 pts
Clarity, writing mechanics, and SWS formatting requirements.
view longer description
18 to >16.2 pts
Exemplary
0–2 errors present.
16.2 to >14.4 pts
Competent
3–4 errors present.
14.4 to >12.6 pts
Needs Improvement
5–6 errors present.
12.6 to >0 pts
Unacceptable
More than 6 errors present.
/ 18 pts
Total Points: 0
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Cover sheet should be attached with assignment Use the excel sheet for your calculations to answer the assignment questionsComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”Maximum 1000 words (Excluding references) Use proper references following APA formatDo proper paraphrasing to avoid plagiarism Do not copy and paste raw tables/results from statistical programs, use your own words and write your answers in a clear and concise fashion.
Unformatted Attachment Preview
Patient ID Age in years Gender
501
38.1 female
502
79.2 male
503
67.2 female
504
76.8 male
505
30.9 female
506
68.0 female
507
75.2 female
508
56.9 female
509
60.9 male
510
48.2 female
511
43.7 male
512
57.9 male
513
60.5 male
514
78.0 male
515
60.7 male
516
63.1 male
517
66.1 male
518
43.7 male
519
67.9 male
520
73.0 male
521
72.1 male
522
48.8 male
523
68.2 male
524
45.0 male
525
56.2 male
526
63.6 female
527
71.8 male
528
43.0 female
529
79.4 female
530
41.5 female
531
74.2 male
532
28.0 male
533
39.1 female
534
57.0 female
535
83.3 female
536
67.3 female
537
65.5 female
538
55.3 male
539
49.3 male
540
48.7 male
541
45.2 male
542
54.5 male
543
70.5 female
544
68.0 female
545
54.0 male
546
60.7 male
smoking status
non-smoker
non-smoker
ex-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
Townsend deprivation Marital status
Third quintile
Married
Second quintile
Not recorded
Second quintile
Single
Second quintile
Not recorded
Third quintile
Married
Fourth quintile
Not recorded
Second quintile
Married
Second quintile
Married
Second quintile
Married
Fourth quintile
Married
Second quintile
Married
Third quintile
Married
Second quintile
Single
Second quintile
Married
Least deprived
Not recorded
Second quintile
Not recorded
Third quintile
Married
Second quintile
Single
Fourth quintile
Not recorded
Second quintile
Not recorded
Least deprived
Not recorded
Second quintile
Not recorded
Third quintile
Not recorded
Second quintile
Married
Second quintile
Married
Second quintile
Married
Least deprived
Married
Third quintile
Married
Second quintile
Married
Third quintile
Not recorded
Second quintile
Divorced
Third quintile
Not recorded
Third quintile
Married
Third quintile
Not recorded
Least deprived
Widowed
Second quintile
Widowed
Second quintile
Widowed
Fourth quintile
Married
Third quintile
Single
Second quintile
Single
Second quintile
Separated
Second quintile
Not recorded
Second quintile
Married
Second quintile
Married
Second quintile
Not recorded
Least deprived
Not recorded
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
35.3 female
51.8 male
30.3 female
57.6 male
31.1 female
45.8 male
33.2 male
72.4 male
50.7 female
79.7 male
59.2 female
56.8 female
72.0 male
50.9 female
73.8 female
75.6 female
66.8 male
75.2 female
42.8 male
78.0 male
46.0 male
75.4 male
65.6 male
27.9 male
36.1 female
49.8 male
58.3 male
76.8 female
48.1 male
45.2 male
58.4 male
22.7 male
50.8 female
81.9 male
67.6 female
59.6 female
56.5 male
72.1 male
53.7 male
62.2 female
56.7 male
91.1 female
74.2 male
73.7 female
48.5 male
34.9 female
32.9 female
non-smoker
current
ex-smoker
non-smoker
current
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
current
ex-smoker
non-smoker
ex-smoker
current
non-smoker
current
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
current
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
Second quintile
Fourth quintile
Fourth quintile
Third quintile
Most deprived
Least deprived
Third quintile
Least deprived
Least deprived
Second quintile
Fourth quintile
Third quintile
Least deprived
Second quintile
Second quintile
Most deprived
Least deprived
Least deprived
Fourth quintile
Third quintile
Least deprived
Third quintile
Second quintile
Fourth quintile
Second quintile
Least deprived
Least deprived
Least deprived
Second quintile
Least deprived
Least deprived
Second quintile
Least deprived
Least deprived
Second quintile
Least deprived
Least deprived
Least deprived
Least deprived
Second quintile
Least deprived
Third quintile
Least deprived
Second quintile
Second quintile
Third quintile
Third quintile
Not recorded
Not recorded
Married
Married
Married
Not recorded
Single
Not recorded
Married
Married
Not recorded
Married
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Single
Single
Married
Married
Married
Married
Married
Married
Not recorded
Married
Married
Married
Married
Not recorded
Married
Married
Married
Married
Divorced
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
69.7 male
51.3 male
84.0 female
31.9 female
73.3 male
54.0 male
56.8 male
46.9 male
42.2 male
72.0 female
68.3 female
37.8 male
50.4 female
32.5 female
53.7 male
35.5 female
54.1 male
79.8 male
57.9 female
50.9 female
78.6 male
64.8 female
66.3 male
60.2 female
53.3 female
55.3 male
56.7 female
65.5 male
57.2 female
71.1 female
59.8 female
73.4 male
43.1 male
74.7 male
38.9 female
90.2 female
58.0 female
44.6 male
62.4 female
74.4 male
59.2 male
34.5 male
43.9 female
43.3 female
60.9 female
41.2 male
68.7 female
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
current
current
current
non-smoker
non-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
current
non-smoker
current
current
non-smoker
Least deprived
Third quintile
Fourth quintile
Fourth quintile
Third quintile
Fourth quintile
Fourth quintile
Third quintile
Second quintile
Fourth quintile
Fourth quintile
Third quintile
Fourth quintile
Most deprived
Fourth quintile
Fourth quintile
Second quintile
Least deprived
Third quintile
Second quintile
Least deprived
Least deprived
Third quintile
Second quintile
Least deprived
Second quintile
Fourth quintile
Fourth quintile
Third quintile
Second quintile
Most deprived
Most deprived
Second quintile
Third quintile
Second quintile
Second quintile
Second quintile
Second quintile
Second quintile
Second quintile
Least deprived
Missing
Missing
Missing
Least deprived
Missing
Third quintile
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
38.8 male
81.1 male
65.8 female
42.0 female
52.0 male
52.0 female
34.4 male
63.7 male
62.3 male
66.4 male
65.6 male
73.1 male
54.3 male
58.4 male
61.1 male
70.7 male
62.5 male
73.5 male
33.7 male
45.1 male
40.3 male
53.6 male
62.9 male
64.9 male
49.5 male
40.8 male
57.4 male
27.8 male
50.4 male
39.4 male
61.4 male
48.4 male
29.3 male
65.6 male
77.3 male
53.9 male
66.7 male
56.6 male
61.6 male
76.1 male
41.4 male
63.2 male
65.4 male
55.5 male
68.3 male
78.6 male
57.6 male
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
current
unknown
current
unknown
non-smoker
unknown
ex-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
unknown
unknown
current
non-smoker
non-smoker
current
ex-smoker
ex-smoker
ex-smoker
Second quintile
Fourth quintile
Second quintile
Second quintile
Third quintile
Third quintile
Second quintile
Second quintile
Third quintile
Second quintile
Least deprived
Third quintile
Third quintile
Third quintile
Second quintile
Least deprived
Least deprived
Third quintile
Third quintile
Second quintile
Fourth quintile
Least deprived
Most deprived
Least deprived
Least deprived
Fourth quintile
Fourth quintile
Least deprived
Third quintile
Least deprived
Second quintile
Fourth quintile
Most deprived
Least deprived
Fourth quintile
Third quintile
Third quintile
Least deprived
Least deprived
Third quintile
Most deprived
Least deprived
Least deprived
Fourth quintile
Fourth quintile
Least deprived
Second quintile
Not recorded
Married
Married
Married
Married
Divorced
Married
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
50.4 male
31.6 male
41.3 male
52.2 male
52.0 male
81.7 male
55.3 female
60.7 female
51.3 female
65.6 female
63.0 female
82.9 female
44.9 female
47.3 female
28.2 female
26.0 female
32.5 female
53.2 female
30.2 female
68.8 female
79.9 female
59.0 female
35.8 female
61.3 female
77.8 female
58.0 female
56.2 female
41.2 female
53.1 female
73.1 female
75.0 female
29.5 female
68.6 female
62.6 female
56.4 female
40.4 female
55.0 female
62.8 female
53.6 female
30.9 female
63.2 male
57.4 female
68.4 female
71.9 female
67.9 female
78.7 female
64.4 male
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
current
non-smoker
unknown
non-smoker
non-smoker
current
non-smoker
ex-smoker
non-smoker
unknown
ex-smoker
non-smoker
non-smoker
non-smoker
current
current
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
unknown
ex-smoker
unknown
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
current
Least deprived
Least deprived
Least deprived
Third quintile
Least deprived
Least deprived
Least deprived
Third quintile
Third quintile
Fourth quintile
Third quintile
Second quintile
Second quintile
Fourth quintile
Second quintile
Fourth quintile
Missing
Fourth quintile
Third quintile
Least deprived
Fourth quintile
Least deprived
Most deprived
Most deprived
Least deprived
Fourth quintile
Most deprived
Fourth quintile
Fourth quintile
Most deprived
Third quintile
Least deprived
Least deprived
Second quintile
Least deprived
Third quintile
Least deprived
Fourth quintile
Third quintile
Fourth quintile
Least deprived
Third quintile
Least deprived
Most deprived
Fourth quintile
Missing
Missing
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
24.3 male
69.6 male
40.9 male
50.2 male
67.6 male
33.3 female
64.2 male
69.3 female
56.0 female
55.6 male
32.0 male
62.8 female
57.3 male
55.4 female
75.1 female
64.9 female
59.9 male
59.5 male
53.7 female
65.1 female
62.7 male
67.2 female
62.5 male
48.9 female
74.1 female
54.9 female
69.4 female
56.0 male
41.3 male
55.6 male
57.0 female
75.4 female
74.3 female
41.7 male
56.8 female
56.8 male
33.8 male
58.5 female
43.5 male
67.5 male
35.9 male
62.0 male
46.3 male
62.7 female
52.2 male
43.9 female
65.6 female
non-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
current
ex-smoker
ex-smoker
current
non-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
Second quintile
Second quintile
Fourth quintile
Least deprived
Most deprived
Most deprived
Most deprived
Most deprived
Missing
Fourth quintile
Most deprived
Third quintile
Third quintile
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Fourth quintile
Second quintile
Fourth quintile
Least deprived
Least deprived
Least deprived
Least deprived
Third quintile
Missing
Least deprived
Least deprived
Least deprived
Second quintile
Third quintile
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Third quintile
Least deprived
Second quintile
Least deprived
Fourth quintile
Third quintile
Fourth quintile
Fourth quintile
Least deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Married
Not recorded
Married
Not recorded
Not recorded
Single
Married
Not recorded
Married
Co-habiting
Not recorded
Not recorded
Single
Not recorded
Not recorded
Not recorded
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
71.7 female
70.9 female
80.2 female
55.7 male
34.6 male
65.0 female
54.5 male
55.6 female
58.0 female
42.1 female
32.8 male
58.2 male
64.4 female
62.9 female
52.0 male
71.1 female
54.3 female
40.2 male
55.4 female
57.6 female
67.8 female
58.5 male
51.6 male
51.4 female
51.9 female
44.5 female
66.8 male
35.4 male
43.2 female
51.3 male
60.0 male
55.7 male
33.1 male
77.1 male
53.0 male
50.7 male
57.7 female
71.0 male
72.0 female
60.2 male
44.8 male
39.9 male
48.0 female
37.6 female
36.3 male
47.9 female
52.4 male
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
current
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
non-smoker
current
non-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
Most deprived
Second quintile
Third quintile
Third quintile
Fourth quintile
Least deprived
Least deprived
Fourth quintile
Second quintile
Second quintile
Least deprived
Second quintile
Most deprived
Second quintile
Third quintile
Most deprived
Least deprived
Least deprived
Fourth quintile
Third quintile
Second quintile
Second quintile
Fourth quintile
Fourth quintile
Most deprived
Least deprived
Fourth quintile
Fourth quintile
Fourth quintile
Fourth quintile
Fourth quintile
Least deprived
Most deprived
Least deprived
Fourth quintile
Most deprived
Third quintile
Third quintile
Third quintile
Least deprived
Third quintile
Third quintile
Third quintile
Most deprived
Fourth quintile
Third quintile
Most deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Married
Married
Not recorded
Married
Not recorded
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844
845
846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875
38.2 male
58.8 female
43.4 male
63.2 female
52.1 female
56.2 female
46.4 female
62.8 male
39.8 male
55.6 male
26.7 female
80.8 male
58.7 female
67.5 male
65.9 female
71.6 male
74.8 female
56.9 male
29.1 female
43.1 male
66.1 female
64.9 female
34.6 female
54.8 female
48.0 female
56.7 female
65.8 male
73.9 female
39.3 male
68.2 female
48.5 male
39.6 female
71.0 male
59.3 female
49.2 female
82.0 male
55.1 male
59.7 female
74.5 female
55.3 male
69.3 male
78.7 male
64.4 male
82.0 female
56.0 female
65.1 male
56.9 female
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
ex-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
ex-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
current
ex-smoker
ex-smoker
non-smoker
non-smoker
current
non-smoker
current
ex-smoker
ex-smoker
non-smoker
current
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
Third quintile
Third quintile
Third quintile
Second quintile
Third quintile
Third quintile
Fourth quintile
Third quintile
Third quintile
Missing
Most deprived
Least deprived
Second quintile
Least deprived
Third quintile
Least deprived
Third quintile
Most deprived
Third quintile
Least deprived
Fourth quintile
Second quintile
Fourth quintile
Second quintile
Third quintile
Least deprived
Third quintile
Third quintile
Third quintile
Second quintile
Fourth quintile
Second quintile
Third quintile
Third quintile
Least deprived
Third quintile
Fourth quintile
Third quintile
Third quintile
Least deprived
Most deprived
Most deprived
Least deprived
Third quintile
Third quintile
Most deprived
Most deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
908
909
910
911
912
913
914
915
916
917
918
919
920
921
922
71.3 female
78.0 male
64.0 female
65.6 male
45.9 female
47.6 male
56.5 male
60.3 male
49.9 male
72.8 female
67.4 male
62.7 female
77.2 female
41.7 male
34.8 female
54.6 female
53.6 female
60.0 male
48.9 female
67.1 male
62.4 male
52.3 male
62.1 male
55.7 female
58.6 male
62.3 female
51.9 male
43.1 female
51.0 female
56.9 female
35.1 male
37.9 male
63.3 male
59.1 male
51.3 female
69.6 male
47.7 male
56.9 female
33.6 female
37.7 female
40.8 male
62.6 female
38.7 male
33.2 male
75.9 male
36.1 male
29.3 female
ex-smoker
ex-smoker
current
non-smoker
current
non-smoker
ex-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
current
current
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
ex-smoker
non-smoker
ex-smoker
Third quintile
Least deprived
Third quintile
Least deprived
Third quintile
Least deprived
Least deprived
Least deprived
Third quintile
Third quintile
Least deprived
Third quintile
Third quintile
Third quintile
Third quintile
Least deprived
Fourth quintile
Fourth quintile
Fourth quintile
Least deprived
Third quintile
Second quintile
Second quintile
Second quintile
Most deprived
Least deprived
Most deprived
Most deprived
Third quintile
Most deprived
Least deprived
Fourth quintile
Fourth quintile
Second quintile
Most deprived
Most deprived
Fourth quintile
Fourth quintile
Third quintile
Least deprived
Third quintile
Third quintile
Second quintile
Fourth quintile
Fourth quintile
Second quintile
Least deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
923
924
925
926
927
928
929
930
931
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
953
954
955
956
957
958
959
960
961
962
963
964
965
966
967
968
969
58.8 female
55.2 female
52.2 male
69.6 male
60.0 male
62.9 female
37.8 female
52.4 male
57.6 female
58.9 male
69.7 female
68.1 male
61.7 male
60.6 male
20.9 female
57.6 male
45.3 female
73.5 male
79.4 male
60.5 male
86.0 male
64.3 female
67.3 male
74.3 female
67.5 male
40.5 female
52.5 female
67.9 male
47.8 male
52.8 male
56.4 female
60.0 male
53.3 male
26.3 female
76.3 female
57.3 female
58.9 female
49.1 female
73.9 female
76.9 male
70.9 male
82.9 female
62.5 female
74.9 male
75.3 male
55.0 male
43.3 male
non-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
current
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
current
ex-smoker
current
non-smoker
current
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
current
Third quintile
Second quintile
Third quintile
Most deprived
Fourth quintile
Second quintile
Second quintile
Least deprived
Least deprived
Fourth quintile
Third quintile
Second quintile
Second quintile
Fourth quintile
Most deprived
Most deprived
Least deprived
Least deprived
Least deprived
Least deprived
Second quintile
Third quintile
Third quintile
Fourth quintile
Second quintile
Third quintile
Least deprived
Least deprived
Fourth quintile
Second quintile
Third quintile
Second quintile
Least deprived
Second quintile
Third quintile
Third quintile
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Second quintile
Second quintile
Least deprived
Least deprived
Least deprived
Fourth quintile
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
970
971
972
973
974
975
976
977
978
979
980
981
982
983
984
985
986
987
988
989
990
991
992
993
994
995
996
997
998
999
1000
37.4 female
43.2 male
56.3 male
42.0 male
73.1 male
47.6 male
60.2 female
31.9 female
76.3 male
33.7 male
44.0 female
70.2 female
69.5 male
70.8 male
73.6 female
69.3 male
65.0 female
60.0 male
32.4 female
63.0 male
62.4 male
63.2 female
72.2 male
54.6 male
48.7 male
59.9 male
48.3 male
60.5 male
60.1 male
45.7 male
63.6 female
non-smoker
current
current
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
current
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
Second quintile
Most deprived
Second quintile
Second quintile
Second quintile
Least deprived
Least deprived
Third quintile
Second quintile
Least deprived
Third quintile
Third quintile
Least deprived
Least deprived
Fourth quintile
Least deprived
Fourth quintile
Least deprived
Least deprived
Least deprived
Fourth quintile
Least deprived
Least deprived
Least deprived
Third quintile
Least deprived
Second quintile
Least deprived
Fourth quintile
Least deprived
Second quintile
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
alcohol status Duration of DiabetesNAFLD
in Years Diastolic BPSystolic
(mmHg)BPatHeight
(mmHg)
baseline
(m)
at Weight
at
baseline
baseline
(kg)Waist
at baseline
circumference
HbA1c (mmol/mol)
(cm) at baseli
at b
never
12.23
0
80
114
1.65
88.00
137.00
81.00
never
13.03
0
70
113
1.80
95.50
114.00
58.74
never
11.59
0
81
134
1.61
116.50
80.00
66.48
never
21.15
0
60
160
1.70
119.00
101.50
67.21
current
18.44
0
83
109
1.59
120.00
97.00
93.44
current
14.45
1
99
108
1.57
112.02
69.00
62.84
never
25.07
0
88
160
1.63
101.50
91.00
59.54
current
14.36
1
76
149
1.59
62.00
77.50
63.93
current
9.90
0
104
160
1.72
74.57
133.00
97.81
current
10.40
0
90
140
1.61
66.00
80.00
61.75
current
13.99
0
80
128
1.63
76.35
105.00
77.00
current
12.50
0
85
150
1.68
92.00
109.00
48.71
current
15.02
0
63
140
1.78
112.67
82.00
51.50
current
4.86
0
83
140
1.60
102.00
136.50
112.57
current
20.30
1
73
120
1.78
108.40
114.00
83.00
current
22.25
0
70
115
1.73
87.50
104.00
84.70
unknown
18.85
0
80
132
1.71
102.00
110.00
55.30
unknown
5.98
0
76
125
1.73
76.00
104.00
70.73
current
1.28
0
80
154
1.81
90.20
104.00
74.00
current
14.74
1
80
155
1.72
90.00
78.74
63.00
never
20.20
1
65
120
1.68
92.70
125.00
48.63
unknown
19.95
1
96
154
1.79
119.00
110.00
49.69
never
23.12
1
73
122
1.78
82.00
108.00
56.83
unknown
0.70
0
75
115
1.88
116.00
110.00
42.00
current
16.83
1
91
136
1.76
81.19
131.50
62.84
current
17.85
0
70
140
1.61
87.00
97.00
61.20
never
9.35
0
80
145
1.75
74.00
89.00
108.74
current
0
60
90
55.00
current
34.76
1
60
130
1.60
73.93
77.50
56.28
never
3.69
0
74
117
1.60
58.00
134.00
50.00
current
16.29
1
75
115
1.72
85.30
88.00
80.38
current
17.47
0
86
135
1.67
108.00
131.50
71.89
never
9.19
0
75
139
1.61
69.30
87.00
47.23
never
21.43
1
90
175
1.61
105.00
112.00
73.22
never
21.08
1
83
123
1.57
77.00
104.00
63.93
never
11.65
1
60
109
1.63
75.23
97.00
65.57
current
16.98
0
80
144
1.70
61.00
111.00
107.50
never
6.57
0
86
133
1.68
115.00
149.00
77.02
current
12.36
0
96
144
1.65
107.00
105.00
111.00
never
13.88
0
86
139
1.82
74.50
111.00
62.84
current
13.45
1
90
160
1.75
83.50
122.00
78.14
ex-drinker
1.91
0
92
152
1.78
110.70
142.45
37.71
unknown
16.67
0
62
138
1.57
72.00
115.00
76.00
current
32.27
0
74
141
1.48
64.00
89.00
63.14
current
1.37
0
80
136
1.74
105.20
91.00
59.00
current
18.55
0
88
165
1.86
86.00
112.00
62.84
current
current
never
never
ex-drinker
current
current
never
never
current
current
current
current
current
current
never
current
current
current
never
current
current
current
current
never
current
current
never
current
current
current
current
current
current
current
unknown
never
unknown
never
current
current
never
current
unknown
current
never
current
10.23
13.16
9.29
5.57
0.53
18.67
0.02
18.84
17.19
16.52
16.58
12.67
20.15
16.19
13.16
4.36
14.19
0.61
3.14
16.11
2.58
14.19
14.31
3.45
12.32
20.86
13.66
16.20
11.72
7.81
17.86
7.37
1.17
7.41
15.31
15.95
12.27
21.26
21.13
0.21
4.10
19.27
21.26
23.31
13.45
15.03
0
1
0
0
0
0
0
1
0
0
0
1
0
0
1
0
1
1
0
1
1
0
0
0
0
0
0
1
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
70
82
82
86
84
84
101
98
66
69
70
84
83
87
70
96
76
74
87
90
90
85
69
101
80
77
78
86
71
96
76
86
80
63
70
81
81
79
74
83
84
71
70
74
60
80
90
122
142
159
154
120
130
156
160
126
134
146
139
167
132
136
181
159
149
129
160
123
153
124
135
133
107
118
146
128
149
148
126
114
110
133
135
134
145
144
148
161
162
143
160
120
138
128
1.63
1.70
1.62
1.61
1.51
1.77
1.81
1.79
1.63
1.70
1.55
1.74
1.80
1.54
1.53
1.63
1.78
1.57
1.86
1.83
1.75
1.83
1.89
1.77
1.63
1.80
1.89
1.51
1.68
1.88
1.71
1.75
1.64
1.93
1.46
1.68
1.78
1.63
1.70
1.57
1.76
1.53
1.93
1.58
1.70
1.68
84.50
107.00
64.15
88.00
121.00
85.00
98.00
73.00
76.60
76.47
89.30
94.30
89.00
93.00
109.00
88.00
102.00
74.30
101.20
134.80
74.47
77.50
65.50
127.00
131.18
75.30
129.63
85.50
107.33
151.50
90.38
108.20
90.00
95.00
61.40
90.00
100.00
96.00
97.00
82.50
106.75
79.20
72.00
120.00
77.87
98.00
79.70
100.00
119.00
110.00
101.00
97.00
118.00
105.60
109.50
93.00
98.00
91.00
83.00
111.76
113.00
111.00
117.50
91.00
100.00
102.00
102.00
149.00
94.00
117.00
125.00
103.00
107.00
98.00
100.00
110.00
124.00
104.00
119.00
77.00
104.14
115.00
94.00
132.00
142.45
136.50
120.00
104.00
102.00
95.00
115.00
106.00
140.00
91.26
70.49
51.91
36.61
73.64
82.51
117.49
64.00
72.68
72.68
83.61
81.49
62.84
110.93
85.79
55.96
61.25
49.73
91.26
80.00
65.57
62.84
66.10
75.96
77.49
65.74
91.19
56.28
63.93
61.75
57.38
72.68
49.50
105.46
67.21
74.86
60.66
55.19
55.19
115.00
57.38
66.00
82.50
98.00
65.03
102.19
86.00
current
current
never
current
never
current
ex-drinker
current
current
never
never
current
never
current
current
never
unknown
current
ex-drinker
never
current
current
current
current
current
current
never
current
current
current
current
unknown
current
current
unknown
unknown
ex-drinker
current
never
current
current
unknown
current
unknown
never
current
current
7.71
5.51
11.16
1.36
14.15
27.34
19.31
14.52
16.79
13.81
16.51
4.15
17.03
0.95
9.83
19.66
2.38
8.45
11.58
15.75
22.60
12.46
10.14
5.74
6.93
21.73
23.71
24.73
26.73
20.48
10.34
11.32
0.62
22.23
45.14
8.73
6.97
32.98
7.65
4.99
22.89
6.02
4.09
10.77
16.63
0.82
23.75
1
1
1
0
1
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
1
1
0
0
0
1
0
0
1
0
1
0
1
0
0
0
0
0
1
80
84
91
80
78
84
90
90
96
70
61
75
81
90
90
60
72
72
88
64
70
82
70
70
79
84
104
72
62
88
80
85
101
82
65
68
92
87
84
96
76
82
94
66
82
67
82
150
128
140
120
125
142
150
145
170
150
139
123
127
130
130
140
118
139
160
130
130
154
120
123
137
149
154
150
140
148
140
143
149
162
120
120
152
146
137
165
146
128
139
142
144
113
152
1.77
1.81
1.56
1.68
1.67
1.78
1.70
1.78
1.83
1.56
1.58
1.79
1.52
1.64
1.69
1.60
1.69
1.63
1.52
1.65
1.86
1.74
1.68
1.67
1.71
1.86
1.52
1.88
1.48
1.62
1.71
1.70
1.68
1.85
1.54
1.63
1.58
1.83
1.62
1.73
1.78
1.88
1.60
1.67
1.68
1.75
1.53
106.00
64.00
71.00
103.00
101.82
102.23
63.50
109.07
78.52
84.00
104.00
79.38
92.30
108.80
97.40
103.10
64.00
95.00
81.50
80.50
111.50
107.00
105.00
75.00
120.67
108.93
68.29
114.33
114.40
60.00
101.00
106.67
145.96
91.20
64.00
55.00
83.60
108.50
81.38
107.96
104.00
116.50
134.00
68.60
79.38
75.80
98.43
108.00
98.00
102.00
108.00
116.00
106.00
118.50
81.50
111.76
88.00
124.00
89.00
97.00
112.00
140.00
124.00
142.45
108.00
110.00
120.00
112.00
117.00
85.00
128.00
97.00
124.00
111.76
92.00
105.00
120.00
125.00
104.00
100.00
108.00
82.00
97.00
103.00
110.50
117.00
110.50
84.00
104.00
106.00
108.00
85.00
103.00
115.00
61.00
32.24
79.04
51.40
58.10
55.19
66.86
97.26
The top executives for your organization have implemented a strategic initiative of increasing patient satisfaction. As a team leader you will need to implement objectives and goals for your team according to the strategic initiative of increasing patient satisfaction. In 1,000-1,250 words discuss the following:Objectives and goals for your team.How you will communicate your goals to your team. Explain how you will communicate how your team goals fit the bigger picture of the organizational goal.How you know that your team is meeting these goals. Include how you will track your team’s goals.How you will celebrate or redirect your team according to goals.Use three to five scholarly resources to support your reasoning for setting and communicating goals and objectives.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. When writing in APA style, it is important that your analysis is written in third person. Writing in third person helps with clarity and conciseness throughout your paper.
i need help to responding on two students disscussion post here is an example of how another student did it here are the questions the students have answered to
Research a community mental health program or organization in your local city or county.
1. Give the name and brief description of the community program or organization you selected. Make sure to cite the source of the information and have a full reference at the end of the post
2. What types of patients would benefit from this program or organization? What resources are available within this program?
3. a.What are potential or actual barriers to patients receiving treatment from this type of program or organization?
b.What can you do as a nurse to eliminate these barriers?
Post by student -A
1. I decided to research the organization called ‘Horizon Homes’ located here in Mankato. Their website is full of information on the types of programs available through their facilities. They have a crisis center, mobile crisis vehicle, inpatient treatment, and home care. This treatment facility aims to “help these individuals develop the skills to become more independent.” (Horizon Homes, 2023). There is a program option for any kind of situation from tapering off medications in a safe environment to needing support through emotional distress.
2. This organization specializes in adults with disabilities and/or mental illness. Age has to be 18 and up, at least 2 past hospitalizations, homelessness, and people who are at risk for a mental health crisis.
3a. The one barrier I could think of is not having a cell phone or phone near you to be able to contact the facility. Other than that they work hard to have the crisis center available 24/7 and they even started a mobile crisis center for individuals that may not be able to drive.
Horizon Homes, inc.. Horizon Homes Inc. (n.d.). https://www.horizonhomes.org/
Response by student B
Hi
Great post about Horizon Homes I didn’t realize that they now had mobile crisis service for those that couldn’t. I think it’s pretty amazing that they are able to reach out to those people as well and provide them with the support and care that they need. I read on their website that they offer the mobile crisis team to children as well as adults, once again reaching out to more of the community. I also noticed for their intensive residential treatment, they would need a referral made, which could be a barrier for patients who need a longer stay than what the crisis center offers. I think that as nurses, we can help point the patient in the correct direction for getting that referral and ensure that we do everything within our power to ensure that they get the referrals they need.
Thanks for sharing!
Home. Horizon Homes Inc. (n.d.). http://www.horizonhomes.org/south-central-crisis-center/i
i will post two disscussion post and what i will need two separeate responsefor eaach : as obsorved above the response much have additional infronmation using their websiteand word limit 150 words
Interactive Activity 8PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action Items“Public Health Data Standards Consortium”. List and describe at least three new tools supporting the collection of public health data?Submission InstructionsComplete and submit this assignment according to your professor’s instructions
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.
Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.
In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographiesLinks to an external site.
The Assignment: (4-5 pages not including the title and reference page)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:
Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
Use the Safe Assign Drafts to check your match percentage before submitting your work.
BY DAY 7 OF WEEK 8
Submit your completed Assignment.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK8Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_5051_Module04_Week08_Assignment_Rubric
NURS_5051_Module04_Week08_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIn a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:· Properly identify 4 peer-reviewed research articles you reviewed.
20 to >17.0 pts
Excellent
The response identifies 4 peer-reviewed research articles for the Assignment.
17 to >15.0 pts
Good
The response identifies 3 peer-reviewed research articles and one peer-reviewed article for the Assignment.
15 to >13.0 pts
Fair
The response identifies 4 or less peer-reviewed articles
13 to >0 pts
Poor
The response identifies less than 4 peer-reviewed articles or peer-reviewed articles are missing
20 pts
This criterion is linked to a Learning Outcome· Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
40 to >35.0 pts
Excellent
The response accurately and thoroughly summarizes in detail each study reviewed, explaining in detail the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described….Specific, accurate, and detailed examples are provided which fully support the response.
35 to >31.0 pts
Good
The response summarizes each study reviewed, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described….Accurate examples are provided which support the response provided.
31 to >27.0 pts
Fair
The response is missing one or two of the required elements or summaries are superficially addressed.
27 to >0 pts
Poor
The response is missing three or more required elements or the summaries are superficially addressed.
40 pts
This criterion is linked to a Learning Outcome· Synthesize the findings from the 4 peer-reviewed research articles in a cohesive conclusion.
25 to >22.0 pts
Excellent
Response includes a synthesis of the findings in an exceptionally well-written conclusion.
22 to >19.0 pts
Good
Response includes a synthesis of the findings in a well-written conclusion.
19 to >17.0 pts
Fair
The response is missing a synthesis of the findings or the conclusion is superficial.
17 to >0 pts
Poor
The response is missing a synthesis of the findings and the conclusion is not accurate or is missing.
25 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization:Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4 to >3.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3 to >2.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.
2 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains a few (1-2) grammar, spelling, and punctuation errors.
3 to >2.0 pts
Fair
Contains several (3-4) grammar, spelling, and punctuation errors.
2 to >0 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – APA:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Complete an ASAM diagnosis and Quadrant of care for Mary
Unformatted Attachment Preview
Complete an ASAM diagnosis and Quadrant of care for Mary.
Susan, alleged that Mary S., Jason’s maternal
grandmother and legal guardian, is physically abusive and intimidating to 15yr old
Jason. Yesterday 9-28-23, she reportedly punched the adolescent in the face after she
told him to clean his bedroom. This is not the first time Mary has used physical force to
intimidate Jason. He is afraid of his grandmother, as she has threatened to shoot him if
he ever hits her back. Also, the grandmother goes out of town gambling, and drinking,
for days at a time and does not leave Jason any money for food. The last time she left
was on Saturday and she did not return until Monday. Mary does not make an alternate
plan for Jason’s care when she travels out of state.” Jason’s mother, Susan, says she
and her husband gave custody of him to her mother when she was 17 because they did
not have any health insurance. Susan says she went to court and filed a petition to
revoke her mother’s guardianship and the next court date is October 26, 2023.
However, she has to serve her mother the paperwork first. Susan says her mother is a
retired New York State corrections officer, and she may still have her weapon.” Susan is
afraid Jason will become re-involved with gangs and drugs if he moves back in the inner
city with her and Mary is the only one who can really control Jason. She reported my
mother is the sweetest person in the world until she starts drinking. She has always
been that way. I remember she came up to my school so drunk dressed in her
nightgown, when they called me down to the principal’s office she was sitting there with
her holster and gun on under her nightgown and nothing else. That’s why my father left
he couldn’t take it anymore. She would stop for awhile but when she starts she acts a
fool, disappears for days at a time. The police has brought her home at least 10 times
stone cold drunk, the only reason she hasn’t been arrested is because she’s one of
them. Just as Susan finishes interviewing a police car pulls up with Mary in the back
seat, the smell of alcohol reeking from her, the officer said her BAL was .25 when he
saw her pulled over on the side of the road with the windows down and the music
blasting. He brought her home when he noticed it was his old training officer, to sleep it
off. He said he will stop by later to check on her. Susan remarked she’s going to have a
heart attack and drop dead one of these days, she knows she has a bad heart.
Dim 1 ______________
Dim 2 _____________
Dim 3 ______________
Dim 4 S.A. ______________
Dim 4. M.H. ______________
Dim 5 S.A. _______________
Dim 5 M.H. _______________
Dim 6. S.A. _______________
Dim 6 M.H. _______________
Locus of Care _________________
Level of Care __________________
Understanding and Using
Current ASAM Criteria
for Ce-Classes.com
Learning Objectives
After completing this course,
participants will:
Identify ASAM and the history of its
development
Describe how ASAM criteria fit into the
assessment process
Identify ASAM Levels of Care
Describe ASAM Dimensional Criteria
2
The 3rd Edition of the ASAM
Criteria
3
Overview of Training
What is ASAM and the history of its
development
How ASAM fits into the assessment process
Levels of Care
Dimensional Criteria
4
ASAM Criteria Background
In the late 1980’s a taskforce is
assembled to integrate existing admission
and continued stay criteria
Both NAATP and ASAM were involved
Ownership of the criteria was left with
ASAM
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
5
ASAM Criteria Background
Goal –
unifying the addiction field to a
single set of criteria
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
6
ASAM Criteria Background
The criteria were developed through a
collaborative process in which consensus
was achieved
Clinical experts, researchers and a
coalition of stakeholders were included in
the process
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
7
ASAM Criteria Background
The edition with which most practitioners
are familiar is the Patient Placement
Criteria-2R (2001) which replaced the
1996 version
A new edition came out in the Fall of 2013
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
8
ASAM Criteria Background
The ASAM criteria are guidelines for:
– Assessment
– Service planning
– Placement
– Continued stay
– Discharge
For clients with substance abuse
disorders
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
9
ASAM Criteria Background
The ASAM criteria is a framework for
patient assessment that is
multidimensional
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
10
ASAM Criteria Background
The ASAM criteria is also a description of
levels of care
– Levels of care refers to the places within
the service continuum from outpatient
to intensive inpatient treatment.
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
11
ASAM Criteria Background
The ASAM criteria provides a means for
deciding upon the appropriate intensity of
service based upon the patient’s severity
of illness
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
12
When to use ASAM
At first contact with client (at assessment,
when referral is made, to see if a referral is
appropriate for your program)
During treatment
– If not doing well
– If achieving goals
At discharge
– To see what the client needs next
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
13
How to Use the Criteria
To assign the appropriate level of
service and level of care.
To make decisions about continued
service or discharge by ongoing
assessment and review of progress.
To do effective treatment planning
and documentation.
14
ASAM Criteria
Basic Concepts
The main goal of the system is to provide
individualized – clinically driven –
treatment
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
15
ASAM Criteria
Basic Concepts
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
16
ASAM Criteria
Basic Concepts
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
17
ASAM Criteria
Basic Concepts
Each element of the process informs
the next
This is a cyclical process
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
18
ASAM Criteria Background
Intensity of Service is often referred
to as IS
Severity of Illness is often referred to
as SI
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
19
ASAM’s New Definition of
Addiction
Addiction is a primary, chronic disease of
brain reward, motivation, memory and
related circuitry. Dysfunction in these
circuits leads to characteristic biological,
psychological, social and spiritual
manifestations. This is reflected in an
individual pathologically pursuing reward
and/or relief by substance use and other
behaviors.
ASAM (2011). Public Policy Statement: Definition of
Addiction
20
ASAM’s New Definition of
Addiction
Addiction is characterized by inability to
consistently abstain, impairment in
behavioral control, craving, diminished
recognition of significant problems with
one’s behaviors and interpersonal
relationships, and a dysfunctional
emotional response. Like other chronic
diseases, addiction often involves cycles of
relapse and remission. Without treatment
or engagement in recovery activities,
addiction is progressive and can result in
disability or premature death.
ASAM (2011). Public Policy Statement: Definition of
Addiction
21
Definition of Other Key Terms
Clinically managed: Directed by non
physician addiction specialist rather
than medical personnel. Appropriate
for individuals whose primary problems
involve emotional, behavioral,
cognitive, readiness to change, relapse
or recovery environment concerns.
Intoxication/withdrawal/biomedical
concerns are all minimal if they exist at
all.
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
22
Definition of Terms
Medically Monitored:
Services
provided by an interdisciplinary staff of
nurses, counselors, social workers,
addiction specialist and other health
and technical personnel under the
direction of a licensed physician.
Medical monitoring is provided through
appropriate mix of direct patient
contact, review of records, team
meetings, 24 hour coverage by a
physician and a quality assurance
program.
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
23
Definition of Terms
Medically Managed:
Services that
involve daily medical care, where
diagnostic and treatment services
are directly provided and/or
managed by an appropriately trained
and licensed physician.
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
24
Dimensional Assessment
ASAM Criteria should be utilized to:
– Determine the appropriate level of service and
level of care
– Conduct effective treatment planning and
documentation
– Make choices about continued service or
discharge through ongoing assessment and
review of progress notes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
25
Dimensional Assessment
Dimension 1: Acute Intoxication/Withdrawal
Potential
Dimension 2: Biomedical Conditions and
Complications
Dimension 3: Emotional/Behavioral/Cognitive
Conditions and Complications
Dimension 4: Readiness to Change
Dimension 5: Relapse/Continued Use/Continued
Problem Potential
Dimension 6: Recovery Environment
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
26
ASAM Criteria
Assessment
Assessment of Biopsychosocial Severity
and Level of Function
This is the first step in the process
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
27
Assessment of Severity &
Level of Function
First identify if there is acute intoxication
and/or withdrawal potential
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
28
Assessment of Severity &
Level of Function
Evaluate
– Biomedical conditions & complications
– Behavioral conditions & complications
– Cognitive conditions & complications
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
29
Assessment of Severity &
Level of Function
Evaluate
– Readiness to change
– Relapse/continued use potential
– Recovery environment
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
30
What is ASAM PPC?
The Patient Placement Criteria
provide:
– A tool to use along with your clinical
judgment
– Criteria for how bad the problem is and
what the client needs
– A framework for determining who needs
what level of care
– Standard descriptions of levels of care
and who might need them
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
31
Client-Directed, Outcome
Informed
Enhances efficient use of limited resources
Variable length of stay determined by client need and
progress
Can increase retention and reduce drop outs and relapse
Broad flexible levels of care, such as mixing IOP and
housing to get a residential type program
Creative use of resources to develop a treatment package
for each client
Client and clinician have a choice about treatment levels –
least intensive while safe and effective
Can enter the system at any level of care and move as
needed
If there are limited levels of care in your area, link with
other providers as needed
32
The Heart of Client-Directed Tx
Build a therapeutic alliance… it is
the greatest determinant of
treatment outcome
33
The Heart of Client-Directed Tx
Come to agreement with your
client about the treatment
–Goals
–Strategies
–Methods
34
The Heart of Client-Directed Tx
If the client is not with you, your
treatment will not be effective
Help the client accomplish what
is important to them, which will
likely involve staying clean and
sober
35
The Heart of Client-Directed Tx
Court-ordered or leveraged
treatment can be effective
The goal may be to satisfy the
court order!
36
Assessment
What does the client want? Why now?
2. Multidimensional assessment including
strengths, supports, resources, risks and
deficits
3. Imminent danger
– Relates to all dimensions
– Immediate Need Profile
– Risks that require immediate attention
Consider the 3 H’s
– History
– Here and now
– How concerned are you
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
1.
37
The Three H’s of Assessment
History
Here and Now
How uncomfortable are you?
38
Rating Risk in the 6 Dimensions
0 – no or very low risk. Stable.
1 – mild discomfort, can be stabilized, functioning
restored easily
2 – moderate risk/difficulty functioning but can
understand support services
3 – serious difficulties – in or near imminent danger
4 – highest concern – severe, persistent, poor ability
to cope with illness, life threatening
Can also rate as LOW, MEDIUM, and
HIGH
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
39
How do the Dimensions lead
to a level of care?
Dimensions 1, 2 and 3 – high risk/severity =
immediate need for high intensity services
Dimensions 4, 5, and 6 – balance out
strengths and challenges in these dimensions
interact – combine and contrast to determine
the lowest intensity service level that is safe
and effective for the client (and others)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
40
Dimension 1 – Acute
Intoxication/Withdrawal
What risk is associated with the
patient’s current level of acute
intoxication?
Are there current signs of
withdrawal?
Does the patient have supports to
assist in ambulatory detoxification, if
medically safe?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
41
Dimension 1 – Acute
Intoxication/Withdrawal
Is there significant risk of severe
withdrawal symptoms or seizures,
based on the patients previous
withdraw history, amount, frequency
chronicity and recent discontinuation
or significant reduction of alcohol or
other drug use.
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
42
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
0= no intoxication or
Does not affect
withdrawal or already
resolved
placement
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
43
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
1= minimum to
Level 1D – outpatient
moderate intoxication
or withdrawal with
minimal risk
(some onsite
monitoring)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
44
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
2= has some difficulty
Level 2D – outpatient
coping with moderate
intoxication or
withdrawal, some risk
of more serious
symptoms
(extended onsite
monitoring)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
45
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
3= has significant
Level 3.2D –
difficulty coping with
severe signs and
symptoms of
intoxication or
withdrawal, risk of
more severe
symptoms
residential (social
setting detox) or
Level 3.7D (social
setting detox with
medication support)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
46
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
4= incapacitated with
Level 4D – inpatient
severe signs and
symptoms, continued
use poses clear
danger, withdrawal
poses clear danger
(hospital)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
47
Dimension 2: Biomedical
Conditions & Complications
Are there current physical illnesses, other than
withdrawal, that need to be addressed because
they create risk or complicate treatment?
Are there chronic conditions that affect
treatment?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
48
Dimension 2: Biomedical
Conditions & Complications
Hypertension, cardiac disorders, vascular
disorders, diabetes, and seizure disorders are all
high on the list
Chronic benign pain syndromes are often an
issue
There are a range of chronic disorders that may
need to be considered in placement decisions
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
49
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
0: no biomedical
Does not affect
problems
placement
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
50
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
1= adequate ability to
Level 1
cope, mild to moderate
signs and symptoms
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
51
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
2= some difficulty coping,
Level 1, 2 or 3
problems may interfere
with treatment, fails to
care for serious
biomedical problems
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
52
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
3= poor ability to cope
Level 4
with serious biomedical
problems
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
53
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
4= incapacitated with
Level 4
severe biomedical
problems
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
54
Dimension 3: Emotional, Behavioral, or
Cognitive Conditions & Complications
Are there current psychiatric illnesses or
psychological, behavioral, emotional, or
cognitive problems that need to be
addressed because they create risk or
complicate treatment?
Are there chronic conditions that affect
treatment?
Do any emotional, behavioral, or
cognitive problems appear to be an
expected part of the addictive disorder,
or do they appear to be autonomous?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
55
Dimension 3: Emotional, Behavioral, or
Cognitive Conditions & Complications
Even if connected with the addictive
disorder, are they severe enough to
warrant specific mental health
treatment?
Is the individual capable of
managing the activities of daily
living?
Does the individual have the
resources to cope with the
emotional, behavioral, or cognitive
problems?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
56
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
0= no emotional or
Does not affect
mental health problem
or if it exists, it is
stable
placement
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
57
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
1= diagnosed mental
Level 1
disorder requiring
intervention but does not
interfere with treatment
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
58
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
2= persistent mental
Level 2
illness with symptoms
that interfere with
treatment but do not
constitute immanent risk
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
59
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
3= serious symptoms,
Level 3
disability, and impulsivity
but not requiring
involuntary hospitalization
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
60
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
4= serious symptoms,
Level 4
disability and impulsivity
requiring involuntary
hospitalization.
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
61
Dimension 4- Readiness /
Motivation
What is the individual’s emotional
and cognitive awareness of the need
to change?
What is his or her level of
commitment to and readiness for
change?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
62
Dimension 4- Readiness /
Motivation
What is or has been his or her
degree of cooperation with
treatment?
What is his or her awareness of the
relationship of alcohol or other drug
use to negative consequences?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
63
Dimension 4: Readiness to Change
Pre-contemplation:
does not
know they have a problem. “In
denial.” Avoids thinking about
their behavior. Risk rating: 4
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
64
Dimension 4: Readiness to Change
Contemplation:
aware of
problem but ambivalent. Teeter
between cost and benefit of
continued use. Risk rating: 3
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
65
Dimension 4: Readiness to Change
Preparation:
intending to take
action in the immediate future
Risk rating: 2
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
66
Dimension 4: Readiness to Change
Action:
specific overt changes
have been made in the last 6
months to reduce risk. Risk
rating: 1
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
67
Dimension 4: Readiness to Change
Maintenance:
achieved change
goals for 6+ months. Risk
rating: 0
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
68
Matching assessment of severity with
level of care
Not as direct a correlation between
Dimensions 4, 5, and 6 and levels of
care
May need to use motivational
strategies to attract them into
treatment
Resistance is expected and does not
exclude clients from treatment
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
69
Matching assessment of severity with
level of care
If risk is low in other dimensions,
may work on increasing motivation
in a lower level of care first to
prepare for treatment: a “discovery
plan”
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
70
Matching assessment of severity with
level of care
If high risk/severity in other
dimensions, may need to “contain”
the client and do motivational
enhancement in a higher level of
care
Look for strengths
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
71
Dimension 5: Relapse, Continued Use
or Continued Problem Potential
Is the patient in immediate danger of
continued severe mental health
distress and or alcohol and drug use?
How aware is the patient of relapse
triggers, ways to cope with cravings
to use, and skills to control impulses
to uses or impulses to harm self or
others?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
72
Dimension 5: Relapse, Continued Use
or Continued Problem Potential
Does the patient have any
recognition of, understanding of, or
skills with which to cope with his or
her addictive or mental disorder in
order to prevent relapse, continued
use or continued problems such as
suicidal behavior?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
73
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
Relapse:
stops using on purpose
and begins again
Continued use:
never stops using
to begin with
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
74
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
Would continued use/relapse be
dangerous to the client or to others
– Children
– Other adults in their lives
– Others in the world
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
75
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
How severe are the problems if the
individual is not successfully engaged
in treatment at this time?
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
76
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
How aware is the individual of relapse
triggers:
– Ways to cope with cravings to use,
– Skills to control impulses to use or,
– Impulses to harm self or others?
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
77
Matching assessment of severity with
level of care
Have to consider in relation to other
dimensions
High severity can indicate need for higher
intensity of services but not necessarily
Consider the lowest intensity that is safe
and effective
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
78
Dimension 6: Recovery/Living
Environment
Assess for risks, issues, strengths, skills, and
resources in:
– Recovery supports
– Living environment
– Family, friends, social network
– Work/school
– Finances
– Transportation
– Legal mandates/requirements
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
79
Matching assessment of severity
with level of care
Consider in relation to other dimensions
High severity can indicate need for higher
intensity of services but not necessarily
Consider the lowest intensity that is safe and
effective
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
80
Continued Treatment
Guidelines
Keep the client in the current level of
care if:
– They are making progress but have not yet achieved
their goals
– They are not yet making progress but have the
capacity to resolve their problems, are actively
working on goals, and continued treatment is
necessary to reach their goals
– New problems have been identified that can be
treated at this level
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
81
Discharge & Transfer Criteria
Consider transferring if:
– They have achieved their goals and
resolved the problem (transfer to a
lower level of care)
– They are unable to resolve the
problem despite adjustments to the
treatment plan (increase level of care)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
82
Discharge & Transfer Criteria
Consider transferring if:
– They demonstrate a lack of capacity to
resolve the problems (increase level of
care)
– If their problems get worse or
– If more problems emerge that can’t be
effectively treated at this level of care
(increase level of care)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
83
Discharge Planning
Discharge planning is part of treatment
planning
It isn’t a separate or isolated activity
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
84
Discharge Planning
A discharge plan is really a deferred
treatment plan
It should be as specific and concrete as
any other treatment plan
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
85
Levels of Service
Each level of care has specific
parameters which define it
86
Outpatient with Supportive Living
Provides structure and support
Primary medical services not
necessary
Patients not in “Imminent Danger”
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
87
Residential Treatment
Provides 24 hour:
– Structure and support (except 3.1 24
hours)
Primary medical services not
necessary
Patients in “Imminent Danger”
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
88
Inpatient Treatment
Provides 24 hour:
– Structure and support
– Access to medical & nursing services
Patients in “Imminent Danger”
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
89
What is Imminent Danger?
A strong probability that certain behaviors
will occur (e.g., continued alcohol or drug
use or non-compliance with psychiatric
medications)
These behaviors will present a significant
risk of serious adverse consequences to
the individual and/or others (as in a
consistent pattern of driving while
intoxicated)
The likelihood that such adverse events
will occur in the very near future
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
90
What is Imminent Danger?
In order to constitute “Imminent
Danger” ALL THREE ELEMENTS
must be present
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
91
Imminent Danger
Requires In-patient treatment
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
92
Immediate Need
A criteria to be considered in
determining level of care
93
Immediate Need Profile
Dimension #1: Acute
Intoxication/Withdrawal Potential:
(a) Have you ever had life-threatening
withdrawal signs or symptoms?
___ No ___Yes
(b) If yes, are you currently having similar
withdrawal symptoms?
___No ___Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
94
Immediate Need Profile
Dimension #2: Biomedical Conditions and
Complications:
(a) Do you have any current, untreated severe
physical problems?
___No ___Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
95
Immediate Need Profile
Dimension #3: Emotional/Behavioral
Conditions & Complications:
(a) Do you feel that you are imminently in
danger and could harm yourself or
someone else?
___No ___Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
96
Immediate Need Profile
Yes to Dimension 1, 2, and/or 3
Questions:
Requires that the caller/client immediately
receive medial or psychiatric care
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
97
Immediate Need Profile
Dimension #4: Treatment
Acceptance/Resistance:
(a) Do you feel that you are in immediate need
of alcohol/drug treatment?
__No __Yes
(b) Have you been referred or required to have
an assessment and/or enter treatment by the
criminal justice system, health or social services,
work/school, or family/significant other?
__No __Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
98
Immediate Need Profile
Yes to Dimension 4 Alone:
Client to be seen for an assessment as
soon as possible – must be within 48
hours,
Client assessed for motivational
strategies, unless client imminently likely
to walk out and needs containment
strategies
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
99
Immediate Need Profile
Dimension #5: Relapse/Continued
Use Potential
(a)Are you currently under the influence?
__No __Yes
(b) Are you likely to continue use of
alcohol and/or other drugs, or to relapse,
in an imminently dangerous manner?
__No __Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
100
Immediate Need Profile
Yes to Dimension 5, Question (a):
Requires the client receive assessment for
withdrawal potential
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
101
Immediate Need Profile
Dimension #6: Recovery
Environment:
(a) Are there any dangerous family,
significant others, living/working
situations threatening your safety,
immediate well-being and/or sobriety?
__No __Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
102
Immediate Need Profile
Yes to Dimension 5 and/or 6 without Yes
in Dimensions 1, 2, and/or 3:
Requires the caller/client be referred to a
safe or supervised environment
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
103
ASAM Criteria
Also details level of care or service
104
Levels of Care / Service
The basic levels of service are:
Level 0.5- Early Intervention
Level 1- Outpatient
Level 2- Intensive Outpatient/Partial
Hospitalization
Level 3- Residential/Inpatient Treatment
Level 4- Medically Managed Intensive
Inpatient Treatment
Shulman & Associates. (2007). Am
Discussion Board 2
The TIGER Nursing Informatics Competencies Model consists of three
parts: Basic Computer Competencies, Information Literacy, and
Information Management. This week’s discussion will focus on basic
computer competencies and information literacy. Go to Learning
Resources under Week 2 > then click on over to page 3 to see the
PDF > Review the TIGER Initiative Nursing Informatics Competencies
presentation especially Appendix A, B, C. For this week’s discussion
response, please address each of the following:
•
•
Select two of the competencies that you feel you have mastered and
select two that you need to improve upon.
Explain what you plan to do to improve upon those competencies you
have chosen that require improvement.
Please support your response with a scholarly source. Please be sure
to respond to at least two peers each week
This activity aligns with unit learning outcomes:
•
Apply the TIGER Nursing Informatics Competencies Model in nursing
practice. (Essential IV.1, IV.4, IV.5, and IV.7)
Discussion Participation
Course: NURS 300 7380 Science and Research in Nursing (2238)
Criteria
Quantity and
Timelines
Knowledge of
discussion topic,
course content
and applicability
to professional
practice.
Level 3
Level 2
Level 1
Criterion Score
10 points
8 points
4 points
/ 10
Completes original
Completes original
Does not complete
posting and
posting late, or
original posting,
responds to two
does not respond
responds to one or
peer postings
to 2 peer postings
two peer postings
10 points
8 points
4 points
Posting
Fair response to
Poor response to
demonstrates
clear evidence of
conference topic
—missing
conference topic –
knowledge of
discussion topic
important details
that leave the
response that is
and course
content. Post is
response
incomplete.
topic. Does not
applicable to
professional
Demonstrates
some evidence of
evidence of
nursing practice
discussion topic
course content.
Post is applicable
to professional
nursing practice.
Clarity and
Coherence
/ 10
provides a
irrelevant or offdemonstrate
knowledge of
discussion topic or
course content.
Post is not
applicable to
professional
nursing practice.
5 points
4 points
3 points
Few or no
grammatical
Response
contains several
Poor writing and
mistakes, and
cites references
grammatical or
mechanical errors
is
appropriately as
required
that may impact
readability but is
No references cited
/5
grammar, response
incomprehensible.
when required.
mostly
comprehensible.
References are
not cited
appropriately
when required
Total
/ 25
Overall Score
Level 3
Level 2
Level 1
29.166666667 points minimum
16.666666667 points minimum
4.166666667 points minimum
Overview
Informatics Competencies for Every Practicing Nurse:
Recommendations from the TIGER Collaborative
www.thetigerinitiative.org
1
Overview
The TIGER Initiative, an acronym for Technology
Informatics Guiding Education Reform, was formed in
2004 to bring together nursing stakeholders to develop
a shared vision, strategies, and specific actions for
improving nursing practice, education, and the delivery
of patient care through the use of health information
technology (IT). In 2006, the TIGER Initiative convened
a summit of nursing stakeholders to develop, publish,
and commit to carrying out the action steps defined
within this plan. The Summary Report titled Evidence
and Informatics Transforming Nursing: 3-Year Action
Steps toward a 10-Year Vision is available on the
website at www.thetigerinitiative.org.
COLLABORATIVE REPORT
This report provides the detailed findings and
recommendations from the Informatics Competencies
Collaborative Team. For a summary of the work of all
nine TIGER Collaborative Teams, please review
“Collaborating to Integrate Evidence and Informatics
into Nursing Practice and Education” available on the
website at www.thetigerinitiative.org.
The TIGER Informatics Competencies Collaborative
(TICC) Team was formed to develop informatics
recommendations for all practicing nurses and
graduating nursing students. TICC completed an
extensive review of the literature as well as surveying
nursing informatics education, research, and practice
groups to obtain examples and identify gaps. This report
describes the background, methodology, findings, and
recommendations for future work in this area.
A COLLABORATIVE APPROACH
Since 2007, hundreds of volunteers have joined the
TIGER Initiative to continue the action steps defined at
the Summit. The TIGER Initiative is focused on using
informatics tools, principles, theories and practices to
enable nurses to make healthcare safer, more effective,
efficient, patient-centered, timely and equitable. This
goal can only be achieved if such technologies are
integrated transparently into nursing practice and
education. Recognizing the demands of an increasingly
electronic healthcare environment, nursing education
must be redesigned to keep up with the rapidly
changing technology environment.
TABLE OF CONTENT
1. Overview (p. 2)
2. Executive Summary (p. 3)
3. Background (p. 4)
4. Methodology (p. 5)
Collaborative teams were formed to accelerate the
action plan within nine key topic areas. All teams
worked on identifying best practices from both
education and practice related to their topic, so that
this knowledge can be shared with others interested in
enhancing the use of information technology
capabilities for nurses. Each collaborative team
researched their subject with the perspective of “What
does every practicing need to know about this topic?”
The teams identified resources, references, gaps, and
areas that need further development, and provide
recommendations for the industry to accelerate the
adoption of IT for nursing. The TIGER Initiative builds
upon and recognizes the work of organizations,
programs, research, and related initiatives in the
academic, practice, and government working together
towards a common goal.
5. Basic Computer Competencies (p. 7)
6. Information Literacy (p. 9)
7. Information Management (p. 11)
8. Implementation Strategies (p. 14)
9. References (p. 15)
10. Appendices (p. 18)
11. Acknowledgements (p. 32)
2
Executive Summary
Nurses are expected to provide safe, competent, and
compassionate care in an increasingly technical and
digital environment. A major theme in this new
healthcare environment is the use of information
systems and technologies to improve the quality and
safety of patient care. Nurses are directly engaged with
information systems and technologies as the foundation
for evidence-based practice, clinical-decision support
tools, and the electronic health record (EHR).
Unfortunately, not all nurses are fully prepared to use
these tools to support patient care. The TIGER
Informatics Competencies Collaborative sought to
evaluate the current preparedness of the nursing
workforce and propose a set of minimum informatics
competencies that all nurses need to practice in today’s
digital era.
While Nursing Informatics is a highly specialized field,
there are foundational informatics competencies that
all practicing nurses and graduating nursing students
should possess to meet the standards of providing safe,
quality, and competent care. The Technology
Informatics Guiding Education Reform (TIGER)
Informatics Competency Collaborative was formed to
develop the informatics recommendations for all
practicing nurses and graduating nursing students.
Following an extensive review of the literature and
survey of nursing informatics education, research, and
practice groups, the TIGER Nursing Informatics
Competencies Model consists of three parts, detailed in
this document:
• Basic Computer Competencies
• Information Literacy
• Information Management
A new specialty, called Nursing Informatics, has
emerged over the past 20 years to help nurses fully use
information technology to improve the delivery of care.
The most recent 2008 American Nurses Association
Nursing Informatics Scope and Standards
defines nursing informatics as the integration of nursing
science, computer and information science, and
cognitive science to manage communication and
expand the data, information, knowledge, and wisdom
of nursing practice. Nurses certified in Nursing
Informatics are:
• skilled in the analysis, design, and implementation
of information systems that support
• nursing in a variety of healthcare settings
• function as translators between nurse clinicians and
information technology personnel
• insure that information systems capture critical
nursing information
The TIGER Informatics Competencies Collaborative
(TICC) team identified a list of competencies for each of
these categories, as well as the resources available to
support the educational needs of nurses in achieving
these competencies. TICC recognized that it may take
some time to meet these competencies for all nursing
staff, and has prioritized the minimum set of
competencies to focus on in the first year, with the goal
of achieving full competency by 2013. These
recommendations are outlined within this report.
The work of the TICC was foundational to several other
TIGER Collaborative teams. Four other TIGER
Collaborative teams focused on how to implement the
TICC competency recommendations: within formal
academic settings (the TIGER Education and Faculty
Development Collaborative), within health care
provider settings for nurses currently in practice (TIGER
Staff Development Collaborative), for nursing leaders
(TIGER Leadership Development Collaborative), and
how to access HIT resources (TIGER Virtual
Demonstration Collaborative). We recommend that
you reference the Collaborative reports from these
related TIGER Collaborative teams for
recommendations on how to implement these
strategies within your environment. These reports can
be located on the TIGER website at
www.thetigerinitiative.org.
These specialized nurses add value to an organization
by:
• increasing the accuracy and completeness of
nursing documentation
• improving the nurse’s workflow
• eliminating redundant documentation
• automating the collection and reuse of nursing data
• facilitating the analysis of clinical data, including
Joint Commission indicators, Core Measures,
federal or state mandated data and facility specific
data
3
Background
computers, the Internet, mobile phones, and
MP3 (Prensky, 2001). There are a number of
digital immigrants in the nursing workforce who
have not mastered basic computer
competencies, let alone information literacy and
how to use HIT effectively and efficiently to
enhance nursing practice.
Nurses have always been at the forefront of
patient care and focused on patient safety. The
impetus for evaluating how prepared nurses are
to use Electronic Health Records (EHRs) to
improve patient care started in 2004. During
President Bush’s State of the Union Address that
year, he mandated that all Americans will be
using electronic health records by the year 2014.
As reported in Building the Workforce for Health
Information Transformation (AHIMA, 2006), “A
work force capable of innovating, implementing,
and using health communications and
information technology (HIT) will be critical to
healthcare’s success.” President Obama
continued this momentum when he took office
in 2009, proposing to “Let us be the generation
that reshapes healthcare to compete in the
digital age.” Less than 30 days after taking
office, President Obama signed the American
Recovery and Reinvestment Act, earmarking $19
billion to develop an electronic health
information technology infrastructure that will
improve the efficiency and access of healthcare
to all Americans. In addition to the substantial
investment in capital, technology and resources,
the success of delivering an electronic healthcare
platform will require an investment in people—
to build an informatics-aware healthcare
workforce.
The TIGER Summit, “Evidence and Informatics
Transforming Nursing,” held in November of
2006, revealed an aggressive agenda that
consisted of a 10-year vision and 3-year action
plan for nurses to carry forward into the digital
age. TIGER ‘s primary objective is to develop a
U.S. nursing workforce capable of using
electronic health records to improve the
delivery of healthcare. For the TIGER Vision to
be realized, the profession must master a
minimum set of informatics competencies that
allow nurses to use EHRs to deliver safer, more
efficient, effective, timely and patient-centered
care. This education will determine how well
evidence and informatics is integrated into dayto-day practice. Since the TIGER Summit, five
TIGER collaborative teams were formed to
identify how to integrate informatics education
into nurses competencies and nursing school
developed recommendations focused on how to
prepare nurses to practice in this digital era (see
Figure 1). The TIGER Informatics Competencies
Collaborative (TICC) team helped develop a
minimum set of informatics competencies that
all nurses need to have to practice today.
This has accelerated the need to ensure that
healthcare providers obtain competencies
needed to work with electronic records,
including basic computer skills, information
literacy, and an understanding of informatics and
information management capabilities. A
comprehensive approach to education reform is
necessary to reach the current workforce of
nearly 3 million practicing nurses. The average
age of a practicing nurse in the U.S. is 47 years.
These individuals are “digital immigrants,” as
they grew up without digital technology, had to
adopt it later, and some may not have had the
opportunity to be educated on its use or be
comfortable with technology. This is opposed to
“digital natives”: younger individuals that have
grown up with digital technology such as
Figure 1 – TIGER Collaborative Teams involved
in Workforce Recommendations:
1. Informatics Competencies
2. Education and Faculty Development
3. Staff Development
4. Leadership Development
4
Methodology
The TIGER Informatics Competencies
Collaborative was charged with the following
goals:
competencies are standards maintained by
existing industry organizations or standards
development organizations. Leveraging existing
competencies that are maintained by standards
development organizations allow the TIGER
Informatics Competency Collaborative (TICC) to
recommend standards that are relevant to
nurses and ones that will be sustainable as these
bodies evolve the standards as necessary. Of
equal or perhaps greater importance, these
standard-setting bodies all have put tremendous
thought, energy and expertise into there
recommended competencies. When those
competencies aligned with the informatics
competency needs for nurses, we adopted
theirs, thus adding strength, rigor, and validity to
the TICC recommendations. Figure 2 illustrates
the relationship between the competency
category and the standard development
organization.
Define the minimum set of informatics
competencies that all nurses need to succeed in
practice or education in today’s digital era.
Fortunately, there was a significant amount of
nursing research completed on informatics
competencies, well ahead of most other
healthcare professions. The TIGER Informatics
Competency Collaborative (TICC) started by
completing an extensive review of the
literature for informatics competencies for
practicing nurses and nursing students. TICC
also collected informatics competencies for
nurses from over 50 healthcare delivery
organizations. The results of these efforts are
available on the TICC Wiki at
http://tigercompetencies.pbwiki.com. This
resulted in over 1000 individual competency
statements.
As like all of the TIGER Collaborative teams, TICC
completed their research with the use of
conference calls and web meetings, electronic
survey tools, and conducted interviews. Their
conclusions are published in this report and were
shared with colleagues through webinars that
were held in 2008. In addition, numerous
presentations on this topic were given at local,
national and international conferences.
Much of the work involved synthesizing this
extensive list of competencies into a list of
competencies that was realistic for the nearly 3
million practicing nurses. This body of
competencies was evaluated and condensed to
create the three parts of the TIGER Nursing
Informatics Competencies Model:
1. Basic Computer Competencies
2. Information Literacy
3. Information Management
Once the competency categories were
established, each was aligned with an existing
set of competencies maintained by standard
development organizations or defacto standards.
For example, excellent alignment was found with
the existing standards of the European Computer
Driving Licence Foundation for basic computer
competencies; the Health Level 7’s EHR
functional model clinical care components for
information management competencies; and the
American Library Association’s information
literacy standards. All of these sets of
5
Methodology
TIGER Nursing Informatics Competencies Model
Component of the Model
Standard
Source (Standard-Setting Body)
Basic Computer Competencies
European Computer Driving
License
European Computer Driving License
Foundation
www.ecdl.org
Information Literacy
Information Management
Information Literacy Competency
Standards
American Library Association
www.ala.org
Electronic Health Record
Functional Model – Clinical Care
Components
Health Level Seven (HL7)
International Computer Driving
License – Health
European Computer Driving License
Foundation
www.hl7.org
www.ecdl.org
Figure 2
6
Basic Computer Competencies
A “digital native” has grown up with digital
technology such as computers, the Internet,
mobile phones, and MP3. A “digital immigrant”
grew up without digital technology and
adopted it later (Presnky, 2001). There are a
substantial number of digital immigrants in the
nursing workforce who have not mastered basic
computer competencies. Many digital natives
have gaps in their basic computer competency
skill set.
RECOMMENDATIONS
The TIGER Informatics Competency Collaborative
(TICC) has adopted the ECDL competencies and
is recommending them for all practicing nurses
and graduating nursing students.
ECDL certification requires 30+ hours of study
and costs more than some institutions may
be able to afford. Therefore, we have ranked the
relative importance of ECDL syllabus
items and recommend the following as a first
step to basic computer proficiency for all
practicing nurses and graduating nursing
students. These are feasible and affordable and
will provide basic computer competencies for
nurses and allow them to go on to obtain
other TICC competencies (see Figure 2).
Europeans realized this shortcoming in the
workforce across many industries and acted on
it. The European Computer Driving Licence
(ECDL) Foundation set basic computer
competencies in the late 1990s and again in this
decade. About seven million Europeans
have now taken the ECDL exam and become
certified in basic computer competencies.
The ECDL syllabus is effectively a global standard
in basic computer competencies (see list of
modules below). ECDL has developed extensive
training materials, including a certification exam.
Module 1: Concepts of Information and
Communication Technology (ICT)
Module 2: Using the Computer and Managing
Files
Module 3, Section 3.1: Word Processing: “Using
the application”
Module 7: Web Browsing and Communication
ECDL Modules
1. Concepts of Information and
Communication Technology (ICT)
2. Using the Computer and Managing
Files
3. Word Processing
4. Spreadsheets
5. Using Databases
6. Presentation
7. Web Browsing and
Communication
A detailed description of these three modules
including the related competency statements
can be found in Appendix A.
7
Basic Computer Competencies
Figure 2 – Basic Computer Competencies Timeline
Recommendation
Timeline for Adoption
All practicing nurses and graduating nursing students gain or
demonstrate proficiency in ECDL modules 1, 2 and 7, as well as
ECDL Category 3.1
By January 2011
All practicing nurses and graduating nursing students become
ECDL certified or hold a substantially equivalent certification
By January 2013
RESOURCES
European Computer Driving Licence (ECDL) Foundation
http://ecdl.com
The ECDL syllabus is maintained and periodically updated by the not-for-profit ECDL
Foundation. The ECDL Foundation makes arrangements with entities in various countries
to localize the ECDL syllabus. Outside of Europe, ECDL is known as International Computer Driving Licence.
ICDL is available in the United States through CSPlacement.
CSPlacement
www.csplacement.com
CSPlacement is the official distributor of ECDL within the United States. They offer CSP Basic, an elearning course and a certification exam that is substantially equivalent to the TICC recommendation of a
first and significant step towards basic computer competency for 2011. In addition, they also offer CSP, an
e-learning course and a certification exam that is substantially equivalent to the entire ECDL syllabus that
will meet the TICC recommendations for 2013.
Healthcare Information and Management System Society (HIMSS)
www.himss.org
HIMSS has a certificate called Health Informatics Training System (HITS). The HITS
program of e-learning, testing, and certification contains content that is substantially
equivalent to the TICC recommendation of a first and significant step towards basic
computer competency, as well as other content.
8
Information Literacy Competencies
is necessary to determine whether the
information and its application resulted in
improvements. Thus, information literacy
competencies are fundamental to nursing and
evidence-based practice. The components of
information literacy are defined in Figure 3.
The Association of Colleges and Research
Libraries (2000) defines Information literacy as
“a set of abilities allowing individuals to
recognize when information is needed and to
locate, evaluate and use that information
appropriately”. Information literacy builds on
computer literacy. Information literacy is the
ability to:
• identify information needed for a
specific purpose
• locate pertinent information
• evaluate the information
• apply it correctly
Information literacy is critical to incorporating
evidence-based practice into nursing practice.
The nurse or healthcare provider must be able to
determine what information is needed. This
involves critical thinking and assessment skills.
Finding the information is based on the
resources available, which can include
colleagues, policies, and literature in various
formats. Evaluating or appraising the
information also involves critical thinking and the
ability to determine the validity of the source.
The actual implementation of the information
results in putting the information into practice or
applying the information. The evaluation process
INFORMATION LITERACY
1.
Determine the nature and
extent of the information
needed
2. Access needed information
effectively and efficiently
3. Evaluate information and its
sources critically and
incorporates selected
information into his or her
knowledge base and value
system
4. Individually or as a member of
a group, use information
effectively to accomplish a
specific purpose
5. Evaluate outcomes of the use
of information
Figure 3 – Information Literacy Components
9
Information Literacy Competencies
Figure 4 – Information Literacy Competencies Timeline
Recommendation
Timeline for Adoption
All practicing nurses and graduating nursing students will have the
ability to demonstrate Information Literacy steps 1 through 3
By January 2011
All practicing nurses and graduating nursing students will have the
ability to demonstrate all 5 Information Literacy steps
By January 2013
As some institutions may find these competencies difficult to implement in their entirety
immediately, as a first and significant step towards information literacy in nurses, the
TICC recommends focusing on the first three competencies for the first year. Once these
are achieved by nurses in a particular organization, the other two can be added so that by
January 2013, all nurses have all five competencies and incoming nurses demonstrate or
are helped to obtain all five.
RESOURCES
American Library Association
The ALA’s report “Information Literacy Competency Standards for Higher Education”
identifies the competencies recommended above as standards. The report also lists
performance indicators and outcomes for each standard. A faculty member or instructor
can effectively use this report to create a more detailed syllabus and or lesson plan(s) to
implement the TICC information literacy competencies.
http://www.ala.org/ala/mgrps/divs/acrl/standards/informationliteracycompetency.cfm
The Information Literacy in Technology
http://www.ilitassessment.com
The iLIT test assesses a student’s ability to access, evaluate, incorporate, and use
information. It is a commercially available test and may be of use in demonstrating
proficiency in information literacy.
Examples of competency
statements related to each
of the Information Literacy
steps can be found in
Appendix B of this report.
10
Information Management Competencies
effective, and efficient manner.
Information management is the underlying
principle upon which TICC Clinical Information
Management Competencies are built.
Information management is a process consisting
of 1) collecting data, 2) processing the data, and
3) presenting and communicating the processed
data as information or knowledge.
The most rigorous as well as practical work on
enumerating the relevant parts of the EHRs for
clinicians was done by Health Level 7 (HL7) EHR
Technical Committee and was published in
February 2007. This approved American
National Standard (ANSI) publication is titled The
HL7 EHR System Functional Model, Release 1,
otherwise known as ANSI/HL7 EHR, R1-2007.
An underlying concept for information
management is the data-information-knowledge
continuum. Data are discrete, atomic-level
symbols, for example, the number 120.
Information is data that is grouped or organized
or processed in such a way that the data has
meaning, for example a blood pressure of
120/80. Knowledge is information transformed
or combined to be truly useful in making
judgments and decisions. An example of
knowledge is that a blood pressure of 120/80 is
dangerously hypertensive in a neonate.
The direct care component of the HL7 EHR
System Functional Model serves as a basis of
information management competencies for
practicing nurses and graduating nursing
students (see Appendix C). Although these
clinical information management competencies
are numerous, they merely make explicit
competencies for proficient use of EHRS clinical
nursing responsibilities that practicing nurses
and graduating nursing students are responsible
for today in a paper information management
environment or a mixed paper and electronic
environment.
Information is managed by nurses in a variety of
ways, but more and more the preferred or
required method is through information
systems. We define an information system as
being composed of human and computer
elements that work interdependently to process
data into information. The most relevant,
important, and fundamental information
management competencies for nurses are those
that relate to the electronic health record
system (EHRs).
However, the direct care component of the HL7
EHR System Functional Model is not quite
sufficient by itself to cover the information
management responsibilities of nurses in the
digital era. What is needed is to translate these
items into a set of competencies that address
both the purpose and intended use of the HIT
system (EHR in this case) and the “due care “
that nurses need to take in managing
information via these systems. For example,
electronic information is accessed and used in
different ways than on paper, and it is important
for the user (nurse) to understand these
differences as well as the subsequent workflow
and policies and procedures.
Using an EHRs will be the way nurses manage
clinical information for the foreseeable future.
However, nursing responsibilities are not
changing in the shift to increased use of EHRs.
For example, nurses are still required to exercise
due care in protecting patient privacy. But the
manner in which these responsibilities to
patients and communities are upheld may be
different. Therefore, all practicing nurses and
graduating nursing students are therefore
strongly encouraged to learn, demonstrate, and
use information management competencies to
carry out their fundamental clinical
responsibilities in an increasingly safe,
Fortunately, the European Computer Driving
Licence Foundation has come up with a set of
items that address these concerns, called ECDLHealth. The following chart (figure 5) illustrates
how the ECDL-Health item can be linked to a
competency statement.
11
Information Management Competencies
ECDL-Health
Syllabus Item
TICC-related Competency Statement
The Nurse will:
Concepts
Health
Information
Systems
HIS Types
Verbalize the importance of Health Information Systems to clinical practice
Have knowledge of various types of Health Information Systems and their
clinical and administrative uses
Due Care
Confidentiality
Assure Confidentiality of protected patient health information when using
Health Information Systems under his or her control.
Access Control
Assure Access Control in the use of Health Information Systems under his or
her control
Security
Assure the Security of Health Information Systems under his or her control
User Skills
Navigation
Decision Support
Output Reports
Have the User Skills as outlined in direct care component of the HL7 EHRS
model, which includes all of the ECDL-Health User Skills of Navigation,
Decision Support, Output Reports and more.
Policy and Procedure
Principles
Understand the Principles upon which organizational and professional
Health Information System use by healthcare professionals and consumers
are based.
Figure 5 – ECDL-Health Topics linked to TICC Competency Statements
This list of competencies came from the Direct Care components of the HL7 EHR System Functional
Model. In some cases functional statements were not changed as they can also serve as competencies. For
example, the HL7 EHR System Functional Model statement of “Access Healthcare Guidance” was
unchanged, except for the preamble that applies to all Clinical Information Management Competencies, as
“Using an EHRS, the nurse can: Access Healthcare Guidance.” An example of a change to the HL7 EHR
System Functional Model statements is ‘Communication with Medical Devices’ where “Communication
with Medical Devices” was changed to “Facilitate Communication with Medical Devices” to make it a
Clinical Information Management Competency.
12
Information Management Competencies
RECOMMENDATIONS
As with the other categories of informatics competencies, the TICC developed a timeline to adopt and
integrate these competencies into nursing practice and education settings. Figure 5 illustrates these
recommendations for adoption.
Figure 5 – Information Management Competencies Timeline
Recommendation
Timeline for Adoption
Schools of nursing and healthcare delivery organizations will
implement the information competencies listed in Appendix.
By January 2012
Schools of nursing and healthcare delivery organizations will
implement the transformed ECDL-Health syllabus items listed
above.
By January 2012
RESOURCES
HL7 EHR System Functional Model
http://www.hl7.org/EHR/
This ANSI standard can be used by nursing instructors in schools of nursing and healthcare delivery
organizations to develop curriculum to impart the recommended information management competencies
to all practicing nurses and graduating nursing students.
ICDL-Health Syllabus
http://www.ecdl.com
A significant portion of the HL7 EHR System Functional Model is covered by the ECDL-Health Syllabus. The
ECDL-Health Syllabus was developed by the ECDL Foundation to extend the foundation of basic computer
competency skills that are not industry specific into the healthcare industry.
Digital Patient Record Certification (DPRC)
http://dprcertification.com
The DPRC Program was developed with a panel of U.S. informatics subject matter experts and is endorsed
by the American Medical Informatics Association. The DPRC web site states that it assesses a healthcare
professional’s ability to accurately, dependably, and legally manage patient records in a digital
environment.
Healthcare Information and Management Systems Society
www.himss.org
The HITS program, sponsored in the United States by the Healthcare Information and Management
Systems Society, uses a more international version of the ICDL-Health syllabus. Both the DPRC and HITS
certifications are a substantial
Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to classmates or your faculty member.
Due Thursday
Respond to the following in a minimum of 175 words:
What specific criteria of the publication guidelines do you have concerns about?
What elements of your exemplar article do you find helpful in formatting your manuscript?
In what areas, if any, do you need additional support?
Due Monday
Post 2 replies to classmates or your faculty member. Be constructive and professional.
Writing Draft: Theoretical Framework – Proposal Draft
Theoretical Framework: Instructions from the RFP
This section describes the theory and relevant theoretical constructs that guide the selection of
strategies and specific activities to address the health issue with the priority population. Drawing
from the ecological perspective, this important section describes the level at which the framing
theory of the program will be applied (i.e., intrapersonal, interpersonal,
institutional/organizational, or community levels), the core constructs of the selected theory, and
why this theory and level are appropriate for the situation the program proposes to address.
Although the program proposal requires a multi-level approach for this assignment, you are
required to explain your theory at only one level.
Draft Instructions
Step 1: Determine the primary level of change for your program
Step 2: Select the most relevant theory to guide your rationale for change (according to the
desired level of change and what you have learned about the problem).
Step 3: Develop an outline and write a 2-3 page draft for this section of the proposal.
Step 4: Ensure that your similarity score is less than 5% when submitting it.
Recommendations:
1. Use headings to organize your sections.
a. Start with the heading for the section as a whole “Theoretical Framework” and
then use sub-headings for the constructs that are associated with the theory you
are using.
i. Introduce the level of change and the appropriateness/relevance of the
selected theory.
ii.
Describe the basic premise of the theory.
2. Introduce and explain all of the constructs of the theory
a. For each construct, explain (briefly) how the construct will be operationalized
(turned into action) in your program.
i. For example, if you are going to be using the Diffusion of Innovation
theory, explain the communication channels that you will be using and
why (what makes the channels you have selected relevant to your
population?).
3. Use Theory At a Glance as a source (or another resource as needed) to support your
description and overview of the theory and the associated constructs.
Week 5 Discussion Previous Next Discussion Question: Considering your role specialization (nurse educator, nurse informatics, nurse administrator, and family or adult-gerontology NP), identify the top three current trends or issues that you believe to be most important with regard to your chosen role and the impact the role has on patient outcomes. Synthesize knowledge from values theory, ethics and legal regulatory statutes, and develop your personal philosophy for a career as an advanced practice nurse. Be sure to incorporate the content of Week 5. Participation Responses: No later than the due date assigned, review and comment on the discussion question responses posted by at least two of your peers and faculty. Continue to monitor your question and responses until the end of the week. Guidelines: Support your responses with scholarly academic references using APA style format. Assigned course readings and online library resources are preferred. Weekly lecture notes are designed as overviews to the topic for the respective week and should not serve as a citation or reference. In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples that demonstrate a clear connection to the readings. 200 words for the response and 100 words each for peer review response
1) Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented. Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal.
The assignment will be used to develop a written implementation plan.
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2) While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.
A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a review (750-1,000 words) that includes the following sections:
Title page
Introduction section
A comparison of research questions
A comparison of sample populations
A comparison of the limitations of the study
A conclusion section, incorporating recommendations for further research
Prepare this assignment according to the guidelines 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.
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3)Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Population Health Concerns and Health Disparities
In your Module 7 Lecture Materials you learned about WHAT Mindfulness is and HOW to practice it and Dr. Lothes voicethread provided 2 mindfulness practices that you could follow along with. As we have mentioned, mindfulness is a practice that will benefit you from regular and intentional effort. Many mindfulness activities are available for you to try, from guided practices like those you’ve learned here or found through online resources or apps, or tried and true mindfulness practices you’ve been introduced to in the past and work well for you.
For this week’s engagement activity, you will practice mindfulness your way, either searching for a new resource or using one that’s already familiar to you. Make a commitment to practice for a total of 10 minutes this week, either multiple brief practices or one 10 minute (or longer if you already practice regularly) mindfulness practice. Whether it’s practiced indoors or out, seated or lying down, eyes closed or open, pay attention to what works best for you and what you notice while practicing mindfulness. As you stay curious to trying something new or continuing a practice you’ve already incorporated into your lifestyle, in this assignment you will share a detailed reflection of your experience.
Once you’ve completed your practice, use the Discussion Board below to write and reflect on the following questions:
How did you attempt your meditation/mindfulness (sitting or lying down, eyes open or close? etc)?
Did you deliberately set time aside or space to practice? Did you find a certain time of day works better than other?
If you used an app or a guided practice please share the name, link or site and give a little feedback on it.
Do you see yourself incorporating a meditation/mindfulness practice into your regular routine and why or why not?
Reflect on what value, if any, this might have for you and why.
Module 7: Thinking Dimension Lecture Materials
To raise your awareness about the thinking dimension and to prepare for your check your understanding will review/study the THREE items below.
Below we will cover how the 5 senses can be utilized to start an observing mindfulness practice.
Then we discuss the WHAT and HOW skills of mindfulness. There are many misconceptions about what mindfulness is and what it can do for us and our thinking. The infographic and video do a simplistic break down of different aspects of mindfulness and how you can utilize them throughout the day.
One thing to keep in mind that many people confuse about mindfulness is that mindfulness is NOT about “not thinking” or clearing your mind as some say. If your mind wanders during your practice, just gently (without judgement) bring it back. If it does happen that you get an “empty mind” while your doing mindfulness, wonderful! Just notice that too. If it doesn’t, that does not mean you did mindfulness wrong or failed at it. Mindfulness is about being present and effective in the moment, even when your mind (thoughts) is wandering. Mindfulness is the skill of bringing it back. The 4th slide in the WHAT and HOW video has an Counting the Breath mindfulness practice built into it. You can do this practice to start to understand how mindfulness plays a role in our thinking.
Think of your mind analogous to a puppy, when you first start walking it on a leash it wants to go everywhere. This is what your mind does often when we start doing mindfulness. Each time your puppy wanders off after a smell, a car, a squirrel, a sound, etc we GENTLY bring it back to walking on the sidewalk with us. We want to treat our mind like we would this puppy, GENTLY bringing it back each time it wanders. This IS the practice of mindfulness.
Lastly, there is a short video from Crossroad’s peer educators that covers issues concerning substance abuse, stress, and treatment resources on campus.
Instructor Presentation
5 Senses Mindfulness Infographic.pdfNow we will do a 5 senses mindfulness practicePlease view the VoiceThread presentation (Mindfulness & Thinking: WHAT and HOW) to learn about the WHAT and HOW skills of mindfulness by Dr. John Lothes. This particular discussion is a very user friendly way to understand just exactly WHAT mindfulness consists of and HOW to do it properly. Mindfulness & Thinking (WHAT and HOW skills of mindfulness)-1.pptxActions
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Introduction to Disease
Course code:
PHC271
CRN:
Assignment title or task:
Diabetes Mellitus (DM) is a common chronic disease in Saudi Arabia. Explain the
epidemiology, pathophysiology, types, risk factors, symptoms, signs, and prevention of
diabetes.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
Out of 10
Proficiency
Some Proficiency
Limited Proficiency
No Proficiency
2
1.5
1.0
0.5
Content Presentation
Criteria
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Thinking
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/ 10
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Start your writing from the next page (page 3)
•
Word limit: Minimum 600 words (3 pages)
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task (PDF is not
acceptable)
•
Submission should be before the deadline (submission after the deadline is not allowed)
Part 1: Initial Post (due by Oct 23 with Module 7)
Create a blog, video, visual representation, or plainly written response that includes the following information about your Wellness Action Step.
Remind your group what your action step was at the last post (Module 6). If you modified it or changed it since the last post, explain what you changed and why.
Explain how satisfied you were with your progress since you last posted.
How successful were you at following through with your action steps? Why?
If you were not successful at your action step, how might not being successful become a learning or growth opportunity?
What is your action step for this week? How does it relate to your goal(s)?
What strategy can you employ to encourage your success with your action step?
Ask your group mates at least one question about their wellness journey or to collect advice/feedback
Part 2: Respond to Group Mates (due by Oct 30 with Module 8)
Respond to the initial post of at least 2 of your group mates.
Your response can be in written or video format.
In your response, answer the question your groupmate posed in their initial post
( I AM 15 WEEKS C SECTION POSTPARTUM PLEASE CHOOSE APPROPRIATE WORKOUTS)
A performance appraisal is a regular review of employee job performance and contribution to organizational objectives. In many cases, performance appraisals are conducted at the end of the year to evaluate employee performance, as well as set performance for the next year. For this assignment, you will evaluate another function of HR and management and its contribution to effective performance management. Prior to beginning work on this assignment, read Chapter 6: Employee Appraisal: Measurement, Assessment, and Management, and the article Adapting the Performance Appraisal Process to Meet the Needs of the Modern Workplace.
In your paper,
Discuss how performance appraisals are a function of HR and management.
Analyze the basic components of an effective performance appraisal.
Explain how performance appraisals can contribute to organizational goals and objectives.
Describe the advantages of performance appraisals and how they contribute to effective training and development.
Explain potential forms of discrimination based on labor laws and regulations when conducting a performance appraisal.
For additional support with completing this assignment, please refer to the following tools:
Finding HR Journals in the UAGC Library. This tip sheet may support you in researching through the University of Arizona Global Campus Library.
What is CRAAPO? This may assist you in determining the reliability of an HR website.
Scholarly and Popular Resources(1).This tutorial explains the differences between scholarly and popular resources.
Human Resources Research with Library OneSearch. This tip sheet may support you in researching through the University of Arizona Global Campus Library.
The Performance Appraisal paper
Must be two to three double-spaced pages in length (not including title and references pages) and formatted according to APA Styleas outlined in the Writing Center’s APA Formatting for Microsoft Word resource.
Must include a separate title page with the following:
Title of paper in bold font
Space should appear between the title and the rest of the information on the title page.
Student’s name
Name of institution (The University of Arizona Global Campus)
Course name and number
Instructor’s name
Due date
Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper.
For assistance on writing Introductions & Conclusions and Writing a Thesis Statement, refer to the Writing Center resources.
Must use at least two scholarly, peer-reviewed, or credible sources in addition to the course text.
The Scholarly, Peer-Reviewed, and Other Credible Sources table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source.
To assist you in completing the research required for this assignment, view Quick and Easy Library Researchtutorial, which introduces the University of Arizona Global Campus Library and the research process, and provides some library search tips.
Must document any information used from sources in APA Style as outlined in the Writing Center’s APA: Citing Within Your Paper guide.
Must include a separate references page that is formatted according to APA Style as outlined in the Writing Center. See the APA: Formatting Your References List resource in the Writing Center for specifications.
Using information from your assigned readings, the literature, the self-paced tutorial, and leaders in your organizations, discuss the following in a 2-3 page paper.
What are three (3) key strategic initiatives for your organization, department and unit. Do they align with each other? Why or why not? Provide rationale.
Does your organization’s strategic plan address recruitment and retention of key clinical roles? If so, discuss the goals and activities around this initiative. If not, discuss two (2) goals with 3-4 activities focused on recruitment and retention.
Does your organization have a customer service/patient experience model? If so, please describe the model. Is if effective? Why or why not? How is patient experience reflected in the organization’s, your department’s and your unit’s strategic plan? Provide examples.
Points: 40
Due Date: Sunday of week 4 by 11:59 p.m. EST of the U.S.
References
Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)
Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.
Style
Unless otherwise specified, all the written assignment must follow APA 7th edition formatting, citations and references.To download the Microsoft Word APA template. Review this annotated student sample paper guide which draws attention to relevant content and formatting in 7th edition APA style. Make sure you cross-reference the APA 7th edition book as well before submitting the assignment. Refer to the ‘LEARNER SUPPORT’ tab for more information regarding APA 7th edition with comparisons to 6th edition.
Number of Pages/Words
Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.
Instructions
To be successful, complete the following steps in order:
STEP 1. Review the instructional materials and finish learning activities in this module.
STEP 2. Review the grading rubric.
STEP 3. Create a new Word document, write your paper based on the above overview.
STEP 4. Refer to APA book and rubric for correctly formatting the paper.
STEP 5. Save the document with the filename: “Lastname_Firstname_Module_4_Assessment_8” (Example: Smith_Jill_Module_4_Assessment_8.docx)
STEP 6. Submit the document by clicking the link on the left titled “M4 A8 WA: SUBMISSION AREA – STRATEGIC PLANNING ”
Note: You will have three (3) attempts to submit a written assignment, only the final attempt will be graded. For each attempt you will receive a SafeAssign originality report. This will give you a chance to correct the assignment based on the SafeAssign score. View instructions on how to interpret your SafeAssign originality report.
Tutorial matirals;1 Strategic management 2Budgeting, productivity, staffing and schedule. 3 Recruitment and retention 4 performance appraisal 5 customer service and the patient experience.
Answer three parts of a case studyShould be detailed as needed and simple to understand in this scenarioMUST have a background in dentistry to help with this assignment
Unformatted Attachment Preview
Host Immunoinflammatory Response Assignment. (24 points)
CASE:
Your patient had full mouth periodontal surgery 2 years ago and has been stable until today
when you notice the following at his 3-month maintenance visit:
• Generalized bleeding on all lingual surfaces
• Increase in buccal furcation #19 and #3 from a class 1 to class II
• Increase in probing depths from 4mm to 6 mm interproximally on all first and second
molars
• O’Leary score is 35% mostly interproximal surfaces of posterior teeth
He has come in regularly every 3 months for his maintenance visits during the past 2 years. He
brushes two times a day using the Bass technique and flosses 1 time a day.
QUESTION:
How would you explain to your patient what is going on in his mouth? Consider the following
in your explanation: symbiosis vs dysbiosis, host immunoinflammatory response, periodontal
disease progression. Remember you are explaining this to a lay person NOT a dental
professional; keep it brief but thorough. (HINT you cannot just say it is due to his host response
you need to explain what that means). Be sure to include what your patient can do to improve
or stabilize his periodontal health.
Explanation 1: Medical history is non- contributory.
Explanation 2: Patient has uncontrolled diabetes.
Explanation 3: Patient has smoked 1 pack of cigarettes per day for the past 8 years.
HOST-INFLAMMATORY EXEMPLARY
ASSIGNMENT RUBRIC
PROFICIENT
DEVELOPING
ASSIGNMENT
REQUIREMENTS:
Answers question for all 3 parts
of the assignment, submits to
Brightspace by deadline
Answers questions for 2 of
the 3 parts of the
assignment, submits to
Answers question in 1 of the 3
parts of the assignment,
submits to Brightspace by
3 (pts.)
Brightspace by deadline. (2
deadline. (1 pts.)
UNACCEPTABLE
/24
Does not complete the
assignment or assignment is
submitted late. (0 pts.)
pts.)
PERIODONTAL DISEASE
EXPLANATION COMPLETE
AND THOROUGH
Explanation includes if host
response is exaggerated or
suppressed, and all factors
involved in this process for each
of the 3 scenarios i.e., what
host response is, symbiosis vs
dysbiosis, how and why
damage occurs to periodontium
Explanation includes if host
response is exaggerated or
suppressed, omits 1 or more
factors involved in this
process for each of the 3
Explanation does not include if
host response is suppressed or
exaggerated and omits 2 or
more factors involved in the
process for each of the 3
scenarios (10 pts.)
scenarios. (6 pts.)
Explanation is inaccurate and/or
does not include if host
response is suppressed or
exaggerated and/or omits 2 or
more factors involved in the
process for 2 or more of the
scenarios. (0 pts.)
(15 pts.)
PERIODONTAL DISEASE
EXPLANATION USES LAY
PERSONS TERMS
Explanation includes 2 or
more terms that a lay person
cannot understand in entire
Explanation includes 3 or more
terms that a lay person cannot
understand in entire
assignment (2 pts.)
assignment. (1 pt.)
Explanation includes accurate
and understandable instructions
for what patient can do manage
their disease for each of the 3
Explanation is missing 1 or
more details regarding what
patient can do to manage
their disease in entire
Explanation is missing 2 or
more details regarding what
patient can do to manage their
disease in entire assignment.
Explanation is missing 3 or more
details regarding what patient
can do to manage their disease
and /or not provided to patient.
scenarios. (3 pts.)
assignment. (2 pts.)
(1 pt.)
(0 pts.)
Explanation is concise, and uses
terminology that a lay person
can understand for each of the 3
Explanation cannot be
understood by lay person. (0
pts.)
scenarios (3 pts.)
EXPLANATION INCLUDES
WHAT PATIENT CAN DO TO
IMPROVE/STABILIZE THEIR
PERIODONTAL HEALTH
Focusing on women’s health:
Name and describe the components and rationale of the gynecological health history.Define and describe each component of the GTPAL system used to document pregnancy history.
Following the guidelines of the United States Preventive Service
Taskforce (USPSTF) what screening recommendations would you do to G.R. a
66-year-old female patient who visits you at the office for the first
time (last visit to her PCP 5 years ago) with only positive health
history of hysterectomy 10 years ago due to fibroids.A 35-year-old women with a BMI of 40 comes in asking about combined
hormonal contraception’s. You explain the contraindications for hormonal
contraception include (name more than 4 contraindications).Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Include at least two references in your post.No AI submissions
Your Financial Strategies Summary provides organization executives with reasons why they should approve financial strategies for your sustainability initiative plan. It demonstrates your ability to critically think through financial strategy development and presents your financial petition to leadership for resources for implementation.
Prepare the Financial Strategies Summary for your sustainability initiative plan in 6 to 8 pages.
Include the following in your plan:
A brief summary of your sustainability initiative proposal
A minimum of 3 financial strategies to fund implementation of your initiative
An analysis of the strengths, weaknesses, opportunities, and threats of each of your financial strategies for implementation of your initiative
An evaluation of how each of the following impacts those financial strategies within your initiative:
Proposed community partnerships
Proposed waste reduction efforts
Proposed improved patient care outcomes
Petition to the leadership for approval of your financial strategies to enact the initiative
Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality). Format your references according to APA guidelines.
The assignment is to include the following information:
1. Patient Information:
Summarize in 2-3 paragraphs pertinent data from health history such as age, sex,
social, occupational and cultural background, marital status and role in family,
physical appearance and health status.
2. Environment:
Identify the location of the interaction and describe the setting.
3. Describe your thoughts/feelings prior to the interaction.
4. State the predetermined objective for the interaction.
5. Identify the phases of the therapeutic nurse/client relationship.
6. The Process Recording:
Process Recording must reflect a 5-minute portion of the conversation. The recording
can be documented on the chart in the module (see sample), or in a narrative form.
Be sure to include the following elements in the paper.
1. Student’s verbal and non-verbal communication.
2. Client’s verbal and non-verbal communication.
3. Communication techniques used by the student.
4. Feelings of the student nurse.
Process Recordings are verbatim recordings (word for word) of verbal and nonverbal
communication that occurred between the nurse and the client. Communication
techniques must be identified as therapeutic or non-therapeutic with the name of the
technique used. For example, “Therapeutic: Reflection,” or “Non-therapeutic: Giving
False Reassurance.” Since the purpose of the assignment is to analyze communication
skills, students are not penalized for the use of non-therapeutic techniques. However,
points will be deducted for incorrect labeling of techniques.
7. Analysis of the Process Recording:
Examine in detail (2-3 paragraphs) the student nurse/client relationship and the effects of
therapeutic and non-therapeutic communication techniques. The analysis section should
include the following:
a. Description of how the following factors influenced the communication process: the
client’s (and students, if applicable) developmental level, gender, social and cultural
background, values, environment, physical and mental/emotional status.
b. Discuss the impact of non-verbal communication such as body language, eye contact,
appearance, and gestures in the conversation. Reflect on the moments of silence that occurred during the conversation and describe your feelings and reactions in the
silence.
c. Reflect on your interviewing techniques. Give examples of how your interview
techniques facilitated or hindered obtaining relevant and accurate data during the
health history.
d. Comment on the communication techniques identified in the Process Recording. Did
your use of therapeutic communication techniques help meet the objective of the
conversation? Would other techniques have been more appropriate? How did the non-
therapeutic communication techniques influence the conversation? What would you
say differently?
e. Describe how your interpersonal skills (trust, respect, empathy, etc.) influenced the
development of a therapeutic relationship with the client.
8. Conclusion: include a statement regarding the learning experience and implications for
further learning of therapeutic communication skills.
Unformatted Attachment Preview
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HEALTH HISTORY
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DEMOGRAPHIC DATA? 23
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Student’s Name:
IPR Grading Rubric
Date Submitted:
Grade
Health History: Completed & submitted
20 points
Patient Information:
v
Summary of pertinent data from health history
¥
Summary includes age, sex, social, occupational &
cultural background, marital status & role in the
family, physical appearance & general health status
Pre-interaction:
Include location & description o f setting _ (2.5 points
Include a description o f student thoughts and feelings p r i o r to
interaction
2.5 points
The objective for interaction is correctly stated & relevant to
the patient?s situation
2.5 points
-)
Correctly Identify the phases o f the nurse-patient relationship
2.5 points
Process Recording
Y reflects 5 minutes o f conversation
v
includes a verbatim record o f the student?s &
patient?s conversation
includes description o f student?s & patient?s nonverbal communication
communication techniques are correctly identified
includes a description o f the student?sf e e l i n g s
during the conversation
Analysis o f Process recording
¥
Examines in detail effects o f therapeutic & nontherapeutic communication techniques on interaction
v
Describes how factors such as age, developmental
level, gender, social-cultural background, values,
environment, physical & emotional status influenced
the communication process
Describes impact o f non-verbal communication on
interaction
v
Describes interviewing techniques & included
examples o f how interviewing skills facilitated or
hindered obtaining information f o r healthh i s t o r y
Describes impact o f interpersonal skills on
development o f therapeutic relationship
Concludes w i t h a statement o f implications f o r further
learning.
Spelling, Grammar, A P A
FINAL GRADE
|
Please follow rubric and case study. My SBU is Cancer ACO. thank you!
Unformatted Attachment Preview
Strategic Plan
Structure and Rubric
Structure
Students should submit a compiled final strategic plan from each of the individual assignments.
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
Title Page
a. Title of project (e.g., SBU name)
b. Course
c. Your name
d. Semester and year
Executive Summary
a. Should not exceed one page.
b. Briefly and succinctly address why strategy relevant to strategic direction, key
findings (IV through VIII), conclusions, and recommendations.
c. Should give the reader—the executive—an overview of the full report.
Table of Contents (must be auto-generated)
Internal Assessment of Corporation
a. Strategic direction (mission, vision, values)
b. Financial analysis (implications of at least 3 ratios, market share, and payer mix)
c. Resources/Core competencies
d. Summarize strengths and weaknesses (reference S.W.O.T. in appendix)
External Assessment of Corporation
a. Competitive Analysis
b. Porter’s Five Forces Model (must articulate 2 types of customers)
c. Summarize opportunities and threats (reference S.W.O.T. in appendix)
Corporate-level Strategy
a. Corporate-level adaptive strategies and market entry
b. Corporate service portfolio, including SBU below (use BCG Matrix)
Strategic Business Unit (SBU) Strategy
a. Description of SBU
i. Strategic innovation of SBU
ii. Corporate/SBU organizational structure
iii. Description of value to patient
iv. Unique selling proposition (Text: 36-42)
b. Explain role of corporate in execution of SBU strategy
c. SBU Competitive Advantage (differentiation and sustainability)
SBU Performance Management (use Balanced Scorecard with KPIs)
a. Objectives (Must include population health and business goals)
b. Measures
c. Targets
d. Initiatives (do not include this; belongs in Business Case/Marketing Plan)
Appendix documents
a. SWOT Analysis
b. Porter’s Five Forces Model
c. BCG Matrix
d. Balanced Scorecard (with Key Performance Indicators)
Strategic Plan
Structure and Rubric
Rubric
•
Each of the 5 strategic plan sections will be graded for content and writing quality. Points
assigned as follows:
o Excellent = Full points
o Good = Half points
o Fair = Quarter points
o Not acceptable = No points
Component
Internal Assessment of Corporation
External Assessment of Corporation
Corporate-level Strategy
Strategic Business Unit (SBU) Strategy
SBU Performance monitoring
Total
•
Points
4
3
4
5
2
18
Professional report writing and USF Style Guide are required:
• Do not exceed 10 pages, excluding appendices
• Use 1” margins
• 12 point Times New Roman or 11 point Arial font
• Numbered pages starting at the body of the report (same font, centered at bottom)
• Single spaced
• Add a single space between paragraphs (paragraph spacing should be set to 0 pt. before
and after paragraphs)
• Create sub-headings with bolded font with single space between sub-heading and
paragraph
• Do not indent paragraphs
• Use left alignment
• Only one space between sentences
• AMA citation style, include in-text citations and reference list
• Use complete sentences, except in bulleted or numbered lists. When using lists, always
provide sufficient information to ensure clarity.
• Use a professional writing tone.
o Do not use first person (“I” or “we”).
o Never use contractions.
o Explain to the readers how you arrived at your conclusions (explanatory) rather
than simply telling them your conclusions (declarative).
o Avoid “fluff.”
o Minimize passive voice.
A population health strategy for Bay City 133
Case Study: A Population Health
Strategy for Bay City
Zachary Pruitt, PhD
Abstract
As the Affordable Care Act (ACA) moves the U.S. healthcare system toward
population health through value-based purchasing policies (Shaw, Asomugha,
Conway, & Rein, 2014), many healthcare organizations have begun to reconsider
their strategies (Coughlin, Long, Sheen, & Tolbert, 2012; Goldsmith, 2011). The
described case scenario provides rich detail for students to apply healthcare
strategic planning knowledge in a value-based, population health-focused
context. With an intricate community description, comprehensive market facts,
and detailed financial data, the case encourages student learning of innovative business models, including Medicare Accountable Care Organizations,
ACA health insurance plans, and Medicaid Coordinated Care Organizations.
Please address correspondence to: Zachary Pruitt, PhD, University of South Florida, Health
Policy and Management, 13201 Bruce B. Downs Blvd., MDC56, Tampa, FL 33612-3805
Phone: (727) 560-9735; Email: zpruitt1@health.usf.edu
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The Journal of Health Administration Education
Winter 2017
Introduction
As the Affordable Care Act (ACA) moves the U.S. healthcare system toward
population health through value-based purchasing policies (Shaw, Asomugha,
Conway, & Rein, 2014), many healthcare organizations have begun to reconsider
their strategies (Coughlin, Long, Sheen, & Tolbert, 2012; Goldsmith, 2011). This
12,000-plus-word case provides rich detail for students to apply healthcare
strategic planning knowledge in a value-based, population health-focused
context. With an intricate community description, comprehensive market facts,
and detailed financial data, the case encourages student learning of innovative business models, including Medicare Accountable Care Organizations,
ACA health insurance plans, and Medicaid Coordinated Care Organizations.
As described in the detailed case, the fictitious CEO of the Bay City University
Health System (BCUHS) sees that the increasing trend of risk-based payments
will require his organization to innovate. The CEO asked the Strategic Planning Committee analysts (i.e., the student teams) to explore innovative ways
for BCUHS to develop population health capabilities. However, the Strategic
Planning Committee members have differing views on how to achieve the
CEO’s vision. To resolve this conflict, student teams compete to develop the
best strategic plan that meets the CEO’s vision.
Team-based learning simulates the work environments of healthcare industry practice (Lieneck and Greathouse, 2015). “Population Health Strategy for
Bay City” enables students to achieve multiple National Center for Healthcare
Leadership competencies, including development of a strategic orientation,
analytical thinking, performance management, information seeking, professionalism, and collaboration (NCHL, 2006). The case has been successfully
utilized in a graduate-level strategic planning course at an AUPHA-certified
and CAHME-accredited institution.
Bay City case scenario
Named the new the CEO nine months ago, John Woodrow, M.H.A., Ph.D.,
promises a new strategy at Bay City University Health System (BCUHS). As
a visionary leader, Dr. Woodrow views the policy changes produced by the
Affordable Care Act (ACA) as an opportunity for BCUHS to shift from the
current medical intervention model toward more holistic population healthbased practices. Dr. Woodrow has asked the Strategic Planning Committee
to develop options to achieve this vision.
BCUHS is an Academic Medical Center comprising two hospitals with
more than 700 staffed beds, an affiliated 237-bed cancer center, 150 ambulatory sites, 14,000-plus employees, and an annual operating budget of more
A population health strategy for Bay City 135
than $2 billion. BCUHS’s two inpatient facilities, Bay City General Hospital
and Oakridge Children’s Hospital, account for 24% of the inpatient market
in the Apollo Bay area, behind St. Basil Health System (29%) and American
Corporate Hospitals (26%). In addition to inpatient market share, the case
provides 13 financial ratios, beds per hospital, and the number of credentialed
physicians for all health system competitors. Data also include BCUHS payer
mix and payment types as a percent of net patient revenue (e.g., capitation).
Health insurance, long-term care, home care, laboratory, and imaging services
market shares are also included.
Bay City is a growing and vibrant city that serves as the metropolitan hub
for over 2 million people in the Apollo Bay region. Market data for the region
includes population characteristics such as racial and ethnic proportions, and
community health characteristics such as disease prevalence. In addition,
descriptions of healthcare policy, including ACA health insurance exchange,
Medicare Accountable Care Organizations, Medicaid expansion, Medicare
readmission penalties, and certificates of need, are made available in the case
for student analysis.
In a recent meeting with the Strategic Planning Committee, Dr. Woodrow
expressed his desire that analysts explore innovative ways for BCUHS to work
across organizational boundaries, increase accountability, and improve the
health of the community. Dr. Woodrow’s main question was, “What will it
mean for BCUHS to be held financially accountable for the total health of patients?” His Chief of Staff took notes at this meeting. Dr. Woodrow explained
that BCUHS needs to:
•
capitalize on business opportunities generated from the ACA;
•
improve population health management capabilities to position BCUHS
to compete in light of value-based purchasing policies;
•
respond to the emerging health care delivery models;
•
analyze the costs of services to take advantage of new reimbursement
methods, such as capitation and global payments;
•
assess the benefits of BCUHS’s recent information technology investments; and
•
strengthen community connections to effectively address social determinants of health.
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The Journal of Health Administration Education
Winter 2017
Student teams and strategic business units
Students are assigned to one of five teams. Each student team explores a
different strategic business unit concept (i.e., business model). The student
teams use information from the case to develop the most persuasive and fully
substantiated strategic plan for their assigned strategic business unit. The
instructor and/or community healthcare executives can judge and rank the
student teams’ performances in a case competition-style review. A student
team represents a different member of the BCUHS Strategic Planning Committee, each of whom advocate a unique strategic business unit concept. The
five team concepts are:
Team 1: John Barbosa, former insurance executive and state senator, current Chairman of the Board, recommends creating a health plan for the
Affordable Care Act’s Health Insurance Exchange, an upstream vertical
integration strategy. “We have a built-in provider network that enables
BCUHS to efficiently offer these new health insurance exchange customers.”
Team 2: Veronica Tanner, President, Pediatrician and BCUHS-owned
Oakridge Children’s Hospital CEO suggests creating a Medicaid Coordinated Care Organization in partnership with the Bay County Health Department. “We need to leverage our information technology infrastructure
and enhance our primary care to reduce costs.”
Team 3: Christine Chassin, Senior Vice President and Chief Strategy and
Business Development Officer of BCUHS, advocates the creation of a
Medicare Accountable Care Organization. “To be successful, we need to
reduce the total costs of care to below a certain benchmark and meet quality goals. The performance bonus could be significant.”
Team 4: Louis Winthorpe III, President of the BCHUS-affiliated Duke
Brothers Cancer Institute and BCUHS board member, recommends partnering with a private insurance company to accept global payments for
specific types of cancer diagnoses, a Cancer-specific Accountable Care
Organization. “We will be incentivized to efficiently manage treatment
and diagnose cancer earlier.”
Team 5: Sal Vinarelli, bank executive and hospital board member, recommends that BCUHS continue the high-volume, high-acuity fee-for-service
model. “I see no reason to stop milking the fee-for-service cash cow. I
believe we should resist any temptation to invest in some new-fangled
pay-for-performance trend. Instead, we should invest in the positioning
BCUHS to provide services to patients throughout the continuum of care.”
A population health strategy for Bay City 137
Teaching Notes
Learning Objectives
This case-based experiential learning activity supports eight objectives: (1)
apply systems thinking to the changing healthcare environment shaped
by the Patient Protection and Affordable Care Act of 2010; (2) interpret the
implications of various reimbursement methods utilized in U.S. healthcare;
(3) develop strategic planning skills, including internal and external environmental analysis; (4) articulate internal capabilities and competitive advantage;
(5) construct goals and objectives for both corporation and strategic business
unit; (6) develop and execute project management plan; (7) prepare a written
strategic plan; and (8) formulate and deliver persuasive oral presentation.
Classroom management
The following are possible class sessions topics and sequence for the teambased activity.
Session 1 – Introduce case scenario: In this session, the instructor should
explain the case scenario and assessment approach, and create teams for
each strategic business unit (e.g., Medicare Accountable Care Organization). It is recommended that groups of no more than five individuals be
formed (Treen, Atanasova, Pitt, & Johnson, 2016). Also, instructors should
clarify that each team should address two different levels of organization
in their strategic plan: the corporate level and the strategic business unit
level. First, the corporate-level strategic plan examines the BCUHS corporate entity, including the two hospitals, outpatient clinics, information
technology infrastructure, and other information provided in the case. The
corporate-level strategic plan can address components such as the strategic
direction (i.e., mission, vision, and values), competitive analysis, core competencies, and the product or service portfolio strategy. The second level is
the strategic business unit ideas promoted by various executive members
of the Strategic Planning Committee (described briefly above and in detail
in the Appendix). The strategic business unit-level plan should be based
on the BCUHS corporate-level strategy. In this case activity, the strategic
business units are different for each student group. For example, one team
will develop a strategic plan that addresses both the BCUHS corporate-level
strategy and the ACA Health Insurance Exchange health plan strategy.
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The Journal of Health Administration Education
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Session 2 – Create internal and external environmental analysis: For the
second session, student groups should complete internal and external
environmental analysis. Internal analyses can include corporate-level strategic direction (mission, vision, and values), BCUHS core competencies,
and financial analysis (see Appendix A, Table 1). The external analyses can
include the service area description, a legal and regulatory assessment, and
competitor analysis.
Session 3 – Strategic positioning: For the third session, students should
complete the strategic position of the corporate entity (BCUHS), which
can include a description of adaptive strategy (e.g., vertical integration),
explanation of the market-entry strategy (e.g., merger), and a discussion
of the strategic portfolio mix (e.g., inpatient versus outpatient).
Session 4 – Strategic business unit strategy: For the fourth session, students should complete the strategic business unit strategy. It is critical that
strategic business unit strategy integrate with the corporate-level strategy
described above. Students should provide an explicit rationale as to why
their particular strategic business unit idea will be successful given the
corporate-level strategy articulated by their plan. Students must offer succinct justification for why the strategic business unit provides a competitive
advantage for BCUHS.
Session 5 – Present strategic plans: In the final session, student groups
should present a persuasive argument as to why their strategic business
unit (e.g., Medicare ACO) is the best approach for achieving the CEO’s vision. Presentations should include goals and objectives of BCUHS and the
strategic business unit; a description of the revenue model; the competitive
advantage of the strategic business unit; and strengths, weaknesses, opportunities, and threats of the strategic business unit. It is recommended
that instructors invite a community executive to act as “John Woodrow,
CEO,” the judge of the student strategic presentation competition.
A population health strategy for Bay City 139
Questions
1.
What are the core competencies of Bay City University Health System
(BCUHS)?
2.
How does the corporate-level strategic plan for BCUHS differ from the
strategic business unit-level strategy?
3.
Your recommended business model would be just one of many products offered by BCUHS. Describe how your strategic business unit
fits within your overall health service portfolio strategy. You may use
BCG Matrix or GE/McKinsey matrix to describe your team’s approach.
4.
What is the competitive advantage for your strategic business unit?
5.
What is the strategic innovation of your recommended strategic business
unit? How does your strategic business unit agree with the population
health vision of the CEO?
References
Coughlin, T. A., Long, S. K., Sheen, E., & Tolbert, J. (2012). How five leading
safety-net hospitals are preparing for the challenges and opportunities of
health care reform. Health Affairs, 31(8), 1690-1697.
Goldsmith, J. (2011). Accountable care organizations: the case for flexible
partnerships between health plans and providers. Health Affairs, 30(1), 32-40.
Lieneck, C., & Greathouse, D. G. (2015). Use of experiential learning activities
to teach implicit communication in health care services marketing.
Journal of Health Administration Education, 32(1), 149-156.
NCHL. (2006). NCHL Healthcare Leadership Competency Model, v2.1. Retrieved
from http://www.nchl.org/Documents/NavLink/NCHL_Competency_
Model-full_uid892012226572.pdf
Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The Patient
Protection and Affordable Care Act: Opportunities for prevention and
public health. The Lancet, 384(9937), 75-82.
Treen, E., Atanasova, C., & Johnson, M. (2016). Evidence from a large sample
on the effects of group size and decision-making time on performance in
a marketing simulation game. Journal of Marketing Education, 38(2), 130-137.
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Winter 2017
Appendix A: Case Details
Bay City case scenario
Named the new the CEO of the nine months ago, John Woodrow, M.H.A.,
Ph.D. promises a new approach to strategic planning at Bay City University
Health System (BCUHS). A visionary leader, Dr. Woodrow views the policy
changes spawned by the Affordable Care Act (ACA) as an opportunity for
BCUHS to shift from the current medical intervention model toward more
holistic population health-based practices.
BCUHS is an Academic Medical Center (AMC) in Bay City comprising
two hospitals with more than 700 staffed beds, 150 ambulatory sites, 14,000
employees, and an operating budget of more than $2 billion. BCUHS strongly
identifies with the community of Bay City, a vibrant city that serves as the
metropolitan hub for more than 2 million people in the Apollo Bay region.
In a recent meeting with the Strategic Planning Committee, Dr. Woodrow
expressed his desire that analysts explore innovative ways for BCUHS to work
across organizational boundaries, increase accountability, and improve the
health of the community. Dr. Woodrow’s main question was, “What will it
mean for BCUHS to be held financially accountable for the total health of
patients?” Dr. Woodrow explained that BCUHS needs to:
•
capitalize on business opportunities generated from the ACA;
•
improve population health management capabilities to position BCUHS
to compete in light of value-based purchasing policies;
•
respond to the emerging health care delivery models;
•
analyze the costs of services to take advantage of new reimbursement
methods, such as capitation and global payments;
•
reap benefits of BCUHS’s recent information technology investments;
and
•
strengthen community connections to effectively address social determinants of health.
A population health strategy for Bay City 141
Strategic direction of Bay City University Health System
Steve Doering: Dr. Woodrow, thank you very much for speaking with me today.
As we begin the strategic planning process, I want to get your thoughts on the strategic direction for Bay City University Health System. Do you mind if I pronounce
“BCUHS” as “BECAUSE?”
Dr. John Woodrow: Not at all. I think that pronunciation reminds us that we have
a sense of purpose. A “because,” if you will.
Doering: Ha! That’s great! So, let’s get started. As you know, a strategic direction
consists of three parts: mission, vision and values–all intertwined. Let’s begin with
our mission, our purpose and reason for existence. Can you describe what we do and
for whom?
Woodrow: Absolutely. We are committed to helping all people of Apollo Bay regional
area maintain healthy lives. Our mission is to eliminate health disparities in our community through service, education, and clinical practice, and scholarship.
Doering: Now, that mission helps us frame the vision, the next part of the strategic
direction. The vision should describe our desired long-term future state.
Woodrow: I think the vision keeps management focused on meeting the needs of
stakeholders, but we need to articulate our big stretch.
Doering: A stretch?
Woodrow: Yes. BCUHS will continue to provide care to those with the most difficult
health challenges. But, with the world changing rapidly around us, I see BCUHS as
a national leader in health care delivery and medical science innovation. I want to
maintain our position as an education and research leader by continuing our emphasis
on information technology. We can get better, though. We need to do an even better job
with collaborating with our network of community and academic providers. I see us
aggressively redesigning care delivery to improve care coordination. This will enable
us to be a leader in population health management in our region.
Doering: That’s a big vision. So, let’s move on to our organizational values that
define our basic philosophy, principles, and ideals. Values represent the “soul” of our
organization.
Woodrow: Above all, we have to accept accountability for excellence in achieving
our mission. It is not enough to say we want to eliminate health disparities in our
community; we have to measure our accomplishments and adjust our performance,
as appropriate. And we must advocate for equitable access to healthcare. We must
respect patients and their families by providing quality care in a compassionate and
culturally sensitive manner.
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Doering: So how do we accomplish that?
Woodrow: We need to implement and codify the best care processes, which we call
our patient-centered approach. Not only patient-centered, but evidence-based. This
means that we have to create new knowledge through research, and then translate this
knowledge into practice. Since we already provide the highest-quality education for
the next generation of healthcare professionals, we value transferring our knowledge.
Parts of our organization have already innovated care delivery through team-based
care, chronic disease management, and population-based practices. Not only can we
teach our organization these award-winning methods, but collaborate with others
across Apollo Bay region to achieve a common purpose and create value.
Doering: Is that possible at an organization the size of BCUHS?
Woodrow: Perhaps AMCs are slow to change. However, other large and complex
organizations, such as Google, are able to move quickly. I think we can innovate.
Also, our brand is the one thing we value, and we must protect it. This can be done by
providing exceptional performance in clinical outcomes AND patient experience. In
addition, as a multifaceted healthcare system, we value lifelong care. Our brand should
focus on the patient value throughout their life, and not just when they are very sick.
Doering: Is that possible at an organization the size of BCUHS?
Woodrow: Yes, but, we’ve got to keep cost-effectiveness in mind. “No margin, no mission,” as they say. But I like to say that we have to maintain a high level of stewardship
for the resources of this amazing community asset of BCUHS. So, in our everyday
practice, cost efficiency should be addressed by the entire organization, with BCUHS
leadership working with providers and staff to identify areas of savings.
Doering: Excellent. I think we have plenty for the teams of analysts to work with in
order to create their strategic plans. Thank you.
Woodrow: Thank you.
Strategic Planning Committe recommendations
George Barbosa, Chairman of the Board (as told to Steve Doering, Chief of Staff)
Barbosa: As you know, I made my money in health insurance. I remember the days
when hospitals, physician practices, ancillary providers, AND insurers were all part
of the same integrated delivery network. Smartly, I stayed out of that integration
business. I resisted it because I knew that some large health systems were just losing
money on the insurance side just to make money on the provider side, or vice versa.
It was a zero-sum game.
A population health strategy for Bay City 143
As a former politician, I also know the importance of having a good name. It’s an asset
you can count on. And BCUHS has a strong brand, which is exactly what we should
leverage in this new health policy environment.
My suggestion—and I’d be interested in hearing what the others think—is to create a
separate insurance company that competes in the ACA’s Health Insurance Exchange.
I know that there are only four current insurance companies competing in the online
marketplace in the Bay City region right now, and we have the opportunity to compete.
InsuraCare doesn’t have a foothold in that market yet, like they do in the commercial
market. And word around town is that Health Matters Health Plans got a larger share
of the ObamaCare market because they underpriced their benefit plans.
As you know, the health insurance exchange is the cornerstone of ACA. Requiring
people to purchase health coverage has been a boon for insurance companies. While
there are only 100,000 people buying insurance in the exchange now, there are another
280,000 people in the Apollo Bay region still without insurance. That means there is
a huge potential for growth in this market.
We have an advantage over many competitors, because we have the built-in BCUHS
provider network to offer these new health insurance exchange customers. As I said,
the BCUHS brand is strong, so we could license the “Bay City University Health
System” name to this new company. I get that we don’t have the core competency
of claims payment and insurance regulatory compliance, but those functions can be
outsourced to competent companies that specialize in offering back-end solutions to
hospitals and health systems. We could concentrate on marketing and clinical operations.
One thing for the strategic planning committee to consider is that starting a health
insurance company will take a substantial amount of capital. Regulations in our state
require that we have a certain amount of cash available in reserves to pay claims. I’m
not sure what that amount would be, so we’d have to talk to actuaries to figure that out.
The actuaries can also help us develop benefit plans within the Health Insurance
Exchange. You know the bronze, silver, gold, and platinum level benefit packages,
right? Of course, the actuaries know about risk. That’s what this opportunity is really about – managing risk. I think we can gain knowledge in that area that will help
us respond to the changes in health policy toward population health or accountable
care, as they say. By developing the expertise in managing the risk of disease – is this
called managerial epidemiology? – we can be positioned to discover how to capitalize
on other emerging business prospects. Well, this business assumes all the risk, upside
and downside, and that would be a big change from the predominantly fee-for-service
world BCUHS operates in now. I think this opportunity is worth the risk, though, if
you’ll excuse the pun. This opens a new revenue stream for BCUHS.
144
The Journal of Health Administration Education
Winter 2017
Instead of focusing on working with the sick people, this business is about finding the
healthy people. If our customers do get sick, we do what any insurance company does,
reduce inpatient costs, especially amongst the services that lose money for BCUHS. I
can envision ways that we tightly control utilization of less profitable services, but yet
funnel profitable services to our providers. This would increase volume and improve
efficiencies for the right kind of services. In the end, the volume from this business
could support the margins from our other, more dominant payers, such as Medicare.
I think we still would be okay with the other commercial plan contracts, InsuraCare
Health, and Health Matters Health Plans, but I guess that’s something to consider.
Instead of integrating our hospitals with physician practices in ways that seem too
complicated to me, we should create a virtually integrated entity, one that is focused
and data-driven. It’s vertically integrating the distribution channel—marketplace,
us with insurance, us at the doctor’s office, us at the hospital. See? I believe that the
combination of our medical science expertise and health services delivery with a new
risk management and insurance competencies, we can position ourselves favorably
for future success.
Sal Vinarelli, bank executive, Board member (as told to Steve Doering)
Vinarelli: I know a winner when I see it. And I know that the fee-for-service model
has worked for hospitals for over 50 years. What makes money is the high-volume,
high-acuity model. This has been proven true by consistently returning substantial
sums of money, albeit with small margins. Let’s get real. Executives at hospitals—and
BCUHS is included here—make six or seven figure salaries to be custodians of huge
community assets. And I see no reason to stop milking that cash cow.
What BCUHS needs is to do is resist any temptation to invest in some new-fangled
trend in population health. Even if accountable care is coming to the healthcare policy
landscape, BCUHS should not be eager to help it along. Instead, we should harvest
the rewards of a fee-for-service payment strategy, at least over the short-term.
This may mean that we reduce the number of commercial payer contracts if they are
not willing to continue fee-for-service arrangements. I don’t think the insurers will
choose to discontinue fee-for-service in favor of pay-for-performance (or whatever they’re
calling it now), because the BCUHS brand is too strong in Bay City to be left out of
their networks. Remember how employees of Bay City-based Healthonics complained
to the newspaper when the St. Basil Health Plan limited their inpatient network to
just the three St. Basil Health System hospitals? That was bad P.R. for St. Basil. So
what if the deal was profitable for them? It damaged their standing in the community.
A population health strategy for Bay City 145
So-called accountable care means lots of coordination costs, and that means big investment in things that don’t get reimbursed. Think case managers. Think IT systems. If
BCUHS spends money on anything at this point, it should be for buying profitable
specialist physician practices, like neurosurgeons and orthopedic surgeons. Basically,
we need to make sure that the best paying patients with the best paying health insurance are coming to BCUHS hospitals.
Speaking of insurance, we need to review our contracts and figure out how to get the
most of the existing fee-for-service arrangements. In outpatient care, are we paid based
on Medicare relative value unit rates? Great! How do we optimize our coding? Another
example – do we duplicate services, like radiation oncology, in a facility setting and a
free-standing setting? Let’s funnel the care to the highest paying location. What about
trauma services? How can we make sure that we are creating a trauma alert each time
that it’s justified? We’re leaving big bucks on the table with this fee-for-service stuff!
For inpatient services, we have to get smart about reducing the average length of stay.
Have we maximized this effort? Why are we reacting to this population health stuff,
when there’s so much money there for us in fee-for-se
After reading Chapter 2, apply what’s been happened with the Covid-19 Pandemic to the 5 basic questions (P.E.R.I.E.) we need to ask that make up what we call the evidence-based public health approach.To do well on this assignment, you need to:Use P.E.R.I.E. to discuss what has been happening with our recent pandemic.First identify the five steps of P.E.R.I.E.For each step in the P.E.R.I.E. process discuss how the public health system has been managing this pandemic.Your paper will be graded not only on content, but also on college level writing and understanding.You should be able to address this assignment in approximately five to six paragraphs. Your work need not be an in-depth midterm quality submission. I’m looking to see if you understand the P.E.R.I.E. process and are able to generally apply it to our current major public health challenge, the Covid-10 pandemic.
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
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For one personal strength include advocacy
Reflect upon the competencies necessary for leadership and policy engagement as an advanced practice nurse. Consider professional development goals and the opportunities to strengthen your skills in these areas. Refer to the assignment criteria table as you respond to the following questions. Submit your essay on the assignment page in Canvas.
Reflect upon your personal leadership strengths and opportunities for enhancement. Describe at least two leadership strengths and two opportunities for enhancement regarding leadership skills.
Identify and describe two leadership competencies that are needed for advanced nursing practice. Explain how each of the two competencies can facilitate effective advocacy and leadership of policy efforts.
Describe two goals for professional development that will cultivate continued growth in these two leadership competencies. What resources will you need to achieve these professional development goals, and how might the future practicum experiences support these goals?
Rubric:
This criterion is linked to a Learning OutcomeLeadership Strengths and Opportunities for Enhancement
20 pts
Distinguished
Distinguished presentation of information evidenced by all of the following covered in a comprehensive and concise manner: • Reflect upon your personal leadership strengths and opportunities for enhancement. • Describe at least two leadership strengths and two opportunities for enhancement regarding leadership skills.
Leadership Competencies
25 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Identify and describe two leadership competencies that are needed for advanced nursing practice. • Explain how each of the two competencies can facilitate effective advocacy and leadership of policy efforts.
This criterion is linked to a Learning OutcomeGoals for Professional Development
25 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Describe two goals for professional development that will cultivate continued growth in these two leadership competencies. • What resources will you need to achieve these professional development goals? • How might the future practicum experiences support these goals?
Graduate-Level Writing Style
5 pts
Distinguished
Distinguished graduate-level writing style is evidenced by meeting all of the following criteria with 0-1 errors total: • Correct use of spelling and sentence structure • Clarity, organization, and logical flow of ideas within writing • No direct quotes in the essay
Due to the reflective nature of the assignment, first person is acceptable.
Requirements: 2-3 Full Page Essay Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph.
Please be sure to carefully follow the instructions.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include one or more in-text citations and one or more credible or scholarly source published within the last 5 years.
In your own words, define autism. Then, identify and briefly describe four symptoms that a child with an autism spectrum disorder might exhibit.In your own words, define ADHD. Then, identify and briefly describe four symptoms that a child with ADHD might exhibit.Describe at least three specific implications (e.g., financial, political, psychological, educational, etc.) of autism and/or ADHD for families, schools, and/or society as a whole.Directions:Respond to each item. Each response should be concise and 2–3 paragraphs in length.Use MS Word to write your responses, and submit your answers to all three questions in one Word document.Copy and paste each question into the document, so your Instructor can see which questions you are answering.
Assessment Description Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week’s entry, students should reflect on the personal knowledge and skills gained. Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing. Topic Focus: The Role of Technology in Improving Health Care Outcomes Use APA format.plagiarism report (less than 10%) Note: For this assignment I need to talk about how the Role of Technology in Improving Health Care Outcomes (the topic focus) relates to this week’s assignments. Please, let me know if you have any questions.
Identify one individual, one institutional, and one situational ethical breach that took place at Abu Ghraib.
For each identified ethical breach, suggest an underlying cause or institutional challenge.
Explain how insights gained from the Stanford Prison Experiment might apply to each underlying cause or institutional challenge.
To prepare:
Review Chapter 3 of the course text The Ethics Challenges in Public Service and focus on institutional challenges to ethical leadership.
Review Chapters 5 and 6 of the Frontline documentary “The Torture Question” and think about the institutional challenges and possible underlying causes of unethical conduct of the guards at Abu Ghraib.
Review the Stanford Prison Experiment slides. Think about what Zimbardo called the “power of the situation” and how preconceived notions contributed to the behaviors of both the student guards and the student prisoners.
Consider the institutional challenges and possible causes of unethical behavior that contributed to the guards’ ethical breaches at Abu Ghraib.
Identify two underlying causes or institutional challenges that led to the ethical breaches at Abu Ghraib.
Support your Assignment with specific references to all resources used in its preparation. You are asked to provide a reference list for all resources, including those in the Learning Resources for this course.
discussion module 9 , Research 505Research the National Committee of BioEthics (NCBE) Implementing Regulations of the Law of Ethics of Research on Living Creatures in Saudi Arabia.Select any of the many articles related to your profession or resonate with your student research topic. How could these guidelines be integrated to ensure the researcher’s adherence to these research regulations and protocols?
Reflect on your experience in this class. Identify key topics that you learned in the course, and develop a plan to incorporate them into your future career. Consider how the information you learned in this course will help you in your future classes.
Unformatted Attachment Preview
Case Study One: Cottage Senior Living
Dania Atieh
Southern New Hamphsire University
Final Project
1
Introduction
Serving the requirements of elderly and disabled people who need daily support, Cottage
Senior Living operates in the dynamic long-term care and assisted living market. Several urgent
issues, such as decreased resident satisfaction, increased employee turnover rates, and heightened
competition, are facing this sector. Given the industry’s predicted growth, fueled by an aging
Baby Boomer generation and longer life expectancies among older people, these challenges are
of the utmost importance. This paper summarizes the challenges, interpretation of the mission,
vision, and values, and their impacts on the challenges faced.
Summary Of the Circumstances and The Problems
Cottage Senior Living is a part of the more significant long-term care and assisted living
sector, which includes a variety of healthcare and residential service providers for elderly and
disabled people in need of help with daily life. The organization faces falling resident
satisfaction, increased staff turnover, and increased competition in the assisted care market.
These concerns are critical given the industry’s anticipated growth, predominantly fueled by the
aging Baby Boomer demographic and rising life expectancy among older people. In addition,
Cottage Senior Living operates in a competitive market where private payers account for a
sizeable portion of revenue and the four top industry providers hold a meager 13 percent of the
market. It is essential to comprehend the demographics of senior living communities, the variety
of care services provided, and the advent of cutting-edge models like continuing care residential
communities (CCRCs) and memory care institutions to address these issues. Despite Medicaid’s
significance to the sector, the organization made the strategic decision not to advertise to or
accept Medicaid recipients, which gives its situation a unique twist (“Cottage Senior Living,
n.d.).
2
Interpretation of the Mission, Vision, and Values of Cottage Senior Living
In the context of the long-term care and assisted living industries, Cottage Senior Living’s
mission, vision, and values come together to provide a guiding framework that determines the
organization’s identity and purpose. The mission statement highlights the organization’s
commitment to improving the quality of life for senior citizens by putting their safety, care, and
comfort first. It reflects a dedication to offering all-encompassing support, considering a person’s
physical, emotional, and social needs. The organization’s daily operations are guided by this
objective, which places a premium on resident pleasure and general welfare. The vision
statement outlines Cottage Senior aspirational aim of becoming the top option for senior living.
It focuses on the pursuit of excellent care and conveys a dedication to going above and beyond
what is expected in the field. The organization’s commitment to adapting to changing healthcare
trends and resident expectations is shown by including “innovation” in the mission statement
(“Cottage Senior Living, n.d.).
These values of compassion, integrity, respect, and quality provide Cottage Senior
Living’s ethical and practical compass. “Compassion” highlights the organization’s commitment
to empathic and sincere care for residents, fostering a supportive and trusting environment.
Reiterating the value of moral behavior and openness, “integrity” ensures all stakeholders can
believe in the organization’s decisions. Regarding inhabitants’ requirements and preferences,
“respect” directs how they are treated decently. “Excellence” establishes a benchmark for
continual progress and motivates the business to offer the best possible care and services. When
taken as a whole, these values foster an organizational culture that aligns with the organization’s
mission and vision, fostering a setting where residents receive exceptional care and staff
members are committed to their jobs (“Cottage Senior Living, n.d.).
3
Impact Of the Mission, Vision, And Values on Organizational Circumstances
How Cottage Senior Living interprets its goal, vision, and values is crucial to how it
responds to its difficulties. The mission establishes high standards for well-being and guides care
on residents’ needs to overcome diminishing satisfaction. The organization is inspired to stand
out and effectively engage with the community since the vision’s emphasis on outstanding
service and innovation aligns with the competitive landscape. The organization’s principles also
foster a supportive workplace culture, which addresses staff turnover issues by encouraging
employee engagement and happiness. According to Fuertes et al. (2020), these guiding principles
give Cottage Senior Living a framework for making strategic decisions that will improve
resident satisfaction, keep it competitive, and increase staff retention while adhering to its
mission to offer great care in a loving and secure environment (“Cottage Senior Living, n.d.).
Conclusion
In the constantly changing environment of the long-term care and assisted living
industries, Cottage Senior Living faces some complex problems. These difficulties include
dwindling resident satisfaction, rising staff turnover, and intensified competition. However, the
organization’s apparent interpretation of its goal, vision, and values provides a strong foundation
for tackling these difficulties. Cottage Senior Living can seek to improve the quality of life for its
residents, excel in the delivery of care, and establish a welcoming workplace that benefits
residents and staff by aligning its actions with these guiding principles. Although the path ahead
may be difficult, the company’s dedication to its goal, vision, and values guide it through these
difficulties, ultimately securing its long-term success and reputation as a top choice for senior
living.
4
Cottage Senior Living specializes in long-term care, among other things. The
administrative center of the business is located in Huntsville, Alabama. Cottage Senior Living
runs three different senior living residences. The Assisted Living, Memory Care, and Active
Adult homes offer long-term care services. As a result, significant changes have been made to
the company’s customer service philosophy and strategy. The current study incorporates market
characteristics to define the three strategic approaches contributing to the firm’s growth and
performance. This case study analysis evaluates the applicability of strategic analysis to identify
the problems the company has and potential remedies.
The Organization’s Approach
Senior Cottage Living is a well-structured organization that aims to help the elderly. Cliff
White, the company’s president, underlined the need to pay particular attention to the interests of
the elderly clients in his speech. Their mission statement states that they want to ensure that
elderly individuals are treated with dignity and compassion. This indicates how the business
bases its strategic decision-making on its target market’s wants and needs (Ginter et al., 2018).
The business has a clear plan for the future, which includes assessing where it is now in terms of
growth and contrasting it with where it needs to be.
The president has divided their expansion into three phases by asking only three
questions regarding the organization’s future development: what, why, and how regarding
location and capacity for growth. The focus on “service offerings” in the vision demonstrates that
Cottage Senior Living is considering a range of services in addition to housing to support
members’ preferred way of life. This all-encompassing approach can be a component of their
master plan to differentiate themselves from the competitors (Harrington et al., 2016). Providing
residents with amenities and services that encourage ongoing physical and social engagement is
5
certainly one of their long-term goals. The company’s president also discussed how serving nonsubsidized, private-pay clients in tertiary markets sets it apart from rivals (“Cottage Senior
Living, n.d.).
The Major Issue Identified From the Case Study
The case study has brought to light a significant need for methods of growth and
expansion. The president of the company presented information showing the company’s aim to
expand into nearby towns, which might be a huge growth engine but is only as good and
effective as the management of the organization (“Cottage Senior Living, n.d.). It is vital to
assess the situation first before moving forward. In each location, franchisees also own the land
on which their businesses are built, which might make it difficult to hire and keep a large enough
pool of qualified workers. However, all business-related tasks, such as hiring staff and running
advertisements, fall within the purview of the Cottage Senior Living corporate office. As a result,
the firm must create an expansion plan that complies with all relevant regulations. An assessment
of present patterns and changes can be used to make predictions about how it will operate in the
future. It will be crucial to assess critical directions for improving a framework for flexible
change in the future (Harrington et al., 2016). The rising proportion of patients with Medicaid
insurance—which is already over 60%—is one of the current trends. Cottage Senior Living does
not currently accept Medicaid patients.
Strategic Planning Concerns
The leadership of the company has pledged its efforts to organize the development
resources of the company to enable it to realize its vision statement. The organization’s goal is to
offer people housing and services that encourage an active, sociable, and involved way of life.
6
This suggests that creating a distinctive way of life for its residents has been a significant priority
of their strategic planning (Ginter et al., 2018).
The Role of Healthcare Manager
Senior Cottage Living is a corporate entity that focuses on assisting the senior population.
Within this organization, a healthcare manager assumes a significant responsibility in ensuring
the provision of high-quality healthcare services to align with the company’s goal and vision
(Ginter et al., 2018). The cottages are categorized according to the specific requirements of the
clientele, namely Assisted Living, Memory Care, and Active Adult (“Cottage Senior Living,
n.d.). Hence, a healthcare manager plays a crucial role in evaluating the suitability of potential
locations for establishing healthcare entities and providing recommendations by the regulatory
framework governing the industry’s corporate operations.
Stakeholders
Customers stand to gain the most from the company’s agenda, as their patronage is
crucial to the success of the enterprise. The growth of the organization is dependent on the
participation of seniors, regardless of their demands. The growth of the business has been
segmented into three areas so that all of its resources can be devoted to serving the needs of the
elderly. As a result, customer satisfaction has become a focal point in the company’s efforts to
serve the community and realize its goals in that regard (Harrington et al., 2016).
Conclusion
Based on the case study, the organization has established its advantages and barriers
related to growth and development, which is its major agenda. From a personal standpoint,
strategic planning is based on a company’s ability to identify its limitations and address them as
growth opportunities. Since Senior Cottage Housing has recognized “empty nesters” as a key
7
demographic within the senior housing industry, the company has devised a plan to expand into
neighboring communities to meet their needs. By using this segmentation strategy, they may
now cater their products and services to this specific demographic.
Companies seek new ways to stand out in competitive marketplaces in today’s fastchanging business environment. Cottage Senior Living (CSL), a tertiary senior home provider
that targets non-subsidized, private-pay users, is one such company that has established itself
effectively. Cottage Senior Living (CSL) seeks expansion while addressing regulatory issues in
tertiary areas to provide specialized elder care.
Brief Summary of the Case Study
The focus of the case study is Cottage Senior Living (CSL), a provider of senior housing
with its main office in Huntsville, Alabama. CSL’s 1980s founding by Peg Thompson and Wade
White introduced a groundbreaking assisted living service framework (“Cottage Senior Living,”
n.d.). The company targets non-subsidized, private-pay consumers in tertiary markets. CSL’s
extensive elder care portfolio includes independent living (IL), assisted living (AL), memory
care (MC), and skilled nursing facility (SNF) choices. The franchise-like CSL structure allows
each facility to operate as a legal company. They pay CSL a management fee to unify operations
and branding throughout the firm (“Cottage Senior Living,” n.d.). CSL aims to exclude Medicaid
beneficiaries to focus on private-pay consumers.
Policies Addressing the Issue
Cottage Senior Living (CSL) deliberately addresses the challenge of supplying nonsubsidized, private-pay consumers in tertiary markets. Medicaid exclusion is a crucial policy that
fits CSL’s overall plan (“Cottage Senior Living,” n.d.). CSL controls its consumer base by
avoiding Medicaid and focusing on private-pay clients, ensuring its services meet its target
8
market. CSL’s franchise-like structure, with each facility as a legal company, pays CSL a
management fee. This structure requires organization-wide branding uniformity, operational
standards, and management fee agreements. In addition, the extensive array of senior care
services offered by CSL, including independent living, assisted living, memory care, and skilled
nursing, strongly supports standards to guarantee quality and compliance for each service
category.
Alignment with Mission and Vision
Cottage Senior Living (CSL) aligns its strategic planning with its mission and vision to
serve non-subsidized, private-pay consumers in tertiary markets. Several factors support this
alignment. First, CSL’s objective is to provide specialized elder care, and its ambition is to
provide high-quality care in tertiary markets (“Cottage Senior Living,” n.d.). By targeting
private-pay consumers, CSL’s strategic strategy carefully follows its objective and vision.
Medicaid enrollees are excluded to ensure CSL’s services target its target market. As stated in its
mission and vision, CSL provides specialized treatment to private-pay customers, ensuring
service quality. CSL may fulfill its mission by entering less crowded areas and offering
specialized treatment. Furthermore, the franchise-like structure in the case standardizes
operations and branding among CSL sites (Crawford-Spencer & Cantatore, 2016).
Standardization fits the organization’s objective of providing specialized services consistently
and a vision of high-quality care across its operations.
SWOT Analysis
Strengths
Specialization in Private-Pay Market: Cottage Senior Living (CSL) excels in serving
non-subsidized, private-pay consumers. CSL differentiates itself in the elder living sector by
9
servicing private-pay consumers and setting pricing structures that reflect its dedication to highquality, specialized care.
Comprehensive Senior Care Portfolio: CSL excels in independent living, assisted living,
memory care, and skilled nursing. This complete solution enables CSL to meet older population
demands, improving its market presence and agility.
Standardized Operations: In CSL’s franchise-like organization, maintaining service
quality and brand awareness requires standardization. For instance, all CSL facilities provide
consistent care, amenities, and experiences, building confidence and loyalty.
Weaknesses
Limited Market Reach: CSL’s strategy concentration on tertiary markets may restrict its
market reach and development prospects. Serving sparsely inhabited regions may reduce
earnings due to a limited number of private-pay consumers.
Revenue Source Limits: CSL may encounter revenue source limits by rejecting Medicaid
clients. In recessions or when prospective inhabitants are low-income, relying only on privatepay consumers is dangerous.
Opportunities
Growth in Tertiary Markets: CSL can benefit from the tertiary markets’ potential for
development. Seniors may require specialized care in tertiary areas, allowing CSL to grow its
client base.
Expansion into New Regions: CSL may reach more private-pay clients by expanding into
new locations. To succeed in new areas, however, extensive market analysis and demographic
adaptation are essential.
10
Service Diversification: CSL may get a competitive edge by diversifying its services to
fulfill consumer demands. Innovative elder care services, wellness initiatives, and technologydriven solutions may expand the consumer base and income. CSL’s specialized treatment makes
it ideal for these chances.
Threats
Competition from Larger Players: CSL confronts significant competition from more
extensive elder living facilities. Established companies may have more significant resources,
marketing strength, and brand awareness.
Economic Fluctuations: Economic downturns threaten CSL’s sole reliance on private-pay
consumers. Seniors may need help to afford private-pay elder care during downturns.
Environmental Factors and Impact on Care Delivery
The environmental elements discovered via the SWOT analysis are crucial in
determining how CSL delivers care and significantly impact its daily operations. CSL’s capacity
to serve private-pay consumers may be affected by healthcare regulatory changes, particularly
Medicaid and Medicare laws. To comply with changing legislation, CSL must be flexible and
explore changing its business strategy, such as partnering with government programs or
diversifying income streams. CSL’s target clientele—private-pay seniors may be affected by
economic downturns. CSL should prepare to help prospective residents overcome financial
difficulties during economic downturns to boost occupancy rates. The senior living market,
where CSL competes, is very competitive and dominated by more prominent firms. In this
context, CSL must spend on marketing, branding, and service quality to stand apart.
Additionally, technology allows CSL to improve care and efficiency. Telemedicine, EHRs, and
smart home technology may enhance treatment and resident experiences.
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In conclusion, Cottage Senior Living’s mission, vision, and strategic planning fit a
changing healthcare sector well. Depending on regulations, the company’s concentration on
private-pay consumers in tertiary markets may be a strength or weakness. CSL’s strategic
planning focuses on specialized, high-quality elder care, matching its purpose and vision.
Demographic changes and wellness trends provide development potential, while regulatory
uncertainty and economic swings represent dangers. CSL must be flexible and imaginative to
provide excellent care while tackling new problems and capitalizing on elder living sector
expansion.
Cottage Senior Living (CSL) has clear rules for its elder care and assisted living services.
Regulatory compliance, resident well-being, and fiscal responsibility depend on these personnel,
healthcare, facility, and financial management rules. As the elder care business changes, CSL
must adjust its internal rules to accommodate new difficulties and possibilities.
Summary of Current Policies
CSL provides elder care and assisted living. CSL has policies covering its operations and
services. Organizational policies include personnel, healthcare, facilities requirements, and
financial management. CSL’s staffing standards mandate LPNs and RNs and specific staffing
ratios to guarantee that residents get proper care (Cottage Senior Living,” n.d.). These rules
comply with state assisted living and memory care standards, showing CSL’s regulatory
compliance. Healthcare policies may ensure that residents get proper medicine delivery,
evaluations, and care plan adherence (Bombard et al., 2018). These policies promote resident
well-being and excellent healthcare. CSL also has safety, construction, and food service rules
(“Cottage Senior Living,” n.d.). These standards guarantee that CSL’s facilities satisfy
regulations and are safe and pleasant for inhabitants.
12
Current Organizational Policies
CSL policies address specific environmental or external issues. These policies emphasize
regulatory compliance and resident well-being, notably in personnel, healthcare, and facility
requirements. CSL’s employment practices maintain state compliance, which is vital in an
industry where regulatory changes may drastically affect operations (“Cottage Senior Living,”
n.d.). In addition, healthcare service policies include medicine delivery and evaluation methods
to protect residents’ health. Facility standards and regulations follow regulatory rules to ensure
resident safety and comfort. However, CSL should frequently evaluate and amend these rules in
order to adequately respond to the evolving eldercare sector.
Internal Policy Changes
I believe that CSL needs particular internal policy modifications and new policies to meet
its issues and potential better. First, CSL should create market growth rules that define how to
penetrate new locations, especially college towns. These strategies should handle state regulatory
differences and establish market research and feasibility evaluations. Second, CSL should
establish technology and innovation strategies that promote ongoing improvement and
technological integration. These policies should describe how to find and adopt new technologies
that improve resident care, operational efficiency, and data-driven decision-making. Third, to
manage growth and financial sustainability, the company should use financial flexibility policies
(Fischer et al., 2019). Finally, CSL should emphasize outreach to residents, their families, and
local communities in its community participation and feedback policy. Regular surveys,
feedback, and resident participation in decision-making should be encouraged by these rules.
Role of Healthcare Manager
13
Healthcare managers are crucial leaders who connect strategy objectives to policy
execution. In an organization like CSL, a healthcare manager’s involvement in directing strategic
planning processes around policy revision or development is crucial. Healthcare managers
should lead policy modification and development strategy planning. This job is crucial owing to
their healthcare policy, regulatory, and industry trends knowledge. Healthcare managers should
be policy specialists, keeping up with changes in legislation and rules to ensure policies meet
industry standards (Huebner & Flessa, 2022). They must also actively engage in strategic
planning to align policies with CSL’s goal and vision. Healthcare administrators should openly
communicate with stakeholders to seek input and resolve policy change concerns. They should
monitor policy implementation, liaising with appropriate departments to guarantee compliance
and resolve issues. Healthcare managers can also promote continuous improvement by assessing
policy efficacy and pushing for changes to adapt to changing external conditions.
Influence of Key Stakeholders
The strategic planning process of policy change or development within an organization
like CSL is significantly influenced by key stakeholders. These stakeholders include residents,
their relatives, employees, regulators, and the community. Residents and their families are
critical partners in policy change and planning. Their tastes, experiences, and comments
influence policy. Since resident happiness and well-being are paramount, CSL must consider
their needs and expectations while creating or amending policies. Staff, healthcare professionals,
and administrators also have significant effects. They understand how policies affect everyday
operations. Staff involvement in planning provides knowledge and encourages ownership and
commitment to policy execution. The elder care business relies on government and regulatory
authorities (Mosadeghrad, 2014). Compliance with these standards is mandatory, and regulatory
14
changes typically require policy modifications. To avoid fines, CSL must continuously monitor
and respond to changing regulatory demands. Local authorities and neighbors might impact
strategic planning. Support or disagreement from the local community might affect CSL’s
capacity to develop or adopt new policies.
In conclusion, Cottage Senior Living must adjust to elder care sector changes. CSL
should revise its internal policies to meet its strategic goals and provide high-quality care to
residents. Leading this process and ensuring that policies stay applicable and efficient in a
changing healthcare environment are crucial duties played by the healthcare manager and other
important stakeholders.
The primary issues facing Cottage Senior Living are its readiness to expand into new
markets for private-pay customers for its range of services and the impacts of changing policies
on assisted living facilities. Also, these core issues represent the organization’s leaders’ concerns
about the appropriateness of its current business model and staffing plan to support its expansion
goals. Similarly, Cottage Senior Living is facing the issues of competition for its franchising
model, a major staffing shortage that is affecting the entire industry, and a highly dynamic
regulatory and legal environment at both federal and state levels While the organization’s
strengths as a leader in the non-subsidized and private-pay senior living market plus
comprehensive care portfolios helps it to deliver consistent quality services to its customers, the
issues remain the focus of its strategic plans. Therefore, the healthcare manager must include
specific actions in the strategic plan to enable the organization to achieve its expansion and
growth objectives.
Recommended Course of Action
15
The analysis of the different courses of action to address the elements of the expansion
issues facing Cottage Senior Living indicated that the healthcare manager should advise the
organization to expand to locations with the right demographics and demand for its services. As
a company that is reputed for serving private-pay consumers efficiently and effectively through
its franchise and staffing models, it has the capacity to expand into these locations successfully.
Also, this approach would enable the organization to leverage the favorable regulations and legal
requirements in these new locations to attract the empty nesters who want to live an active,
vibrant, and engaging lifestyle (Cornell, Zhang, & Thomas, 2020). Although getting land and
spaces that are reasonably priced and located in appropriate locations for its service offerings
might act as barriers, it is recommended that the healthcare manager should leverage the positive
aspects and benefits of CSL’s current franchise and staffing models to overcome the stumbling
blocks to the actualization of the strategic plan to expand the organization’s business into these
new locations. The final aspects of the recommended course of action for the healthcare manager
are the provision of training and competitive pay to attract the right employees in these new
locations (Cornell et al., 2020), individualized memory support services for the growing
population of dementia and Alzheimer’s disease patients across the country (Lam & Covinsky,
2022), and use of technology to lower operational cost, optimize staffing, and maintain service
quality (Poh, Tan, & Lim, 2021). Hence, these recommended courses of action are suitable for
addressing the organization’s concerns regarding its capacity to expand and grow in new
locations across and deal with challenges in the external environment, including competition,
regulations, and legislation.
Driving Key Stakeholders
16
The leaders of Cottage Senior Living (CSL) are the major stakeholders who must drive
all elements of the recommended strategic plan to its successful actualization. In this regard, it is
recommended that the leaders and healthcare managers communicate the importance of the
expansion plan to the organization’s mission, vision, and sustainable growth statements to the
employees and provide the required resources for determining the suitable locations for the new
plan. According to Zimmerman et al. (2022), organizational leaders who drive the elements of its
strategic plan ensures the issues and challenges to its attainment are addressed through policies
and actions that motivate other stakeholder such as the employees to commit to the processes
that require their skills and delivery of their work functions. For example, the use of innovative
technology requires the active involvement of the employees in the design and implementation
aspects of the strategic plan. Therefore, the active involvement of these key stakeholders is vital
to the different components of the strategic plan and the attainment of its overall objectives.
Alignment of Strategic Plan with Policy Processes
Finally, Cottage Senior Living must align its strategic plans and policy processes with its
overall mission and vision to achieve its expansion and growth objectives. One of the approaches
for ensuring better alignment of mission and strategic plans is the inclusion of service offerings
in the new tertiary markets that meet the needs of private-pay customers for quality specialized
assisted living care. The other approach for ensuring alignment between the policy processes and
CSL’s mission and vision is the maintenance of the franchise structure and staffing model, which
has helped the organization sustain brand uniformity and reputation in the tertiary assisted living
market. As Zimmerman et al. (2022) stated, organizational policies that support standardized
operations and brand uniformity are necessary for organizations to strive towards the attainment
of their mission and vision statement of delivering high-quality specialized services to private-
17
pay customers. For example, the use of technology to support the staffing model and lower
operational costs must be made easily accessible to the target consumers and attract the right
staff in the new locations without diminishing the quality of the services. In summary, Cottage
Senior Living must include appropriate specialized assisted living services for its target
customers in its strategic plan and adhere to its policy processes that support the effective use of
its franchise-like structure and staffing models successfully to better align these components of
its business with its mission and vision statements.
18
References
Cornell, P. Y., Zhang, W., & Thomas, K. S. (2020). Changes in long-term care markets: Assisted
living supply and the prevalence of low-care residents in nursing homes. Journal of the
American Medical Directors Association, 21(8), 1161.
https://doi.org/10.1016/j.jamda.2020.01.006
Lam, K., & Covinsky, K. E. (2022). Ensuring assisted living provides the assistance residents
need. JAMA network open, 5(9), e2233877-e2233877.
https://doi.org/10.1001/jamanetworkopen.2022.33877
Poh, L., Tan, Y., & Lim, J. (2021). Governance of assisted living in long-term care: A systematic
literature review. International Journal of Environmental Research and Public Health,
18(21). https://doi.org/10.3390/ijerph182111352
Zimmerman, S., Carder, P., Schwartz, L., Silbersack, J., Temkin-Greener, H., Thomas, K. S.,
Ward, K., Jenkens, R., Jensen, L., Johnson, A. C., Johnson, J., Johnston, T., Kaes, L.,
Katz, P., Klinger, J. H., Lieblich, C., Mace, B., Pace, D. D., Scales, K., . . . Wilson, K. B.
(2022). The imperative to reimagine assisted living. Journal of the American Medical
Directors Association, 23(2), 225. https://doi.org/10.1016/j.jamda.2021.12.004
(n.d.). Cottage Senior Living.
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., Onate, K., Denis,
J.-L., & Pomey, M.-P. (2018). Engaging Patients to Improve Quality of Care: A
Systematic Review. Implementation Science: IS, 13(1). https://doi.org/10.1186/s13012018-0784-z
Fischer, R. J., Halibozek, E. P., & Walters, D. C. (2019). Contingency planning emergency
response and safety. In Introduction to Security (pp. 249–268). Elsevier.
19
Huebner, C., & Flessa, S. (2022). Strategic Management in Healthcare: A Call for Long-Term
and Systems-Thinking in an Uncertain System. International Journal of Environmental
Research and Public Health, 19(14), 8617. h
Assess the health care needs of a selected community by completing a virtual windshield survey and environmental analysis. Summarize the results of your assessment in a 4-5-page report.
Research the National Committee of BioEthics (NCBE) Implementing Regulations of the Law of Ethics of
Research on Living Creatures in Saudi Arabia.
Select any of the many articles related to your profession or resonate with your student research topic.
How could these guidelines be integrated to ensure the researcher’s adherence to these research
regulations and protocols?
Discuss how you would apply coaching in the healthcare work environment.
•
How might a coaching leadership style apply to your current work role?
•
What are the advantages and disadvantages of this style in the context of health care?
•
Consider the implications for employee motivation, satisfaction, and productivity as well as patient
satisfaction, quality of care, and patient safety.
In developing your initial response, be sure to draw from, explore, and cite credible reference materials. In
responding to your classmates’ posts, you are encouraged to examine their opinions, offering supporting
and/or opposing views.
1 : Research the National Committee of BioEthics (NCBE) Implementing Regulations of the Law of Ethics of Research on Living Creatures in Saudi Arabia.
Select any of the many articles related to your profession or resonate with your student research topic. How could these guidelines be integrated to ensure the researcher’s adherence to these research regulations and protocols?
Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
h
.
.
2 : 505 DISSCUSION
Discuss how you would apply coaching in the healthcare work environment.
How might a coaching leadership style apply to your current work role?
What are the advantages and disadvantages of this style in the context of health care?
Consider the implications for employee motivation, satisfaction, and productivity as well as patient satisfaction, quality of care, and patient safety.
In developing your initial response, be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, you are encouraged to examine their opinions, offering supporting and/or opposing views.
Chapter 3 focuses on using family theory to develop critical and creative thinking to support and implement family interventions in a health event or family situation. This chapter lays the groundwork for theory-guided, evidence based family nursing practice. Remember family units can be defined in many different ways. Think beyond biological and consider social and community networks as “family” for your patients.
Potential issues to research for your literature review would include alcoholism, chronic disease, chronic grief, death of a loved one, dementia, stroke, domestic violence, mental illness, or obesity. If your topic is multifaceted, select one aspect of your topic for this paper.
Select a family theory that interests you. The problem will be the focus of your literature review for your paper where you will utilize scholarly, peer-reviewed articles or research papers that discuss this problem and how it should be managed. Utilize at least 3 scholarly articles for this paper.
1. Provide a brief background on your selected family issue, situation, or health event
2. Provide an overview of your theory and include key concepts of your theory such as who is the individual, family, organization, or society that your family theory focuses on
3. Describe and analyze the family theory, discuss the strengths and weaknesses of the theory, include how this theory can be applied to your identified problem
4. Provide a summary of your findings, include what you learned, what more needs to be known about this problem and how it affects families
The body of your paper needs to be 3-4 pages long. This does NOT include the title page and reference page.
In your readings this week, you learned that palliative care provides physical, psychosocial, and spiritual care through assessment and the development of a comprehensive treatment plan. “Palliative” is defined as relieving pain without dealing with the cause of the condition. This definition echoes the World Health Organization (WHO)’s definition of palliative care as a patient-centered approach that improves the quality of life of patients and families when they are experiencing life-threatening illnesses (WHO, 2015).
This week we also learned about the importance of self-care and that it cannot be overstated for the clinician. Work and professional responsibilities, family and home life, coursework, and clinical practicums all demand attention. Self-care and health promotion are major components of caring for patients; it is imperative that as NPs we care for ourselves as well (Dunphy, 2019).
Select one of the following prompts and the corresponding Differentials Table to complete. In the subject line of your post, please identify which prompt you are responding to.
Instructions:
Select one of the following prompts.
Complete the corresponding “Differentials Table” (this week focuses on chronic conditions commonly referred to as palliative care) – include 5 differentials (excluding the example provided).
Upload your Differentials Table and answers to your chosen prompt to the Discussion Board.
Week 8 Prompts
Self-care is important to personal health, professional growth, and the ability to care for others. Discuss the importance of self-care for the APRN. Provide examples with your rationale.
Compassion fatigue is flourishing in our society today, due in part to the increasing demands of managed care, and it can impair your ability to function effectively. Discuss strategies to avoid compassion fatigue. Provide examples with your rational.
Differentials Table
Common Diagnoses Necessitating Palliative Care Referral by Nurse Practitioner Signs/Symptoms Gold Standard Diagnostics Gold Standard Treatment
Ex: COPD Chronic cough, chronic sputum production, shortness of breath worse with physical exertion, progressive symptoms, barrel chest, weight loss; hyperresonance upon percussion, tactile fremitus and egophony is decreased; CXR may show hyperinflation; bullae sometimes present; coarse crackles. Refer to GOLD Report – Global Initiative for Chronic Obstructive Lung Disease.
A diagnosis of COPD should be considered in any patient who has dyspnea, chronic cough or sputum production, a history of recurrent lower respiratory tract infections and/or a history of exposure to risk factors for the disease, but forced spirometry showing the presence of a postbronchodilator FEV1/FVC < 0.7 is mandatory to establish the diagnosis of COPD. Prevention and Maintenance Therapy: Smoking cessation, Vaccination (pneumonia, influenza, COVID-19, Tdap).
Acute exacerbation: SABA (albuterol, levalbuterol). SAMA (Ipratropium bromide) often used in combination with SABA. While continuation of ongoing therapy with long-acting beta agonists (LABAs) or LAMAs has not been specifically studied, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy advises their continuation. Oral Glucocorticoid therapy: 40mg per day for 5-14 days
Antibiotic Therapy: the GOLD strategy recommends empiric antibiotics for patients with COPD exacerbations who have increased sputum purulence and either increased sputum volume or increased dyspnea, or for patients who require ventilatory assistance.
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please follow the sample ” process recording example ” and use the information on the 2nd paper” process lolo ” background information , you can reformulate and add some medications if needed and come out with the remaining part but follow the standard of the process recording example.
Unformatted Attachment Preview
Therapeutic Communication
Student’s Name: Laurence Ngonla Lonla
Date of Interaction: 27 October 2015
Client’s Initials: Mrs.T.S
Therapeutic Communication
ASSESSMENT:
• Background: A 49-year-old patient comes to the clinic with a history of depression and
UTI. She tells the nurse that she was treated for it by a doctor in another county, but he
ran out of pills a week ago and did not know how to get a refill. She could remember the
name of the medication but said ‘‘it was for depression’. She also has been having trouble
sleeping since her husband cheated on her and asked for a divorce. She lost 34pounds in
1 month. A family member called 911 because she was feeling uncontrollable with
suicidal ideation, thoughts of overdose on medications, current denied HI. After a
psychiatric evaluation, she was given a 2-week prescription for fluoxetine (Prozac) and
melatonin for sleep at night, Lexapro 10 mg.
•
•
Medications
1. melatonin, 5mg PO nightly—for sleep
Side effects: dizziness, drowsiness, headaches, nausea, irritability, hormonal
effects for long term use.
2. escitalopram (Lexapro), 10mg cap once PO nightly—for depression and anxiety
disorders.
Side effects: Nausea, fatigue, dizziness, insomnia, constipation or diarrhea, dry
mouth, sweating. Sexual side effects such as decrease libido, difficult achieving
orgasm.
3. Fluoxetine (Prozac), 5mg tab PO nightly—for depression
Side effects: nausea, constipation, headache, anxiety, insomnia, drowsiness,
dizziness, heart palpitations, weight changes, cold symptoms, dry mouth,
impotence
Assess myself: I have been assigned bto work with the nurses in magnolia unit and I
found this case interesting and decided to know more about this particular patient. It was
a pleasure for me to note her 5 priorities values un life as love, family, honesty, respect
and success.
• Assess milieu: There were 12 patients on the unit that day. Many of the patients were
spending time with each other in the day room, laughing and discussing. Base on the
background history,
DIAGNOSIS:
Nursing diagnosis: Risk for self-directed violence, ineffective individual coping, anxiety,
hopelessness, social isolation
PLANNING:
• Describe a tentative goal of the TC: I want the patient to openly discuss her recurrent
suicidal ideations and contemplate stressors. Hopefully I can also direct her to focus on
the positives in her life, like her family and her possibilities.
• By completion of the TC, the patient will:
1. Discuss her desire to die.
2. Recognize possible stressors leading to SI.
3. Focus on the positives and motivations in her life.
IMPLEMENTATION:
Nurse
Patient Communication
Communicati
on
“How are you “Okay. Depressed, I
doing today?” guess, but that’s normal.”
Analysis of Process
Although I’ve talked with this
client before, I was a bit
surprised at her openness.
Therapeutic
Technique
Using broad
openings
“How long
have you been
feeling
depressed?”
“I guess about one year
with major depression,
but about five years
depressed.”
From her chart I knew she had Exploring,
a history of depression, but I
seeking
was curious what her
clarification
perception was.
“How have
you been
feeling
lately?”
“It’s been… well, bad
enough to be hospitalized.
I was having suicidal
thoughts so they thought
it best that I come in.”
“Yeah”
Her feelings have been
fluctuating, so I wanted to
understand why they are
fluctuating.
“Do you still
have suicidal
thoughts?”
“Do you have
the desire to
kill yourself?”
“Tell me more
about that.
What do you
think brings
on those
thoughts?”
“Sometimes.”
General leads
(nodding my
head), exploring
I ask this not just to gauge her Seeking
fluctuating feelings but also to clarification,
check her safety and risk of
exploring
danger to her safety.
After talking with another
client about his lack of desire
to kill himself but the
presence of suicidal thoughts,
I was curious if she actively
desired to end her life. I am
not surprised by her answer,
but I want to understand her
further.
“Well a long time ago I
I hadn’t known about the
was abused, and I blamed abuse, so it is an interesting
my mom for the abuse but piece of her case. Because we
I also blamed myself.”
are alone and it doesn’t sound
like she wants to go into
details with the abuse, I
decide not to press for more
details.
Summarizing,
encouraging
description of
perceptions
Exploring,
focusing, using
broad openings,
seeking
clarification
“That’s
interesting.
Why do you
think you
blame your
mom?”
“You sound
glad that she
talked about it
with you.”
“She was passive. She
was the kind of person
who put on a smile even
if things were going bad. I
respect and admire her in
a lot of ways. She visited
me last week and talked
about the abuse.”
“Yeah, she’s never done
that before, I was very
surprised. She also talked
about my sister’s abuse.
My sister and I only
talked about it recently,
and I felt like I should
have known.”
“You have a
lot of siblings,
right?”
“Yeah, 6 sisters and 3
brothers. Big Catholic
family.”
“Do you get
support from
your family?”
“No, not really. Some
live nearby but I lost
touch with them. I tend to
isolate myself because of
the depression, which I
know I need to fix.”
“Yea, I think I should try
to spend more time with
my family.”
“So you want
to spend more
time with
people.”
“I think I have “Thanks, see you later”
to go now, but
it was great
talking with
you and I hope
you get better
soon. I’ll see
you later.”
E
She has a lot to say about her
mom, so I guess she has
thought a lot about her and
their relationship. Looking
back, I should have asked the
client why she felt guilty for
the abuse.
Restating,
encouraging
description of
perceptions,
seeking
clarification
I feel sad that she endured
abuse within her family, and
that her whole family was
affected by it. Thankfully, by
talking with her mom about
this, it seems like she has
begun to heal from it. I
wonder how she would have
grown up if her family
recognized and dealt with the
abuse sooner.
She chuckled as she said the
last part. I had remembered
her having a big family from a
previous conversation.
Attempting to
translate into
feelings
I found this insight interesting
because she seems to want to
get better and fight her
depression, even though she
sometimes has the desire to
kill herself.
She sounds interested in
improving her health with this
feasible fix.
Focusing,
exploring,
It was time for me to leave for
dinner, but I wanted to assure
her that I listened and
sincerely wanted her to find
healing.
Encouraging
formulation of a
plan of action,
offering self
Exploring
Restating
Identify regulatory agencies that regulate health and the health care system within the US, create a table listing your 5 regulatory agencies and address the following:
Describe the agency, level of regulatory authority (local, state, federal), scope of regulatory authority, and role within the US healthcare system.
Address relevance of the organization or the organization’s authority to the APRN/DNP graduate.
Describe relevance to specialty area, area of practice, or setting of practice. For an example, mental health.
Submission Requirements:
In the table, write the 3 criteria above and respond to them.
The table is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
The table is to be complete and thorough. It should include all items indicated in the assignment.
Incorporate at least 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
Grading Rubric
Your assignment will be graded according to the grading rubric below.
The following content is partner providedThe preceding content is partner provided
Rubric
Essay/Paper Rubric
Essay/Paper Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIdentification of Main Issues/Problems
4 pts
Distinguished
Identify and demonstrate a sophisticated understanding of the issues/problems.
3 pts
Excellent
Identifies and demonstrate an accomplished understanding of most of issues/problems.
2 pts
Fair
Identifies and demonstrate an an acceptable understanding of most of issues/problems.
1 pts
Poor
Identifies and demonstrate an unacceptable understanding of most of issues/problems.
4 pts
This criterion is linked to a Learning OutcomeAnalysis and Evaluation of Issues/Probelms
4 pts
Distinguished
Presents an insightful, thorough analysis and evaluation of issues/problems.
3 pts
Excellent
Presents a thorough analysis and evaluation of most of the issues/problems.
2 pts
Fair
Presents a superficial or incomplete analysis and evaluation of issues/problems.
1 pts
Poor
Presents unacceptable analysis and evaluation of issues/problems.
4 pts
This criterion is linked to a Learning OutcomeDemonstrates a Conceptual Understanding
4 pts
Distinguished
Provides a thorough, competent and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.
3 pts
Excellent
Provides a competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.
2 pts
Fair
Provides a competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.
1 pts
Poor
Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.
4 pts
This criterion is linked to a Learning OutcomeUse of Citations to Course Readings and Additional Research/Literature
4 pts
Distinguished
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.
3 pts
Excellent
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
2 pts
Fair
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
1 pts
Poor
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing.
4 pts
This criterion is linked to a Learning OutcomeWriting Mechanics and APA Formatting Guidelines
4 pts
Full Marks
Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.
3 pts
Excellent
Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.
2 pts
Fair
Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.
1 pts
Poor
Demonstrates issues in writing and communicating clearly. APA style and writing mechanics need serious attention.
Everything you need is listed below. Its a 2 part assignment. (1page word document and a organization chart)
Unformatted Attachment Preview
HSA550 Public Health Management
Overview
While many factors determine policy and decision-making in federal agencies, one that
is significant and often shared among them, is how they are organized and managed.
Next week’s assignment asks you to evaluate a federal healthcare agency’s initial
response to the Covid 19 pandemic. In this activity, you build a foundation to make that
evaluation by researching the management structure of a federal healthcare agency of
your choosing.
Preparation
1. Choose a federal healthcare agency that has had direct involvement in the Covid-19
pandemic response such as the National Institutes of Health (NIH), Centers for
Disease Control (CDC), Department of Health and Human Services (HHS), Food
and Drug Administration, U.S. Public Health Service, et cetera. Research the
organization’s pandemic-related responsibilities and management structure. During
your research, you may want to explore early public messaging disseminated by the
agency as you will be asked to evaluate it in next week’s assignment.
2. In this activity, you will draw an organization chart [Example of Health and Human
Services Organization ChartLinks to an external site.] using MS Word, Visio, or
another graphics program to create an infographic to paste into a Word document. If
you are using Word:
1. Open Microsoft Word.
2. Click on the Insert tab located on the top-left side.
3. Click on SmartArt and choose and modify a graphic of your choosing.
Scenario
Think back to January 2020 when the United States reported its first Covid-19 infection.
Federal (as well as local) public healthcare agencies scrambled to understand the virus
and its possible impact on the population. The government’s response and information
releases were at best uneven during the ensuing months. Each agency needed to
provide messaging to inform and direct the public. Many were frustrated by the uneven
messaging among these agencies. An initial step to a better understanding of policies
and decision-making is to understand the organization making them.
Instructions
Identify a federal healthcare agency that had a direct and significant role in the nation’s
pandemic response and do the following:
1. Describe 3 roles that the organization played in the pandemic response that capture
its main responsibilities or contributions (1 page). Examples include areas such as:
o Information sharing or outreach.
Research.
Response efforts.
Medical assistance.
Vaccine distribution.
2. Draw a diagram that accurately depicts agency personnel/positions or
departments that are directly related to pandemic policy and public outreach.
Paste the diagram into your submission Word document with your answer from
bullet point 1. Include a brief description of responsibilities for key areas or
personnel in your chart.
o
o
o
o
In your initial post, share your thoughts on what you learned throughout this course and comment on how this course will apply to your current and/or future career experiences and long-term career development goals.Also reflect on your final project. As you are finishing your final presentation, consider: What insights did you gain from the process? What would you do differently knowing what you know now? Course IHP wellness across the lifespan
Assessment Description The assignment will be used to develop a written implementation plan. Step 1) Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources. Step 2) Develop a process to evaluate the intervention if it were implemented. Step 3) Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention. Address the following in your summary: What data was collected? What tool will be used to collect the data? Who will be responsible for collecting data? How will this data be communicated to the team? *Use APA format. *plagiarism report (less than 10%)
III. Presentation: In this section, you will develop a presentation directed at an audience who would be able to address the health issue you have analyzed and potentially enact or implement some of the prevention options you have recommended. You will have to communicate the importance of the issue as well as how your prevention recommendations would be helpful. Throughout your presentation, you should be communicating with your audience appropriately, considering their existing knowledge of the health issue and their interests. Along with your presentation you should prepare accompanying speaker notes.a. Describe the health issue, statistics, and population affected by the issue to your audience.b. Communicate the importance of the issue to your audience. You could consider using the individual you have analyzed to support yourresponse. Why is the issue important? How does it impact the population?c. Explain how the prevention options you have identified would be helpful and appropriate for the population.d. Explain to your audience what they could do to help address the issue. For example, how could they enact some of your prevention options?
Compose a written comprehensive psychiatric evaluation of a patient you have seen in the clinic.Upload your completed comprehensive psychiatric evaluation as a Word doc.
SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. S = Subjective data: Patient’s Chief Complaint (CC); History of the Present Illness (HPI)/ Demographics; History of the Present Illness (HPI) that includes the presenting problem and the 8 dimensions of the problem (OLDCARTS or PQRST); Review of Systems (ROS) O = Objective data: Medications; Allergies; Past medical history; Family psychiatric history; Past surgical history; Psychiatric history, Social history; Labs and screening tools; Vital signs; Physical exam, (Focused), and Mental Status Exam A = Assessment: Primary Diagnosis and two differential diagnoses including ICD-10 and DSM5 codes P = Plan: Pharmacologic and Non-pharmacologic treatment plan; diagnostic testing/screening tools, patient/family teaching, referral, and follow-up let’s use the encounter date as October 18, 2023.
Unformatted Attachment Preview
Comprehensive Psychiatric Evaluation Template
With Psychotherapy Note
Encounter date: ________________________
Patient Initials: ______ Gender: M/F/Transgender ____ Age: _____ Race: _____ Ethnicity ____
Reason for Seeking Health Care: ______________________________________________
HPI:_________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SI/HI: _______________________________________________________________________________
Sleep: _________________________________________
Appetite: ________________________
Allergies (Drug/Food/Latex/Environmental/Herbal): ___________________________________
Current perception of Health:
Excellent
Good
Fair Poor
Psychiatric History:
Date
Hospital
Inpatient hospitalizations:
Diagnoses
Length of Stay
Date
Hospital
Outpatient psychiatric treatment:
Diagnoses
Length of Stay
Rev. 2272022 LM
Date
Hospital
Detox/Inpatient substance treatment:
Diagnoses
Length of Stay
History of suicide attempts and/or self injurious behaviors: ____________________________________
Past Medical History
• Major/Chronic Illnesses____________________________________________________
• Trauma/Injury ___________________________________________________________
• Hospitalizations __________________________________________________________
Past Surgical History___________________________________________________________
Current psychotropic medications:
_________________________________________
_________________________________________
_________________________________________
________________________________
________________________________
________________________________
Current prescription medications:
_________________________________________
_________________________________________
_________________________________________
________________________________
________________________________
________________________________
OTC/Nutritionals/Herbal/Complementary therapy:
_________________________________________
_________________________________________
________________________________
________________________________
Rev. 2272022 LM
Substance use: (alcohol, marijuana, cocaine, caffeine, cigarettes)
Substance
Amount
Frequency
Length of Use
Family Psychiatric History: _____________________________________________________
Social History
Lives: Single family House/Condo/ with stairs: ___________ Marital Status:________
Education:____________________________
Employment Status: ______ Current/Previous occupation type: _________________
Exposure to: ___Smoke____ ETOH ____Recreational Drug Use: __________________
Sexual Orientation: _______ Sexual Activity: ____ Contraception Use: ____________
Family Composition: Family/Mother/Father/Alone: _____________________________
Other: (Place of birth, childhood hx, legal, living situations, hobbies, abuse hx,
trauma, violence, social network, marital hx):_________________________________
________________________________________________________________________
Rev. 2272022 LM
Health Maintenance
Screening Tests (submit with SOAP note): Depression, Anxiety, ADHD, Autism,
Psychosis, Dementia
Exposures:
Immunization HX:
Review of Systems (at least 3 areas per system):
General:
HEENT:
Neck:
Lungs:
Cardiovascular:
Breast:
GI:
Male/female genital:
GU:
Neuro:
Musculoskeletal:
Activity & Exercise:
Psychosocial:
Derm:
Rev. 2272022 LM
Nutrition:
Sleep/Rest:
LMP:
STI Hx:
Physical Exam
BP________TPR_____ HR: _____ RR: ____Ht. _____ Wt. ______ BMI (percentile) _____
General:
HEENT:
Neck:
Pulmonary:
Cardiovascular:
Breast:
GI:
Male/female genital:
GU:
Neuro:
Musculoskeletal:
Derm:
Rev. 2272022 LM
Psychosocial:
Misc.
Mental Status Exam
Appearance:
Behavior:
Speech:
Mood:
Affect:
Thought Content:
Thought Process:
Cognition/Intelligence:
Clinical Insight:
Clinical Judgment:
Rev. 2272022 LM
Psychotherapy Note
Therapeutic Technique Used:
Session Focus and Theme:
Intervention Strategies Implemented:
Evidence of Patient Response:
Plan:
Differential Diagnoses
1.
2.
Principal Diagnoses
1.
2.
Plan:
Diagnosis #1
Diagnostic Testing/Screening:
Pharmacological Treatment:
Non-Pharmacological Treatment:
Rev. 2272022 LM
Patient/Family Education:
Referrals:
Follow-up:
Anticipatory Guidance:
Diagnosis #2
Diagnostic Testing/Screening Tool:
Pharmacological Treatment:
Non-Pharmacological Treatment:
Patient/Family Education:
Referrals:
Follow-up:
Anticipatory Guidance:
Signature (with appropriate credentials): __________________________________________
Cite current evidenced based guideline(s) used to guide care (Mandatory)_______________
Rev. 2272022 LM
DEA#: 101010101
STU Clinic
LIC# 10000000
Tel: (000) 555-1234
FAX: (000) 555-12222
Patient Name: (Initials)______________________________
Age ___________
Date: _______________
RX ______________________________________
SIG:
Dispense: ___________
Refill: _________________
No Substitution
Signature: ____________________________________________________________
Rev. 2272022 LM
Take a moment and reflect on the last 10 weeks in this course.Do you have a better understanding of what evidence-based practice is and how it is used in your practice?Have your thoughts about evidence-based practice changed as a result of completing this course? If so, why and how? If not, why not?Describe 3 “take-aways” that resonate with you from this course?How can you apply content from this course in your nursing practice and your role?
I want a narrative review article with All research elements from different researches and rephrase the sentence from these researches . with abstract , and recommendations part in the end of (the body) part using your own words , and updated references . Check for plagiarism less than 10% . (Without using chat GPT please) I will check. The Title (workforce diversity) you can follow the attachment for guidance .
Unformatted Attachment Preview
Writing A Review Article
Dr.Selwa Y Abdeldafie
KSA Octuber 2023
Objective
• The main objective for this presentation is to highlight the main steps
for writing a review article so candidates will be able to write a
publishable review article.
Definition
• It is the process of evaluating a published work or knowledge. Since
they do not contain a new information , new experimental results or
unpublished one they are not a primary published work. (Gábor L.
Lövei 2021) It can also be named a literature review, or a review of
literature.
Introduction
• “a critical, constructive analysis of the literature in a specific field
through summary, classification, analysis, comparison.”(Akhtar
Sherin 2018)
• Usually it doesn’t include material and method chapter, but
introduction , discussion ,conclusion and recommendation must
be there.
Introduction
It may also be referred to as a literature review that includes an outline
of the most recent published work on the subject, or a critical review
that focuses on a specific article with smaller scope.
Title page:
It includes the Authors name, affiliation
Body:
This includes the subtopics that you are addressing.
Conclusion:
Should briefly explain the review and the purpose of the article
Literature cited: Should be in a standardized form
Types of reviews
1- Narrative (Non-systematic)
2-Traditional Review Article
Structure of a typical narrative review article:
* Abstract (structured/ un-structured)
* Introduction & Background
* Methods
* Review/Observation & Discussion
* Conclusions/Summary
* References
Limitation of words, tables, figures and references (varies from journal to journal)
8
Why write a review article?
•To provide a
comprehensiv
e foundation
on a topic.
•To identify gaps
•To
highlight
the
•To explain
in existing studies
main
methodologies
the current
for potential
and
research
state of
future research.
technique
knowledge.
Structure of a typical narrative review article:
* Abstract (structured/ un-structured)
* Introduction & Background
* Methods
* Review/Observation & Discussion
* Conclusions/Summary
* References
Limitation of words, tables, figures and references (varies from journal to journal)
Length of Text: Usually 2000 to 3500 word
* Tables &/or Figures: < 5
* References: 50-75
TITLE:
Title should be concise, informative and should mention “A narrative review”
or “A Review” as subtitle.
Structured Abstract
• Structured Abstract: (< 250-300 words) Format of structured abstracts for narrative review
is variable among various journals and includes following sub-headings:
• Background/ Importance: State the context and overview of the problem and its
significance that prompted the review.
• Objective: Give the main purpose for conducting the review.
• Methods: Briefly describe the methods used to review and evaluate the literature.
• Results /Observations: Present the main observations and findings of the review.
• Conclusions and Relevance: Conclusion should be based on findings of the review
described in the abstract. Indicate the relevance and key implications of the findings for
clinical use, policy development and future research.
Unstructured Abstract
Unstructured Abstract: (< 250-300 words)
• It almost contains the same information as structured abstract but there are no
subheadings. It includes the context & objective
of review; methods of literature search; summarized important findings,
conclusions and recommendations for future research and clinical practice.
KEY WORDS: Use MeSH (Medical Subject Headings)
INTRODUCTION & BACKGROUND
• (150-250 words)
• Introduction is usually written in 2-3 paragraphs.
• METHODS (150-250 words)
• Details of search strategy should include the process to identify, select, and
evaluate the literature
• * Electronic databases and other sources used to conduct the literature search
(e.g. MEDLINE, CINAHL, EMBASE, Scopus, Web of Science, journals and
other search engines etc)
• * Eligibility (Inclusion/exclusion) criteria for selection of studies including
study types, languages and cutoffs dates of literature search.
• REVIEW/OBSERVATION & DISCUSSION (1000-1250 words) Quality
of articles selected for review should be critically appraised. Data synthesis
should be done by summarizing the results of selected literature and may be
presented in tabulated form.
• CONCLUSION : it is sometimes incorporated in the last paragraph of
discussion and at times is written under separate heading.
Conclusion
• In conclusion, during writing process of a review article :
• 1) Get rid of fixed ideas, and obsessions of your own and view the subject from
a large perspective.
• 2) Research articles in the literature should be approached with a
methodological, and critical attitude.
• 3) finally data should be explained in an attractive way.
How to write a review article
• Check the journal’s aims and scope
• Make sure you have read the aims and scope for the journal you
are submitting to and follow them closely.
• Define your scope
• “define the scope of your review so that it is manageable, not too
large or small; it may be necessary to focus on recent advances if the
field is well established.”
How to write a review article
• Finding sources to evaluate
For finding studies for a systematic review in medical sciences, read advice
from NCBI.
• Writing your title, abstract and keywords
(help maximize the visibility of your article online, making sure the right
readers find your research. Your title and abstract should be clear, concise,
accurate, and informative, read our guide to writing a good abstract and
title and our researcher’s guide to search engine optimization
How to write a review article
• Introduce the topic
Does a literature review need an introduction? Yes (help
maximize its wider relevance and impact).
• Include critical discussion
not just a descriptive summary of the topic. If there is
contradictory research in your area of focus, make sure to
include an element of debate and present both sides of the
argument.
How to write a review article
• Sum it up
As part of your conclusion, include making suggestions for future research on the
topic.
• Use a critical friend
Always perform a final spell and grammar check of your article before submission.
• You may want to ask a critical friend or colleague to give their feedback before
you submit.
What is the difference between a research article and a review article?
• Differences in...
• Research article
• Review article
• Viewpoint
• Presents the viewpoint of the author • Critiques the viewpoint of other
authors on a particular topic
• Content
• New content
• Length
• Depends on the word limit provided • Tends to be shorter than a research
by the journal you submit to
article, but will still need to adhere to
words limit
• Assessing already published content
Complete this checklist before you submit your
review article:
Have you
checked the
journal’s aims
and scope?
1
•Have you
defined the
scope of your
article?
2
•Did you use
multiple search
engines to find
sources to
evaluate?
3
Have you written
a descriptive title
and abstract
using keywords?
4
Complete this checklist before you submit your
review article:
•Did you start
with an overview
of the topic?
5
•Have you
presented a
critical
discussion?
6
•Have you included
future suggestions
for research in your
conclusion?
7
•Have you asked
a friend to do a
final spell and
grammar check?
8
Top tips
• Keep the language simple.
• Use referencing software –To make life easier, invest time to learn this skill.
• Get the outline of the review right .
• Always try to include the highest quality version of the images.
• Lastly, take the opportunity of writing a literature review seriously.
• Developing a good understanding of the field you will be working on.
Importance of Review article
• An article review is both a summary and an evaluation of another writer's
article. Teachers often assign article reviews to introduce students to the work
of experts in the field. Experts also are often asked to review the work of other
professionals. Understanding the main points and arguments of the article is
essential for an accurate summation. Logical evaluation of the article's main
theme,
Thanks for Your Attention
Purchase answer to see full
attachment
Collaboration CaféConsider the roles of caring for others and self-care on future advanced nursing practice. In addition, think about how your own professional values will influence opportunities to advocate for equity and support policy engagement. Respond to the following:Explain your personal perspective of caring within advanced nursing practice and recommend one specific strategy to convey caring for others as you advocate for health equity. Include your rationale for the recommended strategy.Analyze one professional value that will shape your advanced nursing practice and recommend one specific strategy to apply that value through policy engagement. Include your rationale for the recommended strategy.Why is self-care essential for effective practice? Explain one strategy to practice self-care and examine how it can strengthen leadership in advanced practice nursing.
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Introduction to Disease
Course code:
PHC271
CRN:
Assignment title or task:
Diabetes Mellitus (DM) is a common chronic disease in Saudi Arabia. Explain the
epidemiology, pathophysiology, types, risk factors, symptoms, signs, and prevention of
diabetes.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
Out of 10
Proficiency
Some Proficiency
Limited Proficiency
No Proficiency
2
1.5
1.0
0.5
Content Presentation
Criteria
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Thinking
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/ 10
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Start your writing from the next page (page 3)
•
Word limit: Minimum 600 words (3 pages)
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task (PDF is not
acceptable)
•
Submission should be before the deadline (submission after the deadline is not allowed)
Both quantitative and qualitative research are useful for understanding or identifying phenomena in public health. The type of research you choose to employ is often guided by the purpose for your research, whether to confirm relationships, explore an apparent disconnect of data through a deeper investigation, or to discover the underlying motivations or perceptions of the target population. Research methods are not limited to choosing from quantitative or qualitative data. Integrating these two methods can provide a vivid and detailed understanding of the issue at hand.
In this Discussion, you will explore integrated research using an example of mixed methods. Using a peer-reviewed research article, you will consider how the authors integrated quantitative and qualitative data and whether the methods used in the study were suitable.
Review the Module Learning Resources.
Choose one of the five research articles below for the discussion.
Akwataghibe, N. N., Ogunsola, E. A., Broerse, J. E. W., Popoola, O. A., Agbo, A. I., & Dieleman, M. A. (2019). Exploring factors influencing immunization in Nigeria—A mixed methods study Frontiers in Public Health, 7 . https://doi.org/10.3389/fpubh.2019.00392
Andrade, E. L., Evans, W. D., Barrett, N., Edberg, M. C., & Cleary, S. D. (2018). Strategies to increase Latino immigrant youth engagements in health promotion using social media: Mixed-methods study JMIR Public Health and Surveillance, 4(4), 106– 118. https://doi.org/10.2196/publichealth.9332
Mailey, E. L., Mershon, C., Joyce, J., & Irwin, B. C. (2018). “Everything else comes first”: A mixed-methods analysis of barriers to health behaviors among military spouses BMC Public Health, 18(1), 1–11. https://doi.org/10.1186/s12889-018-5938-z
McDermott, E., Hughes, E., & Rawlings, V. (2018). The social determinants of lesbian, gay, bisexual and transgender youth suicidality in England: A mixed methods study Journal of Public Health, 40(3), E244–E251 . https://doi.org/10.1093/pubmed/fdx135
Nong, P., Raaj, M., Trinidad, M. G., Rowe, Z., & Platt, J. (2021). Understanding racial differences in attitudes about public health efforts during COVID-19 using an explanatory mixed methods design Social Science & Medicine, 287. https://doi.org/10.1016/j.socscimed.2021.114379
BY DAY 4 OF WEEK 9
Write a post in which you:
Describe how the authors integrated quantitative and qualitative data in the study you chose.
Evaluate the appropriateness of the methods used in the study.
Briefly summarize the quantitative and qualitative data you will use in your CHA.
Explain how the integrated methods used in the study you chose can inform and guide your CHA.
Butons Placeholder
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
Reflect upon the competencies necessary for leadership and policy engagement as an advanced practice nurse. Consider professional development goals and the opportunities to strengthen your skills in these areas. Refer to the assignment criteria table as you respond to the following questions. Submit your essay on the assignment page in Canvas.
Reflect upon your personal leadership strengths and opportunities for enhancement. Describe at least two leadership strengths and two opportunities for enhancement regarding leadership skills.
Identify and describe two leadership competencies that are needed for advanced nursing practice. Explain how each of the two competencies can facilitate effective advocacy and leadership of policy efforts.
Describe two goals for professional development that will cultivate continued growth in these two leadership competencies. What resources will you need to achieve these professional development goals, and how might the future practicum experiences support these goals?
Rubric:
This criterion is linked to a Learning OutcomeLeadership Strengths and Opportunities for Enhancement
20 pts
Distinguished
Distinguished presentation of information evidenced by all of the following covered in a comprehensive and concise manner: • Reflect upon your personal leadership strengths and opportunities for enhancement. • Describe at least two leadership strengths and two opportunities for enhancement regarding leadership skills.
Leadership Competencies
25 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Identify and describe two leadership competencies that are needed for advanced nursing practice. • Explain how each of the two competencies can facilitate effective advocacy and leadership of policy efforts.
This criterion is linked to a Learning OutcomeGoals for Professional Development
25 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Describe two goals for professional development that will cultivate continued growth in these two leadership competencies. • What resources will you need to achieve these professional development goals? • How might the future practicum experiences support these goals?
Graduate-Level Writing Style
5 pts
Distinguished
Distinguished graduate-level writing style is evidenced by meeting all of the following criteria with 0-1 errors total: • Correct use of spelling and sentence structure • Clarity, organization, and logical flow of ideas within writing • No direct quotes in the essay
Due to the reflective nature of the assignment, first person is acceptable.
Cross-cultural Variation in Political Organizations – Over the last century, countries have either imposed political systems on others or have developed governmental structures to deal with the larger world and the growth of their societies. To distinguish different kinds of political organization, anthropologists use a classification system that refers to these systems as bands, tribes, chiefdoms, and states. How do bands, tribes, chiefdoms and states differ from one another? How is leadership determined in each of these political systems? Think about how these different systems evolved and which factors are most responsible for the changes in political organization. In an essay, define each of these political systems, bands, tribes, chiefdoms and states, and describe the political organization that is most common to each system. Identify the factors anthropologists strongly believe determine why changes in political organization occur. Communication and Language – With the globalization of the economy and increased cultural diversity in the workplace, understanding cross-cultural differences in verbal and nonverbal communication is imperative. Think about a real work experience or imagine a workplace scenario that illustrates how ways of verbal communication are similar or different among different cultures. That is, some languages have levels of formality or politeness to be used with people of higher rank; words or expressions used expressly by one gender; or situations in which the use of idioms or slang is acceptable. For example, think about how culture dictates how one might addresses a CEO versus one’s immediate boss. Consider further how spoken language might reflect issues of class, gender, and ethnicity. Write a narrative essay that recounts a personal school or workplace experience in which misunderstanding or confusion arose because of cultural and linguistic differences in verbal communication. As you tell your story, include enough details so that your reader understands the dynamics of the situation and specifically what caused the misunderstanding or confusion. Provide examples of how the speakers’ class, gender, or ethnicity—as reflected in their spoken language—contributed to the miscommunication. Reasons for Marriage – Marriage is customary in nearly every society known to anthropologists, with only one or two exceptions. When a cultural institution is as common as marriage but does not appear to be absolutely essential to human survival—that is, people can reproduce and have families without marriage—anthropologists ask why people get married. Think about different types of societies that you have learned about: foraging, tribal, agricultural, and industrial/postindustrial societies. What are the most important reasons for marrying within each of these societies? Do religion, society, economics, politics, and other factors play a role in the selection of marriage partners and whether marriages are arranged or not? Now imagine you have a son or daughter of marriageable age. Write an essay that compares and contrasts the views of marriage in the following types of societies: foraging, tribal, agricultural, and industrial/postindustrial. Explain the most important reasons for choosing whom you want your child to marry in each of the societies. Cite religious, social, economic, political, geographic, or other reasons you might have for arranging or guiding your child to accept your decision. Pros and Cons of Globalization – Anthropologists usually refer to globalization as the broad-scale changes and transformations that have resulted from the impact of industrialization and the emergence of an interconnected global economy, with the spread of capital, labor, and technology across national borders. Think about the opportunities and problems that globalization poses. For example, consider the pros and cons of how globalization has affected such areas as economics; international trade; cultural change; diffusion among peoples of different continents; employment; land distribution; class equality; health and nutrition; growth of social classes; and movement of ideas and lifestyles. Now think of examples that demonstrate the pros and cons of globalization in these areas. In a well-reasoned essay, evaluate the opportunities and problems that globalization poses. Discuss the pros and cons of how globalization specifically affects the areas of: economics, cultural change, health and nutrition, and politics. Provide relevant examples for each of these areas.
Please see attached files. Please write 3 supporting arguments for an essay topic (2-3 pages) – using in-text citation and APA references. Existing essay will be provided when accepted.Please write a response to the attached discussion board.
Unformatted Attachment Preview
Discussion Board:
The Influence of Values and Ideology on Health Reform
Please consider and describe the influence of American values and ideology on a specific area of health
care delivery. In your response, please describe 1) your chosen health reform topic and 2) the American
values and 3) how those values influence that topic.
Potential topics range across the healthcare “library.” Examples of topics include: Medicare for All,
accessibility of contraception, reduction of disparities in prenatal care, child healthcare in immigration
detention centers, free COVID-19 testing, private health care for Veterans, personable and portable
health insurance, surprise medical billing, reducing pharmaceutical costs, health insurance subsidies for
individuals unemployed as a result of the COVID-19 pandemic. Or you may select another topic and
write about that.
Visit the Morbidity and Mortality Weekly Report: NNDS Weekly Report. If that site does not work, please use CDC Stacks Public Health Publications. This will provide you with individual PDFs of the disease process. The disease is listed at the bottom of each option, in black. It will start with the Year and the week followed by the table number and name (ex. 2023-39 Table 10 Anthrax). A list of notifiable diseases can be found on Ohio Notifiable Diseases.Select a top notifiable disease and state of interest to you and answer the following questions: Provide a brief summary of the disease. Describe the agent-host-environment relationship.Why do you think this disease has a strong presence or weak presence in the state you selected?Identify an intervention for each level of prevention for managing this disease. Explore other factors that can assist in the control of the communicable disease.
This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.
Based on the “Case Study: Healing and Autonomy” and other required topic Resources, you will complete the “Applying the Four Principles: Case Study” document that includes the following:
Part 1: Chart
This chart will formalize the four principles and four boxes approach and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.
Part 2: Evaluation
This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.
Remember to support your responses with the topic Resources.
APA style is not required, but solid academic writing is expected.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Critical Thinking: Evolution of Healthcare in KSA (100 points)
Investigate the evolution of the current health system in Saudi Arabia in terms of quality, cost, access, and innovation.
Consider the socioeconomic factors that affect the Saudi Arabian rural healthcare systems. How do these factors relate to quality, cost, and access? How have they improved patient satisfaction?
Write a paper that addresses the following:
An introduction,
Described how quality has been improved over the past 10 years,
At least two contemporary economic factors that impact the KSA healthcare system,
The role of privatization in the context of reducing cost and improving access,
Explain the role of patient satisfaction in rural areas in quality outcomes,
The role of health innovation in the delivery of care, and
A conclusion.
Requirements:
Your paper should be four to six pages in length, not including the title and reference pages.
You must include a minimum of four credible sources for support. Use the Saudi Digital Library to find your resources.
Your paper must follow Saudi Electronic University academic writing standards and APA style guidelines, as appropriate.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
Explain the ethical guidelines in experimental research with the human participants and discuss the ethical issues that researchers can encounter in experimental research with human participants at different stages of a study Chapter 12: Note: Please prepare your topic and provide it at the specified time in the schedule or before the time.Your discussion should be a minimum of 15 slides or more if you need to.Use proper references in APA style.If you have any concerns do not hesitate to contact me through my email
Present your approved intervention to the patient, family, or group and record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Expand All
Introduction
Baccalaureate-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).
For this assessment, you’ll present your approved intervention to the patient, family, or group and reflect on various aspects of your capstone practicum experience. Such reflection will give you a chance to discuss elements of the project of which you are most proud and aspects of the experience that will help you grow in your personal practice and nursing career.
REFERENCE
Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. Sciedu International Journal of Higher Education, 7(4).
Instructions
Complete this assessment in two parts: (a) present your approved intervention to the patient, family, or group and (b) record a video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program.
Part 1
Present your approved intervention to the patient, family, or group. Plan to spend at least 3 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Be sure you’ve logged all of your practicum hours in Capella Academic Portal.
The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hUse the Intervention Feedback Form: Assessment 5 [PDF] Download Intervention Feedback Form: Assessment 5 [PDF]as a guide to capturing patient, family, or group feedback about your intervention. You’ll include the feedback as part of your capstone reflection video.
Part 2
Record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. A transcript of your video is not required.
You’re welcome to use any tools and software with which you are comfortable, but make sure you’re able to submit the deliverable to your faculty. Capella offers Kaltura, a program that records audio and video. Refer to Using Kaltura for more information about this courseroom tool.
Note: If you require the use of assistive technology or alternative communication methods to participate in these activities, please contact DisabilityServices@Capella.edu to request accommodations. If you’re unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.
Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for supporting evidence.
Assess the contribution of your intervention to patient or family satisfaction and quality of life.
Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.
Explain how your intervention enhances the patient, family, or group experience.
Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.
Explain how the principles of evidence-based practice informed this aspect of your project.
Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.
Identify opportunities to improve health care technology use in future practice.
Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.
Note specific observations related to the baccalaureate-prepared nurse’s role in policy implementation and development.
Explain whether capstone project outcomes matched your initial predictions.
Discuss the aspects of the project that met, exceeded, or fell short of your expectations.
Discuss whether your intervention can, or will be, adopted as a best practice.
Describe the generalizability of your intervention outside this particular setting.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.
Address your provision of ethical care and demonstration of professional standards.
Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.
Communicate professionally in a clear, audible, and well-organized video.
Additional Requirements
Cite at least three scholarly or authoritative sources to support your assertions. In addition to your reflection video, submit a separate APA-formatted reference list of your sources.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 2: Make clinical and operational decisions based upon the best available evidence.
Describe one’s use of evidence and peer-reviewed literature to plan and implement a capstone project.
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain whether capstone project outcomes matched one’s initial predictions and documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Document the completion of nine hours of practicum time.
Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
Assess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how health policy influenced the planning and implementation of one’s capstone project, as well as any contributions the project made to policy development.
Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
Assess the contribution of an intervention to patient, family, or group satisfaction and quality of life.
Competency 8: Integrate professional standards and values into practice.
Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.
Communicate professionally in a clear and well-organized video.
Unformatted Attachment Preview
Intervention Feedback, Assessment 4
Intervention Feedback Form
Assessment 4
Note: Please include this feedback in your capstone video.
You do not have to submit the completed feedback form; it’s simply a guide to help you capture
patient, family, or group feedback about your intervention.
1. Meeting date(s).
2. Length of the meeting(s) (in hours).
3. Location(s) of the meeting(s).
4. Describe the problem you were addressing.
5. Why was this a problem for the patient, family, or group?
6. What was your intervention?
7. How will the patient, family, or group apply the intervention?
8. How often will the intervention be used and under what circumstances?
9. How easy was it for the patient, family, or group to use the intervention?
10. Describe any challenges associated with the patient, family, or group’s use of the
intervention.
11. Were instructions necessary?
12. What did the patient, family, or group say about using the intervention?
13. Was the intervention helpful?
14. How will the patient, family, or group continue to use the intervention?
15. Explain how the intervention positively or negatively affected the patient, family, or
group’s life.
16. How can the effect be measured?
17. Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in
CORE ELMS.
1
In the scenario assignments, you are asked to reflect on responses to the presented scenario. It should not just be writing down your first reaction or what you already know.
Reflection involves critical thinking, which means rethinking your existing knowledge and previously held opinions in light of what we have learned about theories of ethics, logic, and reasoning. You will need to question your current knowledge and beliefs. Discuss the main points of the debate, what stance you take, support that stance, and discuss the opposing argument. Also, discuss an ethical theory that would apply to defend your view.
To complete each scenario assignment:
1. Complete the entire scenario.
2. Fill out the template attached below, ask your professor for details on submission.
3. Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:
Why do you feel the way you do about the issue presented?
Of the four responses offered in the scenario, which do you think is the most ethical and why?
Which ethical theory would you use to support your stance? Why does this theory work?
4. Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.
5. Your reflection must be 1-2 pages in length and follow APA formatting and citation guidelines as appropriate, making sure to cite at least two sources.
6. Review the rubric for specific grading criteria
Activity 11: Develop a Gantt chart, using Microsoft Project, for the WBS you created for the alternative solution you selected as best.A discussion of Gantt charts and an illustration of a Gantt chart generated using Microsoft Project are provided in the reference list. The illustration is similar to what you will produce for your Activity 11. It illustrates the level of detail appropriate for the Gantt chart you prepare for your project. Submit your Gantt chart as an .mpp file (a file produced by Microsoft Project).The due date for posting your completed Activity 11 Please post your final Activity 11 to this link.T11-Gantt Chart.pdf
POVERTY AND RACISM REFLECTION JOURNALShare an episode in your life in which you, or someone you know, experienced poverty, racism, disparity and/or inequality. This assignment should be written as a personal journal and should include not only a recount of the episode, but also a reflection on how the learning material in this course can be applied to this episode and how it has affected and will affect your life, understanding, and/or future actions as a public health professional. This journal should be 300-350 words in length and include at least 2 references relevant to your situation.Learning Objective: Examine the effects of poverty, racism, disparity, or inequality.
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Review the assigned Georgia voting policy, Election Integrity Act of 2021, from the Learning Resources this week. I will provide them once you are selected to work on the question.
You will use this policy to familiarize yourself with the structure of policy documents, as well as the process for policy analysis—an important foundation before you begin your own policy search for your Social Change Project.
Review the Policy Selection Process document in the Learning Resources this week. This document outlines the search for and selection of the Election Integrity Act of 2021—you will need to follow a similar process for your own region or state as part of your Social Change Project.
Identify the social problem(s) addressed in the policy.
Select an excerpt from the policy that you would change—this could be a small change, like an addition, or a large change, like a complete revision or removal—to better alleviate the social problem.
Submit a 3- to 4-page paper that addresses the following:
Describe the social problem(s) addressed in the policy.
Which areas in the policy indicated the social problem(s) to you?
Why, as a social worker, should you be concerned with the problem(s)?
Are there other problem(s) not directly identified that might be impacted, positively or adversely, by the policy?
What makes a social problem a social work problem?
How can social work practice skills be applied to advocacy and policy that promote change?
Determine who defines the problem.
Who is defining the problem?
What values are reflected in this definition of the problem?
What is being omitted in this definition?
Which population(s) is/are impacted by the problem?
What is the relationship between the social problem(s) and the population(s)? In other words, why are some people impacted by the problem(s) when others are not?
How is/are the population(s) taken into consideration in the policy?
Summarize the excerpt from the policy that you identified as needing change.
What are the strengths of this excerpt in helping to alleviate the social problem? It is okay if you do not see any strengths. Explain why.
What are the limitations of this excerpt in helping to alleviate the social problem(s) for the population(s)?
What specific changes would you make to the excerpt to alleviate the social problem(s) for the population(s)? You can describe the changes or quote direct policy language you would change
Requirements: 3-4 Full Pages Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph.
Please be sure to carefully follow the instructions.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each body paragraph.
Please be sure to use at least five scholarly articles published in the last 5 years.
Create a 2-4 page resource that will describe databases that are relevant to EBP around a diagnosis you choose and could be used to help a new hire nurse better engagEvidence-based practice (EBP) integrates the best evidence available to guide optimal nursing care, with a goal to enhance safety and quality. EBP is crucial to nursing practice because it incorporates the best evidence from current literature, along with the expertise of the practicing nurse. The concern for quality care that flows from EBP generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise. To gain the knowledge, you require a good understanding of how to search for scholarly resources, as well as identify which databases and websites are credible for the purposes of implementing evidence-based changes in practice.e in EBP.You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.
To select the diagnosis for the patient in this scenario, review the three diagnoses presented in the Assessment 01 Supplement: Locating Credible Databases and Research [PDF] Download Assessment 01 Supplement: Locating Credible Databases and Research [PDF]resource and select one. You will use this same diagnosis to complete the next two assessments.
Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, journal article, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.
For this assessment:
Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to the diagnosis in this scenario and describe to which of these you would direct a nurse colleague to search for evidence.
Describe where you might go in the work place to complete this research and how you would access the desired, relevant research within research databases or other online sources.
Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.
Describe communication strategies to encourage nurses to research the diagnosis/practice issue, as well as strategies to collaborate with the nurses to access resources.
Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis/health care issue within the context of a specific health care setting.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis/practice issue.
Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis/health care issue.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis/practice issue, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.
Unformatted Attachment Preview
Assessment 01 – Locating Credible Databases and Research
Create a 2-4 page resource that will describe databases that are relevant to EBP around one of
the diagnoses below and could be used to help a new hire nurse better engage in EBP.
Before you complete the instructions detailed in the courseroom, first select one of the
diagnoses below. You will use this diagnosis in subsequent assessments.
•
Pneumonia: An infection that inflames the air sacs in one or both lungs, which may fill
with fluid.
o Interventions: Antibiotic therapy, oxygen therapy, chest physiotherapy,
hydration, and coughing techniques.
o Keywords: Community-acquired pneumonia, hospital-acquired pneumonia, viral
pneumonia, bacterial pneumonia, respiratory therapy.
•
Congestive Heart Failure (CHF): A chronic condition in which the heart doesn’t pump
blood as well as it should.
o Interventions: Diuretics, ACE inhibitors, beta-blockers, fluid restriction, daily
weight monitoring, and patient education on symptom management.
o Keywords: Left-sided heart failure, right-sided heart failure, ejection fraction,
cardiomyopathy, edema.
•
Diabetes Mellitus: A group of diseases that result in too much sugar in the blood.
o Interventions: Insulin therapy, oral hypoglycemic agents, dietary management,
blood glucose monitoring, and patient education.
o Keywords: Type 1 diabetes, type 2 diabetes, hyperglycemia, hypoglycemia,
diabetic ketoacidosis.
1
As a current or future nurse leader, you may be called upon to present to stakeholders and leadership about projects that you have been involved in or wish to implement. The ability to communicate a plan—and potential implications of not pursuing such a plan—to stakeholders effectively can be critically important in creating awareness and buy-in, as well as building your personal and professional brand in your organization. It is equally important that you know how to create compelling presentations for others’ delivery and ensure that they convey the same content you would deliver if you were the presenter.
You are encouraged to complete the Evidence-Based Practice: Basics and Guidelines activity before you develop the presentation. This activity consists of six questions that will create the opportunity to check your understanding of the fundamentals of evidence-based practice as well as ways to identify EBP in practice. The information gained from completing this formative will help promote success in the Stakeholder Presentation and demonstrate courseroom engagement—it requires just a few minutes of your time and is not graded. In addition to summarizing the key points of Assessments 2 and 3, you will provide stakeholders and/or leadership with an overview of project specifics as well as how success would be evaluated—you will essentially be presenting a discussion of the Plan, Do, and Study parts of the PDSA cycle. Again, you will not be expected to execute the project, so you will not have any results to study. However, by carefully examining the ways in which your plan could be carried out and evaluated, you will get some of the experience of the thinking required for PDSA.
When creating your PowerPoint for this assessment, it is important to keep in mind the target audience: your interviewee’s organizational leadership. The overall goal of this assessment is to create a presentation that your interviewee could potentially give in his or her organization.Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Explain an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal.
Summarize an evidence-based interdisciplinary plan to address an organizational or patient issue.
Explain how the interdisciplinary plan could be implemented and how the human and financial resources would be managed.
Propose evidence-based criteria that could be used to evaluate the degree to which the project was successful in achieving the improvement goal.
Communicate the PowerPoint presentation of the interdisciplinary improvement plan to stakeholders in a professional manner, with writing that is clear, logically organized, and respectful with correct grammar and spelling using current APA style.
There are various ways to structure your presentation; following is one example:
Part 1: Organizational or Patient Issue.
What is the issue that you are trying to solve or improve?
Why should the audience care about solving it?
Part 2: Relevance of an Interdisciplinary Team Approach.
Why is using an interdisciplinary team relevant, or the best approach, to addressing the issue?
How will it help to achieve improved outcomes or reach a goal?
Part 3: Interdisciplinary Plan Summary.
What is the objective?
How likely is it to work?
What will the interdisciplinary team do?
Part 4: Implementation and Resource Management.
How could the plan be implemented to ensure effective use of resources?
How could the plan be managed to ensure that resources were not wasted?
How does the plan justify the resource expenditure?
Part 5: Evaluation.
What would a successful outcome of the project look like?
What are the criteria that could be used to measure that success?
How could this be used to show the degree of success?
Again, keep in mind that your audience for this presentation is a specific group (or groups) at your interviewee’s organization and tailor your language and messaging accordingly. Remember, also, that another person will ultimately be giving the presentation. Include thorough speaker’s notes that flesh out the bullet points on each slide.
topic is Health risks for health workers on night shift.
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GROUP PRESENTATION COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN
Assignment title or
task:
(You can write a
question)
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Select one from the following topics: Occupational stress and impact on employee well-being
Health risks for health workers on night shift.
The roles and responsibilities of the occupational health professionals
The role of telehealth in occupational health services
Occupational safety and health measures in Saudi Arabia
Promoting Mental Health in the Workplace
Digital Occupational Health in KSA.
The role of occupational health in the prevention of occupational
diseases
Psychosocial hazards and prevention in the workplace
Occupational health services for small-sized workplaces of less than 20
workers
Promoting Mental Health in the Workplace
Occupational Heat Exposure
Occupational Noise Exposure
Personal Protective Equipment
Prevent Falls in the workplace
Name
Student’s name and ID
Submission date:
ID
Instructor name
Dr.
Grade
… out of 10
Guidelines:
➢ Every student must send me by email with his chosen topic before 10/10/2023
➢ The presentation should be submitted on the blackboard as a PPT file.
➢ The PPT should not be more than 15 slides and not less than 10 slides.
➢ Use appropriate references as per the APA Style.
➢ The oral presentation time should be 7-10 minutes.
➢ All presenters must participate equally and help each other as needed.
➢ It will be conducted in weeks 9, 10, 11.
➢ Your presentation will be evaluated based on the implementation of
communication skills, slides, time, deadline, topic covering.
Week 9
1. ABDULLAH ALAMRI
2. Faisal Alanazi
3. HUSSEIN ALBAHER
4. SULTAN ALDAWSARI
5. MUFEED ALDHU
Week 10
Week 11
1. MUSTAFA
ALHADDAD
1. MUBARAK
ALMURAYR
2. FARIS ALJANFAWI
2. MOHAMMED
ALQARNI
3. SAAD ALKHALIFAH
4. AHMAD ALKUWAITY
5. KHALID ALMATHIBIRI
6. AQEEL ALMUJAYBIL
3. HASSAN ALRUBH
4. hani alrumaih
5. BADER ALSHAMMARI
All students must submit their
6. ABDULRAHMAN
ALSHEHRI
presentation by Monday of
All students must submit their
All students must submit their
week 9
presentation by Monday of
presentation by Monday of
week 10
week 11
6. AHMED MAJRASHI
Please follow the rank and the presentation will be in the virtual session on Wednesday of
the weeks 9,10, and11. Attendance is required for all students.
Good Luck
You were asked to create the initial steps of an Evidence-Based Practice (EBP) project using your chosen topic from Week 3 and the articles your instructor approved in Week 4. After gathering your approved articles, you completed appraisals on a quantitative or qualitative review and systematic review in Week 6.
This week, you will be using your two approved sources to complete your EBP project poster.
Your poster should include:
Explanation of the nursing issue significance with three statements
Description of your position on the issue and three statements on how a nurse can impact this issue
Include only the two approved journal sources used in your Week 6 appraisals to support your position.
Topic:
Among patients with type 2 diabetes mellitus how does telehealth weekly consultation compared to current practice (no telehealth) affect glycemic control within three months ?
Here are the two articles to use:
Miele, F., Clementi, S., Gennaro, R., Nicolao, I., Romanelli, T., Speese, K., & Piras, E. M. (2019). TextMessaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions AmongPatients and Health Care Professionals. JMIR Diabetes, 4(2)https://doi.org/10.2196/11343
Makroum, M. A., Adda, M., Bouzouane, A., & Ibrahim, H. (2022). Machine Learning and Smart Devices for Diabetes Management: Systematic Review. Sensors, 22(5), 1843. https://doi.org/10.3390/s22051843
Attached are two examples of this project
Chapter 15 Case Study 1
Subjective
Medical History
Mr. XO, aged 48 yr, with prior history of type 2 diabetes and ischemic heart disease. He
experiences angina on mild to moderate exertion, 3 to 5 METS, and his hypertension is
controlled with medication. He has a strong family history of type 2 diabetes and was
diagnosed himself 12 yr ago. Mr. XO has never smoked and has a sedentary occupation as a
store manager for a large local corporation. He walks 1 to 2 mi (1.6-3.2 km) each lunchtime,
weather permitting, Over the past 3 mo, he has started to notice increased angina and
shortness of breath when climbing two flights of stairs at work; at the top of the stairs, he
feels some moderate chest pressure that resolves in a couple of minutes after he sits down at
his desk. His primary care physician sends him for a routine exercise stress test.
Medication
Candesartan
4 mg once daily
Bisoprolol
2.5 mg nighttime
Atorvastatin
80 mg daily
Diamicron
60 mg twice daily
Isosorbide mononitrate 120 mg daily
Nicorandil
10 to 20 mg twice daily
Clopidogrel
75 mg daily
GTN spray
As required for angina
Diagnosis
Male, 48 yr old, with angina, dyslipidemia, and diabetes with a lateral infarct and family
history of premature coronary artery disease. Single-vessel coronary artery disease with small
diffusely diseased diagonal culprit not suitable for PCI and marginal for CABG.
Objective and Laboratory Data
Physical Examination Results
Resting ECG: Appears normal
Heart rate: 65 beats · min−1 and regular
Blood pressure: 110/72 mmHg
Heart and lung sounds: Suggestion of pops and crackles
Blood Chemistry Test Results
His fasting blood sugar 3 mo ago was 234 mg/dL and HbA1c was 8.7.
Other Clinical Diagnostic Test Results
Coronary Angiogram
• Procedure: Coronary and left ventricular angiogram
• Indication: 48 yr old with angina, dyslipidemia, and diabetes with a lateral infarct
and family history of premature coronary artery disease
• Technique: RFA 6 FR, JL4, JR4, and pigtail catheters
• Hemodynamics: Aorta: 109/67 mmHg; mean 81 mmHg; LV: 109/22 mmHg
1
From J.K. Ehrman, P.M. Gordon, P.S. Visich, and S.J. Keteyian, Clinical Exercise Physiology HKPropel Access,
5th ed. (Champaign, IL: Human Kinetics, 2023).
Findings
• LMCA: No stenosis
• LAD: 65% to 75% mic calcified stenosis
• Diagonal: Diffusely diseased (90%) vessel first diagonal (culprit), too small for
stent; TIMI II flow (only 1.7 mm vessel despite intracoronary GTN)
• Circumflex: 20% proximal stenosis
• RCA: Dominant, no stenosis
• Ventriculography: LVEF 45%; mid and anterolateral akinesis
Conclusion
• Single-vessel coronary artery disease with small, diffusely diseased diagonal
culprit not suitable for PCI and marginal for CABG
• Proceeded to PCI-LAD
• Medical treatment for diagonal disease
• Preoperative exercise program
• Postoperative exercise program
Exercise Test Results
No tests were conducted.
Discussion Questions
a. Are there any results from the physical examination or blood chemistry or other
diagnostic test results that may influence any recommendations for exercise or
physical activity?
b. Based on the exercise testing results, if applicable, are there any considerations
regarding the safety of exercise training for this individual?
Exercise Assessment and Plan
Some exercise prior to PCI may help his recovery post-PCI, but presurgery, Mr. XO would
be wise to limit his exercise intensity to light (20%-40% peak V̇O2 or 40%-55% HR
maximum, depending on bisoprolol effects on maximum heart rate or RPE on Borg scale [810]). He might be best advised to exercise in multiple short bouts daily (e.g., 3 × 10 min) to
accumulate his physical activity; this avoids long periods of ischemia or angina.
Postsurgery, he can resume light activity and then progress after 2 to 3 wk to longer
exercise bouts, increasing to around 15 min bouts at week 3 and adding 1 to 2 min/wk.
Eventually at 6 to 8 wk, he may start to progress to very short (30-60 s) periods of moderateintensity work if his symptoms allow.
Discussion Questions
a. Based on the information provided, what might you consider when determining
whether this patient should perform exercise training, and what benefits would you
expect to observe?
b. Are there any signs, symptoms, medications, or other items listed that would need to
be considered when assessing this patient for an exercise training program?
c. Develop a 12 wk exercise prescription for cardiorespiratory, resistance, and range of
motion training if applicable. Use the FITT principle when developing your
prescription.
2
From J.K. Ehrman, P.M. Gordon, P.S. Visich, and S.J. Keteyian, Clinical Exercise Physiology HKPropel Access,
5th ed. (Champaign, IL: Human Kinetics, 2023).
d. Discuss issues that might affect this individual’s ability to begin and adhere to
exercise training.
e. What considerations might affect decisions for exercise workload or intensity
progression?
f. Based on the subject’s medical history and test results, identify areas for which the
patient should be further educated (e.g., weight control, diet modification). Are there
other resources that you might use?
3
From J.K. Ehrman, P.M. Gordon, P.S. Visich, and S.J. Keteyian, Clinical Exercise Physiology HKPropel Access,
5th ed. (Champaign, IL: Human Kinetics, 2023).
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Introduction to Disease
Course code:
PHC271
CRN:
Assignment title or task:
Diabetes Mellitus (DM) is a common chronic disease in Saudi Arabia. Explain the
epidemiology, pathophysiology, types, risk factors, symptoms, signs, and prevention of
diabetes.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
Out of 10
Proficiency
Some Proficiency
Limited Proficiency
No Proficiency
2
1.5
1.0
0.5
Content Presentation
Criteria
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Thinking
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/ 10
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Start your writing from the next page (page 3)
•
Word limit: Minimum 600 words (3 pages)
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task (PDF is not
acceptable)
•
Submission should be before the deadline (submission after the deadline is not allowed)
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.Chapter 5, “Public Policy Design” (pp. 87–95 only)Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)Chapter 9, “Interprofessional Practice” (pp. 152–160 only)Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advoc…Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a…Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.
You Have a Friend Suffering from a Mood Disorder
Consider while watching the previously assigned TEDtalk on depression that
you have a friend or loved one who suffers from a mood disorder. TEDtalk on
depression
Explore potential treatments that could be used to help your friend.
• Discuss how you would advise your friend
• What treatment options could you recommend?
• Assume they are nervous about the stigma or about seeking treatment.
What would you say to comfort them?
75 words
In-depth Mood Disorder Discussion
Throughout the lecture this week, we discussed several types of mood
disorders and their possible treatments.
Examine one of the many treatments we briefly touched on.
•
•
•
•
•
When was this treatment developed?
Discuss if there is any controversy around the treatment and if so, why
that controversy exists.
Why does this treatment work for the specific disorder it is used to treat?
What other information do you find interesting or relevant?
Compare and contrast treatments with your peers. Do you agree with
their assessment, and why or why not?
75 words
Social Media and Personality Disorder
There is a prominent conversation that social media has led to a rise in
personality disorders. This occurs because “image” becomes a central focus
of daily life. It can lead to increased stress and cause personality disorders to
from. These articles provide both fact and opinion into the conversation.
Personality Disorders in a Social World
Is Social Media Promoting Personality Disorders?
Histrionic Personality, Narcissistic Personality, and Problematic Social Media Use:
Testing of A New Hypothetical Model
Analyze the argument that social media has led to a rise in personality
disorders.
• Read one or more of the articles and use the information from the
lecture
• Discuss how does social media contribute to the growing amount of
personality disorders
• Do you agree or disagree with the argument that social media gives rise
to personality disorders?
• Is this true of all disorders or only certain ones?
• Discuss your reasoning.
75 words
Combating Mental Health Stigmas
Through the first three weeks of class, we have discussed that stigmas exist
about mental illness. We also discussed common behaviors that contribute
to people feeling stigmatized, including the language that we use. This
article explores ways to end that stigma.
Ways to Fight Mental Health Stigma
Determine what mental illness stigmas exist from what you have learned
so far in this course.
• Are negative stigmas about mental illness prevalent and if so, what
contributes to them?
• Why is it important to combat these negative stigmas?
• What would you say to someone you hear enforce a negative
stereotype about mental illness?
• Discuss what actions can you take to raise awareness for mental illness
and personality disorders?
75 words
Looking Deeper
There are many unanswered questions surrounding mental illness. What is a
question that you have after studying mental illness for four weeks? Research
your question in order to teach your classmates and yourself something new
about mental illness.
Outline an unanswered question that you have and begin to search for
answers.
•
•
•
•
•
•
What is your question?
Why are curious about this specific question?
Where did you go to research? What sources did you use?
What answers were you able to find?
Discuss whether or not you were able to answer your questions.
What questions do you still have?
75 words
Boston Globe Shooting
Read the article from the Boston Globe. Massachusetts government
implemented a law that allows patients more control over their care. However,
this law has complications for the state. The author of this article argues that a
mental illness can get in the way of a patient knowing they need help and
treatment.
Read this article on the Rogers Guardianship
Assess laws that affect people with mental illness.
•
•
•
•
•
What is the Rogers Guardianship?
Research your home state. Does your state have any similar
protections?
In your opinion, are laws that allow mentally ill patients to refuse
medication good or bad?
Include a counter argument to your opinion and a rebuttal
Discuss if you agree or disagree with your classmates
75 words
Learning Environment for Children with ADHD
This article discusses children and how they learn. Whether a child has
difficulty focusing or is diagnosed with ADHD, learning can be challenging.
These articles focus on alternative ways to help children learn when learning
is difficult.
Can climbing trees replace preparing for tests?
Investigate how children with ADHD can learn in their environment.
• Do you believe that our education system needs an overall or that more
care needs to be provided for students with mental illnesses? Why?
• What are risks in more outside play?
• Discuss how families provide care for their child with ADHD?
• Is there anything you disagree with in these articles?
• What did you learn from these readings that you did not know before?
• Do you agree with your classmates’ assessments? Why or why not?
75 words
IDEA Act
The lecture this week mentions the IDEA Act or the Individuals with
Disabilities Education Act. More information about the IDEA Act can be found
at the following websites.
•
•
Government site about the IDEA Act
What is the Individuals with Disabilities Education Act (IDEA)?
Analyze how the effect of the IDEA act on children with mental
illnesses.
• Give a brief summary of the IDEA Act
• Discuss which aspect(s) of the IDEA Act you think are the most
important
• Discuss what you would add to the IDEA Act if you were able to add a
component
75 words
Legal Protections for Older Adults
Aging is a normal part of life. It is likely that in your day to day, you have
relationships with people in this population. It is our responsibility to reach out
and care for the older adults in our lives.
Read: The Simple Guide to Caring for Elderly People
Illustrate your understanding of mental illness in the elderly population
to advocate for this population.
• Read the article
• What are actions you can take to care for older adults
• How can your actions positively affect older adult patients with mental
illness?
•
Discuss if you agree or disagree with your classmates’ assessments.
Why?
75 words
Culture and Older Adults
Different cultures care for their older adults in different ways. Many have
different attitudes toward aging. For example, some cultures value their older
adults and hold them in high esteem with respect to their wisdom and
experience while other cultures stigmatize this population.
Read: How Cultural Attitudes Toward Aging Affect Senior Care
Compare how different cultures care for their elderly.
• Read the article provided.
• Find an additional article from the library database and summarize.
• What are the differences in how cultures care for the older adult?
• How does this care affect the mental health of the older adult?
• Do you agree or disagree with their treatment?
• Discuss which perspectives we could implement into our culture to
better care for our older adults
75 words
Dear College Freshman…
Imagine being 18 again and walking into your college dorm for the first time.
You have just met your roommate and are about to begin this new adventure
of beginning your secondary education. While this is certainly an exciting time,
it can be filled with many potential stressors. As a college freshman, you are
required to adjust rapidly to a new life without the comforts of your home or
family.
Analyze what sort of challenges big life changes might bring to mental
health.
• I would like you to write a brief letter to a college freshman.
• In this letter, you will essentially be giving that person advice – not just
about joining a social circle, studying or partying – but instead wise
words on how to maintain good mental health.
• Discuss any tips that helped you throughout major transitions in your
life.
• Try to place yourself back in their shoes and try to express what would
have helped your mental health most during that crucial time.
150 words
Impact of Stress
Watch: How to make stress your friend
Throughout your collegiate career, it’s inevitable that you have experienced
stress in one way or another. You may encounter fear of the future or faced
with a decision to stand up for what you believe in even when it is difficult. You
may become consumed with what people think about you and make decisions
based on what makes others happy. Stress affects your behavior, your
thoughts, your feelings, and overall, your body in a negative way. We all have
faults and often stress can bring them to light in difficult ways. Most people do
not even realize that a daily headache or battles with insomnia can be
attributed to stress. Identifying how we handle stress (the positive and
negative ways) can help us achieve greater mental wellness. Watch
the TedTalk, “How to Make Stress Your Friend” and discuss.
Establish tangible practices to manage stress.
•
•
•
Identify one area of life where stress is most likely affecting your
wellbeing. This can be in regard to school, family, personal health, or
personal behaviors.
Discuss any stress management tools you have incorporated to improve
your overall mental health well-being.
Identify any poor habits that might be derailing your efforts to deal with
this stressor. Are you over-committed in one or more areas of your life
that prevents you from achieving a good balance in your life? Are you a
person who says “yes” to everything?
75 words
Your Assessment of Alternative Medicine
As we have learned and read, there are many forms of “medicine” that are
safe, healthy, and easily implementable. This article discusses the similarities
and differences in alternative and traditional medicine forms including
criticisms of both. While reading this article, think about the points you agree
and disagree with and points you would like to research further.
Read: Alternative vs Traditional Medicine
Express your personal opinions on holistic medicine
• Discuss whether you agree or disagree with alternative medicine
practices?
• Support your argument with logic-based assessments of
information along with the scholarly reference you found it in
• Do you believe one type of medicine is better than the other, or is it best
to use both in an integrative way?
• Do you have any past experiences with holistic treatment?
• Do you agree or disagree with your classmates’ assessments?
75 words
Practicing Wellness
Watch: Try This One Minute Guided Meditation By Headspace
Report on your experience implementing holistic practices.
• Discuss which practices you chose and why
• What were the results?
• Did you enjoy one over the other and why?
• Did they cause more anxiety than comfort?
• How did your setting and mood affect the outcome of the exercises, if
applicable?
• Did you share similar or have different experiences? Comment on your
classmates’ experiences.
75 words
Total: 1125 words
After reading the article, discuss your role as a nurse in disaster preparedness and response. Describe your current patient population and discuss the challenges you might face in carrying out your responsibilities in a disaster.How could you gain more hands-on training to supplement your academic study of disaster management? How could you feel more prepared? Discuss different training options that you could participate in (e.g. CERT training).Support your answer with evidence from scholarly sources.
BASED ON ALL YOU HAVE LEARNED THIS TERM, IF YOU HAD THE OPPORTUNITY TO OPEN A NEW HEALTHCARE ORGANIZATION IN ANOTHER COUNTRY, WHERE WOULD YOU PICK AND WHY? WHAT WOULD THE ORGANIZATION LOOK LIKE? WHO WOULD YOU WANT TO SERVE? HOW WOULD THIS ORGANIZATION BE FUNDED? BRAINSTORM IDEAS WITH YOUR CLASSMATES.
APPLICATION QUESTION:
Last module, you submitted your final project – a formal written proposal to the senior leadership in support of your chosen service or programmatic enhancement to add to MHS’s service portfolio. This week let’s close out by sharing a description of our proposals with one another. We will do this by creating a press release, an activity that many healthcare leaders will participate in at some point in their careers as part of marketing their organizations.
Create a 1-2-minute oral “press release” that unveils your proposal to the public – in this case your classmates. Here are some parameters for your presentation:
You may use the Canvas audio tool, your phone or computer recorder, or any online software to deliver your pitch.
Be as creative as you wish!
Describe your proposed service in the most persuasive way possible but use at least one piece of evidence to support your service.
Don’t exceed 2 minutes.
To ensure ADA compliance, you must also provide a transcript of your oral presentation (your press release) under your audio link.
You must submit your oral presentation by Thursday, 11:59 PM ET so that your classmates have time to listen to them and provide thoughtful feedback.
Additional Resources:
Writing Press ReleasesLinks to an external site.
8 Tips for Writing a Great Press ReleaseLinks to an external site.
I have chosen Cardiovascular Services as the focal area for the three-part project in this course. My decision stems from recognizing the significant impact of cardiovascular health on the general public’s well-being. Cardiovascular diseases contribute to illness and death worldwide (Bakeret al., 2017). Opting to improve services in this field aligns with the increasing need for preventive and advanced cardiac care. Through this project, I aim to investigate strategies that raise the quality and accessibility of cardiovascular services. Additionally, I intend to explore cost-efficient methods for patient care and develop creative approaches to address the rising effects of cardiovascular conditions. By concentrating on Cardiovascular Services, my goal is to enhance community health outcomes and improve individuals’ overall quality of life.
Reference
Baker, J. J., Baker, R. W., & Dworkin, N. R. (2017). Health care finance. Jones & Bartlett Learning.
Remediation for Midterm
Spontaneous words:
Target
Rabbit
Rainbow
Shoot
star
booth
rain
Gate
Snow
Knees
Peach
Baker
Tent
Same
Child’s form
/wæbɪt/
/woʊwoʊ/
/sut/
/tar/
/but/
/weɪ/
/deɪt/
/sənoʊ/
/nis/
/bits/
/beɪkə/
/dɛn/
/seɪ/
Sound change
r→w
Potential process
gliding
change/no change
from original sample?
Potential process
Words produced after a clinician model:
Target
Child’s form
Show
Tag
Game
Spoon
Rip
Tooth
Goat
/ʃoʊ/
/tat/
/geɪm/
/spun/
/wɪp/
/tut/
/goʊt/
1. Please state which sounds the child produced spontaneously in the first table (independent
analysis) and fill in the chart to include the sound changes (in IPA) and the potential processes
(the first one is completed for you).
2. In the second chart also complete the last 2 columns and make a list of all the sounds/sound
combinations that the child was able to produce after an imitation that they were not able to
produce spontaneously (these are the sounds the child is stimulable for).
3. If you were told that this child is 4 years old, which processes that they are demonstrating
should have already been diminished by this time? And which error do think it most likely to
remain until after the child is 5 years old?
4. Would you characterize this as a phonological issue or articulation issue, and why?
College of Health Sciences
Department of Public Health
GROUP PRESENTATION COVER SHEET
Course name:
Chronic Disease Epidemiology
Course number:
PHC 331
CRN
12651
•
Title of group presentation Topic
Assignment title or task:
(You can write a question)
Name
ID
1.
Students name and ID
2.
3.
4.
5.
Submission date:
Instructor name
Dr. Olla Qadi
Grade
… out of 5
Guidelines:
•
Write the appropriate references using APA style, at least 3 references.
•
Avoid plagiarism.
•
Attach the power point file as a PPT and as PDF file.
•
8-10 slides excluding the first (title slide), last slide (thank you slide), and references
slide(s).
Grading Criteria for the group presentation
Poor
1 pts
Organization Audience
cannot
understand
presentation because
there is no sequence
of information.
Subject
Student does not have
Knowledge
grasp of information;
student
cannot
answer
questions
about subject.
Graphics
Student
uses
superfluous graphics
or no graphics
Mechanics
Student’s
presentation has four
or more spelling
errors
and/or
grammatical errors.
Group
Dynamics
Multiple
group
members
not
participating.
Evident
lack
of
preparation/rehearsal.
Dependence
on
slides.
Fair
2 pts
Audience has difficulty
following
presentation
because student jumps
around.
Good
3 pts
Student presents
information
in
logical sequence
which audience
can follow.
Student is uncomfortable Student is at ease
with information and can with
expected
answer only rudimentary answers to all
questions.
questions but fails
to elaborate.
Excellent
4 pts
Student
presents
information in logical,
interesting sequence which
audience can follow.
Student demonstrates full
knowledge (more than
required) by answering all
class
questions
with
explanations
and
elaboration.
Student occasionally uses Student’s graphics Student’s graphics explain
graphics
that
rarely relate to text and and reinforce screen text
support
text
and presentation.
and presentation.
presentation.
Presentation has three Presentation has Presentation
has
no
misspellings
and/or no more than two misspellings
or
grammatical errors.
misspellings
grammatical errors.
and/or
grammatical
errors.
Significant controlling by Slight domination All presenters knew the
some members with one of one presenter. information, participated
minimally contributing.
Members helped equally, and helped each
Primarily prepared but each other.
other as needed.
with some dependence on Very
well
just reading off slides.
prepared.
Total
(20)
earning Goal: I’m working on a wellness multi-part question and need the explanation and answer to help me learn.
a 10 slide PowerPoint, a simple pamphlet, and a chart.Total: 3750 wordsRequirements: 3750 | .ppt file
Unformatted Attachment Preview
Portrayals of Schizophrenia by Entertainment Media: A
Content Analysis of Contemporary Movies
Read this article about the portrayal of schizophrenia in the media. This article focuses on mental illness
as depicted in contemporary movies. To some, this can raise awareness of issues. To others, in can
perpetuate negative and untrue stigmas around mental illness. Using this article as well as other sources,
write a paper to discuss the portrayal of schizophrenia in the media.
Analyze how the media portrayal of schizophrenia impacts the stigma around mental health.
Include each of the following points in your assignment:
·
·
·
·
·
Write a 2 page paper 1000 words that discusses mental illness as portrayed in the media
What is the key argument of the article?
What are some misleading characteristics of schizophrenia portrayed in media identified in the
article?
Does the media impose negative stereotypes, or can it be used to get rid of these stereotypes?
What is your experience with seeing mental illness in media?
Hope for People Living with Schizophrenia
Read this article: There is Hope for People Living with Schizophrenia
Utilizing this article and other sources, continue our theme on refuting the negative stigmas and
treatments for people living with mental illness. This article focuses on one of the more negatively
stereotyped mental illnesses, Schizophrenia and illustrates that people living with this mental illness can
still live normal and full lives.
Characterize the actions someone with schizophrenia can take to live a long and full life .
Include each of the following points in your assignment:
·
·
·
·
·
Create a simple pamphlet using Word 500 words min
Include symptoms, diagnosis, and key statistics of schizophrenia.
What are reasons someone with schizophrenia might not seek help
List some of the incorrect beliefs about schizophrenia
What forms of treatment are available for someone diagnosed with schizophrenia?
Current Mental Health Legislation
This website by Mental Health America has compiled a list of mental health legislation. Use these sources
to help you choose a stance on whether or not you believe there should be more legislation in place for
adolescent mental health.
Inspect legislation to put in place to help aid in the diagnosis and treatment of mental illness in children
and adolescents.
Include each of the following points in your assignment:
·
·
·
·
Write a letter to your local newspaper or congressperson explaining whether or not you believe
there should be more mental health protections for children.
Summarize some legislation from which you draw ideas
Describe any additions you would make to this piece of legislation and why you think this
addition would be important
Explain if you think it is important to have mental health legislation and why you feel that way.
500 words
Childhood/Adolescent Mental Illness Awareness
write a script where you are a classroom presenter talking to students about mental illness. You have a lot
of creative freedom here.
Demonstrate your understanding of mental illness in children and adolescents.
Create a 10 slide PowerPoint addressing the following:
·
·
·
·
·
·
What demographic you are talking to about mental illness?
Which mental illness(es) you are discussing?
Any sources that would be beneficial for students to have access to
Signs and symptoms to watch for in their peers, loved ones, or family members
Type up a script of what you would say
Feel free to use any pictures or videos that you feel enhances your presentation
500 word min
Caring for the Elderly
Consider that a loved one close to you is experiencing symptoms of dementia.
Read: How to Create a Checklist and Daily Care Plan for Dementia
Develop a safety plan for your loved one. 500 words
Include each of the following points in your assignment:
·
·
·
·
·
List your care plan for your loved one
Work with the elder and family to develop a schedule for your loved one
What would you advise your loved one to do?
Would you seek to hire a caretaker, why or why not?
Would you feel the need to seek counseling or help?
Goal Setting Workshop
For this week’s assignment, you will be working on a goal-setting worksheet. Choose factors within your
circle of influence that you would like to, and are able to change, such as poor eating habits, lack of
exercise, erratic sleeping patterns, or work-life balance, etc. Pick at least four achievable improvements
that you can make to your personal habits. It can be as simple as, “I want to make sure I brush my teeth
three times a day,” or “I want to spend 1 hour away from my phone at an appointed hour.”
Develop a personal goal setting plan for yourself.
Include each of the following points in your assignment:
·
·
·
·
·
·
Create a goal setting chart
Select the goals you would like to achieve
Set concrete steps to achieve the goals each day during the week
Monitor yourself during the week. Did you take actions each day to accomplish your goals?
Mark each day’s accomplishments with a Y or N
At the end of the week, reflect on What was standing in your way? Were those goals that
you wrote down actually achievable? Why or why not? 500 word min
Mental Wellness Throughout the Life Span
For the second assignment, reflect on what mental wellness can look like throughout your life cycle. Each
stage of our life cycle looks different, and therefore our mental wellness approach will need to evolve
with it. The first step, which will happen for some of you sooner than others, will involve graduation from
college. Picture that scenario, then moving to a new city, starting a career, finding a new group of friends,
dating someone new, and adapting to life as a working member of society.
Remember, even happy events that cause a change in your life can be stressful.
Read: Top 10 Stressful Life Events
Explore your personal stressors and mental wellness plan.
Include each of the following points in your assignment:
·
·
Create a journal in which you identify three protentional stressors
What was the cause of these stressors?
·
·
·
How did you react to these stressors?
Why is it important to start working on these stressors now as opposed to later in life?
How can your mental wellness plan help you overcome these stressors?
250 words
Total: 3750 words ,a 10 slide PowerPoint, a simple pamphlet, and a chart.
What are the major problems with the US Health care system today, from your perspective? How effective has the affordable care act been in addressing these problems so far? What major trends do you see occurring in the health care system in the next 5 to 10 years? What changes would you like to see in the system and how could they be brought about? What do you see your role as in improving health and health care?
You are designing an executable population-based change project addressing identified practice-related problems or questions. This strongly emphasizes collaboration between advanced practice nurses and community agencies and includes working with an agency using practice data to provide answers, which are responsive to the needs of clinicians, administrators, and policy makers for improvement of programs or practices.
This section of the change project should include a discussion of key concepts.
Clarify the issue under study.
Propose solutions or interventions based on the literature review.
Compare other views on the problem and solutions.
Address the APRN role in the intervention and discuss implications for clinical practice.
Discuss the implications of your change project.
Some important things to consider and address:
Does your intervention have a clear connection to your research problem?
What are the specific methods of data collection you are going to use, such as surveys, interviews, questionnaires, or protocols?
How do you intend to analyze your results?
Provide a justification for subject selection and sampling procedure.
Describe potential limitations. Are there any practical limitations that could affect your data collection? How will you attempt to control the limitations?
How will your change project help fill gaps in understanding the research problem?
This section should be 6–7 pages in length, not including the cover or reference page. You must reference a minimum of 5 scholarly articles
Topic: Adolescents and unwanted pregnancies/ STDs
Unformatted Attachment Preview
1
Adolescents and Unplanned Pregnancies: A Conceptual Framework
Suzanna Changulyan
Dr. Fuson
October 8, 2023
2
Theoretical Perspectives to Understand Unplanned Pregnancies
The foundation that can be used toward building a suitable framework for understanding
the research problem begins with identifying the pertinent theoretical perspectives. The
problem and solutions that can be used to address unintended pregnancies among adolescents
can be understood using various theories including; social learning theory and social-ecological
model.
Social Learning Theory
The social learning theory, a concept introduced by Albert Bandura, posits that learning
often occurs as a result of various components such as imitation, observation, and modeling
(McLeod, 2011). Besides, this theory suggests that learning is influenced by other factors such
as the emotions, attitudes, and even the level of attention of an individual. This theory can act
as part of the building basis for understanding the various components that contribute to
unplanned pregnancies among adolescents in society.
Social-ecological model
The social-ecological model is a framework that creates a connection between the societal,
community, relationship, and individual factors. Ideally, this theory explores the potential
influence of the aforementioned factors on the healthcare of an individual. As such, this theory
understands that individual, societal, community, physical, and even environmental
interactions influence health (Centers for Disease Control and Prevention, 2015). This theory
can be used to understand the various factors that influence the high prevalence of unplanned
pregnancies among adolescents in society.
3
Developing Conceptual Framework
The development of the conceptual framework that will be used for this research study
will be borrowed from the insights and perspectives presented by past research studies. The
process of the development of the conceptual framework of this project will involve the
identification of the various factors that contribute to unintended pregnancies among
adolescents. In this case, the process will involve selecting the proper dependent variable,
independent variables, and even the intervening variables. This research aims to implement a
conceptual framework similar to the study conducted by (Hall, Mann, Lewis, Stephenson, &
Morroni, 2016), to integrate the concept of planning and preventing unwanted pregnancies.
Assumptions and components of the framework
The primary objective of the conceptual framework in this research is to build a
connection between the potential various demographic and socio-economic factors to address
the problem of unplanned pregnancies. One of the assumptions that will be used to develop the
conceptual framework is that socioeconomic factors in society influence the rate of unplanned
pregnancies. Another assumption that will be used in this framework is that the level of parental
education has a significant influence on the rate of unplanned pregnancies among adolescents.
Ideally, this assumption can further be expounded that adolescents with more educated parents
are less likely to encounter unplanned pregnancies compared to those without educated parents.
Besides, this framework is based on the assumption that religion influences the prevalence of
unplanned pregnancies among adolescents.
4
The main components, presented in Figure 1 below, of the conceptual framework will
include; independent variables, dependent variables and the dependent variable and the
intervening variable. The independent variable in this framework will include; socioeconomic
factors of the individuals, level of parent education, and religion. The intervening variables will
include; access and usage of birth control methods. The dependent variable, on the other hand,
is the rate of unplanned pregnancies among the adolescent.
The elements of social learning and the social-ecological theories can be used to
understand the connection between the identified dependent and the independent variables.
Ideally, these theories can be used to understand the impact of the independent variables on the
prevalence of unplanned pregnancies among adolescents in the community. The rationale
behind the implementation of the selected theories and components in the conceptual
framework is to understand the impact of the various physical, socioeconomic, and
environmental factors on unplanned pregnancies. This framework is also used in identifying
any potential gaps in research and the possible future recommendations that can be undertaken
by the research stakeholders and the policy planners to fight unplanned pregnancies.
Conclusion
This project will adopt the conceptual framework approach to address the problem of
unplanned pregnancies among adolescents. In particular, the development of this framework
begins with the identification of the theoretical perspectives including; social learning theory
and social-ecological model. Besides, the development of this framework will be based on
various components. The framework will be based on the assumption that socio-economic
factors, level of parent education, and religion influence the rate of unplanned pregnancies
among adolescents. The rationale behind this conceptual framework will be to develop a
connection between the dependent and the independent variables in the study.
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Figure 1: Conceptual Framework
6
References
Centers for Disease Control and Prevention. (2015). Models and frameworks for the practice
of community engagement. Retrieved November, 16, 2021.
Hall, J. A., Mann, S., Lewis, G., Stephenson, J., & Morroni, C. (2016). A conceptual
framework for integrating ‘Pregnancy Planning and Prevention’(P3). Journal of
Family Planning and Reproductive Health Care, 42(1), 75-76.
McLeod, S. (2011). Albert Bandura’s social learning theory. Simply Psychology. London.

1
Adolescent Unwanted Pregnancy and STDS
Suzanna Changulyan
West Coast University
Professor Fuson
NURS 619A
October 1, 2023

2
The Impact of the Project
This project on the impacts and prevalence of unintended pregnancies and STDs plays a
significant role in improving the public health sector’s understanding and approach to this
significant issue (Vaina & Perdikaris, 2022). The exploration of variations in teen births across
different demographics offers crucial insights that have wide-ranging benefits in terms of cost,
time, and quality for people, programs, institutions, and communities.
Cost Benefits
The first benefit is economical resource allocation. Identifying the areas with high
prevalence rates and understanding demographic variations allows resources to be allocated
more efficiently, potentially reducing the economic burden associated with unintended
pregnancies and STDs. Implementing tailored preventive measures can potentially reduce the
future economic costs associated with healthcare, social services, and educational support that
teenage parents and their children require (Vaina & Perdikaris, 2022). Also, reducing unplanned
pregnancies can lead to long-term savings for healthcare systems by averting costs related to
pregnancy complications and long-term health implications for young mothers and their children.
Time Benefits
The project’s insights into demographic variations enable the development of targeted
interventions, thus maximizing efficiency and minimizing the time taken to address high-risk
populations. The research helps quickly identify the needs and modifications in the policies

3
addressing unintended pregnancies and STDs, allowing for swift amendments and
implementations. According to Javidi et al. (2021), understanding the prevalent demographics
helps in prioritizing and streamlining educational interventions, saving time in curriculum
development and implementation.
Quality Benefits
Insights drawn from this project aid in developing high-quality, culturally sensitive
interventions that address different demographics’ specific needs and circumstances. This
research facilitates improvements in the quality of healthcare services by offering a nuanced
understanding of the varying needs and challenges associated with different demographics facing
unintended pregnancies. Knowledge from this research supports the enhancement of sex
education quality by addressing the diverse needs and concerns of varied demographics, making
it more impactful and relevant.
Addressing Needs or Changes
This project provides communities, particularly those marginalized or underrepresented,
with the information and resources to effectively address and prevent unintended pregnancies
and STDs. The rich, demographic-specific insights ensure that interventions and policies are
adaptable and responsive to the evolving community needs and changes (Javidi et al., 2021).
This research is crucial in heightening awareness about the socio-economic and racial disparities
in unintended pregnancies and contributes to a more informed dialogue and action.
Impacts and Consequences

4
This project helps in reducing disparities. It highlights disparities in teen births across
various demographics, which acts as a catalyst for change, promoting equitable access to
resources and services (Harris et al., 2023). The comprehensive insights derived from this study
empower individuals, communities, and policymakers to make more informed decisions
regarding reproductive health. The overall improvements in the efficiency, effectiveness, and
relevance of interventions lead to a holistic enhancement in the well-being and quality of life of
individuals and communities affected by unintended pregnancies.
Therefore, this project is not just an academic endeavor but a transformative initiative
with far-reaching implications. It addresses the diverse impacts of unplanned pregnancies and
explores demographic-specific challenges, fostering a better, more equitable, and informed
approach to reproductive health. This has the potential to revolutionize public health policies,
community interventions, and individual choices.
Goals and objectives
To create measurable, shared, and hypothetically agreed-upon goals and objectives for the
project addressing unintended pregnancies and sexually transmitted diseases (STDs), I aligned
them with the project’s success factors. The first goal is to reduce the incidence of unintended
pregnancies and STDs among teenagers in both high-income and lower or middle-income
countries. The objectives of these goals are to decrease the teenage pregnancy rate by 40% over
the next five years and to lower the incidence of STDs among teenagers by 45% in targeted
regions within five years.

5
Another goal is to enhance the accessibility and effectiveness of preventive measures for
unintended pregnancies and STDs. The objectives of this goal are to increase the distribution of
contraceptives to teenagers in prone regions by 30% within the next two years and to improve
sex education in learning centers by introducing comprehensive and evidence-based sex
education programs in 60% of schools within three years. The third goal is to understand and
address demographic disparities in the prevalence of unintended pregnancies and teen births. The
objective is to conduct comprehensive research on the factors contributing to demographic
disparities in unintended pregnancies and teen births, with a focus on race, socio-economic
status, and geography, to publish findings within two years.
Variables to Consider
The first variable to be considered is budget. Budget is a critical variable in this project if
I implement a clinic-wide practice change. In this project, I will need to secure funding.
Consequently, it is crucial to develop a budget plan for prospective financing avenues
(Gusmartina et al., 2021). I will seek grants, partnerships, and fundraising opportunities if
necessary. The second variable is the staff. I will determine the staff and expertise required for
the project to ensure that I have the necessary human resources, whether hiring new staff,
training existing ones, or collaborating with external experts. Another important variable in this
project is regulations and compliance. I will maneuver this by understanding and complying with
relevant regulations and ethical considerations, especially in healthcare research.
Research Method

6
Due to the complex nature of this project, I intend to deploy both qualitative and
quantitative research methods. Quantitative methods will provide statistical insights into the
prevalence of unintended pregnancies and STDs. In contrast, qualitative methods will help
understand the affected population’s underlying causes, experiences, and attitudes, especially
teenage mothers.
Research Contribution to the Community or Social Change
This project aims to foster communal well-being while cultivating meaningful reform
through engaged cooperation by empowering members and inspiring collective progress. The
research will empower policymakers and healthcare professionals to make informed
interventions and resource allocation decisions. The project will reduce health inequalities,
ensuring healthcare services are more equitable across different groups. According to Parida et
al. (2021), a well-rounded education that holistically addresses relationships, health, and
sexuality could cultivate adolescents’ capacities for discovering their own interests while
respecting others’, empowering youth to navigate intimacy with care, responsibility, and mutual
understanding.
Project Purpose, Focus, and Expected Accomplishments
The project aims to curb unintended pregnancies and the spread of STDs by addressing
the challenges faced disproportionately by teenage mothers and certain demographics through
focused interventions and awareness campaigns. The primary focus is on reducing unintended
pregnancies and STDs among teenagers, especially those of disadvantaged demographics. The
project takes a public health perspective, viewing the reduction of unintended pregnancies and

7
STDs as a vital aspect of community well-being. The project expects to significantly reduce
teenage pregnancies and STD rates, with a particular focus on closing demographic disparities.
Timeline
The project will take about six years. The 1st and 2nd years shall be dedicated to
acquiring financing, forming a collaborative group of specialists, and drafting a strategic research
plan. The researchers will use their third and fourth years to collect data and scrutinize results to
gain insights. The 5th and 6th years will be for developing and implementing interventions and
monitoring the progress.

8
References
Harris, B., McCredie, M. N., Truong, T., Regan, T., Thompson, C. G., Leach, W., & Fields, S. A.
(2023). Relations between adolescent sensation seeking and risky sexual behaviors across
sex, race, and age: A meta-analysis. Archives of Sexual Behavior, 52(1), 191-204.
Gusmartina, S., Azlina, N., & Julita, J. (2021). The Effect of Budget Planning, Budget
Implementation, Procurement of Goods and Services, Competence of Human Resources
and Budget Politics on Budget Absorption (Empirical Study on Opd Pelalawan
District). AFEBI Accounting Review, 6(1), 1-9.
Javidi, H., Widman, L., Lipsey, N., Brasileiro, J., Javidi, F., & Jhala, A. (2021). Redeveloping a
digital sexual health intervention for adolescents to allow for broader dissemination:
Implications for HIV and STD prevention. AIDS Education and Prevention, 33(2),
89-102.
Parida, S. P., Gajjala, A., & Giri, P. P. (2021). Empowering adolescent girls, is sexual and
reproductive health education a solution? Journal of Family Medicine and Primary
Care, 10(1), 66.
Vaina, A., & Perdikaris, P. (2022). School-based sex education among adolescents worldwide:
Interventions for the prevention of STIs and unintended pregnancies. British Journal of
Child Health, 3(5), 229-242.
1
Adolescents and Unplanned Pregnancies: An Integrative Literature Review
Suzanna Changulyan
NURS 619A
Professor Fuson
September 24, 2023
2
Introduction
Unintended pregnancies and sexually transmitted diseases (STDs) are represented as
an important problem in the public health sector not only in the high-income countries but also
in the lower and middle-income earning countries. Numerous preventive measures are often
implemented by not only healthcare institutions but also the general community. Some of the
common measures include; the integration of sex education in learning centers and enhancing
the distribution and the accessibility of contraceptives. To fully address this problem, there is
a need to understand not only the challenges caused by the problem but also the differences in
the level of prevalence of the healthcare problem in demographics such as; race and the socioeconomic status in the community. This paper presents an integrated research review on the
various challenges of unplanned pregnancies and the variation in teen births in various
demographics including; race, socio-economic status, and geography.
The impact of unplanned pregnancies on adolescents
According to research conducted by the World Bank in 2022, there were more than 12
million girls, aged between 15 and 19, who gave birth. The World Bank (2022), noted various
challenges encountered by teenage mothers including; social stigma, health risks, and possible
adverse economic impacts for the rest of their adult lives. Gurung, et al. (2020), in their
research, also attempted to explore the various consequences associated with teenage
pregnancy. Through an observational study, Gurung, et al. (2020) noted that pregnant
adolescents are at risk of prolonged labor compared to adult mothers. Besides, this research
3
identified that the risk of malfunction is more than two-fold in the case of adolescent mothers
in comparison to adult mothers. The World Bank (2022) further improves on this comparison
by stating that pregnant adolescent girls experience more birth complications such as low baby
weight and severe neonatal conditions compared to pregnant mothers aged between 20 and 24.
Chakole, Akre, Sharma, Wasnik, & Wanjari (2022), in their research, also conducted
a narrative literature review to explore the impact of teenage pregnancy. According to this
study, teenage pregnancy can result in a high mortality rate because of delivery challenges or
even illegal and botched abortions. According to a study conducted by The World Bank
(2022), more than half of the abortions that occur among adolescent girls across the globe are
unsafe. Besides, the World Bank (2022) also reported on the risk of the high rate of mortality
in pregnant adolescents compared to older pregnant women.
Adolescent pregnancy is also more likely to undermine the economic potential of
teenage mothers. According to The World Bank (2022), teenage mothers are less likely to
proceed with education, which can prevent them from not only realizing but also reaching their
true potential. The inability to proceed with education can undermine the future earnings of the
teenage mother and even contribute to the intergenerational cycles of poverty. Moreover,
pregnancy among adolescents is likely to contribute to psychological impact on the individuals.
According to Chakole, Akre, Sharma, Wasnik, & Wanjari (2022), the physical and financial
stress associated with teenage pregnancy can undermine the emotional stability of an
individual. E, R, & HS, (2023) further expand on the connection of mental health to unplanned
pregnancies among teenagers by indicating that adolescent mothers are likely to get less rest
and sleep, be introverted, and even into anxiety and depression compared to the older pregnant
mothers. The research presented in this study can be used to understand the various problems
that can be encountered by pregnant adolescents and young mothers. Ideally, the information
4
from these articles can offer a proper framework for not only addressing any existing research
gaps but also formulating a basis for implementing the proper interventions to help address the
problem in the various communities across the globe.
Racial and ethnic disparities on adolescents’ unplanned pregnancies
The assessment of the racial and ethnic differences in prevalence of the unplanned
pregnancies among adolescents is another important component that can be used in
understanding the foundation of implementing the proper interventions to address the problem.
According to past research studies, demographic factors such as age, race, social economic
factors, and geographic factors can impact the rate of teen births. Ideally, understanding the
differences in the racial and ethnic teen birth rates can help foster a plan, which can be used to
mitigate the problem.
Among the researchers who have examined the racial and ethnic differences in teen
births is Cox (2020), who explored the differences in the pregnancy rates among black and
white teens in the United States. In 2018, there were more than twice the birth rates of black
and Hispanic teens as that of white teens (Cox, 2020). Dumas, Chu, & Horswell (2020) also
affirm that black teens in the United States have an overall high pregnancy and birth rates
compared to white teens. The racial differences in teen birth rates among various ethnicities
can be due to the different perceptions of access to reproductive healthcare and contraception.
According to Galloway, Duffy, Dixon, & Fuller (2017), the disparities in access to
sexual reproductive services and sexual healthcare among African-American and Hispanic
teens are heavily influenced by inaccurate perceptions and beliefs regarding the reliability of
contraceptives. Besides, this study reported concerns about the side effects of birth control as
5
a major contributor to the adoption of contraceptives among black and Hispanic teens.
Sychareun, et al. (2018), in their qualitative research also noted the negative perceptions of the
reliance on contraceptives as a major contributor to teenage pregnancy. While this study only
focuses on rural Lao, the findings presented in the research can play an essential role in
understanding the differences in teenage birth rates among various races and ethnicities.
Social-economic differences in the adolescents’ unplanned pregnancies
Socioeconomic status is another area of exploration that can be examined to identify the
differences in unplanned pregnancies among adolescents. Ideally, the differences in socioeconomic status can help further identify the distribution of interventions and ultimately
address the problem. Gurung, et al. (2020), in their study, identified that two-thirds of their
research participants, who were adolescent mothers, were from disadvantaged ethnic groups.
Besides, the research noted that individuals who lacked formal education were more likely to
be teenage mothers compared to those with formal education.
Chirwa, et al. (2019), in their research, explored the socio-economic differences in
teenage pregnancies in Malawi. The findings of this research suggested that teenage bearing
and childbearing were more prevalent in the communities with the lower socio-economic status
in the country. Ideally, this study noted wealth status in the families was an important
contributor to teenage pregnancies. Cox (2020) further explored the aspect of socioeconomic
status about the difference in teen birth rates. According to the study, the comparison of the
teens in the black and white communities of equally lower socio-economic status suggested a
reduction in the racial differences in the teen birth rates.
The findings of Dumas, Chu, & Horswell (2020) also support the conclusions presented
by Cox (2020), as the research mentions the lack of significant differences in teen births
between black and white communities. Individuals of lower socioeconomic status, irrespective
6
of age and race, were more likely to encounter teenage pregnancy compared to those of higher
socioeconomic status (Cox, 2020). Okoli, Hajizadeh, Rahman, Velayutham, & Khanam
(2022), in their study, also identified teenagers from lower socio-economic communities were
more likely to encounter unplanned pregnancies. This article noted that the existence of social
economic inequality limited access to information, which in turn contributes to higher birth
rates among adolescents.
Geographic Differences
Moreover, geographic differences can also play a part in the assessment of the
differences in teen births. Ideally, the findings from the exploration of this component can be
used to understand the various gaps and the possible solutions that can be implemented to help
further address the problem. According to the study conducted by Cox (2020), there is a higher
teen birth rate among the communities residing in Arkansas compared to those residing in
Massachusetts. Byonanebye, Brazauskas, Tumwesigye, Young, & Cassidy (2020), also
conducted a geographic variation on teenage pregnancies in Uganda. The findings of this study
indicate that there are higher birth rates among the communities in the Eastern central region
compared to the other regions in the country. The findings of these two studies offer an
informative view regarding the component of geographic variation and its importance in
understanding and noting the differences in teenage birth rates in a country.
Conclusion
Unplanned pregnancies and sexually transmitted diseases form part of important public
health problems not only in the high-income countries but also in the middle income and the
low-income earning countries. The integrated research review reveals unplanned pregnancies
have a significant impact not only on the physical and mental health of an individual but also
on the economic stability and potential. Besides, the review uncovers that teenage pregnancies
7
are more prevalent in the less advantaged racial and ethnic groups and communities in socioeconomic status. Geographical variation also plays a part as a factor that determines the
differences in teen births in various countries. Understanding the challenges caused by teenage
pregnancies and differences in teen births in various communities can help formulate a proper
plan for investment in the proper interventions.
8
References
Byonanebye, J., Brazauskas, R., Tumwesigye, N., Young, S. M., & Cassidy, L. (2020).
Geographic variation and risk factors for teenage pregnancy in Uganda. African
Health Sciences, 20(4), 1898-907.
Chakole, S., Akre, S., Sharma, K., Wasnik, P., & Wanjari, M. B. (2022). Unwanted Teenage
Pregnancy and Its Complications: A Narrative Review. Cureus 14(12): e32662.
doi:10.7759/cureus.32662.
Chirwa, G. C., Mazalale, J., Likupe, G., Nkhoma, D., Chiwaula, L., & Chintsanya, J. (2019).
An evolution of socioeconomic related inequality in teenage pregnancy and
childbearing in Malawi. PloS one, 14(11), e0225374.
Cox, J. E. (2020). Understanding the Differences in Pregnancy and Birth Rates for Black and
White Teens. Journal of Adolescent Health .
Dumas, S. A., Chu, S., & Horswell, R. (2020). Analysis of pregnancy and birth rates among
black and white medicaid-enrolled teens. Journal of Adolescent Health, 67(3), 409415.
E, E., R, W., & HS, M. (2023). The Impact of Unwanted Pregnancy in Adolescents toward
Pregnancy Care: A Systematic Review. . Open Access Maced J Med Sci [Internet].
2022 Feb. 5 [cited 2023 Sep. 22];10(F):7-14. Available from:
https://oamjms.eu/index.php.
Galloway, C. T., Duffy, J. L., Dixon, R. P., & Fuller, T. R. (2017). Exploring AfricanAmerican and Latino Teens’ Perceptions of Contraception and Access to
Reproductive Health Care Services. National Library of Medicine .
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Gurung, R., Målqvist, M., Hong, Z., Poudel, P., Sunny, A., Sharma, S., & Kc, A. (2020). The
burden of adolescent motherhood and health consequences in Nepal. BMC pregnancy
and childbirth , 20 , 1-7.
Okoli, C. I., Hajizadeh, M., Rahman, M. M., Velayutham, E., & Khanam, R. (2022).
Socioeconomic inequalities in teenage pregnancy in Nigeria: evidence from
Demographic Health Survey. BMC Public Health, 22(1), 1-11.
Sychareun, V., Vongxay, V., Houaboun, S., Thammavongsa, V., Phummavongsa, P.,
Chaleunvong, K., & Durham, J. (2018). Determinants of adolescent pregnancy and
access to reproductive and sexual health services for married and unmarried
adolescents in rural Lao. BMC pregnancy and childbirth , 18 , 1-12.
The World Bank . (2022). The Social and Educational Consequences of Adolescent
Childbearing. From: https://genderdata.worldbank.org/data-stories/adolescentfertility/.
Description
2. Etiology
3. Incidence & Demographics
4. Risk Factors and Screening
5. Assessment
6. Physical Exam Findings
7. Mental Status Exam Findings
8. Diagnostic and Laboratory Findings
9. Differential Diagnosis
10. Clinical Management
11. Life Span Consideration
12. Follow-up somatization disorder- Somatic symptom disorder is diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness, or shortness of breath, to a level that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms.undifferentiated somatoform disorder- The characteristic that defines this disorder is that although the person complains, no evidence can be found that these physical symptoms exist. Even with lab test and exams by doctors, no physical signs can be supported to prove that the person has these symptoms. Hypochondriasis- Hypochondria is a type of anxiety disorder. It is also known as health anxiety, or illness anxiety disorder, or hypochondriasis. It is normal for people to worry about their health now and again. But people who experience hypochondria get very worried that they are seriously ill or are about to become seriously ill. conversion disorder-Conversion disorder involves the loss of one or more bodily functions. Examples include Weakness or paralysis. Loss of balance or difficulty walking. pain disorder-A pain disorder is chronic pain experienced by a patient in one or more areas. The pain is often so severe that it disables the patient from normal functioning. The duration may be as short as a few days or if many years. body dysmorphic disorder- Body dysmorphic disorder is a mental health condition in which you can’t stop thinking about one or more perceived defects or flaws in your appearance — a flaw that appears minor or can’t be seen by others. But you may feel so embarrassed, ashamed, and anxious that you may avoid many social situations. When you have body dysmorphic disorder, you intensely focus on your appearance and body image, repeatedly checking the mirror, grooming, or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause you significant distress and impact your ability to function in your daily life. somatoform disorder- In somatoform disorders, physical symptoms suggest a physical disorder, but there are no demonstrable organic findings and there is strong evidence for link to psychological factors or conflicts.
Mr. X, a 42-year-old male presents to your primary care practice today complaining of low back pain.
History – Mr. X states that he has had chronic low back pain since he had a skiing accident about 10 years ago. Three days ago, he felt a pulling sensation in his lower back after moving some boxes. The pain intensity increased over the subsequent 24 hours and is now steady, aching in nature, at 3-4 out of 10. Mr. X also has Type2 diabetes, which is well controlled on metformin with a HGA1c of 5.6. He has a history of DVT 4 months ago for which he takes Coumadin, INR is WNL. He is followed by a specialist for this problem. He recently started taking two OTC products; kava kava for what he describes as “anxiety” and CoEnzyme Q10 on the advice of a friend.
Social – Mr. X is a smoker, 1 pack per week for 15 years. No alcohol or drug use. He is employed as an accountant and has medical insurance. He is divorced.
PE/ROS – Complains of low back stiffness and pain on movement with occasional spasms related to moving in certain directions. You note he has mild difficulty getting onto the exam table but gait is normal. He denies weakness/numbness/tingling of legs, no radiation, no change in bowel or bladder habits. BMI 27. All range of motion of the back is decreased by 25%. Straight leg lift is negative bilaterally, DTR intact. All other systems WNL.
Medications:
Metformin 1000mg ER one tab daily – Type II Diabetes controlled
Coumadin 5 mg. daily – Hx of DVT – Controlled
Kava Kava 50 mg. tid – Self-medication for anxiety
CoQ10 – 200 mg. daily. – Self-medication for unknown reason
Provide a diagnosis for the patient and your rationale for the diagnosis
Provide a treatment plan specifically for this patient, pharmacologic and non-pharmacologic.
Comment on the use of OTC products in relation to Mr. X’s current chronic and acute disease diagnoses and medications. Include drug-drug interactions and side effect profiles.
Provide an education plan for Mr. X
Present this Assignment as a PowerPoint presentation with between 12 and 16 slides (not including opening slide and resource slide).
You will use the Narrative notes section of the presentation to include the majority of your evidentiary support of your treatment choices and education of family complete with in-text citations using APA formatting,
Due by the last day of Unit 9 at 11:59 p.m.
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Submit to and review results of Turnitin. Purdue University Global Student Conduct policy as it relates to plagiarism will be adhered to in this course.
Your writing Assignment should:
follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
utilize APA 7th edition formatting.
For this assignment, you will be developing and presenting an Educational, Narrative PowerPoint. In the presentation of your chosen topic, be sure to examine the pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan (MN551-3).
Narrative, PowerPoint Assignment Requirements
Make sure all of the content topics of the assignment have been addressed.
Cite at least three references in your PowerPoint; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Design and develop a 8- to 12-slide PowerPoint presentation using voice/narrative feature on each slide (the title and reference slides do not count in the slide count, but must be included in the assignment), that will be used to educate the community about one of the following topics:
Type II Diabetes
Atherosclerosis
Hypertension
Depression
Urinary Tract Infection
Narrative, PowerPoint Contents to include, but not be limited to:
Risk factors and causes
Possible consequences
Prevention Strategies
Treatment Modalities
PowerPoint Format:
Follow APA 7th edition format for PowerPoint presentations.
Use the slide notes section in the presentation to include information that follows your narration, being sure to follow the conventions of Standard English.
Slide content should include brief points that identify the areas that will be addressed in the narration.
In-text citations should be included with any brief points that were researched from outside sources, and the narration should fully explain the points.
Reference all sources on a separate reference slide at the end of the presentation and cite each source in the body of the presentation using 7th edition APA format.
Identify the sources of any pictures you use, being sure to cite them correctly in 7th edition APA style, using in-text citations.
Narration Guidelines:
Maintain a professional tone by summarizing observations and evaluations for each slide.
Ensure that your presentation is highly ordered, logical, and unified.
Words should be clearly enunciated and professional tone should be sustained throughout the presentation narration.
Audio recording should be free of background noise and interruptions.
Before finalizing your work, it is important to:
Review Narrative PowerPoint Assignment Requirements (described above) and the Narrative PowerPoint Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
Make sure to review your chosen topic carefully to make sure you have answered all content effectively.
Utilize spelling and grammar checks to minimize errors.
Follow the conventions of Standard English (correct grammar, punctuation, etc.).
Make sure your presentation is original, insightful, and utilizes your logic and critical thinking skills; that your presentation is well-organized, with superior content, style, and mechanics.
Utilize APA 7th edition format.
Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
Watch the above youtube video of a child. Answer all questions. Be aware that
this child does not speak English with an American accent – be sure to indicate if
you think any differences in her speech are due to accent/dialect.
1. Provide a paragraph regarding background information on the child. This
paragraph will be hypothetical (use your imagination). Include pertinent
information that would normally be included in an introduction paragraph,
such as birth and medical information.
2. (This section should include a chart with IPA transcription, required
calculations and a paragraph(s) discussing the errors made and the
information that is requested). Provide a description of all the speech sound
errors you observed from the words produced. If a word is attempted more
than once, make note of all attempts.
a. Make a chart listing each word (the target) and it’s actual production
both in graphemes and IPA and list phonological process present or
significant substitutions, etc (example provided below).
b. Although this was a very short sample, the targets are known so you
should be able to break down the errors for each segment/syllable and
identify any frequently occurring processes.
c. For any sounds that you cannot transcribe you can state that they
were distorted or unintelligible.
d. State whether these errors are expected or not expected for her age
and whether they were typical or atypical substitutions.
e. In addition you should describe the way her articulators are moving
even if you cannot state what exact phoneme she is making (e.g., is
she even able to get her lips to touch for a bilabial?, what are her jaw
movements like?) You should also complete a PCC analysis and
percent words correct analysis. Discuss how intelligible you judge her
to be and how this corresponds with her age (assume that she is 4.9
years old) and how well you think her speech above the one word level
might be understood.
Target
Production
(graphemes)
IPA
Error/process
3. Describe what formal and informal testing procedures you would use (taking
into account the attention span of a 4-year-old). This video has been
provided to you by the parent perhaps, but you also have to do your own
testing. Provide hypothetical results from these tests. This does not have to
be in the form of exact scores, but rather something like 2.0 standard
deviations below the mean or demonstrates a severe delay, etc. Make sure
to describe things like whether or not the child was able to imitate your
models or if she benefited from any verbal, visual, or tactile cueing. Discuss
what a likely diagnosis might be. You must also provide a rationale for why
you chose the assessment procedures that you chose and describe each step
of the evaluation as you proceed. (I do not recommend using more than one
standardized test).
4. State at least 10 questions that you would ask during the parent interview
portion of the evaluation, state what your rationale is for asking them, and
provide the hypothetical answers.
5. Discuss what issues you think might be addressed first in future therapy. You
can pick 2 issues that you think the SLP should address, and write a goal.
You can use a format like ‘client will use the /s/ sound in two-word phrases in
90% of opportunities’ or ‘client will decrease the use of final consonant
deletion to only one time per session’. These are just examples of possible
goal structures. You can use whichever type of structure you think is
appropriate for this child and of course can change the sound/process/word
level, etc.
For this Performance Task, you will analyze hypothesis test data published in a peer-reviewed journal and complete your own hypothesis tests based on data. You will complete your selected test in Excel and draw conclusions based on your data.
You will be assessed on the Professional Skills of Written Communication, Interpreting Data & Quantitative Fluency, and Technology. To make certain you are addressing all aspects of the Professional Skills, please review the rubric to determine what is necessary for meeting the requirements. Visit the Professional Skills resources, as needed.
Instructions
To complete this Assessment, do the following:
Be sure to adhere to the indicated assignment length.
Before submitting your Assessment, carefully review the rubric. This is the same rubric the SME will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.
IMPORTANT INFORMATION ON INTERPRETING THE ASSESSMENT RUBRIC (CLICK TO EXPAND)
Achievement vs. Mastery of the Competency
Mastery of this Competency means that 80% or more of the rows have been assessed as Exceeds Expectations and no rows have been assessed as Does Not Meet Expectations.
Achievement of this Competency means that all rows are assessed at Meets Expectations or above (but lower than the 80% threshold required for Mastery).
Assessment of Individual Rubric Rows
In order to achieve Meets Expectations for a particular row of the rubric, you must have adequately completed all criteria in that row. This means that you have addressed all required elements to the required level of quantity and/or quality.
In order to achieve Exceeds Expectations for a particular row of the rubric, you must have adequately completed all criteria in the row, and in addition, your response must reflect a depth and breadth of knowledge and expertise. Examples of this include—but are not limited to—the following:
You provide additional, specific, and/or particularly relevant examples to illustrate points made.
You seamlessly incorporate your original thoughts and diverse, credible, and relevant academic sources, when applicable, to express your viewpoint or develop a persuasive argument.
You demonstrate a deeper understanding of the subject that draws from discipline-specific knowledge and theory and incorporates the viewpoints of a diverse set of business and management thought leaders.
You draw additional connections between multiple, complex topics to support your explanations.
You are able to apply your knowledge in unique, creative, and/or innovative ways.
You thoroughly break down concepts into simpler parts and use your understanding of business to make connections.
Your analysis is insightful and original.
You design processes, products, and/or solutions that are creative, high-quality, and innovative.
You consider diverse perspectives and relevant social, ethical, and business-related issues when proposing new ideas or formulating judgments.
Rubric
All submissions must follow the conventions of scholarly writing. Properly formatted APA citations and references must be provided where appropriate. Submissions that do not meet these expectations will be returned without scoring.
This Assessment requires submission of two (2) files. The first file is completed on the provided template and includes the two parts. Save your file as follows:
When you are ready to upload your completed Assessment, select Submit Attempt.
You may submit a draft of your assignment to the Turnitin Draft Check area to check for authenticity. When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.
Important Note: As a student taking this Competency, you agree that you may be required to submit your Assessment for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted Assessment materials will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such materials. Use of the Turnitin.com service is subject to the Usage Policy posted on the Turnitin.com site.
Click each of the items below for more information on this Assessment.
Hypothesis Testing
PART 1: HYPOTHESIS TESTING IN RESEARCH ARTICLES
This part makes use of the following article, available in the Walden Library. This article compares the health profile of African Americans raising their grandchildren solo compared to African American single parents.
References
Whitley, D., & Fuller-Thomson, E. (2017). African-American solo grandparents raising grandchildren: A representative profile of their health status. Journal of Community Health, 42(2), 312–323. https://doi.org/10.1007/s10900-016-0257-8
This part focuses on two tables:
Table 1 examines whether different demographics are independent or dependent of parenting status (grandparent vs. parent). The characteristics are gender, age, education level, income category, MSA code, number of children, gender of child, age of child, child’s history of asthma, child received flu shot.
Table 2 examines whether health factors of the caregiver are related to parenting status (grandparent or parent). The indicators are the presence of arthritis, COPD, diabetes, asthma, cancer, heart attack, stroke, angina, and kidney disease, as well as self-rated health status, number of days per month physical health is not good, limitation in activity in the past month, number of days mental health was not good during the past month, presence of depressive disorder, physical exercise in last month, BMI category, and smoking status.
Statistically non-significant relationship
Choose one characteristic listed in Table 1 that does not show a statistically significant relationship with parenting status. Assume an alpha level of 0.05.
Write an appropriate null and alternative hypothesis test for this chi squared test.
Explain why this relationship NOT is considered statistically significant. Explain how the p value provided supports your reasoning.
Write a conclusion statement to clearly explain the results of this hypothesis test.
Explain in the context of your hypothesis statement what it would mean to make a type II error.
Statistically significant relationship
Choose one characteristic listed in Table 2 that shows a statistically significant relationship with parenting status. Assume an alpha level of 0.05.
Write an appropriate null and alternative hypothesis test for this chi squared test.
Explain why this relationship is considered statistically significant. Explain how the p value provided supports your reasoning.
Write a conclusion statement to clearly explain the results of this hypothesis test.
Explain in the context of your hypothesis statement what it would mean to make a type I error.
PART 2: USING THE DATA TO PERFORM A HYPOTHESIS TEST
This part will make use of the body data set created in ST3001. All computations must be done in Excel and provided in the final assessment document.
Be sure to provide an explanation for each of your answers and include supporting evidence from the text and/or Learning Resources.
Comparing BMI by smoking status
You are interested in determining if smokers have an Average BMI that is greater than nonsmokers.
Explain which hypothesis test would be appropriate for this situation (assume population variances are not known and sample variances are not equal).
Explain if this is a left-tailed, right-tailed or two-tailed test and justify your choice.
Complete a hypothesis test in Excel to test your claim. Be sure to include the results from the data analysis tool pack test.
Write a conclusion statement that makes use of Excel data to justify which hypothesis is supported and why.
State your findings in the context of the research question, “Do smokers have a BMI that is greater than nonsmokers?”
Comparing weight by region of the country
Patients were asked to report the region of the country they lived in. This data is coded as follows:
1=north
2=south
3=east
4=west
You are interested in determining if all four regions of the country have mean weights that are considered equal or if at least one is different.
Explain which hypothesis test would be appropriate for this situation.
Complete a hypothesis test in Excel to test your claim. Be sure to include the results from the data analysis tool pack test. Hint: Weight data will need to be sorted by region like the process previously used to sort BMI by smoking status.
Write a conclusion statement that makes use of Excel data to justify which hypothesis is supported and why.
State your findings in the context of the research question, “Do all four regions have equal average weights?”
Create an Excel box plot of all 4 four regions side by side (like in STAT3001) and paste it here. Add a chart title and legend. Write a sentence or two on how this graph justifies your answer in question 4. Remember, these charts show the 5-number summary.
NURS530 Week 8 Discussion Evaluate the potential complications and comorbidities associated with skin disorders, such as secondary infections, scarring, and psychological impact. How can nurse practitioners recognize and manage these complications to optimize patient outcomes and quality of life? Provide an example from your clinical experience.Discuss the pathophysiology of common skin infections in children, such as impetigo, cellulitis, and fungal infections. How do microbial invasion, host immune responses and skin barrier integrity contribute to the development and progression of these infections?Evaluate the potential complications and long-term effects associated with thermal injuries and burns, such as wound infections, contractures, hypertrophic scarring, and psychological distress. How can nurse practitioners recognize and manage these complications to optimize patient outcomes and facilitate physical and emotional recovery?Select one and discuss the pathophysiology of different types of shock, including hypovolemic, cardiogenic, obstructive, distributive, and septic shock. How do alterations in vascular tone, blood volume, cardiac function, and cellular metabolism contribute to the development and progression of each type of shock? NURS 676 Week 8 Discussion Vitamin deficiencies can result from various factors, such as inadequate dietary intake, malabsorption, and certain medical conditions. Discuss one condition that increases the risk of vitamin deficiencies. How can healthcare professionals identify at-risk patients and develop appropriate intervention strategies to prevent or address these deficiencies?Weight loss drugs can be a valuable adjunct to lifestyle interventions for certain patients struggling with obesity. Select one of the different classes of weight loss drugs, its mechanism of action, and the key factors healthcare professionals must consider when selecting this treatment regimen for a specific patient. How do potential side effects, contraindications, and patient preferences factor into this decision-making process?Discuss the challenges and strategies associated with managing dermatological conditions in patients with specific considerations, such as pediatric patients, geriatric patients, or patients with comorbid conditions. How can healthcare professionals tailor their approach to the selection and administration of topical medications for these patient populations to optimize safety and effectiveness while addressing individual needs and preferences?Proper application of topical medications is crucial for their effectiveness and patient safety. Discuss the essential techniques for administering various types of topical medications, such as creams, ointments, gels, and lotions. What are the key patient education and counseling points healthcare professionals should address to ensure patients are able to safely and effectively apply their topical medications?
you will select a diagnosis among high-risk patient populations that are commonly readmitted to the hospital. Prepare a paper that examines the rationale for readmissions among this population and provide evidence-based interventions for reducing hospital readmissions in this population.
Mental Illness Reflection
Write a 2-page paper 1000 words addressing the following elements in your paper:
•
•
What are a few ways you think would improve the understanding and awareness of
mental health?
Why do you think it is important to improve the understanding and awareness of mental
health?
Include a title page and 3-5 references. Please adhere to the APA standards when writing and
submitting assignments.
Mental Health Resources
It may seem during this exploration of the history of mental illness that healthcare has pretty
much done everything wrong. While we may not have met the lofty goals outlined in the federal
acts you have explored, there clearly is progress. Let’s close this week with hope.
Inspect mental illness and wellness resources.
Include each of the following points in your assignment:
·
Search Mental Health Organizations
·
Click on the link that looks like the one above
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Explore these organizations
·
Choose 5 that you feel would be the most helpful
·
Create a simple two-column chart
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Place the name in one column and summarize the organization in the other 500
word min
·
As always, proper grammar and sentence structure, and spelling is required. There is no
copy/pasting allowed. Use your own words.
Comparing Three Types of Mood Disorders
Compare the different types of mood disorders.
Include each of the following points in your assignment:
•
•
•
•
•
•
•
•
Create a PowerPoint in 4 slides
For the first 3 slides, outline each manic, depressive, and bipolar disorder
On the 4th slide, compare similarities and differences between the three types of mood
disorders
What are the similarities and differences between the three types of mood disorders:
manic, depressive, and bipolar?
What are the differences in symptoms?
What do these differences mean for those with a disorder?
Which population of people is the disorder likely to affect?
What are possible treatments?
. 500 words min
Famous Faces of Bipolar Disorder
Throughout this unit we discussed many types of mood disorders. This unit opened up with a
video in which Kanye West discusses his life with bipolar disorder. Many people, famous people
included, suffer from mood disorders. For this assignment read this article about the 8 Famous
faces on Bipolar Disorder. Use the article (or other source) to select two famous people who
have a mood disorder.
8 Famous Faces of Bipolar Disorder
Analyze what the aspects of bipolar disorder looked like for two famous people. Remember,
don’t just look at celebrities but look back in history to find historical figures as well.
Include each of the following points in your discussion:
•
•
•
•
Write a 1-page biography for each of the two people you selected (2 pages total
500 words each) and include elements pertaining to their mood disorder
What did this disorder look like in their daily lives?
What were their behaviors?
How did the disorder affect their lives?
Explaining Personality Disorders
We have covered a wide array of disorders. In order to fully absorb the information, this
assignment will help you to get more specific about the different types of personality disorders.
Explain personality disorders in your own words.
Include each of the following points in your assignment:
•
•
•
•
•
•
Review the personality disorders we have discussed
Select two of the disorders
Create a two-column chart
Make one column for each disease
Side by side, write down the causes, symptoms, signs, and treatments of the two
disorders
At the end, write a brief summary of how the two are similar and different
500 words
Total 3000 words
a 10 slide PowerPoint, a simple pamphlet, and a chart.Total: 3750 words
Unformatted Attachment Preview
Portrayals of Schizophrenia by Entertainment Media: A
Content Analysis of Contemporary Movies
Read this article about the portrayal of schizophrenia in the media. This article focuses on mental illness
as depicted in contemporary movies. To some, this can raise awareness of issues. To others, in can
perpetuate negative and untrue stigmas around mental illness. Using this article as well as other sources,
write a paper to discuss the portrayal of schizophrenia in the media.
Analyze how the media portrayal of schizophrenia impacts the stigma around mental health.
Include each of the following points in your assignment:
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·
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Write a 2 page paper 1000 words that discusses mental illness as portrayed in the media
What is the key argument of the article?
What are some misleading characteristics of schizophrenia portrayed in media identified in the
article?
Does the media impose negative stereotypes, or can it be used to get rid of these stereotypes?
What is your experience with seeing mental illness in media?
Hope for People Living with Schizophrenia
Read this article: There is Hope for People Living with Schizophrenia
Utilizing this article and other sources, continue our theme on refuting the negative stigmas and
treatments for people living with mental illness. This article focuses on one of the more negatively
stereotyped mental illnesses, Schizophrenia and illustrates that people living with this mental illness can
still live normal and full lives.
Characterize the actions someone with schizophrenia can take to live a long and full life .
Include each of the following points in your assignment:
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·
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Create a simple pamphlet using Word 500 words min
Include symptoms, diagnosis, and key statistics of schizophrenia.
What are reasons someone with schizophrenia might not seek help
List some of the incorrect beliefs about schizophrenia
What forms of treatment are available for someone diagnosed with schizophrenia?
Current Mental Health Legislation
This website by Mental Health America has compiled a list of mental health legislation. Use these sources
to help you choose a stance on whether or not you believe there should be more legislation in place for
adolescent mental health.
Inspect legislation to put in place to help aid in the diagnosis and treatment of mental illness in children
and adolescents.
Include each of the following points in your assignment:
·
·
·
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Write a letter to your local newspaper or congressperson explaining whether or not you believe
there should be more mental health protections for children.
Summarize some legislation from which you draw ideas
Describe any additions you would make to this piece of legislation and why you think this
addition would be important
Explain if you think it is important to have mental health legislation and why you feel that way.
500 words
Childhood/Adolescent Mental Illness Awareness
write a script where you are a classroom presenter talking to students about mental illness. You have a lot
of creative freedom here.
Demonstrate your understanding of mental illness in children and adolescents.
Create a 10 slide PowerPoint addressing the following:
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What demographic you are talking to about mental illness?
Which mental illness(es) you are discussing?
Any sources that would be beneficial for students to have access to
Signs and symptoms to watch for in their peers, loved ones, or family members
Type up a script of what you would say
Feel free to use any pictures or videos that you feel enhances your presentation
500 word min
Caring for the Elderly
Consider that a loved one close to you is experiencing symptoms of dementia.
Read: How to Create a Checklist and Daily Care Plan for Dementia
Develop a safety plan for your loved one. 500 words
Include each of the following points in your assignment:
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List your care plan for your loved one
Work with the elder and family to develop a schedule for your loved one
What would you advise your loved one to do?
Would you seek to hire a caretaker, why or why not?
Would you feel the need to seek counseling or help?
Goal Setting Workshop
For this week’s assignment, you will be working on a goal-setting worksheet. Choose factors within your
circle of influence that you would like to, and are able to change, such as poor eating habits, lack of
exercise, erratic sleeping patterns, or work-life balance, etc. Pick at least four achievable improvements
that you can make to your personal habits. It can be as simple as, “I want to make sure I brush my teeth
three times a day,” or “I want to spend 1 hour away from my phone at an appointed hour.”
Develop a personal goal setting plan for yourself.
Include each of the following points in your assignment:
·
·
·
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Create a goal setting chart
Select the goals you would like to achieve
Set concrete steps to achieve the goals each day during the week
Monitor yourself during the week. Did you take actions each day to accomplish your goals?
Mark each day’s accomplishments with a Y or N
At the end of the week, reflect on What was standing in your way? Were those goals that
you wrote down actually achievable? Why or why not? 500 word min
Mental Wellness Throughout the Life Span
For the second assignment, reflect on what mental wellness can look like throughout your life cycle. Each
stage of our life cycle looks different, and therefore our mental wellness approach will need to evolve
with it. The first step, which will happen for some of you sooner than others, will involve graduation from
college. Picture that scenario, then moving to a new city, starting a career, finding a new group of friends,
dating someone new, and adapting to life as a working member of society.
Remember, even happy events that cause a change in your life can be stressful.
Read: Top 10 Stressful Life Events
Explore your personal stressors and mental wellness plan.
Include each of the following points in your assignment:
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Create a journal in which you identify three protentional stressors
What was the cause of these stressors?
·
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How did you react to these stressors?
Why is it important to start working on these stressors now as opposed to later in life?
How can your mental wellness plan help you overcome these stressors?
250 words
Total: 3750 words ,a 10 slide PowerPoint, a simple pamphlet, and a chart.
Apply and integrate the concepts and knowledge gained in prior general management and health care administration courses to industry-relevant challenges.
Assess the relevant strategic decision-making and implementation issues within a health care organization.
Cyber attack on Universal Health Services, Inc., 2018
Ransomware is a type of malware from crypto virology that threatens to publish the victim’s data or perpetually block access to it unless a ransom is paid. While some simple ransomware may lock the system so that it is not difficult for a knowledgeable person to reverse, more advanced malware uses a technique called crypto viral extortion. It encrypts the victim’s files, making them inaccessible, and demands a ransom payment to decrypt. Ransomware attacks are typically carried out using a Trojan disguised as a legitimate file that the user is tricked into downloading or opening when it arrives as an email attachment. International law enforcement authorities during the height of the pandemic warned that hospitals and health-care facilities in multiple countries were being targeted in ransomware attacks.
Often a ransomware attack is the first phase of a multistage extortion attempt from cyber criminals. Criminals routinely demand millions of dollars to unlock the encrypted systems, and then follow that up by threatening to publish stolen data on the internet if they are not paid a second time.
On September 28, 2020, until October 7, 2020, Universal Health Services, which runs more than 400 healthcare facilities in the United States and the United Kingdom, has more than 90,000 employees and cares for about 3.5 million patients each year, had its IT network hit by a ransomware attack which left a number of its hospitals in the United States without access to computer and phone systems, including facilities in California, Florida, Texas, Arizona and Washington, D.C.
The ransomware attack managed to disable multiple antivirus programs in place on the targeted systems. Once the antivirus software was disabled, the malware caused the computers to log out and shut down, and if administrators attempted to reboot these systems, they simply shut down again. With their systems shut down, clinicians were unable to access vital information, including data found in their Electronic Health Record (EHR) or picture archiving and communication system (PACS) system.
Your assignment:
In a MEMO format, in 1000-1200 words, please discuss the following about the Universal Health Services (UHS) Ransomware attack of September, 2020:
What went well with the response?
What were the significant challenges with the response?
In which ways could the response have been improved?
As the Chief Operating Officer (COO) at one of the (UHS) healthcare facilities in the United States or Territories (Universal Health Services, Locations; pick one), how would you augment your healthcare facility’s preparation and response to protect and mitigate against future cyberattacks?
During Week One, we discussed Fayol’s Five Functions of Management: (a) Planning, (b) organizing, (c) coordinating, (d) commanding, and (e) controlling. Discuss ways which you would use all five functions of Fayol’s Five Functions of Management, would influence the development of your plan.
Make certain that your assignment is in the APA 7th edition format with a cover page, separating your sections by the appropriate APA Level Headings. Also, make sure you include a reference page and at least five references.
Write 1-2 paragraphs for each of the following:1. Define the term opportunistic infection. Explain why two individuals exposed to the same bacteria or fungi are not equally affected. What are some people more susceptible than others?2. Research and report on the Black Death of the Middle Ages, the cholera epidemic of the 19th century and the COVID 19 pandemic of today. How are these 3 events similar and how are they different?
Answer the following questions below in at least 600 words. Use 2 scholarly reliable outside sources.Develop a stress management plan for a patient or community.Explain how this plan would help benefit overall health promotion and disease prevention.
I have attached all the other parts of the paper so that you know the topic and can guide yourself. Please follow instructions accordingly. Many points have been deducted before. Plagiarism less than 20%.
You are designing an executable population-based change project addressing identified practice-related problems or questions. This strongly emphasizes collaboration between advanced practice nurses and community agencies and includes working with an agency using practice data to provide answers, which are responsive to the needs of clinicians, administrators, and policy makers for improvement of programs or practices.
This section of the change project should include a discussion of key concepts.
Clarify the issue under study.
Propose solutions or interventions based on the literature review.
Compare other views on the problem and solutions.
Address the APRN role in the intervention and discuss implications for clinical practice.
Discuss the implications of your change project.
Some important things to consider and address:
Does your intervention have a clear connection to your research problem?
What are the specific methods of data collection you are going to use, such as surveys, interviews, questionnaires, or protocols?
How do you intend to analyze your results?
Provide a justification for subject selection and sampling procedure.
Describe potential limitations. Are there any practical limitations that could affect your data collection? How will you attempt to control the limitations?
How will your change project help fill gaps in understanding the research problem?
This section should be 6 pages in length, not including the cover or reference page. You must reference a minimum of 5 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
Points: 80
Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
64 to >52.48 pts
Meets Expectations
Succinctly clarifies the issue under study. Provides a brief summary of the project including main points and anticipated findings. Provides keen insight into obstacles and proposes sound, creative solutions or interventions based on the literature review findings. Expertly compares other views on the problem and solutions with detail. Uses examples to thoroughly address the FNP role in the intervention and discusses implications for clinical practice. Thoughtfully discusses the implications of the change project and its significance to the nursing profession and filling gaps in knowledge. Accurately categorizes and thoroughly explains specific methods of data collection to be used. Explains in detail how data will be analyzed and used. Provides a sound justification for subject selection and sampling procedure. Accurately and thoroughly describes potential limitations to data collection and control. Meets all of the criteria of the written assignment.
52.48 to >48.0 pts
Approaches Expectations
Provides an unclear explanation of the issue under study. Provides a brief summary of the project including main points and anticipated findings. Identifies some obstacles and proposes some solutions or interventions based on the literature review but few connections are made. Minimally compares other views on the problem and solutions. Minimally, addresses the FNP role in the intervention and discusses implications for clinical practice. Briefly discusses the implications of the change project and its significance to the nursing profession but may lack detail or specifics. Explains which methods of data collection will be used, and explains how data will be used. May be lacking analysis and accuracy in the explanation. Provides a general justification for subject selection and sampling procedure. Only briefly describes potential limitations to data collection and control. Meets most of the criteria of the written assignment.
48 to >37.76 pts
Falls Below Expectations
Provides no clarification of the issue under study. Provides little or no project summary or anticipated findings. Identifies few if any obstacles and proposes few if any solutions or interventions based on the literature review Minimal to no comparison to other views on the problem and solutions. Only suggests implications of the change project and its significance to the nursing profession or draws unreasonable conclusions. Identifies some methods of data collection to be used but may fail to explain how data will be used. Data collection methods are unsound, or unjustified for the change project. Justification for subject selection and sampling procedure may be missing or is unsound. Fails to describe potential limitations to data collection and control. Meets only a few of the criteria of the written assignment.
37.76 to >0 pts
Does Not Meet Expectations
No obstacles, opposing views, or comparisons are made to support the project. Data collection methods are not explained, analyzed, or discussed. Does not meet the assignment criteria.
64 pts
This criterion is linked to a Learning OutcomeOrganization
8 to >6.56 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.56 to >6.0 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
6 to >4.72 pts
Falls Below Expectations
Content is disorganized in many places and lacks clarity.
4.72 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized. May be an outline or a list.
8 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
8 to >6.56 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. The assignment is free of spelling and grammatical errors.
6.56 to >6.0 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. The assignment is mostly free of spelling and grammatical errors.
6 to >4.72 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. The assignment contains some spelling and grammatical errors.
4.72 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. The assignment contains many spelling and grammatical errors.
8 pts
Total Points: 80
Unformatted Attachment Preview
1
The Integrative Literature Review
Yiranda Diaz
West Coast University
NURS 691A Culminating Experience I
Instructor: Dr. Tracy Macdonald
September 23, 2023
2
The Integrative Literature Review
Sexual health education has a significant role in preventing STIs and unplanned
pregnancies among young adults. Effective reproductive health plans can offer adolescents the
proper knowledge and insights to base on when making informed decisions concerning their
reproductive health. Opening an intervention center like the OBGYN will help provide a wide
range of reproductive topics that will be age-appropriate. Moreover, the intervention aims to
bridge the existing gap in sexual health to increase abstinence and reduce incidences of unwanted
pregnancy. Various scholars have indulged in the topic to prove the effectiveness of quality
sexual health education.
Mantula et al. (2023) did their study to prove the effectiveness of inclusive sexual health
education. According to the authors, sexual well-being is a state of wholeness in aspects relating
to reproduction. Therefore, sexual health entails effective counseling and providing people with
the proper knowledge, explaining available resources related to sexuality, and addressing any
barriers that compromise knowledge acquisition. The scholars further prove that adolescents
have long been engaging in risky sexual conduct due to the unavailability of effective sexual
education.
Although youths have been accessing details related to sexuality in schools, churches, or
within their families, education has not been enough to induce the correct behavioral change.
Comprehensive sexual education entails emphasizing behold information but providing support
that motivates young adults to attain the right life skills and have appropriate attitudes.
Moreover, practical education should also focus on growth and development, appropriate sexual
behaviors, pregnancy, and health issues related to unethical sexual conduct.
3
Basically, according to Mantula et al. (2023), effective sexual education is necessary for
addressing adolescents’ well-being. Therefore, tailored education programs that offer age-related
and continuous reproductive health updates are appropriate in the contemporary adolescent
world. The education should cover broad aspects related to relationships, contraceptives, the
effects of pregnancy, the necessity of abstinence, and the responsibility of a teen to lead a moral
life. Lastly, ensuring that the education programs are related and friendly is essential while
considering these topics.
Mbizvo et al. (2023) explain that adolescents’ health education, especially about sexuality
and reproduction, is essential to development. The study’s outcomes indicate that early and
unintentional pregnancies are becoming a hot topic among adolescents. The increasing
pregnancy rates indicate that youths have been engaging in risky sex behaviors, increasing their
chances of acquiring HIV and STIs. That implies that adolescents have a high probability of
unhealthy abortions and childbirth health issues. The central contributing aspect is the lack of
comprehensive sexual education to increase their knowledge about sexual health.
The research topic entails identifying if comprehensive sexual education can reduce the
chances of these instances. The researchers imply that effective sexual education significantly
offers young adults the appropriate details about their sexual health. Moreover, education
minimizes assumptions and life skills that help adolescents enhance their decision-making
abilities to choose a proper sex life. That can help reduce the increasing rates of HIV and
unwanted pregnancies. Such an outcome supports the research topic since it helps evaluate if
effective education can reduce incidences of STDs.
Aguirre & Carrión-Yaguana (2023) comprehensively evaluated the impact of
comprehensive sex education in Ecuador. Adolescents have a promising future in the society.
4
However, many challenges, like early pregnancies and risky sexual behaviors, have been
significant among youths. The main reason is adolescents lack the necessary and timely
information about sexuality. Effective sexual and reproductive education motivates individuals
to make competent decisions about their sex lives. Poor knowledge of sexuality is one of the
significant reasons why STIs and unwanted pregnancies have become common among teens.
Adolescents do not have the correct information about contraceptives and the risks and impact of
engaging in early sexual activities.
Therefore, as the study indicates, integrating comprehensive sex education in school
programs helped reduce unwanted pregnancies in Ecuador. The unlimited benefits of sexual
education are evident, supporting the research topic. A reproduction health program that
addresses diverse aspects of sexual life to provide youths with the correct information about their
growth and the effects of early sexual activities is the best solution. That is because thorough
education provides insights on abstinence and preventing STIs.
However, providing abstinence-related education and comprehensive sex education
appears to be the best remedy. Informing adolescents about sexual engagement and
contraceptives has an unpromising future since it can be compromised. However, diverse
education provides teens with the correct information about the dangers of engaging in sexual
behaviors. Teens have the chance to identify how early pregnancies can affect their education,
parents, and career dreams. They also get to understand STIs’ effects on their reproductive
health. That helps create a knowledge base that allows adolescents to make the right decisions
about their sexual lives.
Mark & Wu (2022) indicates that sex education in America has been a major topic
among researchers and legislators. The primary reason is that teen birth has been increasing
5
recently. Most of these births are unwanted and unplanned. The necessity of comprehensive sex
education is evident even with the federal government funding programs like abstinence-only sex
education to provide teens with the right tips about immoral behaviors and the value of
abstaining till marriage. Based on the study outcomes, emphasizing sex education has helped
reduce teen pregnancy by more than 2%. That implies that focusing on more individualized
education strategies can be promising. Tailoring education programs to address the diverse
causes of early pregnancy and STIs can significantly save American teens. Moreover, these
education programs can support addressing societal barriers that hinder teens from accessing the
proper and comprehensive information about sexuality.
Mohamed et al. (2023) provide an analysis of the significant causes of unwanted
pregnancies among teens. Early pregnancy has high risks of premature births or delivering
unhealthy kids. Moreover, early pregnancy increases the economic burden on parents and
introduces mental complications to adolescent mothers. Therefore, finding a remedy to this issue,
as the article implies, can help reduce the impacts and complications of early sexual engagement.
Comprehensive sexual education is the primary solution to increasing unwanted pregnancies.
According to the article, effective sexual education should provide detailed sessions about
contraceptives and making competent decisions about sexual life. Such an analysis supports the
idea that a comprehensive reproduction education would effectively address the increasing rate
of adolescents.
Agbor et al. (2021) evaluate how introducing sex education to youths at an early stage
can help reduce cases of early pregnancy. As the researcher indicates, many teens engage in
unethical behaviors due to societal and economic conditions. Moreover, these young adults lack
the knowledge to avoid STIs and unintended pregnancies. Little engagement between families
6
and children has also increased STDs and unwanted pregnancies. Therefore, comprehensive sex
education has become relevant and supportive for teens despite the challenges they are currently
experiencing. The topic of sexual education has for a long time been considered for married
people. However, these assumptions have proven ineffective, and introducing comprehensive
sexual education has indicated its necessity amongst teens. This education aims to minimize the
chances of adverse effects and STIs. The education provides awareness on enhancing life quality
and enjoying sexuality.
However, as the authors signify, a well-planned and structured education plan is the best
way to address these challenges. Many education programs have failed due to their inconsistency
and shallowness of the topic. They lack the details to inform teens about generating essential life
skills like abstinence and living a moral life. Therefore, cooperating with the correct information
in education would have a promising future for teens.
Lastly, Pires et al. (2021) explain that adolescent pregnancy is a worldwide medical issue.
The main contributing factors include poor female education and lack of knowledge. Lower
perceptions of the topic have been a significant reason why unwanted pregnancies have become
dominant today. Also, teens lack the appropriate expertise on contraceptives and engage in risky
sexual behaviors. Therefore, finding the right interventions, such as comprehensive sex
education, would limit these barriers. The research also provides insights into why adolescents
engage in sexual behavior at an early stage. The primary aspect is having older partners
introduce them to sexual activities before maturity. This information forms the foundation for an
effective education system where adolescents gain the correct information about their sexual
lives.
7
Summary of literature review
All articles in the literature review prove that early pregnancies and STIs among teens
have become a significant healthcare issue today. Many teens face major challenges due to their
introduction to sexual behaviors by their peers and older partners. Moreover, knowledge
inadequacy and a lack of a support system have contributed to these issues. Many teens lack the
proper sexual life knowledge, compromising their ability to make informed decisions. Without
the appropriate expertise, it is hard to make the right choices. Therefore, introducing a
comprehensive education system proves to be an effective remedy for addressing this challenge.
Moreover, introducing the education mechanism will reduce the burden on the advanced
practice nurse. There will be a limited burden of addressing STIs and treating premature births.
Also, the identified gaps, including the causes of significant unwanted pregnancies and why
available programs fail, provide a baseline for the nurse to develop comprehensive education
plans that help address unintended teen pregnancies. Also, the nurse will be able to advocate for
the right resources that connect adolescents with the right support system.
8
References
Agbor, P. E., Chile, O., & Ogu, E. N. (2021). Influence of Sex Education on Early Pregnancy
among Adolescent Female Students in Port Harcourt Metropolis: Implication for Students
Academic Performance. https://seahipaj.org/journals-ci/sept-2021/IJIHCR/full/IJIHCR-S2-2021.pdf
Aguirre, K., & Carrión-Yaguana, V. D. (2023). Empowering youth: the impact of comprehensive
sex education on teenage pregnancy in Ecuador (No. wp-2023-107). World Institute for
Development Economic Research (UNU-WIDER).
https://www.wider.unu.edu/sites/default/files/Publications/Working-paper/PDF/wp2023107-empowering-youth-impact-sex-education-teenage-pregnancy-Ecuador.pdf
Mantula, F., Chauraya, Y., Danda, G., Chaibva, C. N., Ngwenya, T., Gwatiringa, C., & Chamisa,
J. A. (2023). Perspective Chapter: Sexual Health Interventions for Adolescents. In Sexual
Education Around the World-Past, Present and Future Issues. IntechOpen.
https://www.intechopen.com/chapters/1137866
Mark, N. D., & Wu, L. L. (2022). More comprehensive sex education reduced teen births: Quasiexperimental evidence. Proceedings of the National Academy of Sciences, 119(8),
e2113144119.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872707/#:~:text=A%20consistent%20fi
nding%20from%20observational,use%20(29%E2%80%9331).
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Mbizvo, M. T., Kasonda, K., Muntalima, N. C., Rosen, J. G., Inambwae, S., Namukonda, E. S.,
… & Kangale, C. (2023). Comprehensive sexuality education linked to sexual and
reproductive health services reduces early and unintended pregnancies among in-school
adolescent girls in Zambia. BMC public health, 23(1), 1-13.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15023-0
Mohamed, S., Chipeta, M., Kamninga, T., Nthakomwa, L., Chifungo, C., Mzembe, T., … &
Madise, N. (2023). Interventions to prevent unintended pregnancies among adolescents:
A rapid overview of systematic reviews. https://assets.researchsquare.com/files/rs2568862/v1/050a2163-7cde-4133-8f4d-608a5ac40908.pdf?c=1679000290
Paton, D., Bullivant, S., & Soto, J. (2020). The impact of sex education mandates on teenage
pregnancy: International evidence. Health economics, 29(7), 790-807.
https://onlinelibrary.wiley.com/doi/full/10.1002/hec.4021
Pires, R., Araújo-Pedrosa, A., Pereira, J., & Canavarro, M. C. (2021). How Can Unintended
Pregnancies Be Prevented among Adolescents Who Engaged in Sexual Intercourse at
Earlier Ages? The Role of Female Education and Partner Age Difference. International
Journal of Environmental Research and Public Health, 18(20), 10631.
https://www.mdpi.com/1660-4601/18/20/10631
1
Problem Identification and Description
Problem Identification and Description
Prevention and control of Sexually transmitted diseases (STDs) and related conditions are
significant public health concerns and priorities. Sexually transmitted infections (STIs) are
mainly caused by parasites, viruses, and bacteria passed from one person to another through
semen, blood, or bodily fluids. However, apart from sexual intercourse, STIs can be transmitted
2
to infants during childbirth, pregnancy, shared needles, and blood transfusion. It is impossible to
know if someone has STIs in the early stages of the illness, even if they seem healthy. STDs and
unwanted pregnancies are common in nearly every society, affecting adults and adolescents.
Teenage pregnancy and unwanted pregnancy are increasingly affecting the livelihood of many
women, forcing young adults to become mothers earlier than desired. The clinically identified
problem in this paper is the unwanted pregnancies and contraction of STDs due to unprotected
sexual activity. This paper describes the clinical problem, target population, and significance of
the clinical intervention and health promotion.
PICOT Question
Among adolescents (P), can best sexual health education and promotion (I) compared
with no interventions (C) prevent STIs and unwanted pregnancy (O) within one year (T)?
Clinical Setting
In the United States, sexual health education is inconsistent with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices. However, despite sexual health promotion activities, rates of STIs in the United States
are on the rise. The best clinical setting to address and promote sexual health and unwanted
pregnancy is the primary care unit, which is the first point of contact for millions of Americans
seeking healthcare services. The intervention initiative will be in a primary care facility with an
obstetrician-gynecologist (OBGYN) unit that deals with women and mothers. The unit provides
services related to reproductive health and women’s well-being. It encompasses health clinics
that serve pregnant women, young adolescent girls, and boys needing urgent clinical
interventions and emergencies. Thus, the OBGYN unit in primary care is the perfect clinical
setting to promote sexual health and reach both males and females seeking reproductive health.
3
OBGYN Service and Population Group
OBGYN unit offers various services for women planning pregnancy, including prenatal
care, pregnancy services, and postpartum care. It also provides services to young mothers,
monitoring baby’s health, delivery, and postpartum care. Likewise, OBGYN offers patients
services outside pregnancy, including fertility issues, preventive maintenance, gynecologic
procedures, and bleeding complications. With varied clinical specialties, adolescents can access
solutions to address female reproductive organs, both pregnant and non-pregnant women. Even
though people visit primary care with issues unrelated to health problems, unwanted pregnancy
can create more significant problems for young mothers, including psychological issues. Many
adolescent girls and young women visit the clinic seeking alternative solutions to unwanted
pregnancies, including abortion. Even though other medical conditions or complications can lead
to the termination of the pregnancies, young mothers visiting the clinic have other worrying
concerns related to STIs, particularly herpes, HPV, syphilis, gonorrhea, and chlamydia.
Statement Of The Problem and Target Population
In the United States, sexual health education is inconsistent, with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices (Walchonski, 2020). However, despite sexual health promotion activities, rates of STIs
in the United States are on the rise. Multiple interventions have been implemented to promote
women’s health in various settings, including promoting adolescent education to enhance sexual
health. These interventions include comprehensive sexual education, cognitive behavioral
interventions, abstinence-only education, and dyad education for parents and teenagers.
However, sexual behaviors among adolescents are influenced by various factors,
including peer pressure, individual environment, parental involvement, policy, and social
4
situations. Many schools promote abstinence-only, while others offer HIV education with a
choice of content and nuanced values. Despite the education enshrined in school and education
policy, STI rates are on the uptrend, disproportionately among teens. There is an urgent need to
successfully promote awareness to enhance understanding of the risks associated with sex and
adolescents’ reckless practices. This may require state and federal government policy to enforce
teenage reproductive health promotion. Assessing the problem’s dimension and planning
effective efforts to address it is challenging, given the magnitude of social media influence on
today’s teenagers.
Clinical Significance of the EBP Approach
According to the CDC (2021), STIs are rising, compromising national health, with over
2.5 million cases reported in 2021 for syphilis, gonorrhea, and chlamydia. WHO statistics
indicate that over 1 million new cases are reported daily worldwide. The majority are young
people between 15-34 years. Even though most STIs are treatable with antibiotics, they increase
risks for adverse events, including infertility, stillbirth, inflammatory disease, neonatal death, and
HIV infections. Increased over-the-counter prescription of antibiotics has increased resistance
from STI strains that are becoming difficult to treat (WHO, 2023). Research has shown that STIs
among college student is mainly due to a lack of knowledge and awareness of STDs
(Amirkhanzadeh et al., 2019).
Therefore, the best approach is required to overcome teenage and unwanted pregnancies.
Another research in India offers insight into misinformed young people on emergency
contraception that can resolve unwanted pregnancies (Davis et al., 2020). Evidence-Based
Practice (EBP) provides valuable information that guides interventions and policy development
for influential women’s reproductive health development. It is crucial to understand the
5
effectiveness of the best sexual education approach to inform policymakers, particularly in
resource allocation and funding of school-based education. This project’s clinical significance is
applying EBP to find the best reproductive health interventions to close the knowledge gap
among young girls to reduce high cases of STIs and unwanted pregnancies.
6
References
Amirkhanzadeh Barandouzi, Z., & Cong, X. (2019). Knowledge of sexually transmitted diseases
among college students in the USA. Journal of Client-Centered Nursing Care, 5(2), 7380. http://dx.doi.org/10.32598/JCCNC.5.2.73
CDC (2021). Sexually Transmitted Disease Surveillance 2021.
https://www.cdc.gov/std/statistics/2021/default.htm
Davis, P., Sarasveni, M., Krishnan, J., Bhat, L. D., & Kodali, N. K. (2020). Knowledge and
attitudes about the use of emergency contraception among college students in Tamil
Nadu, India. Journal of the Egyptian Public Health Association, 95, 1-11.
https://doi.org/10.1186/s42506-019-0030-9
Walchonski, C. F. (2020). Best Youth Education Methods for Sexually Transmitted Infection
Prevention.
https://cornerstone.lib.mnsu.edu/cgi/viewcontent.cgi?article=1974&context=etds
WHO (2023). Sexually transmitted infections (STIs). https://www.who.int/news-room/factsheets/detail/sexually-transmitted-infections-(stis)
1
Project Aims, Values, and Desired Outcomes
2
Benefits
The project’s goal is to address the pressing issue of unwanted pregnancies and the spread of sexually
transmitted diseases (STDs) in our community, especially among young adults and adolescents (Albertson
et al., 2018). We hope to promote sexual health, improve access to reproductive healthcare, and ultimately
improve the well-being of individuals in our community by implementing a comprehensive intervention
in primary care facilities with obstetrician-gynecologist (OBGYN) units.
The project reduces the need for significant capital investment by leveraging existing primary care
infrastructure. This cost-effective approach allows resources to be reallocated to critical interventions and
programs. For millions of people, primary care facilities are their first point of contact for healthcare
services (Widman et al., 2018). By leveraging these existing structures, reproductive health services can
be delivered more efficiently, ensuring timely access for those in need. Individuals receive high-quality,
comprehensive reproductive healthcare services thanks to the specialized expertise of OBGYN units
within primary care facilities (Marcell et al., 2017). This targeted approach results in more effective
outcomes and improved community health.
The project to improve reproductive health in primary care settings will have a wide-ranging impact on
individuals, programs, and institutions. Individuals will experience fewer unwanted pregnancies and a
lower risk of contracting STDs as access to comprehensive reproductive healthcare services improves
(Widman et al., 2018). This will result in improved overall health and well-being. Individuals, particularly
young adults and adolescents, will be empowered to make informed decisions about their sexual health
through educational programs and access to contraception, resulting in greater autonomy and control over
their futures (Widman et al., 2018). Individuals will experience improved mental, emotional, and physical
well-being as the risks of unintended pregnancies and STDs are reduced, leading to an overall higher
quality of life (Albertson et al., 2018).
3
The project will increase the use of reproductive health services in primary care settings (Albertson et al.,
2018). To meet the needs of the community, this increased demand will necessitate the expansion and
improvement of existing programs. Participation in sexual health education programs will increase,
resulting in a more informed and aware population (Widman et al., 2018). This will almost certainly result
in the creation of more effective and targeted educational resources.
Primary care facilities with OBGYN units will improve their ability to provide comprehensive
reproductive healthcare services (Marcell et al., 2017). This could result in a general improvement in the
reputation and trustworthiness of these institutions in the community. The community will likely view
institutions involved in this project favorably because of their dedication to addressing a critical public
health issue (Albertson et al., 2018). This favorable perception may entice additional support and resources
for future initiatives. With fewer unwanted pregnancies and STD cases, the strain on the broader healthcare
system will be reduced. This includes the possibility of a decrease in the demand for emergency services
and specialized care for pregnancy-related complications.
Goals, Objectives, and Variables
The project’s goal is to reduce unwanted pregnancies and STD transmission among adolescents and young
adults by 30% in two years. This will be accomplished by implementing the strategies outlined below.
Increasing contraception use among sexually active individuals aged 15-24 by 20% will help reduce the
number of unwanted pregnancies. Increasing the percentage of people who get regular STD screenings by
25% will result in earlier diagnosis and treatment, as well as less transmission to others. Providing
comprehensive sexual education to 65% of the community’s adolescents aged 15-19 will help raise
awareness of STD prevention and treatment, as well as unwanted pregnancies.
To track the project’s success, measurable indicators such as contraceptive use rates, STD screening rates,
and the percentage of adolescents receiving sexual education will be used. Measurable indicators will
4
include contraception use rates, STD screening rates, and the proportion of adolescents who receive sexual
education. Surveys and medical records are being used to collect quantitative data on contraceptive use,
STD screening rates, and attendance at sexual education programs.
Research Impact, Desired Outcomes, and Timeline
Research Impact and Social Change:
This research initiative will make a significant contribution to our community’s overall well-being. We
hope to empower individuals with knowledge and access to essential reproductive healthcare services by
addressing the root causes of unwanted pregnancies and STD transmission. As a result, families will be
healthier, educational opportunities will be improved, and the community will be more prosperous (De
Vasconcelos et al., 2018).
Desired Outcomes
The goal of this project is to develop a comprehensive, accessible, and effective reproductive healthcare
system within primary care facilities, with the goal of lowering the number of unwanted pregnancies and
STD transmission among adolescents and young adults (Widman et al., 2018). The project focuses on
providing targeted reproductive health services to a vulnerable population, with the goal of improving
overall health outcomes. The project takes a community-centric approach, recognizing that individual
health and well-being are inextricably linked to the prosperity of the larger community.
Timeline
Months 1-3: Assess needs and form partnerships with key stakeholders.
4-6 months: Create and improve intervention protocols and educational materials.
5
Months 7-9: Implement the intervention in primary care settings and launch public awareness
campaigns.
Months 10-12: Begin data collection and analysis to track progress toward goals.
Year 2: Based on feedback and results, continuously refine and expand the program.
6
References
Albertson, K., Crouch, J. M., Udell, W., Schimmel-Bristow, A., Serrano, J., & Ahrens, K. R. (2018).
Caregiver perceived barriers to preventing unintended pregnancies and sexually transmitted infections
among youth in foster care. Children and Youth Services Review, 94, 82-87.
https://www.sciencedirect.com/science/article/abs/pii/S0190740918303220
Widman, L., Nesi, J., Kamke, K., Choukas-Bradley, S., & Stewart, J. L. (2018). Technology-based
interventions to reduce sexually transmitted infections and unintended pregnancy among youth. Journal
of Adolescent Health, 62(6), 651-660.
https://www.sciencedirect.com/science/article/abs/pii/S1054139X18300892
Marcell, A. V., Burstein, G. R., Braverman, P., Adelman, W., Alderman, E., Breuner, C., … & Levine, D.
(2017). Sexual and reproductive health care services in the pediatric setting. Pediatrics, 140(5).
https://publications.aap.org/pediatrics/article/140/5/e20172858/37895/Sexual-and-Reproductive-HealthCare-Services-in
De Vasconcelos, S., Toskin, I., Cooper, B., Chollier, M., Stephenson, R., Blondeel, K., … & Kiarie, J.
(2018). Behaviour change techniques in brief interventions to prevent HIV, STI and unintended
pregnancies: A systematic review. PloS one, 13(9), e0204088.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204088
1
NIH Protecting Human Research Participants Reflection
Yiranda Diaz
West Coast University
Course: NURS 691A Culminating Experience I
Dr. Tracy Macdonald
September 10, 2023
2
NIH Protecting Human Research Participants Reflection
Prompt 3:
The Belmont Report Summarizes The Ethical Principles And Guidelines For Research
Involving Human Subjects. Three Core Principles Are Identified: Respect For Persons,
Beneficence, And Justice. Even Though These Principles Are Considered Equal, Prioritize
Them In Order Of Importance To You. Explain Your Decisions.
Answer
I believe the core principles outlined in The Belmont Report should be prioritized as
follows. Firstly, respect for autonomy is the most important ethical element in human subject
research. This idea highly values the autonomy and dignity of study participants. It involves
respecting everyone as an individual with unique values, views, and decision-making power.
This principle requires informed consent, allowing participants to participate or withdraw from a
study without coercion (The Belmont Report, 2020). I believe that respecting people is more than
just a matter of ethics. It is a commitment to treating every human subject with respect and
consideration, recognizing their intrinsic worth and right to self-determination in research. The
principle protection for vulnerable populations, including children and individuals with limited
decision-making capacity, to defend their rights.
Secondly, I will prioritize beneficence as my ethical human subject research. Beneficence
is essential to study participant well-being and safety. Maximizing benefits and reducing harm is
moral, emphasizing the researcher’s need to balance scientific progress with participant welfare.
This principle leads researchers to create studies that prioritize the best interests of everyone
participating, minimizing risks and bad consequences while actively finding ways to improve
3
study outcomes (The Belmont Report, 2020). Prioritizing beneficence is ethical and practical, as
ethical research should benefit society while protecting human subjects. Beneficence guides
researchers toward research techniques that maximize good and minimize damage.
Justice is my third Belmont Report fundamental principle. I think it’s essential for
doing ethical research. Justice in human subject research involves the fair allocation of
advantages and obligations. It stresses the need to select study participants fairly and evenly and
share research benefits with society. Due to previous injustices, societal norms, and resource
limits, obtaining justice can be complicated and context-dependent. This principle requires
considerable thinking yet is challenging to implement.
Prompt 4:
Although You Are Not Implementing A Change Project At This Time, And You May Not
Be Directly Involved In Research As Part Of Your Professional Responsibilities, Explain
The Reasons Why You Need to Know About These Rights And Protections.
Answer
For various reasons, understanding human subject study rights and protections is essential
even when I am not currently engaging in a change project or research. Ethical awareness and
civic accountability are first. As a responsible citizen, I should know about human participant
research ethics. With this information, I can promote ethical research and participate in informed
conversations on research ethics in my community and professional circles.
Second, knowing these rights and protections helps me think critically and act ethically.
Despite not performing research, I may need to evaluate its ethical consequences or advise
4
others. A basic awareness of these principles and regulations allows me to consider a research
project’s ethics and human subject protections (NIH, n.d). This understanding can also help me
assess the ethics of policy decisions or research funding allocations.
Furthermore, staying knowledgeable about human subject research rights and protections
protects
Refer to the family systems theory located within the section “The Family as a System” in Ch. 2, “The Family Roles, Responsibilities, and Rights,” of Understanding Child Abuse and Neglect.Format Part III of the worksheet consistent with APA guidelines, if appropriate.Submit your assignment.ResourcesCenter for Writing ExcellenceReference and Citation GeneratorGrammar Assistance
You Have a Friend Suffering from a Mood Disorder
Consider while watching the previously assigned TEDtalk on depression that
you have a friend or loved one who suffers from a mood disorder. TEDtalk on
depression
Explore potential treatments that could be used to help your friend.
• Discuss how you would advise your friend
• What treatment options could you recommend?
• Assume they are nervous about the stigma or about seeking treatment.
What would you say to comfort them?
75 words
In-depth Mood Disorder Discussion
Throughout the lecture this week, we discussed several types of mood
disorders and their possible treatments.
Examine one of the many treatments we briefly touched on.
•
•
•
•
•
When was this treatment developed?
Discuss if there is any controversy around the treatment and if so, why
that controversy exists.
Why does this treatment work for the specific disorder it is used to treat?
What other information do you find interesting or relevant?
Compare and contrast treatments with your peers. Do you agree with
their assessment, and why or why not?
75 words
Social Media and Personality Disorder
There is a prominent conversation that social media has led to a rise in
personality disorders. This occurs because “image” becomes a central focus
of daily life. It can lead to increased stress and cause personality disorders to
from. These articles provide both fact and opinion into the conversation.
Personality Disorders in a Social World
Is Social Media Promoting Personality Disorders?
Histrionic Personality, Narcissistic Personality, and Problematic Social Media Use:
Testing of A New Hypothetical Model
Analyze the argument that social media has led to a rise in personality
disorders.
• Read one or more of the articles and use the information from the
lecture
• Discuss how does social media contribute to the growing amount of
personality disorders
• Do you agree or disagree with the argument that social media gives rise
to personality disorders?
• Is this true of all disorders or only certain ones?
• Discuss your reasoning.
75 words
Combating Mental Health Stigmas
Through the first three weeks of class, we have discussed that stigmas exist
about mental illness. We also discussed common behaviors that contribute
to people feeling stigmatized, including the language that we use. This
article explores ways to end that stigma.
Ways to Fight Mental Health Stigma
Determine what mental illness stigmas exist from what you have learned
so far in this course.
• Are negative stigmas about mental illness prevalent and if so, what
contributes to them?
• Why is it important to combat these negative stigmas?
• What would you say to someone you hear enforce a negative
stereotype about mental illness?
• Discuss what actions can you take to raise awareness for mental illness
and personality disorders?
75 words
Looking Deeper
There are many unanswered questions surrounding mental illness. What is a
question that you have after studying mental illness for four weeks? Research
your question in order to teach your classmates and yourself something new
about mental illness.
Outline an unanswered question that you have and begin to search for
answers.
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•
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What is your question?
Why are curious about this specific question?
Where did you go to research? What sources did you use?
What answers were you able to find?
Discuss whether or not you were able to answer your questions.
What questions do you still have?
75 words
Boston Globe Shooting
Read the article from the Boston Globe. Massachusetts government
implemented a law that allows patients more control over their care. However,
this law has complications for the state. The author of this article argues that a
mental illness can get in the way of a patient knowing they need help and
treatment.
Read this article on the Rogers Guardianship
Assess laws that affect people with mental illness.
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•
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•
What is the Rogers Guardianship?
Research your home state. Does your state have any similar
protections?
In your opinion, are laws that allow mentally ill patients to refuse
medication good or bad?
Include a counter argument to your opinion and a rebuttal
Discuss if you agree or disagree with your classmates
75 words
Learning Environment for Children with ADHD
This article discusses children and how they learn. Whether a child has
difficulty focusing or is diagnosed with ADHD, learning can be challenging.
These articles focus on alternative ways to help children learn when learning
is difficult.
Can climbing trees replace preparing for tests?
Investigate how children with ADHD can learn in their environment.
• Do you believe that our education system needs an overall or that more
care needs to be provided for students with mental illnesses? Why?
• What are risks in more outside play?
• Discuss how families provide care for their child with ADHD?
• Is there anything you disagree with in these articles?
• What did you learn from these readings that you did not know before?
• Do you agree with your classmates’ assessments? Why or why not?
75 words
IDEA Act
The lecture this week mentions the IDEA Act or the Individuals with
Disabilities Education Act. More information about the IDEA Act can be found
at the following websites.
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•
Government site about the IDEA Act
What is the Individuals with Disabilities Education Act (IDEA)?
Analyze how the effect of the IDEA act on children with mental
illnesses.
• Give a brief summary of the IDEA Act
• Discuss which aspect(s) of the IDEA Act you think are the most
important
• Discuss what you would add to the IDEA Act if you were able to add a
component
75 words
Legal Protections for Older Adults
Aging is a normal part of life. It is likely that in your day to day, you have
relationships with people in this population. It is our responsibility to reach out
and care for the older adults in our lives.
Read: The Simple Guide to Caring for Elderly People
Illustrate your understanding of mental illness in the elderly population
to advocate for this population.
• Read the article
• What are actions you can take to care for older adults
• How can your actions positively affect older adult patients with mental
illness?
•
Discuss if you agree or disagree with your classmates’ assessments.
Why?
75 words
Culture and Older Adults
Different cultures care for their older adults in different ways. Many have
different attitudes toward aging. For example, some cultures value their older
adults and hold them in high esteem with respect to their wisdom and
experience while other cultures stigmatize this population.
Read: How Cultural Attitudes Toward Aging Affect Senior Care
Compare how different cultures care for their elderly.
• Read the article provided.
• Find an additional article from the library database and summarize.
• What are the differences in how cultures care for the older adult?
• How does this care affect the mental health of the older adult?
• Do you agree or disagree with their treatment?
• Discuss which perspectives we could implement into our culture to
better care for our older adults
75 words
Dear College Freshman…
Imagine being 18 again and walking into your college dorm for the first time.
You have just met your roommate and are about to begin this new adventure
of beginning your secondary education. While this is certainly an exciting time,
it can be filled with many potential stressors. As a college freshman, you are
required to adjust rapidly to a new life without the comforts of your home or
family.
Analyze what sort of challenges big life changes might bring to mental
health.
• I would like you to write a brief letter to a college freshman.
• In this letter, you will essentially be giving that person advice – not just
about joining a social circle, studying or partying – but instead wise
words on how to maintain good mental health.
• Discuss any tips that helped you throughout major transitions in your
life.
• Try to place yourself back in their shoes and try to express what would
have helped your mental health most during that crucial time.
150 words
Impact of Stress
Watch: How to make stress your friend
Throughout your collegiate career, it’s inevitable that you have experienced
stress in one way or another. You may encounter fear of the future or faced
with a decision to stand up for what you believe in even when it is difficult. You
may become consumed with what people think about you and make decisions
based on what makes others happy. Stress affects your behavior, your
thoughts, your feelings, and overall, your body in a negative way. We all have
faults and often stress can bring them to light in difficult ways. Most people do
not even realize that a daily headache or battles with insomnia can be
attributed to stress. Identifying how we handle stress (the positive and
negative ways) can help us achieve greater mental wellness. Watch
the TedTalk, “How to Make Stress Your Friend” and discuss.
Establish tangible practices to manage stress.
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Identify one area of life where stress is most likely affecting your
wellbeing. This can be in regard to school, family, personal health, or
personal behaviors.
Discuss any stress management tools you have incorporated to improve
your overall mental health well-being.
Identify any poor habits that might be derailing your efforts to deal with
this stressor. Are you over-committed in one or more areas of your life
that prevents you from achieving a good balance in your life? Are you a
person who says “yes” to everything?
75 words
Your Assessment of Alternative Medicine
As we have learned and read, there are many forms of “medicine” that are
safe, healthy, and easily implementable. This article discusses the similarities
and differences in alternative and traditional medicine forms including
criticisms of both. While reading this article, think about the points you agree
and disagree with and points you would like to research further.
Read: Alternative vs Traditional Medicine
Express your personal opinions on holistic medicine
• Discuss whether you agree or disagree with alternative medicine
practices?
• Support your argument with logic-based assessments of
information along with the scholarly reference you found it in
• Do you believe one type of medicine is better than the other, or is it best
to use both in an integrative way?
• Do you have any past experiences with holistic treatment?
• Do you agree or disagree with your classmates’ assessments?
75 words
Practicing Wellness
Watch: Try This One Minute Guided Meditation By Headspace
Report on your experience implementing holistic practices.
• Discuss which practices you chose and why
• What were the results?
• Did you enjoy one over the other and why?
• Did they cause more anxiety than comfort?
• How did your setting and mood affect the outcome of the exercises, if
applicable?
• Did you share similar or have different experiences? Comment on your
classmates’ experiences.
75 words
Total: 1125 words
The purpose of this discussion activity is to learn how to use appropriate resources in an academic activity; writing an Annotated Bibliography; and sharing resources with peers.
Directions
Step 1: Conduct a literature search and choose articles that discuss the role of one member of the palliative care team such as RN, Social Worker, Dietician, Chaplain, etc.
Step 2: Select three articles for your annotated bibliographies. The criteria for your literature selection include:
The articles must have been published within the last five years.
The articles must be from peer reviewed professional health-related journals.
Step 3: Create an annotated bibliography on each of the three articles you selected, ensuring that they are each in the proper format with APA style.
Step 4: Submit an initial discussion post which includes:
Your topic listed in the title of the post.
A brief introduction to your topic, and why you chose it.
Three properly formatted annotated bibliographies on your topic.
Provide a summary of each article describing the team member’s role and responsibilities in palliative care for providing quality care and promoting quality of life for the patient and family.
A final concluding paragraph to summarize your key points.
Step 5: When entering into the discussion with your peers:
Discuss what opportunities (prevention of symptoms from advancing disease, provision of spiritual care, gaining acceptance, etc) for the patient/family would not be available if this healthcare member was not present on the palliative care team.
Discuss ways these team members roles could be expanded.
Due Sunday by 11:59pm
Points 50
Submitting a text entry box or a file upload
Unit 7Case Study
Unit 7: Introduction (1 of 4)
Unit 7: Reading and Activities (2 of 4)
Current Assignment: Unit 7: Assignment Case Study (3 of 4)
Unit 7: Discussion PTSD and Trauma (4 of 4)
Instructions
You will then complete a Mental Status Examination for this Case Study and submit a 1-2 page word document that conducts an assessment using the format below.
Complete the Mental Status Examination for this Case study: Marmarie on page 323, Dziegielewski, S. (2014). DSM-5 In ActionLinks to an external site.. (3rd ed.). Wiley and Sons.
Identify the Risk and Protective Factors: Biological, Psychological and Social by answering the following questions.
Complete the Mental Status Examination for this Case study
Identify the Risk and Protective Factors: Biological, Psychological and Social by answering the following questions.
Biomedical Assessment:
Medical Conditions: Does the client report physical conditions? In what ways does it affect the client’s social and occupational functioning and activities of daily living?
Psychological Assessment:
Cognitive Functioning: Does the client have the ability to think and reason about what is happening to them? Is the client able to participate and make decisions regarding their best interest?
Lethality: Would the client harm themselves or anyone else because of perception of the problem experienced?
Social/Environmental Assessment:
Social/Societal: Is the client open to outside help?
What support system or helping networks are available?
Does the client have support from neighbors, friends or community organizations (church, membership) What support does the client have from family?
Occupational Assessment:
Does the client have a disability that impairs or prohibit their ability to work?
Is the client a member of a cultural or religious group
Provide the Clinical Diagnosis using the DSM 5 TR using Diagnostic Criteria along with the DSM 5TR Code and title of the diagnosis. Provide a brief justification on why this diagnosis was selected.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 3 hours
Assignment Resources
Brief Mental Status examinationLinks to an external site. (pdf)
Rubric
MSW620 Unit 7 MSE Rubric
MSW620 Unit 7 MSE Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
MSE
10 pts
Mastered
All components of the MSE are clearly complete and accurate for the presented case study
9 pts
Excels
All components of the MSE are clearly complete and accurate but not clearly linked to case study
8 pts
Competent
All components of the MSE are somewhat complete and somewhat connected to case study
7 pts
Needs Improvement
Minimal information on the MSE
0 pts
Not Present
No MSE provided
10 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Biomedical
8 pts
Mastered
Medical Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study
7.2 pts
Excels
Medical Conditions are clearly assessed by providing detail for all of the questions with some connection to case study
6.4 pts
Competent
Medical Conditions are partially assessed by providing detail for some of the questions with some connection to case study
5.6 pts
Needs Improvement
Medical Conditions are minimally assessed
0 pts
Not Present
The medical conditions are not assessed
8 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Psychological
8 pts
Mastered
Psychological Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study
7.2 pts
Excels
Psychological Conditions are clearly assessed by providing detail for all of the questions with some connection to case study
6.4 pts
Competent
Psychological Conditions are partially assessed by providing detail for some of the questions with some connection to case study
5.6 pts
Needs Improvement
Psychological Conditions are minimally assessed
0 pts
Not Present
The Psychological conditions are not assessed
8 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Social/Emotional
8 pts
Mastered
Social/ Emotional Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study
7.2 pts
Excels
Social/ Emotional Conditions are clearly assessed by providing detail for all of the questions with some connection to case study
6.4 pts
Competent
Social/ Emotional Conditions are partially assessed by providing detail for some of the questions with some connection to case study
5.6 pts
Needs Improvement
Social/ Emotional Conditions are minimally assessed by
0 pts
Not Present
The Social/ Emotional conditions are not assessed
8 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Occupational Assessment
8 pts
Mastered
Occupational Assessment is clearly assessed by providing detail for all of the questions with clear connection to case study
7.2 pts
Excels
Occupational Assessment is clearly assessed by providing detail for all of the questions with some connection to case study
6.4 pts
Competent
Occupational Assessment is partially assessed by providing detail for some of the questions with some connection to case study
5.6 pts
Needs Improvement
Occupational Assessment is are minimally assessed
0 pts
Not Present
The Social/ Emotional conditions are not assessed
8 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Diagnosis
8 pts
Mastered
Diagnosis is correct and justified with diagnostic criteria
Apply and integrate the concepts and knowledge gained in prior general management and health care administration courses to industry-relevant challenges.
Assess the relevant strategic decision-making and implementation issues within a health care organization.
Cyber attack on Universal Health Services, Inc., 2018
Ransomware is a type of malware from crypto virology that threatens to publish the victim’s data or perpetually block access to it unless a ransom is paid. While some simple ransomware may lock the system so that it is not difficult for a knowledgeable person to reverse, more advanced malware uses a technique called crypto viral extortion. It encrypts the victim’s files, making them inaccessible, and demands a ransom payment to decrypt. Ransomware attacks are typically carried out using a Trojan disguised as a legitimate file that the user is tricked into downloading or opening when it arrives as an email attachment. International law enforcement authorities during the height of the pandemic warned that hospitals and health-care facilities in multiple countries were being targeted in ransomware attacks.
Often a ransomware attack is the first phase of a multistage extortion attempt from cyber criminals. Criminals routinely demand millions of dollars to unlock the encrypted systems, and then follow that up by threatening to publish stolen data on the internet if they are not paid a second time.
On September 28, 2020, until October 7, 2020, Universal Health Services, which runs more than 400 healthcare facilities in the United States and the United Kingdom, has more than 90,000 employees and cares for about 3.5 million patients each year, had its IT network hit by a ransomware attack which left a number of its hospitals in the United States without access to computer and phone systems, including facilities in California, Florida, Texas, Arizona and Washington, D.C.
The ransomware attack managed to disable multiple antivirus programs in place on the targeted systems. Once the antivirus software was disabled, the malware caused the computers to log out and shut down, and if administrators attempted to reboot these systems, they simply shut down again. With their systems shut down, clinicians were unable to access vital information, including data found in their Electronic Health Record (EHR) or picture archiving and communication system (PACS) system.
Your assignment:
In a MEMO format, in 1000-1200 words, please discuss the following about the Universal Health Services (UHS) Ransomware attack of September, 2020:
What went well with the response?
What were the significant challenges with the response?
In which ways could the response have been improved?
As the Chief Operating Officer (COO) at one of the (UHS) healthcare facilities in the United States or Territories (Universal Health Services, Locations; pick one), how would you augment your healthcare facility’s preparation and response to protect and mitigate against future cyberattacks?
During Week One, we discussed Fayol’s Five Functions of Management: (a) Planning, (b) organizing, (c) coordinating, (d) commanding, and (e) controlling. Discuss ways which you would use all five functions of Fayol’s Five Functions of Management, would influence the development of your plan.
Make certain that your assignment is in the APA 7th edition format with a cover page, separating your sections by the appropriate APA Level Headings. Also, make sure you include a reference page and at least five references.
Due Sunday by 11:59pm
Points 50
Submitting a text entry box or a file upload
Unit 7Assignment Resource Guide III
Unit 7: Introduction (1 of 5)
Unit 7: Reading and Activities (2 of 5)
Unit 7: Discussion Specialty Courts (3 of 5)
Current Assignment: Unit 7: Assignment Resource Guide III (4 of 5)
9780826164407_ch08.pptx, File (5 of 5)
Instructions
Throughout this course, you will be developing a resource guide. Once completed, this guide will serve as a resource for you while working with individuals with mental health challenges.
For this unit, you will identify a minimum of 5 mental health disorders or challenges experienced by juveniles or adults in the criminal justice system, at least one evidence-based treatment to treat each of those challenges, and a resource to support those experiencing the disorder or challenge.
Continue to add to the document you uploaded in the Unit 5 Resource Guide assignment.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 3 hours
Rubric
MSW628 Resource Guide Part III Rubric
MSW628 Resource Guide Part III Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIdentify mental health disorders or challenge
15 pts
Mastered
Clearly identifies five childhood challenges or disorders
13.5 pts
Excels
Clearly identifies four childhood challenges or disorders
12 pts
Competent
Clearly identifies three childhood challenges or disorders
10.5 pts
Low-Level Competency
Clearly identifies two childhood challenges or disorders
9 pts
Needs Improvement
Clearly identifies one childhood challenge or disorders
0 pts
Not Attempted
Does not identify challenges
15 pts
This criterion is linked to a Learning OutcomeEvidence-Based Practice
20 pts
Mastered
Identifies at least one evidence-based intervention that is clearly connected to each challenge or disorder and provides citation/ reference
18 pts
Excels
Identifies at least one evidence-based intervention that are somewhat connected to each challenge or disorder and provides citation/ reference
16 pts
Competent
Identifies at least one evidence-based intervention that is somewhat clearly connected to most of the challenges or disorders and provides citation/ reference
14 pts
Low-Level Competency
Identifies at least one evidence-based intervention that are somewhat connected to each challenge or disorder with limited or no citations
12 pts
Needs Improvement
Identifies at least one intervention that is connected to each challenge or disorder
0 pts
Not Attempted
Does not identify evidence-based intervention
20 pts
This criterion is linked to a Learning OutcomeResources
15 pts
Mastered
Identifies at least one resource that is clearly connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including a website
13.5 pts
Excels
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including website
12 pts
Competent
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including website to some of the issues identified
10.5 pts
Low-Level Competency
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder
9 pts
Needs Improvement
Identifies some resources that don’t have a clear connection to the challenge
Case Assignment: Crisis Intervention Techniques and SOAP Notes
Unit 7: Introduction (1 of 4)
Unit 7: Reading and Activities (2 of 4)
Current Assignment: Unit 7: Case Assignment: Crisis Intervention Techniques, and SOAP Notes (3 of 4)
Unit 7: Discussion Crisis Recovery Skills (4 of 4)
Instructions
For this assignment you will submit a 1-2 page word document and a SOAP note. For the word document provide the following:
Develop a scenario where a client is experiencing a crisis, this could be developmental or situational including the client characteristics and behaviors.
Explain the strategies or model selected that was used to work with the client in crisis. (cite with references)
Outline the steps and principles in crisis intervention that you have learned in this unit that you would apply to this client. (cite with references)
In addition: Complete a SOAP note on the client that experienced the crisis using the template below.
Please review the grading rubric for specific details about this assignment’s requirements.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
This criterion is linked to a Learning OutcomeCompetency 6Engage Individuals, Families, Groups
14 pts
Mastered
Case scenario is developed with a clear explanation of the crisis and provides detailed characteristics of the client and client behaviors are clearly described
12.6 pts
Excels
Case scenario is developed with a somewhat clear explanation of the crisis and provides detailed characteristics of the client and client behaviors are clearly described
11.2 pts
Competent
Case scenario is developed with a somewhat clear explanation of the crisis and provides limited characteristics of the client and client behaviors are clearly described
9.8 pts
Needs Improvement
Case scenario is developed with a somewhat clear explanation of the crisis and provides limited characteristics of the client with no behaviors described
0 pts
Not Present
Does not provide a case scenario
14 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
12 pts
Mastered
The model and rationale for the selection of the model was clearly explained, directly applies to the crisis scenario and includes at least one reference
10.8 pts
Excels
The model and rationale for the selection of the model was clearly explained, somewhat applies to the crisis scenario and includes at least one reference
9.6 pts
Competent
The model and rationale for the selection of the model was somewhat clearly explained, somewhat applies to the crisis scenario with no references
8.4 pts
Needs Improvement
The model and rationale for the selection of the model was somewhat explained
0 pts
Not Present
The model and rationale for the selection of the model was not discussed
12 pts
This criterion is linked to a Learning OutcomeCompetency 8Intervene Individuals, Families, Groups
12 pts
Mastered
The steps in the crisis intervention model are clearly outlined, applied to the scenario and includes at least one reference
10.8 pts
Excels
The steps in the crisis intervention model are somewhat outlined, applied to the scenario and includes at least one reference
9.6 pts
Competent
The steps in the crisis intervention model are somewhat outlined, not directly applied to the scenario and includes at least one reference
8.4 pts
Needs Improvement
The steps in the crisis intervention model are somewhat outlined, not directly applied to the scenario with no reference provided
0 pts
Not Present
No crisis intervention model provided
12 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
12 pts
Mastered
SOAP note created and fully completed with detailed information about the hypothetical crisis intervention visit
10.8 pts
Excels
SOAP note created and fully completed with some information about the hypothetical crisis intervention visit
9.6 pts
Competent
SOAP note created and somewhat completed with some information about the hypothetical crisis intervention visit
8.4 pts
Needs Improvement
SOAP note created and somewhat completed with limited information about the hypothetical crisis intervention visit
Due Sunday by 11:59pm
Points 50
Submitting a text entry box or a file upload
Unit 7Theory Chart
Unit 7: Introduction (1 of 4)
Unit 7: Reading and Activities (2 of 4)
Current Assignment: Unit 7: Assignment Theory Chart (3 of 4)
Unit 7: Discussion Conflict Theory (4 of 4)
Instructions
Use the chart attached below each week to document theories covered in the class readings and films. You may copy and paste main points, definitions, and the theorist names from the readings. Do not copy information from your peers. The Application to practice section should be in your own words so you can demonstrate integration of theory to practice. The spaces in the chart will expand as needed. You will submit this chart each week throughout the semester. By the end of the semester, you will have a complete study guide of relevant theories and their application to Social Work practice. Each week is worth up to 50 points for a total of 700 points for the course.
In the chart, please address the following theories:
Conflict theory Marx, Webber
Strength Based Theory – Saleebey
Solution focused – DeShazer, Berg (Chapter 11)
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete 2 hours
Assignment Resources
MSW600 Theory ChartDownload MSW600 Theory Chart
Rubric
Unit 7 Theory Chart Rubric
Unit 7 Theory Chart Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Main points of the theory
20 pts
Exceptional Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theory contributed to understanding people. Described in exceptional detail how the theories considers human differences and is culturally informed. Described the limitations of the theory in detail.
18 pts
Proficient Demonstration
Listed or summarized the main points of the theory in exceptional detail. Described how the theories contributed to understanding people. Described in profecient detail how the theory considers human differences and is culturally informed. Described the limitations of the theory in detail.
16 pts
Competent Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theories contributed to understanding people. Described in detail how the theory considers human differences and is culturally informed. Described the limitations of theories.
12 pts
Emerging Demonstration
Listed some of the main points of the theories. Described how the theory contributed to understanding people. Attempted to describe how the theories considers human differences and is culturally informed. Described the limitations of the theory. Or, only provided information on partial theories this week.
8 pts
Attempted Demonstration
Listed limited points of the theories. Described how the theories contributed to understanding people. Attempted to describe how applied to human differences. Described some limitations of the theories. Or only provided information on one theory this week.
0 pts
Not Competent
Did not complete
20 pts
This criterion is linked to a Learning OutcomeVocabulary
10 pts
Exceptional Demonstration
Clearly provided key words and exceptional definitions from each theory
8 pts
Proficient Demonstration
Clearly provided key words and definitions from each theory
7 pts
Competent Demonstration
Provided key words and definitions for each theory
5 pts
Emerging Demonstration
Provided key words and definitions for some theories this week.
3 pts
Attempted Demonstration
Attempted to provide some definitions for some theories this week.
0 pts
Not Competent
Did not complete
10 pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Application to practice
20 pts
Exceptional Demonstration
Exceptionally linked all theories to practice. Provided many examples of who theories apply to working with clients. Included information on how all theories will help prepare them to engage, assess, and intervene with clients.
18 pts
Proficient Demonstration
Clearly linked the theories to practice. Provided several examples of how theories apply to working with clients. Included information on how theory will help prepare them to engage, assess, and intervene with clients.
16 pts
Competent Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients.
12 pts
Emerging Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients. Only completed partial assigned theories this week.
8 pts
Attempted Demonstration
Provided superficial view of how theories apply to working with clients. No specifics or not all theories covered.
Clinical Journaling #2- APA format ( Safety and Caring )How do nurses promote safety and caring in the nursing profession and why is it important? (Minimum of 2 pages.) Hello there, i hope you doing great. When you writing the assignment, copying from artificial intelligence or Internet sources is not allowed ** Please use your own words **
Unformatted Attachment Preview
APA Reference Guide:
The reference page: The big four
There are four fundamental pieces of information to include in a reference citation:
1. Author: Who created the source? This can be one author, a group of authors, or an
organization. Click on the next page for examples of how to address different numbers
and types of authors.
2. Date: When was the source published? This is the publication date of your source. If you
are unable to locate a date of publication, you can use the abbreviation “n.d.” for no date.
3. Title: What is the name of the source material? This is a title of the webpage, article,
image, etc. For a journal article, you should include both the title of the specific article
and the title of the journal (along with the accompanying volume, issue, and page
numbers).
4. Location: Where did you access the source? For an electronic resource, this is often the
URL where the information is located or a DOI number. For a source you actually have
in hand, this represents the publication information.
The following is a generic example:
Author. (Date). Title of the source. Access location or publication information
In-text citations
In-text citations follow a specific format. Remember that the author’s last name and year of
publication are always next to each other in a citation.
Citing a paraphrase or summary
When citing a paraphrase* or summary*, include the author’s last name and publication
year.
For example:
APA is a wonderful formatting tool for students (Gordon, 2018).
Provide the publication year after the author’s name when the name is in the sentence.
For example:
Gordon (2018) argues that APA is a wonderful formatting tool for students.
Citing a quotation of 39 words or fewer
When citing a quotation* of 39 words or fewer, include the author’s last name, year of
publication, and page number of the quotation. When there is no page number, use
the paragraph number and write the citation using “para.” instead of the numeric page number.
For example:
According to one researcher, “Consistent use of APA Style helps students create well-written
research papers” (Gordon, 2018, p. 3).
Note: The highlighted text at the beginning of the sentence uses a signal phrase. Signal Phrases
can help you integrate paraphrases and quotations into your sentences. Click on this sentence for
more information on signal phrases.
When the author’s name and date of publication are in the sentence, use the page number of the
quotation.
For example:
Gordon (2018) explained that a “consistent use of APA Style helps students create well-written
research papers” (p.3).
Citing a quotation of 40 or more words
When citing a quotation of 40 or more words, use a block quotation. Block quotations do not use
quotation marks and are indented one-half inch from the left margin to create a block of text.
You still need to provide the citation information as shown below; however, the period comes
before the end citation.
Dr. Gordon (2018) emphasized the importance of good citation practices:
Ideally, students would have the time to study the APA Style Manual. However, we know this is
not practical or realistic. Having access to the manual or resources that support APA style is
really all that is needed for students to gain confidence in their understanding and application of
APA. (p. 17)
Books
Editor or Author:
Sometimes sources have editors. Whether you’re using a source collected by an editor, or
whether you’re using an article or chapter in an edited book, you will need to list the editor in
your references list.
Note: Use “Retrieved from” when an online source is accessible to anyone with the URL. Use
“Available from” when an online source requires a login or credentials to access it.
Edited book
Here is an example of a reference entry for an edited book:
Bagchi, D. (Ed.) (2011). Global perspectives on childhood obesity: Current status, consequences,
and prevention. Available
from https://wgu.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=tru
e&db=nlebk&AN=345026&site=eds-live&scope=site&ebv=EB&ppid=pp_Cover
Here is an example of a correlating in-text citation for a quotation from this reference entry:
“Pediatric obesity has rapidly become one of the leading international public health challenges”
(Bagchi, 2011, p. 3).
Chapter from an edited book
For example, here is an example of a reference entry for a chapter from an edited book:
Kersh, R., & Elbel, B. (2011). Childhood obesity: Public health impact and policy responses. In D.
Bagchi (Ed.), Global perspectives on childhood obesity: Current status, consequences, and
prevention (pp. 281-288). Available
from https://wgu.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=tru
e&db=nlebk&AN=345026&site=eds-live&scope=site&ebv=EB&ppid=pp_281
Here is an example of a correlating in-text citation for a paraphrase from this reference entry:
Kersh and Elbel (2011) argue that even though public policy is the most effective way to reduce
childhood obesity, the U.S. has few such policies.
Books
Title:
Titles of books, whether in print or online, are italicized.
Note: Use “Retrieved from” when an online source is accessible by anyone with the URL. Use
“Available from” when an online source requires a login or credentials to access it.
Book–first edition
For example:
Offit, P. A., & Moser, C. A. (2011). Vaccines and your child: Separating fact from
fiction. Available
from http://wgu.idm.oclc.org/login?url=search.ebscohost.com/login.aspx?direct=true&db=
nlebk&AN=707113&site=eds-live&scope=site&ebv=EK&ppid=Page-__-1
The correlating in-text citation for a paraphrase from the source above is as follows:
Offit and Moser (2011) address the benefits over the risks of vaccinations.
Book–other than first edition
Offit, P. A., & Bell, L. M. (2009). Vaccines: What you should know (3rd ed.). Hoboken, NJ: J.W.
Wiley & Sons.
The correlating in-text citation for a quotation from the source above is as follows:
“Vaccines have prevented more disease and death than any other preventive program in history
(with the possible exception of the purification of drinking water)” (Offit & Bell, 2009, p. 4).
Note: Use the ampersand (&) only within parentheses and on the references page.
Books
Date:
Books only require the year of publication.
Book with an individual author
Borbye, L. (2011). Sustainable innovation: A guide to harvesting the untapped riches of opposition,
unlikely combinations, and a Plan
B. https://doi.org/10.2200/S00359ED1V01Y201105TME003
Note: Books, like journal articles, may have a DOI. Use the DOI, if one is assigned, rather than
the URL.
The correlating in-text citation for a paraphrase from the source above is as follows:
Borbye (2011) advocates for innovation that respects resources, the environment, and the people
it impacts.
Book with an organizational author
Committee on Prospering in the Global Economy of the 21st Century. (2007). Rising above the
gathering storm: Energizing and employing America for a brighter economic
future. Washington, DC: National Academies Press.
The correlating in-text citation for a quotation from the source above is as follows:
“The focus on national needs is important both to ensure an adequate supply of doctoral
scientists and engineers and to ensure that there are appropriate employment opportunities for
students once they receive their degrees” (Committee on Prospering in the Global Economy
of the 21st Century, 2007, p. 9).
Books
Location:
When including a book in your references list, identify whether or not the book was accessed
online.
Note: Use “Retrieved from” when an online source is accessible by anyone with the URL. Use
“Available from” when an online source requires a login or credentials to access it.
Online or digital books
Seavey, J. W., Aytur, S. A., & McGrath, R. J. (2014). Health policy analysis: Framework and tools
for success. Available
from https://wgu.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=tru
e&db=nlebk&AN=782335&site=eds-live&scope=site
For an in-text citation, the first time three to five authors are mentioned, list all the authors’
names. For example:
No single policy is likely to solve an issue such as the obesity epidemic immediately upon its
adoption; therefore, envisioning a realistic scope and anticipating negative as well as positive
outcomes is an important step right from the planning stage (Seavey, Aytur, &
McGrath, 2014).
Note: Use the ampersand (&) only within parentheses and on the references page.
Subsequent citations from this source should only use the first author followed by et al.
The implementation phase, Seavey et al. (2014) note, may actually involve re-envisioning the
policy or rewriting its regulations to accommodate the realities of its enforcement, a process that
can take years.
Here’s another example:
Plant, R. (2008). An executive’s guide to information technology: Principles, business models, and
terminology [Kindle DX version]. Retrieved from http://Amazon.com
Note: Include a format description in brackets after the title of a specially formatted digital or
online book.
The correlating in-text citation for a quotation from the source above is as follows:
Adbots can be invasive to user privacy and “act as a type of spyware sending back information to
their advertising source pertaining to the user’s behavior” (Plant, 2008, p. 4).
Print
Silin, P. (2001). Nursing homes: The family’s journey. Baltimore, MD: Johns Hopkins University
Press.
Note: For when you have the actual book in hand, include the publisher’s location (City, ST),
followed by a colon and the publisher’s name.
The correlating in-text citation for a quotation from the source above is as follows:
Silin (2001) asserts that deciding on nursing home care for a family member has emotional and
psychological ramifications, not just financial ones.
Authors and organizations as authors:
Most sources will have an author, whether that author is an individual, several individuals, or an
organization. The patterns below show how to cite most of the author situations you will
encounter.
Notice that the references page includes an authors’ initials and the in-text citation does not.
Remember: Reference list entries are always organized alphabetically. When titles are
alphabetized, articles (a, an, the) are not included, and titles that begin with numerals are
alphabetized according to how the number is spelled.
One Author:
If a source has one person listed as the author, use the following format for the reference citation:
Goldbas, A. (2014). Childhood obesity: Can it really be child neglect? International Journal of
Childbirth Education, 29(2), 37-40. Retrieved from http://ajph.aphapublications.org/loi/ajph
Here is the correlating in-text citation:
Obesity may not result simply from consuming too many calories (Goldbas, 2014).
Remember: All sources listed on your reference citation must have a correlating in-text citation
that appears at least once in your essay.
Authors and organizations as authors
Multiple Authors:
The general pattern for listing multiple authors will change depending on the number of authors
the source has.
Two authors
If a source has two people listed as the author, you will use the following format:
Farley, T. A., & Dowell, D. (2014). Preventing childhood obesity: What are we doing
right? American Journal of Public Health, 104(9), 1579-1583. Retrieved
from http://ajph.aphapublications.org/loi/ajph
The correlating in-text citation will either look like this:
Farley and Dowell (2014) observed a decline in childhood obesity rates.
OR like this:
Childhood obesity rates have declined (Farley & Dowell, 2014).
Note: Use the ampersand (&) only within parentheses and on the references page.
Three to seven authors
The rules for formatting three to seven authors differs from the references page to the in-text
citations.
If a source has three to seven people listed as the author, you will use the following format:
Gollust, S. E., Niederdeppe, J., & Barry, C. L. (2013). Framing the consequences of childhood
obesity to increase public support for obesity prevention policy. American Journal of Public
Health, 103(11), e96-e102. Retrieved from http://ajph.aphapublications.org/loi/ajph
For the correlating in-text citation, the first time three to five authors are mentioned, list all the
authors’ names. For example:
Gollust, Niederdeppe, and Barry (2013) investigated the relationship between political
ideology and obesity perspectives.
Subsequent citations of this source should use only the first author followed by et al. For
example:
Political ideology and public perspectives determine the level of policy support on public issues
such as obesity (Gollust et al., 2013).
Note: When using et al., you do not include a period after et (only after al.).
The first and subsequent citations for a source with six or more authors includes the first
author’s name followed by et al.
Eight or more authors
If a source has eight or more people listed as the author, you will use the first six authors,
include an ellipsis (. . .), and then list the final author. In other words, although the source has
eight or more authors, you will have a total of only seven authors listed. The ellipsis represents
the names that you left out.
For example:
Behl, M., Rao, D., Aagaard, K., Davidson, T. L., Levin, E. D., Slotkin, T. A., . . . Holloway, A.
C. (2013). Evaluation of the association between maternal smoking, childhood obesity, and
metabolic disorders: A national toxicology program workshop review. Environmental Health
Perspectives, 121(2), 170-180. Retrieved from http://ehp.niehs.nih.gov/journal-archive/
The first and subsequent citations for a source with six or more authors includes the first
author’s name followed by et al. For example:
Behl et al. (2013) identified a link between mothers who smoke during pregnancy and increased
childhood obesity.
Note: When using et al., you do not include a period after et (only after al.).
Authors and organizations as authors
Organization
Some sources aren’t written by individuals but by organizations.
For example, here is a reference citation for a source with an organization as the author:
Committee on Prospering in the Global Economy of the 21st Century. (2007). Rising above the
gathering storm: Energizing and employing America for a brighter economic future. Retrieved
from http://www.nap.edu/read/11463/chapter/1
Here is the correlating in-text citation for a paraphrase from this referenced source:
The United States is lagging behind other countries to adequately compete in a global economy
(Committee on Prospering in the Global Economy of the 21st Century, 2007).
Here is another example of a reference citation for a source with an organization as the author:
United States Department of Justice. (n.d.). About DOJ. Retrieved
from https://www.justice.gov/about
When you are using an organization-authored source in your essay, and if the organization has a
familiar abbreviation, use it after you have written the organization name in full the first time,
followed by the abbreviation in brackets. Subsequent citations can then use the abbreviation for
the author. For example, here is a correlating in-text citation for a quotation from this referenced
source:
The Department of Justice has a “sacred duty” to ensure the lawfulness of the United States
(United States Department of Justice [US DOJ], n.d., para. 7).
Note: Use the paragraph number (written as para.) when there are no page numbers.
Authors and organizations as authors
Unknown
If a source has no person or organization listed as the author, use the source title in the author
position.
For example, here is a reference citation for a dictionary:
Obese. (n.d.). In Dictionary.com. Retrieved
from http://dictionary.reference.com/browse/obese?s=t
Note: Most encyclopedia entries (including Wikipedia) don’t have a specific author. Follow this
same format as indicated above.
When creating an in-text citation, for sources without a named author, the citation uses the title
(surrounded by quotation marks) and year of publication. For example:
In Latin, obesity is defined as overfat (“Obese,” n.d.).
Here is a reference citation for a newspaper article:
The NLRB vs. Boeing. (2011, June 15). The Los Angeles Times. Retrieved
from http://articles.latimes.com/2011/jun/15/opinion/la-ed-boeing-20110615
Note: Dates for newspapers should include the year, month, and day of publication when
available.
When you quote a source without a named author, the in-text citation uses the title (surrounded
by quotation marks), the year of publication, and the page number (use the paragraph number
[written as para.] when there are no page numbers).
The outcome of this dispute is that “companies may be reluctant to locate in union-friendly states
for fear of being trapped there” (“The NLRB vs. Boeing,” 2011, para. 5).
Authors and organizations as authors
Reference Twins
It is necessary to distinguish between sources that have the same author and the same date of
publication.
Use a lowercase letter immediately after the date to differentiate between the sources. Use as
many letters as you need to distinguish between the sources.
Citing multiple pages from a website with no individual author and no publication date
Here is an example of citing multiple pages from a website with no individual author and no
publication date:
American Red Cross. (n.d.-a). Mission and values. Retrieved
from http://www.redcross.org/about-us/who-we-are/mission-and-values
American Red Cross. (n.d.-b). Our history. Retrieved from http://www.redcross.org/aboutus/who-we-are/history
Note: For references where there is no date, use n.d. followed by a dash and the lowercase letter:
(n.d.-a), (n.d.-b), and so forth.
In-text citations also need to distinguish between sources with the same author and publication
date. For example, the following in-text citations pair with the American Red Cross reference
citations provided above:
One hundred eighty-seven countries benefit from the humanitarian work provided by the Red
Cross network (American Red Cross, n.d.-a).
The American Red Cross (n.d.-b) provides disaster relief to the general population and services
to the armed forces.
Citing multiple sources from the same author with the same publication date
Here is an example of citing multiple sources from the same author with the same publication
date:
Koriat, A. (2008a). Easy comes, easy goes? The link between learning and remembering and its
exploitation in metacognition. Memory & Cognition, 36, 416-428. doi:10.3758/MC.36.2.416
Koriat, A. (2008b). Subjective confidence in one’s answers: The consensuality principle. Journal of
Experimental Psychology: Learning, Memory, and Cognition, 34, 945-959. doi:10.1037/02787393.34.4.945
The following in-text citation examples pair with the Koriat reference citations provided above:
Koriat (2008a) questioned how much the effort to learn impacts recall and fluency.
The researcher also examined the idea of learners self-monitoring the accuracy of their
knowledge (Koriat, 2008b).
Journal articles
Title
This example shows a journal article with a title and subtitle. The subtitle follows the colon.
Notice the first word after the colon is capitalized.
When including journal articles in your references list, the name of the journal, volume and issue
number (when available), and page numbers of the article must also be included. The name of
the journal and the volume number should be italicized. Notice that the name of the journal is
formatted in title-case capitalization style (all major words are capitalized).
For example:
Albaladejo, R., Villanueva, R., Navalpotro, L., Ortega, P., Astasio, P., & Regidor, E. (2014). Risk
behaviors and sports facilities do not explain socioeconomic differences in childhood
obesity: A cross-sectional study. BMC Public Health, 14(1), 1-18. doi:10.1186/1471-2458-141181
The correlating in-text citation for a paraphrase from the source above is as follows. Note: The
first time six or more authors are mentioned, list the first author followed by et al.
Albaladejo et al. (2014) assess the relationship between a family’s economic status and the
prevalence of childhood obesity.
Journal articles
Date
For journal articles, include the year, and for journals that have no volume or issue numbers, also
include the month, when available, inside the parentheses, separating the year and month with a
comma (2016, April). Some publications come out seasonally, so in those cases, include the year
and season (2016, Spring).
Non-scholarly journal article
Facing up to China. (2010, February 4). The Economist. Retrieved
from https://www.economist.com/node/15452821
The correlating in-text citation for a quotation from the source above is as follows. Notice that
only the publication year is used in an in-text citation.
China is expressing “a new self-confidence these days” as its economic strength grows (“Facing
up to China,” 2010, para. 5).
Note: Use the paragraph number (written as para.) when there are no page numbers.
Scholarly journal article
Manent, P. (2002). The wars of the twentieth century. Perspectives on Political Science, 31(3), 139147. doi:10.1080/10457090209600730
The correlating in-text citation for a paraphrase from the source above is as follows:
According to Manent (2002), the removal of the remnants of wars, such as boundary lines and
walls, signifies a changing mindset toward war.
End of tab content.
Journal articles
Location
When including a journal article in your references list, identify whether or not the article was
accessed online.
Online journals: DOI available
Note: When no DOI is available, include the article’s full URL or the site’s homepage URL,
whichever takes you to the source more reliably. Notice as well that when an online journal
article has no page numbers, the journal information ends with the volume (and issue) number,
and the location information follows.
•
•
•
doi.org/10.1037/arc0000014
http://dx.doi.org/10.1037/arc0000014
https://doi.org/10.1037/arc0000014
Gebauer, J., Shaw, M. J., & Gribbins, M. L. (2010). Task-technology fit for mobile information
systems. Journal of Information Technology, 25(3), 259-272. doi:10.1057/jit.2010.10
For the correlating in-text citation, the first time three to five authors are mentioned, list all the
authors’ names. For example:
Gebauer, Shaw, and Gribbins (2010) contend that mobile information systems positively
impact task performance.
Subsequent in-text citations from this source should only use the first author followed by et al.
Mobile information systems can be negatively impacted by poor network connections (Gebauer
et al., 2010).
Here’s another example.
Note: In the example below, the DOI is available and is shown in the new format for DOIs.
Soysal, P., & Isik, A. (2016). Effects of acetylcholinesterase inhibitors on nutritional status in elderly
patients with dementia: A 6-month follow-up study. Journal of Nutrition, Health, and
Aging, 20(4), 398-403. http://dx.doi.org.wgu.idm.oclc.org/10.1007/s12603-015-0603-z
Note: For articles with a DOI that looks like a URL, you do not need to add “Retrieved from”
before it.
The correlating in-text citation for a paraphrase from the source above is as follows:
Nutritional status impacts the progression of dementia in elderly patients (Soysal & Isik, 2016).
Online journals: No DOI available
Shields, P. (2018). Capturing and evaluating process semantics from front-line nurses: A pilot
study. Online Journal of Nursing Informatics, 22(1). Retrieved
from http://www.himss.org/library/capturing-and-evaluating-process-semantics-front-linenurses-pilot-study
Note: When no DOI is available, include the article’s full URL or the site’s homepage URL,
whichever takes you to the source more reliably.
The correlating in-text citation for a paraphrase from the source above is as follows:
Shields (2018) describes nursing process semantics as the daily lived experiences of nurses.
Print
Schacht, C. (2018). I don’t grok you: When unfamiliar subjects can’t be translated. WLN: A Journal
of Writing Center Scholarship, 42(5-6), 22-25.
Note: When you have the actual journal in hand, location information is not required.
The correlating in-text citation for a quotation from the source above is as follows:
Schacht (2018) explains that “[to] grok someone is to understand them on an emotional,
communal level without necessarily being able to describe what it is you understand” (pp. 2223).
Webpages
Title
This is a basic webpage references list entry. Notice the proper noun in the title is capitalized.
For example:
Brabant, M. (2014, November 8). Have the Danes cracked childhood obesity? Retrieved
from http://www.bbc.com/news/health-29755469
The correlating in-text citation for a paraphrase from the source above is as follows.
Brabant (2014) reports that a Danish pediatrician has determined that childhood obesity can be
resolved by making several, specific lifestyle adjustments.
Webpages
Date:
Online materials do not always put the date in the same place. Below are some guidelines.
1.
2.
3.
4.
5.
Check near the title of the page.
Check after the last sentence of text on the page.
Use the date if it is included as a byline near the title or after the last sentence of text.
Do NOT use the date if it’s the copyright for the site.
Do NOT use the following dates: date last modified or date last reviewed. If the page
notes a date of last update, use this date only when an original publication date is also
noted; otherwise, if no previous publication date is evident, do not use the date of last
update. The goal is to use the date on which the material was published, and we do not
know exactly what these other dates might signify (e.g., the modification or revision may
have corrected a misspelling or changed the font).
6. If you cannot find a date, use (n.d.), which stands for no date.
If the web page lists the month and/or month and day of the publication, include those along with
the year. The month and day will always follow the year, separated by a comma.
For example:
Crouch, L. (2016, February 14). The pigeon will see you now. Retrieved
from http://www.bbc.com/news/health-35542678
The correlating in-text citation for a paraphrase from the source above is as follows:
Medical science has determined that animals can be trained to detect illness (Crouch, 2016).
Webpages
Location:
When including a webpage in your references list, remember to acknowledge the location of the
exact page you are referencing and not the website’s homepage. Make sure to copy and paste the
URL from your browser’s address bar so that the URL is accurate. Additionally, do not break the
URL with a space, tab, or hard return in your reference list, for those formatting commands
cause a URL to be irretrievable.
For example:
United States Environmental Protection Agency. (n.d.). Drinking water requirements for states and
public water systems: Information about public water systems. Retrieved
from http://www.epa.gov/dwreginfo/information-about-public-water-systems
For the correlating in-text citation, when citing familiar terms, use an abbreviation to enhance
reader understanding. The first time you use a term, use the spelled-out version followed by the
abbreviation. For example:
A transient non-community water system is “a public water system that provides water in a place
such as a gas station or campground where people do not remain for long periods of time”
(United States Environmental Protection Agency [EPA], n.d., para. 7).
Note: When the spelled-out version appears in parentheses, put the abbreviation in brackets.
When the spelled-out version appears outside of a parenthetical citation, put the abbreviation in
parentheses.
Once you’ve used an abbreviation, use only the abbreviation throughout the rest of the task. For
example:
The EPA (n.d) defines a transient non-community water system as “a public water system that
provides water in a place such as a gas station or campground where people do not remain for
long periods of time” (para. 7).
Note: Use the paragraph number (written as para.) when there are no page numbers.
Videos
If the video lists the month and/or month and day of the publication, include those along with the
year. Including the month and/or month/day is important when using videos in your references
because content may be updated.
Include bracketed information to help readers understand that this is a unique format. For
example, review the following citations from a YouTube source and a TED talk.
YouTube
Pourgol, S. [Shahin Pourgol]. (2012, November 14). Top 20 health care careers [Video file].
Retrieved from https://www.youtube.com/watch?v=rMXq0O6t7ZY
The correlating in-text citation for a paraphrase from the source above is as follows.
Audiologists are one of the lower paid healthcare professionals (Pourgol, 2012).
TED Talk
Irby, A. (2017, November). How to inspire every child to be a lifelong reader [Video file]. Retrieved
from http://www.ted.com/talks/alvin_irby_how_to_inspire_every_child_to_be_a_lifelong_reader
The correlating in-text citation for a paraphrase from the source above is as follows.
Irby (2017) advises educators to practice cultural competence as a way to improve reading
skills.
Images
General information about citing images
If a photograph lists the month and/or month and day of the publication, include those along with
the year. Including the month and/or month/day is important when using photographs in your
references because content may be updated.
Titles of images should be italicized.
Include bracketed information to help readers understand that this is a unique format.
Photograph
Sorpov, A. (2018, March 14). Take the plunge [Photograph]. Retrieved
from http://www.nationalgeographic.com/photography/photo-of-the-day/2018/03/crimea-cliffdiving/
The correlating in-text citation for the source above is as follows.
Sorpov (2018) photographed cliff divers at the Extreme Crimea sports festival.
Painting
Matisse, H. (1917). The three sisters [Painting]. Retrieved from http://www.museeorangerie.fr/en/artwork/three-sisters
The correlating in-text citation for the source above is as follows.
In the painting, The Three Sisters (Matisse, 1917), the heads of the women form an isosceles
triangle.
Infographic
BioExpedition Publishing. (2014). American flamingo [Infographic]. Retrieved
from http://www.flamingos-world.com/american-flamingo-infographic/
The correlating in-text citation for the source above is as follows.
Male Caribbean flamingos weigh 79% more than the females (BioExpedition
Publishing, 2014).
Social media
General information about citing social media
If the social media lists the month and/or month and day of the publication, include those along
with the year. Including the month and/or month/day is important when using social media in
your references because content may be updated.
Include bracketed information to help readers understand that this is a unique format.
Blog
Heasman, B., & Corti, K. (2015, August 18). How to build an echoborg: PhD researcher Kevin Corti
featured on the BBC [Blog post]. Retrieved
from http://blogs.lse.ac.uk/psychologylse/2015/08/18/how-to-build-an-echoborg-phd-researcherkevin-corti-featured-on-the-bbc/
The correlating in-text citation for a paraphrase from the source above is as follows.
Heasman and Corti (2015) define echoborgs as “hybrid social agents consisting of a real person
who speaks words determined by a computer program” (para. 1).
Note: Use the paragraph number (written as para.) when there are no page numbers.
Facebook post
Federal Emergency Management Agency. (2018, March 9). A team of our site inspectors partnered
up with the City of Punta Gorda, Florida, to assess and repair Hurricane Irma damages to the
city’s seawalls [Facebook status update]. Retrieved
from http://www.facebook.com/FEMA/videos/10155737656609965/
Note: Click on the date and time stamp to get the specific URL for the post.
The correlating in-text citation for a paraphrase from the source above is as follows.
After Hurricane Irma, it took a month for the Federal Emergency Management Agency
(FEMA) (2018) to assess the damage to the many miles of seawalls.
Note: When citing familiar terms, use an abbreviation to enhance reader understanding. The first
time you use a term, use the spelled out version (for example, Federal Emergency Management
Agency) followed by the abbreviation in parentheses (for example, FEMA). Once you’ve used an
abbreviation, use only the abbreviation throughout the rest of the task.
Software
General information about citing social software
Include bracketed information to help readers understand that this is a uniq
Review the assigned Georgia voting policy, Election Integrity Act of 2021, from the Learning Resources this week. You will use this policy to familiarize yourself with the structure of policy documents, as well as the process for policy analysis—an important foundation before you begin your own policy search for your Social Change Project. Review the Policy Selection Process document in the Learning Resources this week. This document outlines the search for and selection of the Election Integrity Act of 2021—you will need to follow a similar process for your own region or state as part of your Social Change Project. Identify the social problem(s) addressed in the policy. Select an excerpt from the policy that you would change—this could be a small change, like an addition, or a large change, like a complete revision or removal—to better alleviate the social problem. Submit a 3- to 4-page paper that addresses the following: Describe the social problem(s) addressed in the policy.Which areas in the policy indicated the social problem(s) to you? Why, as a social worker, should you be concerned with the problem(s)? Are there other problem(s) not directly identified that might be impacted, positively or adversely, by the policy?What makes a social problem a social work problem? How can social work practice skills be applied to advocacy and policy that promote change?Determine who defines the problem.Who is defining the problem? What values are reflected in this definition of the problem? What is being omitted in this definition? Which population(s) is/are impacted by the problem? What is the relationship between the social problem(s) and the population(s)? In other words, why are some people impacted by the problem(s) when others are not? How is/are the population(s) taken into consideration in the policy?Summarize the excerpt from the policy that you identified as needing change. What are the strengths of this excerpt in helping to alleviate the social problem? It is okay if you do not see any strengths. Explain why. What are the limitations of this excerpt in helping to alleviate the social problem(s) for the population(s)? What specific changes would you make to the excerpt to alleviate the social problem(s) for the population(s)? You can describe the changes or quote direct policy language you would change
Hello, I will need a help with an Article critique for Care and prevention of athletic injuries class.
Instructions: Find an article dealing with a Sports Related LOWER extremity injury and write critique of the article to turn in. Article needs to come from a Scholary source. (NOT SPORTS ILLUSTRATED, ETC.) Review the attached example and rubric for more information. I will send a rubric and an example later.
Develop an article critique to turn in. (Maximum length 2 pages)
You must provide evidence to support your ideas and reference your evidence appropriately! (APA formatted) (2 minimum) (Original source and one more)
Follow the Article Critique guidelines below:
The review must be in APA format (headers, title, Times New Roman, 12 pt. font, etc.)
Please follow citation rules for paraphrasing and direct quotations
Article must be from a peer reviewed journal, published within the last 5 years.
Follow the format below. Your critique should follow this order. Please put in paragraph form.
Format/ What to include in paper:
1. Reference:
APA Reference at the top of your paper after your name and course information (see example)
2. Why are you interested in reading the article? What information can you gain by reading this article?
3. What is the main purpose of this article? Be specific and accurate. Summarize the purpose in your own words.
4. What is the key question the authors are asking?
5. What is the most important information in this article? Please make sure to answer each of the following:
Review the literature used. Key things to look for – age of the references, guidelines used, what data/statistics from other studies is given
Authors reasoning for the study
Methodology
Research design
Results – review the statistics (significant or not)
Limitations (authors and your own)
6. What is the conclusion the authors came to about the study?
7. What are the implications of this article? What would the outcomes be if we followed the article’s findings? Include both positive and negative.
1. Descriptive statistics
1. Compute the descriptive statistics for each level of your independent variable and
for them combined. So if you chose sex as your IV, you’d compute the
appropriate descriptive statistics for males, females, and total combined.
1. Include analysis on: Age, Sex, Suc_maint, Health, Edu_2, and Income_2.
ii.
Include analysis on: your dependent variable
2. Inferential statistics
1. Conduct analysis to:
1. Determine if your dependent variable meets the four necessary
assumptions to conduct a t-test. Paste relevant output.
1. Independence of observations
2. Outliers
3. Normality
4. Homogeneity of variances
2. Determine the 95% confidence intervals for your dependent variable.
3. Conduct an independent sample t-test to test your research hypothesis
b. Write brief inferential results paragraphs for each of the
following:
1. A detailed account of why you feel you met the assumptions of a parametric test
and any changes you made to meet them.
2. A description of the type of test, null hypothesis (reject/accept), and results to get
the 95% confidence intervals.
3. A description of the type of test, null hypothesis (reject/accept), and
results for your research hypothesis.
c. Create and include a bar chart created illustrating the
results of your Independent Sample t-test results including
confidence intervals.
Reference section
1. Appropriately cite the source you referenced in the introduction using APA style.
Citation guide:
Strategic planning can be done with the use of a variety of planning tools. The tools that you use in the planning process will depend on what is being planned and the end product desired.
Select a health care organization you would like to research or one that you are familiar with. (Note: It may be a good idea for you to select an organization that you would like to work for).
Make sure you can gather credible information from the organization that you selected. Select a topical area to create a strategic plan. For example, Trident University Hospital: Decreasing ER Wait Time. Using the chart below or a similar one that you create yourself, complete the following:
Identify your organization and topical area of strategic plan.
Create a Strategic Vision and Mission based on your topical area.
Create 5 goals for the strategic plan.
Identify 2 objectives for each goal.
Identify an action plan to attain each goal.
Identify how the action plan will be measured to ensure goals are met.
Note: You should be detailed when providing your goals, objectives, action plans, and measurements.
Organization Name and Title of Strategic Plan
Strategic Vision
Strategic Mission
# Goal Objectives Action Plan Measurement
1
2
3
4
5
Assignment Expectations
Support your paper with peer-reviewed articles, with at least 3 references. Use the following link for additional information on how to recognize peer-reviewed journal
Harris, J. M. (Ed.). (2018). Section 3: The strategic planning process. In Healthcare strategic planning (4th ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Harrison, J. P. (2016). Chapter 1: Leadership, mission, vision, and culture: The foundation for strategic planning. In Essentials of strategic planning in healthcare (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Harrison, J. P. (2016). Chapter 3: Fundamentals of strategic planning. In Essentials of strategic planning in healthcare (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Harrison, J. P. (2016). Chapter 4: Strategic planning and SWOT analysis. In Essentials of strategic planning in healthcare (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Optional Reading
Speziale, G. (2015). Strategic management of a healthcare organization: Engagement, behavioral indicators, and clinical performance. European Heart Journal Supplements, 17( suppl_A), A3–A7. doi: 10.1093/eurheartj/suv003. Retrieved from https://academic.oup.com/eurheartjsupp/article/17/…
Organizational planningQuestion: Try to remember a situation in your own life that involved unnecessary change. Why do you think that the change was unnecessary? What types of turmoil did it cause? Were there things a change agent could have done that would have increased unfreezing in this situation? Introduction :Change in all forms of life frequently acts as a double-edged sword. However, not every implemented change produces positive results, particularly in situations like the workplace. These adjustments might occasionally cause more disruption than benefit. The study also examines a particular situation that illustrates the time when I underwent unnecessary change that seemed to create more problems than they solved. Why do you think that the change was unnecessary?The company I was employed with recently decided to redesign our workspace fully. They replaced the traditional, personalized cubicles with a more modern open floor plan. The management believed that this contemporary approach to corporate culture would encourage more face-to-face interactions, stimulate creative thinking, and foster a transparent, barrier-free work environment. Also, they hoped that removing physical barriers would improve communication and create a greater sense of solidarity among team members. As a result, the choice made by management left me and my coworkers confused. Despite the common belief that the open floor design was better, we found the cubicle arrangement more beneficial. It provided us with private areas where we could concentrate on our work without being interrupted by the chatter of an open office. Although our choice to adopt the most recent workplace design trends was considered, it was largely symbolic because our workforce was already open and collaborative (Patel & Angne Alfaro, 2021). What types of turmoil did it cause?The change had several consequences. Initially, there was a noticeable decline in productivity levels. The constant noise of conversations, phone calls, and ad hoc meetings in the new environment created incessant distractions. Additionally, the lack of personal space affected the team, leading to discussions that focused on feelings of intrusion and ultimately causing discomfort and mild resentment. The transition process was also challenging, with misplaced documents, logistical hiccups, and the time spent collectively adjusting to the new arrangement.
What is more important – pay for performance or recognition for performance?
You are a healthcare leader at a local hospital and motivation has been identified as a central issue with your staff. You are looking into the evidence to see if providing raises/bonuses or recognition will be more effective to increase motivation.
Using evidence (from chapters 12, 13 of the e-text for this course), provide an argument for one of the two approaches based on the evidence you have read. Remember to include pros/cons of both approaches in your answer.
Format:
One – Two pages double spaced
APA format
12pt font (Arial/Times New Roman)
Submitted by end of class (deduction in mark for late submission)
Unformatted Attachment Preview
12 – Pay for Performance
Cathy C. Durham and Kathryn M. Bartol
The principle:
Our principle is pay for performance. This principle involves providing monetary rewards through
carefully designed compensation systems that base pay on measured performance within the
control of participants. It also includes incorporating appropriate concerns for procedural and
distributive justice. In most situations, properly designed pay-for-performance systems will lead to
better performance results.
Well-designed pay-for-performance systems make major contributions to performance through two
main mechanisms. First, they positively influence the motivation to perform. Second, they impact the
attraction and retention patterns of organizations (i.e., who joins and who remains), thereby affecting
the caliber of individuals available to perform.
A number of different pay delivery plans qualify as pay-for-performance systems, although they vary
widely with respect to how closely they tie pay to performance. Pay-for-performance systems can
deliver monetary rewards at the individual, small group, and/or division or organizational level.
Evidence suggests that pay for performance at each of these levels can positively impact
performance.
Individual level
At the individual level, there are three major types of pay-for-performance systems: traditional
incentive systems, variable pay configurations, and merit pay plans. Traditional incentive plans
include piece-rate plans and sales commissions. With piece-rate incentive plans, an employee is
paid a specified rate for each unit produced or each service provided. Mitchell, Lewin, and Lawler
(1990) estimate that proper use of piece-rate plans leads to performance gains in the 10–15%
range. Based on their review of the literature, Locke, Feren, McCaleb, Shaw, and Denny (1980)
concluded that the median productivity improvement from piece-rate plans is 30%. A meta-analysis
involving mainly piece-rate pay found that financial incentives are associated with higher
performance in terms of quantity and also found no detrimental impact on quality ( Jenkins, Mitra,
Gupta, and Shaw, 1998). The other traditional incentive, the commission, is a sales incentive that is
typically expressed as a percentage of sales dollars, a percentage of gross profit margins, or some
dollar amount for each unit sold (Colletti and Cichelli, 1993). The available research indicates that
salespeople tend to prefer commissions over other forms of reward (Lopez, Hopkins, and Raymond,
2006) and can be effectively motivated by them (e.g., Banker, Lee, Potter, and Srinivasan, 1996;
Ford, Walker, and Churchhill, 1985; Harrison, Virick, and William, 1996).
The second major type of individual-level pay-for-performance plan, variable pay , is performancerelated compensation that does not permanently increase base pay and that must be re-earned to
be received again. Because base pay tends to move up more slowly with variable pay plans, the
amount of bonus that can be earned needs to be substantial to make up for the fact that part of the
pay is “at risk” (Schuster and Zingheim, 1996). The risk stems from the possibility that desired
performance might not be achieved and therefore the pay not earned. The piece-rate and
commission pay plans discussed above actually constitute forms of variable pay, albeit forms in
which a greater proportion of pay is typically tied to performance than is the case with newer forms
of variable pay. According to a Hewitt survey of Fortune 1000 companies, a growing number of
employers are moving to variable pay: The portion of US companies offering one or more variable
pay plans rose from 51% in 1991 to 78% in 2005 (Dean, 2006). Research suggests that variable pay
plans are useful in boosting performance (e.g., Chung and Vickery, 1976; Lee, 1988; Smilko and Van
Neck, 2004; Yukl and Latham, 1975).
A form of variable pay that is currently popular is a lump-sum bonus for achieving particular goals.
Locke (2004) identifies four methods of linking bonuses to goals: assigning stretch goals and paying
bonuses only if the goals are achieved, having multiple goal levels and corresponding bonuses that
increase as higher goals are met, offering bonuses that grow incrementally as performance improves
(with no upper limit), and setting specific, challenging goals but making decisions about bonuses
after the fact so that contextual factors can be taken into account . Locke notes that each choice has
its pros and cons. For example, bonuses paid only when stretch goals are met, although highly
motivating, might also encourage employees to take shortcuts or cheat. Also, they could be
discouraging for those who approach but do not reach the goals. Having either multiple or
continuous goal and bonus levels (which are similar to piece-rate pay plus goals) may be less likely
to result in cheating or gaming, but it is unclear whether such approaches can motivate the highest
levels of performance. Setting goals but determining pay after the fact, while accounting for
situational factors, requires bosses to understand the full context of employees’ performance more
than they often can do. Nonetheless, this method has been the approach of choice at both Microsoft
(Shaw, 2004) and General Electric (Kerr and Landauer, 2004). Lacking comparative research to
guide choices, Locke highlights the need for more experimental studies about how best to link
bonuses to goals. The third major type of individual level pay-for-performance plan, merit pay ,
rewards individuals for past work behaviors and outcomes by adding dollar amounts to their base
pay. Merit pay is the most widely used pay system in US organizations (Bretz, Milkovich, and Read,
1992; O’Dell, 1987). Milkovich and Newman (2008) report that 90% of US firms reward employees
through merit pay. Based on a review of 25 studies, Heneman (1992) concludes that merit pay plans
appear to be moderately effective in influencing performance. Taking a longer-term view, Harris,
Gilbreath, and Sunday (1998) provide evidence that the connection between merit pay and
performance may be greater than short-term studies can detect because the cumulative effects of
various types of merit pay adjustments linked to performance, such as those related to promotions,
can be substantial.
Team level
In addition to pay for performance at the individual level, there is considerable interest in pay-forperformance plans focused on small groups or teams (Parker, McAdams, and Zielinski, 2000). Such
pay plans provide monetary rewards based on the measured performance of the group or team.
Small work groups or teams are official (designated or recognized by management) multi-person
work units composed of individuals who operate interdependently in the performance of tasks that
affect others associated within the organization (Guzzo and Dickson, 1996; Hackman, 1987). One
survey found that almost 70% of Fortune 1000 companies are using some type of work group or
team incentives (Lawler, Mohrman, and Ledford, 1995). Usage in smaller organizations may be less,
with one survey showing that 35% of the 140 companies responding, most of which had 2000 or less
employees, reported using team rewards (McClurg, 2001). Evidence suggests that performance
gains can be associated with the use of monetary rewards for groups (Cotton and Cook, 1982;
Gomez-Mejia and Balkin, 1989; Quigley, Tesluk, Locke, and Bartol, 2007; Wageman and Baker,
1997), but that the results are likely to be heavily influenced by situational factors (Balkin and
Montemayor, 2000; DeMatteo, Eby, and Sundstrom, 1998; Lawler, 2003). Increased interest in team
pay is also emerging in the executive suite, particularly with respect to top management teams
(Devers, Cannella, Reilly, and Yoder, 2007).
organizational level
At the organizational level, three pay systems that potentially link pay and performance are
gainsharing , profit sharing , and stock options . Gainsharing is a compensation plan in which an
organization shares with employees a portion of the added earnings obtained through their collective
increases in productivity (Henderson, 1997) or the achievement of other goals, such as customer
satisfaction with quality (Gerhart and Rynes, 2003). Such plans usually involve a significant portion
of an organization’s employees and possibly all. In large organizations, plans may apply to plants,
divisions, or other significant subsystems of the organization. In recent years, gainsharing has been
growing in popularity, extending its reach beyond traditional industrial settings to other realms such
as health care ( Jain and Roble, 2008; Patel, 2006). The available evidence on gainsharing indicates
that such plans have generally led to gains in productivity (Welbourne and Gomez-Mejia, 1995), as
well as to other positive outcomes, such as decreases in absenteeism and the number of grievances
(Arthur and Jelf, 1999).
The second type of organizational-level pay system aimed at performance is profit sharing, which
provides payments to employees based on the profitability of the business. Payments can be made
through current distribution plans (paid in cash), deferred plans (paid toward retirement), or a
combination of both, although most companies establish deferred plans because of the associated
tax advantages. According to one estimate, more than 60% of Fortune 1000 companies have profit
sharing plans (Lawler et al., 1995). Data supporting the performance effects of profit sharing plans is
somewhat unclear. Kruse (1993) found that productivity growth in firms using profit sharing was 3.5–
5.0% higher than in firms that did not use profit sharing. However, Kim (1998) found that profit
sharing companies tend to have higher labor costs than other companies, thereby erasing any
advantage of profit sharing. There are some weaknesses inherent in profit sharing plans as a direct
means of boosting performance. One is that it can be somewhat difficult to establish a clear
connection (sometimes referred to as “line of sight”) between individual actions and impact on
profits, especially in large organizations. Evidence for this is Kruse’s (1993) finding that annual
productivity growth was greater in smaller profit sharing companies than in larger ones (11–17%
productivity growth in companies having fewer than 775 employees, versus 0.0–6.9% in companies
having 775 or more). Another weakness is that accounting and financial management practices and
other factors outside employees’ control can also impact the bottom line. Finally, the deferred nature
of many of these plans may not provide strong valence with respect to motivating performance.
Indeed, Kruse (1993) found that productivity growth was higher for plans paying cash rewards than
for those making deferred payments.
A third type of organizational level reward system is employee stock ownership . One study of
Fortune 1000 companies showed that 71% had stock ownership programs of some type (Lawler et
al., 1995). During the 1990s, the most rapidly growing approach was via stock options, which give
employees the right to purchase a specific amount of stock at a designated price over a specified
time period (Brandes, Dharwadkar, Lemesis, and Heisler, 2003). The basic rationale is that
employees will be more concerned about the longterm success of the organization and increase
their efforts if they can reap the benefits as reflected in the rising price of the organization’s stock.
Additionally, extending ownership can both attract new talent and enhance perceptions of fairness
(and thus retention) in current employees. In 2000, a study of 490 organizations reported that
companies with stock option plans that were broadly dispersed (beyond the executive level)
performed better and had higher average compensation levels than companies without broad-based
plans, and also that increases in productivity seemed to counterbalance any dilution of earnings per
share that occurred when the options were exercised (Sesil, Kroumova, Kruse, and Blasi, 2000).
Since 2000, however, conditions have changed radically. In a much-debated ruling in 2005, the
Financial Accounting Standards Board required companies to recognize stock options as a cost on
their income statements in the year they were awarded rather than merely list them in the footnotes
– a change that diluted earnings per share in the year options were granted and rendered options
less attractive to many employers (Deshmukh, Howe, and Luft, 2008). Further, the value of options
plummeted early in the decade and then again beginning in 2007, when a crisis in the mortgage
markets ultimately led to the historic “Wall Street bailout” by the US government in 2008 and to
widespread fear of a steep global recession. When an option is “underwater” (when its exercise price
exceeds the current market price), the value is neutralized and employees’ anticipated wealth –
along with any motivational potential that might have existed in holding the option – evaporates
(Delves, 2001). And, even in times of rising stock prices, the effect may be less than hoped for. One
study found that when stock prices have risen above the option price, lower-level employees tend to
exercise their options shortly after vesting, a factor that may truncate some of the longer-term
motivational potential of the incentive (Huddart and Lang, 1996). Overall effects There is some
debate regarding whether there are best practices that are applicable to most organizations
(Gerhart, Trevor, and Graham, 1996; Huselid, 1995), or whether it is important to match pay systems
to particular strategies (Montemayor, 1994; Youndt, Snell, Dean, and Lepak, 1996). The weight of
evidence seems to be shifting toward the strategy argument (e.g., Shaw, Gupta, and Delery, 2001;
Yanador and Marler, 2006), but more research needs to be done on how best to align pay systems
with strategy to ultimately enhance organizational performance (Gerhart, 2000).
The direct impact of pay plans on performance is not the only effect to consider. Growing evidence
suggests that there are indirect pay plan effects stemming from influences on attraction and retention
patterns in organizations. For example, several studies support the notion that the level of
compensation influences attraction to organizations (e.g., Saks, Wiesner, and Summers, 1996;
Schwoerer and Rosen, 1989; Williams and Dreher, 1992). Moreover, individuals appear to be more
attracted to organizations in which the pay system rewards individual rather than group performance
and for job outcomes rather than acquiring new skills (Cable and Judge, 1994; Highhouse,
Steierwalt, Bachiochi, Elder, and Fisher, 1999). Individuals may also be more attracted to
organizations that offer fixed pay, rather than variable pay, unless there is sufficient upside potential
to balance the pay risk (Bartol and Locke, 2000).
Pay for performance can also have a positive effect on retention. Research indicates positive
relationships between employee perceptions of pay for performance and both pay satisfaction
(Heneman, Greenberger, and Strasser, 1988; Huber, Seybolt, and Venemon, 1992; Williams,
McDaniel, and Nguyen, 2006) and job satisfaction (Kopelman, 1976), factors that are related to
intention to leave and turnover (Chapter 7). General level of pay is also a factor encouraging
retention (Batt, 2002). There is some evidence that profit sharing is an important determinant of
organizational commitment (Florkowski and Schuster, 1992; Coyle-Shapiro, Morrow, Richardson,
and Dunn, 2002), which has which has been shown to be related to lower turnover. Based on a
meta-analysis, Williams and Livingstone (1994) argue that pay-for-performance systems encourage
better performers to remain with the organization while inducing poorer performers to leave. One
caveat is that a high degree of pay dispersion, in which pay is much higher for relatively few
employees at the top of the pay structure than for others, can lead to higher probabilities of turnover
among managers (Bloom and Michel, 2002). These negative effects seem to be lessened when pay
levels generally are high (Brown, Sturman, and Simmering, 2003). Interestingly, due to the flexibility
and control over labor costs that it provides, variable pay may also reduce turnover. By having more
money allocated to bonuses or other forms of variable pay, an organization can shrink its payroll
costs during downturns rather than downsize. Gerhart and Trevor (1996) provide evidence that
variable pay plans lessen organizational employment variability, allowing for greater employment
stability for employees and their organizations.
What is Required to Make the Principle Work?
Define performance
First, it is essential to identify explicitly what performance is desired. Clearly defining performance,
however, requires looking beyond individual jobs and thinking strategically about the organization as
a whole. It means developing a business model based on what drives the business (e.g., customer
satisfaction), after which goals can be set at the various levels of the organization and
determinations made about what will be rewarded. Without a business model (or with the wrong
one), management risks setting goals and rewarding employees for the wrong things – and finding
its employees doing those wrong things very efficiently, to the organization’s detriment. Focusing on
what drives the business leads to the setting of appropriate performance goals for individual
employees at all organizational levels. Then, the act of tying incentives to the achievement of those
goals will have not only motivational but also informational value, because people will receive a clear
message about what specific behaviors and/or outcomes are expected via communications about
the reward system. A temptation to resist is that of defining performance in terms of job aspects that
are easily quantifiable, thereby ignoring job dimensions that may be critically important but difficult to
measure. This can lead an organization to fall into the trap of “rewarding A while hoping for B” (Kerr,
1995). For pay for performance to be effective, strategically important job dimensions – even hardto-measure ones – must be identified, communicated, assessed, and rewarded.
Communicate
Because it is impossible to be motivated by incentives one does not grasp, it is critically important
not only to design a pay plan that is understandable but also to communicate both clearly and
frequently how the program works and what employees must do to bring about the results that will
trigger a payout. Communication also implies providing feedback along the way about progress
toward targets (Smilko and Van Neck, 2004). Young, Burgess, and White (2007) describe the effects
of a failure to communicate in a pay-forquality project for physicians. Participants found the rules
complicated, failed to fully understand the plan, and were not sufficiently engaged by meager
attempts to explain it. Thus, although 75% of those eligible received a bonus payment in the first
year, very few knew whether they had received their payment or, if they did, realized that it was for
their performance on the program’s quality measures. Some physicians were so unaware of the
financial rewards available to them that they discarded, unopened, the mail that included their bonus
checks.
Ensure competence
Employees must have the appropriate knowledge, skills and abilities (KSAs), and self-efficacy
(Chapter 10) to perform at the desired level. Instituting pay for performance is a futile exercise if
employees are unable to perform at the level required to receive the reward. Hiring people who are
efficacious and who possess (or can readily obtain through training) the relevant KSAs is essential.
Make pay systems commensurate with employees’ values
Pay for performance will only work if the rewards being offered are valued and the amount is viewed
as sufficient, given what employees are being asked to accomplish. Employers can generally
assume that money is a value to their employees, both practically and symbolically. Some
employees, however, may not value the incremental gain being offered for high-level performance if
the amount is viewed as paltry and thus not worth the additional effort. Further, a pay system can fail
if it is perceived as undermining employees’ other values. For example, individuals may be
uninterested in obtaining even a substantial amount of additional pay if they believe that achieving
performance goals means sacrificing greater personal values, such as time to pursue their own
interests (e.g., family life), a low-stress work environment, or a commitment to high-quality work or to
standards of ethical behavior.
Use non-financial motivators too
Most employers assume that money is an effective motivator because it enables employees to buy
things that they want or need. Also, money is important from a justice standpoint, giving high
performers what is due them for their exceptional contributions to the organization’s success.
Nonetheless, exclusive reliance on financial incentives would be an unwise policy because it would
ignore other important sources of work motivation. Nonmonetary motivators include a diverse
assortment of activities, such as providing interesting and important work assignments (Chapter 6),
engendering commitment to the realization of a vision (or to a visionary leader; Chapter 20),
assigning challenging goals in conjunction with ongoing performance feedback (Chapter 9), granting
autonomy regarding how a job is accomplished (Chapter 11), providing public and/or private
recognition for outstanding contributions (Chapter 13), or simply enabling one to do work that one
loves.
Use money in conjunction with intrinsic motivation
Amabile (1993) argues that it is possible to achieve “motivational synergy” by encouraging both
intrinsic and extrinsic motivation (see Chapter 26). She posits that intrinsic motivation arises from the
value of the work itself to the person. It can be fostered through such measures as matching
employees to tasks on the basis of their skills and interests, designing work to be optimally
challenging, and bringing together diverse individuals in high-performing work teams. Amabile further
suggests that, when creativity is particularly important, it may be best to hold off heavily emphasizing
extrinsic motivators during the problem presentation and idea generation stages when intrinsic
motivation appears to be most important. Extrinsic factors may be particularly helpful during the
sometimes-difficult validation and implementation stages. A meta-analytic study (Eisenberger and
Cameron, 1996) and a set of laboratory and field studies (Eisenberger, Rhoades, and Cameron,
1999) also indicated that tangible rewards can enhance, rather than undermine, the effects of
intrinsic motivation. Some (e.g., Ryan and Deci, 2000), however, contest this view.
Target the appropriate organizational level
Performance-based pay must be at the appropriate level. Increasingly, firms are rewarding
performance at the group and/or organizational levels rather than at the individual level alone, in
hopes of boosting organizational performance through enhanced information sharing, group decision
making, and teamwork (Bartol and Hagmann, 1992; Parker et al., 2000). Lawler (1971) argues that
the distinction between individual and group pay plans is important because individual and group
plans are viewed differently by employees and have different effects. A key decision for
management, then, concerns whether incentive pay should be based on individual or group
performance. Further, if the organization chooses to reward group performance, decisions must be
made about what constitutes a “group” for performance-measurement purposes. For example, will
group-based pay be based on the performance of a team, a work unit, a division, or the entire
organization?
There has been little actual research to offer guidance regarding the level of performance to which
incentives should be tied, although several views have been advanced by compensation experts
(e.g., Gomez-Mejia and Balkin, 1992; Mitchell et al., 1990; Montemayor, 1994). Key factors that
should be considered when making this important decision include:
◆ Nature of the task . Pay for performance at the individual level is considered most appropriate
when the work is designed for individuals, where the need for integration with others is negligible,
where group performance means only the sum of members’ individual performances, or where the
work is simple, repetitive, and stable. For sequential teams that perform various tasks in a
predetermined order, so that group performance cannot exceed that of the lowest individual member,
it has been recommended that base pay be skill based, and team incentives be team bonuses with
payouts distributed as a percentage of base pay. Alternatively, groupbased incentive programs,
through which all members receive equal shares of a team bonus, are generally considered
appropriate when teams are composed of individuals from the same organizational level, when
members have complementary roles and must depend upon each other and interact intensively to
accomplish their work, so that group performance is enhanced by cooperation, and when the nature
of the technology and workflows allow for the identification of distinct groups that are relatively
independent of one another. Emerging research (Beersma, Hollenbeck, Humphrey, Moon, Conlon,
and Ilgen, 2003) suggests that, when highly interdependent teams have members who are high in
extraversion and high in agreeableness, they produce more accurate work under a cooperative
reward system than teams with members who are relatively low on these personality dimensions.
The increased accuracy, which was found to be due largely to the greater sharing of information
(Chapters 17 and 18), came at the expense of speed. The decrement in speed was also related to a
tendency for free riding by the lowest performer under the cooperative reward scheme. In contrast, a
competitive reward system led to greater speed, but lower accuracy, regardless of the personalities
of members. When the work is highly interdependent and a cooperative reward system is in place, it
may be helpful to select individuals who are high on extraversion and agreeableness.
◆ Some coaching of the team (Chapter 15) may help the group develop norms that discourage free
riding (Hackman and Wageman, 2005), thus enabling accurate work with less decrement in speed.
Ability to measure performance . Good performance measures are critically important in any pay-forperformance plan. Pfeffer (1998) argues that performance can often be more reliably assessed at
aggregate than at individual levels. He concludes that individual incentive pay should be replaced by
collective rewards based on organizational or subunit performance that highlight the
interdependence among organizational members. Although many are unwilling to go as far as Pfeffer
in discounting the potential value of individual incentives, most agree that group incentives are a
suitable alternative when the identification of individual contributors is difficult due to the nature of
the task. For gainsharing plans in particular, it is not only necessary that there be good performance
measures for the unit or plant, but also that there be a reliable performance history in order to
develop a gainsharing formula. When group performance is rewarded with gainsharing, however, it
is nonetheless important, particularly in Western cultures, to provide a means for identifying
individual contributions to the group effort (e.g., through peer evaluations), so that members keep in
mind their accountability at both the individual and group levels. Organizational culture . Group
incentive plans are best suited to situations in which the organizational culture emphasizes group
achievements (Chapter 33). Group incentives work best when free riding is unlikely (e.g., because
members hold each other accountable or because employees are professionals who possess high
intrinsic motivation). If a corporate culture is strongly individualistic and competitive, group plans
such as team incentives will likely encounter considerable resistance from organizational members
accustomed to focusing on individual accomplishments and/or may lead to lower levels of
cooperative behavior (Hill, Bartol, Tesluk, and Langa, 2009). Management’s purpose . Group
incentives are recommended in situations in which there is a need to align the interests of multiple
individuals into a common goal, or when management wishes to foster entrepreneurship at the
group level. At the organizational level, profit sharing is often used to communicate the importance of
the firm’s financial performance to employees, heightening their awareness of the overall financial
performance of the organization by making a portion of their pay vary with it. This is thought to be
most motivating when employees believe that they can substantially influence the profit measure,
such as in smaller organizations and those in which the means by which profits are achieved are
well understood.
Some have proposed mixed models, whereby incentive pay is based partially on individual
measures of performance and partially on group measures. Wageman (1995), however, found that
teams having mixed forms of reward (i.e., rewards based on both individual and group performance),
mixed tasks (i.e., some tasks performed solely by individuals and some by interdependent groups),
or both, had lower performance than those with task and pay designs that were clearly either
individual level or team level. She proposes that mixed tasks and rewards may lead to inferior
performance by adding a group element to what is primarily an individual task, thereby undermining
attention to the task.
It also may be more difficult to develop supporting norms for cooperation in the team (Quigley et al.,
2007). In addition, teams executing mixed tasks may need more time to adjust because of the
greater complexity of tasks that have both individual and group performance components. In fact,
one study (Johnson, Hollenbeck, Humphrey, Ilgen, Jundt, and Meyer, 2006) has shown that it even
may be more difficult for a team to shift from a competitive to a cooperative reward structure than
from cooperative to a competitive one. When a competitive reward structure was shifted to a
cooperative one, team members seem to engage in “cutthroat cooperation” in which team members
retained much of their competitive behavior within the new reward systems intended to foster
cooperation. Another complicating factor is that some workers may prefer individual pay over teambased pay (Cable and Judge, 1994; Haines and Taggar, 2006; Shaw, Duffy, and Stark, 2001). The
question remains, then, how best (or when) to mix individual and group-based incentive plans.
Make pay commensurate with the level of risk employees are required to bear
Risk refers to uncertainty about outcomes (Sitkin and Pablo, 1992), and, by definition, pay-forperformance systems involve uncertain outcomes for employees. Employees tend to be risk-averse
concerning pay because they have no way of minimizing their income risk through diversification, as
investors are able to do with their stock portfolios. At least four factors can affect employees’
perceptions concerning the riskiness of a pay-for-performance plan. First is the proportion of
employee pay that is performance based. Although the average percentage of variable pay in the
USA is only 5%, the proportion ranges widely, from 0 to 70% (and even to 100% for salespersons;
Gomez-Mejia and Balkin, 1992). The higher the proportion of variable pay, the more risk the
employee must bear, in a tradeoff between income security and the potential for higher earnings
(Gomez-Mejia, Balkin, and Cardy, 1998). At some point the level of risk may be perceived as so
great that it would be unacceptable to the majority of employees, regardless of the potential for high
pay. The second factor that influences employees’ regardless of the potential for high pay. The
second factor that influences employees’ perceptions of risk is their self-efficacy (Chapter 10) that
they can achieve the performance goals on which pay is contingent. Those who are confident of their
ability to perform at a high level should perceive contingent pay as less risky than those who are less
confident of their ability. Third, to the extent that the performance measure on which pay is based is
influenced by factors outside individual employees’ control (e.g., technology or
The topic I chose was “The impact of the healthcare environment on the mental well-being of both patients and healthcare workers.” Therefore please make the essay about this providing: 5-7 pages APA format (in text citations)using 5 outside cited sources/ articles websites
Read the case on page 413 of the assigned reading. Do you think that the FTC made the correct decision in requesting that ProMedica divest St. Luke’s? Why or why not and support your answer.The responses should be: 2-3 pages double spaced, font Times New Roman size 12.Cover page (with title, name, course and date) and running header Formal essay with correct grammar, punctuation and spellingReference page with 3-5 sourcesAPA format for in-text citations and reference page (see guidelines posted under content)
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Mrs. Hadia Meashi
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style
• AVOID PLAGIARISM
• Due date; 07/10/2023 11:59 PM
Best of Luck
Many of the early queer characters were “queer” in name only meaning that they didn’t really engage in public displays of affection or in actual or assumed sexual activities. That is to say, many of them were “celibate” gays. For this week’s discussion post, I want you to discuss how cable shows have been able to expand the representation of queer characters and storylines. I want you to specifically discuss the differences between regular cable (Noah’s Arc, The Fosters, and Pose) vs premium cable’s (Queer as Folk, the L Word, and Shameless) representation.Also, when discussing individual shows, pay attention to when they aired; there was almost a decade and a half difference between Noah’s Arc and Pose for instance.
The assignment will be used to develop a written implementation plan.
Step 1) Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources.
Step 2) Develop a process to evaluate the intervention if it were implemented.
Step 3) Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention.
Address the following in your summary:
What data was collected?
What tool will be used to collect the data?
Who will be responsible for collecting data?
How will this data be communicated to the team?
APA style is not required, but solid academic writing is expected.
For this assignment, you will identify a problem within an organization that requires to be improved using virtual care. You will research the organization and be responsible for creating various decision-support tools and resources to engage other healthcare team partners within and outside the organization that will improve accessible and patient quality outcomes. In your report, you will include and complete:
Section 1: Background and Situational Analysis
1. Description of your problem and the focus for improvement (i.e. Improving smoking cessation among women). Answer in 3 major sections the following key questions: AIM: What problem are we trying to solve? In this case, desire to increase sessional fees to foster a system to support patient quality care. MEASURE: What changes might we introduce and why? CHANGE: How will we know that a change is actually an improvement?
2. Population characteristics (demographics such as age, income, ethnicity, education attainment, gender).
Section 2: Current Situation
3. Name, Purpose, Role, Statistics/Facts and Focus of the organization (i.e. must be a known Ontario health care provider).
4. Type of Leadership employed to solve your problem and lead the change (i.e. identify your leadership and the rationale for the approach you are taking)
Section 3: Change Management and Plans
5. Key stakeholders that are part of addressing the solution. Identify the partner, their common interests and the roles & responsibilities.
6. Identify constraints/challenges/barriers and what measures you will measure to overcome them.
7. List out ethical factors and considerations and the goals/objectives to ensure integrity.
8. Identify key data and the three (3) main measures you will be using to evaluate change.
9. Education methods and quality measurement tools, you will be utilizing to evoke and spread change
Unformatted Attachment Preview
Type
Written Assignment
INFO 6057 Health Systems Management
Assessment
Section 1 Independent Creative Assignment:
Leadership; Novel & Adaptive Learning
Weighted Evaluation
20%
Purpose of the Assessment:
▪
▪
This assignment is cumulative and covers all aspects associated from weeks 1 to weeks 5 inclusive.
Specifically assessing the following vocational learning outcomes and skills, namely: Decision support,
quality control, leadership, operations management, organizational culture, big data, knowledge
management, big data security, ethical decision-making, change management, change and transition
management.
You will be responsible for all readings, PPT lectures, recordings, announcement details communicated,
as well as instructions to undertake additional research and analysis to complete the assignment.
Format:
▪
▪
▪
▪
▪
▪
The assignment must be completed in WORD in the proper format. Font: Times New Roman Size: 12pt
Single space and five (5) pages in length (excluding cover, table of contents, and reference page).
Included as part of the assignment is a cover page with your first and last name, student number, title of
assignment, professor’s name and date.
References following APA 7th edition must be provided at the end of the document.
Completion of necessary practical tools and resources supporting the objective of the assignment.
Your assignment will be saved with your: First name_Lastname_Assignment 1
Reminders:
All Assignments must meet the due date in drop box and not accepted via email.
In addition, the following are the four (4) minimum standards for all written assignments:
1. Integrity: Ensure your assignment contains no plagiarized segments and is 100% paraphrased. Note:
Quotations and paraphrasing of any source without proper in-text citations and attached reference
list is considered plagiarism. The turn-it-in score must not exceed 15% and have more than one
consecutive copied sentence from any source. If there is plagiarism, your assignment will be
considered an academic offence.
2. Purpose: Ensure that your assignment answers the key objectives of the assignment and achieves the
primary purpose.
3. Readability: Ensure that your assignment is edited to account for the majority of grammar,
punctuation, and spelling errors. If it contains too many errors that create confusion of meaning and
severely limits communication, then it will not meet the minimum standards.
4. References: You must reference ALL sources from which you obtained information, and provide a
citation for any information using APA 7th edition format (see A136 Academic Integrity).
Remember for this assignment, please only use Canadian context. US context is not relevant or
consistent with Canadian healthcare system. All the best! Professor Silvie MacLean
Created and Written by Dr. S. MacLean
p. 1
MGMT 6181 Assessment
Context:
▪
▪
▪
▪
Virtual care has transformed health care delivery in Canada and around the world. When an inperson visit with a health care provider isn’t possible or even desirable, having access to virtual care
can mean the difference between a patient receiving the care necessary to improve their health or
dealing with the consequences of untreated ailments.
When patients and clinicians opt for virtual care, they can help prevent the spread of infections, save
time and money, engage in more timely medical interventions and enjoy flexibility with regards to
receiving and delivering health care. During the COVID-19 pandemic, virtual care enabled patients
to continue receiving the care they needed while keeping themselves and their families safe.
Virtual care can benefit a variety of patients, such as people with mobility issues, residents living in
remote areas and busy parents and workers who want the convenience of connecting through their
device (possibly avoiding child care services or time off work, as a result).
Considering the benefits, it’s no surprise that the adoption of virtual care solutions and services is
growing across Canada’s entire health system.
Instructions:
For this assignment, you will identify a problem within an organization that requires to be improved
using virtual care. You will research the organization and be responsible for creating various decisionsupport tools and resources to engage other healthcare team partners within and outside the organization
that will improve accessible and patient quality outcomes. In your report, you will include and complete:
Section 1: Background and Situational Analysis
1. Description of your problem and the focus for improvement (i.e. Improving smoking cessation
among women). Answer in 3 major sections the following key questions: AIM: What problem are
we trying to solve? In this case, desire to increase sessional fees to foster a system to support patient
quality care. MEASURE: What changes might we introduce and why? CHANGE: How will we
know that a change is actually an improvement?
2. Population characteristics (demographics such as age, income, ethnicity, education attainment,
gender).
Section 2: Current Situation
3. Name, Purpose, Role, Statistics/Facts and Focus of the organization (i.e. must be a known Ontario
health care provider).
4. Type of Leadership employed to solve your problem and lead the change (i.e. identify your
leadership and the rationale for the approach you are taking)
Section 3: Change Management and Plans
5. Key stakeholders that are part of addressing the solution. Identify the partner, their common interests
and the roles & responsibilities.
6. Identify constraints/challenges/barriers and what measures you will measure to overcome them.
7. List out ethical factors and considerations and the goals/objectives to ensure integrity.
8. Identify key data and the three (3) main measures you will be using to evaluate change.
9. Education methods and quality measurement tools, you will be utilizing to evoke and spread change.
Created and Written by Dr. S. MacLean
p. 2
MGMT 6181 Assessment
3
0 Not acceptable
1 Needs improvement
2 Competent
Your written work will be evaluated by the criteria below in order
to give you specific feedback to help guide your development as a
writer. Communicating in writing is an essential skill required in
the 21st century.
3 Good
This rubric is designed to make clear the grading process for
written communication by informing you, the writer, what key
elements are expected by the College in a “good” piece of
written analysis work.
4 Excellent
RUBRIC:
Measurement Indicator
Quality (/5)
1. The purpose and focus are clear and consistent.
2. The main claim is clear, significant, and challenging.
3. Organization is purposeful, effective, and appropriate.
4. Sentence form and word choice are varied and appropriate.
5. Punctuation, grammar, spelling, and mechanics are
appropriate. APA 7th edition documentation is followed.
Content (/5)
1. Information and evidence are accurate, appropriate, and
integrated effectively with purpose.
2. Claims and ideas are supported and elaborated.
3. Alternative perspectives are carefully considered and
represented.
4. Contains original ideas. Academic integrity is followed.
5. All ideas are clearly developed, organized logically, and
connected with effective transitions.
Analysis (/5)
1. Connections between and among ideas are made.
2. Analysis/synthesis/evaluation/interpretation are effective and
consistent.
3. Independent thinking is evident.
4. Creativity/originality is evident.
5. Effectively applied appropriate tools for decision support
Assignment Specific Criteria (/5)
1. Responds to all aspects of the assignment.
2. Documents evidence appropriately.
3. Considers the appropriate audience/implied reader.
4. All relevant module concepts are applied appropriately.
5. Structure and format enhances delivery of the
information.
Overall Evaluation: Scored out of 20 points
D
Excellent
D
Competent
Created and Written by Dr. S. MacLean
D
p. 3
Not Acceptable
MGMT 6181 Assessment
Organizational Decision Support
MGMT 6181
Week 1, Class 1
Introduction Clarifying Expectations & Course Overview
To Address Meaning of “Decision Support”
Professor Dr. Silvie MacLean, EdD, CPA CMA, MHSc, HBA
Educate, Engage, Empower, Excite
Week 1
Class 1
Administration Overview
2
Disclaimer:
The session is recorded.
The cloud recording will
only be shared in the
course shell with the
participants in our class.
❑ People outside of the
class will NOT have
access to the
recording.
❑ Once the course is
over, I will delete the
recordings.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 3
MHSc, HBA, BA,
Preamble:
You will require your own laptop with a webcam and reliable internet.
Refer to weekly schedule located on FOL to understand the
theme/topic of the week.
Please ensure to review each weeks lesson plan videos before you
review the PPT lectures.
These videos are separately located on FOL each week.
Understanding expectations is very important.
Please never hesitate to email me if you have concerns and/or
questions with the material.
Remember to reach the FOL supplementary readings.
Presented by Dr Silvie MacLean, EdDm CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
4
Today’s Objective:
Part 1 (Classroom Foundation):
❑Introductions (You/Me)
❑Review the Course Outline
❑Review FOL
❑Classroom Expectations
❑Importance of Academic Integrity
Part 2 (Week 1 Course Content):
❑Organizational Behaviour
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
5
Introduction:
Dr. Silvie MacLean, EdD, CPA, CMA, MHSc, HBA
“Empowering learning minds to continuously innovate bolder and new
integrated care solutions for effective change”
Philosophy: My approach to learning
builds on a deep personal regard for
appreciative inquiry and transformative
power. In an environment of constant
change and diversity, I believe
students best learn when they are
supported in a safe community
classroom and provided with a variety
of tools, knowledge and competency
based skills to assist them to unlock
their full potential.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
6
With the aim to educate, engage,
empower and excite, the following
are some inspirational quotes:
Aim
Quote
Educate
We cannot solve our problems with the same thinking we
used when we created them.
Author of
Quote
Albert
Einstein
Engage
If you don’t like something, change it. If you can’t change
it, change your attitude.
Maya
Angelou
Empower You will never do anything in this world without courage.
It is the greatest quality of the mind next to honor.
Aristotle
Excite
Walt Disney
If you can dream it, you can do it.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
7
Getting to know you:
Teacher
Subject
Matter
Student
Please share:
▪ Your name
▪ Where you are
currently taking the
course (e.g. country)
▪ Your last degree title
▪ One (1) favourite pasttime
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
8
About the Professor and the Research:
Logo here
Scholar, Activist, and Researcher
Professor within the Post Graduate Health Systems Management Program, School of
Information Technology at Fanshawe College in London Ontario, Canada
Twenty-four years working in healthcare in a diverse range of positions within the Ontario
Provincial Service and Ontario hospitals’:
• CFO/Chief Performance & Strategy Officer, Transform Shared Services
• Senior Executive Director of Strategic Improvement, Woodstock Hospital
• Senior Program Manager at the MOHLTC acute care division working on several policy and population program service
changes.
Education consists of:
• Doctoral degree in Education (Western University);
• Chartered Professional Accountant/Certified Management Accountant (Toronto);
• Masters in Health Science, within the Health Policy Management and Evaluation Program at the (University of
Toronto);
• Honours business and psychology degree (Western University).
D r. S i l v i e M a c L e a n ,
E d D , C PA , C M A , M H S c , H B A
( s h e , h e r, e l l e , e l l a )
Volunteer on several various health and education Board of Directors and Community
Council Committees teaching financial literacy & strategic planning
Course Overview:
▪
▪
▪
▪
▪
▪
▪
▪
Course Description
Contact Information
Learning Outcomes
Weekly Schedule
FOL communication
FOL Resources
Evaluation/Grades
Overall expectations
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
10
Course Description:
MGMT 6181 Organizational Decision Support:
Managerial decision-making on operational efficiencies and
effectiveness are often complex ones that involve having
effective decision support. This course is designed to integrate
theory and practice with leadership, operational finance, and the
utilization of quality tools to improve performance and
population health outcomes. In this course, students will
become familiar with leadership and operational factors that
affect planning, implementation, and decision-making. Individual
and simulated group exercises along with critical analysis of
case material relevant to the healthcare setting that is specific
for health information management professionals will be used to
enhance a practical understanding of theoretical concepts.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
11
Contact Information:
Email: smaclean@fanshaweonline.ca
Office hours: Based on students needs. Please email to make arrangements
Class Schedule: Refer to FOL master list and weekly
Please read course FOL announcements daily
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
12
Learning Outcomes:
Is a statement (not a product)
indicating what a learner is
expected to KNOW, DO or
BEHAVE LIKE as the RESULT of
the learning experience.
Expression of skill (Do),
knowledge (Know) or attitude
(Behave)
Reflects an essential, integrated,
complex PERFORMANCE
Helps everyone (students,
teachers, employers) understand
the purpose, or the performance
required
All materials are assessed to
ensure you are prepared for the
real HIM world
Ministry Mandate (Binding Agreement for
Healthcare Administration Skills)
Ontario College (Fanshawe)
Workforce Development
Health Care Administration and Service
Management
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 13
MHSc, HBA, BA,
Weekly Schedule:
❑This course is directly linked to
the Ministry Binding Agreement
with the Ministry
❑Colleges are “self-governing,”
but…
❑Ministry of Colleges and
Universities (MCU) ensure quality
❑Institutional and program policies
and procedures for consistency
❑Follow Binding Agreement for
Vocational Learning Outcomes
(VLOs) and Essential Educational
Skills (EESs)
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 14
MHSc, HBA, BA,
FOL Communication:
Learning
Outcomes
(lowest to
highest):
Know / Remember
Understand /
Comprehend
Apply
Analyze
Evaluate /
Create
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
15
Evaluation/Grades:
Assessment
Measure
Lab 1
10%
Creative Assignment 1 (weeks 1-5)
20%
Creative Assignment 2 (weeks 6-10)
20%
Creative Assignment 3 (weeks 11-15)
20%
Quiz 1 (weeks 1-5)
10%
Quiz 2 (weeks 6-10)
10%
Quiz 3 (weeks 11-15)
10%
Total
100%
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 16
MHSc, HBA, BA,
Overall Expectations:
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
17
Secret to success in learning:
▪ Do all required readings prior to coming to class. This
requires project managing your time.
▪ Complete all assignments to the best of your ability.
▪ 3:1 rule.
▪ RESPECT EACH OTHER: Stay engaged and do not
distract the learning of others (no abetting permitted as this
is an academic offence and it will go on your record).
▪ Attend class and complete the required weekly review of
all materials.
▪ Complete the assignments to your best ability (lots of
resources for you).
Presented by Dr Silvie MacLean, EdD,CPA CMA, MHSc, HBAEdD, 18
MHSc, HBA, BA,
Overall expectations:
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 19
MHSc, HBA, BA,
Introduction to Decision Support
20
Decision-support is a main focus:
Require a global
mind-set
Require to be able to
adapt to change
Need
implementable skills
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 21
MHSc, HBA, BA,
What is a global mind-set?
Definition
• A global mindset is the ability to
recognize, read, and adapt to
cultural signals, both overt and
subtle, so that your effectiveness
isn’t compromised when you are
dealing with different backgrounds
Need to possess:
• Individual qualities
• Communication skills
• Actionable knowledge relevant to
health care
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
22
Global Mindset Abilities Involves:
Adopting a global perspective.
Empathizing and acting effectively across cultures.
Processing complex information about novel
environments.
Developing new multilevel mental models.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
MHSc, HBA, BA,
23
Global mindset begin within:
Begins with selfawareness.
• Compare own mental
models with those of people
from other cultures/regions.
• Develop better knowledge of
people and cultures,
preferably through
immersion.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 24
MHSc, HBA, BA,
Understanding Change:
Buller, J. (2015). Leading reactive
change. In Change leadership in
higher education: A practical guide to
academic transformation (pp. 155174). San Francisco, CA: JosseyBass.
Kezar, A. (2014). Creating deep
change. In How colleges change:
Understanding, leading, and enacting
change (pp. 61-83). New York:
Routledge.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 25
MHSc, HBA, BA,
Defining Change:
Not a singular concept
• Instead a multi-faceted concept
Buller (2015) defines change as:
• Replacement + Resilience
Change
Video:
Abdulgeder, A. (2009). We need
change. Retrieved from:
https://www.youtube.com/watch?v=vL
gxr9MARYs
(p. 33)
Kezar (2014) defines change as:
• Isomorphism + Adaptation + Organizational
Change + Innovation/Reform (p. xii)
Change v. Transition:
• Change: Outward and visible
• Transition: Inward and spiritual
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 26
MHSc, HBA, BA,
Buller’s (2015) Perspective on Change:
Five reasons why change
processes fail or are
unsuccessful:
• Unsuitability of management models
• Adequate needs case
• Incompatible strategic planning
methods
• Lack of attention of culture
embracing change
• Treat all change alike
Sees change as a constant –
but aims to understand
different types of change
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 27
MHSc, HBA, BA,
Buller’s (2015) Perspective on Change:
Change factors are both
visible and invisible
• Visible (obvious ones such as:
cost, time, and quality)
• Invisible (lie hidden below the
surface are often overlook: power
relationships, politics, perceptions
and beliefs, ego and distrust)
Three resources to help
foster a culture of innovation:
Krüger, W. (n.d). The change management iceberg. Retrieved
from: http://www.datagroup.com.au/Images/MT_Images/Change_Management_Iceberg
.JPG
• Innovation
• Creativity
• Entrepreneurialship
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 28
MHSc, HBA, BA,
Buller’s (2015) Core Takeaways:
Metaphor and his rationale of taking advantage of ICE resources
• Avoid lurking dangers
Highlights 3 different ways in which HEI may discover they may
need to change
• Forced
• Eventually be forced on them
• Needed because of internal rather than external factors
Identifies 5 different levels of institutional change in HEI. Namely,
changes in:
• Direction
• Personnel
• Tactics
• Structure
• Procedures
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 29
MHSc, HBA, BA,
Kezar (2014) Perspective on Change:
Focuses on second-order or deep change
• Also called transformational, punctuated change, doubleloop learning, where organizations challenge existing
assumptions and beliefs
Sees this second-order change requiring:
Chapter 4: Creating deep
change (pp. 61-83)
• Sensemaking (1) individuals attach new meaning to
familiar concepts; and 2) individuals develop new
language and new concepts that describe a change
institution)
• Organizational Learning (relies more on a rational and
data-oriented approach)
To learn, we must become aware of our own
and others’ mental models which can shape
the possibilities for learning
30
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD,
Kezar’s (2015) Perspective on Change:
Must become aware of
our own and others’
mental models
Not all organizational
learning is positive
Review institutional
context before a deeper
dive takes place ($)
Sensemaking
Organizational learning
• Focused on second-order change
and more effective with large
groups
• Far less research
• Individual base
• Helps with facilitating human
interactions
• Norms play an important role
• Focused on first-order change
• Based on the assumption that data
results in solving problems
• Lends well to managerial views of
organization
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 31
MHSc, HBA, BA,
Kezar’s (2015) Core Takeaways:
Ongoing
widespread
conversations
Collaborative
leadership
Developing
crossdepartmental
teams
Flexible vision
Sponsoring
faculty and staff
development
opportunities
Drawing on and
discussing
external ideas
Creating
documents and
concept papers
Preparing and
giving public
presentations
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 32
MHSc, HBA, BA,
Implementable Skills (knowing 3 c’s):
Complexity.
• Number of distinct/important identities people
perceive about themselves.
• People have multiple self-concepts.
• Higher complexity when selves are separate
(not similar).
Consistency.
• Multiple selves require similar personality
attributes.
• Self-views are compatible with actual attributes.
Clarity.
• Self-concept is clear, confidently defined, and
stable.
• Clarity increases with age and high consistency.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 33
MHSc, HBA, BA,
Outcomes of “Self-Concept”:
People have better well-being with:
• Multiple selves (complexity).
• High-consistency selves.
• Well-established selves (clarity).
Effects on individual behaviour and performance.
• High self-concept complexity – more adaptive, more diverse
networks, more stressful, more resources needed to maintain
several identities.
• Less complex selves – more investment in fewer roles, which
may lead to higher performance.
• High self-concept clarity – better performance, leadership, career
development, less threatened by conflict.
• But very high clarity may cause role inflexibility.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 34
MHSc, HBA, BA,
Outcomes of “Self Enhancement”:
Drive to promote and protect a positive selfview.
• Competent, attractive, lucky, ethical, valued.
• Evident in common and important situations.
Self-enhancement outcomes.
• Better mental and physical health.
• Higher motivation due to “can-do” beliefs.
• Riskier decisions, inflated perceived personal causation,
slower to recognize mistakes.
• Better decision-making supporters
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 35
MHSc, HBA, BA,
Outcomes of “Self-Verification”:
Motivation to confirm and maintain our selfconcept.
• Stabilizes our self-concept.
• We communicate self-concept to others.
• We seek confirming feedback.
Self-verification outcomes.
• Affects perceptions — selective attention.
• Dismiss feedback contrary to self-concept.
• Motivated to interact with those who affirm our self-view.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 36
MHSc, HBA, BA,
Outcomes of “Self-Evaluation:”
Self-esteem.
• Extent to which people like, respect, and are satisfied with
themselves.
• High self-esteem: less influenced by others, more persistent,
more logical thinking.
Self-efficacy.
• Belief that we can successfully perform a task (MARS factors).
• General self-efficacy, “can-do” belief across situations.
Locus of control.
• General belief about personal control over life events.
• Higher self-evaluation with internal locus of control.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 37
MHSc, HBA, BA,
Outcomes of “Social-Self:”
Opposing motives:
• Need to be distinctive and unique (personal identity).
Need for inclusion and assimilation with
others (social identity).
• We define ourselves by groups we are easily
identified with, that have high status, and our
minority status in a situation
• We define ourselves by how we differentiate Integrity
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 38
MHSc, HBA, BA,
Integrity is key:
Integrity is the quality of being honest and having
strong moral principles and moral uprightness
With integrity, your perceptions will always remain
whole
• Perception: the process of receiving information about and
making sense of the world around us.
• Selective attention: selecting versus ignoring sensory information.
• Affected by characteristics of perceiver and object perceived.
• Emotional markers are assigned to selected information.
• Selective attention biases.
• Assumptions and expectations.
• Confirmation bias.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 39
MHSc, HBA, BA,
Second order thinking and sensemaking is also
Important:
As Kezar (2014) highlighted, knowledge structures that we
develop to describe, explain, and predict the world around us.
• Visual: image road maps.
• Relational: cause–effect.
• Important for sense-making.
Problem: Mental models make it difficult to see the world in
different ways.
• Need to constantly question our mental models.
• Need to constantly ask questions to gain truth
Without asking questions, we will never be supporting
decisions correctly
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 40
MHSc, HBA, BA,
Summary:
The perceptual process of deciding whether an observed behaviour or
event is caused mainly by internal or external factors requires
• A global mindset
• Adapting to change
• Implementing skills with Integrity
Change is extremely complex and occurs at multiple levels of culture and
within departments and within individuals perceptions
Understanding the self requires assessment on 4 levels:
• Self-enhancement
• Self-verification
• Self-evaluation
• Social self
Demonstrating integrity is going to differentiate you in the 21st century
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 41
MHSc, HBA, BA,
Next Session
Organizational Behaviour
and Open Systems
42
Organizational Decision Support
MGMT 6181
Week 2, Class 1
Operations Management, Quality Control
& Leadership
Professor Dr. Silvie MacLean, EdD, CPA CMA, MHSc, HBA
Educate, Engage, Empower, Excite
Today’s Learning Objectives:
1. Define operations management.
2. Explain the importance of quality in healthcare.
3. Describe the six dimensions used by the WHO to address
quality outcomes for healthcare organizations.
4. Discuss what impact quality in healthcare.
5. Describe the EFQM model and how it could be widely
used by organizations.
6. Outline the importance of 3 C’s and 4 P’s in leadership
and compare the difference between management and
leadership.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBAEdD, 2
MHSc, HBA, BA,
Operation Management:
Definition:
• Operations management is the
administration of business
practices to create the highest
level of efficiency possible within
an organization.
• It is concerned with converting
materials and labor into goods
and services as efficiently as
possible to maximize the profit
of an organization.
• Operations management teams
attempt to balance costs with
revenue to achieve the highest
net operating profit possible.
FACT: Operations
management is important in a
business organization
because it helps effectively
manage, control and
supervise goods, services
and people.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
3
“Operation Management” Class Discussion:
How would you modify
this definition to be
more specific to
operations
management in health
care?
What kinds of roles
would engage in
operations
management?
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
4
Operational Management requires Quality:
What is does quality mean
in healthcare management?
• World Health Organization: the
extent to which health care services
provided to individuals and patient
populations improve desired health
outcomes. In order to achieve this,
health care must be safe, effective,
timely, efficient, equitable and
people-centred.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
5
What does quality mean in healthcare?:
What we should continue to target and measure with special populations in mind
Safe
Delivering health care that minimizes risks and harm to service users, including avoiding
preventable injuries and reducing medical errors
Effective
Providing services based on scientific knowledge and evidence-based guidelines
Timely
Reducing delays in providing and receiving health care
Efficient
Delivering health care in a manner that maximizes resource use and avoids waste
Equitable
Delivering health care that does not differ in quality according to personal characteristics
such as gender, race, ethnicity, geographical location or socioeconomic status
Peoplecentred
Providing care that takes into account the preferences and aspirations of individual service
users and the culture of their community
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
6
Special populations to consider in Canada:
Aboriginals
Children < 18
years
Mental
Health/Addictions
Women/Girls
Seniors
New Immigrants
Mennonite/Amish
LBQT2S
Homeless
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
7
Video:
Institute for Healthcare Improvement
“How can we define quality in healthcare”(4:36)
VIDEO:
Dr. Donald Berwick, defining quality.
Group Discussion:
1. Selecting a special population group, what
would be the top three quality indicators that
you would select and why?
2. What quality indicators are most important
and why?
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
8
What effects quality in healthcare?
What element within inputs, process, and outputs is most important?
Oakland, J. S. (n.d.). Total Quality Management and Operational Excellence: Text with cases (4th Edition) [Texidium version]. Retrieved from
http://texidium.com
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
9
What is quality control and quality assurance?
Quality control
Quality assurance
is essentially the activities and
techniques employed to achieve
is broadly the prevention of quality
and maintain the quality of a
problems through planned and
product, process, or service. It
includes a monitoring activity, but systematic activities (including
is also concerned with finding and documentation). These will
include the establishment of a
eliminating causes of quality
problems so that the requirements good quality management system
and the assessment of its
of the customer are continually
adequacy, the audit of the
met.
operation of the system and the
review of the system itself.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
10
Importance of the 4 P’s and 3 C’s:
Let’s
Discuss
Oakland, J. S. (n.d.). Total Quality Management and Operational Excellence: Text with cases (4th Edition) [Texidium version]. Retrieved from
http://texidium.com
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
11
People, Planning, Process, Performance:
People
Planning
Process
Performance
• Are the assets
to the
organization.
• Concerned
with how well
the human
resource
practices tie
into and are
aligned with
the
organisation's
strategic
directions
• Focuses on
the
organisation's
strategic and
business
goals, and
employment of
plan, along
with the
organisation's
attention to
customer and
operational
performance
requirements.
• a series of
actions or
steps taken in
order to
achieve a
particular end.
• Focuses on
quality
operational
and business
outcomes.
• Uses
indicators to
measure
employee
morale,
productivity,
quality of
output, and
delivery
performance.
Presented by Dr Silvie MacLean, EdD, CPA CMA, MHSc, HBA
12
Culture, Communication, Commitment:
Culture
Concerns what and how
people believe, feel, think
and how they behave (over
time) and how this is
reflected in collective habits,
rules, norms, symbols and
artifacts
Communication
Commitment
Is often described as a
subset of organisational
climate that refers to the
Is the extent of engagement with
relationships and
safety promotion and accident
interactions in the workplace. prevention in an organisation.
Communication includes
F
College of Health Sciences
Department of Health Informatics
ASSIGNMENT COVER SHEET
Course name:
Public health outbreak and disaster management
Course number:
PHC 372
Assignment 1 Questions
– What makes Hajj different than other mass
gatherings?
– What are the risk factors associated with
Hajj?
– Then Choose only one of the following:
o Choose one potential disaster in Hajj
and propose your plan to manage it.
(Explain your disaster management
plan in each phase of the disaster
(Mitigation, Preparedness, Response,
Recovery)
Assignment
question
o Review one disaster incident that
happened in Hajj (explain the
strategies used in the 4 phases, if
possible, to manage the disaster, and
what are the lessons learned out of
that incident)
Note:
•
You can use the following resource (page 2) to review
a brief of the 4 phases of disaster.
Lindsay, B. R. (2012, November). Federal emergency
management: A brief introduction. Congressional Research
Service, Library of Congress.
https://apps.dtic.mil/sti/pdfs/AD1172029.pdf
College of Health Sciences
Department of Health Informatics
Student name:
Student ID:
CRN
Submission date:
Instructor name:
Dr. Ahmed Hazazi
Grade:
…. Out of 10
Paper assignment guidelines
Short essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PM
•
•
•
•
•
•
•
Conduct your own research to explore further online resources to provide the conceptual
idea and avoid using advertising or commercial material.
Do not use bullet points in representing your answer.
The assignment should have the COVER PAGE with SEU logo and the details of who is
submitting and to whom is it submitted.
Assignments should be submitted through Blackboard in Word document only and not
through email.
Font should be 12 Times New Roman, color should be black and line spacing should be
1.5
Use APA referencing style. Please see below link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism.
Part I: Share Your ExperienceBased on your experience, discuss the following question: What actions can you personally make to advocate for quality in health care? Part II: Apply Your KnowledgeNow, applying what you’ve learned from the readings, let’s go through the rest of the discussion together. Ensure you cite your sources when appropriate using APA format. Review the top health care trends from within the last year. Select a trend and explain it to the class. How does the selected trend impact health care quality?
Orginal Post: My focus is on the clinical issue of medication errors in nursing practice. This is because it is an important topic that has a direct impact on the well-being of patients and the outcomes of their care (Polit & Beck, 2022). Medication errors take place whenever there is a failure in the process of prescribing, dispensing, or giving medication to a patient, which results in unintended harm to the patient. This matter is quite troubling due to the fact that it may result in unfavorable impacts, extended hospital admissions, and even fatalities.
I have selected medication errors as the focus of my study due to their severe implications on patient safety. Nurses fulfill a vital function in the administration of medications, rendering them an essential part of the prevention of such errors. For appropriate patient care, medical professionals must play a role in determining that each individual receives precisely the right amount of the correct prescription at the fitting moment. In the healthcare industry, it is common practice to observe patients receiving incorrect medication. The results that could occur are always quite serious, such as allergic responses, and put a person’s life in danger. It is crucial that we solve this problem to both better patient treatment results and lessen the chance of potential harm, as finding an answer is necessary to enhance outcomes and lower risks.
Moreover, this is a critical nursing issue because nurses are the last line of defense in the fight against the occurrence of drug errors. They are accountable for ensuring that prescription orders are accurate, identifying whether or not any patients have an allergy, and safely carrying out the drug administration process. According to Alqenae et al. (2020) article, medication errors are far too common in clinical settings. This study’s results highlight how nurses can decrease the risks of medication faults while making certain patients obtain all the medicines prescribed for their care. Focusing on this clinical issue enables nurses to contribute to improving the quality of patient care and care outcomes.
Population: Healthcare workers (Nurses)
Influence: Concentration on medication administration, treatments, patient’s allergies, and rights.
Comparison: Multitasking/ lack of focus
Outcome: Fewer medication errors, improved patient-centered care
PICO QUESTION: Amongst healthcare workers, specifically nurses (P), would sole concentration on medication administration, treatments, and patient’s rights (I) compared to multitasking (C) decrease medication errors and ultimately improve patient-centered care (O)?
References
Alqenae, F. A., Steinke, D., & Keers, R. N. (2020). Prevalence and nature of medication errors and medication-related harm following discharge from hospital to community settings: a systematic review. Drug safety, 43, 517-537.
Polit, F. D., & Beck, T. C. (2022). Essentials of nursing research: Appraising evidence for nursing practice (10th Ed.). Lippincott Williams & Wilkins.
________________________________________
First download the PICO and Evidence Paper Template (attached) You will use this to create your paper. The basic APA features are done for you. On the title page please type in your name and the date only.
You will be required to complete the following
In this template please use Times New Roman 12 Font. As the paper template is in this font. It must be used throughout the whole paper.
Use double spacing for the entire paper.
Citations must be appropriate, meaning you need to paraphrase. Using the author’s ideas BUT putting them in your own words. Then you cite (author, and year).
Direct quotes should be used minimally. No more than 3 direct quotes can be used in this paper. When you use a direct quote you must have quotation marks around the words and a citation after with (author, year, and page number). See pages 270-272 in your APA 7th edition manual.
References (should be on a separate page using APA formatting. Please see examples of journal references and book references in your APA 7th edition manual pages 317-324.
This is a professional paper so refrain from using I/me/my/our statements
Assignment Questions
Use the required PICO and Evidence Paper Template. As a reminder this paper must be written in paragraph form. The only exception to not writing in paragraph form is your PICO elements.
Please answer the following:
Under the title of the paper on page 2, write your introductory paragraph. Do not use the heading “Introduction”. Please state what this paper is about (one paragraph).
Under the heading “Clinical Nursing Issue,” explain why you chose this issue and why it is a current problem. (Provide one piece of research evidence to backup that this problem exists)
Under the same heading “Clinical Nursing Issue,” explain why it is significant to nursing (Prove this is not just a general problem but that there is evidence to support how this relates to nursing with one research study)
Write out your PICO Elements
Write out your PICO Question
Under the heading ” Search Strategy Conducted,” explain which electronic databases you will use to find your evidence. Using your PICO question, develop four search terms to retrieve your evidence within the databases. (One paragraph)
Identify one planned intervention/solution to your problem, and in your own words provide the research evidence that tests your hypothesis (Use one research study)
Conclusion (summarize the paper and what you learned in one paragraph)
References
Alqenae, F. A., Steinke, D., & Keers, R. N. (2020). Prevalence and nature of medication errors and medication-related harm following discharge from hospital to community settings: a systematic review. Drug safety, 43, 517-537.
Polit, F. D., & Beck, T. C. (2022). Essentials of nursing research: Appraising evidence for nursing practice (10th Ed.). Lippincott Williams & Wilkins.
Unformatted Attachment Preview
1
PICO and Evidence Paper
Name
School of Nursing and Allied Health, SUNY Empire State College
NURS 3025: Nursing Research
Dr. Kimberly Balko
Date
5/21 KB
2
PICO and Evidence Paper
Clinical Nursing Issue
Significance of the Problem to Nursing
3
One Intervention/Solution to the Problem
PICO Elements
•
Population (P):
•
Intervention (I):
•
Comparison (C):
•
Outcome (O):
PICO Question
4
Search Strategy Conducted
Conclusion
5
References
TABLE 1.3: Question Templates for Clinical Questions: PICO
Type of Question
PICO Question Template
(Questions With an Explicit
Comparison)
Therapy/treatment/
intervention
In __________ (Population),
what is the effect of
__________ (Intervention), in
comparison to
__________ (Comparative/
alternative intervention), on
__________ (Outcome)?
Diagnosis/assessment
For __________ (Population),
does
__________ (Identifying tool/
procedure) yield more accurate
or more appropriate diagnostic/
assessment information than
__________ (Comparative tool/
procedure) about
__________ (Outcome)?
Prognosis
In __________ (Population),
does
__________
(Influence/exposure to disease
or condition), relative to
__________ (Comparative
disease/
condition OR absence of the
disease/
condition) increase the risk of
__________ (Outcome)?
Etiology/harm
In __________ (Population),
does
__________
(Influence/exposure/
characteristic) compared to
__________ (Comparative
influence/
exposure OR lack of influence or
exposure) increase the risk of
__________ (Outcome)?
Sources of Research Problems
Your research problem can come from several areas for example:
• Clinical practice
• Education experiences
• Feedback from patients or personal experiences
• Professional literature
• Quality Improvement
• Social Issues
• Research reports
Type of Question Definitions
Therapy/treatment/intervention: questions that ask what intervention/therapy/treatment most
effectively leads to an outcome.
Diagnosis/assessment: questions that ask what mechanism or test most accurately diagnoses an
outcome.
Prognosis: questions that ask what indicators are most predictive of or carry the most associated risk
for an outcome.
Etiology/harm: questions that ask to what extent a factor, process, or condition is highly associated
with an outcome, usually undesirable.
Reference: Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and
healthcare: A guide to best practice (4th.ed). Wolters Kluwer
Definition of each PICO Element
P: the population or patients (What are the key characteristics of the patients or people?)
I: the intervention, influence, or exposure (What is the intervention or therapy of interest? or,
What is a potentially beneficial-or harmful-influence?)
C: an explicit Comparison to the “I” component (With what is the intervention or influence
being compared?)
O: the Outcome (What is the outcome in which we are interested?
Examples of PICO Elements and Questions
Example A
PICO elements are created first, please review the definitions above and start like this:
P: Psychiatric patients who currently smoke
I: having smoke cessation education
C: no smoke cessation education
O: increase the desire to quit
From these elements you create the question like this:
Among psychiatric patients who are active smokers (P) does the administration of smoke cessation
education(I) compared to patients that do not receive smoke cessation education (C) impact the desire
to quit (O)
Example B
Elements
P: cardiac surgery procedures performed
I: multidisciplinary rounds
C: no multidisciplinary rounding
O: decrease the length of stay post-operatively
Question
Among 60+ and older patients who have cardiac surgery procedures performed (P), does
multidisciplinary rounds (I) compared to no multidisciplinary rounding (C) decrease the length
of stay of these patients post-operatively?
Example C
Elements
P (Population): immobile patients 75 or older on an inpatient unit
I (Intervention): Implementation of turn teams that work to reposition immobile patients
C (Comparison): Turn teams versus No turn teams
O (Outcome): Number of pressure ulcer injuries resulting from long-term inpatient stays (stage 1
or higher)
Question
Among immobile patients aged 75 or older, what is the effect of implementing turn teams on incidences
of pressure ulcer formation compared to no turn teams to decrease the formation of pressure ulcers?
please the topic I am doing is ( Obesity among Adolescents aged 12 to 19)
Unformatted Attachment Preview
NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Paper Guidelines
Purpose
This assignment allows the learner to apply knowledge gained about health promotion concepts and strategies,
enhance written communication skills, and demonstrate a beginning understanding of cultural competency.
Course outcomes: This assignment enables the student to meet the following course outcomes:
1. Discuss the professional nurse’s role in health promotion activities. (PO 1 and 2)
3. Discuss health promotion, illness prevention, health maintenance, health restoration, and rehabilitation in
relation to the nurse’s role in working with various populations. (PO 1, 2, and 8)
7. Identify health promotion strategies throughout the life span. (PO 1, 2, and 4)
Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies
to this assignment.
Total points possible: 100 points
Preparing the assignment
Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
1) Identify a health problem or need for health promotion for a particular stage in the life span of a population
from a specific culture in your area.
2) Choose one of the Leading Health Indicator (LHI) priorities from Healthy People.
https://health.gov/healthypeople/objectives-and-data/leading-health-indicators
3) Research a topic related to health and wellness associated with one of the Healthy People topic areas.
4) Submit your topic to the instructor for approval at least 2 weeks prior to the final assignment due date, but
earlier if desired. All topics must be approved.
5) You will develop an educational health promotion project addressing the population/culture in your area.
6) Use TurnItIn in time to make any edits that might be necessary based on the Similarity Index prior to submitting
your paper to your faculty. Consult with your faculty about the acceptable Similarity Index for this paper.
7) For writing assistance, visit the Writing Center page
https://mychamberlain.sharepoint.com/sites/StudentResourceCenter/WC.
8) Include the following sections (detailed criteria listed below and in the Grading Rubric).
a. Introduction and Conclusion- 15 points/15%
• Introduction establishes the purpose of the paper and describes why topic is important to health promotion
in the target population in your area.
• Introduction stimulates the reader’s interest.
• Conclusion includes the main ideas from the body of the paper.
• Conclusion includes the major support points from the body of the paper.
b. Relate Topic to Target Population- 25 points/25%
• Describes the topic and target cultural population.
• Includes statistics to support significance of the topic.
• Explains how the project relates to the selected Healthy People topic area.
• Applies health promotion concepts.
c. Summary of Articles- 25 points/25%
• A minimum of three (3) scholarly articles, from the last 5 years, are used as sources.
• Articles meet criteria of being from scholarly journals and include health promotion and wellness content.
• At least one article is related to the chosen cultural group.
• Summaries all key points and findings from the articles.
NR222 Health Promotion Project Guidelines V6.docx
®2022 Chamberlain University. All Rights Reserved
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NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Paper Guidelines
•
•
Includes statistics to support significance of the topic.
Discusses how information from the articles is used in the Health Promotion Project, including specific
examples.
d. Health Promotion Discussion – 25 points/25%
• Describes approaches to educate the target population about the topic.
• The approaches are appropriate for the cultural target population.
• Identifies specific ways to promote lifestyle changes within the target population.
• Applies health promotion strategies.
e. APA Style and Organization – 10 points/10%
• TurnItIn is used prior to submitting paper for grading.
• Revisions are made based on TurnItIn originality report.
• References are submitted with assignment.
• Use current APA format and is free of errors.
• Grammar and mechanics are free of errors.
• Paper is 3-4 pages, excluding title and reference pages.
• Information is organized around required components and flows in a logical sequence.
NR222 Health Promotion Project Guidelines V6.docx
®2022 Chamberlain University. All Rights Reserved
2
21
NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Project Guidelines
Grading Rubric
Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment.
Assignment Section and
Required Criteria
(Points possible/% of total points available)
Introduction and Conclusion
(15 points/15%)
Required criteria
1. Introduction establishes the purpose of the paper
and describes why topic is important to health
promotion in the target population in your area.
2. Introduction stimulates the reader’s interest.
3. Conclusion includes the main ideas from the body of
the paper.
4. Conclusion includes the major support points from
the body of the paper.
Relate Topic to Target Population
(25 points/25%)
Required criteria
1. Describes the topic and target cultural population.
2. Includes statistics to support significance of the
topic.
3. Explains how the project relates to the selected
Healthy People topic area.
4. Applies health promotion concepts.
Summary of Articles
(25 points/25%)
Required criteria
1. A minimum of three (3) scholarly articles, from the
last 5 years, are used as sources.
2. Articles meet criteria of being from scholarly
journals and include health promotion and wellness
content.
3. At least one article is related to the chosen cultural
NR222 Health Promotion Project Guidelines V6.docx
Highest Level of
Performance
High Level of
Performance
Satisfactory
Level of
Performance
Unsatisfactory
Level of
Performance
Section not
present in
paper
15 points
13 points
12 points
8 points
0 points
Includes no fewer
than 4 requirements
for section.
Includes no fewer
than 3 requirements
for section.
Includes no fewer
than 2 requirements
for section.
Includes 1 or fewer
requirements for
section.
No requirements
for this section
presented.
25 points
20 points
15 points
10 points
0 points
Includes no fewer
than 4 requirements
for section.
Includes no fewer
than 3 requirements
for section.
Includes no less
than 2 requirements
for section.
Includes 1 or fewer
requirements for
section.
No requirements
for this section
presented.
25 points
23 points
21 points
10 points
0 points
Includes no fewer
than 6 requirements
for section.
Includes no fewer
than 5 requirements
for section.
Includes no fewer
than 4 requirements
for section.
Includes 1-3
requirements for
section.
No requirements
for this section
presented.
®2022 Chamberlain University. All Rights Reserved
31
NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Project Guidelines
group.
4. Summaries all key points and findings from the
articles.
5. Includes statistics to support significance of the
topic.
6. Discusses how information from the articles is used
in the Health Promotion Project, including specific
examples.
Health Promotion Discussion
(25 points/25%)
Required criteria
1. Describes approaches to educate the target
population about the topic.
2. The approaches are appropriate for the cultural
target population.
3. Identifies specific ways to promote lifestyle changes
within the target population.
4. Applies health promotion strategies.
APA Style and Organization
(10 points/10%)
Required criteria
1. TurnItIn is used prior to submitting paper for
grading.
2. Revisions are made based on TurnItIn originality
report.
3. References are submitted with assignment.
4. Uses current APA format and is free of errors.
5. Grammar and mechanics are free of errors.
6. Paper is 3-4 pages, excluding title and reference
pages.
7. Information is organized around required
components and flows in a logical sequence.
25 points
23 points
21 points
10 points
0 points
Includes no fewer
than 4 requirements
for section.
Includes no fewer
than 3 requirements
for section.
Includes no fewer
than 2 requirements
for section.
Includes 1 or fewer
requirement for
section.
No requirements
for this section
presented.
10 points
9 points
8 points
4 points
0 points
Includes no fewer
than 7 requirements
for section.
Includes no fewer
than 6 requirements
for section.
Includes no fewer
than 5 requirements
for section.
Includes 1-4
requirements for
section.
No requirements
for this section
presented.
Total Points Possible = 100 points
NR222 Health Promotion Project Guidelines V6.docx
®2022 Chamberlain University. All Rights Reserved
41
The body of your paper should be 3-4 pages long NOT including the title page and reference page. Papers that are more than 4 pages long will not be accepted
References – incorporate information from the course text plus a minimum of two (2) scholarly references published within the last five (5) years. Textbooks are not to be considered scholarly references.
Use current APA format to style your paper and to cite your sources. Your source(s) should be integrated into the paragraphs. Use internal citations pointing to evidence in the literature and supporting your ideas.
Headings are required.
Discuss all aspects of healthcare coordination in context to the chosen diagnosis.
Your paper must include the following:
Identifying a chronic health condition listed on the CMS websiteLinks to an external site
Description of the health issue chosen from the CMS website.
The incidence and prevalence of this condition in the US.
How the condition is diagnosed, monitored, and treated in individuals with this condition?
Description of the interdisciplinary team that will participate in coordinating care. Specifically, define the role of the APRN in management and coordination.
Can care teams use the CCCR model? Think in terms of systems and complexity reflective thinking. If not, name another model to help manage care?
What is the cost of managing this disease in the county you live? Download the CMS Excel to determine the cost of the condition in context to the state and county. Use the CMS link below:
Spending County Level: All Beneficiaries, 2007-2018 (ZIP)Links to an external site.
What resources are available to help manage the costs of care related to this condition?
Identify barriers or challenges that you foresee for patients and care teams. How can barriers be overcome?
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Introduction to Disease
Course code:
PHC271
CRN:
Assignment title or task:
Diabetes Mellitus (DM) is a common chronic disease in Saudi Arabia. Explain the
epidemiology, pathophysiology, types, risk factors, symptoms, signs, and prevention of
diabetes.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
Out of 10
Proficiency
Some Proficiency
Limited Proficiency
No Proficiency
2
1.5
1.0
0.5
Content Presentation
Criteria
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Thinking
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/ 10
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Start your writing from the next page (page 3)
•
Word limit: Minimum 600 words (3 pages)
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task (PDF is not
acceptable)
•
Submission should be before the deadline (submission after the deadline is not allowed)
Congratulations, you just learned that you passed your NCLEX and you are ready to apply for jobs. Consider the following to discuss where you will apply for positions as a registered nurse:
How do you think the organizational structure of the Nursing department will have an impact on your orientation, ability to provide care?
There aren’t a lot of jobs for new grads in your area, how will you utilize the nurse practice act to determine if you want to apply for a position in a different state? How do you access the nurse practice act or board of registered nursing?
One hospital is a magnet hospital but only hires BSN nurses.
One Hospital is 80 beds and one is 200 beds.
One of the hospitals has had a nursing strike in the last year.
When you look on Indeed, you note that one hospital has a lot of vacant RN positions that have been posted for greater than 3 months.
Do you look at Yelp for opinions of the hospital?
Do you go to Hospital compare to see how the hospital ranks?
If you look out of state for a job, what are the nurse ratios if any?
Do you consider team or primary care nursing in your decision to apply?
How will you get the “inside scoop” from someone who works at the facility to see if you will be a match?
What if they don’t have a new grad program where they have an extended orientation?
Would you apply for an externship program instead of a staff nurse program?
https://dl.konkur.in/post/Book/Dentistry/Little-an… this one of important source referenceBackground
According to the American Dental Association (2023):
In 2000, the Surgeon General issued a report on the status of oral health in the US,
recognizing an association between periodontal diseases and cardiovascular health,
stroke, diabetes, and adverse pregnancy outcomes, and calling for more research to
determine whether causation may be established.
Instruction
For this project, you will be answering the call to action placed by the Surgeon General. Your
group will choose which topic/objective you would like to research to determine whether
causation between oral health and systemic health may be established. You will pick an
objective from the Healthy People 2030 website:
https://health.gov/healthypeople/objectives-and-da… that correlates with a
topic we are learning from your textbook: Dental Management of the Medically Compromised
Patient. 9th edition. Little, Falace, Miller, Rhodus. Elsevier 2018. ISBN 978-0-323-44355-5.
First Part of Project
Once your topic has been chosen, you and your partner will conduct the research to gather the
appropriate data necessary to draw a conclusion. You will then individually write a 3-5 (not
including title and reference) page paper. APA 7 format with at least 3 references (1 reference
may be your course textbook).
Second Part of Project
Once your research has concluded, you will create an infographic to help your audience
understand the complex concepts between the systemic disorder and oral health based on your
research findings. You and your partner will also create 10 national board style questions on your
topic. You will provide the correct answer for each question along with the rationale for the
answer. The rationale MUST be properly cited to include the source information. The question
must be well written, and appropriate questions. Please limit the amount of easy/simple questions
and strive to develop questions that are challenging , detailed, and will require applied,
developed, and critical thinking.
Putting the Project Together
You and your partner are free to decide how you would like to finalize your project for your in
class presentation. Whether you use PowerPoint, PDF file, a file for your infographic and a
flashcard style presentation for your 10 questions etc that is your choice, but it must be agreed
upon. On your presentation day, your group will have 15 minutes to present. Once you have
completed your presentation, one of you will post the 10 board style questions on the discussion
board titled “10 National Board Style Questions.”
rubric
WRITTEN: Complete description of pathophysiology of medical conditions including a brief anatomy and physiology and clinical manifestations, both intraorally and extraorally
This criterion is linked to a Learning Outcome WRITTEN:List of common medications (classifications and specifics) that patient may be on
This criterion is linked to a Learning OutcomeWRITTEN:Needs assessment (problems that may require treatment interventions) and interventions to meet those needs
This criterion is linked to a Learning OutcomeWRITTEN:Spelling and Grammar, format size and font size 24 (for presentation or larger). For your paper: APA 7 format. Font and size: Arial or Times New Roman and 12pt. Double spaced. At least 3 credible references. 1 reference can be your textbook.
This criterion is linked to a Learning OutcomeWRITTEN:Provide 10 National Board Style test questions with rationale and references, answers must be in bold
do 3 critical points remediation for LEADERSHIP ATI PROCTOR 2019 based on the given topics that r about 20-28 topicsDO THE COMPLETE DOC AND EXAMPLE IS ATTACHED FOR ANOTHER CLASS AND MAKE SURE YOU PUT THE RIGHT REFERENCES no plagirism
Unformatted Attachment Preview
“3 Critical Concepts – Remediation Document”
Upon completion of the required Practice Assessment, conduct a focused review by downloading the “ATI Individual Performance Profile” Report.
Complete the “3 Critical Concepts – Remediation Document” by using each NCLEX Client Need Category, listed under the “Topics to Review
Section” in the report to identify 3 Critical Concepts learned and or understand better about the concept. Use reliable evidence-based resources
to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per Syllabus). Cite your sources (APA formatting not required).
8 NCLEX Client Need Categories
1) Management of Care, 2) Safety and Infection Control, 3) Basic Care and comfort, 4) Health Promotion and Maintenance, 5) Psychosocial Integrity, 6)
Pharmacological and Parenteral Therapies, 7) Reduction of Risk Potential, and 8) Physiological Adaptation
Reflection Section – include one of the 6 Cognitive Functions
•
Reflect on how the 3 critical concepts you learned, helped you gain a better understanding of the 6 Cognitive Functions of the National Council for State
Boards of Nursing (NCSBN) – Clinical Judgement Measurement Model (NCJMM) – which follows the Nursing Process:
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment,
urgency, signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
Topics To Review – F y h t y r om y o u r j oj g o 5 j o r j o t r6 5 h y 5 oj 5 o6
List the NCLEX Client Need Categories, Topics, and Concepts to review from your report here – as shown in the example provided.
NCLEX Client Need Category Topic Concept
Safety and Infection Control (1 item)
Reporting of Incident/Event/Irregular Occurrence/Variance (1 item)
Safe Medication Administration and Error Reduction: Priority Action Following a Medication Error
Remove the 5 lines above, add information from your report before submission.
Date
Student Name
Instructor Name
Assessment Name
# of Topics to Review
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
Reflection – Address 1 of the 6 Cognitive
understand better about this topic)
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
References:
Include your references here. Below is an example – delete this line and the examples below and add the references you used.
Halter, M. J. (2022). Varcarolis’ Foundations of Psychiatric Mental Health Nursing 9th ed. Publisher: Saunders/Elsevier. St. Louis, Missouri.
ATI Content Mastery Series Review Module: RN Mental Health 11.0 ed.
McCuistion, L.E., DiMaggio, K., Winton, M.B., & Yeager (2023). Pharmacology: A Patient-Centered Nursing Process Approach. 11th. Ed. Publisher: Elsevier.
ATI Content Mastery Series Review Module: RN Pharmacology 11.0 ed.
“3 Critical Concepts – Remediation Document”
Upon completion of the required Practice Assessment, conduct a focused review by downloading the “ATI Individual Performance Profile”
Report. Complete the “3 Critical Concepts – Remediation Document” by using each NCLEX Client Need Category, listed under the “Topics
to Review Section” in the report to identify 3 Critical Concepts learned and or understand better about the concept. Use reliable evidencebased resources to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per Syllabus). Cite your sources (APA formatting not
required).
8 NCLEX Client Need Categories
1) Management of Care, 2) Safety and Infection Control, 3) Basic Care and comfort, 4) Health Promotion and Maintenance, 5) Psychosocial
Integrity, 6) Pharmacological and Parenteral Therapies, 7) Reduction of Risk Potential, and 8) Physiological Adaptation
•
Reflection Section – include one of the 6 Cognitive Functions
Reflect on how the 3 critical concepts you learned, helped you gain a better understanding of the 6 Cognitive Functions of the National
Council for State Boards of Nursing (NCSBN) – Clinical Judgement Measurement Model (NCJMM) – which follows the Nursing Process:
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or
problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk
assessment, urgency, signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned
outcomes to promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent
to which outcomes have been met.
Topics To Review r j o j g o 5 j o r j o t r 6 5 h y 5 o j 5 o 6
Date
Student Name
Instructor Name
Assessment Name
# of Topics to Review
Topic
Concept
Therapeutic
Communication
Hospitalization, illness and
Play: Preparing a 4-year-Old
child for surgery
3 Critical Concepts (I learned, and/or,
understand better about this topic)
1.
I learned that communication with
the kids should include simple and
concise words and details. I can
now inform and persuade a 4-yearold child to get into a surgery room
with minimal fear (Kennedy &
Howlin, 2021).
2. I learned that preschoolers should
be given medical kits and allowed
to play with them. The kit helps
them to express their feelings in a
medical operation room
environment.
3. I understand that a child being
prepared for surgery should be
given books that contain pictures of
medical equipment to read. The
books can help the child reduce any
possible tension.
Reflection – Address 1 of the 6 Cognitive
Functions
I need more understanding of how I can aid
a preschooler and know that they did
nothing for them to get hospitalized and be
subjected to surgery. I need to understand
this concept more because a preschooler
could be aware of the negative side of their
health.
Reduction of Risk Potential
Topic
Concept
Laboratory Values
Renal Disorders: Expected
Laboratory Findings of
Hemolytic Uremic Syndrome
3 Critical Concepts (I learned, and/or,
understand better about this topic)
1.
I learned that the patient should
show excess lactate dehydrogenase
and bilirubin. The latter should be
above 3 mg/dL (Bishop, 2021).
2. I understand that the hemolytic
uremic syndrome reduces
hemoglobin levels. The laboratory
findings could show hemoglobin of
less than 10 g/dL(Bishop, 2021).
3. I learned that a patient with
hemolytic uremic syndrome could
have excessive creatinine. I expect
Reflection – Address 1 of the 6 Cognitive
Functions
I did not comprehend how acute kidney
injury can be detected when conducting
laboratory analysis of hemolytic uremic
syndrome investigations. I will need to
understand the information that indicates
acute kidney injury.
over 0.7 mg/dL for a preschooler
(Bhandari & Sedhai, 2020).
Potential for
Complications from
Surgical Procedures and
Health Alterations
Chronic
Neuromusculoskeletal
Disorders: Providing
Teaching About Increased
Intracranial Pressure
Physiological Adaptation
Unexpected Response to Fractures: Monitoring for
Therapies
postoperative complications
1. I comprehended that patients
should be advised to raise their
head level in bed by 30 degrees. A
pillow raised to elevate the head by
30 degrees lowers ICP.
2. I learned that patients should be
informed about the dangers of high
ICP. These dangers include stroke,
hypertension, brain infection,
tumors, and aneurysms (Pinto et al.,
2019).
3. I learned that patients should be
warned of possible headaches and
vomiting. These are the initial
signs, so the patient should seek
medical attention should they have
one of these conditions (Pinto et al.,
2019).
I did not understand the possible aids to
educate patients about increased ICP.
There should be some instructional
resources to help the patients comprehend
the information.
1. I comprehended the actions that
should be taken to manage wounds
after operations. I learned that
wounds should be covered using
adhesive bandages 24-48 hours
after the operation. An ace wrap
can be reapplied 5-7 days after
surgery should the wound start
swelling (Johan et al., 2023).
2. I learned how to observe closely the
signs of increased pulse rate, blood
pressure, and respiratory rate.
Measurements of these signs can
reflect a possible deterioration of
patients’ conditions.
I did not grasp the assessment and
evaluation of fluid volume by checking the
mental status and the turgor. I need to
understand how to effectively assess fluid
volume by checking the patient’s mental
status and turgor.
3. I learned that the patient should be
monitored for postanesthetic
shivering. For a hypothermic
patient, I would note these
conditions 30-45 minutes after
admitting them to PACU.
Clinical Judgement
Topic
Concept
Analyze Cues
Cystic Fibrosis: Anticipated
Prescribed Medications
Prioritize Hypotheses
Gastrointestinal diagnostic
procedures: priority nursing
actions for a toddler who
ingested a foreign object
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
1. I learned that children aged 12 and
older should be given an oral
medication of tezacafter/ivacaftor
combination. This medication
enhances salt and water balance,
especially in the lungs
(Bacalhau et al., 2023).
2. I learned that patients can be
administered with ivacaftor alone.
The FDA has approved this
medication for over 60% of
children and adults, so It is
considered safe (FDA, 2023).
3. I understood that an alternative for
the ivacaftor and tezacafter is
Pulmozyme. I learned that this
medication disintegrates
extracellular DNA to loosen lung
mucus.
1. I learned that the physician should
avoid an invasive treatment.
Instead, the physician should be
subjected to asymptomatic
treatment.
2. Second, I learned that when
toddlers have foreign objects
lodged in the esophagus, the ideal
way is to remove them
I did not comprehend the specific dosages
for each medication for people of various
ages. I need to revisit the details of each
medication and in what quantities it is
administered to patients of different ages.
I did not understand why medical
management is not recommended for
patients. Initially, I though muscle
relaxants, emetics, and meat tenderizers
could be effective medical management
interventions.
endoscopically (Conners et al.,
2023). Endoscopy is helpful when
removing large and sharp-pointed
objects.
3. I learned that a specialist should be
sought for objects lodged at the
lower gastroesophageal junction
(Conners et al., 2023). Sometimes,
surgery can be the best option to
remove such objects; thus, a
specialist should give directives.
References:
Bacalhau, M., Camargo, M., Magalhães-Ghiotto, G. A. V., Drumond, S., Castelletti, C. H. M., & Lopes-Pacheco, M. (2023). Elexacaftor-TezacaftorIvacaftor: A Life-Changing Triple Combination of CFTR Modulator Drugs for Cystic Fibrosis. Pharmaceuticals, 16(3), 410.
https://doi.org/10.3390/ph16030410
Bhandari, J., & Sedhai, Y. R. (2020). Hemolytic Uremic Syndrome. PubMed; Stat Pearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK556038/
Bishop, J. A. (2021). Head and Neck Pathology, An Issue of Surgical Pathology Clinics. Elsevier Health Sciences.
Conners, G. P., Mohseni, M., & Wallace, D. (2023). Pediatric Foreign Body Ingestion (Nursing). PubMed; Stat Pearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK568742/#:~:text=In%20cases%20of%20suspected%20foreign
FDA. (2023). NDA multi-disciplinary review and evaluation. https://www.fda.gov/media/172624/download
Johan S.R. Clausen, Victor Brun Boesen, Ismail Gögenur, & Watt, T. (2023). A Content Framework of a Novel Patient-Reported Outcome Measure
for Detecting Early Adverse Events After Major Abdominal Surgery. World Journal of Surgery, 47(11), 2676–2687.
https://doi.org/10.1007/s00268-023-07143-w
Kennedy, M., & Howlin, F. (2021). Preparation of children for elective surgery and hospitalization: A parental perspective. Journal of Child Health
Care, 26(4), 136749352110328. https://doi.org/10.1177/13674935211032804
Pinto, V. L., Tadi, P., & Adeyinka, A. (2019). Increased intracranial pressure. Nih.gov; Stat Pearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK482119/
You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.
Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.To Prepare:
Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.
Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.
CHOSEN SPECIALTY- PSCHIATRIC-MENTAL HEALTH PRACTIONER
Required readings and resource
Bickford, C. J., Marion, L., & Gazaway, S. (2015). Nursing: Scope and standards of practice, third edition – 2015Links to an external site.. Retrieved from http://ebooks.iospress.nl/publication/12524
Cherry, B., Caramanica, L, Everett, L. Q., Fennimore, L., & Elaine, S. (2019).Leveraging the power of board leadership in professional nursing organizationsLinks to an external site.. JONA: The Journal of Nursing Administration, 49(11), 517-519.
Echevarria, I. M. (2018). Make connections by joining a professional nursing organizationLinks to an external site.. Nursing, 48(12), 35–38.
Truant, R., & Chan, R. J. (2017). Future ready: Strengthening oncology nursing leadership in the context of professional oncology nursing organizationsLinks to an external site.. Canadian Oncology Nursing Journal, 27(1), 2-4.
Walden University. (n.d.).Master of Science in Nursing (MSN)Links to an external site.. Retrieved November 14, 2018, from https://www.waldenu.edu/masters/master-of-science-…
Document: Academic Success and Professional Development Plan Template Download Academic Success and Professional Development Plan Template(Word document)
Choose among the following to review your specialization’s Scope and Standards of Practice or Competencies:
Nursing Informatics
Ebook: Nursing Informatics: Scope and Standards of Practice
American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.)Links to an external site.. Silver Spring, MD: Author.
“The Scope of Nursing Informatics Practice: Functional Areas of Nursing Informatics” (pp. 18–39)
Nursing EducationWebsite: Core Competencies for Academic Nurse Eeducators
National League for Nursing. (2022).Nurse educator core competencyLinks to an external site.. Retrieved from https://www.nln.org/education/nursing-education-co…Note: The competencies for the Academic Nurse Educator do not encompass the competencies or scope and standards of practice for the Nursing Professional Developer. The set of competencies associated with that specific role within the Nurse Education specialization will be examined in future competencies throughout your specialization program of study.
Nurse ExecutiveWebsite: Nurse Executive Competencies
American Organization for Nursing Leadership. (2015). AONL Nurse Executive competenciesLinks to an external site.. Retrieved from https://www.aonl.org/resources/nurse-leader-compet…
Public Health NursingWebsite: Public Health Nursing Competencies
Quad Council Coalition. (2018). Community/Public Health NursingLinks to an external site. [C/PHN] competencies. Retrieved from https://www.cphno.org/wp-content/uploads/2020/08/Q…
American Nurses Association. (2013). Public health nursing: Scope and standards of practiceLinks to an external site.(2nd ed.). Silver Spring, MD: Author.
APRNWebsite: APRN Consensus Model
APRN Consensus Work Group & the National Council of State Boards of Nursing APRN Advisory Committee. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & educationLinks to an external site.. Retrieved from https://www.nursingworld.org/~4aa7d9/globalassets/…
Adult-Gerontology Acute Care and Primary Care NP CompetenciesWebsite: AGAC and ACPC NP Competencies
Adult-Gerontology NP Competencies Work Group. (2016). Adult-gerontology acute care and primary care NP competenciesLinks to an external site.. https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Nurse Practitioner Core CompetenciesWebsite: Nurse Practitioner Core Competencies
The National Organization of Nurse Practitioner Faculties. (2012). Nurse Practitioner core competenciesLinks to an external site.. https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Nurse Practitioner ProgramsWebsite: Nurse Practitioner Programs
National Task Force on Quality Nurse Practitioner Education. (2016).Criteria for evaluation of Nurse Practitioner programsLinks to an external site.(5th ed.). https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Population-Focused NP CompetenciesWebsite: Population-Focused Nurse Practitioner Competencies
Population-Focused Competencies Task Force. (2013). Population-focused Nurse Practitioner competenciesLinks to an external site.. https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Unformatted Attachment Preview
10/21/23, 1:39 PM
Topic: Module 6: Discussion
This is a graded discussion: 100 points possible
due Nov 1 at 10:59pm
Back to Module at a Glance
(https://waldenu.instructure.com/courses/81543/modules/items/2424772)
EXAMINING NURSING SPECIALTIES
You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically
pictured, along with a quote designed to inspire.
Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical
part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of
information that can help you make an informed choice.
Note: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are
required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to
the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward
your own initial posting in a timely manner.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/81543/modules/items/2424784)
To Prepare:
Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your
program/specialization.
BY DAY 3 OF WEEK 10
Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice,
and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide
details on becoming a member.
BY DAY 6 OF WEEK 10
Respond to at least two of your colleagues’ posts by sharing your thoughts on their specialty, supporting their choice or offering suggestions if they
have yet to choose.
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Assignment Topic
Assignment 1 is a 2,500 word critical reflection.
You are required to identify a vulnerable group. You will demonstrate a critical reflection on the
approach health professionals might take to assess the extent and nature of the group’s
vulnerability, and the strategies which might be employed to meet their needs, demonstrating a
critical analysis of relevant models, theoretical perspectives, approaches and other evidence.
The following structure would be appropriate for your essay:
Introduction: Your introduction should provide an overview of the plan for your assignment,
providing an overview of your group and a rationale for your chosen group and why they might
be considered vulnerable (250 words).
Main body: Demonstrate a critical reflection on the approach health professionals might take to
identify a group as vulnerable (and the issues that may arise in relation to identifying groups as
vulnerable), and the strategies that might be employed (in the context of both national and global
policy and legislation) to meet the groups needs demonstrating a critical analysis of relevant
models, theoretical perspectives and other evidence (for example, principles of empowerment)
(2000 words).
Conclusion: Summarise the main points of the assignment. Think about your take home
message (250 words).
Your Assessment is Linked to the Following Learning Outcomes:
•
•
•
Identify and assess vulnerable individuals, groups and communities using evidence-based
approaches.
Demonstrate a critical understanding of the principles of empowerment in healthcare
contexts.
Demonstrate an awareness of global perspectives on supporting vulnerable individuals,
communities and populations.
Departmental Guidelines on Preparation and Submission of Coursework
•
•
•
•
•
Assignments should be submitted in either MS Word or Open Office format unless stated
otherwise on the assignment submission page.
Use standard margins: 1″ (2.5cm) on all sides.
Use standard Arial 12-point font size.
Use double-line spacing.
Pages should be numbered consecutively.
Academic Integrity and Plagiarism
We take academic integrity very seriously. Academic integrity means acting with fairness and
honesty, giving credit to others where you are referring to their ideas or research and respecting
the work of others. Plagiarism is defined as: ‘Using or copying the work of others (whether
written, printed or in any other form) without proper acknowledgement’. Before you finalize your
assignment take time to check that all your statements are backed up with supporting evidence,
that all sources you use – whether referring to their ideas, quoting directly or paraphrasing – are
correctly referenced in the text. Correct use of referencing acknowledges the academic whose
work has informed yours, enables the reader to find the sources you have used and demonstrates
your ability to find and analyses relevant information.
Failure to properly acknowledge the work of others is an academic offence and may result in
your work incurring a penalty or, in the most serious cases, you being removed from the course
for academic dishonesty.
If you are unsure about referencing or plagiarism, there are useful resources available in the
Study Skills Hub which is accessible from the menu on the left hand side. If you are still
experiencing difficulties with academic integrity, then you can for individualized support.
Please note, a word count penalty applies to this assessment.
If your assessment exceeds the word count limit or range by more than 10% then your awarded
grade will be reduced by 10% grade points. For more information please see your
Not meeting the word count
There is no grade reduction applied if your assignment does not meet the word count range or
limit, but to maximise your opportunity to achieve the highest grade possible, you should aim to
meet the word count or range as closely as possible.
Turnitin Originality Check
Before submitting your assignment, it is important to check the originality of your work by
submitting your assignment to
By submitting your assignment to this tool you will receive an originality report which can be
used to check that you have not included other authors work without correct citation. It is
important to note that submitting your work to the Turnitin Originality Check tool does not count
as a submission of your final work. You must still submit your assignment below.
Submission Instructions:
•
•
Please ensure that you do not include your name on your work, in line with the
anonymous marking policy.
Submit your saved document below before the end of Unit 6.
•
•
After the deadline, the submission page will be locked.
If you need to apply for Late Submission, please complete the
1. For each of the three biomedical ethical principles—beneficence, justice, and respect for persons—complete the following: Compose a definition of each principle in your own words , 2. Provide a brief example of how each principle was violated in the Tuskegee Syphilis Study.Finally, provide a brief example of how each principle was upheld in one of the journal articles that you are using for your literature review.Discuss your reaction to The Deadly Deception video. What personal values of yours did you see violated in the video? What social work values were violated?Your paper should be approximately two double-spaced pageshttps://kaltura.uga.edu/media/t/1_r7152x9v/3126161…
In quantitative research a researcher investigates phenomena that leads itself to precise measurement and quantification, and often involves a rigorous and controlled design (Polit & Beck, 2022). So when you think of this design using precise measurement think of statistical data or numbers to describe quantitative design. When you think about rigorous and controlled design think about experimental or non-experimental research. If you want to divide this further say you decided to do an experimental study as you form your research question this will guide you to a certain design but anyway there are other studies under experimental such as Randomized Controlled Trials and quasi-experimental design. Non- experimental designs consist of descriptive research and correlational studies as well as cross-sectional, and longitudinal which are considered time dimension designs. Now let’s discuss the terms used in quantitative research. When investigating we look at concepts, constructs, variables. A variable is an attribute that varies, that is, takes on different values (e.g., heart rate, anxiety)” (Polit & Beck, 2022, p. 403). A variable can be dependent (behavior, characteristic) or independent (cause of or influence on the dependent. Qualitative research according to Polit and Beck (2022) is the “investigation of phenomena in a in-depth and holistic fashion, through the collection of rich narrative materials using a flexible research design” (p. 396). Research done under a qualitative framework would consist of Ethnography, Phenomenology, Hermeneutics, Grounded Theory, and Historical Analysis. Instead of statistics like in quantitative research, qualitative uses narrative data where the researcher analyzes patterns and themes.Please review the article ” Parents’ Use of Praise and Criticism in a Sample of Young Children Seeking Mental Health Services” in your Polit and Beck text pages 331-332 Appendix A (only the first two pages).Discuss what research method and design was used and if it supports the research questions.Please review the article “Posttraumatic Growth After Birth Trauma: I Was Broken. Now I Am Unbreakable” in your Polit and Beck text pages 340-341. Appendix B (only the first two pages).Discuss what research method and design was used and if it supports the research purpose.Which method of research (Quantitative or Qualitative) and which research design under that specific method would you use to answer your PICO question? Please provide details.
Informed consent as an underlying principle of ethical research implies (and depends on) each research participant’s ability to make a decision autonomously. However, cultural beliefs or customs may place a higher value on the prerogative of an individual, such as a village chief or a male head of household to make decisions for others. Individual autonomy may hold a much lower value and may even be seen as challenging an established structure. How can informed consent be ensured in societies in which individual autonomy is not a priority?
You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.
Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.
Note: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.To Prepare:
Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.
Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.
CHOSEN SPECIALTY- Psychiatric- Mental health practitioner.
WEEKLY READINGS AND RESOURCE
Bickford, C. J., Marion, L., & Gazaway, S. (2015). Nursing: Scope and standards of practice, third edition – 2015Links to an external site.. Retrieved from http://ebooks.iospress.nl/publication/12524
Cherry, B., Caramanica, L, Everett, L. Q., Fennimore, L., & Elaine, S. (2019).Leveraging the power of board leadership in professional nursing organizationsLinks to an external site.. JONA: The Journal of Nursing Administration, 49(11), 517-519.
Echevarria, I. M. (2018). Make connections by joining a professional nursing organizationLinks to an external site.. Nursing, 48(12), 35–38.
Truant, R., & Chan, R. J. (2017). Future ready: Strengthening oncology nursing leadership in the context of professional oncology nursing organizationsLinks to an external site.. Canadian Oncology Nursing Journal, 27(1), 2-4.
Walden University. (n.d.).Master of Science in Nursing (MSN)Links to an external site.. Retrieved November 14, 2018, from https://www.waldenu.edu/masters/master-of-science-…
Document: Academic Success and Professional Development Plan Template Download Academic Success and Professional Development Plan Template(Word document)
Choose among the following to review your specialization’s Scope and Standards of Practice or Competencies:
Nursing Informatics
Ebook: Nursing Informatics: Scope and Standards of Practice
American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.)Links to an external site.. Silver Spring, MD: Author.
“The Scope of Nursing Informatics Practice: Functional Areas of Nursing Informatics” (pp. 18–39)
Nursing EducationWebsite: Core Competencies for Academic Nurse Eeducators
National League for Nursing. (2022).Nurse educator core competencyLinks to an external site.. Retrieved from https://www.nln.org/education/nursing-education-co…Note: The competencies for the Academic Nurse Educator do not encompass the competencies or scope and standards of practice for the Nursing Professional Developer. The set of competencies associated with that specific role within the Nurse Education specialization will be examined in future competencies throughout your specialization program of study.
Nurse ExecutiveWebsite: Nurse Executive Competencies
American Organization for Nursing Leadership. (2015). AONL Nurse Executive competenciesLinks to an external site.. Retrieved from https://www.aonl.org/resources/nurse-leader-compet…
Public Health NursingWebsite: Public Health Nursing Competencies
Quad Council Coalition. (2018). Community/Public Health NursingLinks to an external site. [C/PHN] competencies. Retrieved from https://www.cphno.org/wp-content/uploads/2020/08/Q…
American Nurses Association. (2013). Public health nursing: Scope and standards of practiceLinks to an external site.(2nd ed.). Silver Spring, MD: Author.
APRNWebsite: APRN Consensus Model
APRN Consensus Work Group & the National Council of State Boards of Nursing APRN Advisory Committee. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & educationLinks to an external site.. Retrieved from https://www.nursingworld.org/~4aa7d9/globalassets/…
Adult-Gerontology Acute Care and Primary Care NP CompetenciesWebsite: AGAC and ACPC NP Competencies
Adult-Gerontology NP Competencies Work Group. (2016). Adult-gerontology acute care and primary care NP competenciesLinks to an external site.. https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Nurse Practitioner Core CompetenciesWebsite: Nurse Practitioner Core Competencies
The National Organization of Nurse Practitioner Faculties. (2012). Nurse Practitioner core competenciesLinks to an external site.. https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Nurse Practitioner ProgramsWebsite: Nurse Practitioner Programs
National Task Force on Quality Nurse Practitioner Education. (2016).Criteria for evaluation of Nurse Practitioner programsLinks to an external site.(5th ed.). https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Population-Focused NP CompetenciesWebsite: Population-Focused Nurse Practitioner Competencies
Population-Focused Competencies Task Force. (2013). Population-focused Nurse Practitioner competenciesLinks to an external site.. https://cdn.ymaws.com/www.nonpf.org/resource/resmg…
Unformatted Attachment Preview
10/21/23, 1:39 PM
Topic: Module 6: Discussion
This is a graded discussion: 100 points possible
due Nov 1 at 10:59pm
Back to Module at a Glance
(https://waldenu.instructure.com/courses/81543/modules/items/2424772)
EXAMINING NURSING SPECIALTIES
You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically
pictured, along with a quote designed to inspire.
Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical
part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of
information that can help you make an informed choice.
Note: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are
required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to
the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward
your own initial posting in a timely manner.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/81543/modules/items/2424784)
To Prepare:
Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your
program/specialization.
BY DAY 3 OF WEEK 10
Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice,
and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide
details on becoming a member.
BY DAY 6 OF WEEK 10
Respond to at least two of your colleagues’ posts by sharing your thoughts on their specialty, supporting their choice or offering suggestions if they
have yet to choose.
https://waldenu.instructure.com/courses/81543/discussion_topics/684972?module_item_id=2424777
1/2
10/21/23, 1:39 PM
Search entries or author
Topic: Module 6: Discussion
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Write a policy brief from the list of four topics. Come up with a country and an issue to fit in the prompt.
Unformatted Attachment Preview
Foundations of Global Health
POLICY BRIEF ASSIGNMENT
General Instructions
In this course, students will be asked to write two policy briefs selected from the list of
topics below. Papers should be no more than 5 pages in length (strictly enforced)
excluding references and figures/tables (which are not required), 12 pt. font size, 1”
margins, and double spaced.
Please use a standard reference style and include all references used as either footnote
or in a reference list at the end of the paper with references linked to the specific
citation in the text (Wikipedia citations are not acceptable). Please list all the resources
and publications that provide the evidence upon which the briefing is based.
More detailed Instructions and best practices for writing an effective policy brief as
well as a suggested outline and grading rubric are provided below. Please be sure to
carefully read the briefs, guidelines, and rubric prior to writing and ask questions early
on if you need clarification.
Please submit your papers via NYU Brightspace no later than 11:55 pm. on the following
due dates:
● Policy Brief 1 Due on Sunday 10/22/23
● Policy Brief 2 Due on Sunday 12/03/23
Policy Brief Topics
For each policy brief, please select a topic/prompt from the list below. Please note that
you cannot use the same prompt for both briefs (e.g., if you choose #1 for the first brief,
you must select a different one for the second brief). Keep in mind that if the prompt
gives you a particular role (e.g., Minister of Health), you must write the brief from that
person’s point of view.
1. You are the Minister of Health of a country you select. COVID-19 has had a negative
impact on progress toward addressing the different priority disease burdens that
existed in 2020, i.e., before the pandemic. Write a policy brief to the Prime
Minister/President of your country recommending three priority actions that the
country should take to address your country’s delay in progress towards one major
pre-COVID-19 disease priority (e.g., child immunization). Each recommended action
must address barriers created by covid-19 response to one or two of the health
system building blocks within the context of the chosen country: (i) service delivery;
(ii) health workforce; (iii) health information; (iv) medical products, vaccines, and
technologies; (v) health financing; (vi) health leadership and governance; or
community-based interventions.
2. You are the leader of a local community-based organization in an LMIC of your
choice, which represents and advocates for a specific disadvantaged population
1
Foundations of Global Health
group (e.g., women, children, disabled communities, the very poor, older people, etc.).
You need your local politician to advocate for more resources for your organization
in the national parliament. You have been asked to write a policy brief for that local
politician that details two to three actions to improve your disadvantaged population
group’s “equitable” access to specific health services (e.g., maternal health services;
adolescent sexual and reproductive health services; vaccinations; water, sanitation,
and hygiene (WASH); rehabilitation and palliative care, etc.).
3. Though the private sector is encouraged to support achieving the SDGs, there are
often concerns that there may be conflicts of interest in such partnerships with
multilateral e.g., WHO and national public organizations in regard to financing and
other management priorities. You are the head of global affairs at a large
multinational company in a development-related industry (e.g., pharma, health
technology, food and nutrition, clean energy) and are invited to a WHO-sponsored
global forum, which includes international health officials, national leaders, and
corporate executives. In the forum, you are presenting a policy brief proposing three
action steps in which your industry can lead and support the WHO in advancing the
progress on a global health issue you select.
4. You are the new chief executive officer (CEO) of a private foundation that is active in
addressing a global health priority (Choose any ONE global health topic you wish, e.g.
air pollution, non-communicable diseases, gender-based violence, child
malnutrition). Your foundation has been criticized for its efforts being too
disease-focused and failing to also strengthen Primary Health Care (PHC) and you
have to prepare a policy paper for your foundation’s Board of Directors that states
how you will modify your foundation’s current strategies to make them also support
strengthening PHC, and not just one disease area. Your policy paper must include
three areas of action and use a specific low-income country as an example of how to
operationalize your suggested strategies.
2
Foundations of Global Health
POLICY BRIEF OUTLINE & GRADING RUBRIC
Category
Problem & Target Audience:
Poor
Satisfacto
ry
Excelle
nt
0-0.5
1-1.5
2
0-0.5
1-1.5
2
0-0.5
1-1.5
2
1-2
3-5
6
● Clearly state the target audience is for the issue
you selected.
● Clearly state your role as the author of the policy
brief.
● Clearly state the issue/problem you will be
addressing in the brief.
Introduction/Background:
● Provide an explanation of what the issue is and
why it is important to the target audience.
● Provide data/research findings that support
the argument of importance and are relevant
for the target audience (you can include tables,
graphs, or photos to help make your case).
Past and Current Policy Options
● Briefly discuss past and/or current policy
actions that have been taken (globally or
nationally) and identify the strengths and
weaknesses, as well as lessons learned, of the
various efforts.
● Identify different policy options that can build
on past efforts or propose new options being
sure to provide an evidence base for each
option and an explicit consideration of the
feasibility of implementation.
Recommended Action
● Identify the action(s) you recommended from
those available.
3
Foundations of Global Health
● Support your choice of option(s) by providing
an argument illustrating why and how this
option(s) is preferable to the other proposed
options
● Identify the role of key stakeholders needed
for successful implementation.
● Identify the next steps needed by the target
individual or audience to take your
recommendations forward.
References
0
0.5
1
0
0.5-1
2
● Standard reference style is used consistently
throughout the brief and references are
credible sources (e.g., not Wikipedia).
Language & Expression
● Demonstrates clear organization and logical
development of ideas.
● Language is clear and concise.
● The presentation of ideas is free of
grammatical, spelling, punctuation,
typographical errors, colloquialisms, and slang
Total
15
4
Foundations of Global Health
RESOURCE INFORMATION FOR WRITING POLICY BRIEFS *Adapted
from the Global HIV/AIDS Network Policy Briefs Background Document*
What is a policy brief?
A policy brief is a short and concise document that presents research findings,
policy options, and recommendations to individuals in a position to make or
influence policymaking.
Policy briefs synthesize a large amount of complex information and present
findings and recommendations in a format that enables the reader to easily and
quickly understand an issue.
A policy brief is a valuable communications tool with the potential to improve the
chances that policymakers will read, consider, and apply evidence when making
policy decisions.
This is because evidence that is presented through policy briefs is more likely to
reach policymakers who do not have time to read academic papers (or the
expertise to understand them) and are overwhelmed by various sources of
information but need to be informed about a specific issue.
Policy briefs target a particular audience. They do not replace academic
articles and media coverage but complement them.
Policy briefs should be part of any comprehensive communication strategy and
should be used when:
● Research results are applicable to specific national and sub-national
contexts in which policymakers operate,
● Researchers are prepared to make value-driven judgments about the
outcome that would best address a specific issue,
● Policy recommendations are feasible, actionable, and clearly connected
to specific decision-making junctures in the policy-making process.
Writing policy briefs: Start with the issue
● Identify an issue, not just a topic. Topics identify a subject of study – but
issues identify a specific problem that can have many potential solutions.
● Frame your issue in one sentence. A framed issue helps define the problem
and identify potential solutions.
● Put forward a statement of purpose early in the text that clearly
communicates what the policy brief will tell the reader and that acts as an
enticement to the reader
5
Foundations of Global Health
● What key themes are emerging from the research?
● Are there any findings that are particularly important, interesting, or
contradict conventional wisdom?
● Any cross-country findings?
From research findings to policy recommendations
● What are the lessons and policy implications of the findings?
● Detail shortcomings of the current approach or options being implemented
and therefore, illustrate both the need for change and focus on where change
needs to occur.
● What audience are they most relevant for (international/ national/ district/
local level policy makers/global health initiatives/program
managers/non-governmental organizations)?
Identifying the policy recommendations and the target audience
● What is the reach of your target audience – what can they change, or influence,
what are
their interests? Assume that the target audience has asked for your analysis
of the issue as well as your policy recommendations to address it.
● What would you recommend (for agenda setting, policy formulation,
implementation, or
evaluation), and what do they need to change or do differently (only
recommendations that are appropriate for this audience, and that they
can feasibly implement)?
● Is there any other research that supports these recommendations?
When writing a policy brief, it is important to target the messages to a group of
stakeholders specifically, or even individual stakeholders (if applicable). At the
beginning and throughout the process of writing the policy brief ensure that:
● The content of the message is relevant to the target audience
● The language and style are suitable for their level of understanding
● The design (layout, choice of photos, letter types used, amount of text) is
appropriate
Some general rules:
● Identify background information that is relevant. Explain why policymakers
should be
concerned about the issue being presented. BUT keep it short and concise. Few
6
Foundations of Global Health
policymakers have time to read a long report from cover to cover. To be
effective, the brief should pass the ‘breakfast test’, whereby the reader can
identify the main points in the time that it takes to eat a quick breakfast. The
policy brief should also be self-contained so that the reader does not have to
refer to other documents.
● Only include findings and recommendations that have direct relevance for the
target audience, present messages in clear and jargon-free language, and be
transparent about the source of the evidence behind policy recommendations.
Effective policy briefs should develop a persuasive line of argument that
maintains the scientific credibility of the information (by using quality evidence
and providing a short, annotated list of sources and publications) while
highlighting its relevance and urgency for policy issues, as it applies to agenda
setting, policy formulation, implementation, or evaluation. This can be achieved
by distilling the complexity of research findings into digestible and clear
messages while taking into consideration other competing influences over
policy-making processes, such as donor priorities, historical-political
sensitivities, and cultural values.
● Use a clear structure to guide the reader. Start with an overview that tells the
reader why the subject is relevant and timely and outlines the main issues that
will be discussed in the order they appear.
Key ingredients of Effective Policy Briefs:
Tips for writing clearly
● Use short sentences and short paragraphs: make a key idea or argument explicit
within the first sentence of the paragraph with other sentences being used to
develop and amplify the idea. Construct, order, and connect paragraphs to guide
readers from one topic to the next, along a logical train of thought.
● Write concisely: use no unnecessary words or sentences
● Avoid using jargon and technical terms: if this is not possible then define terms
clearly in the main text or at least in a box that can be easily spotted.
● Spell out acronyms when they are first used – i.e., London International Development
● Centre (LIDC) – and then use the acronym in subsequent references. It is not
necessary to spell out the acronyms of very familiar words -i.e., US, UN, etc.
● Use figures and graphs: in place of or at least to illustrate words, but make sure they
are clearly and consistently labeled, not too complex, and easily interpretable
● Use clear, descriptive titles: for headings and sub-headings that lead the reader
through the document
● Avoid using general terms like ‘large’ and ‘most of’ without qualification
7
Foundations of Global Health
● Use the language of the stakeholder you are targeting, international languages or
local languages; try to also use concepts, expressions, and terminology that is
familiar to the stakeholder
Editing Guidance
After you have drafted the policy brief, consider the following
questions: ● Is the purpose of the briefing note clear?
● Is the language simple, clear, and jargon-free?
● Is everything there that needs to be there?
● Is there anything there that isn’t essential to the purpose?
● Is the policy brief easy to read, understand, and remember?
● Do the sections lead logically from one to another?
● Is the policy brief designed so that it is inviting to the reader?
● Is there a good balance between white spaces and text?
● Has the briefing note been carefully edited and proofread?
Language and expression
● Demonstrate clear organization and logical development of ideas
• Language is clear and concise
● The presentation of ideas is free of grammatical, spelling, punctuation, and
typographical errors, colloquialisms, and slang
● Uses credible sources and provides all necessary citations
Further reading and additional resources on Policy Briefs & Writing
Clearly
1. Jones, N., Walsh, C. (2008) Policy briefs as a communication tool for
development research Background Note, Overseas Development
Institute: London. Available at:
http://www.odi.org.uk/publications/background-notes/2008/policy
briefscommunication-tool-development-research.pdf
2. World Health Organization, Evidence Informed Policy Network – SURE
Guides for Preparing and Using Evidence-Based Policy Briefs.
Available at:
http://global.evipnet.org/SURE-Guides/
3. Research to Action: How to write actionable policy recommendations.
8
Foundations of Global Health
Available at:
http://www.researchtoaction.org/2013/07/how-to-write-actionable
policyrecommendations/
4. Plain English Campaign Guides. Available at:
http://www.plainenglish.co.uk/freeguides.html
9
Describe the practice population’s goals and objectives using the SMART format. These goals should be measurable and specific to the client or key stakeholders.
For DP students, this should be a mutually agreed-upon list of goals and objectives for your individual client.
For CAP students, this will be a mutually agreed upon list of goals and objectives from key stakeholders.
THEORY
Conduct a review of the relevant literature and provide a rationale for the selection of an evidence-based intervention strategy. Identify and describe the theoretical practice model supporting the selected intervention strategy. If the intervention is not supported by a practice theory, identify and describe one that could have been used to facilitate better outcomes.
INTERVENTION
Describe the intervention from beginning to end, including termination. If you have not yet concluded the intervention or terminated with the practice population, describe your plans for how you will do this. Include a discussion of how you helped the practice population prevent or resolve problems. Include a discussion of you negotiated, mediated, and advocated for your practice population.
PRACTICE TECHNIQUES
Identify and discuss three (3) practice techniques used with the practice population during the intervention. PLEASE make sure to cite each of the techniques used in the intervention. These are not the engagements skills used in the prior paper but are grounded in the practice theory used above.
EVALUATION METHOD
Describe your evaluation plan to measure the effectiveness of the selected intervention. Include a description of the methods used to evaluate change and improvement with the practice population.
For DP students, this is likely a single subject research design (SSRD) or a pre-test/post-test observation.
For CAP students, you likely conducted a program evaluation (e.g, needs assessment, process evaluation, outcome evaluation). Other methods may be used, but these are the most common.
Provide a rationale for the evaluation method selected. Describe the method used including the type of method (qualitative, quantitative, mixed methods), variables assessed, data collection procedures, sampling plan (if applicable), and instruments used. Be sure and include citations for any instruments used and include a blank copy in the appendix. If your agency does not have a method for assessing outcomes, propose an appropriate method including the components listed above.
EVALUATION RESULTS
Discuss the results of the evaluation. For DP students, discuss whether the individual client outcomes improved. Discuss what went well with the intervention and what could be done to improve the client’s outcomes.
EVALUATION CRITIQUE
Critique the intervention and be specific using the data you collected to support your thoughts and recommendations.
For DP students, discuss how the intervention could be viewed as empowering or discriminatory/oppressive.
For CAP students, discuss recommendations based on the evaluation.
ETHICS
Identify and describe one or more potential ethical and values conflict related to the intervention or evaluation for this practice situation.
SOCIAL JUSTICE
Conclude with a discussion of the policy, practice, and research implications of the evaluation. Based on your intervention evaluation, what needs to be kept, expanded, advocated, research and/or modified in the intervention selected. Ask yourself, is this intervention meeting the client’s or key stakeholders goals?
GUIDELINES
The body of the paper should be 4-6 pages, excluding the cover page and reference page.
Use APA 7th edition for formatting and citing in the body of the paper and references. Remember, this section of the paper should be written in 3rd person.
In a brief paragraph, highlight your experience in leadership and management from all aspects of your life – past or present – personal or professional (for example: charge nurse, past committee chair, and current coach). please you choose charge nurse. In a second paragraph of this discussion, address the following questions: What is the most pressing professional issue that nursing leadership faces today? Do not use staffing or nurse-patient ratios as the issue to discuss but rather choose one which you and your nursing colleagues can effectively address. Examples of these issues include social determinants of health, structural racism, patient outcomes, legal and ethical issues, cultural diversity and inclusion, use of technology, leading change, building teams, and use of evidenced-based practice to name a few.Related to this issue, what one recommendation for improvement would you propose?In what ways will effective leadership contribute to the proposed improvements?
Synthesize financial and market information to guide strategic decision making and improve patient outcomes.
Instructions: Due Tuesday of Week 10 by 11:59 pm EST.
Read Case 28 (pages 183-187) from Gapenski’s Cases in Healthcare Finance – “Clarinda Community Hospital.”
Prepare your response in memo format, suitable for presentation to a senior level executive. All Excel work should be imported into the memo in table format (in the body of the document) or enclosed as an Appendix within the same document.
What is the economic ordering quantity for SKU Number 53104 if the forms are ordered from Supplier A? From Supplier B? Round your answers up to the next whole unit.
How many orders should be placed each year if the hospital buys from Supplier A? If it buys from Supplier B?
Calculate the total inventory cost (the cost of ordering plus the cost of carrying inventories) that the hospital would incur under each supplier. On the basis of the information developed, which supplier should the hospital use?
For some additional guidance on how to construct a professional memo, please see the link below.
Discuss how you would apply coaching in the healthcare work environment.
* How might a coaching leadership style apply to your current work role?
* What are the advantages and disadvantages of this style in the context of health care?
* Consider the implications for employee motivation, satisfaction, and productivity as well as patient satisfaction, quality of care, and patient safety.
In developing your initial response, be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, you are encouraged to examine their opinions, offering supporting and/or opposing views.
2
discussion module 9 , Research 505
Research the National Committee of BioEthics (NCBE) Implementing Regulations of the Law of Ethics of Research on Living Creatures in Saudi Arabia.
Select any of the many articles related to your profession or resonate with your student research topic. How could these guidelines be integrated to ensure the researcher’s adherence to these research regulations and protocols?
Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.
To Prepare:
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
Review the Resources and reflect on the role of professional nurses in policy evaluation.
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.
REQUIRED READINGS/RESOURCE
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)
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 transitionLinks to an external site.. American Journal of Public Health, 93(8), 1261–1267.
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 inequitiesLinks to an external site.. Journal of Racial and Ethnic Health Disparities, 4(5), 983–991.
Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerationsLinks to an external site.. Nursing Outlook, 66(4), 386–393.
Document: Healthcare Program/Policy Evaluation Template (Word document)
Unformatted Attachment Preview
10/21/23, 1:15 PM
Topic: Week 9: Discussion
This is a graded discussion: 100 points possible
due Oct 25 at 10:59pm
Back to Module at a Glance
(https://waldenu.instructure.com/courses/80874/modules/items/2426832)
THE ROLE OF THE RN/APRN IN POLICY EVALUATION
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design
is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some
nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for
patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with
government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/80874/modules/items/2426850)
To Prepare:
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
Review the Resources and reflect on the role of professional nurses in policy evaluation.
BY DAY 3 OF WEEK 9
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.
BY DAY 6 OF WEEK 9
Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the
challenges described by your colleagues.
*Note: Throughout this program, your fellow students are referred to as colleagues.
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Choose a public health organization or company to evaluate. How do they market themselves (specifically online and on social media)? Post a link to their website. Provide a critique of their use of marketing and social media..
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Introduction to Disease
Course code:
PHC271
CRN:
Assignment title or task:
Diabetes Mellitus (DM) is a common chronic disease in Saudi Arabia. Explain the
epidemiology, pathophysiology, types, risk factors, symptoms, signs, and prevention of
diabetes.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
Out of 10
Proficiency
Some Proficiency
Limited Proficiency
No Proficiency
2
1.5
1.0
0.5
Content Presentation
Criteria
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Thinking
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/ 10
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Start your writing from the next page (page 3)
•
Word limit: Minimum 600 words (3 pages)
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task (PDF is not
acceptable)
•
Submission should be before the deadline (submission after the deadline is not allowed)
Table Assignment Instructions Using the Clinical Evaluation Form with your clinical objectives, you will discuss your progress toward the objectives thus far. If you have met the goal completely, list 2-3 ways in which you have accomplished this. This is a midterm evaluation so it is not expected that you have met all of your goals. With the goals not met you need to identify ways to reach the goals, please be specific. When writing these, consider the objectives for the course and give examples of how you are meeting them or what you will plan to do to meet them through the rest of the semester. There is a clinical self-evaluation form in the template section of the modules I WOULD MAKE IT SUCH THAT ALL CLINICAL OBJECTIVES HAVE BEEN MET AND LIST 2-3 SENTENCES OF HOW EACH OBJECTIVE HAS BEEN MET USING AT LEAST 1 SCHOLARLY, PEER-REVIEWED REFERENCE FOR EACH CLINICAL OBJECTIVE NO OLDER THAN 5 YEARS.ONLY THE MIDTERM COLUMN SHOULD BE COMPLETED RUBRIC APPEARS BELOW. Clinical Objectives Mid-term Self-Evaluation THIS COLUMN SHOULD BE COMPLETED Final Self-evaluation THIS COLUMN SHOULD NOT BE COMPLETED Maintain relationships with clients and families which are caring, supportive and culturally sensitive through therapeutic use of self and advanced interpersonal skills.Document an accurate Comprehensive Mental Health assessment.Develop diagnoses and differential diagnoses derived from the collection and synthesis of assessment data.Identify appropriate pharmacologic agents for patients with psychiatric disorders based on individual characteristics.Integrate appropriate non-pharmacologic treatment modalities into a plan of management based on the clients’ individual characteristics.Evaluate results of interventions using accepted outcome criteria.Revise the patient plan of care accordingly and consulting and referring when needed.Collaborate as a member of the interdisciplinary mental health and other health care teams. Additional Comments: Self evaluation Rubric Self evaluation Rubric Criteria Ratings Pts This criterion is linked to a Learning OutcomeTimeliness 5 pts Self-evaluation is submitted on time 0 pts Self-evaluation is not submitted on time 5 pts This criterion is linked to a Learning OutcomeSelf-evaluation 5 pts If the objective is met, the student addresses each objective with examples of how they are met. If not met, discusses progress toward the objective and identifies plan to complete the objective 3 pts Has discussed all objectives that were met by giving examples, does not identify a plan on how to complete the objective if unmet. 1 pts Addresses each objective but does not give examples on how they are met. OR If not met, does not discusses plan to complete the objective 0 pts No Marks 5 pts Total Points: 10
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.To Prepare:
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
Review the Resources and reflect on the role of professional nurses in policy evaluation.Select an existing healthcare program or policy evaluation or choose one of interest to you.Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.
REQUIRED READINGS/RESOURCES
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)
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 transitionLinks to an external site.. American Journal of Public Health, 93(8), 1261–1267.
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 inequitiesLinks to an external site.. Journal of Racial and Ethnic Health Disparities, 4(5), 983–991.
Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerationsLinks to an external site.. Nursing Outlook, 66(4), 386–393.
Document: Healthcare Program/Policy Evaluation Template (Word document)
Unformatted Attachment Preview
10/21/23, 1:15 PM
Topic: Week 9: Discussion
This is a graded discussion: 100 points possible
due Oct 25 at 10:59pm
Back to Module at a Glance
(https://waldenu.instructure.com/courses/80874/modules/items/2426832)
THE ROLE OF THE RN/APRN IN POLICY EVALUATION
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design
is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some
nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for
patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with
government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/80874/modules/items/2426850)
To Prepare:
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
Review the Resources and reflect on the role of professional nurses in policy evaluation.
BY DAY 3 OF WEEK 9
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.
BY DAY 6 OF WEEK 9
Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the
challenges described by your colleagues.
*Note: Throughout this program, your fellow students are referred to as colleagues.
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10/21/23, 1:15 PM
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Begin by identifying an organizational problem within your own workplace healthcare setting or a hypothetical healthcare organization. Propose an initiative that addresses this chosen problem, utilizing evidence-based literature and quality standards. If you choose a problem in your workplace, be sure to utilize data from that healthcare organization; if you have created a hypothetical healthcare organization, you may use a public domain database with instructor permission. As this is a scholarly initiative, this assignment must adhere to all APA requirements and formatting and include peer-reviewed and evidence-based sources to support any and all claims.
Specifically, the following critical elements must be addressed:
What Is the Organizational Problem?
Provide the organizational problem that you have chosen. How does this problem fail to meet quality or other regulatory requirements?
Articulate organizational challenges posed by the problem (e.g., interdepartmental conflicts, communication failure, budgeting issues).
Evidence-Based Support
Provide data that supports the existence of the problem. You may utilize public sources to find data related to your selected problem.
How has this problem been addressed in the past? What information management systems or patient care technologies have been utilized when addressing this problem? Be sure to use peer-reviewed literature to support your answer.
Discuss relevant accreditation standards, safety standards, compliance standards, and quality initiatives. How do these standards promote a culture of safety within the department? Be sure to cite the appropriate standards within your answer.
Performance Improvement Initiative
Propose an initiative that will address this problem within the department of your chosen healthcare organization. What specific relevant quality standard will this quality initiative address?
Describe the type of data that will reveal a quality outcome.
Implementation of the Plan in the Organization
How will this implementation plan be communicated among departments?
How will the data be displayed and shared with the organization?
If the plan for this initiative was implemented, what do you believe would be the hypothetical effect(s) on patient care outcomes? How will health information systems support those improvements in patient care?
What do you think the hypothetical effect of the quality or performance plan would be on the culture of safety within the organization?
Success of the Performance Improvement Plan
If this initiative is successful, how would the organization monitor the financial implications?
How would the current information management systems contribute to the success of your plan?
What current organizational processes will help the plan be successful?
How will the plan be communicated among departments? How will this communication help team members commit to the performance improvement plan?
The issue is getting medications approved through insurance companies and getting medications delivered to patients as soon as possible. Some insurance like Medicare or Medicaid do not like to pay the full price of medications, which causes a delay in the patient receiving their medications. Educating patients and healthcare providers on patient assistance programs is very critical for those who have insurance that will not cover treatment
First discussion should include the following
questions▪ Briefly describe your role in the internship?▪ What differences have you noticed as you have transitioned
from your role as student to intern?▪ What new knowledge or skill did you learn since the beginning
of the internship?
Instructions
Answer these questions from the reality of your training placeReply at least 3 classmates
Electronic health information exchange (HIE) is a budding, dynamic landscape that is emerging to improve data sharing between providers and to empower patients with full access to their health records. HIE enhances the coordination of care by enabling healthcare providers and patients to appropriately access and securely share complete patient health information. Data and information exchange are key factors in delivering quality care and ensuring organizations are effective. The proper, timely sharing of vital patient information can inform better clinical decision making by reducing errors, preventing duplication of tests and decreasing readmissions. There are various models that can be implemented to do this based on cost, interoperability, efficiency, security, and improvements in care delivery. Yet, because of the sensitivity of patient health information, there are several regulations and standards that also need to be considered prior to implementing HIEs. Consequently, health information managers are evaluating the available models for their benefits and impact to all affected stakeholders. In developing your HIE implementation plan, you will consider the different types of HIE models as well as how these models solve the challenges experienced by the case study organization, Memorial Hospital. You will select the technologies, tools, standards, and regulations that you will apply and state the rationale for your choices. You will also determine the means by which you will promote adoption and achieve buy-in for your plan from all relevant stakeholders.
In this assignment, you will demonstrate your mastery of the following course outcomes:
Develop an effective information governance plan for facilitating the adoption of health information systems and technologies
Recommend strategies for implementing an appropriate health information exchange model that promotes accurate data capture and exchange
Develop data management strategies for ensuring secure and compliant collection and use of patient data across an organization
Determine the impact of health information exchange on data quality and coordination of patient care for informing improvements to the continuum of care
Prompt
Memorial Hospital is the largest trauma hospital in Manchester County. It consists of a main hospital with 1,100 beds and six surrounding outpatient and specialty clinics. Memorial has been having a difficult time sharing information and coordinating the care of its patients throughout the care cycle. Currently, when a patient is discharged from the hospital, there is no way to track the patient’s outcomes unless he or she revisits or is readmitted to the hospital. Additionally, when a patient comes into Memorial as a new trauma patient or is transferred from a different hospital, it takes a great deal of time to retrieve the patient’s medical information (past medical history, comorbidities, tests received, current medications, etc.). These challenges have led to further issues such as duplicate tests, delays in diagnoses, increased medication errors, more hospital readmissions, and decreased patient satisfaction.
In an attempt to combat these issues, Memorial Hospital recently joined a board that is leading an initiative to create a new community-wide health information exchange (HIE) network. Greater Manchester County is planning to build the Manchester Health Access Network (MHAN). The MHAN is a nonprofit HIE system that would be governed by this local community public health board. The primary objective for establishing the MHAN is to link all healthcare providers in the region and improve care coordination via a secure network of electronic medical record systems. The MHAN would cover ten boroughs with roughly 2.6 million people and would involve 1,950 providers in 12 member hospitals.
The community board received state funds to complete the project, but it is on a tight budget. The good news is that all the providers in the network already store patient information electronically via electronic medical records (EMRs) that consist of useful portals and interfaces that can quickly and securely transmit information. However, while Memorial Hospital has a functional clinical data warehouse (CDW) and an accompanying data dictionary that describes the collected data types, formats, structures, and usage components, not all of the hospitals in the network do as yet. The existence of the CDW and data dictionary will help facilitate interoperability, which is a key component of the project.
The board will need to consider additional building blocks for interoperability as well. The standards that MHAN would like to employ to achieve successful interoperability include those set forth by the Nationwide Health Information Network (NHIN). The NHIN was established by the Office of the National Coordinator for Health Information Technology (ONC) to provide recommendations for a common, web-based platform for health information exchange. These recommendations involve securing HIE transmission via services, protocols, standards, specifications and legal agreements such as the following: standardized healthcare classifications and vocabularies like ICD-10-CM and SNOMED CT for homogenizing meanings; HL7 for normalizing structures; laws, policies, and formal procedures for regulating the transport of information; National Institute of Standards and Technology (NIST) standards for controlling security; and application programming interfaces (APIs) for standardizing services. Moreover, MHAN would like to use a master patient index (MPI) to ensure patient information is stored in one record and is not duplicated. This MPI database makes certain that every patient is listed just once within all hospital data systems.
The board must decide which model is the best to achieve interoperability and stay within budget all while improving the efficiency, coordination, and quality of care. It must also determine what type of data extraction techniques to use. The board can choose between centralized, federated/decentralized, or hybrid models.
The centralized model will come with a single clinical data warehouse (CDW) that will be maintained by the board but will also include a health information manager (HIM) from each member organization. With this model, the patient information from each member hospital will be securely stored in and transmitted from the CDW. Additionally, the information will be continually updated through interfaces that connect each member hospital’s electronic health record (EHR) to the CDW using unique patient identifiers. This model enables a high level of interoperability. However, it is very expensive to develop and difficult to maintain.
The alternative is a decentralized or federated model. Rather than a single CDW, the federated HIE model is composed of multiple CDWs belonging to each member hospital. Each member hospital provides the central HIE-governing body with patient identifiers unique to the particular hospital, which are then stored in an overall HIE registry. This registry will be filled with various unique types of identifiers based on those given by each hospital. In order to obtain patient data in this type of HIE, the member hospital must send a query to the overall HIE registry. The HIE registry has a record locator that is searchable by patient identifiers, and the central governing body supplies the physical location of the record to the requesting organization. The requesting organization must then request the patient information from the facility that houses the information. The facility will then send the information via some kind of secure service (e.g., VPN, email, portal). Although it is quicker to develop, less costly, and easier to maintain, this decentralized model involves several steps to acquire data, is more time-consuming, and is less interoperable than the centralized HIE model. Furthermore, it generates such challenges as increasing the risk of duplicate health records due to CDWs existing at multiple locations and hindering the consolidation of a patient’s complete, updated health record.
The hybrid model would be a combination of the two, likely including a centralized CDW interfacing with data from each local remote CDW. The remote CDWs would transmit information to the centralized CDW, all systems would use the same unique identifier, and the patient information would be directly accessible to the representatives of each member hospital. The healthcare leaders on the MHAN central governing board need to determine the best HIE architecture model to implement. Regardless of which model is chosen, it appears that adopting the MHAN infrastructure is just what Memorial Hospital needs to resolve its current challenges.
Specifically, the following critical elements must be addressed:
Introduction
Based on the details provided in the scenario, summarize the issues the hospital is experiencing.
Determine what information and data should be exchanged between organizations. Justify your reasoning.
Determine what information and data should not be exchanged between organizations. Justify your reasoning.
Describe the health information exchange (HIE) model you would implement. Justify why you selected this model.
Based on the HIE model you would implement, describe how you will extract data you are seeking from the health information system.
Explain how you will analyze and use the data in the HIE network to improve patient outcomes.
Interoperability
Determine the classification standards and terminologies necessary for successful interoperability and security.
Describe the technologies needed for successful interoperability and security.
Determine the legal and ethical standards and regulations that impact a health information exchange.
From a compliance standpoint, describe the measures that should be put into place to protect patient information
Explain the steps in the information governance life cycle, justifying the importance of including these components in an information governance plan.
Data Dictionary
Explain the content that should be included in a data dictionary, justifying your explanation with examples.
Explain how you would manage and maintain the elements in a data dictionary.
Explain the importance of adopting and using vocabulary standards.
Explain how the application of the data dictionary to the organization’s information system infrastructure can support data standardization and exchange.
Communication
Describe the stakeholders that will be affected by the change.
Based on who will be affected by the change, describe how you will communicate the impact of this change to those individuals.
Describe how you will ensure buy-in and participation from stakeholders.
1. Case Study Chosen #1: Mildred is a 45-year-old married female with three children. She presents to the clinic with complaints of fatigue and difficulty sleeping. She states she wants to get a good night’s sleep and is requesting a prescription to help her sleep. Mildred tells you she is awake off and on during the night, frequently thinking about her husband’s recent layoff from construction work and the effect this is having on the family. She lies down often during the day and has been so fatigued that she took some time off from work during the last two weeks. She is tearful at times during the visit and looks sad and anxious. On further discussion, she says she feels overwhelmed, helpless, and anxious. She tells you about an episode where she felt her heart beating rapidly, had difficulty catching her breath, felt she was going to have a heart attack, and became frightened until her husband was able to help calm her down. She is not eating as much as usual, and when she reads the newspaper, she does not remember what she has read.
Demographics: 45 y/o Female
SUBJECTIVE
CC: “I have been having trouble sleeping, it has caused me a great amount of fatigue and I need something that keeps me asleep. My family has been greatly affected by my husband’s layoff leaving me anxious, overwhelmed, helpless and crying. I even experienced a heart-attack-like feeling and my husband had to calm me down.”
HPI: 45 y/o female visiting the office this morning ℅ stress, helplessness, anxiety, difficulty concentrating and sleeping that has been going on for a few weeks. Pt states that the symptoms are constant. Pt symptoms are relieved by the comfort of her husband
Past medical hx: Do you have any past medical hx?
Past surgical Hx: Do you have any past surgical hx? If so, what are the dates of the surgeries?
Family hx? Do you have any family history on either side (mother/father)?
Current Medications: Are you currently taking any medications? Are you taking any OTC pain relievers, or OTC supplements?
Allergies: Do you have any medication, food, or chemical allergies? If so, what is the reaction?
Immunization hx: Do you currently have all of your up-to-date immunizations including flu, covid-19 + boosters?
Health Maintenance: When was your last dental, eye, physical examination?
Social HX: Are you currently employed? What are your eating habits? Do you smoke tobacco products, drink alcohol, or use illicit drugs? Where are you currently living? Who do you live with? Are you married, single? Are you sexually active?
ROS
General: Are you having any malaise, weakness, fever, chills. Have you noticed weight gains/losses of >20 lbs over the last 6 months.
Neurological: Have you noticed unusual headaches, history of head injury or loss of consciousness, lightheadedness, dizziness, vertigo. Have you noticed any numbness of a body part or weakness on one side of the body? Any feeling of pins and needle sensation, abnormal movements, or seizure disorder. Any hx of previous strokes, seizures or neurological disorders.
Psychiatric/mental status: Pt reports difficulty concentrating and change of memory. Do you have any anxiety or depression? Any difficulty sleeping, persistent thoughts or worries, decrease in sexual desire, abnormal thoughts, visual or auditory hallucinations? Any hx of psychosis or schizophrenia?
Cardiovascular: Pt reports chest discomfort, heaviness or tightness. Pt reports an abnormal heartbeat or palpitations. Have you had any SOB, or had to sleep elevated on 2 pillows or more? Have you noticed swelling to feet, or passing out or nearly passing out? Any hx of heart attack/heart failure.
Respiratory: Have you noticed a cough? phlegm production, coughing up blood, wheezing, sleep apnea, exposure to inhaled substances in the workplace or home? Any exposure to TB or travel outside of the country? Any hx of asthma, COPD/emphysema or any other chronic pulmonary disease?
Gastrointestinal: Ask about changes in appetite, nausea, vomiting, and bowel movements
Musculoskeletal: Pt reports muscle/joint pain. Have you noticed any back/neck pain? Have you had any recent accidents or injuries? Any physical disability or condition that limits activity or ADLs?
OBJECTIVE
General:
Take all VS of patient: BP, HR, RR, Weight, Height, BMI
Physical Exam Elements:
General: Vital signs stable, in no acute distress. Alert, well developed and well nourished.
Neuro: Assess cranial nerves, DTRs, sensation to light touch, and motor/sensory deficits.
Respiratory/chest: Auscultate the lungs for any respiratory abnormalities.
Cardiovascular:Auscultate the heart for any Cardiac abnormalities.
Psych: Pt reports memory change. Assess if the patient is A&OX3. Assess mood/affect/judgment, and insight during visit. Perform a mini-mental exam.
Gastrointestinal: Assess bowel sounds. Tenderness, masses, hernias.
Musculoskeletal: Assess gait, and station. Assess ROM. Assess muscle strength and tone and arm swing.
POC Testing (any Point of Care (POC) testing specifically performed in the office):
EKG
ASSESSMENT
Working Diagnosis:
Major depressive disorder with anxious distress – ICD – F41.2
Mixed anxiety-depressive disorder (MADD) is a new diagnostic category defining patients who suffer from both anxiety and depressive symptoms of limited and equal intensity accompanied by at least some autonomic features. Patients do not meet the criteria for specific anxiety or depressive disorders. The emergence of the symptoms is independent of stressful life events. Mildred is going through a stressful time in her life.
(NIH, 2022).
Feeling persistently worried.
Feeling flat or hopeless.
Thinking negatively.
Feeling unmotivated.
Feeling irritable.
Having trouble concentrating.
Being unable to enjoy the things you used to.
Differential Diagnosis:
Generalized Anxiety Disorder -ICD- 10 F41.1
GAD means that you are worrying constantly and can’t control the worrying. The symptoms of GAD can happen as a side effect of a medicine or substance use. It can also be related to medical conditions, such as hyperthyroidism, that increase hormones. This can make the body respond more excitable. GAD can be triggered by family or environmental stress. Chronic illness and disease can also trigger GAD (Hopkins, 2023).
Trouble falling or staying asleep
Lightheadedness
Trouble breathing
Tense muscles
Irritability
Trembling
Twitching
Headaches
Sweating
Hot flashes
Nausea
(Hopkins, 2023).
Panic Disorder – ICD – 10: F41.0
Panic disorder is an anxiety disorder that involves multiple unexpected panic attacks. A main feature of panic disorder is that the attacks usually happen without warning and aren’t due to another mental health or physical condition. There’s often not a specific trigger for them.
(Cleveland Clinic, 2022).
Racing heart.
Chest Pain
Nausea
Tingling/Numbness in fingers/toes
Difficulty breathing, such as hyperventilation.
Trembling or shaking.
Chills
Sweating.
PLAN
Diagnostic studies:
Sending patients out for the following w/ orders.
Lab: CBC, CMP, Thyroid function tests including TSH and thyroid hormones, troponin levels
Treatment: Lexapro 10 mg PO QD (30 tabs) 1 refill
Selective serotonin reuptake inhibitors (SSRIs) are a class of medications most commonly prescribed to treat depression. They are often used as first-line pharmacotherapy for depression and numerous other psychiatric disorders due to their safety, efficacy, and tolerability (NIH, 2023).
Referrals:
Psychiatric or mental health follow-up care and to support groups.
Refer to a cardiologist due to the cardiovascular symptoms she presented such as her heart beating rapidly, having difficulty catching her breath, feeling she was going to have a heart attack.
Education:
Psychotherapy
Breathing techniques
Review possible triggers to stay away from
Decrease caffeine intake
Medication adherence, and education on SSRIs (need to continue to take- 2 weeks to kick in)
Encourage the patient to make positive lifestyle changes, including regular exercise, a balanced diet, adequate sleep, and stress management techniques.
Discuss the importance of seeking support from family, friends, or support groups.
Teach stress reduction techniques, such as deep breathing, mindfulness, and progressive muscle relaxation.
2. Case Study Chosen: Kylie, a 24-year-old female patient, comes to your office for a refill of her allergy medication. Before going into the room, you note that her Patient Health Questionnaire – Depression (PHQ-9) score is 20, and that she is not currently on any medication for depression. When you enter the room, you notice that Kylie is easily startled, and she is sitting in the corner of the room very close to the wall.
Demographics:
Age- 24
Gender- Female
SUBJECTIVE
CC: “I need a refill on my allergy medication”
HPI: Kylie is a 24 year old that presents with a chief complaint of requesting a refill for her allergy medication. Before entering the room, it was noted that her Patient Health Questionnaire – Depression (PHQ-9) score is 20, and she is not currently on any medication for depression. Upon entering the room, she appears easily startled and is sitting in the corner of the room very close to the wall.
Past medical hx: Do you have any past medical hx?
Past surgical Hx: Do you have any past surgical hx? If so, what are the dates of the surgeries?
Family hx? Do you have any family history on either side (mother/father)?
Current Medications: Are you currently taking any medications? Are you taking any OTC pain relievers, or OTC supplements?
Allergies: Do you have any medication, food, or chemical allergies? If so, what is the reaction?
Immunization hx: Do you currently have all of your up-to-date immunizations including flu, covid-19 + boosters?
Health Maintenance: When was your last dental, eye, physical examination?
Social HX: Are you currently employed? What are your eating habits? Do you smoke tobacco products, drink alcohol, or use illicit drugs? Where are you currently living? Who do you live with? Are you married, single? Are you sexually active?
Subjective: (What questions will you ask? Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent).
Cardiovascular
Any chest pain?
Have you had palpitations?
Any swelling?
Are you feeling tired?
Family history we should know of?
Pulmonary
Any shortness of breath?
Do you have a cough?
Any wheezing or chest pain?
Have you coughed up any blood or mucus?
HEENT
Is your nose runny?
How long have you had allergies?
What are your symptoms?
Have you had any reactions to medications?
Any triggers?
What relieves your allergies?
Psyche
How is your sleep?
Do you feel safe?
Any changes in your daily routine?
Do you feel like hurting yourself or others?
Do you have a plan?
Do you feel anxious or worried?
Any significant life events?
Loss of interest?
OBJECTIVE
General:
Vital Signs
BP: 136/88
HR: 98
RR: 20
Weight:127
Height: 5’3
BMI: 24.3
Physical Exam Elements: (Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent.)
General: clean, alert and oriented x4
Cardiovascular: S1 and S2 sounds even and clear, WNL blood pressure
Respiratory: No labored breathing, no crackles, clear and even breaths
HEENT: rhinitis noted, no difficulty breathing, able to clear throat, no coughing or airway obstruction.
POC Testing (any Point of Care (POC) testing specifically performed in the office):
None performed during this office visit
ASSESSMENT
Working Diagnosis: Depressive Disorder ICD-10: F32.9
Depressive disorder is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods of time. Depression is different from regular mood changes and feelings about everyday life. Depressed mood, anhedonia, fatigue, hopelessness, hypersensitivity, irritability, social withdrawal (Navneet and Abdijadid, 2022).
Differential Diagnosis:
Social Anxiety- F40.10: Social anxiety disorder is an intense, persistent fear of being watched and judged by others. This fear can affect work, school, and other daily activities. It can even make it hard to make and keep friends (Social Anxiety Disorder, 2022). A person with social anxiety disorder feels symptoms of anxiety or fear in situations where they may be scrutinized, evaluated, or judged by others.
Generalized Anxiety Disorder- F41.1: Generalized anxiety Disorder means that you are worrying constantly and can’t control the worrying.usually involves a persistent feeling of anxiety or dread that interferes with how you live your life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events (National Institute of Mental Health, 2022).
PLAN
Diagnostic studies:
CBC with diff
Thyroid Function Test
CMP
Treatment:
Sertraline 50mg daily PO for depression
Referrals:
Psychiatrist
Psychologist
Education:
Explain that her medication is an SSRI and takes a few weeks to notice a difference. Please take medication as prescribed and we can taper off if needing to discontinue.
Contact us if you experience SI, thoughts harm to self or others, or are experiencing side effects of medication that affect your daily living.
Disc 1, What is medical technology? How does it impact healthcare cost, quality, and access in healthcare today? How will medical technology impact the system in the future? In response to classmates, share an example or an experience you have had with medical technology and describe the outcome.
Disc 2, Explain cost containment. Why is this an important concept to look at in health care? Identify one initiative in the U.S. healthcare system that is helping with cost containment. Use a reference to support your response.
Essay ;The purpose of this assignment is to gain an understanding of health care costs, access to care, and quality of care. For this assignment, you will examine the effects of cost and the issues associated with accessing quality care.
In a 750-1,000-word paper, address the following:
Identify the factors contributing to the rising cost of health care. Why are health care costs continuing to rise?
Describe two challenges seen today when accessing health care. How does cost impact access to care?
Discuss the challenges that health care organizations face with delivering quality care. How has legislation impacted health care quality strategies and initiatives?
What role does technology play in cost, access, and quality of care?
Do not include the title page or the references page when determining whether you have achieved the required word count for this assignment.
A minimum of two references, in addition to your textbook, is required for this assignment.
Prepare this assignment according to the guidelines 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.
Create one Word documents containing all parts of the assignment.
Format your document with one-inch margins and 12-point Times New Roman font.
Instructions: Part 1
Click on the article below to open and read it.
Technology in Small Practice_ATI.pdf Technology in Small Practice_ATI.pdf – Alternative Formats
Instructions Part 2
Then, Read Capko, Chapter 7 “Amazingly Productive Doctor.”
-. Answer the following question:
Please write a one page double spaced summary of three examples of technology (from this article link) which can be implemented to improve the operation of this practice.
Instuctions Part 3
For the video EHR DONE RIGHT, explain why this is successful implememation of an EHR system in a medical office.
“Culturally aware nurses are conscious of culture as an influencing factor on differences between themselves and others and are receptive to learning about the cultural dimensions of clients.” (Stanhope & Lancaster, p. 147). For this Assignment, you will analyze effective ways to work with culturally diverse populations in your practice settings.
The Assignment:
Write a 1- to 2-page paper that includes the following:
Identify and describe a diverse population that you might encounter in your nursing practice.
Identify and describe potential community resources that might be available in helping provide public health services to this population.
Explain at least two strategies you might use in providing culturally competent care to the population you selected.
USW1_NURS_6710_week08_Assignment_Rubric
USW1_NURS_6710_week08_Assignment_Rubric
Criteria Ratings Pts
Quality of Work Submitted: The extend of which work meets the assignned criteria and work reflects graduate level critical and analytic thinking.
30 to >26.0 ptsExcellentAssignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics. 26 to >23.0 ptsGoodAssignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics. 23 to >20.0 ptsFairAssignment meets most of the expectations. One required topic is either not addressed or inadequately addressed. 20 to >0 ptsPoorAssignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.
30 pts
Quality of Work Submitted: The purpose of the paper is clear.
5 to >4.0 ptsExcellentA clear and comprehensive purpose statement is provided which delineates all required criteria. 4 to >3.5 ptsGoodPurpose of the assignment is stated, yet is brief and not descriptive. 3.5 to >3.0 ptsFairPurpose of the assignment is vague or off topic. 3 to >0 ptsPoorNo purpose statement was provided.
5 pts
Assimilation and Synthesis of Ideas: The extend to which the work reflects the student’s ability to:Understand and interpret the assignment’s key concepts.
10 to >8.0 ptsExcellentDemonstrates the ability to critically appraise and intellectually explore key concepts. 8 to >7.0 ptsGoodDemonstrates a clear understanding of key concepts. 7 to >6.0 ptsFairShows some degree of understanding of key concepts. 6 to >0 ptsPoorShows a lack of understanding of key concepts, deviates from topics.
10 pts
Assimilation and Synthesis of Ideas: The extend to which the work reflects the student’s ability to:Apply and integrate material in course rsources (i.e. video, required readings, and textook) and credible outside resources.
20 to >17.0 ptsExcellentDemonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to support point of view. 17 to >15.0 ptsGoodIntegrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view. 15 to >13.0 ptsFairMinimally includes and integrates specific information from 2-3 resources to support major points and point of view. 13 to >0 ptsPoorIncludes and integrates specific information from 0 to 1 resoruce to support major points and point of view.
20 pts
Assimilation and Synthesis of Ideas: The extend to which the work reflects the student’s ability to:Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.
20 to >17.0 ptsExcellentSynthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice. 17 to >15.0 ptsGoodSummarizes information gleaned from sources to support major points, but does not synthesize. 15 to >13.0 ptsFairIdentifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped. 13 to >0 ptsPoorRarely or does not interpret, apply, and synthesize concepts, and/or strategies.
20 pts
Written Expression and FormattingParagraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.
5 to >4.0 ptsExcellentParagraphs and sentences follow writing standards for structure, flow, continuity and clarity 4 to >3.5 ptsGoodParagraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time. 3.5 to >3.0 ptsFairParagraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time. 3 to >0 ptsPoorParagraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time.
5 pts
Written Expression and FormattingEnglish writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 4 to >3.5 ptsGoodContains a few (1-2) grammar, spelling, and punctuation errors. 3.5 to >3.0 ptsFairContains several (3-4) grammar, spelling, and punctuation errors. 3 to >0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
Written Expression and FormattingThe paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 to >4.0 ptsExcellentUses correct APA format with no errors. 4 to >3.5 ptsGoodContains a few (1-2) APA format errors. 3.5 to >3.0 ptsFairContains several (3-4) APA format errors. 3 to >0 ptsPoorContains many (≥ 5) APA format errors.
5 pts
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.
Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.
In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
REQUIRED READING/RESOURCES
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Chapter 5, “Public Policy Design” (pp. 87–95 only)
Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)
American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advoc…
Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a…
Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.
Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.
Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.
To Prepare:
Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
Select a healthcare program within your practice and consider the design and implementation of this program.
Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–4 pages)In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
Unformatted Attachment Preview
10/21/23, 12:47 PM
Week 8: Assignment
Start Assignment
Due Sunday by 10:59pm
Points 100
Submitting a text entry box or a file upload
Attempts 0
Allowed Attempts 2
Back to Module at a Glance (https://waldenu.instructure.com/courses/80874/modules/items/2426796)
ADVOCATING FOR THE NURSING ROLE IN PROGRAM DESIGN
AND IMPLEMENTATION
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but
struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving
species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives.
Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.
Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design
effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the
requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that
meet objectives.
In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a
collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional
organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/80874/modules/items/2426819)
To Prepare:
Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
Select a healthcare program within your practice and consider the design and implementation of this program.
Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–4 pages)
In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you
impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare
programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
BY DAY 7 OF WEEK 8
Submit your interview transcript.
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SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start
Here area.
1. To submit your completed assignment, save your Assignment as WK8Assgn+LastName+Firstinitial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.
NURS_6050_Module04_Week08_Assignment_Rubric
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Week 8: Assignment
Criteria
Program DesignIn a 2- to 4-page
paper, create an interview
transcript of your responses to the
following interview questions.·
Tell us about a healthcare
program within your practice.
What are the costs and projected
outcomes of this program?· Who
is your target population?· What
is the role of the nurse in providing
input for the design of this
healthcare program? Can you
provide examples?· What is your
role as an advocate for your target
population for this healthcare
program? Do you have input into
design decisions? How else do
you impact design?
Ratings
45 to >40.0 pts
Excellent
40 to >35.0 pts
Good
35 to >31.0 pts
Fair
31 to >0 pts
Poor
Response provides a clear and
complete summary of the
Response provides a
summary of the healthcare
Response provides a
summary of the healthcare
Response provides a
summary of the healthcare
healthcare program, including
an accurate and detailed
description of the costs and
program, including a
description of the costs and
project outcomes of the
program that is vague or
incomplete or does not
include costs or projected
program that is vague and
inaccurate, does not include
costs or projected outcomes
projected outcomes of the
program. …Response provides
program. …Response
provides an accurate
outcomes of the program.
…Description of the target
of the program, or is
missing. …Description of the
a clear and accurate description
that fully describes the target
population. …Response
description of the target
population. …Response
provides an accurate
population is vague or
inaccurate. …Explanation of
the role of the nurse in
target population is vague
and inaccurate or is missing.
…Explanation of the role of
provides a clear and accurate
explanation of the role of the
nurse in providing input for the
explanation of the role of the
nurse in providing input for
the design of the program,
providing input for the design
of the program is vague,
inaccurate, or does not
the nurse in providing input
for the design of the
program, and specific
design of the program, including
specific examples. …Response
including some examples.
…Response provides an
include specific examples.
…Description of the role of
examples is vague and
inaccurate, or is missing.
provides an accurate and
detailed description of the role
of the nurse advocate for the
accurate description of the
role of the nurse advocate for
the target population for the
the nurse advocate for the
target population for the
healthcare program selected
…Description of the role of
the nurse advocate for the
target population for the
target population for the
healthcare program selected.
healthcare program selected.
…Response provides an
is vague or inaccurate.
…Explanation of how the
healthcare program selected
is vague and inaccurate or is
…Response provides an
accurate and detailed
explanation of how the
accurate explanation of how
the advocate’s role influences
design decisions and
advocate’s role influences
design decisions and
impacts to program design is
missing. …Explanation of
how the advocate’s role
influences design decisions
advocate’s role influences
design decisions as well as fully
somewhat explains impacts
to program design.
vague or inaccurate.
and impacts to program
design is vague and
explaining impacts to program
design.
Program Implementation· What is
the role of the nurse in healthcare
program implementation?How
does this role vary between
design and implantation of
healthcare programs? Can you
provide examples?· Who are the
members of a healthcare team
that you believe are most needed
to implement a program? Can you
explain why you think this?
Pts
45 pts
inaccurate, or is missing.
40 to >35.0 pts
Excellent
35 to >31.0 pts
Good
31 to >27.0 pts
Fair
27 to >0 pts
Poor
Response provides a clear,
accurate, and complete
Response provides an
accurate explanation of the
Explanation of the role of the
nurse in healthcare program
Explanation of the role of the
nurse in healthcare program
explanation of the role of the
nurse in healthcare program
implementation. …Response
role of the nurse in healthcare
program implementation.
…Response provides an
implementation is vague,
inaccurate, and/or
incomplete. …Explanation of
implementation is vague and
inaccurate or is missing.
…Explanation of how the role
provides an accurate and
detailed explanation of how the
accurate explanation of how
the role of the nurse is
how the role of the nurse is
different between design and
of the nurse is different
between design and
role of the nurse is different
between design and
implementation of healthcare
different between design and
implementation of healthcare
programs and may include
implementation of healthcare
programs is vague or
inaccurate and/or does not
implementation of healthcare
programs is vague and
inaccurate or is missing.
programs, including specific
examples. …Response
provides an accurate and
some specific examples.
…Response provides and
accurate description of the
include specific examples.
…Description of the members
of a healthcare team needed
…Description of the
members of a healthcare
team needed to implement
detailed description of the
members of a healthcare team
members of a healthcare
team needed to implement
to implement the program
selected is inaccurate or
the program selected is
vague and inaccurate,
needed to implement the
program selected.
the program selected.
incomplete.
incomplete, or is missing.
https://waldenu.instructure.com/courses/80874/assignments/781261?module_item_id=2426812
40 pts
3/4
10/21/23, 12:47 PM
Week 8: Assignment
Criteria
Written Expression and Formatting
– Paragraph Development and
Organization: Paragraphs make
clear points that support well
developed ideas, low logically, and
demonstrate continuity of
ideas.Sentences are carefully
focused– neither long and
rambling nor short and lacking
substance. A clear and
comprehensive purpose statement
Ratings
Pts
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Paragraphs and sentences
Paragraphs and sentences
Paragraphs and sentences
Paragraphs and sentences
follow writing standards for flow,
continuity, and clarity. …A clear
and comprehensive purpose
follow writing standards for
flow, continuity, and clarity
80% of the time. …Purpose,
follow writing standards for
flow, continuity, and clarity
60%- 79% of the time.
follow writing standards for
flow, continuity, and clarity <
60% of the time. ...Purpose,
statement, introduction, and
conclusion is provided which
introduction, and conclusion
of the assignment is stated,
...Purpose, introduction, and
conclusion of the
introduction, and conclusion
of the assignment is
delineates all required criteria.
yet is brief and not
descriptive.
assignment is vague or off
topic.
incomplete or missing.
5 pts
and introduction is provided which
delineates all required criteria.
Written Expression and Formatting
- English Writing Standards:
Correct grammar, mechanics, and
proper punctuation
Written Expression and
Formatting:The paper follows
correct APA format for title page,
font, spacing, margins,
indentations, parenthetical/in-text
citations, and reference list (if
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Uses correct grammar,
Contains a few (1-2)
Contains several (3-4)
Contains many (≥5) grammar, spelling,
spelling, and punctuation
with no errors.
grammar, spelling, and
punctuation errors.
grammar, spelling, and
punctuation errors.
and punctuation errors that interfere
with the reader’s understanding.
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Uses correct APA format with
Contains a few (1-2) APA
Contains several (3-4) APA
Contains many (≥5) APA
no errors.
format errors.
format errors.
format errors.
5 pts
5 pts
sources are cited).
Total Points: 100
https://waldenu.instructure.com/courses/80874/assignments/781261?module_item_id=2426812
4/4
The purpose of this assignment is to create a visual map that connects the work of the course (assignments, readings, discussion board, internet reviews , etc.) to all of the objectives specified below.
Take some time now to mindfully reflect over the assignments, readings, discussion board, and web site exploration activities of the course, Population Health, Epidemiology, and Statistical Principles. Next, take a look at the written directions for the assignment and the rubric for the assignment. You will be constructing a Concept Map that relates (connects) the activities of the course to all of the outcome objectives provided for you in the Requirements section below.
ACTIVITY LEARNING OUTCOMES
This assignment enables the student to meet the following course outcomes:
Synthesize knowledge of population health to the role of political advocacy as an Advanced Practice Nurse.
DUE DATE
This assignment must be submitted by Sunday, 11:59 p.m. MT at the end of Week 7.
TOTAL POINTS POSSIBLE
This assignment is worth 50 points.
PREPARING THE ASSIGNMENT
Requirements
The Concept Map must visually connect all of the specified objectives (Program Outcomes, MSN Essentials, and NONPF Competencies) to course work (such as specific discussion board topics, written assignments, exams, lessons, and reading content).
All items should be labeled, for instance, label the objectives and label the course work you select with name of the assignment/reading/discussion board topic and which week it was introduced.
Use Microsoft Word or a PowerPoint to create a Concept Map. You can use the features found on the “Insert” tab of a Word doc (in the horizontal ribbon on the top of a Word doc page). For instance, if you click on “insert” you will see shapes and SmartArt. You can use a PowerPoint slide with shapes and lines to create a concept/mind map. This is not a PowerPoint presentation , but a PowerPoint slide can be used to “draw” the Map.
Outcomes/Competencies to be connected with course learning:
MSN Program Outcome #2:
Create a caring environment for achieving quality health outcomes (Care-Focused).
MSN Essential VIII:
Clinical Prevention and Population Health for Improving Health
National Organization of Nurse Practitioner Competencies #4
Practice Scholarship and Translational Science
Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.
Your Concept Map will visually depict how you see the assignments of the course meeting the outcomes above.
Preparing the Assignment
View the following video: How to Create a Concept MapLinks to an external site.
ASSIGNMENT CONTENT
Category Points % Description
MSN Program Outcome #2 15 30%
The Map visually connects the Category to a minimum of two (2) assignments.
Each assignment is clearly labeled with week and content topic.
MSN Essential VIII 15 30%
The Map visually connects the Category to a minimum of two (2) assignments.
Each assignment is clearly labeled with week and content topic.
NONPF Competencies #4 15 30%
The Map visually connects the Category to a minimum of two (2) assignments.
Each assignment is clearly labeled with week and content topic.
Total FORMAT Points = 5 pts
ASSIGNMENT TOTAL = 50 points
Rubric
NR503_Concept Map_Sept19
NR503_Concept Map_Sept19
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 45 PointsMSN Program Outcome Objective #2
15 pts
Excellent
The reflection specifically identifies and addresses the pre-determined program outcome and provides two (2) or more examples of how the student specifically achieved or had exposure to this outcome during this course/clinical. All items are labeled.
14 pts
V. Good
The reflection specifically identifies and addresses the pre-determined program outcome and provides one (1) example of how the student specifically achieved or had exposure to this outcome during this course/clinical. All items may or may not be labeled.
12 pts
Satisfactory
The reflection is vague and/or does not address the correct pre-determined program outcome that the student achieved or had exposure to during the course/clinical. All items may or may not be labeled.
8 pts
Needs Improvement
The reflection addresses the pre-determined program outcome in a generic manner without a specific example of exposure to or achievement of the outcome during this course/clinical. All items may or may not be labeled.
0 pts
Unsatisfactory
The reflection does not address the program outcomes or the assignment has not been submitted.
15 pts
This criterion is linked to a Learning OutcomeMSN Essential VIII Competence Objective
15 pts
Excellent
The reflection specifically identifies and addresses the pre-determined MSN Essential Competency and provides two (2) or more examples of how the student specifically achieved or had exposure to this competency during the course/clinical. All items are labeled.
14 pts
V. Good
The reflection specifically identifies and addresses the pre-determined MSN Essential Competency and provides one (1) example of how the student specifically achieved or had exposure to this competency during this course/clinical. All items may or may not be labeled.
12 pts
Satisfactory
The reflection addresses the pre- determined MSN Essential Competency in a generic manner without a specific example of exposure to or achievement of the competency during this course/clinical. All items may or may not be labeled.
8 pts
Needs Improvement
The reflection is vague and/or does not address the correct pre-determined MSN Essential Competency that the student achieved or had exposure to during the course/clinical. All items may or may not be labeled.
0 pts
Unsatisfactory
The reflection does not address the MSN Essential Competence.
15 pts
This criterion is linked to a Learning OutcomeNONPF Competencies #4
15 pts
Excellent
The reflection specifically identifies and addresses the pre-determined NONPF competencies and provides two (2) or more examples of how the student specifically achieved or had exposure to this competency during this course/clinical. All items are labeled.
14 pts
V. Good
The reflection specifically identifies and addresses the pre-determined NONPF Competencies and provides one (1) example of how the student specifically achieved or had exposure to this competency during this course/clinical. All items may or may not be labeled.
12 pts
Satisfactory
The reflection addresses the pre- determined NONPF Competencies in a generic manner without a specific example of exposure to or achievement of the competency during this course/clinical. All items may or may not be labeled.
8 pts
Needs Improvement
The reflection is vague and/or does not address the correct pre-determined NONPF Competencies that the student achieved or had exposure to during the course/clinical. All items may or may not be labeled.
0 pts
Unsatisfactory
The reflection does not address the NONPF Competencies.
15 pts
This criterion is linked to a Learning OutcomeAssignment Format Possible Points = 5 PointsGrammar, Syntax, Spelling & Punctuation
5 pts
Excellent
Grammar, spelling, and/or punctuation are accurate, or with zero to one error.
4 pts
V. Good
Two to four errors in grammar, spelling, and syntax noted.
3 pts
Satisfactory
Five to seven errors in grammar, spelling, and syntax noted.
2 pts
Needs Improvement
Eight to nine errors grammar, spelling, and syntax noted.
0 pts
Unsatisfactory
Post contains ten or greater errors grammar, spelling, and/or punctuation or repeatedly makes the same errors after faculty feedback.
5 pts
This criterion is linked to a Learning OutcomeLate penalty deductionsStudents are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
You’ve already found a newspaper article from the past year on the topic of Human Resources in Healthcare. About any current event in the news that deals with a topic covered somewhere in the textbook. With the newspaper article you’ve drawn connections between the article and information covered in the textbook. You’ve explained WHY this information is important and HOW it is related to the material covered in this class. You explained which chapter covers the topic you are talking about and how that material relates to your news article. You explained what is “Best Practice” in this area? you supported your Initial Post with information from at least 3 peer reviewed journal articles. (Note that the references must be from peer reviewed journals and provided in APA format.)
INSTRUCTIONS: FEEDBACK Posts! You must provide FOUR Feedback posts to the uploaded 4 student post below which is numbered student 1,2,3,4. Which means you need to write at least one long paragraph (At least 8 sentences) for EACH of the student’s posts. Each of your response statements must be supported with a different reference for each student from only a peer reviewed journal article in APA format.
IMPORTANT NOTES: I am looking for detailed and well thought out responses. With a response of “I agree” without any follow-up justification are not considered to be appropriate interaction and no credit will be received for these responses. Additionally, please do NOT state in your Feedback, “That was a great post.” This does not add any relevant information to our discussion. Your grade will depend on the quality of your interaction and responses to the postings made by other students. Read messages posted by other students. Ask questions if you are unclear about someone’s response. If you disagree with someone’s post, feel free to explain your position and support your statement with references.
Student 1) https://www.hr-brew.com/stories/2023/06/22/how-one-hospital-holds-onto-employees-amid-burnout-in-the-healthcare-industryLinks to an external site.
-This article was published this year and brings attention to what I believe is a significant issue plaguing the healthcare industry, which is hospital burnout. The pandemic was incredibly devastating to the healthcare industry and put serious strain on their resources. Not only was it financially dependent on it but from a mental health standpoint, it caused many issues with workers. The pandemic created significant mental health issues among its workers (Spoorthy et al., 2020). Today we have a shortage of healthcare workers in many positions and the stress of the pandemic is one of those reasons for many healthcare workers becoming stressed out to the point where they left the industry. This article specifically interviews Janel Allen the Executive Vice President and people officer at the Children’s Hospital & Medical Center located in Omaha. Janel understands these issues the healthcare industry is facing, which is why she is allocating significant resources to improving the mental health of healthcare workers that feel over stressed and burned out. Some of the symptoms caused by burnout by healthcare workers have led to significant issues including depression, anxiety, insomnia, memory loss and back pain (Peterson et al., 2008).
-Mental health is incredibly important for people these days and can cause serious issues/ The healthcare industry is already a stressful environment but with increased people requiring healthcare, it creates an increased demand. The healthcare industry can be considered so stressful that workers have been diagnosed with the same psychological anguish experienced by soldiers in the way called moral injuries (Greenberg et al., 2020). This is a truly relevant article to a major issue affecting the healthcare industry and it is nice to know that people in senior positions understand the problem and are willing to act on it. Janel Allen essentially allocated significant resources to providing mental health improvements to healthcare workers under her command, so they do not feel overstressed or burned out from the tedious daily tasks they do. A strong mental health policy is important to deliver consistent best practice daily to people who require healthcare. The text constantly offers ways to improve healthcare delivery, but it all starts with a strong mental game. It is impossible to deliver quality healthcare if mental health is poor, which is why this study is relevant to course material.
-Best practice as described by the textbook involved consistently delivering the best methods, interventions, procedures, or techniques that are backed by scientific evidence to deliver the best patient care and medical outcomes. Scientific research highlights ways to improve practice, but the most demanding thing is applying that research into the healthcare environment, which requires significant education and training (Nutbeam, 1996). The reason this article is relevant to delivering best practice is because it is important to retain workers that have been educated and trained. The way you do this is avoid stress and burnout, which is easier said than done. A strong response to achieving this goal would be to improve the mental health of workers so they do not feel burned out. That is exactly what Janel Allen is trying to do with this new policy. You are unable to deliver the best practice for a patient if healthcare workers are constantly leaving, forcing you to educate and train another.
References:
Greenberg, N., Docherty, M., Gnanapragasam, S., & Wessely, S. (2020). Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ, m1211. https://doi.org/10.1136/bmj.m1211Links to an external site.
Nutbeam, D. (1996). Achieving ‘best practice’ in health promotion: Improving the fit between research and Practice. Health Education Research, 11(3), 317–326. https://doi.org/10.1093/her/11.3.317
Peterson, U., Demerouti, E., Bergström, G., Samuelsson, M., Åsberg, M., & Nygren, Å. (2008). Burnout and physical and mental health among Swedish Healthcare Workers. Journal of Advanced Nursing, 62(1), 84–95. https://doi.org/10.1111/j.1365-2648.2007.04580.xLinks to an external site.
Spoorthy, M. S., Pratapa, S. K., & Mahant, S. (2020b). Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A Review. Asian Journal of Psychiatry, 51, 102119. https://doi.org/10.1016/j.ajp.2020.102119
Student 2) https://web.p.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=88&sid=777833f8-01b1-4c0f-a16e-73e20f600413%40redisLinks to an external site.
-This article was published in the New York Amsterdam News in January of 2023, and covers the nursing union workers strike. The NY State Nurses Association (NYSA) were in contract negotiations with New York based Health Care Organizations for increased wages, and most importantly, improved staffing. If agreements were not made by all hospitals by the deadline of January 8th, nurses at the remaining facilities were to walk out and go on strike. Two hospitals were left on that Sunday night where no agreement was reached, Mount Sinai and Montefiore Medical Center, and the nurses walked out on their shifts. NYSA union members stressed that the strike and contract negotiations were primarily over enforcing the nursing staffing requirements that the 2021 Safe Staffing for Quality Care Act mandated for all medical facilities set appropriate nurse to patient ratios that will ensure the best quality patient care, which NY hospitals were not adhering to (Carillo, 2023).
-The New York Amsterdam News article is connected to the text in chapter 7 of the course textbook. Chapter 7 covers nursing and what is required for nurses to deliver excellent care, which includes planning and scheduling nursing staff to support patient care, and ensuring an adequate supply of nurses from promoting healthy work environments. NYSA members were dissatisfied with the nurse to patient ratio because in the Mount Sinai Intensive Care Unit (ICU) the ratio was 3-4 patients per nurse when the appropriate ratio is no more than 2 patients per nurse in the ICU (Carillo, 2023). Chapter 7 discusses how nurses maintain quality care through staffing decisions that establish the number of care providers for each nursing unit. When there are not enough nurses on staff, this quality care measure is jeopardized, which places importance on involving nurses in the decision making process of developing staffing approaches (White & Griffith, 2019). Chapter 7 reviews how sustaining the nurse supply to prevent future nursing shortages. Nursing shortages pertain to the newspaper article because nurses who are dissatisfied with their working conditions will leave the industry, creating a shortage of nursing providers. The text explains how excellent HCOs will work to reduce nursing turnover to under 10% by increasing engagement, empowerment, continuous improvement, and work satisfaction (White & Griffith, 2019).
– The best practices in nursing staffing to prevent such a situation as was reported in the New York Amsterdam News is to implement strategies to support retention in the workforce. A major indicator of nursing turnover that leads to staffing shortages is chronic burnout. A best practice strategy for staff retention and to prevent burnout is to fill staffing gaps with float employees and tele-health providers, rather than overwork permanent nursing staff and disrupt their work-life balance (Franzosa et al., 2022). Telehealth is a solution to provide high quality care to monitor patients, such as in the ICU, that lends to improved patient care outcomes. The use of Telehealth during the Covid pandemic proved to support nursing teams along with providing bedside support to patients, regardless of the provider’s location (Gibson et al., 2021). Retention strategies that focus on improving work-life balance and stress reduction should have consistent support by leadership. These retention strategies should include supporting nationally mandated staffing ratios, empowerment of nurses by allowing them to be heard in decision making processes, and offering opportunities for professional development, education, and promotion (Brown et al., 2023).
References
Brown, J. S., Gomez, N., Harper, M., & Olivares, R. (2023). Combating the nursing shortage: Recruitment and retention of Nephrology Nurses. Nephrology Nursing Journal, 50(1), 49. https://doi.org/10.37526/1526-744x.2023.50.1.49
Carillo, K. J. (2023, January 12). NYC nurses strike, push for staffing changes. The New York Amsterdam News, p. 10.
Franzosa, E., Mak, W., R. Burack, O., Hokenstad, A., Wiggins, F., Boockvar, K. S., & Reinhardt, J. P. (2022). Perspectives of Certified Nursing Assistants and administrators on staffing the nursing home frontline during the COVID‐19 pandemic. HealthServices Research, 57(4), 905–913. https://doi.org/10.1111/1475-6773.13954Links to an external site
Gibson, N. A., Arends, R., & Hendrickx, L. (2021). Tele-U to tele-ICU: Telehealth nursing education. Critical Care Nurse, 41(5), 34–39. https://doi.org/10.4037/ccn2021109
White, K. R., & Griffith, J. R. (2019). The well-managed healthcare organization. Health Administration Press.
Student 3) LINK: https://www.proquest.com/docview/2814140459?pq-origsite=primoLinks to an external site.
-SUMMARIZE the article. This article discusses how we should address the current and future challenges we face in healthcare. Focusing on how prevention can help improve population health and hospital costs. In Ireland, there has been an increase in average life expectancy by two years, with women reaching the age of 84 and men reaching the average age of 81. They are seeing an increasing aging population, correlating with an increasing prevalence of preventable chronic disease. The author explains that these issues are happening not just in Ireland but worldwide. Some challenges include a shortage of healthcare workers, the rising cost of services, and the public needing to be more demanding of the care they receive and where they receive it. The article explains that we need to help prevent and address these challenges. The article goes on to project that in 2035, the healthcare system will increase its focus on preventing people’s health and well-being. With earlier intervention, it will result in better outcomes for patients and cost reductions. If diseases are caught earlier, the cost of services for the patient will decrease, and they will not need services again later on. As more new technology emerges, we will be better able to support prevention in hospitals. One of the shifts to improved prevention is improving the number of workers; they do this by implementing new care programs, like virtual healthcare, bringing in new staffing, and increasing access to increased prevention rates.
-CONNECTION TO TEXT: This article connects to Chapter 9, Population Health, as the chapter goes on to explain how prevention and intervention are essential in the healthcare industry. The textbook goes on to state some intervention and prevention opportunities, such as supporting care-providing teams, establishing a community health mission, improving access, and using the epidemiologic panning model, can help with predicting the demand based on the population. “Preventable and chronic disease is an important avenue to reducing the cost of healthcare.” (White & Griffith, 2016). The other importance of this information is that we can forecast different methods by which we can prevent many different challenges that are to come. The healthcare industry can use these methods to be ahead of the employee shortages and diseases that are to come. Both the textbook and the article explain how there needs to be prevention plans in place to help with challenges that are to go or be predicted.
– BEST PRACTICE: What is “Best Practice” in this area? The best practice is for the healthcare industry to have plans in place in case a challenge is predicted, whether it is staffing shortages and forecasting any diseases or chronic diseases that are to come. “Because it reduces risk, prevention appears to be a useful tool for insurers.” (Gauchon et al., 2020). There are many different ways that prevention programs can be implemented. For example, Gallo et al., (2022) article talks about how they integrated a distal educational intervention program during the COVID-19 pandemic for hygienic practices such as washing hands and using gloves could hinder this skin. They concluded that these educational interventions saw changes in individuals’ behavior, not excessively washing or wearing gloves for prolonged periods of time. Participants also found these intervention and prevention programs to be useful and applied the advice that they received to prevent any skin issues during this time when COVID-19 was happening. Prevention plans can also help with burnout if the organization adequately implements them. “Coinciding with this heightened awareness and appreciation for infection prevention specialists were Herculean demands that have contributed to burnout and infection prevention workforce erosion.” (Stevens et al., 2022). As we can see, using prevention methods can reduce and overall improve the healthcare industry with their workers, turnover rates, population health, and decrease the cost.
Reference
Gallo, R., Guarneri, F., Gasparini, G., Oddenino, G., Carmisciano, L., Rovini, E., & Parodi, A. (2022). Implementation of a distance learning hand eczema prevention program for healthcare workers during the COVID‐19 pandemic. Contact Dermatitis, 87(3), 297–300. https://doi.org/10.1111/cod.14159
Gauchon, R., Loisel, S., & Rullière, J.-L. (2020). Health policyholder clustering using medical consumption. European Actuarial Journal, 10(2), 599–626. https://doi.org/10.1007/s13385-020-00244-z
Irish Times. (2023, May 17). The future of healthcare is bright and patient-focused: healthcare systems are transitioning to focus more on prevention and the preservation of health and wellbeing. advancements in technology will deliver more patient centred care, says yvonne mowlds, healthcare lead at pwc. Retrieved from https://www.proquest.com/docview/2814140459?pq-origsite=primoLinks to an external site..
Stevens, M. P., Wright, S. B., Kaye, K. S., Zuckerman, J. M., Passaretti, C. L., Martinello, R. A., Babcock, H. M., Edmond, M. B., & Snyder, G. M. (2022). At the vanguard: Leaders’ perspectives on establishing healthcare system infection prevention programs. Antimicrobial Stewardship & Healthcare Epidemiology, 2(1). https://doi.org/10.1017/ash.2022.334
White, K. R., & Griffith, J. R. (2016). The well-managed healthcare organization. Griffith and White, Health Administration Press.
Student 4) Link: https://www.miamiherald.com/news/health-care/article259064333.htmlLinks to an external site.
-Summary The article discusses the apparent shortage of physicians which while it is being witnessed in many states in the US, Florida is particularly taking a big hit. As a result, in a city where the aging population is on a steep rise, access to healthcare is restricted which endangers the lives of these older citizens. The correspondent argues that while most countries have recovered from the onslaught of the Covid pandemic, the United States is still not in its better state, considering the loss of physicians to the pandemic and the added number of transfers to the worst-hit states. The aftermath of this situation is that Florida is largely understaffed which means that the state is largely unprepared to deal with a healthcare crisis such as an outbreak. Therefore, it is critical to reinvest in medical school infrastructure while revisiting physician compensation.
-Connection to Text There are various ways the article connects with the text such as the focus on ways of ensuring continuous improvement in the healthcare workforce. According to chapter six of the text, it is critical for the physician organization in any healthcare setting to realize its central position in ensuring better healthcare (White & Griffith, 2016). As such, the newspaper article shows there has been neglect on the part of the Florida Health Department responsible for ensuring that physicians are available, qualified and adequately compensated. Moreover, the text interlocks with the article by mentioning the primary role of the physician organization in ensuring that staffing is adequate (Kirch & Petelle, 2017). The primary goal is to promote access to quality care for all people while also ensuring that physicians are compensated well for their efforts. Lastly, it is critical to be prepared for emergencies as a healthcare department to avoid repeating the current issues in Florida.
-Best Practices The human resource agency serves various roles in physician management but most importantly, the physician organization plays a critical role. Best practices mean that HR is responsible for ensuring that physicians have better conditions to ensure they provide quality services to the populace (Dunphy et al., 2020). For instance, Florida has to revamp its medical school because while it is possible to hire doctors from abroad, the stiff competition for residents means that there will be a perpetual shortage (Figueiredo et al., 2023). Cost and limited access to proper treatments, outside policies, and accessible resources were the most commonly mentioned obstacles. In addition, it is essential to review the staffing ratio because while the hospitals in Florida may be compensating their physicians well, the excess strain could be causing burnout and possibly a higher turnover rate (Varley et al.,2019).
References
Dunphy, J. N., Weinberger, M., & Silberman, P. (2020). Strategies for implementing best practices in independent physician associations. The American Journal of Managed Care, 26(6), 262-266.
Figueiredo, A. M. D., Labry Lima, A. O. D., Figueiredo, D. C. M. M. D., Neto, A. J. D. M., Rocha, E. M. S., & Azevedo, G. D. D. (2023). Educational Strategies to Reduce Physician Shortages in Underserved Areas: A Systematic Review. International Journal of Environmental Research and Public Health, 20(11), 5983.
Kirch, D. G., & Petelle, K. (2017). Addressing the physician shortage: the peril of ignoring demography. Jama, 317(19), 1947-1948.
Laviolette, J. L. (2022, March 21). Can’t find a doctor? Florida facing physician shortage amid growth, aging population. https://www.miamiherald.com/news/health-care/article259064333.htmlLinks to an external site.
Varley, A. L., Lappan, S. N., Jackson, J., Goodin, B. R., Cherrington, A., Copes, H., & Hendricks, P. S. (2019). Understanding barriers and facilitators to the uptake of best practices for the treatment of Co-Occurring chronic pain and opioid use disorder. Journal of Dual Diagnosis, 16(2), 239–249. https://doi.org/10.1080/15504263.2019.1675920Links to an external site.
White, K. R., & Griffith, J. R. (2016). The well-managed healthcare organization. Griffith and White, Health Administration Press.
In your Personal Wellness Reflection Paper you will share what you have learned this semester about wellness and about yourself. This is to be an integrative paper, summarizing and synthesizing what you learned from the personal wellness assessments you completed throughout the semester and from tracking your dietary intake physical activity on My Fitness Pal. The paper will include an Introduction, the personal assessment paragraphs you have developed throughout the course (overview of assessment, your outcome, reflection on what you learned and why it is important) and a Summary of how this will influence your future actions. This paper must be substantive in depth and personal in nature. It should be at least six pages and at least 20 well developed paragraphs (introductory paragraph, a paragraph for each assessment topic, a summary paragraph stating personal insights and future plans). Be sure to submit your paper to the course dropbox BEFORE the due date and time.
PAPER
Please use the Name of each Assessment as a Heading for each paragraph.
Paragraph 1 (or more): Introduction to Wellness: what does wellness mean, why is it important
Paragraphs 2 – 19:
Personal Outcomes and Reflections from EACH Assessment. Be sure to include a paragraph summarizing NUTRITION outcomes from My Fitness Pal and a paragraph summarizing PHYSICAL ACTIVITY outcomes from My Fitness Pal. This is the main body of paper, at least one strong paragraph (>3 sentences) must be devoted to each assessment topic and each paragraph should include…..
Subheading: Name of the Assessment
Overview of assessment: explain purpose and why the topic is important
Report of your personal outcomes on each assessment
Identification of personal strengths/weaknesses in the assessment
Identification of changes that you could make to improve/enhance
Paragraph 20: Summary of what you learned and implications for future actions (final paragraph).
This assignment is designed to allow you to demonstrate your understanding and application of the components of fitness and wellness in your own life. Be sure to retain all of your work throughout the semester, as it will be crucial to the writing of your final Personal Wellness Reflective Paper.
As you come to the end of this course, you now know the current state of healthcare technology and communication in relation to HIEs. Technology is in constant motion. Using the concepts you have learned as building blocks in this term, consider the future evolution of technology in healthcare informatics.. How do you think the evolutions of communication and technology affect the HIM professional? Consider the barriers of growth for HIEs in the future. Refer back to the concepts you learned this term in regard to data standardization, security, and integrity
I had the opportunity
to shadow my field supervisor at her 2nd Job and loved it. Adult outpatient therapy with Rochester
Regional Health in Canandaigua, NY. It was a nice change from doing my selected internship at CPEP. he reflective journal is a tool for cultivating your personal-professional self and should focus on the competencies and knowledge you are learning in your field practicum (about yourself, others, social problems, helping relationships, social change &/or social work practice). Its contents should include the following: Reflections on how you see yourself as a developing social worker. Reflections on your understanding of your personal values and the values and ethics of our profession. Reflections on the parallel processes you are experiencing with supervision and practice. Specifically address Cultural Diversity and Cultural Humility Self-Assessment of Journals I believe self-evaluation and assessment is a valuable tool to support equity in learning. You will be asked to self-assess the quality of your work on these journals. When journals are submitted, you will also be required to submit a self-assessment using the rubric provided in this syllabus. Both a point value and supporting comments are required for each area of the rubric. I will still be providing my own feedback and numeric rating, and where our numeric values differ, I will average the two in calculating the total grade for the assignment. The rubric must be completed before the assignment will be assessed by the instructor. Highlighted areas of the rubric are the ones that the student completes.
Unformatted Attachment Preview
These are the Social work competencies.
Competency 1 –Demonstrate Ethical and Professional Behavior Advanced practice social workers use
theoretical concepts, evidence-based practice knowledge, and social work skills to inform
decisions related to ethical tensions and challenges. They apply the value base of the profession,
its ethical standards, as well as relevant laws and regulations to practice while using a
selfreflective stance and initiating use of collaboration, consultation, and supervision. The
advanced practice social worker uses practice interventions to enhance the well-being of
individuals, families, groups and communities in an ethical manner. Social Workers:
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Competency 1 –Demonstrate Ethical and Professional Behavior
1.2Tasks, Practice Activities and Time Frames: (Please be specific – what, with who, by when,
etc.)
1.3 demonstrate professionalism in appearance, behavior, punctuality, time management,
attendance, and oral, written, and electronic communication.
1.4 effectively engage in collaboration, consultation, and supervision with supervisors, peers,
and interprofessional team members to guide professional judgments.
Competency 2 –Advance Human Rights and Social, Economic, and Environmental Justice
Advanced practice social workers understand that every person has fundamental human rights
and advocates 9/5/23, 10:17 AM Student Learning Contract
https://www.alceasoftware.com/web2/form.php?formid=4254&print=1 3/9 for these rights as
well as social, racial, economic, and environmental justice. Social workers assess the role of
power and privilege and take action to address systemic and structural barriers affecting human
rights and justice. Through inclusion of clients and collaborating with partners, social workers
plan and develop interventions, programs, policies, and laws that are just. Social workers:
2.1 identify and use knowledge of relationship dynamics, including power differentials, to
advocate at multiple system levels for social, racial, economic, and environmental justice and
human rights;
2.2 engage in practices to promote social, racial, economic, and environmental justice and
human rights.
Competency 3 –Engage Anti-Racism, Diversity, Equity, and Inclusion (ADEI) in Practice Advanced
practice social workers apply knowledge of diversity and difference in understanding the
intersectionality of power, privilege, oppression, discrimination, marginalization, disparities, and
their impact on human experiences. Social workers practice using a cultural humility framework,
incorporating critical reflection, self-awareness, self-regulation, and discovery, to build positive
relationships while also addressing power imbalances. Social workers understand how various
dimensions of diversity, equity, and belonging impact health, well-being, and the human
experience as well as the social work practice process. Social workers:
3.1 understand diversity and difference, including the intersectionality of power, privilege,
oppression, discrimination, marginalization, and disparities, and their impact on human
experience
3.2 demonstrate cultural humility incorporating critical reflection, self-awareness, selfregulation, and discovery;
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3.3 demonstrate anti-racist and anti-oppressive social work practice by applying concepts of
diversity, equity, and belonging throughout the social work practice process including
engagement, assessment, intervention, and evaluation.
Competency 4 –Engage In Practice-Informed Research and Research-Informed Practice Advanced
practice social workers use ethical, culturally informed, anti-racist, and anti-oppressive
approaches to contribute to the knowledge base, including conducting research and program
evaluation, and make practice decisions. Aligned with an evidence-based practice approach,
advanced practice social workers access, critique, and synthesize salient empirical evidence to
inform practice
4.1 access, analyze, critique, and synthesize evidence to inform social work practice, programs,
and policies from an evidence-based practice approach;
4.2 use ethical, culturally informed, anti-racist, and anti-oppressive approaches to contribute to
the knowledge base of the social work profession
Competency 5 –Engage in Policy Practice Advanced practice social workers use advocacy
methods to analyze, formulate, and implement policies that advance health, well-being, and the
human experience. Advanced social workers approach policy formulation, analysis,
implementation, and evaluation within practice settings through rights-based, antioppressive,
and anti-racist approaches.
5.1 apply critical thinking to analyze, formulate, and advocate for policies that advance health,
wellbeing, and the human experience;
5.2 approach policy formulation, analysis, implementation, and evaluation within practice
settings through rights-based, anti-oppressive, and anti-racist approaches
Competency 6 –Engage with Individuals, Families, Groups, Organizations, and Communities
Advanced practice social workers engage client systems by understanding and applying a range
of appropriate theories, such as human behavior; perspectives, such as person-in-environment;
and frameworks, such as interprofessional. To foster engagement, social workers apply the
principles of relationship building while recognizing the dynamic, interactive, and reciprocal
process of engagement with diverse populations including bias, power, and privilege.
6.1 apply knowledge of human behavior and the social environment, person-in-environment,
interprofessional, and other theoretical perspectives and frameworks to engage with client
systems;
6.2 manage the dynamics and contextual factors, including bias, power, and privilege, that
influence relationship building with client systems through empathy, reflection, and
interpersonal skills
Competency 7 –Assess Individuals, Families, Groups, Organizations, and Communities Advanced
practice social workers have the knowledge and skills, including in theoretical perspectives and
frameworks, to conduct comprehensive assessments that include an understanding of
intersectionality issues as they impact the client experience. Social workers select appropriate
methods and processes for assessment based on client need and specific context. Social workers
consider multiple sources of data and actively collaborate with others in the assessment process.
Social workers are self reflective and understand how bias, power, privilege, and their personal
values and experiences may affect their assessment and decision making. Social workers:
7.1 apply relevant theoretical perspectives, knowledge, and skills to conduct comprehensive
assessments;
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7.2 engage in self-reflection and cultural humility to understand how bias, power, privilege, and
personal values and experiences affect assessment processes;
7.3 consider multiple sources of data including active collaboration with others to gather
necessary information;
7.4 develop mutually agreed upon goals and intervention strategies based on continuous
assessment
Competency 8 –Intervene with Individuals, Families, Groups, Organizations, and Communities
Advanced practice social workers use theoretical and empirical knowledge to develop and
implement an assessment-based intervention plan that is culturally responsive and clientcentered. Advanced social workers identify, critique, and implement evidence-based techniques,
strategies, and to achieve goals. Social workers:
8.1 apply critical thinking and understanding of theoretical and empirical knowledge in
identifying interventions;
8.2 develop and implement an intervention plan that is culturally responsive and client centered;
Competency 9 –Evaluate Practice with Individuals, Families, Groups, Organizations, and
Communities Advanced practice social workers evaluate processes and outcomes to promote
service, practice, and policy effectiveness. In evaluating practice, social workers apply evidencebased practice principles, relevant theoretical perspectives, and an anti-racist and antioppressive approach. Evaluation results and plan are disseminated to relevant systems,
collaborators, and stakeholders. Social workers:
9.1 evaluate the social work processes and outcomes to promote effectiveness;
9.2 approach evaluation from an evidence-based, anti-racist and anti-oppressive approach
informed by relevant theoretical perspectives;
9.3 disseminate evaluation findings and plan to relevant systems, collaborators, and
stakeholders.
I had the opportunity to shadow my field supervisor at her 2nd Job and loved it. Adult
outpatient therapy with Rochester Regional Health in Canandaigua, NY. It was a nice change
from doing my internship in CPEP.
https://www.rochesterregional.org/services/behavioral-health
Information on where I did my 1 day inpatient internship….
At Rochester Regional Health, our philosophy is to meet and accept every individual wherever
they are in their path of recovery. Our multidisciplinary team will work with you or your loved
one to develop an individualized treatment plan. This plan works to meet your specific needs to
allow a safe return home or to a less restrictive level of care as soon as the patient is ready.
Mental Health Conditions We Treat
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Suicidal Thoughts or Actions
If you or a loved one are struggling with suicidal thoughts or actions, it is not too late to seek
help. In times of crisis, the Suicide and Crisis Lifeline at 988 is an excellent resource. And in
times of non-crisis, the mental health providers at Rochester Regional are here to help you
reframe your thoughts and separate your emotions from your actions.
Learn about our Suicidal Ideation services
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Anxiety
Anxiety is the most common mental health illness, taking your normal reaction to stress and
involving excessive anxiety or fear. With the help of our mental health providers, you can find
lasting, highly-effective treatments personalized for you.
Learn about our Anxiety services
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Schizophrenia
Schizophrenia can present with any number of symptoms and affects each person differently.
Our knowledgeable mental health providers prioritize continuing education to ensure we can
provide accurate diagnosis and individualized schizophrenia treatment.
Rochester Regional Health – Canandaigua
Address: 35 North Street – Canandaigua, NY
General Phone Number: 585-394-0530
Admissions Phone Number: 585-922-9900
Website: http://www.rochesterregional.org
Facility Type
Rochester Regional Health provides the following mental health rehabilitation services in
Canandaigua.
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Mental Health Treatment
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Provides Addiction Treatment
Rochester Regional Health is run by a private for-profit organization.
Service Settings (e.g., Outpatient, Residential, Inpatient, etc.)
Rochester Regional Health provides treatment in the following settings.
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Outpatient mental health rehabiliation
Emergency Mental Health Services
Rochester Regional Health provides the following emergency mental health treatment and
services.
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We do not have any information about emergency services provided by this facility.
Mental Health Treatment Approaches
Rochester Regional Health utilizes the following treatment approaches.
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Behavior modification
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Cognitive behavioral therapy
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Dialectical behavior therapy
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Eye Movement Desensitization and Reprocessing therapy
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Group therapy
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Individual psychotherapy
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Trauma therapy
Pharmacotherapies & Medications
Rochester Regional Health utilizes the following pharmacotherapies & medications in the
treatment process.
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Fluphenazine (Prolixin®)
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Haloperidol (Haldol®)
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Loxapine (Loxitane®)
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Perphenazine (Trilafon/Etrafon/Triavil/Triptafen®)
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Pimozide (Orap®)
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Trifluoperazine (Stelazine®)
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Aripiprazole (Abilify®)
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Asenapine (Saphris/Sycrest®)
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Brexpiprazole (Rexulti®)
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Cariprazine (Vraylar®)
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Clozapine (Clozaril®)
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Lurasidone (Latuda®)
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Olanzapine (Zyprexa®)
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Olanzapine/Fluoxetine combination (Symbyax®)
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Paliperidone (Invega Trinza®)
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Quetiapine (Seroquel®)
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Risperidone (Risperdal®)
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Ziprasidone (Geodon®)
Payment Information
Information regarding payment(s) accepted at Rochester Regional Health and possible financial
assistance.
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Medicare
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Medicaid
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Private Insurance
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Cash or Self Payment
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State-Financed Healthcare Plan Other Than Medicaid
Special Programs / Groups Offered
Information regarding specialty programs and groups offered at Rochester Regional Health.
Screening & Testing
Rochester Regional Health offers the following screening and testing services to mental health
clients.
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There is no information provided regarding screening at Rochester Regional Health
Ancillary Services
Rochester Regional Health provides the following ancillary services in addition to mental health
treatment.
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Court-ordered outpatient treatment
My future goal as an MSW is to work in Private Practice
In my private practice, I would like to focus on trauma work, PTSD, and Work with Sexual assault victims
of substance abuse.
I am currently doing my internship for my MSW at Clifton Springs Hospital CPEP but had an opportunity
to work in Rochester Regional outpatient counseling in Canandaigua, NY.
My class Assignment
The reflective journal is a tool for cultivating your personal-professional self and should focus on the
competencies and knowledge you are learning in your field practicum (about yourself, others, social
problems, helping relationships, social change &/or social work practice). Its contents should include the
following:
1. Reflections on how you see yourself as a developing social worker.
2. Reflections on your understanding of your personal values and the values and ethics of our
profession.
3. Reflections on the parallel processes you are experiencing with supervision and practice.
4. Specifically address Cultural Diversity and Cultural Humility
Self-Assessment of Journals
I believe self-evaluation and assessment is a valuable tool to support equity in learning. You will be asked
to self-assess the quality of your work on these journals. When journals are submitted, you will also be
required to submit a self-assessment using the rubric provided in this syllabus. Both a point value and
supporting comments are required for each area of the rubric. I will still be providing my own feedback
and numeric rating, and where our numeric values differ, I will average the two in calculating the total
grade for the assignment. The rubric must be completed before the assignment will be assessed by the
instructor. Highlighted areas of the rubric are the ones that the student completes.
MSW Field Seminar Reflective Journal Grading Rubric—
Student Name: _ Journal# ___2____
Assignment components
Reflection: (Please check those areas that are
addressed in journal)
___ (1) Reflections on, and reactions to, both the
content and process of our seminar sessions (drawing
implications for your developing personal-professional
self and future social work practice);
Student
Numeric(points) __5___(out of 5)
Comments that support this rating –
_ (2) Reflections on how you are seeing yourself as a
developing social worker;
___ (3) Reflections on your understanding of your
personal values and the values and ethics of our
profession;
___ (4) Reflections on the parallel processes you are
experiencing with supervision and practice;
______________________________________
Instructor
Numeric(points) _____(out of 5)
___ (5) Reflections on how you are integrating content
and readings from all social work courses and their
relationship to field practicum experiences.
Point Values:
Meets Expectations (5-4) Points: Addresses in
detail at least three reflection areas and provides
clear examples
Partially Meets Expectations (3-2) Points:
Addresses at least 2 reflective examples in some
depth, limited examples
Does not Meet Expectations (1-0) Points:
Limited or no reflection provided
Competence and Practice Behaviors: Show
relevance to practice behaviors and competencies and
progress/obstacles in achieving the objectives
Reflections on your development towards achieving
practice behavior competence (e.g. areas of tension and
challenges, as well as ah ha moments and discussion
about how you are developing in your practice
knowledge and skills).
Point Values:
Meets Expectations (2) Points: Provides
relevance and discusses progress and /or obstacles
Partially Meets Expectations (1) Points: Lists
relevance to practices behaviors but does not
describe progress/obstacles
Does not Meet Expectations (0) Points: Does
not address
Comments that support this rating-
Averaged Score___
Student
Numeric(points) __2___(out of 2)
Comments that support this rating
______________________________________
Instructor
Numeric(points) _____(out of 2)
Comments that support this rating-
Averaged Score___
Quality of Writing & Use of Literature to Support
Statements: Journals will be assessed based on the
quality of writing, including organization, clarity,
sentence structure, spelling, grammar etc.
Journals require a minimum of two references from
the professional literature, such as social work
journals or texts using the appropriate APA format.
Point Values:
Meets Expectations (3-2) Points: Effectively
communicates ideas and information in an
organized manner, well written.
Uses at least two references with appropriate APA
format
Partially Meets Expectations (1) Points:
Generally clear presentation with occasional
inconsistencies in format & other mechanics of
writing & /or some citing format error; Uses only
1 reference
Does not Meet Expectations (0) Points:
Inconsistent presentation errors in grammar,
spelling; No references used
Final Score: ___________/10
Student
Numeric(points) __3___(out of 3)
Comments that support this rating
______________________________________
Instructor
Numeric(points) _____(out of 3)
Comments that support this rating-
Averaged Score___
Can you summarize the Practicum Clinical Journal #1 information into a PowerPoint presentation? For the slides, I recommend about 22 substantive slides using EACH subtopic outlined in the rubric below for at least 1 substantive PP slide plus a title slide and references slides.
The chief complaint slide, for example, would only have the patient quote. If information becomes too voluminous it can be included in the slide notes.
Clinical Journal Rubric
Clinical Journal Rubric
Criteria
Ratings
Pts
Chief Complaint – Patient’s presenting complaint
view longer description
2 pts
Chief Complaints identifies reason for the visit
1 pts
Chief Complaint does not identify reason for the visit
0 pts
No Chief Complaint
1 / 2 pts
History of Present Illness – Symptom analysis for each complaint. Assessment elements to be documented will include: Associated symptoms, onset, duration, quality, severity, presence or absence of stressors, factors that alleviate or exacerbate symptoms, functional ability
view longer description
4 pts
Full symptoms assessment for each complaint
4 points
3 pts
Majority of symptom analysis is evident for each complaint
3 points
2 pts
Partial symptom analysis for each complaint
2-1
0 pts
No symptom assessment
0 points
2 / 4 pts
Psychiatric Review of Symptoms (Psych ROS) – Asks about symptoms for Depression, Mania, GAD, Panic, OCD, Trauma, Social anxiety, phobias, Hallucinations, Delusions, ADHD, disordered eating
view longer description
4 pts
Completes a full Psych ROS
4 points
3 pts
Addresses most of Psych ROS (has 7 or more components)
3 points
2 pts
Addresses partial Psych ROS (has less than 7 components)
2-1 points
0 pts
No Psych ROS
0 points
4 / 4 pts
Safety Assessment – Includes suicidal ideation/homicidal, access to weapons, past suicidal/homicidal attempts, other risk factors
view longer description
3 pts
Detailed safety assessment
3 points
2 pts
Partial Safety Assessment
2 points
1 pts
Safety Assessment needs improvement
1 point
0 pts
No safety assessment
0 Points
2 / 3 pts
Substance Abuse history – Includes detail of each substance used, last used and past interventions (rehab, groups)
view longer description
3 pts
Detailed substance abuse history
2 points
2 pts
Substance Abuse history mostly complete
2 points
1 pts
Substance Abuse history need improvement
1 point
0 pts
No substance abuse history
0 Points
2 / 3 pts
Past Psychiatric History – Includes past therapy, psychiatry, hospitalizations, past psychiatric medications
view longer description
3 pts
Detailed Past Psychiatric History
3 points
2 pts
Past Psychiatric History mostly complete
2 points
1 pts
Past Psychiatric History needs improvement
1 Point
0 pts
No Past Psychiatric History
0 Points
3 / 3 pts
Past Medical History – Includes last PE, current medical conditions, hx of surgeries, current non-psychiatric medications
view longer description
3 pts
Has detailed Past Medical History
3 Points
2 pts
Past Medical History is mostly complete
2 points
1.2 pts
Past Medical History needs improvement
1 point
0 pts
No Past Medical History
0 Points
3 / 3 pts
Medical Review of Systems – Includes Constitution, EENT, Cardiovascular, Respiratory, Gastrointestinal, Genitourinary, Musculoskeletal, Integumentary, Endocrine, Neurological, Immunological, Reproductive, and Hematological Systems
view longer description
3 pts
Has >90% of Medical Review of Systems accurately documented
3 points
2 pts
Has 50% of Medical ROS accurately documented
2 Points
1 pts
Has less than 50% of Medical ROS or system documentation is very limited
1 Point
0 pts
No Family History
0 Points
3 / 3 pts
Family History – Includes family psychiatric and pertinent medical history, family substance abuse, family legal history, family SI/HI history
view longer description
3 pts
Has complete Family history
3 points
2 pts
Family history mostly complete
2 points
1 pts
Family History needs improvement
1 point
0 pts
No Family History
0 Points
3 / 3 pts
Developmental History – Includes childhood development, childhood home atmosphere, educational history, employment history
view longer description
3 pts
Has complete Developmental History
3 Points
2 pts
Developmental History is mostly complete
2 Points
1 pts
Developmental History needs improvement
1 Point
0 pts
No Developmental History
0 Points
3 / 3 pts
Social History – Includes relationship (SO, Family), current supports, spirituality, hobbies, future plans
view longer description
3 pts
Has full Social History
3 Points
2 pts
Has most of Social History
2 points
1 pts
Social History needs improvement
1 Point
0 pts
No Social History
0 points
3 / 3 pts
PE & Objective Information Includes VS, Wt/Ht, BMI, Labs and any other pertinent information (i.e. screenings if present) If labs are not available, documents what labs they would like to see for this patient
view longer description
2 pts
Full PE and labs documented
2 points
1 pts
Partial PE
1 Points
0 pts
No PE or Labs
0 Points
2 / 2 pts
Mental Status Examination (MSE) – Includes Appearance, Behavior, Attitude, Speech, Affect, Mood, Thought Process & Content, Attention, Memory, Orientation, Memory, Abstraction, Intelligence, Insight, Judgment
view longer description
8 pts
Complete components of MSE accurately
8 Points
6 pts
Documents the majority of MSE components accurately
7-6 Points
4 pts
Documents half the components of MSE accurately
5-4 Points
2 pts
Documents less than half MSE components accurately
2-1 Points
0 pts
No MSE
0 Points
6 / 8 pts
Diagnostic Formulation – The diagnosis(es) flow from the histories and exam. Each diagnosis has rationale and supporting evidence taken from the histories/Exam
view longer description
18 pts
>90% diagnosis(es) are addressed in a clear and organized manner, including rationale for each Dx that is supported by the histories/exam
18 Points
11 pts
Majority of diagnosis(es) are addressed in a clear and organized manner, limited rationale or supporting evidence for each Dx
17-11 Point
6 pts
Diagnosis(es) addressed but lacking organization and wordy, no rationale for each Dx
10-6 Points
1 pts
Diagnosis(es) identified in brief manner; No rationale for each Dx OR inaccurate Dx
5-1 Points
0 pts
No Diagnostic Formunlation
0 Points
11 / 18 pts
Differential Diagnosis(es) – Includes possible diagnosis(es) identified in histories but missing criteria to rule in completely, gives rationale for each DDx
view longer description
10 pts
All Differential Diagnosis(es) identified from the history and rationale is documented in a clear and concise manner
10 Points
5 pts
Partial Differential Diagnosis(es) identified from the histories and rationale documented in a clear and concise manner
9-5 Points
1 pts
Has limited rationale documented for identified DDx
4-1 Points
0 pts
No DDx identified
0 Points
4 / 10 pts
Problem List – Includes the ICD-10 and DSM diagnostic codes for all Dx, DDx and medical dx identified
view longer description
2 pts
All codes are listed for identified Dx & DDx
2 Points
1 pts
Missing ICD-10 and DSM codes
1 Point
0 pts
No Codes Listed
0 points
Comments
Make the problem list just a list with ICD’s
1 / 2 pts
Treatment Planning: Pharmacological – Identifies appropriate medication(s) for identified Diagnosis(es); Written as a script, including medication name, dose, sig, refills
view longer description
4 pts
Has appropriate use of pharmacological intervention written in the form of script
4 Points
2 pts
Has medication identified but missing dose and sig OR Potential dangerous interactions with other medications
Points 3-2
1 pts
Incorrect use or incorrect dose of medication(s) OR possible contraindications
1 Point
0 pts
No medications identified
0 Points
4 / 4 pts
Treatment Planning: Non-pharmacological – Includes referrals, therapies, other interventions (i.e. exercise, support groups)
view longer description
4 pts
Identifies comprehensive list of non-pharmacological interventions for pt need
4 Points
1 pts
Identified Partial list of non-pharmacological interventions for pt need
3-1 Points
0 pts
No Non-pharmacological Interventions identified
0 Points
4 / 4 pts
Treatment Planning: Education – Includes disease prognosis, medication education (side effects, administration, off label use), safety planning, nutrition, sleep hygiene, how to reach provider….
view longer description
4 pts
Addresses all educational needs
4 Points
2 pts
Addresses the majority of educational needs
3-2 Points
1 pts
Educational needs addressed but needs improvement
1 Point
0 pts
No educational needs addressed
0 Points
4 / 4 pts
Psychopharmacology Rationale (Psychiatric Meds Only) – Thorough explanation that includes medication class, mechanism of action, side effects, black box warnings, contraindications. Also includes rationale as to why each medication was chosen for this patient. Uses high quality evidence based resources to support medication choices
view longer description
5 pts
Includes all elements listed and full rationale for medication(s) chosen
5 Points
4 pts
Includes most elements addressed and rationale for medication(s) chosen
4 Points
3 pts
For each medication chosen has several missing elements and/or brief to no rationale
3-1 Points
0 pts
No psychopharmacology rationale provided
0 Points
5 / 5 pts
Reflection and Supervision Log – Reflection includes what you have learned from clinical encounter, questions regarding clinical issues, thoughts on challenges, problems, successes, and your progress toward Class Objectives Supervision includes the number of hours of supervision obtained since your last clinical journal and a summary of what was discussed with your preceptor
view longer description
3 pts
Includes both Weekly Reflection that includes progress toward clinical objectives and Supervision Log
3 Points
2 pts
Includes weekly reflection and Supervision logs, does not address progress toward clinical objectives
2 Points
1.8 pts
Missing either Weekly Reflection or Clinical Supervision Log
1 Point
0 pts
No Weekly Reflection or Clinical Supervision Log
0 Points
3 / 3 pts
Overall Note – Note is organized, succinct, clear understanding of subjective and objective data. Grammar and punctuation are correct. If references used, APA format is correct
view longer description
6 pts
Note is organized, succinct, clear understanding of subjective and objective data. Grammar and punctuation are correct
6 Points
3 pts
Note is somewhat organized, succinct, clear understanding of subjective and objective data. And/or mistakes in grammar and punctuation, if references used has mistakes in APA format
5-1
0 pts
Poor organization of note, use of grammar/puncuation
0 Points
3 / 6 pts
Total Points: 76
Unformatted Attachment Preview
RE: PowerPoint Presentation
Can you summarize the Practicum Clinical Journal #1 information into a PowerPoint
presentation? For the slides, I recommend about 22 substantive slides using
EACH subtopic outlined in the rubric below for at least 1 substantive PP slide plus a title
slide and references slides.
The chief complaint slide, for example, would only have the patient quote. If information
becomes too voluminous it can be included in the slide notes.
Clinical Journal Rubric
Clinical Journal Rubric
Criteria
Ratings
Pts
Chief Complaint – Patient’s presenting
2 pts
1/
complaint
2
Chief Complaints identifies
view longer description
pts
reason for the visit
1 pts
Chief Complaint does not
identify reason for the visit
0 pts
No Chief Complaint
History of Present Illness – Symptom analysis
4 pts
for each complaint. Assessment elements to be
documented will include: Associated symptoms,
onset, duration, quality, severity, presence or
absence of stressors, factors that alleviate or
exacerbate symptoms, functional ability
2/
4
Full symptoms assessment for
each complaint
4 points
pts
Clinical Journal Rubric
Criteria
Ratings
view longer description
3 pts
Pts
Majority of symptom analysis is
evident for each complaint
3 points
2 pts
Partial symptom analysis for
each complaint
2-1
0 pts
No symptom assessment
0 points
Psychiatric Review of Symptoms (Psych ROS) –
4 pts
Asks about symptoms for Depression, Mania,
GAD, Panic, OCD, Trauma, Social anxiety,
phobias, Hallucinations, Delusions, ADHD,
4/
4
Completes a full Psych ROS
4 points
disordered eating
3 pts
view longer description
Addresses most of Psych ROS
(has 7 or more components)
3 points
2 pts
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
Addresses partial Psych ROS
(has less than 7 components)
2-1 points
0 pts
No Psych ROS
0 points
Safety Assessment – Includes suicidal
3 pts
ideation/homicidal, access to weapons, past
suicidal/homicidal attempts, other risk factors
view longer description
2/
3
Detailed safety assessment
3 points
2 pts
Partial Safety Assessment
2 points
1 pts
Safety Assessment needs
improvement
1 point
0 pts
No safety assessment
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
0 Points
Substance Abuse history – Includes detail of
3 pts
each substance used, last used and past
interventions (rehab, groups)
view longer description
2/
3
Detailed substance abuse history
pts
2 points
2 pts
Substance Abuse history mostly
complete
2 points
1 pts
Substance Abuse history need
improvement
1 point
0 pts
No substance abuse history
0 Points
Past Psychiatric History – Includes past therapy, 3 pts
3/
psychiatry, hospitalizations, past psychiatric
3
medications
view longer description
Detailed Past Psychiatric History
3 points
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
2 pts
Past Psychiatric History mostly
complete
2 points
1 pts
Past Psychiatric History needs
improvement
1 Point
0 pts
No Past Psychiatric History
0 Points
Past Medical History – Includes last PE, current 3 pts
3/
medical conditions, hx of surgeries, current non-
3
psychiatric medications
Has detailed Past Medical
History
view longer description
3 Points
2 pts
Past Medical History is mostly
complete
2 points
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
1.2 pts
Past Medical History needs
improvement
1 point
0 pts
No Past Medical History
0 Points
Medical Review of Systems – Includes
3 pts
Constitution, EENT, Cardiovascular,
Respiratory, Gastrointestinal, Genitourinary,
Musculoskeletal, Integumentary, Endocrine,
3/
3
Has >90% of Medical Review of
Systems accurately documented
Neurological, Immunological, Reproductive, and 3 points
Hematological Systems
2 pts
view longer description
Has 50% of Medical ROS
accurately documented
2 Points
1 pts
Has less than 50% of Medical
ROS or system documentation is
very limited
1 Point
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
0 pts
No Family History
0 Points
Family History – Includes family psychiatric and 3 pts
3/
pertinent medical history, family substance
3
abuse, family legal history, family SI/HI history
view longer description
Has complete Family history
pts
3 points
2 pts
Family history mostly complete
2 points
1 pts
Family History needs
improvement
1 point
0 pts
No Family History
0 Points
Developmental History – Includes childhood
3 pts
development, childhood home atmosphere,
educational history, employment history
3/
3
Has complete Developmental
pts
Clinical Journal Rubric
Criteria
Ratings
view longer description
History
Pts
3 Points
2 pts
Developmental History is mostly
complete
2 Points
1 pts
Developmental History needs
improvement
1 Point
0 pts
No Developmental History
0 Points
Social History – Includes relationship (SO,
3 pts
Family), current supports, spirituality, hobbies,
future plans
view longer description
3/
3
Has full Social History
3 Points
2 pts
Has most of Social History
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
2 points
1 pts
Social History needs
improvement
1 Point
0 pts
No Social History
0 points
PE & Objective Information Includes VS,
2 pts
Wt/Ht, BMI, Labs and any other pertinent
information (i.e. screenings if present) If labs
are not available, documents what labs they
2/
2
Full PE and labs documented
pts
2 points
would like to see for this patient
1 pts
view longer description
Partial PE
1 Points
0 pts
No PE or Labs
0 Points
Mental Status Examination (MSE) – Includes
Appearance, Behavior, Attitude, Speech, Affect,
8 pts
6/
8
Clinical Journal Rubric
Criteria
Ratings
Pts
Mood, Thought Process & Content, Attention,
Complete components of MSE
pts
Memory, Orientation, Memory, Abstraction,
accurately
Intelligence, Insight, Judgment
8 Points
view longer description
6 pts
Documents the majority of MSE
components accurately
7-6 Points
4 pts
Documents half the components
of MSE accurately
5-4 Points
2 pts
Documents less than half MSE
components accurately
2-1 Points
0 pts
No MSE
0 Points
Diagnostic Formulation – The diagnosis(es) flow 18 pts
11
from the histories and exam. Each diagnosis has
/
>90% diagnosis(es) are
Clinical Journal Rubric
Criteria
Ratings
Pts
rationale and supporting evidence taken from
addressed in a clear and
18
the histories/Exam
organized manner, including
pts
rationale for each Dx that is
view longer description
supported by the histories/exam
18 Points
11 pts
Majority of diagnosis(es) are
addressed in a clear and
organized manner, limited
rationale or supporting evidence
for each Dx
17-11 Point
6 pts
Diagnosis(es) addressed but
lacking organization and wordy,
no rationale for each Dx
10-6 Points
1 pts
Diagnosis(es) identified in brief
manner; No rationale for each
Dx OR inaccurate Dx
5-1 Points
Clinical Journal Rubric
Criteria
Ratings
Pts
0 pts
No Diagnostic Formunlation
0 Points
Differential Diagnosis(es) – Includes possible
10 pts
diagnosis(es) identified in histories but missing
criteria to rule in completely, gives rationale for
each DDx
10
All Differential Diagnosis(es)
identified from the history and
rationale is documented in a
view longer description
4/
clear and concise manner
10 Points
5 pts
Partial Differential Diagnosis(es)
identified from the histories and
rationale documented in a clear
and concise manner
9-5 Points
1 pts
Has limited rationale
documented for identified DDx
4-1 Points
0 pts
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
No DDx identified
0 Points
Problem List – Includes the ICD-10 and DSM
2 pts
diagnostic codes for all Dx, DDx and medical dx
identified
1/
2
All codes are listed for identified
pts
Dx & DDx
view longer description
2 Points
1 pts
Missing ICD-10 and DSM codes
1 Point
0 pts
No Codes Listed
0 points
Comments
Make the problem list just a list
with ICD’s
Treatment Planning: Pharmacological –
4 pts
Identifies appropriate medication(s) for
identified Diagnosis(es); Written as a script,
including medication name, dose, sig, refills
4/
4
Has appropriate use of
pharmacological intervention
written in the form of script
pts
Clinical Journal Rubric
Criteria
Ratings
view longer description
4 Points
Pts
2 pts
Has medication identified but
missing dose and sig OR
Potential dangerous interactions
with other medications
Points 3-2
1 pts
Incorrect use or incorrect dose of
medication(s) OR possible
contraindications
1 Point
0 pts
No medications identified
0 Points
Treatment Planning: Non-pharmacological –
4 pts
Includes referrals, therapies, other interventions
(i.e. exercise, support groups)
4
Identifies comprehensive list of
non-pharmacological
view longer description
4/
interventions for pt need
4 Points
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
1 pts
Identified Partial list of nonpharmacological interventions
for pt need
3-1 Points
0 pts
No Non-pharmacological
Interventions identified
0 Points
Treatment Planning: Education – Includes
4 pts
disease prognosis, medication education (side
effects, administration, off label use), safety
planning, nutrition, sleep hygiene, how to reach
4/
4
Addresses all educational needs
4 Points
provider….
2 pts
view longer description
Addresses the majority of
educational needs
3-2 Points
1 pts
Educational needs addressed but
needs improvement
1 Point
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
0 pts
No educational needs addressed
0 Points
Psychopharmacology Rationale (Psychiatric
5 pts
Meds Only) – Thorough explanation that
includes medication class, mechanism of action,
side effects, black box warnings,
contraindications. Also includes rationale as to
5/
5
Includes all elements listed and
full rationale for medication(s)
chosen
why each medication was chosen for this patient. 5 Points
Uses high quality evidence based resources to
support medication choices
4 pts
view longer description
Includes most elements
addressed and rationale for
medication(s) chosen
4 Points
3 pts
For each medication chosen has
several missing elements and/or
brief to no rationale
3-1 Points
0 pts
No psychopharmacology
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
rationale provided
0 Points
Reflection and Supervision Log – Reflection
3 pts
includes what you have learned from clinical
encounter, questions regarding clinical issues,
thoughts on challenges, problems, successes, and
your progress toward Class Objectives
Supervision includes the number of hours of
supervision obtained since your last clinical
3/
3
Includes both Weekly Reflection
that includes progress toward
clinical objectives and
Supervision Log
3 Points
journal and a summary of what was discussed
with your preceptor
2 pts
view longer description
Includes weekly reflection and
Supervision logs, does not
address progress toward clinical
objectives
2 Points
1.8 pts
Missing either Weekly
Reflection or Clinical
Supervision Log
1 Point
0 pts
No Weekly Reflection or
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
Clinical Supervision Log
0 Points
Overall Note – Note is organized, succinct, clear
6 pts
understanding of subjective and objective data.
Grammar and punctuation are correct. If
references used, APA format is correct
6
Note is organized, succinct, clear
understanding of subjective and
objective data. Grammar and
view longer description
punctuation are correct
6 Points
3 pts
Note is somewhat organized,
succinct, clear understanding of
subjective and objective data.
And/or mistakes in grammar and
punctuation, if references used
has mistakes in APA format
5-1
0 pts
Poor organization of note, use of
grammar/puncuation
0 Points
Total Points: 76
3/
pts
Clinical Journal Rubric
Clinical Journal Rubric
Criteria
Ratings
Pts
Chief Complaint – Patient’s presenting complaint
view longer description
2 pts
Chief Complaints
identifies reason for
the visit
1 pts
Chief Complaint
does not identify
reason for the visit
0 pts
No Chief Complaint
1 / 2 pts
History of Present Illness – Symptom analysis for
each complaint. Assessment elements to be
documented will include: Associated symptoms,
onset, duration, quality, severity, presence or
absence of stressors, factors that alleviate or
exacerbate symptoms, functional ability
view longer description
4 pts
Full symptoms
assessment for each
complaint
4 points
3 pts
Majority of
symptom analysis is
evident for each
complaint
3 points
2 pts
Partial symptom
analysis for each
complaint
2-1
0 pts
No symptom
assessment
0 points
2 / 4 pts
Psychiatric Review of Symptoms (Psych ROS) Asks about symptoms for Depression, Mania, GAD,
Panic, OCD, Trauma, Social anxiety, phobias,
Hallucinations, Delusions, ADHD, disordered
eating
view longer description
4 pts
Completes a full
Psych ROS
4 points
3 pts
Addresses most of
Psych ROS (has 7 or
4 / 4 pts
Clinical Journal Rubric
Criteria
Ratings
Pts
more components)
3 points
2 pts
Addresses partial
Psych ROS (has less
than 7 components)
2-1 points
0 pts
No Psych ROS
0 points
Safety Assessment – Includes suicidal
ideation/homicidal, access to weapons, past
suicidal/homicidal attempts, other risk factors
view longer description
3 pts
Detailed safety
assessment
3 points
2 pts
Partial Safety
Assessment
2 points
1 pts
Safety Assessment
needs improvement
1 point
0 pts
No safety assessment
0 Points
2 / 3 pts
Substance Abuse history – Includes detail of each
substance used, last used and past interventions
(rehab, groups)
view longer description
3 pts
Detailed substance
abuse history
2 points
2 pts
Substance Abuse
history mostly
complete
2 points
1 pts
Substance Abuse
history need
improvement
1 point
2 / 3 pts
Clinical Journal Rubric
Criteria
Ratings
Pts
0 pts
No substance abuse
history
0 Points
Past Psychiatric History – Includes past therapy,
psychiatry, hospitalizations, past psychiatric
medications
view longer description
3 pts
Detailed Past
Psychiatric History
3 points
2 pts
Past Psychiatric
History mostly
complete
2 points
1 pts
Past Psychiatric
History needs
improvement
1 Point
0 pts
No Past Psychiatric
History
0 Points
3 / 3 pts
Past Medical History – Includes last PE, current
medical conditions, hx of surgeries, current nonpsychiatric medications
view longer description
3 pts
Has detailed Past
Medical History
3 Points
2 pts
Past Medical History
is mostly complete
2 points
1.2 pts
Past Medical History
needs improvement
1 point
0 pts
No Past Medical
History
0 Points
3 / 3 pts
Clinical Journal Rubric
Criteria
Ratings
Pts
Medical Review of Systems – Includes Constitution,
EENT, Cardiovascular, Respiratory,
Gastrointestinal, Genitourinary, Musculoskeletal,
Integumentary, Endocrine, Neurological,
Immunological, Reproductive, and Hematological
Systems
view longer description
3 pts
Has >90% of
Medical Review of
Systems accurately
documented
3 points
2 pts
Has 50% of Medical
ROS accurately
documented
2 Points
1 pts
Has less than 50% of
Medical ROS or
system
documentation is
very limited
1 Point
0 pts
No Family History
0 Points
3 / 3 pts
Family History – Includes family psychiatric and
pertinent medical history, family substance abuse,
family legal history, family SI/HI history
view longer description
3 pts
Has complete Family
history
3 points
2 pts
Family history
mostly complete
2 points
1 pts
Family History
needs improvement
1 point
0 pts
No Family History
0 Points
3 / 3 pts
Developmental History – Includes childhood
development, childhood home atmosphere,
educational history, employment history
3 pts
Has complete
Developmental
3 / 3 pts
Clinical Journal Rubric
Criteria
Ratings
view longer description
History
3 Points
2 pts
Developmental
History is mostly
complete
2 Points
1 pts
Developmental
History needs
improvement
1 Point
0 pts
No Developmental
History
0 Points
Pts
Social History – Includes relationship (SO, Family),
current supports, spirituality, hobbies, future plans
view longer description
3 pts
Has full Social
History
3 Points
2 pts
Has most of Social
History
2 points
1 pts
Social History needs
improvement
1 Point
0 pts
No Social History
0 points
3 / 3 pts
PE & Objective Information Includes VS, Wt/Ht,
BMI, Labs and any other pertinent information (i.e.
screenings if present) If labs are not available,
documents what labs they would like to see for this
patient
view longer description
2 pts
Full PE and labs
documented
2 points
1 pts
Partial PE
1 Points
0 pts
2 / 2 pts
Clinical Journal Rubric
Criteria
Ratings
Pts
No PE or Labs
0 Points
Mental Status Examination (MSE) – Includes
Appearance, Behavior, Attitude, Speech, Affect,
Mood, Thought Process & Content, Attention,
Memory, Orientation, Memory, Abstraction,
Intelligence, Insight, Judgment
view longer description
8 pts
Complete
components of MSE
accurately
8 Points
6 pts
Documents the
majority of MSE
components
accurately
7-6 Points
4 pts
Documents half the
components of MSE
accurately
5-4 Points
2 pts
Documents less than
half MSE
components
accurately
2-1 Points
0 pts
No MSE
0 Points
6 / 8 pts
Diagnostic Formulation – The diagnosis(es) flow
from the histories and exam. Each diagnosis has
rationale and supporting evidence taken from the
histories/Exam
view longer description
18 pts
>90% diagnosis(es)
are addressed in a
clear and organized
manner, including
rationale for each Dx
that is supported by
the histories/exam
18 Points
11 pts
Majority of
diagnosis(es) are
11 / 18
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
addressed in a clear
and organized
manner, limited
rationale or
supporting evidence
for each Dx
17-11 Point
6 pts
Diagnosis(es)
addressed but
lacking organization
and wordy, no
rationale for each Dx
10-6 Points
1 pts
Diagnosis(es)
identified in brief
manner; No rationale
for each Dx OR
inaccurate Dx
5-1 Points
0 pts
No Diagnostic
Formunlation
0 Points
Differential Diagnosis(es) – Includes possible
diagnosis(es) identified in histories but missing
criteria to rule in completely, gives rationale for
each DDx
view longer description
10 pts
All Differential
Diagnosis(es)
identified from the
history and rationale
is documented in a
clear and concise
manner
10 Points
5 pts
Partial Differential
Diagnosis(es)
identified from the
histories and
rationale
4 / 10
pts
Clinical Journal Rubric
Criteria
Ratings
Pts
documented in a
clear and concise
manner
9-5 Points
1 pts
Has limited rationale
documented for
identified DDx
4-1 Points
0 pts
No DDx identified
0 Points
Problem List – Includes the ICD-10 and DSM
diagnostic codes for all Dx, DDx and medical dx
identified
view longer description
2 pts
All codes are listed
for identified Dx &
DDx
2 Points
1 pts
Missing ICD-10 and
DSM codes
1 Point
0 pts
No Codes Listed
0 points
Comments
Make the problem
list just a list with
ICD’s
1 / 2 pts
Treatment Planning: Pharmacological – Identifies
appropriate medication(s) for identified
Diagnosis(es); Written as a script, including
medication name, dose, sig, refills
view longer description
4 pts
Has appropriate use
of pharmacological
intervention written
in the form of script
4 Points
2 pts
Has medication
identified but
missing dose and sig
OR Potential
4 / 4 pts
Clinical Journal Rubric
Criteria
Ratings
Pts
dangerous
interactions with
other medications
Points 3-2
1 pts
Incorrect use or
incorrect dose of
medication(s) OR
possible
contraindications
1 Point
0 pts
No medications
identified
0 Points
Treatment Planning: Non-pharmacological Includes referrals, therapies, other interventions
(i.e. exercise, support groups)
view longer description
4 pts
Identifies
comprehensive list
of nonpharmacological
interventions for pt
need
4 Points
1 pts
Identified Partial list
of nonpharmacological
interventions for pt
need
3-1 Points
0 pts
No Nonpharmacological
Interventions
identified
0 Points
4 / 4 pts
Treatment Planning: Education – Includes disease
prognosis, medication education (side effects,
administration, off label use), safety planning,
4 pts
Addresses all
educational needs
4 / 4 pts
Clinical Journal Rubric
Criteria
Ratings
nutrition, sleep hygiene, how to reach provider….
view longer description
4 Points
2 pts
Addresses the
majority of
educational needs
3-2 Points
1 pts
Educational needs
addressed but needs
improvement
1 Point
0 pts
No educational
needs addressed
0 Points
Psychopharmacology Rationale (Psychiatric Meds
Only) – Thorough explanation that includes
medication class, mechanism of action, side effects,
black box warnings, contraindications. Also
includes rationale as to why each medication was
chosen for this patient. Uses high quality evidence
based resources to support medication choices
view longer description
5 pts
Includes all elements
listed and full
rationale for
medication(s) chosen
5 Points
4 pts
Includes most
elements addressed
and rationale for
medication(s) chosen
4 Points
3 pts
For each medication
chosen has several
missing elements
and/or brief to no
rationale
3-1 Points
0 pts
No
psychopharmacology
rationale provided
0 Points
Pts
5 / 5 pts
Clinical Journal Rubric
Criteria
Ratings
Pts
Reflection and Supervision Log – Reflection
includes what you have learned from clinical
encounter, questions regarding clinical issues,
thoughts on challenges, problems, successes, and
your progress toward Class Objectives Supervision
includes the number of hours of supervision
obtained since your last clinical journal and a
summary of what was discussed with your
preceptor
view longer description
3 pts
Includes both
Weekly Reflection
that includes
progress toward
clinical objectives
and Supervision Log
3 Points
2 pts
Includes weekly
reflection and
Supervision logs,
does not address
progress toward
clinical objectives
2 Points
1.8 pts
Missing either
Weekly Reflection
or Clinical
Supervision Log
1 Point
0 pts
No Weekly
Reflection or
Clinical Supervision
Log
0 Points
3 / 3 pts
Overall Note – Note is organized, succinct, clear
understanding of subjective and objective data.
Grammar and punctuation are correct. If
references used, APA format is correct
view longer description
6 pts
Note is organized,
succinct, clear
understanding of
subjective and
objective data.
Grammar and
punctuation are
correct
6 Points
3 pts
Note is somewhat
3 / 6 pts
Clinical Journal Rubric
Criteria
Ratings
organized, succinct,
clear understanding
of subjective and
objective data.
And/or mistakes in
grammar and
punctuation, if
references used has
mistakes in APA
format
5-1
0 pts
Poor organization of
note, use of
grammar/puncuation
0 Points
Total Points: 76
Pts
Comprehensive Psychiatric Evaluation
Journal #1
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Practicum Clinical Journal #1
Date: October 5, 2023
Time started: 10:00 a.m.-11:30 a.m.
Site: Integrated Healthcare Services Behavioral Health/IHS BH
Level of Supervision: Primary (>50%)
Identifying Data
Patient Initials: AD
Age: 35 years
Gender: Female
Marital Status: Married
Religion: Unknown
Occupation: Office Manager
Language Spoken: English
Living Arrangements: Lives with spouse and two children in a condominium
Source and Reliability
Accompanied By: None; patient presented alone
Source of Information: Patient
Chief Complaint (CC):”Constant worrying and fear that something terrible is going to happen.”
History of Present Illness
AD states that for the past six months, she has been experiencing excessive worrying,
restlessness, and a constant sense of unease. She reports that these symptoms have been
progressively getting worse and have become increasingly intrusive, significantly affecting her
daily life and causing sleep disturbances. According to AD, the quality of her anxiety feels like
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an overwhelming sense of dread, and she describes it as a constant ‘knot in her stomach.’ She
rates the severity of her symptoms as 9 out of 10, emphasizing the profound impact on her
overall well-being. AD mentions that these symptoms have been persistent for the past six
months, indicating their chronic nature. She further reports that her anxiety seems unpredictable,
lacking any specific timing or context-dependent trigger, and it occurs even when there are no
apparent stressors. AD states that while she briefly finds relief through mindfulness exercises,
her anxiety quickly returns, and there are no consistent modifying factors that alleviate her
distress. Additionally, she reports experiencing associated physical manifestations, including
muscle tension, headaches, and gastrointestinal discomfort, which further contribute to her
distress.
Psychiatric Review of Symptoms (Psych ROS)
Depression: AD reports no feelings of depression, stating that she generally does not experience
prolonged periods of sadness or hopelessness. However, she states that she feels tired, has
trouble sleeping, and sometimes has low interest in doing things. Her PHQ score was 9.
Mania: AD states that she has not experienced any symptoms of mania, such as elevated mood,
excessive energy, or impulsivity. AD states that she is not easily irritable and denies any negative
thoughts. Her MDQ score was 4.
GAD (Generalized Anxiety Disorder): AD emphasizes that her primary concern leading to the
visit is her overwhelming and persistent anxiety, which she describes as a constant state of worry
and unease. She also adds that she is easily fatigued, irritable, difficulty in concentrating and
sleeps about 4 hours then wakes up continuously. The GAD-7 score for AD is 14, which is
moderate anxiety.
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Panic: AD reports occasional panic attacks, describing them as sudden and intense episodes of
extreme fear, palpitations, and shortness of breath. She mentions that these episodes can be
distressing and disruptive.
OCD (Obsessive-Compulsive Disorder): AD states that she has not been troubled by
obsessions or compelled to perform repetitive behaviors characteristic of OCD.
Trauma: AD firmly denies a history of trauma, indicating that she has not experienced any
significant traumatic events in her life.
Social Anxiety: AD does not mention specific social anxiety symptoms, suggesting that her
anxiety is not limited to social situations but is more generalized.
Phobias: AD does not identify any specific phobias or intense fears that trigger her anxiety.
Hallucinations: AD states that she has not experienced any hallucinations, indicating that she
does not perceive things that are not present.
Delusions: AD reports no delusions, affirming that she maintains a firm grip on reality.
ADHD (Attention-Deficit/Hyperactivity Disorder): AD mentions that she has not noticed
symptoms associated with ADHD, such as inattention, hyperactivity, or impulsivity.
Disordered Eating: AD states that she does not engage in any disordered eating behaviors, such
as binge eating, purging, or restrictive eating patterns.
Safety Assessment
Suicidal Ideation/Homicidal: AD firmly denies experiencing any current or past thoughts of
harming herself or others. She emphasizes that she has never entertained the idea of suicide or
homicidal actions throughout her life.
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Access to Weapons: AD states that there is no access to any weapons within her household. She
clarifies that her living environment is free from any firearms, sharp objects, or potentially
harmful items.
Past Suicidal/Homicidal Attempts: AD states that she has never made any suicidal or
homicidal attempts in the past. She reports that her history is void of any such actions,
reinforcing her commitment to her own safety and the safety of others.
Other Risk Factors: AD indicates that there are no other immediate risk factors of concern. She
does not mention any circumstances, relationships, or situations that could pose a risk to her
mental or emotional well-being.
Substance Abuse History
Alcohol: AD reports her alcohol consumption habits, describing occasional use typically limited
to social occasions. She clarifies that her alcohol intake is moderate and does not result in
excessive or problematic drinking.
Tobacco: AD denies any use of tobacco products, highlighting her non-smoker status.
Illicit Drugs: AD states that she has never engaged in the use of illicit drugs. She emphasizes her
commitment to a drug-free lifestyle.
Prescription Medications: AD indicates that she is currently taking oral contraceptives solely
for birth control purposes. She emphasizes that this medication is prescribed and used in
accordance with medical guidelines.
Past Psychiatric History: AD asserts that she has no prior history of psychiatric treatment or
medications. She states that her visit marks her first engagement with psychiatric evaluation and
intervention, implying that her current symptoms of anxiety are her first encounter with such
mental health concerns.
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Past Medical History
Insurance and Providers: AD is currently insured through XYZ Insurance. She states that she
had her comprehensive body check-up three years ago.
Medical History: AD reports that her primary care provider is Dr. Smith, and her psychiatrist is
Dr. Johnson. She states that she is currently under no medication. She indicated that yesterday
she took 400mg ibuprofen for her headache. She states that she took the medication once and the
headache subsided.
Seizure History:AD reports no history of seizures or epilepsy. She has never experienced
seizures, and there is no family history of seizure disorders.
Last Physical Examination: AD affirms that she underwent her most recent physical
examination within the past year, which was part of her routine check-up. This indicates her
commitment to regular health maintenance and suggests an active interest in monitoring her
physical well-being.
Current Medical Conditions:AD clearly states that she is not currently dealing with any
medical conditions. Her self-report is indicative of a generally healthy physical state, devoid of
any ongoing illnesses or health concerns.
OTC/Supplements: 400mg Ibuprofen yesterday for her headache. Denies being on any
supplements.
History of Surgeries: AD provides insight into her surgical history by mentioning that she
underwent an appendectomy at the age of 18. This information helps establish a comprehensive
medical background, highlighting a past surgical procedure that is relevant to her current health
status.
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Allergies: She states that she does not react to any drug or food. She adds that there are no
known environmental allergies.
Current Non-Psychiatric Medications: AD confirms that she is currently taking oral
contraceptives, specifically a combination of ethinyl estradiol and norgestimate, on a daily basis.
This medication, typically prescribed for birth control, is mentioned explicitly, demonstrating her
awareness of and adherence to prescribed non-psychiatric medications.
Medical Review of Systems
Constitutional: AD reports the absence of fever, weight loss, or fatigue. These observations are
essential in ruling out systemic illnesses that might present with these constitutional symptoms.
Her report suggests an overall sense of well-being in terms of general health.
HEENT (Head, Eyes, Ears, Nose, Throat):AD reports that there are no visual or auditory
disturbances reported by AD. This indicates normal sensory functions in her eyes and ears,
which is vital for her daily functioning and quality of life.
Cardiovascular: AD states that she has not experienced chest pain or palpitations. These
symptoms can be indicative of cardiac issues, and their absence in her report is reassuring
regarding her heart health.
Respiratory: She denies shortness of breath or cough. These symptoms are essential indicators
of respiratory conditions. The absence of such symptoms suggests that AD’s respiratory system
is functioning normally.
Gastrointestinal: AD mentions occasional abdominal discomfort attributed to anxiety. This
observation is significant, as it aligns with her anxiety disorder diagnosis. Anxiety can manifest
with gastrointestinal symptoms, and her disclosure provides context for her condition.
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Genitourinary: AD does not report any urinary symptoms. This information suggests the
absence of urinary tract problems or related issues.
Musculoskeletal: She acknowledges experiencing muscle tension associated with anxiety. This
symptom is consistent with her generalized anxiety disorder (GAD) diagnosis and is a common
physical manifestation of anxiety.
Integumentary: AD reports no skin issues. This is reassuring, as skin problems can be indicative
of various dermatological conditions, which are not presently a concern for her.
Endocrine: She does not mention any symptoms suggestive of hormonal imbalance. This is
pertinent in ruling out endocrine disorders, which could affect various bodily functions.
Neurologic: AD specifically denies seizures, headaches associated with anxiety, or neurological
deficits. Her clarification regarding headaches underscores their relation to her anxiety and not a
separate neurological issue.
Immunological: She states that she has no history of autoimmune disorders. This information is
significant in assessing her immune system health.
Reproductive: AD notes regular menstrual cycles and no gynecological complaints. This
information indicates normal reproductive and gynecological health.
Hematologic: She reports no bleeding or clotting disorders. Hematological issue
a Word document, provide short answers to the questions below. Each answer should be 250-300 words in length.What role does technology play in emotional and mental status testing?What are the strengths and challenges in interpreting and reporting results via the use of a computer-aided assessment tool?Technological advances that assist with interpreting and reporting results should only be used as a “tool” by the counselor. Why this is the case? Provide at least two examples.What are some concerns regarding the use of social media, especially in relation to maintaining professional status within the counseling field
You are designing an executable population-based change project addressing identified practice-related problems or questions. This strongly emphasizes collaboration between advanced practice nurses and community agencies and includes working with an agency using practice data to provide answers, which are responsive to the needs of clinicians, administrators, and policy makers for improvement of programs or practices.
This section of the change project should include a discussion of key concepts.
Clarify the issue under study.
Propose solutions or interventions based on the literature review.
Compare other views on the problem and solutions.
Address the APRN role in the intervention and discuss implications for clinical practice.
Discuss the implications of your change project.
Some important things to consider and address:
Does your intervention have a clear connection to your research problem?
What are the specific methods of data collection you are going to use, such as surveys, interviews, questionnaires, or protocols?
How do you intend to analyze your results?
Provide a justification for subject selection and sampling procedure.
Describe potential limitations. Are there any practical limitations that could affect your data collection? How will you attempt to control the limitations?
How will your change project help fill gaps in understanding the research problem?
This section should be 6–7 pages in length, not including the cover or reference page. You must reference a minimum of 5 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
This criterion is linked to a Learning OutcomeContent
64 to >52.48 pts
Meets Expectations
Succinctly clarifies the issue under study. Provides a brief summary of the project including main points and anticipated findings. Provides keen insight into obstacles and proposes sound, creative solutions or interventions based on the literature review findings. Expertly compares other views on the problem and solutions with detail. Uses examples to thoroughly address the FNP role in the intervention and discusses implications for clinical practice. Thoughtfully discusses the implications of the change project and its significance to the nursing profession and filling gaps in knowledge. Accurately categorizes and thoroughly explains specific methods of data collection to be used. Explains in detail how data will be analyzed and used. Provides a sound justification for subject selection and sampling procedure. Accurately and thoroughly describes potential limitations to data collection and control. Meets all of the criteria of the written assignment.
52.48 to >48.0 pts
Approaches Expectations
Provides an unclear explanation of the issue under study. Provides a brief summary of the project including main points and anticipated findings. Identifies some obstacles and proposes some solutions or interventions based on the literature review but few connections are made. Minimally compares other views on the problem and solutions. Minimally, addresses the FNP role in the intervention and discusses implications for clinical practice. Briefly discusses the implications of the change project and its significance to the nursing profession but may lack detail or specifics. Explains which methods of data collection will be used, and explains how data will be used. May be lacking analysis and accuracy in the explanation. Provides a general justification for subject selection and sampling procedure. Only briefly describes potential limitations to data collection and control. Meets most of the criteria of the written assignment.
48 to >37.76 pts
Falls Below Expectations
Provides no clarification of the issue under study. Provides little or no project summary or anticipated findings. Identifies few if any obstacles and proposes few if any solutions or interventions based on the literature review Minimal to no comparison to other views on the problem and solutions. Only suggests implications of the change project and its significance to the nursing profession or draws unreasonable conclusions. Identifies some methods of data collection to be used but may fail to explain how data will be used. Data collection methods are unsound, or unjustified for the change project. Justification for subject selection and sampling procedure may be missing or is unsound. Fails to describe potential limitations to data collection and control. Meets only a few of the criteria of the written assignment.
37.76 to >0 pts
Does Not Meet Expectations
No obstacles, opposing views, or comparisons are made to support the project. Data collection methods are not explained, analyzed, or discussed. Does not meet the assignment criteria.
64 pts
This criterion is linked to a Learning OutcomeOrganization
8 to >6.56 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.56 to >6.0 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
6 to >4.72 pts
Falls Below Expectations
Content is disorganized in many places and lacks clarity.
4.72 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized. May be an outline or a list.
8 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
8 to >6.56 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. The assignment is free of spelling and grammatical errors.
6.56 to >6.0 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. The assignment is mostly free of spelling and grammatical errors.
6 to >4.72 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. The assignment contains some spelling and grammatical errors.
4.72 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. The assignment contains many spelling and grammatical errors.
8 pts
Unformatted Attachment Preview
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Language Barrier Among the Hispanic Population in Miami, FL
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Language Barrier Among the Hispanic Population in Miami, FL
Project’s Benefits
This project has several benefits in terms of addressing the requirements of persons
within the Hispanic group experiencing language barriers. Given that language barriers bring
about various challenges when it comes to attaining high satisfaction levels among health
professionals and patients from this population, this project will aim to provide ways to address
these barriers. Specifically, this project will focus on ways to achieve high-quality healthcare and
sustain patient safety in the Hispanic population. At present, various healthcare organizations and
institutions serving the Hispanic population are offering interpreter services to advance
healthcare access, communication, and patient involvement and satisfaction (Kwan et al., 2023).
However, these interpreter resources increase the duration of treatment approaches as well as the
cost. For these reasons, this project will aim to provide useful insights into the influence of
language barriers on healthcare access within this population and recommend solutions to
address these challenges.
Also, language difficulties significantly influence the cost and healthcare quality,
especially when it comes to the Hispanic population. Despite the language limitations, healthcare
providers serving this population need to deliver top-notch healthcare that aligns with their
healthcare needs and follows the principles of health equity and human rights. As a result, this
project will aim to address health disparities faced by members of this population. More
importantly, this project will venture into health inequalities such as unequal treatment and
discrimination related to language differences. This is because these health disparities within this
population often result in unequal health outcomes as well as inadequate access to healthcare. A
study by Al Shamsi et al. (2020) outlines that individuals who have dialectal difficulties tend to
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experience various challenges concerning healthcare services access and as a result, these
patients often have poorer health results in comparison to patients who speak or understand the
local language. Considering the evidence that language barriers within this population in one
way or another influence the quality of healthcare they receive, this project will focus on ways to
advance communication between Hispanic patients and their medical professionals.
Considering that Hispanic patients with language difficulties are likely to utilize more
preventive and clinical healthcare services and have more adverse events, this project will
provide strategies on how to improve the utilization of these services, especially among persons
with limited English proficiency. Also, research indicates that patients who receive medical care
from healthcare professionals who do not speak the local language have challenges
comprehending medical instructions, resulting in increased occurrence of medical errors and
poor treatment adherence (Green & Nze, 2017). Taking that into account, this project will aim to
provide patients from the Hispanic population with the means to adhere to medical follow-ups so
that they do not miss health appointments due to language barriers. One benefit associated with
this is that these patients will have higher levels of satisfaction with the quality of healthcare they
receive.
Goals and Objectives
The project’s goals and objectives include:
1. To increase and improve patient satisfaction concerning access to healthcare access by
90% among members of the Hispanic population with language limitations within 6
months.
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2. To demonstrate the importance of interpreter resources when it comes to healthcare
access among the Hispanic population within the first month of the project
implementation.
3. To advance the utilization of interpreter resources in all healthcare centers serving
members of the Hispanic population within the first year of introduction of these
resources.
4. To increase the use of inpatient services and medical care follow-ups using interpreter
services in the first month of project implementation.
5. To reduce healthcare disparities and improve patient safety as well as healthcare delivery
within the Hispanic population by 60% by the first year of the project implementation.
6. To minimize miscommunication between healthcare professionals and patients by 100%
to achieve better patient outcomes and advance healthcare delivery quality in the first two
months of project initiation.
7. To minimize indirect healthcare costs associated with language barriers within the
Hispanic population by 50% in the first year of project implementation.
Variables to be Considered
Several variables need to be considered for this project to be successful. One of these
variables is patient satisfaction. According to Funk and Lopez (2022), most members of the
Hispanic population tend not to utilize preventive and clinical services due to a lack of health
coverage as well as language and cultural obstacles. These limitations in one way or another
contribute to disparate health results for members of the Hispanic population, resulting in low
levels of patient satisfaction. Therefore, patient satisfaction needs to be considered within this
population because high levels of satisfaction indicate Hispanic Americans are receiving
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equitable healthcare that aligns with their healthcare needs. Healthcare providers serving
members of this population experiencing language barriers do not have control over patient
satisfaction as this factor depends on the quality of care delivered and the patient’s perception of
that care.
The other variable that needs to be considered when it comes to addressing the needs of
the members of the Hispanic population with language difficulties is interpreter resources. This
is because to overcome some of the language obstacles faced by this population concerning
healthcare access, interpreter services are essential. However, the implementation and utilization
of these resources are associated with various challenges such as misinterpretation, confusion,
and financial burden (Al Shamsi et al., 2020). For these reasons, some healthcare providers may
opt out of utilizing interpreter services or they may access subpar interpreter resources. Given
that these interpreter resources may contribute to high levels of patient satisfaction as well as
improved patient care among members of the Hispanic population with language differences,
this variable must be considered by healthcare providers. These providers have control of this
variable because they either choose to hire language assistants or provide healthcare services
without interpreter resources as they are associated with several challenges, including increased
healthcare costs and length of physician visits. Lastly, if I were to implement this study, I would
apply mixed-method research to obtain both qualitative and qualitative data.
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References
Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of
language barriers for healthcare: A systematic review. Oman Medical Journal, 35(2),
e122. https://doi.org/10.5001%2Fomj.2020.40
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Green, A. R., & Nze, C. (2017). Language-based inequity in health care: who is the “poor
historian”? AMA journal of ethics, 19(3), 263-271. https://journalofethics.amaassn.org/article/language-based-inequity-health-care-who-poor-historian/2017-03
Kwan, M., Jeemi, Z., Norman, R., & Dantas, J. A. (2023). Professional interpreter services and
the impact on hospital care outcomes: An integrative review of the
literature. International Journal of Environmental Research and Public Health, 20(6),
5165. https://doi.org/10.3390%2Fijerph20065165
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Language Barrier Among the Hispanic Population in Miami, FL: Theoretical Frameworks
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Language Barrier Among the Hispanic Population in Miami, FL: Theoretical Frameworks
Theoretical Frameworks
It is evident that individuals from minority populations, including those from the
Hispanic population, experience a variety of challenges when it comes to accessing and utilizing
healthcare services because of language limitations. As a result, this change project paper will
apply the Access to Healthcare framework and framework of Communication Accommodation
Theory (CAT) to explore the implications of language barrier among the Hispanic population.
Within minority groups, language barriers significantly contribute to the underutilization
of clinical and preventive health services, patient dissatisfaction, increased care costs, poor
communication between care providers and patients, and adverse health outcomes. Taking that
into account, the issue of language barrier has been addressed mostly by focusing on
communication. However, language is more than communication as it is associated with
relationship-building and social interactions. As a result, it is critical to address the language
barrier among the Hispanic population from various contexts, including access to medical
services and not only communication. This is the reason why the Access to Healthcare
framework and the framework of CAT were selected for the study.
Access to Healthcare Framework
Access to Healthcare framework is a model that focuses on understanding and improving
healthcare delivery and how individuals access various medical services from the patient’s
perspective (Levesque et al., 2013). This model outlines vital dimensions and components that in
one way or another influence healthcare access by considering various factors that limit or
improve the utilization of healthcare services. These dimensions include availability,
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accommodation, acceptability, approachability, and affordability. Based on this model, these
dimensions are connected and influence how people access and utilize care services.
The mentioned five dimensions of the Access to Healthcare framework guide this study
in various ways. First, the availability dimension focuses on the existence of various medical
care services in a certain location (Levesque et al., 2013). When it comes to addressing the issue
of the language barrier, this dimension entails identifying the need for interpreter resources in all
clinical settings or the need to hire healthcare providers who can speak more than one language.
In that way, patients with language limitations can access care without fear of discrimination as
there is a diverse medical staff.
The accommodation dimension of this framework involves providing care services that
align with the needs of minority patients. To mitigate language limitations, based on this
framework, healthcare providers must initiate plans to promote linguistic and cultural sensitivity.
In that way, these care providers can respect and appreciate the individual differences and
cultural backgrounds of their patients and in turn, change their styles of communication
accordingly. The third dimension of this framework is approachability, and it guarantees that
individuals irrespective of language barriers can access medical services (Levesque et al., 2013).
This can be achieved by offering language support through the utilization of interpreter services
to ensure patients present their cases and comprehend conveyed health information.
Under this framework, acceptability entails the inclination of patients to seek out medical
services. To address the language barrier issue among the Hispanic population, this framework
suggests that healthcare practitioners must communicate effectively and build trust with
individuals from this group. The last dimension under this framework is affordability and this
entails the costs associated with care access. To mitigate language limitations, this model
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outlines that language barriers should not contribute to healthcare costs increment. In other
words, interpretation services should be provided free or covered by insurance.
By applying the Access to Healthcare framework, healthcare facilities serving the
Hispanic population in Miami can recognize and at the same time, mitigate language barriers that
hinder some of the members of this population from accessing optimal healthcare. This
framework applies to this change project as it provides a guideline on how various components
can be utilized to address the language barrier among minority groups. Additionally, this model
demonstrates that persons from minority groups with language limitations can access equitable
and optimal care irrespective of their linguistic needs.
Framework of the Communication Accommodation Theory (CAT)
CAT is a theoretical model that describes how individuals change their communication
habits so that they can understand those they interact with. Dragojevic et al. (2015) outline that
CAT suggests that individuals are likely to utilize convergence and divergence tactics to
effectively communicate or avoid interactions with other people. Considering the challenges that
persons from minority groups face due to language barrier issues, this framework can be
employed to overcome language hurdles. This is because by utilizing CAT, healthcare
practitioners can initiate programs and interventions to close healthcare access gaps brought
about by language limitations and in doing so, advance communication and engagements
between patients and care providers.
The two components of this framework are convergence and divergence, and they can be
applied differently to mitigate the issue of language barrier among persons from the Hispanic
population. Based on CAT, healthcare providers, and organizations can introduce convergence
approaches to ensure their communication styles align with those of patients from minority
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groups. According to Squires (2018), healthcare practitioners can do so not only by using
interpreter resources but also by trying to be culturally competent and sensitive. In that way, they
can build trust and meaningful relationships with the patients they serve. Also, divergence
approaches can be applied to mitigate language limitations where care providers create a
supportive setting that inspires patients from minority groups to express their issues related to
language barriers without fear of discrimination. Also, they can employ divergence to address
language obstacles by using clear language, and visual aids, and encourage those with language
limitations to make inquiries.
By utilizing CAT, healthcare institutions and providers serving the Hispanic population
in Miami, can improve communication with persons facing language difficulties. In doing so,
these providers can build trust with members of this population. More importantly, with
improved communication, they can offer patient-focused and equitable care, resulting in better
health outcomes within this population.
Pertinent Research that Used These Theoretical Frameworks
The Access to Healthcare model is utilized in the research by Bayram and Sakarya
(2023). This research explores how language influences healthcare access among persons who
have problems speaking the official language. These authors discovered that individuals who
have challenges using the official language experience language-related obstacles such as delay
in seeking treatment. In my opinion, this research uses the Access to Healthcare framework
appropriately to outline interventions that can be implemented to mitigate care access language
barriers.
CAT is utilized in research conducted by Meuter et al. (2015). Using this framework, this
research attempts to comprehend the language barriers that often arise between care providers
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and patients in healthcare settings. These authors discovered that understanding a second
language in healthcare settings is essential in delivering patient-centered care as poor
communication can result in severe health consequences. In my opinion, this research applied
CAT appropriately to understand issues that can arise from language limitations.
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References
Bayram, T., & Sakarya, S. (2023). Oppression and internalized oppression as an emerging theme
in accessing healthcare: findings from a qualitative study assessing first-language related
barriers among the Kurds in Turkey. International Journal for Equity in Health, 22(1), 6.
https://doi.org/10.1186/s12939-022-01824-z
Dragojevic, M., Gasiorek, J., & Giles, H. (2015). Communication accommodation theory. The
international encyclopedia of interpersonal communication, 1-21.
https://doi.org/10.1002/9781118540190.wbeic006
Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care:
Conceptualising access at the interface of health systems and populations. International
journal for equity in health, 12, 1-9. https://doi.org/10.1186/1475-9276-12-18
Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. (2015). Overcoming
language barriers in healthcare: A protocol for investigating safe and effective
communication when patients or clinicians use a second language. BMC Health Services
Research, 15(1), 1-5. https://doi.org/10.1186%2Fs12913-015-1024-8
Squires, A. (2018). Strategies for overcoming language barriers in healthcare. Nursing
management, 49(4), 20. https://doi.org/10.1097%2F01.NUMA.0000531166.24481.15
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Language Barrier Among the Hispanic Population in Miami, FL: The Integrative
Literature Review
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Language Barrier Among the Hispanic Population in Miami, FL: The Integrative
Literature Review
Literature Review
To guarantee patient safety, care quality, and the satisfaction of both healthcare providers
and patients, good and effective communication between these two parties is crucial. Whitaker et
al. (2022) outline that excellent communication between healthcare providers and patients is
associated with effective care management and the provision of accurate diagnosis. Generally,
good communication, which is not hampered by language limitations, is very important at every
phase of the medical care process, from recognizing the health issue of a patient and delivering
patient-focused treatment and care through patient engagement and involvement.
A study conducted by Bombard et al. (2018) indicates that patient care experiences and
outcomes may be negatively influenced by the capability of healthcare providers to listen,
demonstrate, and understand the complaints presented by the patient. However, the presence of a
language barrier makes it challenging for healthcare providers, including nurses among other
healthcare professionals to communicate. This is because, problems associated with language
barriers in one way or another may impact persons from minority populations in terms of the
level of healthcare quality delivered (De Moissac & Bowen, 2019). As a result, effective
communication and appropriate patient interactions are required to address some of the health
disparities in healthcare access and the level of care delivered among minority populations as
well as to improve the patient’s understanding of treatment approaches. At present, healthcare
systems are heavily investing in the utilization of interpreter resources and other forms of
language access services as well as advancing cultural competency and establishing meaningful
relationships with patients and healthcare providers to eliminate some of the negative
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consequences linked to language issues (Al Shamsi et al., 2020). Apart from the use of
interpreter resources, health systems are utilizing digital technologies, signage, and translated
health information to provide essential services.
Given that every human being has the right to receive the best probable form of
healthcare regardless of ethnicity or socioeconomic status, healthcare providers must deliver
optimal medical care that aligns with human rights as well as equity to all patients (Al Shamsi et
al., 2020). Taking into account that language barriers in one way or another hinder minority
populations from accessing and utilizing healthcare services leading to various health disparities
and poor health outcomes, language differences pose a significant problem to healthcare
delivery. For example, a study by De Moissac & Bowen (2019), outlines that patients who do not
speak the common dialect tend to be disadvantaged when it comes to healthcare services access
and availability. Also, results from research performed by Al Shamsi et al. (2020) highlight that
patients who face language obstacles have worse health outcomes in comparison to those who
communicate and interact using the common dialect. As a result, persons who experience
language limitations tend to utilize more healthcare services to address their health issues and
have more adverse events due to a lack of healthcare comprehension and fear of receiving lowquality care and discrimination.
Taking a look at the Hispanic population in Miami, FL, some of the individuals from this
minority group face various issues associated with language barriers. Since most persons from
this population do not speak fluent English, healthcare providers must adapt to their needs and
initiate strategies to minimize these language obstacles to prevent or reduce health disparities.
This is because, the inability of healthcare providers to mitigate language differences among the
Hispanic population can lead to health inequality (Velasco-Mondragon et al., 2016). In addition
4
to that, these language differences can put the safety of persons from this population at risk in
terms of increased prevalence of medical errors and providing care that does not align with their
health needs. Within the Hispanic population, according to CMS (2022), healthcare providers
need to implement strategies to overcome language barriers, particularly when it comes to
offering language assistance services, to avoid discriminating against non-English-speaking
patients.
Key Findings of the Research
Research indicates that language barriers among the Hispanic population are associated
with various impacts, especially when the level of healthcare provided does not meet their needs
or is inaccurate. According to Kelson et al. (2022), language limitations within the Hispanic
population significantly contribute to the increased prevalence of medical errors. In all healthcare
settings, the medical history and information of a patient should be considered when providing
medical care. However, several studies outline that language differences can make healthcare
delivery challenging, particularly when it comes to engaging with patients to receive their
medical history and other healthcare-related information. If the patient does not entirely
understand the information that is needed from them, language limitations could be an issue
because they could contribute to numerous adverse events. As a result, research indicates that
when language proficiency and understanding pose a significant problem to healthcare delivery,
professional interpreters must be involved in the process. This is because the use of interpreter
resources advances patient teaching and in turn, promotes their safety as well as ensures the
efficacy of the suggested treatment approaches.
Also, research outlines inaccurate assessment as an impact of language barriers among
minority groups, including the Hispanic population. Hollingshead et al. (2016) outline that
5
patients from the Hispanic population who experience language difficulties tend to undergo
inaccurate assessment in all aspects of care, especially when it comes to pain management.
Several studies state that there is a lot of patient teaching and instruction that is needed when
describing the scale of pain to patients. This is because the described level of pain may be wrong
if the patient cannot rate their pain level as a result of language differences. In all healthcare
settings, different cultural groups have varying ways of explaining their health conditions and as
a result, miscommunication can lead to inaccurate diagnosis as well as undermedication or
overmedication, which could lead to poorer health outcomes. Taking that into account,
individuals need to understand that when providing medical care to persons from the Hispanic
population with language problems, inaccurate assessments can significantly influence their
treatment plans and this can result in the aggravation of existing health conditions.
Another key finding of the research is that patients with language problems may be
psychologically stressed and this can to severe consequences. According to Funk and Lopez
(2022), members of the Hispanic population facing language barriers are likely to miss medical
appointments, which makes follow-up and treatment difficult. Besides that, these persons have
an increased chance of misunderstanding their treatment plan and this minimizes their potential
for medical adherence. Considering that, we need to know that medical decisions within the
Hispanic population could be dangerous if the patient does not understand the diagnosis or if the
healthcare provider cannot comprehensively explain the risk factors that are linked to the
diagnosis. Many persons do not know that understanding medical information presents a
significant issue for any patient, regardless of their ethnicity. Therefore, all persons, especially,
healthcare providers need to know that language obstacles influence the level of health literacy
of a patient, making it more difficult for the patient to comprehend sophisticated medical
6
treatments and diagnoses. Moreover, language barriers among the Hispanic population are
associated with health inequity. For this reason, some members of this population have a higher
chance of not obtaining the level of patient care that aligns with their health needs.
There are two things that we do not know regarding addressing the care needs of the
Hispanic group. One of the things is the influence of interpreting services in healthcare delivery.
According to Whitaker et al. (2022), interpreter resources do not substitute direct communication
and may lead to various safety risks. This is because, in one way or another, the use of interpreter
services limits the capacity of patients to be involved in their own care, pushing them to play a
passive part. Generally, this leads to a disconnect between patients and their healthcare providers
as various interactions may not be interpreted appropriately. The second thing that we do not
know concerning addressing the care needs of persons from the Hispanic group is the impact of
the current health policies. These policies need to be reviewed to promote the health and safety
of persons from the Hispanic population with language problems.
Gaps in Knowledge
The issue of language barriers in care delivery poses more threat than it appears. For
instance, healthcare policies are designed to guarantee there is no discrimination towards persons
from minority groups, according to Yearby et al. (2022). However, there are no well-established
guidelines on how to utilize the policies to minimize health disparities faced by minority groups.
Given the ineffectiveness of some of the implemented health policies on language differences,
healthcare institutions need to hire qualified medical interpreters and provide language assistance
services. This is because, research indicates that the use of interpreter services is associated with
various healthcare delivery benefits such as better patient health results, low rates of
readmission, and increased healthcare utilization. Also, in all healthcare settings, patient
7
involvement is associated with culturally consistent care as this facilitates trust development and
provides patients from minority groups with a chance to communicate their health needs directly
and effectively to healthcare providers. As a result, health systems need to implement programs
that bridge the gap in the Hispanic population and healthcare provider communication.
8
References
Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of
language barriers for healthcare: a systematic review. Oman Medical Journal, 35(2),
e122. https://doi.org/10.5001%2Fomj.2020.40
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., … & Pomey, M. P.
(2018). Engaging patients to improve quality of care: a systematic
review. Implementation Science, 13, 1-22. https://doi.org/10.1186/s13012-018-0784-z
CMS. (2022). Providing language services to diverse populations: Lessons from … – CMS.
Centers for Medicare & Medicaid Services. https://www.cms.gov/About-CMS/AgencyInformation/OMH/Downloads/Lessons-from-the-Field.pdf
De Moissac, D., & Bowen, S. (2019). Impact of language barriers on quality of care and patient
safety for official language minority Francophones in Canada. Journal of Patient
Experience, 6(1), 24-32. https://doi.org/10.1177/2374373518769008
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Hollingshead, N. A., Ashburn-Nardo, L., Stewart, J. C., & Hirsh, A. T. (2016). The pain
experience of Hispanic Americans: A critical literature review and conceptual model. The
Journal of Pain, 17(5), 513-528. https://doi.org/10.1016%2Fj.jpain.2015.10.022
Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J.
A. (2016). Hispanic health in the USA: a scoping review of the literature. Public Health
Reviews, 37, 1-27. https://doi.org/10.1186/s40985-016-0043-2
9
Whitaker, K. L., Krystallidou, D., Williams, E. D., Black, G., Vindrola-Padros, C., Braun, S., &
Gill, P. (2022). Addressing language as a barrier to healthcare access and quality. British
journal of general practice, 72(714), 4-5. https://doi.org/10.3399/bjgp22X718013
Yearby, R., Clark, B., & Figueroa, J. F. (2022). Structural racism in historical and modern us
health care policy: Study examines structural racism in historical and modern US health
care policy. Health Affairs, 41(2), 187-194. https://doi.org/10.1377/hlthaff.2021.01466
GROUP PRESENTATION COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN
Assignment title or
task:
(You can write a
question)
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Select one from the following topics: Occupational stress and impact on employee well-being
Health risks for health workers on night shift.
The roles and responsibilities of the occupational health professionals
The role of telehealth in occupational health services
Occupational safety and health measures in Saudi Arabia
Promoting Mental Health in the Workplace
Digital Occupational Health in KSA.
The role of occupational health in the prevention of occupational
diseases
Psychosocial hazards and prevention in the workplace
Occupational health services for small-sized workplaces of less than 20
workers
Promoting Mental Health in the Workplace
Occupational Heat Exposure
Occupational Noise Exposure
Personal Protective Equipment
Prevent Falls in the workplace
Name
Student’s name and ID
Submission date:
ID
Instructor name
Dr.
Grade
… out of 10
Guidelines:
➢ Every student must send me by email with his chosen topic before 10/10/2023
➢ The presentation should be submitted on the blackboard as a PPT file.
➢ The PPT should not be more than 15 slides and not less than 10 slides.
➢ Use appropriate references as per the APA Style.
➢ The oral presentation time should be 7-10 minutes.
➢ All presenters must participate equally and help each other as needed.
➢ It will be conducted in weeks 9, 10, 11.
➢ Your presentation will be evaluated based on the implementation of
communication skills, slides, time, deadline, topic covering.
Week 9
1. ABDULLAH ALAMRI
2. Faisal Alanazi
3. HUSSEIN ALBAHER
4. SULTAN ALDAWSARI
5. MUFEED ALDHU
Week 10
Week 11
1. MUSTAFA
ALHADDAD
1. MUBARAK
ALMURAYR
2. FARIS ALJANFAWI
2. MOHAMMED
ALQARNI
3. SAAD ALKHALIFAH
4. AHMAD ALKUWAITY
5. KHALID ALMATHIBIRI
6. AQEEL ALMUJAYBIL
3. HASSAN ALRUBH
4. hani alrumaih
5. BADER ALSHAMMARI
All students must submit their
6. ABDULRAHMAN
ALSHEHRI
presentation by Monday of
All students must submit their
All students must submit their
week 9
presentation by Monday of
presentation by Monday of
week 10
week 11
6. AHMED MAJRASHI
Please follow the rank and the presentation will be in the virtual session on Wednesday of
the weeks 9,10, and11. Attendance is required for all students.
Good Luck
Please have each question on a different page. The opinion can be on the same page with a heading “opinion” What are some of the areas of a client’s life that might help a counselor develop/identify patterns of mental illness in a case conceptualization? 150 words and 150 word opinion response How do patterns of mental illness differ according to population? Name examples where one psychological symptom could be interpreted in two different ways based on age/gender/identified problem. 150 words and 150 word opinion response Identify two types of assessments discussed in the textbook, and/or additional readings. How could the use of technology impact the administration of these assessments? Do you feel that the incorporation of technology would be a benefit to administration? Why or why not? Provide specific examples to support your position. 150 words and 150 word opinionIdentify and discuss the standards for the use of technology in the counseling setting according to your state governing board and the ACA. What are potential implications for the counselor if these standards are not followed? 150 words response and 150 word opinion
APA format with referencesJohn is a 24-year-old who presents to urgent care with a 2 week history of cough and congestion. He says it started out as a “normal cold” and it will not go away. He has a productive cough of green mucous and has green nasal discharge. He says that he has had a low-grade temperature for the past 2 days. John reports an intermittent frontal headache with this cold. He is otherwise healthy, with no known drug allergies.The patient’s assessment is as follows:Vital signs are stable and temperature is 99.9°F. Tympanic membranes (TMs) are clear bilaterally, pharynx is pink with no exudate, he has greenish postnasal drainage, turbinates’ are swollen and red, there is tenderness when frontal sinuses palpated, there is no cervical adenopathy, and lungs are clear.Answer the following questions. What medications do you anticipate being prescribed/recommended and why?What patient education would you anticipate giving the patient regarding the medications you chose?
Unformatted Attachment Preview
10/18/23, 5:52 PM
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Case Study Rubric – 20 Pts
Course: NSG6005-Advanced Pharmacology CP03
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Answered
items
completely.
Developed
adequate
responses to
questions. Plan
shows depth
and
application of
course
concepts.
Student did not
submit case
study.
Case study does
not meet
expectations;
plan has no
depth or has
inaccurate
elements listed.
Case study
meets minimal
expectations
with minimal
development of
portions of case
study.
Case study
meets
expectations by
including good
depth for all
elements of plan
but does not
demonstrate
good application
of course
content.
Case study
meets or exceeds
expectations
with creative,
innovative
strategies for
case study.
Identified and
described
pharmacologic
al concepts
and care as
needed.
Student did not
submit case
study.
Case study does
not meet
expectations; no
resources listed.
Case study
meets minimal
expectations
with few
resources listed.
Case study
meets
expectations;
resources listed
are well
developed in all
but a few areas.
/8
Case study
meets or exceeds
expectations
with all resources
well developed
(i.e., textbook,
peer-reviewed
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0 points did not
Student
Emerging
1 point
Numerous
issues
Satisfactory
2 points
Case
study
Proficient
3 pointserrors that
Minor
Exemplary
4 points
Case
study
Criterion
Score
/4
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
Criteria
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
format.
Total
Criterion Score
/8
/ 20
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582507&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
1/2
10/18/23, 5:52 PM
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0
points did not
Student
Emerging
1
point
Numerous
issues
Satisfactory
2
points
Case
study
Proficient
3
pointserrors that
Minor
Exemplary
4
points
Case
study
Criterion Score
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
/4
format.
Total
/ 20
Overall Score
No Submisssion
Emerging
Satisfactory
Proficient
Exemplary
0 points minimum
12 points minimum
14 points minimum
16 points minimum
18 points minimum
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582507&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
2/2
Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families.
AllCEUs Counseling Education. (2017, November 4). 187 models of treatment for addiction | Addiction counselor training seriesLinks to an external site.[Video]. YouTube.
Medmastery. (2022, March 8). How to use motivational interviewing in addiction medicineLinks to an external site.. [Video]. YouTube.
To prepare:
Review this week’s Learning Resources and consider the insights they provide about diagnosing and treating addictive disorders. As you watch the 187 Models of Treatment for Addiction video, consider what treatment model you may use the most with clients presenting with addiction.
THE ASSIGNMENT
In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit.
Provide an overview of the article you selected.
What population (individual, group, or family) is under consideration?
What was the specific intervention that was used? Is this a new intervention or one that was already studied?
What were the author’s claims?
Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?
Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.
Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides.
Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.
Unformatted Attachment Preview
NRNP 6645 Week 8 Assignment Psychotherapy for Clients With Addictive
Disorders Rubric Detail
Select Grid View or List View to change the rubric’s layout
Excellent
90%–100%
Good
80%–89%
Fair
70%–79%
Develop a 5- to 10-slide
PowerPoint
18 (18%) – 20 (20%)
presentation on your
The presentation
0 (0%) –
selected research article
thoroughly and accurately 16 (16%) – 17 (17%)
14 (14%) – 15 (15%)
There is
discussing a therapeutic
defines the considered
The presentation defines
There is an incomplete definitio
approach for treating
population.
the considered
definition of the
consider
clients, families, or
population.
considered population.! it is mis
groups with addictive
The specific intervention
disorders. •Provide an
used is fully and
The specific intervention
overview of the article
write my paper
The spe
accurately described. The used is described. The
you selected, including:
The specific intervention used is p
description clearly
description indicates
What population
used is partially or
inaccura
indicates whether the
whether the intervention
(individual, group, or
inaccurately described. is missin
intervention is new or
is new or whether it was
family) is under
whether it was already already studied.
consideration? What
The response includes a The resp
studied.
was the specific
partial or inaccurate
partial o
The response includes a
intervention that was
description of the
descript
The response includes a description of the
used? Is this a new
author’s claims.
author’s
thorough and accurate
author’s claims.
intervention or one that
missing
description of the
was already used? What
author’s claims.
were the author’s
claims?
0 (0%) –
18 (18%) – 19 (19%)
23 (23%) – 25 (25%)
The pre
The presentation includes
The presentation includes 20 (20%) – 22 (22%)
an inacc
a somewhat inaccurate or
o Explain the
a thorough and accurate The presentation includes
incompl
incomplete review of the
findings/outcomes of the
review of the findings of a review of the findings
findings
findings of the selected
study in the article.
the selected article.
of the selected article.
article, o
article.
Include whether this
will translate into
The response fully
The response addresses
The resp
practice with your
The response partially or
addresses whether or not whether or not the
inaccura
clients. If so, how? If
inaccurately addresses
the outcomes will
outcomes will translate
whether
not, why?
whether or not the
translate into practice
into practice with clients.
outcome
outcomes will translate
with clients.
into pra
into practice with clients.
or is mi
23 (23%) – 25 (25%)
20 (20%) – 22 (22%)
18 (18%) – 19 (19%)
0 (0%) –
• Explain whether the
The presentation includes The presentation includes The presentation includes The pre
limitations of the study
a thorough and accurate an explanation of the
a somewhat inaccurate or an inacc
might impact your
explanation of the
whether the limitations of incomplete explanation of incompl
ability to use the
whether the limitations of the study might impact the whether the
the whe
Excellent
Good
Fair
90%–100%
80%–89%
70%–79%
findings/outcomes the study might impact your ability to use the
limitations of the study limitatio
presented in the article. your ability to use the
findings presented in the might impact your ability might im
findings presented in the article.
to use the findings
to use th
article.
presented in the article. presente
is missin
9 (9%) – 10 (10%)
7 (7%) – 7 (7%)
0 (0%) –
•Use the Notes function The Notes function of the 8 (8%) – 8 (8%)
The Notes function of the The Not
of PowerPoint to craft presentation is
The Notes function of the
presentation is utilized presenta
presenter notes to appropriately used to
presentation is adequately
but notes are vague or
inaccura
expand upon the
comprehensively expand used to expand upon the
contain small
upon the
content of your slides. upon the presentation
presentation slides.
inaccuracies.
slides, o
slides.
• Support your response
7 (7%) – 7 (7%)
with at least three peer- 9 (9%) – 10 (10%)
8 (8%) – 8 (8%)
The presentation is
reviewed, evidence- The presentation is
The presentation is
0 (0%) –
supported with two or
based sources. Explain strongly supported with atsupported with at least
The pre
three peer-reviewed,
why each of your
least three peer-reviewed, three peer-reviewed,
supporte
evidence-based, scholarly
supporting sources is evidence-based, scholarly evidence-based, scholarly
peer-rev
sources. Accurate
scholarly. References sources. References are sources. References are
based, s
references may not be
are included on your included on the last slide. included on the last slide.
or the so
included on the last slide.
last slide. PDFs of PDFs of sources are
PDFs of sources are
missing
PDFs of sources may be
sources are included included with submission.included with submission.
missing.
with submission.
5 (5%) – 5 (5%)
3.5 (3.5%) – 3.5 (3.5%) 0 (0%) –
4 (4%) – 4 (4%)
Slides are clear, concise,
Slides may be somewhat Slides a
Slides are clear and
and visually appealing.
unorganized or crowded. and/or c
concise. Sentences follow
Sentences in presenter
Sentences follow writing Sentenc
writing standards for
notes follow writing
standards for flow,
standard
flow, continuity, and
standards for flow,
continuity, and clarity
continui
clarity 80% of the time.
continuity, and clarity.
60%–79% of the time. 60% of
Written Expression and
0 (0%) –
Formatting – English 5 (5%) – 5 (5%)
4 (4%) – 4 (4%)
3.5 (3.5%) – 3.5 (3.5%) Contain
writing standards:
Uses correct grammar, Contains 1 or 2 grammar, Contains 3 or 4 grammar, gramma
Correct grammar,
spelling, and punctuation spelling, and punctuation spelling, and punctuation punctua
mechanics, and proper with no errors.
errors.
errors.
interfere
punctuation
understa
Total Points: 100
Describe three to five options that can be considered for addressing the problem by the audience for this policy analysis. Include a description of the positive and negative aspects or pros and cons of each option. Describe the criteria you are using to analyze the pros and cons/positives and negatives for each action. For example, criteria can include cost, feasibility or ease of implementation, legality, fairness, timeliness, or targeted impact on the audience affected by the problem. For your recommendation, you should choose one of the options you described. Describe why this option is preferred over the other options, despite the cons or negative aspects of the policy action. Part 3 will include the following components in a narrative of VIII. Options for Policy Action: 1. 3 to 5 options, 2. Positive and negative aspects or pros and cons of each action. 3. Criteria for analyzing the pros and cons of each action. IX. Recommendation: 1 Description of one of the options for policy action as the recommended action, 2. Description as to why this option is preferred over the other options.
Unformatted Attachment Preview
1
Cordell King
MPH Capstone Project – Part 1
PUB-690 Public Health Capstone Project
Ormand Clarke
08/30/2023
2
Background for the Problem
The problem of less time spent with doctors during appointment visits that typically last
for a standard 15 minutes or less has gained excessive attention over the years. Moreover, the trend
has elicited concerns among healthcare policymakers, professionals, and patients. According to
the American Medical Association (AMA), the standard duration for a doctor’s appointment is 15
minutes, thus established on the premise that it would be enough for medical consultations
(Solomon, 2008). Nevertheless, multiple variables have called for a review of this antique practice.
To begin with, the instances where the doctor’s visit is constrained to 15 minutes imply that the
appointment would address a few issues and thus diminish the in-depth understanding. Therefore,
Mechanic et al. (2001) claim that the time-consuming psychological health determinants would be
unattended within the stipulated duration. The consequences are declined patient satisfaction,
congested emergency service utilization, and noncompliance with diagnosis plans (Geraghty et al.,
2007).
The most significant aspect provided to patients by doctors is time. However, in most cases,
patients feel that they need more time during the doctor’s visits, and doctors normally feel hasty
in their efforts to offer quality care despite being confronted with insurmountable pressure to offer
quality care and engage more patients (Zhu et al., 2010). For this reason, the current standard
duration for visiting physicians for an appointment has been associated with patient dissatisfaction,
low delivery of quality care, and reduced patient outcomes (Geraghty et al., 2007). However,
studies examining the duration of a doctor’s visit have needed clarification on the impact of the
case mix. Furthermore, there is a wide consensus that primary care has declined considerably the
length of patient visits to the doctors for appointments. The case mix of office-based doctor visits
3
has become more multifaceted; thus, the average length of the visit may have amplified rather than
declined. For this reason, there is a need for more time for each visit (Zhu et al., 2010).
The most recent study has indicated that 53 percent of healthcare providers experience time
pressure during clinical encounters. For this reason, many providers described exhaustion and fear
of making clinical errors (Mechanic et al., 2001). Moreover, some healthcare providers employ a
free-for-service system that needs to be better developed to deliver comprehensive care. As a
result, some healthcare providers feel like they are on the manufacturing line instead of engaging
in a mission to treat the sick and diagnose chronic illnesses. Mechanic et al. (2001) state that the
standard duration prescribed by AMA needs to be longer as the current one allows patients to
initiate a few topics ask a few questions, and curtly answer the questions. As a result, the doctors
may underestimate the severity of their conditions (Solomon, 2008).
Why the problem has been selected
The selected problem for analysis is an important aspect of delivering quality primary care
due to its impact on patient outcomes. Mechanic et al. (2001) state that insurance providers pay
clinics, hospitals, and doctors enough to justify the limited 15-minute doctor visits. Manganelli
(2016) further states that the conventional 15-minute time frame for doctor-patient interactions has
existed for a long time and is thus critical to evaluate its adequacy in the modern healthcare
landscape. Multiple reasons justify the selection of the problem:
Dynamic healthcare landscape: In recent years, the healthcare landscape has significantly
revolutionized through advances in medical technology, increased chronic illness, and an aging
population. For this reason, there is a need to enjoy the real benefits of allowing enough visit times
for primary care, such as low hospital utilization and emergency care, improved patient
4
satisfaction, reduced unnecessary referrals, and few ill-advised diagnostic treatments (Geraghty et
al., 2007).
The complexity of health issues: Multiple health issues have increasingly become
complex, and thus, there is a need for enough time for diagnosis, patient education, and treatment.
Moreover, patients with several chronic conditions typically need long consultations to manage
their health concerns effectively (Mechanic et al., 2001). Delivering efficient care to patients for a
long duration could avoid the changing needs of the patients, thus resulting in better results and
providing access by minimizing the necessity for return visits (Manganelli, 2016).
Effective Patient-Centered Care: The paradigm shift towards patient care focuses on
shared decision-making, addressing patient concerns, and active listening. However, the current
visit restriction interferes with this technique’s implementation. Additionally, Manganelli (2016)
claims that more time improves communication and would result in clinician satisfaction and wellbeing, critical features in handling the current crisis of dilapidating primary care employees.
Minimizing medical errors: Consultations done hastily can result in medical errors,
missed opportunities, and misdiagnosis in preventive care, which immensely causes severe
consequences in patient health.
Issue Importance and why it needs urgent attention
The 15-minute doctor visit is a significant issue and needs immediate attention for multiple
reasons. Firstly, there is a need to extend the consultation duration to facilitate effective patient
outcomes. Therefore, adequate time provides room for a robust assessment, discussion on
diagnosis options, patient awareness education, and thus, more improved and informed health
decisions (Felix, 2014). Secondly, the long doctor visits will ensure efficient care delivery in
facilities. For this reason, doctors can ask more comprehensive questions, consider a wide range
5
of options for diagnosis, and evaluate all the treatment alternatives that will enhance healthcare
quality (Manganelli, 2016). Thirdly, the individual patients will feel that their health concerns are
heard, and questions are answered more comprehensively with their healthcare experience. As a
result, there will be high patient retention and compliance with treatment plans. Fourthly, the study
will also examine how longer visits of more than 15 minute offers an opportunity for health
education and preventive patient care. Ultimately, the strategy will reduce the chronic illness
burden and promote healthy lifestyles (Zhu et al., 2010). Finally, despite seeming
counterproductive, longer doctor visits can improve the healthcare system. Moreover,
comprehensive tackling of the initial patient issues can result in efficiency in the system. As a
result, addressing these issues more comprehensively during initial visits would result in low
follow-up appointments and less expensive medical interventions in the long run (Felix, 2014).
Problem Statement
The issue under review is the outdated practice of restricting doctor’s visits to a standard
15-minute duration or less, which no longer takes care of the multifaceted healthcare needs of
modern patients. Moreover, the outdated approach results in patient dissatisfaction, interferes with
the quality of care, and deters communication efficiency between physicians and patients. For this
reason, there is a need for robust changes that will increase the allocated time for doctor-patient
visits. The fundamental problem statement in the study seeks to determine the following issue:
1. Should there be a comprehensive paradigm shift in healthcare to increase the duration of
doctor-patient consultations and address the increased complexities of healthcare for
enhanced patient outcomes, patient satisfaction, and overall healthcare quality?
1
MPH Capstone Project – Part 2
PUB-690 Public Health Capstone Project
Policy Analysis
Overview of Current Policy
In 1992, Medicare established a policy stating that a typical doctor’s visit should be
fifteen minutes. Medicare also found the Relative Value Unit (RVU) formula to calculate
2
physician fees effectively and enhance consistency. The formula indicated a typical primary care
doctor visit should be 1.3 RVUs or about fifteen minutes (Linzer et al., 2015). Medicare also set
reimbursement rules for the 15-minute doctor visit policy, influencing private insurance
companies to follow it. Consequently, the 15-minute doctor visit policy became the norm. The
policy has raised critical concerns because it significantly affects patient outcomes and exposes
physicians to time pressure. For instance, Freedman et al. (2021) found that large physician
networks misused the 15-minute policy to maximize their profit by attending to more patients. In
this sense, it influences physicians to focus on money rather than patient satisfaction.
Physicians also experience burnout as they strive to attend to as many patients as
possible. Thus, more than fifteen minutes is needed because physicians spend much time on
computers, keeping and analyzing large volumes of electronic health records regarding patients’
conditions. This time pressure exposes patients to medical errors, including misdiagnoses and
unnecessary drug prescriptions. Sufficient evidence shows that the 15-minute time limit
increases the risk of inappropriate prescription and disease management. Linzer et al., 2015
reveal that time pressure resulting from the 15-minute time limit leads to doctors’ burnout,
undermining the quality of care. Physician burnout is a critical risk factor for medical
malpractices, such as hospital-acquired infections, treatment delays, and inadequate follow-up,
which cause communication problems and inadequate patient assessment (Linzer et al., 2015). In
this sense, the 15-minute doctor visit policy exposes patients to health risks.
Many patients complain about the inadequate time doctors spend with them. According
to Freedman et al. (2021), sixty-five percent of patients feel their time with their physicians is
limited. Only eleven percent of patients and fourteen percent of primary care physicians feel they
spend adequate time together (Freedman et al., 2021). Following the increased population of
3
patients with chronic conditions, the 15-minute time limit exposes patients and their families to
frustration as physicians rush them through appointments. The time limit makes many patients
and their families feel overwhelmed, overlooked, and unsatisfied with the US healthcare system.
Although healthcare providers make multiple appointments, they do not aim at shorter
visits. Instead, heavy workloads and overlooked schedules lead to a lack of time with patients.
For instance, Freedman et al. (2021) argue that physicians work an average of fifty-one hours
weekly and attend to twenty patients daily – and a quarter of the time is spent on non-clinical
paperwork. A related study by Freedman et al. (2021) documented that providers spent thirtyseven percent of the fifteen-minute time on paperwork, leaving inadequate time to assess their
patients. This data shows that the 15-minute doctor visit time limit does not recognize other tasks
physicians perform when assessing the patient, leading to time pressure and patient satisfaction
issues.
Additionally, the 15-minute doctor visit policy influences policymakers to rethink
physician shortages. The demand for medical services increases rapidly following the increased
patient and aging populations. The policy exacerbates the physician shortage issue since the time
limit influences patients to book additional appointments to revisit physicians. Freedman et al.
(2021) reveal that inadequate physicians in the US lead to longer waiting times for appointments,
increased patient costs, and decreased quality of patient care. Thus, policymakers are seeking
effective ways to maximize the 15-minute limit for doctor visits.
Key Stakeholders
Healthcare providers are critical stakeholders in analyzing the 15-minute doctor visit
policy because they face time pressure and burnout, minimizing productivity. Engaging
healthcare providers in developing the 15-minute doctor visit policy can help increase
4
productivity in primary care units. Primary care reflects the first contact for many patients and
informs initial diagnosis and treatment. Understanding how the 15-minute doctor visit policy
affects the primary care providers’ productivity can help address time pressure and burnout
issues. The primary care providers’ productivity comprises the care quality (i.e., the number of
patients and health conditions attended per visit and the care quality) along multiple dimensions
that patients and players may not observe. The 15-minute time limit is a critical factor for the
structure of the primary care providers because it influences the provider-patient relationship,
accuracy, and decision-making (Swanson et al., 2022). Swanson et al. (2022) also found that half
of the physicians’ experience time pressure during appointments, and their work pace is chaotic.
In this sense, healthcare providers are vital stakeholders in analyzing the 15-minute doctor visit
policy because they have critical information regarding the policy’s impact on their job
satisfaction and quality of care.
Patients are also vital stakeholders in analyzing the 15-minute doctor visit policy because
it exposes them to relatively long waiting times and health risks. Since fifteen minutes is
inadequate to assess all health problems for patients with multiple chronic conditions, many
patients make additional appointments, leading to an increased number of individuals who want
to see the doctor. Consequently, patients wait relatively long as healthcare providers attend
multiple appointments. Waiting loses valuable time and discourages patients from adhering to
medical treatment (Linzer et al., 2015). In addition, the 15-minute doctor visit policy exposes
patients to health risks associated with medical errors. The time limit exposes healthcare
providers to malpractices that potentially affect patients’ health. In this sense, patients are vital
stakeholders in analyzing the 15-minute doctor visit policy because they possess vital
information regarding its impact on their health and waiting time.
5
Moreover, healthcare policymakers are vital stakeholders in analyzing the 15-minute
doctor visit policy because they shape health-related rules and regulations. While the federal
government funds most of the nation’s health care (Medicare and Medicaid), state governments
regulate much of health. At the local level, healthcare policymakers can influence health by
informing decisions about planning and zoning with communities (Swanson et al., 2022). For
instance, local governments can collect data about the impact of the 15-minute time limit on
patients with chronic conditions to improve the quality of care. In addition, healthcare payers
(i.e., the federal government and insurance firms) are essential stakeholders in maximizing the
policy because they pay for medical services. The federal government is the largest payer and
has a constitutional mandate to promote its citizens’ general welfare (Dieleman et al., 2020).
Therefore, the federal government must examine the impact of the 15-minute policy on health
care cost and quality of care. On the other hand, insurance firms must examine the impact of
policy changes on medical coverage to ensure client satisfaction (Dieleman et al., 2020).
Key Factors/Multidisciplinary Impacts
Epidemiological and medical factors are vital in analyzing the 15-minute doctor visit
policy. Caring for socially underprivileged patients involves unique challenges requiring
additional time and teamwork. Communicating with patients from different cultural, language,
and health literacy backgrounds takes a relatively long time. Socially underprivileged patients
also have worse physical and psychological health, including more visual, cognition, and hearing
impairments that slow communication (Schwarz et al., 2022). Healthcare providers must build
rapport and identify patient needs during the visit. Building rapport across ethnicity, race, and
educational level may be challenging. Identifying patient needs and negotiating the appropriate
treatment option can take longer due to additional symptoms, illnesses, and concerns. In
6
addition, patients with relatively low health literacy might need to recognize primary symptoms
on time (Schwarz et al., 2022). Schwarz et al. (2022) also reveal that time pressure can
undermine physician empathy, reducing trust in marginalized patients.
Other epidemiological and medical factors to consider in analyzing the 15-minute doctor
visit policy include information-sharing, examination, and decision-making. Gathering
information regarding the illness in marginalized patients, including psychosocial context and
key symptoms, is more time-consuming due to more complex illness and symptoms than in the
general patient population (Schwarz et al., 2022). Exploring the patients’ perspective is vital for
establishing an effective clinical relationship and understanding patients’ beliefs. However,
exploring patients’ perspectives and building effective clinical relationships across various sociocultural backgrounds is more time-consuming.
Economic factors are also vital in analyzing the 15-minute doctor visit policy.
Marginalized patients face severe health inequalities, leading to poorer health status, increased
exposure to patient safety incidents, and higher premature morbidity (Cheraghi-Sohi et al.,
2022). Following increased healthcare costs and limited membership of marginalized
populations in insurance programs, they may need to meet the cost of the additional doctor visits
resulting from time limitations. In addition, physical examination in marginalized patients can
also take longer because of more significant healthcare burdens and disabilities that inhibit
patient care. For example, uninsured marginalized patients may not meet the cost of extended
preventive care requiring disrobing (e.g., breast, rectal, and pap smear exams).
Ethical and legal factors are also vital in analyzing the 15-minute doctor visit policy. Due
to limited time, healthcare providers may refrain from engaging patients with language
limitations in healthcare. Discussion regarding diagnosis and treatment entails sharing illness-
7
related information, promoting behavioral change, and complex decision-making. However,
these tasks may require longer for patients with different health beliefs, languages, trust levels,
and cultures. Participatory decision-making may not address the unique needs of marginalized
patients. While the Equality Act 2020 prohibits discrimination against patients based on
protected characteristics (i.e., gender, age, race, pregnancy, sexual orientation, etc.), the time
limit may influence healthcare providers to discriminate against specific patient populations
(Gonzales & Gavulic, 2020). For example, older patients may need to receive appropriate
examinations due to their complex, multiple conditions within fifteen minutes.
Moreover, political factors are vital in analyzing the 15-minute doctor visit policy.
Medicare adopted the RVU in the early 1990s. In a budget-fair system, introducing new
procedures at significantly high RVU levels has undermined cognitive care, including evaluation
and management services. Following reduced compensation by managed care contracts and
private insurers, providers increased daily amounts to stabilize their incomes. Consequently, use
the fee-for-service (FFS) system to maximize the income from daily visits. The FFS system is
ineffective in delivering comprehensive care because it influences primary care providers to
focus on maximizing profits rather than healing patients and preventing severe illnesses (Linzer
et al., 2015). Hence, policymakers should examine the healthcare providers’ willingness to
maximize the 15-minute time limit because healthcare providers are the only beneficiaries
References
Cheraghi-Sohi, S., Panagioti, M., Daker-White, G., Giles, S., Riste, L., Kirk, S., … & Sanders, C.
(2020). Patient safety in marginalized groups: a narrative scoping review. International
journal for equity in health, 19(1), 1-26.
8
Dieleman, J. L., Cao, J., Chapin, A., Chen, C., Li, Z., Liu, A., … & Murray, C. J. (2020). US
health care spending by payer and health condition, 1996-2016. Jama, 323(9), 863-884.
Freedman, S., Golberstein, E., Huang, T. Y., Satin, D. J., & Smith, L. B. (2021). Docs with their
eyes on the clock? The effect of time pressures on primary care productivity. Journal of
Health Economics, p. 77, 102442. https://doi.org/10.1016%2Fj.jhealeco.2021.102442
Gonzales, G., & Gavulic, K. A. (2020). The Equality Act is needed to advance health equity for
lesbian, gay, bisexual, and transgender populations—American Journal of Public Health,
110(6), 801.
Linzer, M., Bitton, A., Tu, S. P., Plews-Ogan, M., Horowitz, K. R., Schwartz, M. D., &
Association of Chiefs and Leaders in General Internal Medicine (ACLGIM) Writing
Group*. (2015). The end of the 15–20 minute primary care visit. Journal of General
Internal Medicine, 30, 1584–1586. https://link.springer.com/article/10.1007/s11606-0153341-3
Schwarz, T., Schmidt, A. E., Bobek, J., & Ladurner, J. (2022). Barriers to accessing health care
for people with chronic conditions: a qualitative interview study. BMC Health Services
Research, 22(1), 1-15.
Swanson, K. M., Matulis III, J. C., & McCoy, R. G. (2022). Association between primary care
appointment lengths and subsequent ambulatory reassessment, emergency department
care, and hospitalization: a cohort study. BMC Primary Care, 23(1), 39.
APA format with referencesPatrick is a 24 year old male who was playing soccer and twisted his ankle approximately 4 hours before presenting at Urgent Care. He is healthy and takes no medications on a regular basis.The patient’s assessment is as follows:His x-ray is negative for fracture and his examination is consistent with a moderate ankle sprain.Answer the following questions. What medication would you anticipate recommending/prescribing and why?What patient education would you anticipate giving this patient relating to the medication that you chose?
Unformatted Attachment Preview
10/18/23, 5:48 PM
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Case Study Rubric – 20 Pts
Course: NSG6005-Advanced Pharmacology CP03
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Answered
items
completely.
Developed
adequate
responses to
questions. Plan
shows depth
and
application of
course
concepts.
Student did not
submit case
study.
Case study does
not meet
expectations;
plan has no
depth or has
inaccurate
elements listed.
Case study
meets minimal
expectations
with minimal
development of
portions of case
study.
Case study
meets
expectations by
including good
depth for all
elements of plan
but does not
demonstrate
good application
of course
content.
Case study
meets or exceeds
expectations
with creative,
innovative
strategies for
case study.
Identified and
described
pharmacologic
al concepts
and care as
needed.
Student did not
submit case
study.
Case study does
not meet
expectations; no
resources listed.
Case study
meets minimal
expectations
with few
resources listed.
Case study
meets
expectations;
resources listed
are well
developed in all
but a few areas.
/8
Case study
meets or exceeds
expectations
with all resources
well developed
(i.e., textbook,
peer-reviewed
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0 points did not
Student
Emerging
1 point
Numerous
issues
Satisfactory
2 points
Case
study
Proficient
3 pointserrors that
Minor
Exemplary
4 points
Case
study
Criterion
Score
/4
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
Criteria
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
format.
Total
Criterion Score
/8
/ 20
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582505&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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10/18/23, 5:48 PM
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0
points did not
Student
Emerging
1
point
Numerous
issues
Satisfactory
2
points
Case
study
Proficient
3
pointserrors that
Minor
Exemplary
4
points
Case
study
Criterion Score
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
/4
format.
Total
/ 20
Overall Score
No Submisssion
Emerging
Satisfactory
Proficient
Exemplary
0 points minimum
12 points minimum
14 points minimum
16 points minimum
18 points minimum
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582505&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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Cultural Diversity Worksheet
As a healthcare provider, it is important to care for a patient and maintain their culture as much as possible. Using this worksheet, fill out the boxes for specific
cultures (listed below). Different cultures have different values, beliefs and practices. A woman’s cultural background can affect her needs and expectations
during pregnancy and childbirth, as well as how she and her family raise children.
**This worksheet was created in Microsoft Word. Please download to your computer, adjust the size of the boxes, print out, write legibly
For example:
•
•
•
•
•
During pregnancy, women from some cultures do not eat certain foods.
During labor, women from some cultures avoid moving too much; some stay lying down, some prefer to sit or squat.
In some cultures, the father does not attend the birth, but the mother or mother-in-law of the woman does.
After childbirth, some women follow strict rules, such as staying in bed for several days.
****Do your own work!!
Prenatal Care/Habits
or rituals once they
are pregnant
United States
Mexico
Antepartum (during
labor) i.e. hospital vs
home; birthing
process, etc.
Pain management
during labor;
Emotions/How do
they act during labor
(loud, quiet)
Birth rituals when
child is born;
preferred method of
feeding
(breast/bottle)
What is typically
done with the
placenta?
Cultural rituals for
the mother after
delivery
Cultural rituals for
the newborn after
delivery
Saudi Arabia
China
Turkey
Sweden
APA format with referencesAnn is a 34-year-old African American woman who presents with a 6 week history of initial and terminal insomnia and a 10 pound weight loss over that same period. She admits to feeling sad almost every day for the past 6 weeks that occurred after she lost her job. She denies feeling enjoyment, has not engaged in any previously enjoyable activities, and wonders if life is worth living. Her physical examination is negative, vital signs and blood work including a thyroid profile are all within normal limits, and her body mass index is 22. Her mother and sister both had episodes of depression and were treated successfully with sertraline. Answer the following questions. Which medication would you anticipate starting Ann on and why?What is critical education to share with her?
Unformatted Attachment Preview
10/18/23, 5:51 PM
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Case Study Rubric – 20 Pts
Course: NSG6005-Advanced Pharmacology CP03
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Answered
items
completely.
Developed
adequate
responses to
questions. Plan
shows depth
and
application of
course
concepts.
Student did not
submit case
study.
Case study does
not meet
expectations;
plan has no
depth or has
inaccurate
elements listed.
Case study
meets minimal
expectations
with minimal
development of
portions of case
study.
Case study
meets
expectations by
including good
depth for all
elements of plan
but does not
demonstrate
good application
of course
content.
Case study
meets or exceeds
expectations
with creative,
innovative
strategies for
case study.
Identified and
described
pharmacologic
al concepts
and care as
needed.
Student did not
submit case
study.
Case study does
not meet
expectations; no
resources listed.
Case study
meets minimal
expectations
with few
resources listed.
Case study
meets
expectations;
resources listed
are well
developed in all
but a few areas.
/8
Case study
meets or exceeds
expectations
with all resources
well developed
(i.e., textbook,
peer-reviewed
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0 points did not
Student
Emerging
1 point
Numerous
issues
Satisfactory
2 points
Case
study
Proficient
3 pointserrors that
Minor
Exemplary
4 points
Case
study
Criterion
Score
/4
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
Criteria
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
format.
Total
Criterion Score
/8
/ 20
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582506&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
1/2
10/18/23, 5:51 PM
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0
points did not
Student
Emerging
1
point
Numerous
issues
Satisfactory
2
points
Case
study
Proficient
3
pointserrors that
Minor
Exemplary
4
points
Case
study
Criterion Score
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
/4
format.
Total
/ 20
Overall Score
No Submisssion
Emerging
Satisfactory
Proficient
Exemplary
0 points minimum
12 points minimum
14 points minimum
16 points minimum
18 points minimum
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582506&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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Purpose: To facilitate synthesis across the body of evidence to answer the clinical question and determine if there is sufficient evidence to support a practice change.
Directions:
Using the information extracted in your evidence table, you will synthesize the information by determining the quantity of evidence based on the Level you’ve assigned, evaluate consistency across findings, and assess applicability to your population and feasibility to the organization. Finally, you will appraise the strength of the overall evidence to guide a practice recommendation. See the grading rubric embedded in Brightspace.
Instructions:
1. Complete column 2 titled “# of Sources” by entering the number of articles for that Level of Evidence.
2. Complete column 3 titled “Consistency” by evaluating how consistent the findings were for all articles at that Level of Evidence. Did they all come to the same or similar conclusions/recommendations?
3. Complete column 4 titled “Findings” by reviewing the findings for all articles at that Level of Evidence.
Include only statements that directly answer the PICO question.
Summarize and synthesize findings within each level of evidence. This may require you to make a judgement on conflicting evidence from each study within the level.
4. For the row titled “Fit/Applicability,” enter a narrative explanation on how the practice change is applicable to (or “fits”) your population and the needs of the agency. Consider the following:
Is the evidence relevant to the population in your PICO question?
Are resources and support available to implement the intervention? Consider the amount of time for training, length of training, supplies, and other resources that would need to be used. This should be based on critical thinking about the resources and limits of current healthcare agencies.
5. For the row titled “Recommendation,” synthesize the Level of Evidence + the Consistency of Findings + Applicability to recommend (or not recommend) a practice change. Include a narrative explanation on why you have chosen that option. Use the following as a guide:
Option 1: strong evidence, consistent results, high applicability: Solid indication for a practice change is indicated.
Option 2: good evidence, consistent results, moderate to high applicability: Consider pilot of change or further investigation.
Option 3: Good but conflicting evidence, moderate to low applicability: No indication for practice change; consider further investigation for new evidence or develop a research study.
Option 4: Little or no evidence, no applicability: No indication for practice change; consider further investigation for new evidence, develop a research study, or discontinue project.
If you selected either the 1st option or the 2nd option, full or pilot implementation is indicated. If not, implementation is not indicated.
Note about your recommendations:
When evidence includes multiple studies of Level 1, 2, and 3 evidence, there is a similar population or setting of interest, and there is consistency across findings, EBP teams can have greater confidence in recommending a practice change. However, with a majority of Levels 4, 5, 6 evidence, the team should proceed cautiously in making practice changes. In this instance, recommendation(s) typically include completing a pilot before deciding to implement a full-scale change.
Generally, practice changes are not made on Level 4, 5 or 6 evidence alone. Nonetheless, EBP teams have a variety of options for actions that include, but are not limited to: creating awareness campaigns, conducting informational and educational updates, monitoring evidence sources for new information, and designing and conducting research studies.
The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.
Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 750-1,000-word response that addresses the following:
Explain what a health care organization’s administrative role is in executing risk management policies and ensuring compliance with managed care organization (MCO) standards.
Explain what value the regulatory statutes of a typical MCO provide to a health care organization and include strategies pertaining to policies such as conflict resolution and risk management that affect patients and families as well as employees and employers.
Explain what MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Centers for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws.
Identify strategies that can be implemented for developing a culture of reporting and transparency.
In addition to your textbook, you are required to support your analysis with at least three credible health-related resources.
Prepare this assignment according to the guidelines 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.
The purpose of this assignment is to provide the student an opportunity to reflect on learning in the course related to course outcomes, program outcomes, and competencies. Reflective inquiry allows for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes:
CO 1: Employ appropriate health promotion guidelines and disease prevention strategies in the management of mature and aging individuals and families. (PO 5)
CO 2: Formulate appropriate diagnoses and evidence-based management plans for mature and aging individuals and families. (PO 5)
CO 3: Incorporate cultural preferences, values, and health beliefs in the care of mature and aging individuals and families. (PO 5)
CO 4: Integrate theory and evidence-based practice in the care of mature and aging individuals and their families. (PO 5)
CO 5: Assess and manage risk factors for common conditions prevalent in mature and aging individuals and families. (PO 5)
CO 6: Conduct pharmacologic assessment addressing polypharmacy, drug interactions and other adverse events in the care of mature and aging individuals and their families. (PO 5)
CO 7: Apply appropriate evidence-based screening tools in the functional assessments of mature and aging individuals and their families. (PO 5)
DUE DATES
This assignment is due by Saturday at 11:59 p.m. MT of Week 8.
The course ends on Saturday of Week 8. There is no late submission allowed for this assignment.
TOTAL POINTS POSSIBLE
This assignment is worth a total of 50 points.
PREPARING THE ASSIGNMENT
Follow these guidelines when completing this assignment. Contact your course faculty if you have questions.
Describe how the assigned readings, activities, assessments, and clinical experiences in this course helped you to meet Program Outcome 2: Create a caring environment for achieving quality health outcomes. (Care-Focused). Provide at least two specific examples.
Select one of the competencies from AACN Essentials Domain 9 listed below and describe how learning in this course helped you to meet the advanced-level nursing education competency. Provide at least two specific examples.
9.1 Demonstrate ethical comportment in one’s practice reflective of nursing’s mission to society.
9.1h Analyze current policies and practices in the context of an ethical framework.
9.1i Model ethical behaviors in practice and leadership roles.
9.1j Suggest solutions when unethical behaviors are observed.
9.1k Assume accountability for working to resolve ethical dilemmas.
9.2 Employ participatory approach to nursing care
9.2h Foster opportunities for intentional presence in practice.
9.2i Identify innovative and evidence-based practices that promote person-centered care.
9.2j Advocate for practices that advance diversity, equity, and inclusion.
9.2k Model professional expectations for therapeutic relationships.
9.2l Facilitate communication that promotes a participatory approach.
9.3 Demonstrate accountability to the individual, society, and the profession.
9.3i Advocate for nursing’s professional responsibility for ensuring optimal care outcomes
9.3j Demonstrate leadership skills when participating in professional activities and/or organizations.
9.3k Address actual or potential hazards and/or errors.
9.3l Foster a practice environment that promotes accountability for care outcomes.
9.3m Advocate for policies/practices that promote social justice and health equity.
9.3n Foster strategies that promote a culture of civility across a variety of settings.
9.3o Lead in the development of opportunities for professional and interprofessional activities
9.4 Comply with relevant laws, policies, and regulations.
9.4d Advocate for policies that enable nurses to practice to the full extent of their education.
9.4e Assess the interaction between regulatory agency requirements and quality, fiscal, and value-based indicators.
9.4f Evaluate the effect of legal and regulatory policies on nursing practice and healthcare outcomes.
9.4g Analyze efforts to change legal and regulatory policies that improve nursing practice and health outcomes.
9.4h Participate in the implementation of policies and regulations to improve the professional practice environment and healthcare outcomes.
9.5 Demonstrate the professional identity of nursing.
9.5f Articulate nursing’s unique professional identity to other interprofessional team members and the public.
9.5g Evaluate practice environment to ensure that nursing core values are demonstrated.
9.5h Identify opportunities to lead with moral courage to influence team decision-making.
9.5i Engage in professional organizations that reflect nursing’s values and identity
9.6 Integrate diversity, equity, and inclusion as core to one’s professional identity.
9.6d Model respect for diversity, equity, and inclusion for all team members.
9.6e Critique one’s personal and professional practices in the context of nursing’s core values.
9.6f Analyze the impact of structural and cultural influences on nursing’s professional identity.
9.6g Ensure that care provided by self and others is reflective of nursing’s core values.
9.6h Structure the practice environment to facilitate care that is culturally and linguistically appropriate.
9.6i Ensure self and others are accountable in upholding moral, legal, and humanistic principles related to health.
Select one of the competencies from the NONPF Ethics CompetencyLinks to an external site. listed below and describe how learning in this course helped you to meet the competency. Provide at least two specific examples.
Integrates ethical principles in decision making.
Evaluates the ethical consequences of decisions.
Applies ethically sound solutions to complex issues related to individuals, populations and systems of care.
Submit the assignment using correct grammar mechanics and APA style standards.
Writing is free of grammar, syntax, spelling, and punctuation errors
A title page is included in APA format
Document is double-spaced
A reference page is included if references were cited. If a reference page is included, use APA format.
Rubric
NR601_W8 Reflection on Learning Rubric
NR601_W8 Reflection on Learning Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeReflection on LearningReflections should be clear and sufficient in detail.
1. Describe how course assignments or activities will help you achieve Program Outcome 2: Create a caring environment for achieving quality health outcomes (Care-Focused).
a. Provide at least two specific examples.
2. Describe how course assignments or activities will help you achieve ONE of the advanced-level nursing education competencies from AACN Essentials Domain 9.
3. Describe how course assignments or activities will help you achieve ONE NONPF Independent Practice Competency.
45 pts
Excellent
All requirements met.
37 pts
Satisfactory
2 requirements met.
20 pts
Needs Improvement
1 requirement met.
0 pts
Unsatisfactory
No requirements met.
45 pts
This criterion is linked to a Learning OutcomeProfessionalism in CommunicationCommunicate with minimal errors in English grammar, spelling, syntax, and punctuation.
Kindly provide details about the patient’s condition, symptoms, relevant assessment findings, treatment options, nursing care, nursing diagnosis, and education for the patient and their family. Each group has a 15-minute time slot for their presentation. Remember to cite your sources in-text and include a reference list using APA format. You can choose your topic using the Chat section in Moodle, and please stick to one topic per group. Creativity is encouraged
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.
Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.
In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
REQUIRED READINGS FOR THIS ASSIGNMENT/ RESOURCES
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Chapter 5, “Public Policy Design” (pp. 87–95 only)
Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)
American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advoc…
Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a…
Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.
Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.
Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–54To Prepare:
Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
Select a healthcare program within your practice and consider the design and implementation of this program.
Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–4 pages)In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
Unformatted Attachment Preview
10/21/23, 12:47 PM
Week 8: Assignment
Start Assignment
Due Sunday by 10:59pm
Points 100
Submitting a text entry box or a file upload
Attempts 0
Allowed Attempts 2
Back to Module at a Glance (https://waldenu.instructure.com/courses/80874/modules/items/2426796)
ADVOCATING FOR THE NURSING ROLE IN PROGRAM DESIGN
AND IMPLEMENTATION
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but
struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving
species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives.
Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.
Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design
effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the
requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that
meet objectives.
In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a
collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional
organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/80874/modules/items/2426819)
To Prepare:
Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
Select a healthcare program within your practice and consider the design and implementation of this program.
Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–4 pages)
In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you
impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare
programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
BY DAY 7 OF WEEK 8
Submit your interview transcript.
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Week 8: Assignment
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start
Here area.
1. To submit your completed assignment, save your Assignment as WK8Assgn+LastName+Firstinitial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.
NURS_6050_Module04_Week08_Assignment_Rubric
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Week 8: Assignment
Criteria
Program DesignIn a 2- to 4-page
paper, create an interview
transcript of your responses to the
following interview questions.·
Tell us about a healthcare
program within your practice.
What are the costs and projected
outcomes of this program?· Who
is your target population?· What
is the role of the nurse in providing
input for the design of this
healthcare program? Can you
provide examples?· What is your
role as an advocate for your target
population for this healthcare
program? Do you have input into
design decisions? How else do
you impact design?
Ratings
45 to >40.0 pts
Excellent
40 to >35.0 pts
Good
35 to >31.0 pts
Fair
31 to >0 pts
Poor
Response provides a clear and
complete summary of the
Response provides a
summary of the healthcare
Response provides a
summary of the healthcare
Response provides a
summary of the healthcare
healthcare program, including
an accurate and detailed
description of the costs and
program, including a
description of the costs and
project outcomes of the
program that is vague or
incomplete or does not
include costs or projected
program that is vague and
inaccurate, does not include
costs or projected outcomes
projected outcomes of the
program. …Response provides
program. …Response
provides an accurate
outcomes of the program.
…Description of the target
of the program, or is
missing. …Description of the
a clear and accurate description
that fully describes the target
population. …Response
description of the target
population. …Response
provides an accurate
population is vague or
inaccurate. …Explanation of
the role of the nurse in
target population is vague
and inaccurate or is missing.
…Explanation of the role of
provides a clear and accurate
explanation of the role of the
nurse in providing input for the
explanation of the role of the
nurse in providing input for
the design of the program,
providing input for the design
of the program is vague,
inaccurate, or does not
the nurse in providing input
for the design of the
program, and specific
design of the program, including
specific examples. …Response
including some examples.
…Response provides an
include specific examples.
…Description of the role of
examples is vague and
inaccurate, or is missing.
provides an accurate and
detailed description of the role
of the nurse advocate for the
accurate description of the
role of the nurse advocate for
the target population for the
the nurse advocate for the
target population for the
healthcare program selected
…Description of the role of
the nurse advocate for the
target population for the
target population for the
healthcare program selected.
healthcare program selected.
…Response provides an
is vague or inaccurate.
…Explanation of how the
healthcare program selected
is vague and inaccurate or is
…Response provides an
accurate and detailed
explanation of how the
accurate explanation of how
the advocate’s role influences
design decisions and
advocate’s role influences
design decisions and
impacts to program design is
missing. …Explanation of
how the advocate’s role
influences design decisions
advocate’s role influences
design decisions as well as fully
somewhat explains impacts
to program design.
vague or inaccurate.
and impacts to program
design is vague and
explaining impacts to program
design.
Program Implementation· What is
the role of the nurse in healthcare
program implementation?How
does this role vary between
design and implantation of
healthcare programs? Can you
provide examples?· Who are the
members of a healthcare team
that you believe are most needed
to implement a program? Can you
explain why you think this?
Pts
45 pts
inaccurate, or is missing.
40 to >35.0 pts
Excellent
35 to >31.0 pts
Good
31 to >27.0 pts
Fair
27 to >0 pts
Poor
Response provides a clear,
accurate, and complete
Response provides an
accurate explanation of the
Explanation of the role of the
nurse in healthcare program
Explanation of the role of the
nurse in healthcare program
explanation of the role of the
nurse in healthcare program
implementation. …Response
role of the nurse in healthcare
program implementation.
…Response provides an
implementation is vague,
inaccurate, and/or
incomplete. …Explanation of
implementation is vague and
inaccurate or is missing.
…Explanation of how the role
provides an accurate and
detailed explanation of how the
accurate explanation of how
the role of the nurse is
how the role of the nurse is
different between design and
of the nurse is different
between design and
role of the nurse is different
between design and
implementation of healthcare
different between design and
implementation of healthcare
programs and may include
implementation of healthcare
programs is vague or
inaccurate and/or does not
implementation of healthcare
programs is vague and
inaccurate or is missing.
programs, including specific
examples. …Response
provides an accurate and
some specific examples.
…Response provides and
accurate description of the
include specific examples.
…Description of the members
of a healthcare team needed
…Description of the
members of a healthcare
team needed to implement
detailed description of the
members of a healthcare team
members of a healthcare
team needed to implement
to implement the program
selected is inaccurate or
the program selected is
vague and inaccurate,
needed to implement the
program selected.
the program selected.
incomplete.
incomplete, or is missing.
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40 pts
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Week 8: Assignment
Criteria
Written Expression and Formatting
– Paragraph Development and
Organization: Paragraphs make
clear points that support well
developed ideas, low logically, and
demonstrate continuity of
ideas.Sentences are carefully
focused– neither long and
rambling nor short and lacking
substance. A clear and
comprehensive purpose statement
Ratings
Pts
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Paragraphs and sentences
Paragraphs and sentences
Paragraphs and sentences
Paragraphs and sentences
follow writing standards for flow,
continuity, and clarity. …A clear
and comprehensive purpose
follow writing standards for
flow, continuity, and clarity
80% of the time. …Purpose,
follow writing standards for
flow, continuity, and clarity
60%- 79% of the time.
follow writing standards for
flow, continuity, and clarity <
60% of the time. ...Purpose,
statement, introduction, and
conclusion is provided which
introduction, and conclusion
of the assignment is stated,
...Purpose, introduction, and
conclusion of the
introduction, and conclusion
of the assignment is
delineates all required criteria.
yet is brief and not
descriptive.
assignment is vague or off
topic.
incomplete or missing.
5 pts
and introduction is provided which
delineates all required criteria.
Written Expression and Formatting
- English Writing Standards:
Correct grammar, mechanics, and
proper punctuation
Written Expression and
Formatting:The paper follows
correct APA format for title page,
font, spacing, margins,
indentations, parenthetical/in-text
citations, and reference list (if
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Uses correct grammar,
Contains a few (1-2)
Contains several (3-4)
Contains many (≥5) grammar, spelling,
spelling, and punctuation
with no errors.
grammar, spelling, and
punctuation errors.
grammar, spelling, and
punctuation errors.
and punctuation errors that interfere
with the reader’s understanding.
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Uses correct APA format with
Contains a few (1-2) APA
Contains several (3-4) APA
Contains many (≥5) APA
no errors.
format errors.
format errors.
format errors.
5 pts
5 pts
sources are cited).
Total Points: 100
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Concept Map Assignment InstructionsA Direct-Focused Care Written Assignment This assignment will utilize a template designed to promote critical thinking and clinical judgment and to see how these relate to the nursing process. The patient you choose might have multiple co-morbidities. Build your concept map around the concept you chose; this might not necessarily be the patient’s priority concern.For example, you chose the concept of ‘Infection’. Your patient might have co-morbidities related to Perfusion and Gas Exchange which will most often be a higher priority than ‘Infection’. However, to increase your knowledge about ‘Infection’, complete you map according to cues (signs and symptoms) and appropriate interventions related to ‘Infection’. You now have your concept and your patient. Familiarize yourself with the rubric and the assignment requirements; then you are ready to begin.Gather the patient data and organize the information on the nursing process template of the Concept Map Worksheet. Use The nursing process template. After completing the nursing process template, utilize this information to help you build the concept map assignment. The arrows in the map show you the order in which the map is intended to be completed. All boxes should be completed related to the concept you chose.Give credit to your references. You do not need a separate ‘Reference Page’, but APA-style references should be identified at the bottom of the assignment.
Review the assigned case study. Utilizing your selected treatment model, develop a Case conceptualization based on your model of
choice, and respond to the questions as indicated below in a scholarly format addressing the following criteria.
1. Develop a Case Conceptualization using the model of your choice
2. Include all identifying client information as indicated in the case.
3. Include all evidence of the core concepts and related information of the family in the case, based on your selected model.
4. Include- if any- the effects of culture/diversity/inclusion on the case presented
5. In scholarly format, respond to the following:
a. Describe how you would conduct the first session of therapy based on your chosen model of therapy. Include at
least three questions (and proposed responses) you would ask, and how you would establish the initial goals of
therapy. Note: A complete response demonstrates congruence between the clinical model and clinical choices in
questions and goal setting. Be specific in the actual question and proposed answer.
b. Kathy returns for a follow up session. In this session, she mentions to you that she sometimes wonders if she can
“go on” or if she’s “made a terrible mistake” in her life. What are your next steps? A complete answer includes
specific questions the PMNHP would ask the client with specific steps you would take based on the responses.
6. Paper should be in narrative format – maximum 3 pages excluding the title and reference page.
7. Include an introductory paragraph, purpose statement, and a conclusion.
8. Include level 1 and 2 headings to organize the paper.
9. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: I,
we, you, me, our may not be used.
10. Include a minimum of two professional peer-reviewed scholarly journal references to support the paper
11. APA format required (attention to spelling/grammar, a title page, a reference page, and in-text citations)
MHACB/520 Competency 1 Assessment and Rubric
Course Title: Sector Stakeholders: Identifying and Cultivating Alliances
Competency Assessment Title: Identifying Stakeholders and Forming Alliances
Assignment Directions
Identifying Stakeholders and Forming Alliances
Part of having a professional online presence is creating professional content for peers to engage with and to share your expertise.
Imagine that as a member of the executive team working on the strategic plan of the recent merger between the hospital and medical center, you
are asked about the strategies you use to forge growing professional relationships with internal and external stakeholders.
Write a 700- to 1,050-word paper that discusses developing strategic alliances with key internal and external stakeholders and how to network
effectively within the health care sector in which you work.
•
•
•
•
Describe the health care sector in which you work.
Identify key internal and external stakeholders.
Describe strategies used to develop relationships with internal and external stakeholders.
Provide guidelines on networking through different venues such as online events, conferences, social media, professional meetings, or
social events.
Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or
other sources of similar quality).
Include a citation of your article in your assignment as the author of the article. An APA-formatted citation should be included in the body of the
article and referenced at the end of the article.
Publish the article on your LinkedIn® account.
Format your citations according to APA guidelines.
Submit a link to your article.
Alternative Assignment Option
If you are unable to, or would rather not, complete the assignment in LinkedIn, you may submit the assignment using a Word document. Please let
your faculty know if you intend to choose this option. In the document, please include all necessary components as described in the assignment
instructions. If you have any questions or need any clarification about the requirements, please ask your instructor.
Copyright 2022 by University of Phoenix. All rights reserved.
MHACB/520 Competency 1 Rubric
Page 2 of 2
Competency Assessment Rubric
Assignment/Performance
Criteria
Mastery
100%
Meets Expectations
85%
1. Health Care Sector
(weight 30%)
Thoroughly and clearly described
the health care sector in which
the student works
Partially described the health care
sector in which the student works
Did not describe the health care
sector in which the student works
2. Internal and External
Stakeholders
(weight 30%)
Thoroughly and clearly identified
key internal and external
stakeholders; thoroughly
described innovative strategies
used to develop relationships
with internal and external
stakeholders
Partially identified key internal and
external stakeholders; partially
described moderate strategies used
to develop relationships with internal
and external stakeholders
Did not describe key internal and
external stakeholders; did not
describe strategies used to develop
relationships with stakeholders
3. Networking Guidelines
(weight 30%)
Provided appropriate and useful
guidelines on networking through
different venues such as online
events, conferences, social
media, professional meetings, or
social events
Provided somewhat appropriate and
useful guidelines on networking
through venues such as online
events, conferences, social media,
professional meetings, and social
events
Provided inappropriate and unusable
guidelines on networking through
venues such as online events,
conferences, social media,
professional meetings, and social
events
4. References
(weight 5%)
Cited 3 reputable references to
support the assignment (e.g.,
trade or industry publications,
government or agency websites,
scholarly works, or other sources
of similar quality)
Cited 1 to 2 reputable references to
support your assignment (e.g., trade
or industry publications, government
or agency websites, scholarly works,
or other sources of similar quality)
Did not cite reputable references
5. Grammar and Writing
Mechanics
(weight 5%)
Accuracy in grammar, sentence
structures, sentence boundaries,
and word choice enhanced the
content.
Rare inaccuracies/errors in
grammar, sentence structures,
sentence boundaries, and word
choice did not detract from the
content.
Occasional or frequent
inaccuracies/errors in grammar,
sentence structures, sentence
boundaries, and word choice
detracted from the content.
Copyright 2022 by University of Phoenix. All rights reserved.
Not Met
0%
MHACB/520 Competency 2 Assessment and Rubric
Course Title: Sector Stakeholders: Identifying and Cultivating Alliances
Competency Assessment Title: Collaborative Assignment Reflection
Assignment Directions
Collaborative Assignment Reflection
Part 1: Hospital Merger and Culture Considerations
Imagine that your hospital has recently merged with a group of medical centers. As a high-level executive, you have been asked to develop a
strategy to integrate the two cultures. Success with this effort must also translate into the optimization of patient care, quality, safety, cost of
services, and access to care.
Research best practices and devise approaches to address potential issues and pushback. Create a proposal of 700 to 875 words that includes
the following:
•
•
•
•
•
Identify and describe the personnel groups affected by the merger.
Predict and explain challenges in merging the two cultures. Consider the cultures of the clinical staff and the medical staff.
Propose strategies or solutions to address those challenges.
Explain the negotiation strategies that may be useful to elicit buy-in on the decisions.
Design the modes of communication you will use to convey these strategies to the clinical and medical staff.
o Identify who should be the primary communicator.
o Outline the information that should be included.
o Explain how buy-in will occur.
Part 2: Reflection
Facilitation and negotiation are skills you will use on a regular basis as a leader in health care. You researched best practices and applied them to
a merger of two workforce cultures.
Reflect on the research you completed as well as your proposal you wrote in Part 1. Write 350 words on the following:
Copyright 2022 by University of Phoenix. All rights reserved.
MHACB/520 Competency 2 Rubric
Page 2 of 4
•
•
•
Examine the overall strategy and implementation you devised to address the different aspects of the company merger. What were the
major factors and considerations that led you to make the strategic decisions for the merger?
Discuss the health sector best practices you drew from your research to help determine the decision-making and negotiation approaches
defined in your proposal.
Describe any facilitation and negotiation strategies that you have used or experienced in any setting that you can use in your professional
life.
Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or
other sources of similar quality).
Combine your proposal and the reflection.
Format your citations according to APA guidelines.
Submit your assignment.
Copyright 2022 by University of Phoenix. All rights reserved.
MHACB/520 Competency 2 Rubric
Page 3 of 4
Competency Assessment Rubric
Assignment/Performance
Criteria
Mastery
100%
Meets Expectations
85%
Not Met
0%
1. Part 1: Personnel
Groups
(weight 15%)
Thoroughly and clearly identified
and described the personnel
groups affected by the merger
Generally identified and described
the personnel groups affected by
the merger
Did not identify or describe the
personnel groups affected by the
merger
2. Part 1: Merging Cultures
(weight 15%)
Clearly predicted and thoroughly
explained challenges in merging
the two cultures; clearly considered
the cultures of the clinical staff and
the medical staff; proposed
innovative and clear strategies or
solutions to address those
challenges
Partially predicted and explained
challenges in merging the two
cultures; somewhat considered the
cultures of the clinical staff and the
medical staff; proposed general
strategies or solutions to address
those challenges
Did not clearly predict or explain
challenges in merging the two
cultures; did not clearly consider the
cultures of the clinical staff and the
medical staff; did not propose clear
strategies or solutions to address
those challenges
3. Part 1: Modes of
Communication
(weight 15%)
Thoroughly and clearly explained
the negotiation strategies that may
be useful to elicit buy-in on the
decisions; designed clear and
thorough modes of communication
that will be used to convey these
strategies to the clinical and
medical staff; clearly identified who
should be the primary
communicator; clearly outlined the
information that should be included;
clearly and thoroughly explained
how buy-in will occur
Partially explained the negotiation
strategies that may be useful to
elicit buy-in on the decisions;
designed general modes of
communication that will be used to
convey these strategies to the
clinical and medical staff;
somewhat clearly identified who
should be the primary
communicator; partially outlined
the information that should be
included; generally explained how
buy-in will occur
Did not clearly explain the
negotiation strategies that may be
useful to elicit buy-in on the
decisions; did not design clear
modes of communication that will be
used to convey these strategies to
the clinical and medical staff; did not
clearly identify who should be the
primary communicator; did not
clearly outline the information that
should be included; did not clearly
explain how buy-in will occur
4. Part 2: Implementation
and Strategy
(weight 15%)
Thoroughly and clearly examined
the overall strategy and
implementation devised to address
the different aspects of the
company merger; clearly provided
the major factors and
considerations that led to the
strategic decisions for the merger
Partially examined the overall
strategy and implementation
devised to address the different
aspects of the company merger;
somewhat clearly provided the
major factors and considerations
that led to the strategic decisions
for the merger
Did not clearly examine the overall
strategy and implementation devised
to address the different aspects of
the company merger; did not clearly
provide the major factors and
considerations that led to the
strategic decisions for the merger
Copyright 2022 by University of Phoenix. All rights reserved.
MHACB/520 Competency 2 Rubric
Page 4 of 4
Assignment/Performance
Criteria
Mastery
100%
Meets Expectations
85%
Not Met
0%
5. Part 2: Health Sector
Best Practices and
References
(weight 20%)
Thoroughly discussed the health
sector best practices drawn from
research to help determine the
decision-making and negotiation
approaches defined in the proposal;
cited 3 reputable references to
support the assignment (e.g., trade
or industry publications,
government or agency websites,
scholarly works, or other sources of
similar quality)
Generally discussed the health
sector best practices drawn from
research to help determine the
decision-making and negotiation
approaches defined in the
proposal; cited 1 to 2 reputable
references to support the
assignment (e.g., trade or industry
publications, government or
agency websites, scholarly works,
or other sources of similar quality)
Did not clearly discuss the health
sector best practices drawn from
research to help determine the
decision-making and negotiation
approaches defined in the proposal;
did not cite reputable references to
support the assignment (e.g., trade
or industry publications, government
or agency websites, scholarly works,
or other sources of similar quality)
6. Part 2: Facilitation and
Negotiation Strategies
(weight 15%)
Thoroughly and clearly described
any facilitation and negotiation
strategies that have been used or
experienced in any setting that can
be used in professional life
Generally described any facilitation
and negotiation strategies that
have been used or experienced in
any setting that can be used in
professional life
Did not clearly describe any
facilitation and negotiation strategies
that have been used or experienced
in any setting that can be used in
professional life
7. Grammar and Writing
Mechanics
(weight 5%)
Accuracy in grammar, sentence
structures, sentence boundaries,
and word choice enhanced the
content.
Rare inaccuracies/errors in
grammar, sentence structures,
sentence boundaries, and word
choice did not detract from the
content.
Occasional or frequent
inaccuracies/errors in grammar,
sentence structures, sentence
boundaries, and word choice
detracted from the content.
Copyright 2022 by University of Phoenix. All rights reserved.
APA format with referencesYou have been following your patient for the past 2 years. You have worked with them to lose weight by changing lifestyle and nutritional habits. They continue to be overweight (body mass index [BMI] of 33) and have tried to cut down carbohydrate and fat intake, but now presents with polyuria, polydipsia, and an elevated random blood sugar of 164. You have ordered anHbA1c test in the past, and the values were less than 6.2%. However, the most recent test indicated an HbA1c greater than 7%. They are not on any medications, but does have a sulfa allergy.You officially have enough evidence to officially start treating this patient for Type II Diabetes Mellitus. Their 3 P symptoms, their random blood sugar (BS), and A1C are all evidence ofT2DM.Answer the following questions. What is the first medication you would prescribe? Discuss how you determined which one to give first and how you based this decision on specific factors.What education regarding medication management would you need to do?
Unformatted Attachment Preview
10/18/23, 5:46 PM
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Case Study Rubric – 20 Pts
Course: NSG6005-Advanced Pharmacology CP03
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Answered
items
completely.
Developed
adequate
responses to
questions. Plan
shows depth
and
application of
course
concepts.
Student did not
submit case
study.
Case study does
not meet
expectations;
plan has no
depth or has
inaccurate
elements listed.
Case study
meets minimal
expectations
with minimal
development of
portions of case
study.
Case study
meets
expectations by
including good
depth for all
elements of plan
but does not
demonstrate
good application
of course
content.
Case study
meets or exceeds
expectations
with creative,
innovative
strategies for
case study.
Identified and
described
pharmacologic
al concepts
and care as
needed.
Student did not
submit case
study.
Case study does
not meet
expectations; no
resources listed.
Case study
meets minimal
expectations
with few
resources listed.
Case study
meets
expectations;
resources listed
are well
developed in all
but a few areas.
/8
Case study
meets or exceeds
expectations
with all resources
well developed
(i.e., textbook,
peer-reviewed
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0 points did not
Student
Emerging
1 point
Numerous
issues
Satisfactory
2 points
Case
study
Proficient
3 pointserrors that
Minor
Exemplary
4 points
Case
study
Criterion
Score
/4
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
Criteria
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
format.
Total
Criterion Score
/8
/ 20
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582504&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
1/2
10/18/23, 5:46 PM
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0
points did not
Student
Emerging
1
point
Numerous
issues
Satisfactory
2
points
Case
study
Proficient
3
pointserrors that
Minor
Exemplary
4
points
Case
study
Criterion Score
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
/4
format.
Total
/ 20
Overall Score
No Submisssion
Emerging
Satisfactory
Proficient
Exemplary
0 points minimum
12 points minimum
14 points minimum
16 points minimum
18 points minimum
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582504&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
2/2
Write a learning Portfolio addressing the pointers below.A concept map that provides an overview of the negotiated contract between a student and the advisor with respect to expected course outcomes across all components of the clinical experienceCareer intentions supported by the selected clinical activitiesObjectives in current clinical placement toward program goalsResearch experience supporting program progressionReflective commentary and evidence (examples) of progress toward achieving specific course objectivesPresentations at local, regional, national, or international meetingsAudit projects undertaken and completedMemorable opportunities and organizational challengesAnything else you feel may be relevant
APA Format with referencesA patient is followed for several years with heart failure. His case is early at stage A.Answer the following questions. Which stage A patients would benefit from adding an angiotensin-converting enzyme inhibitor?As the patient progresses through the heart disease stages, when are diuretics typically added? Are all heart failure patients candidates for diuretics at this stage?
Unformatted Attachment Preview
10/18/23, 5:42 PM
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Case Study Rubric – 20 Pts
Course: NSG6005-Advanced Pharmacology CP03
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Answered
items
completely.
Developed
adequate
responses to
questions. Plan
shows depth
and
application of
course
concepts.
Student did not
submit case
study.
Case study does
not meet
expectations;
plan has no
depth or has
inaccurate
elements listed.
Case study
meets minimal
expectations
with minimal
development of
portions of case
study.
Case study
meets
expectations by
including good
depth for all
elements of plan
but does not
demonstrate
good application
of course
content.
Case study
meets or exceeds
expectations
with creative,
innovative
strategies for
case study.
Identified and
described
pharmacologic
al concepts
and care as
needed.
Student did not
submit case
study.
Case study does
not meet
expectations; no
resources listed.
Case study
meets minimal
expectations
with few
resources listed.
Case study
meets
expectations;
resources listed
are well
developed in all
but a few areas.
/8
Case study
meets or exceeds
expectations
with all resources
well developed
(i.e., textbook,
peer-reviewed
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0 points did not
Student
Emerging
1 point
Numerous
issues
Satisfactory
2 points
Case
study
Proficient
3 pointserrors that
Minor
Exemplary
4 points
Case
study
Criterion
Score
/4
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
Criteria
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
format.
Total
Criterion Score
/8
/ 20
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582503&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
1/2
10/18/23, 5:42 PM
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0
points did not
Student
Emerging
1
point
Numerous
issues
Satisfactory
2
points
Case
study
Proficient
3
pointserrors that
Minor
Exemplary
4
points
Case
study
Criterion Score
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
/4
format.
Total
/ 20
Overall Score
No Submisssion
Emerging
Satisfactory
Proficient
Exemplary
0 points minimum
12 points minimum
14 points minimum
16 points minimum
18 points minimum
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582503&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
2/2
Substance Abuse and Suicide Prevention Action Plan: Read ″Substance Abuse and Suicide Prevention: Evidence & Implications″ from the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA). (https://books.google.com/books?hl＝en&lr＝&id＝0cn1fZ6OB2YC&oi＝fnd&pg＝PA1&dq＝Substance+Abuse+and+Suicide+Prevention:+Evidence+and+Implications&ots＝QhV92dQrU3&sig＝ssq8q1gXSV-BitzypjaDLCxLfm4#v＝onepage&q＝Substance%20Abuse%20and%20Suicide%20Prevention%3A%20Evidence%20and%20Implications&f＝false) Write a 2-page action plan that you can present to the public health authorities in your local community, which has experienced a steady growth in the incidences of death by suicide in the past decade. You want to suggest that a program be instituted that can address the behavioral disorders that may lead to death by suicide and help prevent it. The action plan must address the following: . The means to better understand the relationships among mental illnesses, substance abuse, and death by suicide . A public health approach to prevent behavioral disorders and death by suicide . The steps to develop and implement the program . The means to evaluate the effectiveness of the program at designated future time intervals Format your assignment according to APA guidelines.
Write something simplified and do some mistake in grammar because English is my second language and I don’t want the doctor to know that I got help. Use your own words and attach a source for it.
As a healthcare provider, it is important to care for a patient and maintain their culture as much as possible. Using this worksheet, fill out the boxes for specific cultures (listed below). Different cultures have different values, beliefs and practices. A woman’s cultural background can affect her needs and expectations during pregnancy and childbirth, as well as how she and her family raise children.
**This worksheet was created in Microsoft Word. Please download to your computer, adjust the size of the boxes, print out, write legibly
For example:
• During pregnancy, women from some cultures do not eat certain foods.
• During labor, women from some cultures avoid moving too much; some stay lying down, some prefer to sit or squat.
• In some cultures, the father does not attend the birth, but the mother or mother-in-law of the woman does.
• After childbirth, some women follow strict rules, such as staying in bed for several days.
• ****Do your own work!!
Prenatal Care/Habits or rituals once they are pregnant
Antepartum (during labor) i.e. hospital vs home; birthing process, etc.
Pain management during labor; Emotions/How do they act during labor (loud, quiet)
Birth rituals when child is born; preferred method of feeding (breast/bottle)
Human-Technology Interface Assignment
The purpose of this paper is to explore the human-technology interface and what nurses need to
consider when implementing human-technology interface to improve the quality of patient care
along with patient privacy concerns.
You are the head nurse at Regions Hospital emergency department. The hospital is adopting a
new human-technology interface system that will expedite admissions for patients arriving by
ambulance. This technology will involve scanning the barcode on the patient’s driver’s license
while at the scene and electronically sending the personal data to the receiving emergency
department. You need to design an implementation plan. Write a 3-5 page paper on your chosen
method to implement this technology. Write out the steps to successfully complete this
implementation.
Assignment Rubric
Criteria
Introduction to the Human-technology
Interface
Description of data transfer process
• Include patient privacy information
Description of method used for
implementation with rationale
Discussion of steps required from
implementation to completion
Identify potential problems with
implementation and provide solutions for
avoiding the anticipated problems
Conclusion
APA 7th edition, Spelling, Grammar
Total points
Points
20
50
50
30
25
15
10
200
All the instructions are in the attachment. I chose Huntingtons Disease.
Unformatted Attachment Preview
1
NURSING 2290 PATHOPHYSIOLOGY
INSTRUCTIONS FOR WRITTEN ASSIGNMENTS
Purpose: This Pathophysiology course is designed for the conceptual study of disease in general
rather than studying specific disorders. All disorders can be approached using the concepts
introduced on the first day of class. You will apply these concepts to investigate one disease of
your choice in a term paper worth 15% total. We will use a stepped approach to develop the
paper using proper APA format.
General Instructions:
1) Step #1: Choose one disease from the list of diseases associated with the content of the
course. You will become an expert on this disease! If you don’t see the disease you are
interested in, discuss it with the instructor. Do NOT re-use a topic or paper that you have
previously written for another class. Choose a NEW topic for this paper!
AIDS/HIV
Arthritis, Rheumatoid
Asthma
Cancer: Breast
Cancer: Other (pick one!)
Cancer: Ovarian
Cancer: Prostate
Cerebrovascular Accident (CVA –
Stroke)
Congestive Heart Failure
Crohn’s Disease
Cystic Fibrosis
Diabetes Type 1
Diabetes Type 2
Emphysema (COPD)
Hemophilia
Hodgkin’s Lymphoma
Huntington’s Disease
Hypertension
Leukemia
Lupus, Systemic
Myocardial Infarction
Multiple Sclerosis
Muscular dystrophy
Peripheral Vascular Disease
Renal Insufficiency/Failure/Acute
Renal Insufficiency/Failure/Chronic
Scleroderma
Sickle Cell Disease (Anemia)
Thalassemia major
If you would like to do a disease that is not listed, please get the approval of the
professor before you start.
2) Step #2: Annotated bibliography (Pass/Fail: 1 Point)
Directions: Locate a minimum of 3 sources on your topic. At least one must be a
NURSING source. They may be from library databases or a professional book (written
for professionals, NOT patients). Do NOT use the textbook. NO MATERIAL FROM
PATIENT-EDUCATION WEBSITES WILL BE ACCEPTED. If it does not have an
author listed, don’t use it. Class notes are not appropriate. Sources must be professional,
peer-reviewed material. Patient education material is NOT acceptable. If you have
never used a library database before, please see our librarians to learn how. Their motto is
“Bother me!”
Use a cover sheet as per the paper instructions below. List each article reference using
correct APA style, exactly as you would write it on a reference page. Summarize each
2
article below its’ reference in one or two paragraphs. Use your own words – do NOT
quote the article! Give specific details found in the article. Submit the bib on Canvas.
3) Step #3: Write your paper (14 points) and submit to “turnitin.com.”
Follow the outline provided. Each topic should get at least a paragraph. Each subtopic
should get a sentence. One idea per sentence, one topic per paragraph works well.
***Note: students often ask what an “acceptable” percentage of similarity from Turn-itin. is. College-level work requires that the student read many sources and summarize and
synthesize the material IN THE STUDENT’S OWN WORDS. This does NOT mean
substituting a word here and there. Quotes should be used when appropriate, but most of
a paper should be the student’s explanation of the material. While a completely original
paper is an unrealistic expectation, a similarity index of greater than 25% is getting high
for a college-level paper. Over 30% should be reworked. The teacher will always review
the actual Turn-it-in report, but the student is expected to review it and make changes
based on the results before the paper is submitted.
Double-space between sections and underline your headings. Perfect spelling and
grammar are expected. Do NOT rely on spell-check – it won’t tell you if you used the
correct word! If you use a medical term, define it. You are expected to use sources other
than your textbook, such as professional journals and books. This is to be a scholarly
paper representing your best effort. All papers should have references and citations.
Don’t forget that the Writing Center is available to help, but you must come prepared and
make an appointment!
Lists with bullets are not acceptable. Everything should be in complete sentences and
PARAGRAPH form. Charts, graphs, and illustrations are not appropriate for this paper.
Explain information in full sentences and paragraphs.
You may submit your paper to www.turnitin.com as many times as needed to rework it.
The first submission will return immediate results, but subsequent submissions will need
at least 24 hours for a live person to review it, so allow enough time for revisions.
***NOTE: positive comments on the annotated bibliography do not guarantee a specific
grade on the paper. The paper is graded on its’ own merits as above.
All students are expected to do their own individual work, put the material in their
own words, and use appropriate citations. Plagiarized work violates the Molloy
University Code of Conduct. It will receive an automatic 0 and will be forwarded to
the Assistant Vice President of Academic Affairs for remedial intervention. Use of
AI (artificial intelligence) programs or ghost-writing services is not permitted and
will result in a grade of 0 and disciplinary referral as well.
The copy of the paper that is in Turn-it-in on the due date will be the one that is graded.
If there is no paper, there is no grade. It is up to the student to make sure that the paper
submitted is compatible with Turn-it-in, and that there is a similarity index showing.
Word files are preferred. PAGES files are not compatible.
3
An abstract is not necessary. The cover page should include the following:
Name of student
Pathophysiology Nur 2290 Section ___
Professor Mary E. Fassetta
Date
Name of the Disease you chose.
A). Briefly define the disease. For instance, “Chick pox is a contagious viral disease
most commonly seen in childhood that results in a generalized raised, red,
maculopapular rash accompanied by intense itching, known as pruritis.” Be sure to
use and define any medical terminology. Only use one or two sentences. Cite all
sources in the text, even if the material is paraphrased.
B). State the morbidity and mortality of the disease (how many people get it – either
% of the population or the number per 100,000 each year.) Cite your sources. If the
statistics are from another country, specify which country.
C). Identify the etiology of the disease. If there is no specific etiology, explain some of
the theories that scientists currently believe about the disease.
D). Identify any risk factors for the disease. Be sure to put these in paragraph form – I
will take off for lists! Be very specific: say what age, what gender, etc. For instance,
say “African American males over aged 65” rather than race, gender, and age.
E). Explain the pathophysiology of the disease. Be sure to explain what is
happening on the cellular level and link it to the signs and symptoms. This should
be the largest portion of the paper. I am looking for terms and concepts used class.
F). Identify and define the signs and symptoms of the disease. Be sure to use the
correct medical terminology for the signs and symptoms and explain them. I am
looking for how the pathophysiology causes the signs and symptoms.
G). Identify and describe the diagnostic tests used and the abnormal findings that would
confirm the diagnosis of the disease. Again, be specific. Give normal and
diagnostic values for lab tests, abnormal scan findings, etc.
H). Describe the standard treatments used for this disease. Tell me what meds are used
and what they do. Briefly describe surgeries and treatments.
I).
Describe the complications and sequellae that may arise from the disease. Use
appropriate medical terminology and define any terms.
J). Include the references and appropriate citations in APA style on a separate page.
4
GRADING CRITERIA
PATHOPHYSIOLOGY TERM PAPER
Name of student:
Topic:
The assignments will be graded using the rubric below as a guideline:
Grade:
Mastery level
Content
(80%)
Expression
(10%)
APA style/
spelling/
grammar
(10%)
EVALUATION:
Poor: 60-69
Fair: 70-79
Good: 80-89
Excellent: 90-100
Incomplete info,
inadequate,
significant
omissions
40-49
Fair: missing
details or sections,
barely covers
material done in
class
50-59
Brief, basic,
lacks college-level
vocabulary, does
not follow outline.
6-7
Incorrect APA
style, minimal use
of resources and/or
inadequate
citations,
occasional spelling
or grammar issues
6-7
Good: information
basic but generally
complete.
Fulfills
requirements.
60-69
Average,
acceptable, flows
smoothly, easy to
read
8-9
Minor APA
corrections/
several extra
sources, missing a
nursing source,
rare spelling or
grammar issues
8-9
Excellent: includes
extensive detail & current
research, sophisticated
content, goes beyond
requirements.
70-80
Thorough, clear, identifies
nuances, complex but
understandable, flows well
from topic to topic.
10
Correct APA style,
rich variety of
sophisticated resources,
perfect spelling and
grammar
10
Disorganized,
confusing, hard to
follow ideas
Cut & paste = 0
0-5
Not APA style,
and/or inadequate
resources, and/or
Frequent spelling/
grammar errors
that interfere with
readability
0-5
Turn-it-in report:
Content (80%):
Expression (10%):
APA Style/Spelling/Grammar (10%):
5
APA REMINDERS
If you are unfamiliar with APA style, access it on the JET Library home page of the Molloy
website, or refer to the Publication Manual of the American Psychological Association. Below
you will find a few brief reminders of how to use APA style. It is by no means complete. Please
refer to the Manual for specific instructions. Don’t forget to utilize the services of the Writing
Lab, located on the lower level of the Casey building.
Writing Style: Formal academic writing should NOT sound like normal conversation. Do not
use abbreviations or contractions. Do not include the words “I, You, or Your” or any personal
anecdotes. When organizing your work, use one thought per sentence and one topic per
paragraph. Read your work out loud, or better yet, have someone proofread it, to pick up
incomplete or run-on sentences. Make sure that the tense of the subject agrees with the verb.
NEVER begin a sentence with “Being that…” It is incorrect.
Citations: Footnotes are not used in APA style. Citations within the text should be used when
material is obtained from another source. If the material is paraphrased, the citation need only
include the author’s last name and the year of publication. For example, a paraphrased
paragraph would be followed by (Smith, 2006). Alternately, you could say “Smith (2006)
suggested that….” If the material is a direct quote, the citation should include the page number,
as in (Smith, 2006, p. 52). For works without authors, works with multiple authors, or other
combinations, please refer to the Manual. Be sure to include adequate documentation of your
sources. You probably have no first-hand knowledge of this material, so frequent citations are
expected.
References: Use only references from professional, peer-reviewed books and journals. If it
does not have an author’s name, do not use it. Do NOT use the textbook or your class notes!
References should be no more than ten years old to have the most accurate information. They
should be in alphabetical order by lead author’s last name. Titles such as MD or RN are not
used, only initials of first and middle name. All authors should be included. In general,
references should look like the following examples (American Psychological Association, 7th
editon):
Examples of References
Bastione, J.K., Pepitone, S., & Collard, G. (2001). The relationship between personality type
and area of practice in graduate baccalaureate nurses. Nursing Administration,11(7),315321. http://doi.org/1234567890
Rowan, D.Q. (2004). APA references for nursing students. Nursing Education Quarterly,
4(2), 57-62. http://doi.org/0987654321
Smith, M.B. & Jones, L.C. (2006). Pathophysiology for nursing students. Lippincott, Williams
& Wilkins. http://doi.org/13-246813570
Updated 7.28.23
1) Create one Word documents containing all parts of the assignment.
Format your document with one-inch margins and 12-point Times New Roman font.
One page, double-spaced for each part.
Instructions: Part 1
1. -Read Capko, Chapter 1: ” Managing Revenue to Maximize Profit” Provide a
summary of the three key points (one paragraph each) that you have learned from the
chapter.
-In your opinion, what is the one biggest challenge for successful revenue cycle
management?
Instructions: Part 2
Provide a one page summary of the article “What is healthcare revenue cycle
management.”
Readings:
https://revcycleintelligence.com/features/what-is-healthcare-revenue-cycle-management
SEPARATE WORD DOCUMENT
Instructions:
1. Review the following:
•
•
Article: What Is Healthcare Revenue Cycle Management?
Video: Medical Billing – The Revenue Cycle, Co-Pays, Claims, Deductibles and More!
2. You have just been hired in your first job as a medical practice administrator.Your top priority, according
to the doctors, is to “fix the billing department”
What are four indicators/benchmarks you will identify to determine what needs to be “fixed”
Week 9 discussionThink about a familiar clinical practice area where interest groups are attempting to bring about a change in clinical care or systems of service delivery. Assume new, game-changing research finding are published and received wide attention. Identify groups that might have an interest in these finding. What are their likely reactions to new research?The discussion must address the topic.Rationale must be provided400 words in your initial post Minimum of two scholarly references in APA format within the last five years published
Managing peptic ulcer disease may require adjustments to patients’ treatment plans over time due to changes in their symptom severity, underlying health conditions, or comorbidities. Discuss the process of evaluating and monitoring patients with peptic ulcer disease to determine the most appropriate treatment plan and when modifications may be necessary.
Peptic ulcer disease is a complex and intriguing gastrointestinal illness that requires healthcare professionals to be adamant in its evaluation and management. Patients affected by the condition often suffer from severe symptoms and other health conditions (Laucirica et al., 2023). For this reason, healthcare providers must continually monitor and assess these patients to ensure they receive the most effective treatment plan. I will analyze the procedures of evaluating and monitoring peptic ulcer disease and discuss plausible modifications to patient treatment plans where necessary.
When a patient with peptic ulcer disease is admitted for healthcare service, practitioners go through various diagnosis processes to evaluate clinical symptoms (Lee et al., 2022). Using endoscopy, Helicobacter testing, and optic imaging procedures helps healthcare professionals identify crucial symptoms and factors contributing to the progression of the disease. A patient’s lifestyle choices, genetic history, and medical history are analyzed to facilitate the initiation of an appropriate treatment plan (Lee et al., 2022). Initial medical treatments may involve interventions, prescription drugs such as antacids, proton pump inhibition method, and Helicobacter pylori eradication.
However, the treatment, as mentioned earlier, plans are only a prerequisite, and regular follow-up appointments and checkups are essential to continue monitoring the patient’s progress and possible outcomes (Luo et al., 2022). Healthcare providers must assess the patient’s drug adherence and repeatedly conduct endoscopic testing to look for complications. They may modify a patient’s treatment plans to relieve symptoms and reduce severity by adjusting the drug doses, changing the drugs themselves, or even performing surgical operations to alleviate the most severe cases (Luo et al., 2022). Patients require education and professional guidance to manage peptic ulcer disease effectively.
Candice Rawlins
Prompt #2 The treatment of hepatitis, a viral infection affecting the liver, has evolved significantly over the past few decades with the introduction of new antiviral agents. Select and discuss one of the different classes of drugs used to treat various types of hepatitis (e.g., hepatitis B and C), their mechanisms of action, and the factors healthcare professionals must consider when selecting the most appropriate treatment regimen for a specific patient, such as the viral genotype, disease stage, and potential drug interactions.
Over recent years, there have been advancements in treating hepatitis B and C variants. Such drugs include nucleoside/nucleotide analogs for hepatitis B and direct-acting antivirals (DAAs) for hepatitis C. Nucleoside/nucleotide analogs for hepatitis B act by inhibiting the reverse transcriptase enzyme, which is crucial for viral replication and thus is incorporated into the growing viral DNA chain, causing premature termination (Zenchenko et al., 2021). It is essential to consider the viral genotypes of hepatitis B since each variant responds differently to treatment. Furthermore, we should consider the disease stage or severity, potential drug interactions, and renal and hepatic function to ensure correct dose adjustments and monitor treatment efficacy. Furthermore, it is crucial to monitor medication resistance since the patient may resist the drug over time. Direct-acting antivirals (DAAs) target specific viral proteins essential for replication of the hepatitis C virus. They also inhibit viral replication at various stages in the lifecycle (Dietz & Maasoumy, 2022). To ensure better health outcomes, it is crucial to consider viral genotypes to ensure the correct choice of DAA. Additionally, considering disease severity or stage helps determine the treatment duration. Furthermore, it is crucial to consider prior treatment history and possible drug interactions to monitor for treatment response. Therefore, it is essential to develop a personalized treatment plan to optimize treatment outcomes for hepatitis patients.
On what policy issues might nurses lobby Congress? What strategies might nurse use to have their voices heard?The discussion must address the topic.Rationale must be provided400 words in your initial postMinimum of two scholarly references in APA format within the last five years published
Choose at least 5 of the golden rules of leadership, and explain the best way you can implement them in your workplace with samplesSubmission Instructions:Your PPT will follow the A.P.A. style for PPT presentation and tips for effective PPT provided by your instructor (see attachment)Support from at least two-three academic sources.
Project title: Improving Medication Adherence and Health Outcome in African American Adults with Hypertension
number of participants: 15
1. Table. Create a data coding sheet. You will use this in order to “code” your study data (See file for example)
2. Paper. How will you collect your study data? What demographic information will you collect about your study participants? Hint: look at what other similar studies have reported. What data do you need to complete to measure the outcomes for your DNP project? Create your data collection tools that you will use during your DNP project. Include a place to the information from the data coding sheet.
Project Outcome to use to complete above titled table and paper
The primary outcome is an apparent alteration in blood pressure measurements pre- and post-intervention. These measurements will be documented at the initial visit, during follow-ups, and at the three-month mark to conduct a comprehensive assessment. The intervention’s efficacy will be evaluated by comparing these readings. The anticipated outcome is not only to improve blood pressure readings but also to enhance stability. The product will be assessed statistically using paired t-tests depending on the normality of the data distribution.
Measurement and Evaluation Strategy
Measuring the clinical and financial outcomes will require a quasi-experimental research design utilizing a pre-test and post-test approach. Initial baseline measurements of blood pressure, Hill-Bone Scale scores, and relevant demographic and clinical data will be acquired upon recruitment and initiation of the intervention. Utilizing the tool will be essential in evaluating the secondary clinical outcome: Improvement in Hill-Bone Compliance Results. Telehealth and in-person visits over three months will monitor progress, address barriers, and reinforce education. Participant feedback and knowledge assessments through pre- and post-intervention questionnaires will measure the third clinical outcome: Enhanced Knowledge and Understanding of HTN. A concluding evaluation will be undertaken three months post-baseline to assess any alterations in blood pressure and Hill-Bone Scale scores.
Unformatted Attachment Preview
Coding Table for DNP Project “ title”
Assigned?
Subject 1
Subject 2
Subject 3
Subject 4
Subject 5
Subject 6
Subject 7
Subject 8
Subject 9
Subject 10
Subject 11
Subject 12
Subject 13
Subject 14
Subject 15
Subject 16
Subject 17
Subject 18
Subject 19
Subject 20
Informed
Consent
AA01
NT45
Etc… please
make sure
it’s unique
and not
traceable to
the
participant(s)
in your study
Demographic
Sheet
B249
O64
Pre-Test
Post-Test
Z104
VR56
Le99
KM7
Kay complete an ASAM level of care placement & DSM Diagnosis
Kay never knew her biological father. When she was four years old her mother, married a man whom she called
“Daddy,” an alcoholic whom she thought for several years was her father. He was affectionate to her while her
mother was cold and critical; however, this affection soon took the form of sexual molestation. By the age of nine,
she realized “something was wrong here,” and she started trying to escape from him. For the next six years he was
“always trying to rape me.” When he was drunk and she resisted, he would physically abuse her as well, but not
her stepsister who was five years older and his biological daughter. Finally when she was 15, his alcoholism
became “so bad that he became abusive to my mother,” and her mother left him. Throughout this period some
extended family members were aware of the sexual abuse of Kay, but were afraid to bring it to her mother who
was in denial about it. Kay, who also felt it was useless to tell her mother, was left feeling unprotected, depressed,
and with “low self esteem.” She ran away to Florida but soon met a man who introduced her to marijuana and
cocaine. She began using socially just to stay awake so she could dance at the night club. Eventually she was
spending nights with customers for money and soon had a clientele of about twenty men per week. Each time she
engaged with a customer she would escape as she described as if she was in a dream and leave her body until the sex
act was over. She never used drugs while engaging with her customers. During the interview she reported that she
was tired, hungry, and had been smoking cocaine alone for three days before she ran out of money, she is depressed
since she sold her car for ten bags and has no way of getting to work.
Dimension 1 ___________________Dimension 2 ___________________
Dimension 3 _____________________
Dimension 4 ______________________
M.H. __________
Dimension 5 ______________________
M.H. ___________
Dimension 6 _____________________
M.H. _____________
Locus (QUADRANT) of CARE __________________
ASAM Level of Care _________________
DSM -5 Diagnosis _____________________________________________________________
DSM-5 Diagnosis ______________________________________________________________
Mental Health 224 in-class assignment
ASAM / LOCUS
Level of Care Utilization System/ American Society of Addiction Medicine
For the following case determine the proper ASAM.
(utilize or infer using your clinical judgement from the information provided below)
The client is a 38-year-old Hispanic/Latina woman who is the mother of two teenagers. Maria M.
presents with an 11-year history of crack cocaine dependence avg. $200 per week, and a 2-year
history of opioid dependence about $30 per day. She also has a history of trauma related to a
longstanding abusive relationship (now over for 6 years). She is not currently in an intimate
relationship at present and there is no current indication that she is at risk for either violence or
self-harm. Maria has a history of persistent major depression, and panic disorder being effectively
treated with antidepressants. She is motivated to stop using drugs. She supports her drug usage by
selling Marijuana, and also receives regular child-support from her wealthy ex- spouse, who
although abusive provides financial support for Maria and his two children. Maria currently smokes
cigarettes, about a pack every three days besides that she reports no major medical concerns.
Dim 1 ___________
Dim 2_____________
Dim 3_____________
DIM 4 S.A. ___________
DIM 4 M.H._____________
DIM 5. S.A._______________
DIM 5. M.H.______________
DIM 6. S.A._______________
DIM 6. M.H.______________
W/M _______
LEVEL OF CARE________________
Understanding and Using
Current ASAM Criteria
for Ce-Classes.com
Learning Objectives
After completing this course,
participants will:
Identify ASAM and the history of its
development
Describe how ASAM criteria fit into the
assessment process
Identify ASAM Levels of Care
Describe ASAM Dimensional Criteria
2
The 3rd Edition of the ASAM
Criteria
3
Overview of Training
What is ASAM and the history of its
development
How ASAM fits into the assessment process
Levels of Care
Dimensional Criteria
4
ASAM Criteria Background
In the late 1980’s a taskforce is
assembled to integrate existing admission
and continued stay criteria
Both NAATP and ASAM were involved
Ownership of the criteria was left with
ASAM
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
5
ASAM Criteria Background
Goal –
unifying the addiction field to a
single set of criteria
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
6
ASAM Criteria Background
The criteria were developed through a
collaborative process in which consensus
was achieved
Clinical experts, researchers and a
coalition of stakeholders were included in
the process
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
7
ASAM Criteria Background
The edition with which most practitioners
are familiar is the Patient Placement
Criteria-2R (2001) which replaced the
1996 version
A new edition came out in the Fall of 2013
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
8
ASAM Criteria Background
The ASAM criteria are guidelines for:
– Assessment
– Service planning
– Placement
– Continued stay
– Discharge
For clients with substance abuse
disorders
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
9
ASAM Criteria Background
The ASAM criteria is a framework for
patient assessment that is
multidimensional
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
10
ASAM Criteria Background
The ASAM criteria is also a description of
levels of care
– Levels of care refers to the places within
the service continuum from outpatient
to intensive inpatient treatment.
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
11
ASAM Criteria Background
The ASAM criteria provides a means for
deciding upon the appropriate intensity of
service based upon the patient’s severity
of illness
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
12
When to use ASAM
At first contact with client (at assessment,
when referral is made, to see if a referral is
appropriate for your program)
During treatment
– If not doing well
– If achieving goals
At discharge
– To see what the client needs next
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
13
How to Use the Criteria
To assign the appropriate level of
service and level of care.
To make decisions about continued
service or discharge by ongoing
assessment and review of progress.
To do effective treatment planning
and documentation.
14
ASAM Criteria
Basic Concepts
The main goal of the system is to provide
individualized – clinically driven –
treatment
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
15
ASAM Criteria
Basic Concepts
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
16
ASAM Criteria
Basic Concepts
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
17
ASAM Criteria
Basic Concepts
Each element of the process informs
the next
This is a cyclical process
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
18
ASAM Criteria Background
Intensity of Service is often referred
to as IS
Severity of Illness is often referred to
as SI
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
19
ASAM’s New Definition of
Addiction
Addiction is a primary, chronic disease of
brain reward, motivation, memory and
related circuitry. Dysfunction in these
circuits leads to characteristic biological,
psychological, social and spiritual
manifestations. This is reflected in an
individual pathologically pursuing reward
and/or relief by substance use and other
behaviors.
ASAM (2011). Public Policy Statement: Definition of
Addiction
20
ASAM’s New Definition of
Addiction
Addiction is characterized by inability to
consistently abstain, impairment in
behavioral control, craving, diminished
recognition of significant problems with
one’s behaviors and interpersonal
relationships, and a dysfunctional
emotional response. Like other chronic
diseases, addiction often involves cycles of
relapse and remission. Without treatment
or engagement in recovery activities,
addiction is progressive and can result in
disability or premature death.
ASAM (2011). Public Policy Statement: Definition of
Addiction
21
Definition of Other Key Terms
Clinically managed: Directed by non
physician addiction specialist rather
than medical personnel. Appropriate
for individuals whose primary problems
involve emotional, behavioral,
cognitive, readiness to change, relapse
or recovery environment concerns.
Intoxication/withdrawal/biomedical
concerns are all minimal if they exist at
all.
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
22
Definition of Terms
Medically Monitored:
Services
provided by an interdisciplinary staff of
nurses, counselors, social workers,
addiction specialist and other health
and technical personnel under the
direction of a licensed physician.
Medical monitoring is provided through
appropriate mix of direct patient
contact, review of records, team
meetings, 24 hour coverage by a
physician and a quality assurance
program.
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
23
Definition of Terms
Medically Managed:
Services that
involve daily medical care, where
diagnostic and treatment services
are directly provided and/or
managed by an appropriately trained
and licensed physician.
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
24
Dimensional Assessment
ASAM Criteria should be utilized to:
– Determine the appropriate level of service and
level of care
– Conduct effective treatment planning and
documentation
– Make choices about continued service or
discharge through ongoing assessment and
review of progress notes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
25
Dimensional Assessment
Dimension 1: Acute Intoxication/Withdrawal
Potential
Dimension 2: Biomedical Conditions and
Complications
Dimension 3: Emotional/Behavioral/Cognitive
Conditions and Complications
Dimension 4: Readiness to Change
Dimension 5: Relapse/Continued Use/Continued
Problem Potential
Dimension 6: Recovery Environment
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
26
ASAM Criteria
Assessment
Assessment of Biopsychosocial Severity
and Level of Function
This is the first step in the process
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
27
Assessment of Severity &
Level of Function
First identify if there is acute intoxication
and/or withdrawal potential
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
28
Assessment of Severity &
Level of Function
Evaluate
– Biomedical conditions & complications
– Behavioral conditions & complications
– Cognitive conditions & complications
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
29
Assessment of Severity &
Level of Function
Evaluate
– Readiness to change
– Relapse/continued use potential
– Recovery environment
Retrieved from: http://www.slideshare.net/ChangeCo/whats-new-in-theasam-criteria-22205861
30
What is ASAM PPC?
The Patient Placement Criteria
provide:
– A tool to use along with your clinical
judgment
– Criteria for how bad the problem is and
what the client needs
– A framework for determining who needs
what level of care
– Standard descriptions of levels of care
and who might need them
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
31
Client-Directed, Outcome
Informed
Enhances efficient use of limited resources
Variable length of stay determined by client need and
progress
Can increase retention and reduce drop outs and relapse
Broad flexible levels of care, such as mixing IOP and
housing to get a residential type program
Creative use of resources to develop a treatment package
for each client
Client and clinician have a choice about treatment levels –
least intensive while safe and effective
Can enter the system at any level of care and move as
needed
If there are limited levels of care in your area, link with
other providers as needed
32
The Heart of Client-Directed Tx
Build a therapeutic alliance… it is
the greatest determinant of
treatment outcome
33
The Heart of Client-Directed Tx
Come to agreement with your
client about the treatment
–Goals
–Strategies
–Methods
34
The Heart of Client-Directed Tx
If the client is not with you, your
treatment will not be effective
Help the client accomplish what
is important to them, which will
likely involve staying clean and
sober
35
The Heart of Client-Directed Tx
Court-ordered or leveraged
treatment can be effective
The goal may be to satisfy the
court order!
36
Assessment
What does the client want? Why now?
2. Multidimensional assessment including
strengths, supports, resources, risks and
deficits
3. Imminent danger
– Relates to all dimensions
– Immediate Need Profile
– Risks that require immediate attention
Consider the 3 H’s
– History
– Here and now
– How concerned are you
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
1.
37
The Three H’s of Assessment
History
Here and Now
How uncomfortable are you?
38
Rating Risk in the 6 Dimensions
0 – no or very low risk. Stable.
1 – mild discomfort, can be stabilized, functioning
restored easily
2 – moderate risk/difficulty functioning but can
understand support services
3 – serious difficulties – in or near imminent danger
4 – highest concern – severe, persistent, poor ability
to cope with illness, life threatening
Can also rate as LOW, MEDIUM, and
HIGH
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
39
How do the Dimensions lead
to a level of care?
Dimensions 1, 2 and 3 – high risk/severity =
immediate need for high intensity services
Dimensions 4, 5, and 6 – balance out
strengths and challenges in these dimensions
interact – combine and contrast to determine
the lowest intensity service level that is safe
and effective for the client (and others)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
40
Dimension 1 – Acute
Intoxication/Withdrawal
What risk is associated with the
patient’s current level of acute
intoxication?
Are there current signs of
withdrawal?
Does the patient have supports to
assist in ambulatory detoxification, if
medically safe?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
41
Dimension 1 – Acute
Intoxication/Withdrawal
Is there significant risk of severe
withdrawal symptoms or seizures,
based on the patients previous
withdraw history, amount, frequency
chronicity and recent discontinuation
or significant reduction of alcohol or
other drug use.
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
42
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
0= no intoxication or
Does not affect
withdrawal or already
resolved
placement
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
43
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
1= minimum to
Level 1D – outpatient
moderate intoxication
or withdrawal with
minimal risk
(some onsite
monitoring)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
44
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
2= has some difficulty
Level 2D – outpatient
coping with moderate
intoxication or
withdrawal, some risk
of more serious
symptoms
(extended onsite
monitoring)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
45
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
3= has significant
Level 3.2D –
difficulty coping with
severe signs and
symptoms of
intoxication or
withdrawal, risk of
more severe
symptoms
residential (social
setting detox) or
Level 3.7D (social
setting detox with
medication support)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
46
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
4= incapacitated with
Level 4D – inpatient
severe signs and
symptoms, continued
use poses clear
danger, withdrawal
poses clear danger
(hospital)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
47
Dimension 2: Biomedical
Conditions & Complications
Are there current physical illnesses, other than
withdrawal, that need to be addressed because
they create risk or complicate treatment?
Are there chronic conditions that affect
treatment?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
48
Dimension 2: Biomedical
Conditions & Complications
Hypertension, cardiac disorders, vascular
disorders, diabetes, and seizure disorders are all
high on the list
Chronic benign pain syndromes are often an
issue
There are a range of chronic disorders that may
need to be considered in placement decisions
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
49
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
0: no biomedical
Does not affect
problems
placement
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
50
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
1= adequate ability to
Level 1
cope, mild to moderate
signs and symptoms
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
51
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
2= some difficulty coping,
Level 1, 2 or 3
problems may interfere
with treatment, fails to
care for serious
biomedical problems
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
52
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
3= poor ability to cope
Level 4
with serious biomedical
problems
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
53
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
4= incapacitated with
Level 4
severe biomedical
problems
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
54
Dimension 3: Emotional, Behavioral, or
Cognitive Conditions & Complications
Are there current psychiatric illnesses or
psychological, behavioral, emotional, or
cognitive problems that need to be
addressed because they create risk or
complicate treatment?
Are there chronic conditions that affect
treatment?
Do any emotional, behavioral, or
cognitive problems appear to be an
expected part of the addictive disorder,
or do they appear to be autonomous?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
55
Dimension 3: Emotional, Behavioral, or
Cognitive Conditions & Complications
Even if connected with the addictive
disorder, are they severe enough to
warrant specific mental health
treatment?
Is the individual capable of
managing the activities of daily
living?
Does the individual have the
resources to cope with the
emotional, behavioral, or cognitive
problems?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
56
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
0= no emotional or
Does not affect
mental health problem
or if it exists, it is
stable
placement
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
57
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
1= diagnosed mental
Level 1
disorder requiring
intervention but does not
interfere with treatment
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
58
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
2= persistent mental
Level 2
illness with symptoms
that interfere with
treatment but do not
constitute immanent risk
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
59
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
3= serious symptoms,
Level 3
disability, and impulsivity
but not requiring
involuntary hospitalization
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
60
Matching assessment of
severity with level of care
Assessment of Severity
Level of Care
4= serious symptoms,
Level 4
disability and impulsivity
requiring involuntary
hospitalization.
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
61
Dimension 4- Readiness /
Motivation
What is the individual’s emotional
and cognitive awareness of the need
to change?
What is his or her level of
commitment to and readiness for
change?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
62
Dimension 4- Readiness /
Motivation
What is or has been his or her
degree of cooperation with
treatment?
What is his or her awareness of the
relationship of alcohol or other drug
use to negative consequences?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
63
Dimension 4: Readiness to Change
Pre-contemplation:
does not
know they have a problem. “In
denial.” Avoids thinking about
their behavior. Risk rating: 4
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
64
Dimension 4: Readiness to Change
Contemplation:
aware of
problem but ambivalent. Teeter
between cost and benefit of
continued use. Risk rating: 3
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
65
Dimension 4: Readiness to Change
Preparation:
intending to take
action in the immediate future
Risk rating: 2
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
66
Dimension 4: Readiness to Change
Action:
specific overt changes
have been made in the last 6
months to reduce risk. Risk
rating: 1
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
67
Dimension 4: Readiness to Change
Maintenance:
achieved change
goals for 6+ months. Risk
rating: 0
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
68
Matching assessment of severity with
level of care
Not as direct a correlation between
Dimensions 4, 5, and 6 and levels of
care
May need to use motivational
strategies to attract them into
treatment
Resistance is expected and does not
exclude clients from treatment
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
69
Matching assessment of severity with
level of care
If risk is low in other dimensions,
may work on increasing motivation
in a lower level of care first to
prepare for treatment: a “discovery
plan”
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
70
Matching assessment of severity with
level of care
If high risk/severity in other
dimensions, may need to “contain”
the client and do motivational
enhancement in a higher level of
care
Look for strengths
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
71
Dimension 5: Relapse, Continued Use
or Continued Problem Potential
Is the patient in immediate danger of
continued severe mental health
distress and or alcohol and drug use?
How aware is the patient of relapse
triggers, ways to cope with cravings
to use, and skills to control impulses
to uses or impulses to harm self or
others?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
72
Dimension 5: Relapse, Continued Use
or Continued Problem Potential
Does the patient have any
recognition of, understanding of, or
skills with which to cope with his or
her addictive or mental disorder in
order to prevent relapse, continued
use or continued problems such as
suicidal behavior?
Lee, Editor (2001) ASAM PPC-2R, ASAM Patient Placement Criteria
for the Treatment of Substance Related Disorders, 2nd Ed Revised,
73
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
Relapse:
stops using on purpose
and begins again
Continued use:
never stops using
to begin with
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
74
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
Would continued use/relapse be
dangerous to the client or to others
– Children
– Other adults in their lives
– Others in the world
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
75
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
How severe are the problems if the
individual is not successfully engaged
in treatment at this time?
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
76
Dimension 5: Relapse, Continued
Use or Continued Problem Potential
How aware is the individual of relapse
triggers:
– Ways to cope with cravings to use,
– Skills to control impulses to use or,
– Impulses to harm self or others?
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
77
Matching assessment of severity with
level of care
Have to consider in relation to other
dimensions
High severity can indicate need for higher
intensity of services but not necessarily
Consider the lowest intensity that is safe
and effective
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
78
Dimension 6: Recovery/Living
Environment
Assess for risks, issues, strengths, skills, and
resources in:
– Recovery supports
– Living environment
– Family, friends, social network
– Work/school
– Finances
– Transportation
– Legal mandates/requirements
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
79
Matching assessment of severity
with level of care
Consider in relation to other dimensions
High severity can indicate need for higher
intensity of services but not necessarily
Consider the lowest intensity that is safe and
effective
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
80
Continued Treatment
Guidelines
Keep the client in the current level of
care if:
– They are making progress but have not yet achieved
their goals
– They are not yet making progress but have the
capacity to resolve their problems, are actively
working on goals, and continued treatment is
necessary to reach their goals
– New problems have been identified that can be
treated at this level
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
81
Discharge & Transfer Criteria
Consider transferring if:
– They have achieved their goals and
resolved the problem (transfer to a
lower level of care)
– They are unable to resolve the
problem despite adjustments to the
treatment plan (increase level of care)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
82
Discharge & Transfer Criteria
Consider transferring if:
– They demonstrate a lack of capacity to
resolve the problems (increase level of
care)
– If their problems get worse or
– If more problems emerge that can’t be
effectively treated at this level of care
(increase level of care)
Posze, L . ASAM PPC-2R Patient Placement Criteria 101
83
Discharge Planning
Discharge planning is part of treatment
planning
It isn’t a separate or isolated activity
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
84
Discharge Planning
A discharge plan is really a deferred
treatment plan
It should be as specific and concrete as
any other treatment plan
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
85
Levels of Service
Each level of care has specific
parameters which define it
86
Outpatient with Supportive Living
Provides structure and support
Primary medical services not
necessary
Patients not in “Imminent Danger”
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
87
Residential Treatment
Provides 24 hour:
– Structure and support (except 3.1 24
hours)
Primary medical services not
necessary
Patients in “Imminent Danger”
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
88
Inpatient Treatment
Provides 24 hour:
– Structure and support
– Access to medical & nursing services
Patients in “Imminent Danger”
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
89
What is Imminent Danger?
A strong probability that certain behaviors
will occur (e.g., continued alcohol or drug
use or non-compliance with psychiatric
medications)
These behaviors will present a significant
risk of serious adverse consequences to
the individual and/or others (as in a
consistent pattern of driving while
intoxicated)
The likelihood that such adverse events
will occur in the very near future
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
90
What is Imminent Danger?
In order to constitute “Imminent
Danger” ALL THREE ELEMENTS
must be present
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
91
Imminent Danger
Requires In-patient treatment
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
92
Immediate Need
A criteria to be considered in
determining level of care
93
Immediate Need Profile
Dimension #1: Acute
Intoxication/Withdrawal Potential:
(a) Have you ever had life-threatening
withdrawal signs or symptoms?
___ No ___Yes
(b) If yes, are you currently having similar
withdrawal symptoms?
___No ___Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
94
Immediate Need Profile
Dimension #2: Biomedical Conditions and
Complications:
(a) Do you have any current, untreated severe
physical problems?
___No ___Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
95
Immediate Need Profile
Dimension #3: Emotional/Behavioral
Conditions & Complications:
(a) Do you feel that you are imminently in
danger and could harm yourself or
someone else?
___No ___Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
96
Immediate Need Profile
Yes to Dimension 1, 2, and/or 3
Questions:
Requires that the caller/client immediately
receive medial or psychiatric care
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
97
Immediate Need Profile
Dimension #4: Treatment
Acceptance/Resistance:
(a) Do you feel that you are in immediate need
of alcohol/drug treatment?
__No __Yes
(b) Have you been referred or required to have
an assessment and/or enter treatment by the
criminal justice system, health or social services,
work/school, or family/significant other?
__No __Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
98
Immediate Need Profile
Yes to Dimension 4 Alone:
Client to be seen for an assessment as
soon as possible – must be within 48
hours,
Client assessed for motivational
strategies, unless client imminently likely
to walk out and needs containment
strategies
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
99
Immediate Need Profile
Dimension #5: Relapse/Continued
Use Potential
(a)Are you currently under the influence?
__No __Yes
(b) Are you likely to continue use of
alcohol and/or other drugs, or to relapse,
in an imminently dangerous manner?
__No __Yes
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the Criteria.
100
Immediate Need Profile
Yes to Dimension 5, Question (a):
Requires the client receive assessment for
withdrawal potential
Shulman & Associates. (2007). American Society of Addiction
Medicine (ASAM) How and When to Use the C
Physiology of Adrenal Gland
Cushing’s Syndrome: Definition
Cushing’s Syndrome: Physiology (Concepts (e.g., perfusion, cellular regulation, gas exchange, glucose regulation, hormonal regulation, etc.) don’t forget to include that.
Total of 4 slides okay
Also find a article on cushion syndrome and write a summary 2 pages
please send me the link of article to be approved from the professor before typing the summary
Peer-reviewed journal article within the last 5 years
I attached the project we are doing as a group but my part is the part Im having you do
Unformatted Attachment Preview
GLENDALE COMMUNITY COLLEGE
FALL 2023
Syllabus
Nursing Science 212
Medical-Surgical Nursing II
I. Catalog Statement
NS 212 continues the study of the adult with unmet needs resulting from health problems. This course addresses the
needs of patients across the adult life span whose health care needs require more complex nursing interventions and
skills using the nursing process. The student is encouraged to build on previously acquired nursing skills, including
the use of health care informatics. Clinical experiences are included, which provide an opportunity for the student to
apply theoretical concepts and build clinical reasoning skills as part of the healthcare team.
Course Units
Total Lecture Units: 2.0
Total Laboratory Units: 2.5
Total Course Units: 4.5
Contact Hours
Total Lecture Hours: 32 hours (16 weeks x 2 = 32 hours)
Total lab and clinical hours = 120 hours (16 x 7.5)
Lab hours = 24 hours
Clinical hours = 96 hours
Total Faculty Contact Hours: 152 hours
Prerequisite: NS211
Recommended Corequisite: NS 202
II. Course Entry Expectations
Prior to enrolling in the course, the student should be able to:
1. Incorporate knowledge of scientific principles, psychosocial needs, and developmental concepts, as well as
previously learned nursing knowledge and skills, into patient care
2. Calculate and administer medication dosages accurately
3. Document and communicate nursing care activities and patient/client responses to the plan of care, utilizing
correct terminology, spelling, sentence structure, and grammar
4. Complete previously learned nursing skills and procedures safely, applying principles to practice
5. Provide safe and effective nursing care for at least two acutely ill patients in the clinical setting
III. Course Exit Standards
Upon successful completion of the required coursework, the student will be able to:
1. Use the Hierarchy of Human Needs as a holistic framework for assessing and providing nursing care for
patients/clients
2. utilize the nursing process in the care of the patient/client with increasingly complex health care needs in a variety
of settings
3. identify and describe nursing goals and behaviors associated with preventing illness, promoting health, and
restoration of the wellbeing g of patients/clients and family
4. demonstrate increasing clinical skills by providing safe, organized, patient-centered, and effective care for 2 – 3
patients/clients
5. provide care designed to reduce risk factors including, but not limited to, common physiological and cultural
considerations in aging adults, such as a decline in physical function, social isolation, and increasing disability
6. demonstrate a satisfactory level of growth and proficiency in clinical competencies and indicators as measured on
the clinical evaluation tool
7. identify and discuss complex, interrelated variables which impact acutely ill patients and their families
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
1
GLENDALE COMMUNITY COLLEGE
FALL 2023
8. incorporate knowledge of scientific principles, psychosocial needs, and developmental concepts, as well as
previously learned nursing knowledge/skills into individualized patient care
9. apply knowledge of medical-surgical health problems, treatment modalities, and nursing skills in the clinical
setting with increasing proficiency
10. interpret results of appropriate laboratory and diagnostic tests, differentiating values for older adults
11. plan and demonstrate appropriate communication techniques when collaborating with patients, family members,
peers, and other members of the health care team
12. identify guidelines that provide the nurse with the direction needed to address ethical issues and problems.
IV. Student Learning Outcomes
Upon successful completion of this course, the student will be able to:
1. Demonstrate increasing skills by providing nursing care for up to three patients in adult and geriatric
populations.
2. Demonstrate the knowledge of complex, interrelated variables which impact the acutely ill patient and
identify appropriate nursing care for this patient.
3. Demonstrate second-level competencies as defined by the clinical evaluation tool.
V. Course Content
A.
Human Needs and the Application of the Nursing Process to Medical-Surgical Nursing
1. Assessment, Human Needs Hierarchy, and the medical-surgical patient
2. Nursing Diagnosis
3. Planning
4. Nursing interventions
5. Evaluation
1.0 Hour
B.
Social, Ethnic, and Cultural Diversity in Nursing
1. Cultural, social, and racial disparities
2. Geriatric considerations on medical-surgical health problems
3. Conflict management
4. Implicit bias
1.0 Hours
C.
Health Problems Related to Oxygenation/Perfusion Needs: Nursing Management of
Cardiac Concerns Part
(Oxygenation-Perfusion Needs)
1. Cardiovascular changes associated with aging
2. Heart failure
3. Valvular disorders
4. Inflammation and infection
3.0 Hours
D. Health Problems Related to Oxygenation/Perfusion Needs: Nursing Management of
Vascular Concerns Part II
(Oxygenation-Perfusion Needs)
1. Hypertension
2. Peripheral arterial problems
3. Venous health problems
3.0 Hours
E.
5.0 Hours
Health Problems Related to Nutrition-Hydration and Elimination Needs: Nursing
Management of Gastrointestinal Concerns
(Nutrition and Elimination Needs)
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
2
GLENDALE COMMUNITY COLLEGE
FALL 2023
1.
2.
3.
4.
5.
F.
Neoplasms
Intestinal disorders
Inflammatory bowel diseases
Ostomy procedures and nursing care
Intravenous supplemental nutrition
Health Problems Related to Regulation and Metabolism: Nursing Management of
Patients with Endocrine Disorders
(Body Integrity Needs)
1. Adrenal
2. Thyroid/parathyroid
3. Pituitary
4. Pancreas
6.0 Hours
G. Health Problems Related to Male and Female Sexual Needs: Reproductive Concerns
(Sexuality Needs)
1. Reproductive issues/problems across the lifespan
2. Inflammation and infection
3. Tumors
4. Structural abnormalities
5. Problems of sexual function
6. Rape
7. Sexually transmitted infections
6.0 Hours
H. Health Problems Related to Oxygenation Needs: Respiratory Concerns, Part I
(Oxygenation Needs)
1. Upper airway problem
2. Neoplasm
4.0 Hours
I.
Nursing Management of Health Problems Related to Tissue Perfusion Needs:
Hematologic Concerns
(Body Integrity Needs)
1. Anemias
2. White cell disorders
3. Platelet disorders
3.0 Hours
J.
Clinical laboratory
1. Patient-centered plan of care
• Individualize nursing care plan based on the patients’ preferences, needs,
and values.
2. Evidence-based practice
• Practice National Patient Safety Goals, including medication
administration, patient identifiers, and infection control
3. Teamwork and collaboration
• Collaborate with assigned RN and CNA in clinical
• Provide SBAR communication report
4. Quality improvement
• Review Quality Improvement Measures by the Joint Commission
• Review Agency for Healthcare Research and Quality’s (AHRQ)
Improving Diabetes Care Quality
120.0 Hours
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
3
GLENDALE COMMUNITY COLLEGE
FALL 2023
5. Patient safety
• Practice National Patient Safety Goals, including medication
administration, patient identifiers, and infection control
6. Information technology
• Utilize electronic health record to gather patient data
VI. Required Textbooks and Resources
Elsevier Clinical Skills: Essentials Collection (online software program)
Harding, M. M., Kwong, J., & Roberts, D., Hagler, D., & Reinisch, C. (2020). Lewis’s medical-surgical
nursing: Assessment and management of clinical problems (11th ed.). Elsevier. (ISBN: 9780323551496)
Kaplan Nursing Integrated Testing Program (online software program)
Lippincott DocuCare. Software Program.
Lippincott CoursePoint Enhanced for Karch’s Focus on Nursing Pharmacology, 8th Edition.
Morris, D. (2017). Calculate with confidence (7th ed.). Elsevier. (ISBN: 978-1974805310)
Pagana, K. & Pagana, T. (2018). Mosby’s manual of diagnostic and laboratory tests (6th ed.). Elsevier. (ISBN:
978-0323446631)
Potter, P. A, Perry, A. G., Stockert, P. A., Hall, A. M., & Ostendorf, W. R. (2021). Fundamentals of nursing
(10th ed). Elsevier. (ISBN: 978-0323677721)
Skidmore-Roth, L. (2021). Mosby’s 2022 nursing drug reference (35th ed.). Elsevier. (ISBN: 978-0323826075)
Swearingen, P. L., & Wright, J. (2018). All-in-one nursing care planning resources (5th ed.). Elsevier. (ISBN:
978-0323532006)
VII. Methods of Evaluation
1. Four Unit Exams (10% + 10% + 20% + 20%) ……………… 60%
a. Unit Exam 1……………………………10%
b. Unit Exam 2……………………………10%
c. Unit Exam 3……………………………20%
d. Unit Exam 4……………………………20%
2. Pop Quizzes…………………………………………………. 7%
3. Homework Assignment …………………………………… 1%
4. Kaplan Integrated Exam…………………………………… 2%
5. Kaplan Medical-Surgical II Exam…………………………. 2%
6. Group Assignment: Presentation/Group Activities………… 3%
7. Class Participation…………………………………………. 1%
8. Comprehensive Final Exam………………………………… 24%
Total: 100%
9. Written papers: pass/fail
10. Simulated skills assessment/practicum: pass/fail
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
4
GLENDALE COMMUNITY COLLEGE
FALL 2023
11. Clinical performance: pass/fail
GRADING SCALE
91-100% =
A
82-90%
=
B
75-81%
=
C
74.5% or less=
F
(Score below 74.5 will not be rounded to a passing grade.)
Note: There is no “D” grade given in the Department of Nursing
Clinical performance is evaluated as satisfactory or unsatisfactory (pass or fail). 12 hours of community service is
required for NS212 clinical. Both lecture and clinical evaluations must be completed satisfactorily to pass NS212.
The final exam week is from December 11 to 16, 2023. It is mandatory for keeping your schedule open during the
final exam week, as the final exams can be scheduled anytime during the week. Kaplan Integrated and Mid-Curricular
Exams will also be administered before or during the final exam week. Student who misses the final exam will receive
an “F” for NS212. No make up exam is given for the final exam.
VIII. Instructor Office Hours and Contact Information
Jing X. Johnson, RN, MSN, PHN.
Phone: (818) 240-1000 ext. 5837
Email: jingxuj@glendale.edu
Office hours: (by appointment only)
Tuesday 1 pm – 2 pm
Wednesday 2 pm- 5 pm
Friday 2 pm – 5 pm
Students must demonstrate professionalism and accountability by adhering to any appointments with the instructors.
Students who cannot attend a scheduled appointment must inform the instructor 24 hours before the meeting via
email. Failure to follow the guidelines will result in an administrative warning, impacting the students’ status in the
program.
IX. Information on Assignments and Projects
a. Nursing Care Plans:
A nursing care plan (NCP) will be assigned during the clinical rotation, and NCPs should be typed and submitted to
the clinical instructor on time. NCP will be graded based on the NS212 clinical syllabus’s grading criteria. The
instructor may limit the number of NCP based on the quality and the grades of the previously completed assignments.
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
5
GLENDALE COMMUNITY COLLEGE
FALL 2023
Grading Criteria for Nursing Care Plans
Student’s name: __________________________________________________________________
Clinical instructor: ________________________________________________________________
Criteria
Pt information: Initials, Age, height, weight, ethnicity, allergies, smoker, ETOH, IVDA
Brief background, chief complaint & current medical diagnosis, history of present illness,
past medical problems, surgeries, and current patient status. (report)
Vital signs: including an explanation of abnormal findings.
Code Status:
Isolation:
Physical Assessment: (complete head to toe)
Activity order:
Diet order and why the patient is on this specific diet
Date of Saline Lock/PICC/ CVC insertion:
Fluid budget:
Fall precaution:
Restraints: if applicable
Braden scale score:
Culture, health belief, religion, and socioeconomic considerations
(End of section 1)
Summary of one (1) acute major medical diagnosis, pathophysiology, pertinent
signs/symptoms, laboratory and diagnostic studies, and treatment. Underline or highlight
what the patient has or had.(research part)
Current, routine, PRN, and IV medications focus on nursing implications and precautions.
Pertinent laboratory results:
Explain the abnormal findings of the patient’s condition. Include pertinent laboratory
studies including CBC, BMP, Urinalysis, Coagulation Panel, Toxicology, and LFTS.
Pertinent diagnostic tests:
Explain the abnormal findings of the patient’s condition. Include all pertinent diagnostic
studies, including:
• Imaging: CT, ultrasound, MRI, MRA, Nuclear Med, X-rays
• Cardiology-related tests: echo, stress test, angiogram
• Resp related tests: PFTs
• GI-related tests: swallow study, endoscopy, colonoscopy
List top three nursing care priorities based on Maslow’s human needs hierarchy
Medical priorities as listed in progress note: (read MD progress note)
(End of section 2)
Objective findings for physiological NANDA below
Subjective findings for physiological NANDA below
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
Maximum
points
Partial
points
Few/No
Points
2
1
0
5
1
0
12
11-5
4-0
3
2-1
0
5
4-2
1-0
10
9-5
4-0
5
4-2
1-0
5
4-2
1-0
5
4-1
0
2
1
0
2
1
0
2
1
0
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Physiological NANDA Statement (problem): An actual NANDA (physiological)
2
1
0
1
N/A
0
2
1
0
2
1
0
8
7-4
4-0
4
3-2
2-1
2
1
0
2
1
0
2
1
0
2
1
0
5
4-2
1-0
2
1
0
SPICES (for geriatric patients> 65 years of age): elaborate on each SPICES criterion
based on your patient’s condition
2
1
0
QSEN competencies: list one (1) QSEN and elaborate using KSA based on your patient’s
condition. Refer to the QSEN competencies sample.
2
1
0
Related to (etiology)
Manifested by (signs and symptoms)
Patient outcome/goal must be S.M.A.R.T (specific, measurable, attainable, realistic,
timeframe)
At least four (4) nursing interventions with specific time frames include:
• At least two (2) independent nursing interventions.
• At least one (1) interdependent nursing intervention (medication, oxygen
administration, etc.)
• At least one (1) assessment and one (1) intervention
• At least one (1) patient/family education
Rationale(s) for each nursing intervention listed above with citation and references.
Delegations of each nursing intervention listed above to an LVN and/or UAP.
Time frame and/or frequency for each nursing intervention listed above.
Evaluation of whether the goal was met, partially met, or unmet, and the reason(s) why.
Recommendation(s) for evaluation, and the reason(s) why.
APA format for entire care plan and references. Please refer to the latest APA format.
Consultations: e.g., cardiologist, pulmonologist, etc., and why they are consulted?
Geriatric considerations (patients 65 years or older): list specific concerns/interventions
given above findings with medical diagnosis and NANDA.
4
3-2
0
(End of section 3)
Total points = 100% (90% and above is satisfactory grade)
Maximum points: All complete data is provided. Information is organized, legible, and medically sound. The nursing process
is pertinent to the patient’s condition and subjective and objective findings. The nursing diagnosis is complete with correct
R/T and AEB. If unable to obtain any data, include the reason(s) why the pertinent data was unavailable.
Partial points: Most data are presented, but some parts are missing and did not note other needs. The correct nursing process is
presented but lacks completed related to and manifested by parts. Almost complete but lacks polish and fine-tuning for all
possible parts of the care needed and lacks specific measures and thresholds.
Few or no points: Not organized, many data components are missing; no mention of assessments that may be needed or does
not address needs to gather additional info to complete the assessment. There is confusion between subjective and objective
data; NANDA is incomplete, not in 3-part form, and not a priority nursing diagnosis. Did not access resources for a complete
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
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plan of care; Lacks specifics, such as lacking information on patient’s culture and socioeconomic consideration. Goals are not
S.M.A.R.T (specific, measurable, attainable, realistic, and time-sensitive) and are inappropriate for the patient in this situation.
No QSEN competencies.
b. Group Project:
The group project will promote teamwork, collaboration among peers, and understanding of a specific nursing topic.
Each group member must contribute equally to the project to receive full credit. Students will work in groups to
research, collect, and present the data to the class.
There are four areas of this group project:
1. Nursing process and concepts related to the assigned health topic
2. Evidence-based practice, case study, and handout
3. Presentation method and professionalism
4. Group collaboration and participation
The instructor must approve all topics. Students must research the approved topic by including at least five peerreviewed journals as references (published within the last five years) in addition to current textbooks.
Evidence-based practice, case study, and handout:
Select one of the following activities and use evidence-based practice (EBP):
a. In your clinical setting, select as many patients as possible with this health issue and compare the care they
received, from your chart review, with the current evidence-based best practice or their response to the care
reported in the literature.
b. Conduct an actual patient/client interview about your chosen health issue. Compare the care given to the
client and its outcome for this patient with the current best practice.
c. Research studies on the selected topic including actual patient case studies in periodical articles (journals,
magazines, newspapers), books, dissertations, online resources such as online scholarly journals, official
government, or health organization websites (American Association of Clinical Endocrinologists, American
College of Endocrinology), YouTube videos, blogs, television broadcasts, etc.
Grading Criteria for Group Project
Criteria
Points
Minutes
Nursing Process and Concepts
Compare two endocrine diseases based on the assigned topic in a table or concept map format using
the following criteria:
1. Definition & basic pathophysiology [5 points]
2. Concepts (e.g., perfusion, cellular regulation, gas exchange, glucose regulation, hormonal
regulation, etc.) [5 points]
3. Assessment: [7.5 points]
a. Risk factors (e.g., culture, values, and beliefs)
b. Signs & Symptoms
c. Labs/Diagnostic studies
d. Possible complications
4. Intervention: [7.5 points]
a. Independent Nursing
b. Collaborative Care
5. Evidence-based practice based on research articles within the last five (5) years [5 points]
30
10
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
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Case Study
Create a short case study (on an actual patient or from a research article) based on one of the two
diseases using the following criteria:
1. Relevant information about a patient, including patient demographic, HPI, diagnosis, PMH, VS,
assessment, labs/diagnostic studies, and treatment. [5 points]
2. Formulate questions for the audience/participants on the following: [5 points]
a. Top three (3) concepts or nursing diagnoses based on Maslow’s Human Needs Hierarchy
b. One (1) assessment for each concept or nursing diagnosis
c. One (1) intervention for each concept or nursing diagnosis
d. One (1) patient teaching
3. One (1) QSEN competency applicable to the case study [2 points]
4. The information presented is related to current nursing topics and concepts [2 points]
5. Information is presented in logical sequence/structure [1 point]
30
10
15
N/A
Presentation & Professionalism
1. Presenters are knowledgeable and familiar with the material, and it is evident that the presentation
was rehearsed. [2.5 points]
2. Presenters’ voices are clear and slow enough to be heard by the participants. [2.5 points]
3. Presenters encourage audience participation and clarify and answer any questions from the
participants. [2.5 points]
4. Presenters are dressed professionally. [2.5 points]
10
N/A
Presenting Time Limit
1. The presentation must be completed within 20 minutes, and no extra time will be provided
5
N/A
Group Members’ Participation
1. Students must participate in all group meetings and fully contribute to researching, collecting, and
presenting the data [5 points]
2. Each group member will grade their peers based on their participation [2.5 points]
3. The peer evaluation form must be submitted on the day of the presentation [2.5 points]
10
N/A
Presentation Materials (PowerPoints, Concept Maps, or Handouts)
1. Presentation materials should be typed, clear, concise, and complete [5 points]
2. Presentation materials must contain all the following: [5 points]
a. Concepts & Nursing Process [first section]
b. Case Study [second section]
3. Presentation materials must be posted one week before the presentation day on Canvas [5 points]
Note: PowerPoint slides should be kept brief without excessive wording
Total Score
100
Note: Individual students who do not contribute to the group project may receive a zero in this assignment and a
deduction in the class participation grade.
c. Kaplan Assignment (TBA Hours)
Below are the assignments for the NS212 & NS 202 courses to be completed for Kaplan Focused Review Tests
(www.kaptest.com). All assignments must be completed by December 1, 2023.
KAPLAN Focused Review Tests & Remediation
a. Kaplan Cardiovascular System A
b. Kaplan Cardiovascular System B
c. Kaplan Hematology-Immune A
d. Kaplan Oncology A
e. Kaplan Endocrine System A
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
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f.
Kaplan Fluid and Electrolyte Balance A
Instruction: Complete the Focused Review Tests listed from (a) to (f) and spend at least two (2) hours on
remediating by reviewing all the questions answered and rationales. Work hours on KAPLAN will be
monitored online by the instructor.
X. Course Policies
a. Attendance/Absence/Tardiness Policy:
Classroom Attendance Policy:
Students must attend all online and/or in-person class meetings. Students must notify the instructor of any absence
before the beginning of the class. A student may be dropped for cumulative absences of two class meetings, which
equals four hours of absences. Additionally, the student may be dropped for failure to attend all the meetings during
the first week of instruction without prior arrangement with the faculty.
Clinical Attendance Policy:
12 hours of community service are counted as part of the mandatory clinical hours. The community service sites must
be approved by the clinical instructors prior to. Written proof of service will be collected at the end of the clinical
rotation.
Students must attend all clinical hours. Students may be dropped for failure to participate in all meetings during the
first week of clinical rotation. Students who incur more than 15-hour of absence will be dropped from the course and
receive an “F” for NS 212. Being tardy three times in clinical rotation is equivalent to a one-day absence. Tardiness is
defined as either late arrival or early departure. Late arrival to the clinical or early departure from clinical for more
than one hour is counted as a one-day absence. It is mandatory to notify the instructor if the students cannot attend a
clinical day. Students must submit a healthcare provider’s note for any sick calls and a reasonable/acceptable
explanation for any other emergencies as the reason for absence.
Missing clinical hours cannot be made up. For any clinical absence, students must complete assignments to meet the
clinical objectives. However, the assignments do not substitute for the missing clinical hours. Students will still
receive an “F” for NS 212 if exceeding the maximum hours of absences.
•
•
•
•
Reasons for excused absence include the student’s illness, serious illness in the student’s immediate family, death
of a family member, automobile accidents, appearance in court, inclement weather with hazardous driving
conditions, and a child’s birth or an unforeseen catastrophic event.
Unexcused absences will result in a failing grade in the course. Students must provide documentation from the
physician or health care provider for any major illnesses. Absences for reasons that are non-health-related will
also require documentation from the student (i.e., jury duty notice).
If the student has a significant illness, a released statement from a physician or health care provider is required to
return to the clinical setting.
Students with contagious illnesses should not attend clinical. Students must obtain a clearance letter to return to
clinical from their healthcare providers. Makeup work should be rescheduled with the clinical instructor as soon
as possible after the danger of transmitting the illness is over.
b. General Exam and Quiz Policy:
•
All quizzes and exams are timed, and you will be notified of the amount of time for each quiz/exam.
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
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•
•
•
•
•
Students must take quizzes and exams at the scheduled time. The quizzes and exams will no longer be available
once they have passed the timeframe.
Post-exam questions review sessions will be conducted in person as a group during class to protect the integrity of
the questions.
Makeup unit exams will not be allowed except for emergencies and under the instructor’s discretion. The makeup
unit exams may be given in any format, including essays, short answers, and case studies. Students will receive a
deduction of ten percent (-10%) from the unit makeup exam score for taking the exam late. Makeup unit exams
must be completed within one week from the scheduled time of the exam. There are no makeups for quizzes,
Kaplan exams, and the Final Exam. Students who are late to class will not be allowed to take the quiz at the
beginning of the class.
Quizzes & Exams: Students will receive seven (7) quizzes (No quizzes on the day of unit exams). Makeup
quizzes and Kaplan exams will not be given for any reason.
Professionalism Quiz: All students must take the quiz on professionalism on Canvas during the first week of the
semester. Students must follow and demonstrate the competencies of professionalism in the classroom and
clinical settings.
c. Electronic Exam Policy:
•
•
•
•
•
Students must use their laptops/tablets/computers to take the quizzes on Canvas.
Students tested and granted accommodation must submit the signed paperwork to the instructor ahead of time.
Students cannot use mobile or cell phones to take their quizzes/exams. All quizzes and/or exams are conducted
using academic integrity software–HonorLock.
Students who use their laptops/tablets for quizzes/exams are strongly encouraged to do the following before the
quizzes/exams start:
o Have the electronic devices rebooted/restarted the day before the quizzes/exams.
o Have the electronic devices fully charged the day before the quizzes/exams. Students are encouraged to bring
their chargers for the electronic devices to class.
o Turn off all communication applications such as iMessenger, texts, etc.
o Adjust the lighting on the screen for optimal viewing during the quizzes/exams.
o Silence all electronic devices completely.
o Disable pop-up blockers: Pop-up blockers may interfere with the normal functioning of Canvas.
o Close all windows and applications. Only open the Canvas quiz browser window. Do not have any browser
windows or programs open while taking quizzes as other programs and browsers can interfere with the
Canvas quiz/exam.
o Do not leave the quiz/exam page while taking the quiz (for example, to view course materials or another Web
site).
o Do not close the browser window while taking the quiz.
o Have your Canvas username and password ready and saved on the electronic device.
o Log on to Canvas before the exam starts so that you are ready to take the quizzes/exams.
If the internet connection is lost during online testing, all questions answered will be automatically saved, and
students may resume the test once the internet connection has been restored.
d. Academic Honesty Policy:
1. There is a zero-tolerance policy on cheating in the GCC nursing program. It is expected that GCC nursing
students will exhibit the highest standards of ethical behavior in their clinical and scholastic endeavors. Nurses
provide care and advocacy for vulnerable populations and must conduct themselves with integrity.
2. If any student in the Department of Nursing is guilty of cheating, they may be subject to the following:
a. 0% on the test/assignment
b. Mandatory meeting with the entire faculty and/or administrators.
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
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3.
4.
5.
6.
c. Ineligibility of an applicant for enrollment in a nursing program, and/or
d. Resultant probation, suspension, or dismissal
The Nursing Department adheres to the GCC Academic Honesty Policy. (See College Catalog/GCC Student
Handbook/Nursing Student Handbook – Section V.)
In addition, students who allow others to copy their work or exams or who participate in supplying answers
during testing/evaluation situations will also be considered as committing acts of academic dishonesty.
Students will commit not to share information about items or content on exams with other students to provide
them with test information. Violation of this will be considered an act of academic dishonesty.
Students will commit not to share information about the items or content on the exams or quizzes with other
students. Violation of this will be considered an act of academic dishonesty. Students must complete the Pledge of
Academic Integrity and Understanding of Course Syllabi Quiz posted on Canvas and comply with all the policies.
e. Assignment Policy:
Nursing Care plans are required for clinical and are graded according to the rubric, and students must receive 90% or
higher to obtain a passing grade. If the student fails to pass the care plan activity, they will be required to repeat the
care plan until the clinical instructor assigns the passing grade.
Kaplan Focused Review Tests: The following Kaplan Focused Review Tests must be completed during this semester
(see TBA hours sheet for due dates):
1. Kaplan Cardiovascular System A
2. Kaplan Cardiovascular System B
3. Kaplan Hematology-Immune A
4. Kaplan Oncology A
5. Kaplan Endocrine System A
6. Kaplan Fluid and Electrolyte Balance A
Each late assignment will result in a 0.5% deduction of the Homework and Assignment grade.
f.
Classroom Requirements and Instructor Expectation Policy:
Class Participation includes attendance and participation during the lecture. Students are expected to actively
participate in class discussion and contribute to collective learning. Class participation will be graded based on the
following criteria:
Grading Criteria for Class Participation:
Grade
0
1
2
•
•
•
•
•
•
•
•
•
Criteria
Does not participate.
Tries to respond when called on but does not offer much.
Demonstrates very infrequent involvement in the discussion.
Missing two class meetings during the semester.
Demonstrates adequate preparation, such as knowing basic information, but does not show
evidence of trying to interpret or analyze them.
Offers straightforward information without elaboration or very infrequently.
Does not offer to contribute to the discussion but contributes to a moderate degree when
called on.
Demonstrate sporadic involvement.
Missing one class meeting during the semester.
JING JOHNSON, RN, MSN, PHN
Updated on 08/19/2023.
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•
•
3
•
•
•
Demonstrates good and excellent preparation, such as knowing and analyzing information
well and relating them to readings and other materials.
Offers interpretations, analysis, synthesis, or evaluation of information by connecting them
through discussion to advance further discussion.
Contributes well to the ongoing discussion by keeping analysis focused while responding
thoughtfully to comments and feedback.
Demonstrates consistent and ongoing involvement.
Attends all class meetings during the semester.
NOTE: We may not discuss every topic on the syllabus during lecture time. Students are responsible for all the
information, whether they are covered during the lecture.
ALL mobile phones and electronic devices MUST be turned off or silent during class. Students whose mobile phones
or other devices go off during class will be asked to leave the class for the day and will be considered absent for the
entire class. Using a smartphone during
Use the information from your assigned readings, the literature, the self-paced tutorial and leaders in your organization to write a 2-3 page paper that addresses the following questions. Title page and references are not included in 2-3 page limit.
Health care professionals have an ethical duty to ensure patient safety. Safe technologies are increasingly being implemented throughout health care organizations to improve patient safety, streamline work processes, and improve the quality and outcomes of health care delivery. In a 2-3 page paper, you will discuss one (1) technology safety initiative that has been or can be implemented in a health care setting to improve patient safety and work processes, and improve patient outcomes.
You may use one of the following examples or chose your own. Some examples are:
Smart pumps
Bar code medication administration
Clinical decision support systems
RFID technology
Smart rooms
Wearable technology
Robotics
1. Describe the technology and its users.
2. What data is gathered using the technology?
3. What are the benefits to patient safety, workflow processes and patient outcomes?
4. What are the cons of this technology?
5. Do the benefits outweigh the cons? Provide rationale
6. Describe the role of the nurse leader in selecting, implementing and sustaining technology. Provide 2 examples of effectiveness of the technology of patient safety, workflow processes, and patient outcomes.
Points: 40
Due Date: Sunday of week 3 by 11:59 p.m. Eastern Standard Time (EST) of the US
References
Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)
Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.
Style
Unless otherwise specified, all the written assignment must follow APA 7th edition formatting, citations and references. Review or download the Microsoft Word APA template . Review this annotated student sample paper guide which draws attention to relevant content and formatting in 7th edition APA style. Make sure you cross-reference the APA 7th edition book as well before submitting the assignment. Refer to the ‘LEARNER SUPPORT’ tab for more information regarding APA 7th edition with comparisons to 6th edition.
Number of Pages/Words
Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.
Instructions
To be successful, complete the following steps in order:
STEP 1. Review the instructional materials and finish learning activities in this module.
STEP 2. Review the grading rubric.
STEP 3. Create a new Word document, write your paper based on the above overview.
STEP 4. Refer to APA book and rubric for correctly formatting the paper.
STEP 5. Save the document with the filename: “Lastname_Firstname_ Module_3_Assessment_7” (Example: Smith_Jill_ Module_3_Assessment_7.docx)
STEP 6. Submit the document by clicking the link on the left titled “M3 A7 WA: SUBMISSION AREA – INFORMATICS TOOLS TO PROMOTE PATIENT SAFETY, IMPROVE WORK PROCESSES, AND PATIENT OUTCOMES”
Note: You will have three (3) attempts to submit a written assignment, only the final attempt will be graded. For each attempt you will receive a SafeAssign originality report. This will give you a chance to correct the assignment based on the SafeAssign score. View instructions on how to interpret your SafeAssign originality report
Module 2 Individual Case Study Discussion Questionsuse
Use the article that I uploaded
you can to add another reference
Chapter 5
Evan and Marlyce have a 4-year-old son (Micah) who has cerebral palsy. Their life is very challenging because they both have to work and recently lost their home to foreclosure. Micah is being discharged to home this afternoon, and Marlyce is obviously anxious. Marlyce states, “I just feel like we are always out of touch when we go home. I have other children to care for, and we are always on the go.“ This case study is based on a longitudinal qualitative study from Canada (Woodgae, Edwards, & Ripat, 2012).
1. Propose a qualitative research study purpose that would help the nurse provide better care for Micah’s family.
2. As the researchers set up a qualitative study for families of patients such as Micah, they used purposive sampling. What does this mean, including some ideas for inclusion and exclusion factors?
3. Now that inclusion and exclusion criteria are set for the study, how can the participants be recruited? How many participants would be necessary?
Chapter 6
Simon is undergoing cardiac catheterization after a heart attack. Throughout his hospital stay, the case manager asks about resources at home. Much to everyone’s amazement, it is discovered that Simon is homeless. Simon is supposed to undergo extensive follow-up and cardiac rehabilitation. Because of the location of this facility, the case manager knows that there are other situations similar to Simon’s in this community.
1. If the case manager wanted to research Simon’s experience (managing cardiac disease while being homeless), how might the researcher maintain rigor?
2. Describe a grounded theory study and an ethnographic study structure for Simon’s case.
3. The case manager is using an ethnographic research methodology for patients who are homeless and have heart disease. Describe the data gathering process.
Chapter 7
Two teenaged girls visit the school nurse and are concerned about acne. Both have tried “things and food” that their friends told them about, but nothing is working. They are asking for more information and something that will help with “these totally annoying zits.”
1. Propose using social media to better understand how acne affects teenaged girls.
2. For a researcher collecting data through social media, how might their interaction affect the results and how could this be avoided?
3. Discuss how the researcher could verify the findings from the qualitative research.
Chapter 8
The nurse recognizes that there has been an increase in the number of urinary tract infections (UTIs) on one unit of the rehabilitation facility. He heard about a new type of peri-care bath wipes. The nurse would like to try them as a way of seeing if they help decrease the incidence of cystitis.
1. What are the independent and dependent variables in this study?
2. List some extraneous variables in this study.
3. How might the nurse ensure randomization of the participants to the experimental or control groups?
Chapter 9
Mirlande is an 18-year-old woman in the clinic with asthma. She has been in the United States for 6 months and has gone through three albuterol inhalers and two salmeterol inhalers. The nurse practitioner is considering treatment strategies for the client.
1. As the nurse practitioner considers research studies about the best treatment option, she is frustrated that she cannot find purely experimental studies. Is there value in reviewing a study that used quasi-experimental methodology? Provide rationale for your answer.
2. If the nurse practitioner was unable to find research specifically about the young adult or older adolescent, what may be an acceptable alternative? Provide rationale for your answer.
3. Propose a study for clients with asthma that would compare using a long-acting inhaler (anti-inflammatory) with an oral medication (anti-inflammatory). Describe the methodology if a Solomon four-group design was used.
Chapter 18
A woman brings in her 8-year-old child, who has a serious history of asthma. The nurse notes that the mother is tired looking, and the child is very “clingy.” As the nurse asks questions of the mother, the mother takes a deep breath and looks away. The nurse senses that there is something concerning the parent. After the nurse says, “You seem pretty tired,” the mother states that she is worn out from “chasing around all the kids.”
1. On the basis of an appraisal of the article by Cerdan et al (2012), can the nurse assume that the client’s mother is likely to become divorced? Support your answer.
2. The nurse would like to compare the current research (Cerdan et al, 2012) to a known evidence-base. What would you recommend?
3. As the nurse reviews the Cerdan et al article, she notes that in previous research, there was no correlation between the number of emergency department visits and parental quality of life scores. Conversely, in the Cerdan et al study data, there was a significant correlation. How should the nurse use this information?
Unformatted Attachment Preview
Available online at www.sciencedirect.com
Applied Nursing Research 25 (2012) 131 – 137
www.elsevier.com/locate/apnr
Original Articles
Asthma severity in children and the quality of life of
their parents
Noelle S. Cerdan, RN, CPNPa , Patricia T. Alpert, DrPH, APNb,⁎, Sheniz Moonie, PhDc ,
Dianne Cyrkiel, MSN, APNd , Shona Rue, MSN, CPNPd
a
Oshiro Pediatrics, Las Vegas, NV 89119-6183, USA
School of Nursing, University of Nevada, Box 453018, Las Vegas, NV 8154-3018, USA
c
School of Community Health Sciences, University of Nevada, Box 453063 Las Vegas, NV 89154-3063, USA
d
School of Nursing, University of Nevada, Box 453018, Las Vegas, NV 8154-3018, USA
Received 31 March 2010; revised 3 January 2011; accepted 17 January 2011
b
Abstract
This study examines the effect of asthma severity of children aged 7–17 years and sociodemographic
characteristics on the caregiver’s quality of life. For parents of asthmatic children, there was a
negative correlation between overall asthma severity and quality-of-life score. Measuring parental
quality of life enables the development of effective asthma programs.
Published by Elsevier Inc.
1. Introduction
2. Background
Quality of life (QOL) can be described as general
satisfaction with everyday living (Vila et al., 2004) and is
closely related to health status. Along with asthma
symptoms and other clinical indicators, QOL measurements are important when assessing asthmatic children
and their caregivers holistically (Juniper, Guyatt, Feeny,
Ferrie, & Townsend, 1996). This descriptive, crosssectional study examines the effect of asthma severity
on caregivers’ QOL using the Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) of
Juniper et al. (1996), which considers activity limitation
and emotional function. The PACQLQ also examines the
relationship between caregivers’ QOL and caregiver
sociodemographic characteristics.
Asthma is one of the most common chronic diseases in
the United States, affecting about 22.2 million people,
6.5 million of which were children, in 2005 (National
Center for Health Statistics [NCHS], 2007). School-age
children with asthma are affected by the frequency and
severity of episodes, hospital admissions, side effects of
medications, morbidity and mortality, and costs of hospitalizations (Vila et al., 2004). Asthma also affects other aspects
of life, such as school attendance, physical activity, family
dynamic, coping style, psychological functioning, and sleep
(Marsac, Funk, & Nelson, 2006; Moonie, Sterling, Figgs, &
Castro, 2006).
Parents as caregivers are responsible for many aspects of
their children’s care, including symptom observation,
medication administration, and transportation to health care
services (Halterman et al., 2004). Because asthma is a
chronic condition, parents can experience long-term stressors that impact work productivity, medical decisionmaking, and overall care and discipline issues (Halterman
et al., 2004; Laforest et al., 2004).
In addition, other sociodemographic factors such as
marital status, smoking status, educational level and income,
presence of family and support systems, presence of other
children in the household, and the parents being diagnosed
with asthma themselves can contribute to changes in parental
⁎ Corresponding author. Tel.: +1 702 895 3810; fax: +1 702 895 4807.
E-mail addresses: cerdann@unlv.nevada.edu (N.S. Cerdan),
patricia.alpert@unlv.edu (P.T. Alpert), sheniz.moonie@unlv.edu
(S. Moonie), dianne.cyrkiel@unlv.edu (D. Cyrkiel), shona.rue@unlv.edu
(S. Rue).
0897-1897/$ – see front matter. Published by Elsevier Inc.
doi:10.1016/j.apnr.2011.01.002
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N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
QOL. Many studies show that childhood morbidity and
mortality related to asthma are associated with being lowincome families, being a minority, and living in the inner city
(NCHS, 2007).
To date, research results relating asthma characteristics
including clinical measures and or symptoms and PACQLQmeasured QOL are inconsistent. Developed in Canada by
Juniper et al. (1996), the PACQLQ showed acceptable levels
of correlation between asthma status and parental QOL.
Results showed that the PACQLQ was able to detect QOL
changes over time (p b .001) and detect stability in those
who did not change (p b .0001). Following school-age
children through the school year in the United States.,
Halterman et al. (2004) showed that baseline asthma severity
measured by asthma severity symptoms (i.e., daytime and
nighttime symptoms, the need for rescue inhaler use, and the
number of symptom-free days) significantly correlated with
the PACQLQ score (range r = .23–.51, all p b .1). The
highest correlation was between symptom-free days and
parental QOL (r = .51, p b .001). At the end of the school
year, significant correlations were found with all measures
of asthma severity, except for rescue inhaler use. An
increase in symptom-free days over time correlated with an
improvement in PACQLQ scores (r = .30, p b .001).
Conversely, an increase in daytime (r = −.27, p = b.001) and
nighttime (r = −.22, p = .005) symptoms correlated with
lower PACQLQ scores.
Over a 3-month period, Osman, Baxter-Jones, and Helms
(2001) showed a significant correlation between a change in
children’s asthma symptoms and PACQLQ scores (r =
.54–.57, p b .001) even if the PACQLQ scores were not
clinically significant. This suggests that other social and or
psychological factors, in addition to asthma severity, may
influence PACQLQ scores (Vila et al., 2004).
Many studies relate children’s asthma prevalence to
sociodemographic characteristics such as minority families
living in low-income urban neighborhoods (Akinbami &
Schoendorf, 2002). One study suggests that the prevalence
and severity of asthma are associated with being African
American or Hispanic and to poverty-related factors such as
young maternal age, secondhand exposure to cigarette
smoke, low birth weight, and living in crowded inner cities
(Williams, Sternthal, & Wright, 2009).
Erickson et al. (2002) showed that household income
and lower perceived asthma severity were statistically
significant predictors of QOL as measured by the
PACQLQ. Longer length of time diagnosed with asthma,
longer length of time enrolled in a specialty clinic, fewer
siblings living in the household, and greater convenience
of seeing the physician were all related to higher QOL.
Using Carstair’s deprivation scores to describe the sociodemographics of the families in their study, Osman et al.
(2001) found that younger mothers, those who come from
less affluent families, and those with greater social
deprivation had lower PACQLQ scores. Parental work
absenteeism related to the child’s illness can have economical
implications for parents (Dean, Calimlim, Kindermann,
Khandker, Tinkelman, 2009; Laforest et al., 2004).
This study is different from other studies that utilized the
PACQLQ because this study used the current National
Asthma Education and Prevention Program (NAEPP)
guidelines in diagnosing asthma severity in children. The
guidelines categorize patients based on worsening physical
symptoms such as increased nighttime awakenings, increased use of rescue medication for symptom control,
interference with normal activity, and decreased lung
function. Very few studies have documented asthma severity
using NAEPP guidelines, and for those that did, they have
had inadequate sample sizes. In addition, this study uses
several measurement tools and clinical indices such as
pulmonary function tests (PFTs), whereas other studies
depended solely on self-reported asthma severity or
administrative records, which can underestimate asthma
prevalence. Lastly, the current QOL literature for asthma is
conflicted and not highly abundant, so this study lends
greater insight to the current research literature.
This study is important to nursing because it offers a more
holistic focus when addressing asthmatic children and their
parents in the clinical setting. Operationalizing parental QOL
measures as functional limitations and emotional dimensions
allows nurse researchers to quantify the degree of burden that
parents experience so that more effective asthma programs
can be developed (Halterman et al., 2004). In addition, being
familiar with the NAEPP (2007) guidelines in daily practice,
nurses can better identify at-risk parents of asthmatic
children to more quickly implement appropriate care. QOL
has been shown to be an important outcome measure, and
being aware of its effect on the individual is important for
adherence to medical treatment (Marsac et al., 2006). The
objective of this study was to examine the effect of children’s
asthma severity and sociodemographic factors on parental
QOL measured through the PACQLQ.
3. Research design and methodology
This correlational study utilized a convenience sample of
parents of children and adolescents, aged 7 to 17 years, with
medical diagnoses of mild intermittent to severe persistent
asthma. This study was reviewed and approved by the
institutional review board at the University of Nevada, Las
Vegas. From August 2008 to February 2009, participants
were chosen from a pediatric pulmonology outpatient clinic
located in Las Vegas, Nevada. Parents of children aged from
7 to 17 years were targeted because parents with children in
this age range were used to validate the PACQLQ (Juniper
et al., 1996). Parents surveyed were legal guardians of the
asthmatic children. The clinic was chosen by the investigators because the clinic had patients with a greater variety of
asthma severity (i.e., mild, moderate, or severe) and
sociodemographic factors (i.e., health insurance coverage,
parental age and ethnicity, and other variables). Children
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
with a diagnosis of other chronic conditions such as
depression, cerebral palsy, diabetes, hypothyroidism, and
cancer were excluded from the study. Because most children
with asthma also have atopic conditions such as eczema,
allergy, and rhinoconjunctivitis, patients with atopy were not
excluded from this study (Reichenberg & Broberg, 2001).
One of the researchers reviewed the charts of all
scheduled patients to verify asthma diagnosis and age.
Those deemed to be eligible to participate were approached
in the waiting room by the researcher as patients and parents
came in for their scheduled appointments. All potential
participants were told that the researcher was not an
employee of the clinic. They were also told that their
participation was voluntary and declining participation
would not jeopardize their relationship with their doctor or
office staff. Those who agreed to participate completed the
informed consent and their children offered assent. Participants were asked to confirm the age of their children and
their children’s asthma diagnosis. They were also asked their
relationship to the children and were excluded if they were
not the biological parents, adoptive parents, stepparents,
legal guardians, or foster parents. Only one set of
questionnaires were completed for each family.
Prior to completing the three questionnaires, the
researcher gave parents explicit instructions on how to
answer the items for each questionnaire, including the option
not to answer questions that made them feel uncomfortable.
If participants had questions after they started completing
the questionnaires, they were told to choose the answer that
they most strongly agreed with. To maintain participant
confidentiality, participant questionnaires were assigned
numbers, and participant names or any other identifying
information such as address, telephone number, or birth date
were not recorded. The parents returned the questionnaires
to the researcher in an unmarked manila envelope to further
ensure confidentiality.
The three questionnaires utilized were as follows: (1) the
PACQLQ (Juniper et al., 1996), (2) the asthma severity
questionnaire, and (3) the sociodemographic factors questionnaire. The PACQLQ, a 13-item questionnaire, measures
activity limitation and emotional function. This tool is
frequently utilized to measure the burden that parents
experience in caring for their asthmatic children (aged 7 to
17 years). Specifically, this tool measures how a child’s
asthma interferes with the parent’s daily activities (activity
limitation) and the emotions generated (emotional function).
The questionnaire contains four items addressing activity
limitations and nine items addressing emotional function,
with all questions being weighed equally. Parents respond
to this questionnaire using a 7-point Likert-type scale,
where 1 represents severe impairment and 7 represents no
impairment. Examples of questions include the following:
“How often did your child’s asthma interfere with your job
or work around the house?” and “How often were you
bothered because your child’s asthma interfered with family
relationships?” The PACQLQ score produced a mean
133
activity limitation score, a mean emotional function score,
and a total mean score (Juniper et al., 1996). The
questionnaire has been studied to be reliable and valid in
certain populations. The PACQLQ has good reliability, with
an intraclass correlation coefficient for overall QOL = .85,
emotional function = .80, and activity limitation = .84
(Juniper et al., 1996).
The Asthma Severity Questionnaire was developed by
the researchers for use in this study and includes 18
questions to categorize the child’s asthma severity, which
mirrors the 2007 NAEPP asthma classification guidelines.
The NAEPP asthma classifications include intermittent
asthma, mild persistent asthma, moderate persistent
asthma, and severe persistent asthma. The NAEPP guidelines to classify asthma severity were turned into
questions. Examples of questions included the following:
“In the past 30 days, how often has your child had asthma
symptoms such as wheezing, coughing, and shortness of
breath during the day? and “In the past 30 days, how often
did your child wake up during the night due to asthma
symptoms such as wheezing, coughing, and shortness of
breath?” Participants were also asked about medication use
within the past week to verify appropriate classification
severity-specific treatment based on NAEPP guidelines.
Other questions (not specific to the NAEPP guidelines),
such as the number of days of school the child has missed,
the number of days spent in the emergency room (ER) or
hospital, and parental perception of asthma severity and
control, were included based on findings of a literature
review. The questionnaire was reviewed by two content
experts but was not piloted prior to use in this study. In
addition, spirometry readings, including forced expiratory
volume in one second (FEV1) and Forced expiratory
volume in one second/forced vital capacity ration (FEV1/
FVC) ratios, were obtained from the children’s medical
records with the permission of the pediatric pulmonologist
and informed consent from the parents to further
categorize the children’s asthma severity based on the
NAEPP guidelines.
The Sociodemographic Factor Questionnaire, developed
by this study’s investigators, was based on literature
identification of the demographic variables associated with
asthma morbidity and mortality. This questionnaire asked 18
questions on age, ethnicity, income, education level, place of
residence, employment, health insurance coverage, social
support, and other variables.
3.1. Data analysis
Data entry and analyses were performed utilizing the
Statistical Package for the Social Sciences Version 17.0. To
assess the relationship between asthma severity and parental
QOL, Spearman’s correlation (ρ), analysis of variance
(ANOVA), and linear and multivariate regressions were
performed. To determine the relationship between sociodemographic factors and parental QOL, Spearman’s correlation (ρ), chi-square, and independent t tests were performed.
134
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
4. Results
Table 2
Demographic characteristics by percentages (n = 101)
A total of 112 parents who met the study criteria were
invited to participate in the study. Ten parents were not
interested in participating in the study and one parent did not
return the survey to the researcher. Of the original 114
parents invited, 101 (88.59%) participated in the study.
Tables 1 and 2 show the demographic characteristics of the
participants. The Cronbach alpha coefficient for the
PACQLQ was .89 of the total score, which suggests good
internal consistency.
Before correlation analyses on the data were performed,
scatterplots were generated and checked for violation of
assumptions of normality, linearity, and homoscedasticity.
Using Spearman’s correlation (ρ), significant negative
correlations were found between overall asthma severity
and mean activity limitation scores (ρ = −.400, p b .001),
mean emotional function scores (ρ = −.258, p b .001), and
mean total PACQLQ scores (ρ = −.342, p b .001).
Significant moderate, negative correlations were found
between PACQLQ scores and asthma day symptoms,
asthma night symptoms, and asthma exercise symptoms.
As asthma severity and other asthma factors increased,
PACQLQ scores decreased, indicating poorer QOL. No
significant relationships were found between PFT scores and
PACQLQ scores.
In addition, significant positive correlations were found
between employment income and mean activity limitation
scores (moderate correlation, ρ = .363, p b .001), mean
emotional function scores (small correlation, ρ = .291, p b
.05), and mean total PACQLQ scores (moderate correlation,
ρ = .346, p b .001). This indicates that parents with higher
incomes experience increased QOL. Table 3 provides the
details of these analyses.
ANOVA was used to compare mean PACQLQ scores for
each asthma severity group. Participants were divided based
on asthma severity rating prescribed according to NAEPP
guidelines. The assumption of homogeneity of variance was
not violated. The overall PACQLQ scores were statistically
significant for the four asthma severity groups, F(2, 101) =
4.942, p = .003. The effect size, calculated using eta squared,
was .132. Post hoc comparisons using Tukey’s honestly
Caregiver or child characteristics
Table 1
Demographic characteristics by means (n = 101)
Caregiver or child characteristics
Child
Age (years)
Length of diagnosis (years)
ER visits in the past year
Hospitalizations in the past year
School days missed in the past year
Caregiver
Age (years)
Workdays missed in the past year
Number of people living in home
Number of children living in home
M
SD
10.26
6.49
1.01
0.25
5.85
2.78
3.90
1.98
0.79
9.24
39.34
4.46
3.67
2.63
7.71
7.43
1.78
1.21
Child
Male
Female
Caregiver
Male
Female
Age
≤30 years
N30 years
Martial status
Single
Married
Separated/Divorced
Living with significant other
Ethnicity
White/Caucasian
Hispanic
Black/African
Other
Caregiver type
Mother
Father
Other
Parent perception of control
Owning a vehicle
Language
English
Spanish
English and Spanish
Parent with medically diagnosed asthma
Family history of asthma
Smokers
Employed
Work hours per weeka
b40
≥40
Education
High school
College
Graduate school
Annual incomea
Less than $30,000
$30,000 to $45,000
$45,000 to $60,000
$60,000 to $75,000
Greater than $75,000
Insurance
No insurance
Medicaid
Private insurance
Ability to pay for health expenses
Residence type
Own
Rent
Family or friend support
a
%
55.4
44.6
20.8
79.2
11.9
87.1
12.9
64.4
18.8
4.0
58.4
20.8
15.8
5.0
75.2
18.8
6.0
74.3
95
89.1
4.0
5.9
38.6
73.3
9.9
69.3
24.5
42.1
32.7
58.4
8.9
15.8
18.8
10.9
9.9
12.0
5.0
16.8
78.2
86.1
68.3
29.7
88.1
n = 72.
significant different (HSD) test indicated that the mean score
for the mild intermittent group (M = 5.25, SD = 1.18) was
significantly different from that of the moderate persistent
group (M = 4.31, SD = 1.21) and that of the severe persistent
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
Table 3
Correlation between asthma severity rating and PACQLQ scores
Table 5
Univariate regression model predicting QOL
Asthma severity
measure
Activity
limitation
subscale (ρ)
Emotional
function
subscale (ρ)
PACQLQ
summary
scores (ρ)
Asthma severity
Day symptoms
Exercise symptoms
Night symptoms
Rescue inhaler use
ER visits
Hospitalization days
Parental perception of
asthma severity
Parental perception of control
School days missed
Workdays missed
Annual income
−.40⁎⁎
−.43⁎⁎
−.44⁎⁎
−.48⁎⁎
−.31⁎⁎
−.45⁎⁎
−.22⁎
−.58⁎⁎
−.26⁎⁎
−.29⁎⁎
−.30⁎⁎
−.33⁎⁎
ns
−.41⁎⁎
−.20⁎
−.49⁎⁎
−.34⁎⁎
−.37⁎⁎
−.39⁎⁎
−.43⁎⁎
ns
−.46⁎⁎
−.24⁎
−.58⁎⁎
−.37⁎⁎
−.36⁎⁎
−.49⁎⁎
.36⁎⁎
−.28⁎⁎
−.24⁎⁎
−.24⁎
.29⁎
−.34⁎⁎
−.31⁎⁎
−.37⁎⁎
.35⁎⁎
Note. ρ = Spearman ρ; ns = not significant.
⁎ p b 0.05.
⁎⁎ p b 0.001.
group (M = 4.11, SD = 1.49). Table 4 provides the details of
these analyses.
ANOVAs to compare activity limitation scores showed
statistical significance in overall PACQLQ scores for the
four asthma severity groups, F(3, 101) = 7.56, p = .0005.
The effect size, calculated using eta squared, was .189. Post
hoc comparisons using Tukey’s HSD test indicated that the
mean score for the mild intermittent group (M = 5.37, SD =
1.31) was significantly different from that of the moderate
persistent group (M = 4.02, SD = 1.75) and that of the severe
persistent group (M = 3.55, SD = 1.91). The mild persistent
group (M = 5.13, SD = 1.25) was significantly different from
the severe persistent group (M = 3.55, SD = 1.91).
ANOVA comparisons of emotional function scores
showed statistical significance in PACQLQ scores for the
four asthma severity groups, F(3, 101) = 2.855, p = .041. The
effect size, calculated using eta squared, was .08. Post hoc
comparisons using Tukey’s HSD test showed no significant
differences among the four groups of asthma severity.
Univariate linear regression was used to determine which
asthma severity and sociodemographic factors predicted
Table 4
PACQLQ scores and researcher rating of asthma severity
Asthma
severity rating
by caregiver
Activity
limitation
subscale,
M (SD)a
Emotional
function
subscale,
M (SD)b
PACQLQ
summary
scores,
M (SD)c
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent
5.37 (1.31)
5.13 (1.25)
4.02 (1.75)
3.55 (1.91)
5.20 (1.22)
4.68 (1.14)
4.43 (1.14)
4.36 (1.51)
5.25 (1.18)
4.82 (0.95)
4.31 (1.21)
4.11 (1.49)
df = 3, F = 7.56, p = .0005, η2 = .189.
df = 3, F = 2.855, p = .041, η2 = .08.
c
df = 2, F = 4.942, p = .003, η2 = .132.
a
b
135
Predictor
Annual income
Hospitalization days
ER visits
School days missed
Workdays missed
Activity
limitation
subscale
Emotional
function
subscale
PACQLQ
summary
scores
B
R2
B
R2
B
R2
.23
−.57
−.33
−.08
−.11
.08⁎⁎⁎
.06⁎
.15⁎⁎
.18⁎⁎
.21⁎⁎
ns
ns
−.20
−.03
−.04
ns
ns
.09⁎⁎
.04⁎
.05⁎
.14
−.30
−.24
−.05
−.06
.05⁎
.03⁎⁎
.13⁎⁎
.10⁎⁎⁎
.12⁎
Note. B = unstandardized beta coefficient; R2 = adjusted r2; ns = not
significant.
⁎ p b 0.05.
⁎⁎ p b 0.005.
⁎⁎⁎ p b 0.001.
parental QOL scores. Prior to performing linear regression,
the data set was assessed for multicollinearity, singularity,
outliers, normality, linearity, homoscedasticity, and independence of residuals. Predictor of better QOL included
increased income. Factors predicting poor QOL included
increased hospitalization days, increased ER visits, and
increased school days and workdays missed (Table 5). The
significant variables (i.e., income, ER visits, hospitalization
days, school days missed, and workdays missed) were
further tested using multiple linear regression. Relationships
between ER visits and mean total PACQLQ scores, mean
activity limitation scores, and mean emotional function
scores were significant. The correlation between the mean
activity limitation score and workdays missed (β = −.069,
p b .043, r2 = .317) was also significant (Table 6).
Independent t tests were performed to compare the mean
PACQLQ scores between different paired groups of sociodemographic factors (i.e., male vs female, owning a home vs
renting, and other groups). Prior to performing the data
analyses, the samples were checked for normal distribution,
homogeneity of variance, independence of observations, and
level of measurement. Parents who were not Black or
African, owned a car, were able to pay health costs, owned a
home, and perceived their children’s asthma as under control
had higher mean total, mean activity limitation, and mean
emotional function PACQLQ scores.
Table 6
Multiple regression models predicting QOL
Predictor
ER visits
Workdays missed
Activity
limitation
subscale
Emotional
function
subscale
PACQLQ
summary
scores
B
R2
B
R2
B
R2
−.25
−.07
.32⁎
.32⁎
−.18
ns
.08⁎
ns
−.20
ns
.19⁎
ns
Note. B = unstandardized beta coefficient; R2 = adjusted r2; ns = not
significant.
⁎ p b 0.05.
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N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
5. Discussion
The main finding in this study is that higher levels of
asthma severity reflected decreased PACQLQ scores, or
decreased parental QOL. This current study affirms findings
by Williams et al. (2000), who also found a negative
correlation between PACQLQ scores for parents and their
children’s asthma severity scores over a period of 4 months
(r = −.39, p b .001). They also found that PACQLQ scores
were correlated negatively with the number of days missed
from school (r = −.24, p b .001), which this study supports.
One explanation may be that parental QOL is affected by
concerns of rising medical expenses with increasing asthma
severity, stress related to the disease process, availability of
social support, access to medical care and appropriate
medication, and the impact of asthma on daily activities in
the home (Annett, Bender, DuHamel, & Lapidus, 2003;
Erickson et al., 2002).
Participants grouped by asthma severity according to
NAEPP guidelines showed significant differences in
PACQLQ scores. As asthma severity increased, mean
parental PACQLQ scores decreased, indicating decreased
QOL (df = 3, F = 7.56, p = .0005, η2 = .189). This finding
indicates that parents of children with mild asthma claimed
better QOL. This suggests that children with higher asthma
severity require levels of care that place greater activity
restriction and emotional responsibility on parents.
In this current study, several sociodemographic factors
were shown to influence parental QOL, some of which do
not support current findings in the literature. For example,
increased ER visits were significantly related to decreased
overall QOL in this study. This is contrary to findings by
Halterman et al. (2004), who identified increased symptomfree days and the parental perceptions of asthma control.
They did not find ER visits to be a significant factor
associated with parental QOL. Instead, their predictive
factors of worse QOL included Hispanic ethnicity, use of
daily maintenance medication, and secondhand smoke
exposure in the home. Research by Erickson et al. (2002)
and Annett et al. (2003) were more closely aligned with
findings from this study.
Several studies suggested that the prevalence and severity
of asthma are associated with ethnicity and poverty-related
factors such as young maternal age, maternal cigarette
smoking, low birth weight, and living in crowded conditions
in the inner city (Williams et al., 2009). This study supported
the idea that sociodemographic factors also influence
parental perception of QOL. A family history of asthma;
being single, divorced, or widowed; and perceived poor
asthma control yielded significantly lower PACQLQ scores.
Correlational analyses of mean PACQLQ scores and
sociodemographic factors revealed different findings from
other studies. For example, Osman et al. (2001) found
sociodemographic factors such as being a young mother,
being from less affluent families, and having increased
socioeconomic deprivation scores also scored lower on the
PACQLQ. Dalheim-Englund, Rydstrom, Rasmussen, Moller, and Sandman (2004) found another set of sociodemographic factors; place of residence, age of the child,
and severity of the child’s asthma impacted PACQLQ
scores. These findings suggest that many factors in addition
to asthma severity can influence parental QOL, which is
similar to this study’s findings.
The strengths of this study included the close timing of
actual events and responses to the questionnaires. The
PACQLQ and asthma severity questionnaires ask questions
within the past week and past month, respectively. Because
parents would better remember important events related to
their children’s asthma within these time frames, this reduced
the risk of recall error and improved accuracy of reporting
the data (Reichenberg & Broberg, 2001). The PACQLQ was
studied to be both reliable and responsive with moderate
validity (Juniper et al., 1996), which strengthened the results
obtained. Many studies used the PACQLQ showing
reliability and validity (Dalheim-Englund et al., 2004;
Laforest et al., 2004; Osman et al., 2001; Reichenberg
et al., 2001).
This study had several limitations. First, utilizing a crosssectional study design provides a snapshot of the lives of
children with asthma and their parents at a specific point in
time, and answers to the questionnaires could have been
different if a longer period or a different period (seasonal
influence of certain types of asthma) was used (DalheimEnglund et al., 2004; Reichenberg et al., 2001). Ideally, a
longitudinal research study would provide ongoing changes
in QOL as related to changes in life events related to asthma.
Another limitation is selection bias because some parents
were more willing to participate in the study due to the
manifestation of their children’s asthma severity.
6. Conclusion and recommendations
The evidence presented in this study supports the idea that
numerous factors such as asthma severity and sociodemographic factors are capable of influencing QOL. Measuring
parental QOL can help to develop more effective asthma
programs that take the experiences of parents into consideration (Halterman et al., 2004), an important component for
successful medical and nursing care.
One area for future research is to test a larger number of
participants over a longer period in multiple settings.
Examining a larger number of participants in different
settings allows assessment for study consistency, and the
longitudinal design may account for changing sociodemographic and asthma severity on QOL. Several other measures
such as parents’ own physical disabilities, coping abilities,
psychological health, family context, and other unknown
factors may be revealed in a longitudinal study design. Recent
studies suggest that psychological factors and parents’ mental
health influence PACQLQ scores and health care utilization
for their asthmatic children (Dalheirm-Englund et al., 2004;
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
Vila et al., 2004). Thus, another area for future research
should be to examine other factors besides asthma severity
and sociodemographic factors that may influence QOL. To
determine if other factors influence QOL, instrumentation
research to develop other measurement tools aside from the
PACQLQ needs to occur.
Supporting previous research findings, this current study
helped affirm the idea that nurses working with families of
asthmatic children need to aggressively provide care
through patient education and vigilant monitoring. This
study showed that asthma severity is closely aligned with
parental QOL. Understanding this relationship, nurses can
positively influence care by assuring tight control of asthma
severity, and even reversing the asthma severity category of
patients has the potential to elevate QOL for both parents
and asthmatic children especially in families that are the
most vulnerable.
References
Akinbami, L. J., & Schoendorf, K. C. (2002). Trends in childhood asthma:
Prevalence, health care utilization, and mortality. Pediatrics 110,
315–322.
Annett, R. D., Bender, B. G., DuHamel, T. R., & Lapidus, J. (2003). Factors
influencing parent reports on quality of life for children with asthma.
Journal of Asthma 40, 577–587.
Dalheim-Englund, A., Rydstrom, I., Rasmussen, B. H., Moller, C., &
Sandman, P. (2004). Having a child with asthma—Quality of life for
Swedish parents. Journal of Clinical Nursing 13, 386–395.
Dean, B. B., Calimlim, B. M., Kindermann, S. L., Khandker, R. K., &
Tinkelman, D. (2009). The impact of uncontrolled asthma on
absenteeism and health-related quality of life. Journal of Asthma 46,
861–866.
Erickson, S. R., Munzenberger, P. J., Plante, M. J., Kirking, D. M., Hurwitz,
M., & Vanuya, R. Z. (2002). Influence of sociodemographic factors on
the health-related quality of life of pediatric patients with asthma and
their caregivers. Journal of Asthma 39, 1
Your poster should include:Explanation of the nursing issue significance with three statementsDescription of your position on the issue and three statements on how a nurse can impact this issueInclude only the two approved journal sources used in your Week 6 appraisals to support your position.Follow the example file I provided.USE SYSTEMIC AND QUANTATIVE ARTICLES THAT I ATTACHED HERE TO CREATE THE POSTER. I NEED THIS ASSIGNMENT BY SUNDAY OCTOBER 22 ,AT 5 PM.
ESSAY #4 – SOCIAL DETERMINANTS OF HEALTH (2pgs)
Purpose
Students will watch a short video, participate in an activity, and take a survey to explore the social determinants of health and disease.
Instructions
Watch the 5-minute Trailer for the Unnatural Causes documentary series. In the trailer, the question “Is inequality making us sick?” is posed, and some ideas about how this question might be answered are presented. One overarching theme is whether our health is determined strictly by the genes we are born with or shaped by the social conditions in which we grow and develop and the experiences we have. Discuss some of the ideas presented that help you understand whether and how inequality is making us sick.
On the Unnatural Causes documentary website, go to the “Interactivities” page. Scroll down to the “Tale of Two Smokers”activity, which follows Joe and Jill on their journey to quit smoking and lose 20 lbs. Read the introduction page, and then click through each of the “Suggestions to Lower Blood Pressure”, reading Joe and Jane’s responses to each of those suggestions. Watch the graph of their allostatic load change as you go through.
Compare and contrast Joe and Jane’s experiences trying to get healthier.
How do the choices they make depend on the choices they have? In other words, why does it take more than willpower and discipline to change unhealthy habits and behaviors?
Relate this to a health goal you or someone you know have set, and describe some of the challenges and successes you faced due to external factors unrelated to your willpower and discipline.
On the same “Interactivities” page, go to the “Health Equity Quiz”. Take the quiz.
What was your score, and are you surprised by it?
Which questions were the most surprising or interesting to you?
Discuss at least two things you learned from taking this quiz.
Grading Criteria
See Attached Rubric
GUIDELINES FOR ALL WRITING ASSIGNMENTS:
As per UNLV second-year seminar requirements, this course has a heavy writing component. There are four major essays (2 pages), two reflection papers about two non-fiction books (4 pages), and a final research paper (4 pages). You are expected to complete every one of these larger assignments and may receive a failing grade if more than 1 is not completed.
Use ESSAY format. No sub-headers or numbered paragraphs.
Use FORMAL writing, not casual as if you are chatting with a friend. No SLANG or Idioms.
Include a DISTINCT Introductory paragraph that tells the purpose of the paper and previews topics to be covered and a Concluding paragraph that summarizes.
DOUBLE SPACE, indent paragraphs 0.5inches, don’t leave extra space between paragraphs, 1 inch margins, size 12 font, either Times New Roman or Arial.
NO title page or Running Header required.
HEADER: 3 lines only, SINGLE-SPACED: Name, Date, Assignment title. Must show on every page; Use “insert header” in Word.
MEET or EXCEED minimum page length requirement. Consider going 1-2 lines onto the next page to be sure you do not lose points.
REFERENCES: Required. Must include all websites required for an assignment and any others you use, Must be academic. Separate page at the end. See APA Module.
IN-TEXT CITATIONS: Required in most paragraphs. NO quotations permitted for this class; Use paraphrasing with citation. See APA Module.
CHECK your Turnitin Similarity score, which should be 20% or less.
EDITING: Spelling, mechanics, word selection (correct use of words), and grammar count. Please proofread your paper carefully.
IF THESE REQUIREMENTS ARE NOT MET, PAPER MAY BE RETURNED TO YOU WITH A ZERO GRADE UNTIL YOU REDO IT. LATE PENALTIES WILL APPLY
Think about a crisis or conflict in your work area (Hospice), and develop an essay of a minimum of three pages explaining how, as a D.N.P. Leadership Role, you can use the strategies for conflict solution and crisis management to avoid this type of conflict. But remember that making a decision is not always solving the problem.Contribute a minimum of three pages. It should include at least three academic sources, formatted and cited in APA.
i have attached 4 asessements . they are serequel to each other and i have attached documents need for each asessement.
Unformatted Attachment Preview
To select the diagnosis for the patient in this scenario, review the three diagnoses
presented in the Assessment 01 Supplement: Locating Credible Databases and Research
[PDF] Download Assessment 01 Supplement: Locating Credible Databases and
Research [PDF]resource and select one.- I have attached the document You will use this
same diagnosis to complete the next two assessments.
The purpose of this assessment is to understand where to find evidence that can be
applied to clinical scenarios and to learn effective communication and collaboration with
clinical staff during the process of evidence location. As a baccalaureate-prepared nurse,
you will not only use research for self-improvement in your clinical role, but you will also
serve as a mentor to supervised nursing staff. Therefore, you will need to be able to
communicate and collaborate effectively to guide them toward resources to find
research, as well as support them through the initial evidence location process. In doing
so, nurses can gain access to evidence that can be analyzed and utilized to stay current
on best practices. This allows them to provide safe, patient-centered care and improve
patient outcomes.
For this assessment:
•
•
•
Describe your role as a baccalaureate-prepared nurse supervising clinical staff
nurses with regard to communication and collaboration in locating evidence
for application to a nursing practice scenario.
Compile a list of five online databases or other online sources (that is,
websites, journals, facility policies or guidelines, et cetera) that can be used to
research evidence to apply to the diagnosis in this scenario and describe to
which of these you would direct a nurse colleague to search for evidence.
Describe where you might go in the work place to complete this research and
how you would access the desired, relevant research within research
databases or other online sources.
Be sure to address the following in this assessment, which correspond to the grading
criteria in the scoring guide. Please study the scoring guide carefully so that you will
know what is needed for a distinguished score.
o
o
o
o
Describe communication strategies to encourage nurses to research the
diagnosis/practice issue, as well as strategies to collaborate with the nurses to
access resources.
Describe the best places to complete research and what types of resources
you would want to access to find pertinent information for the
diagnosis/health care issue within the context of a specific health care setting.
Identify five sources of online information (medical journal databases,
websites, hospital policy databases, et cetera) that could be used to locate
evidence for a clinical diagnosis/practice issue.
Explain why the sources of online information selected should provide the
best evidence for the chosen diagnosis/health care issue.
o
Communicate using writing that is clear, logical, and professional with correct
grammar and spelling using current APA style.
Note: While you are not selecting and evaluating specific evidence to help with the
clinical diagnosis/practice issue, you should still be citing the literature and best practices
to support your description of your communication and collaboration approach.
Additionally, it is appropriate to cite best practices related to EBP and evaluating
databases to support your explanation as to why you selected the five sources of online
information that you did.
•
•
•
Length of submission: 2-4 pages (not including the title page or the reference
page) description of communication, collaboration, and evidence location
process, including a list of databases or other sources with description of why
they are appropriate for clinical scenario diagnosis/health care issue (that is,
something that would be useable in professional practice for other nurses). Be
sure to include an APA-formatted reference page at the end of your
submission.
Number of references: Cite a minimum of three sources of scholarly or
professional evidence that supports your findings and considerations.
Resources should be no more than five years old.
APA formatting: References and citations are formatted according to current
APA style.
Assessment 01 – Locating Credible Databases and Research
Create a 2-4 page resource that will describe databases that are relevant to EBP around one of
the diagnoses below and could be used to help a new hire nurse better engage in EBP.
Before you complete the instructions detailed in the courseroom, first select one of the
diagnoses below. You will use this diagnosis in subsequent assessments.
•
Urinary Tract Infection (UTI): An infection in any part of the urinary system, including
kidneys, bladder, or urethra.
o Interventions: Antibiotic therapy, increased fluid intake, urinary analgesics, and
bladder training.
o Keywords: Cystitis, pyelonephritis, bacteriuria, dysuria, urinary frequency.
•
Deep Vein Thrombosis (DVT): A blood clot that forms in a deep vein, usually in the
legs.
o Interventions: Anticoagulant therapy, compression stockings, leg elevation, and
patient education on mobility.
o Keywords: Venous thromboembolism, pulmonary embolism, clotting factors,
INR monitoring, heparin.
•
Cellulitis: A common bacterial skin infection that can spread to other parts of the body.
o Interventions: Antibiotic therapy, warm compresses, elevation of the affected
area, and wound care.
o Keywords: Skin infection, erythema, edema, abscess, staphylococcus.
1
For this assessment, use the specific diagnosis/health issue you selected for the first assessment
For this assessment:
For this assessment:
• Explain the criteria that should be used when determining the credibility of journal articles as
well as websites.
• Support your explanations with references to the literature or research articles that describe
criteria that should be used to determine credibility.
o Your identification and determination of credibility should be done within the context of
your chosen diagnosis for this assessment. Your initial identification of resources should
be of resources that will best help address the presented diagnosis you selected. Since
you are locating resources to help provide evidence-based care for the diagnosis/health
care issue you identified in the first assessment, you may want to begin your literature
and evidence search from the databases that were identified.
Be sure to address the following in this assessment, which correspond to the grading criteria in the
scoring guide. Please study the scoring guide carefully so that you will know what is needed for a
distinguished score.
• Describe a chosen diagnosis that could benefit from an evidence-based approach.
• Explain criteria that should be considered when determining credibility of resources such as
journal articles and websites.
• Analyze the credibility and relevance of evidence and resources within the context of a chosen
diagnosis.
o This is where you are selecting the specific resources to help address the diagnosis you
selected for the first assessment.
• Identify the Evidence-Based Practice model and explain the importance of incorporating credible
evidence into the EBP model used to address a chosen diagnosis. Review the literature below
and choose the appropriate model for your diagnosis.
Your assessment should meet the following requirements:
•
•
•
Length of submission: 2-4-page scholarly paper, this does not include the
APA-formatted title page and reference list.
Number of references: Cite 3-5 sources of scholarly or professional evidence
that support your findings and considerations. Resources should be no more
than five years old.
APA formatting: References and citations are formatted according to current
APA style.
For this assessment, use the specific diagnosis/health issue you selected for the first assessment
For this assessment:
For this assessment:
• Explain the criteria that should be used when determining the credibility of journal articles as
well as websites.
• Support your explanations with references to the literature or research articles that describe
criteria that should be used to determine credibility.
o Your identification and determination of credibility should be done within the context of
your chosen diagnosis for this assessment. Your initial identification of resources should
be of resources that will best help address the presented diagnosis you selected. Since
you are locating resources to help provide evidence-based care for the diagnosis/health
care issue you identified in the first assessment, you may want to begin your literature
and evidence search from the databases that were identified.
Be sure to address the following in this assessment, which correspond to the grading criteria in the
scoring guide. Please study the scoring guide carefully so that you will know what is needed for a
distinguished score.
• Describe a chosen diagnosis that could benefit from an evidence-based approach.
• Explain criteria that should be considered when determining credibility of resources such as
journal articles and websites.
• Analyze the credibility and relevance of evidence and resources within the context of a chosen
diagnosis.
o This is where you are selecting the specific resources to help address the diagnosis you
selected for the first assessment.
• Identify the Evidence-Based Practice model and explain the importance of incorporating credible
evidence into the EBP model used to address a chosen diagnosis. Review the literature below
and choose the appropriate model for your diagnosis.
Your assessment should meet the following requirements:
•
•
•
Length of submission: 2-4-page scholarly paper, this does not include the
APA-formatted title page and reference list.
Number of references: Cite 3-5 sources of scholarly or professional evidence
that support your findings and considerations. Resources should be no more
than five years old.
APA formatting: References and citations are formatted according to current
APA style.
➢ Create a 3-5 page submission in which you develop a PICO(T) question for the diagnosis
you worked with in the first two assessments and evaluate the evidence you locate, which
could help to answer the question. For this assessment, please use the diagnosis you
worked with in the first two assessments.
➢ After reviewing the materials you created to research a specific diagnosis in the first two
assessments, apply the PICO(T) process to develop a research question and research it.
➢ Your initial goal is to define the population, intervention, comparison, and outcome. In some
cases, a time frame is relevant and you should include that as well, when writing a question you
can research related to your issue of interest. After you define your question, research it, and
organize your initial findings, select the two sources of evidence that seem the most relevant to
your question and analyze them in more depth. Specifically, interpret each source’s specific
findings and best practices related to your chosen diagnosis, and explain how the evidence
would help you plan and make decisions related to your question.
➢ If you need some structure to organize your initial thoughts and research, the PICOT Question
and Research Template document (accessible from the “Create PICO(T) Questions” page in the
Capella library’s Evidence Based Practice guide) might be helpful.
➢ In your submission, make sure you address the following grading criteria:
• Define a practice issue to be explored via a PICO(T) approach. Create a PICO(T)formatted research question
• Identify sources of evidence that could be potentially effective in answering a PICO(T)
question (databases, journals, websites, etc.).
• Explain the findings from articles or other sources of evidence as it relates to the
identified health care issue.
• Explain the relevance of the findings from chosen sources of evidence to making
decision related to a PICO(T) question.
• Communicate using writing that is clear, logical, and professional with correct grammar
and spelling using the current APA style.
•
•
•
Length of submission: Create a 3-5 page submission focused on defining a
research question and interpreting evidence relevant to answering it.
Number of references: Cite a minimum of four sources of scholarly or
professional evidence that support your findings and considerations.
Resources should be no more than 5 years old.
APA formatting: Format references and citations according to the current
APA style.
I know this assignment requires a video but I want it typed then I can present it
Create a 5-10 minute video of yourself, as a presenter, in which you will propose an evidencebased plan to improve the outcomes the patient in the provided case study, and examine how
remote collaboration provided benefits or challenges to designing and delivering the care.
Review the case study in the Assessment 04 Supplement: Remote Collaboration and EvidenceBased Care [PDF] Download Assessment 04 Supplement: Remote Collaboration and EvidenceBased Care [PDF]resource. You will use this case study as the focus for this assessment. I have
attached this
For this assessment, you are a presenter! You will create a 5–10-minute video using Kaltura or similar
software. In the video:
• Propose an evidence-based care plan that you believe will improve the safety and outcomes of
the patient in the case study presented in the Assessment 04 Supplement: Remote Collaboration
and Evidence-Based Care [PDF] Download Assessment 04 Supplement: Remote Collaboration
and Evidence-Based Care [PDF]resource I will attach this document . Add your thoughts on what
more could be done for the patient and what more information may have been needed.
• Discuss the ways in which an EBP model and relevant evidence helped you to develop and make
decisions about the plan you proposed
• Wrap up your video by identifying the benefits of the remote collaboration in the scenario, as
well as discuss strategies you found in the literature or best practices that could help mitigate or
overcome one or more of the collaboration challenges you observed in the scenario.
Be sure you mention any articles, authors, and other relevant sources of evidence that helped inform
your video. Discuss why these sources of evidence are credible and relevant. Important: You are
required to submit an APA-formatted reference list of the sources you cited specifically in your video or
used to inform your presentation. You are required to submit a narrative of all your video content to this
assessment and to SafeAssign.
The following media is an example learner submission in which the speaker successfully addresses all
competencies in the assessment.
• Exemplar Kaltura Reflection.
o Please note that the scenario that the speaker discusses in the exemplar is different
from the Vila Health scenario you should be addressing in your video. So, the type of
communication expected is being model, but the details related to the scenario in your
submission will be different.
Make sure that your video addresses the following grading criteria:
• Propose your own evidence-based care plan to improve the safety and outcomes for a patient in
the provided case study.
• Explain the ways in which you used an EBP model to help develop your plan of care for the
client.
• Reflect on which evidence you found in your search that was most relevant and useful when
making decisions regarding your care plan.
• Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to
plan care within the context of a remote team.
• Communicate in a professional manner that is easily audible and uses proper grammar, including
a reference list formatted in current APA style.
Length of video: 5-10 minutes.
•
•
References: Cite at least three professional or scholarly sources of evidence to
support the assertions you make in your video. Include additional properly
cited references as necessary to support your statements.
APA reference page: Submit a correctly formatted APA reference page that
shows all the sources you used to create and deliver your video. Be sure to
format the reference page according to current APA style. Submit a narrative
of all of your video content
NURS 461 Plan of Care Rubric
The Nursing Plan of Care is used to organize patient data which enables nursing personnel to deliver safe
and effective care for a client. Students need to complete one (1) care plan for the semester. A total
score of seventy-seven (77) per care plan constitutes a “PASS” grade. Anything below a seventy-seven
(77) constitutes a “FAIL” grade. Students must complete two “PASS” care plans. The instructor will use
the following rubric to assign points for the care plan. Graded care plan by the clinical instructor must be
uploaded into Moodle by the student at the designated due date.
Topic
Assessment Findings (data):
(including pertinent negative findings)
•
Clustered in order of priority
•
Related to nursing diagnosis
•
Documented source
Nursing Diagnosis:
•
Prioritizing (using the NANDA format)
•
Based on the data collected
•
One actual and one at risk diagnoses selected
Distribution of Points
25 points
8 points
Expected Outcome:
(attainable through nursing interventions)
•
Two short-term outcomes per nursing diagnosis (16 points)
•
Must be measurable with a realistic timeframe (4 points)
20 points
Interventions & rationale:
•
Three nursing specific interventions for each short-term goal
(not to include monitoring a patient)
•
Congruent with the nursing diagnosis
•
Demonstrate theoretical/scientific principles and integrate
research
•
Documented with supportive literature
Evaluation (rationale):
(outcome criteria met, partially met, or not met)
35 points
Medication table:
•
Completed for all medications assigned to the client
•
Dosage range appropriately completed
•
Indications for use specific to client
•
Inclusion of appropriate nursing considerations and side
effects
Formatting:
•
Grammar, spelling and terminology must be correct
•
Minimal use of standard abbreviations
•
References cited in APA format and within last 3-5 years
Total points:
5 points
LAST UPDATED: 12/28/2017 KD & SM, NURS 461 6/19/18
SS
Points Earned
2 points
5 points
100 possible points
1
This week you have studied advanced physical assessment of the eyes, ears, nose, throat, head, neck, and skin (HEENT). Describe the classification of rashes. What resources for HEENT advanced health assessment skills are beneficial in developing knowledge and psychomotor skills? Post a concept to the discussion board that you have had difficulty with and note where you are with the resolution of your difficulties. Please describe the issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls.’ A concept I have difficulties with is examining the ear: inner and middle ear, tympanic membrane, etc.
PHC 241-Group presentation
This assignment is a group effort. Students will work in groups of three to five and will choose
one of these topics on nutrition and public health:
1. Protein Energy Malnutrition and Early Child Development
2. Iron Deficiency Anemia in the Kingdom of Saudi Arabia
3. Maternal Nutrition and Low Birth Weight
4. Nutrition in School-Age Children and Cognitive Development.
5. Fast Food Consumption and Obesity among University Students
6. The Nutritional Transition and Its Implications for the Developing World
7. The Covid-19 Pandemic and Food Consumption Patterns
8. Food Insecurity and Malnutrition in Developing Countries
9. Food Security in a Global Pandemic
10. Elderly Health: Nutritional Issues of Older Adults
Presentations should include the following:
An adequate description of the nutritional issue, including a general or specific case.
Discussion of preventive or treatment strategies, and any related local or national
policies.
Practical recommendations for reducing malnutrition.
Questions for class discussion.
Important guidelines for students:
Presentation should consist of no more than 15 PowerPoint slides (including one page of
class discussion questions).
The cover slide should include the following: university logo; presentation title, group
members names and students ID numbers.
Presentation time should be 10–12 minutes, followed by five minutes of class discussion.
Each group should have a maximum of five students.
Support your presentation with at least three references (APA style).
The group will be graded as per the “Presentation Marking Rubric”
Poor
0.25 pts
Fair
0.50 pts
Good
0.75 pts
Excellent
1 pts
Organization Audience cannot
understand
presentation because
there is no sequence
of information.
Audience has
difficulty
following
presentation
because
student jumps
around.
Subject
Knowledge
Student does not
have grasp of
information; student
cannot answer
questions about
subject.
Student is
uncomfortable
with
information
and is able to
answer only
rudimentary
questions.
Student
presents
information
in logical
sequence
which
audience can
follow.
Student is at
ease with
expected
answers to all
questions, but
fails to
elaborate.
Graphics
Student uses
superfluous graphics
or no graphics
Mechanics
Student’s
presentation has four
or more spelling
errors and/or
grammatical errors.
Student
occasionally
uses graphics
that rarely
support text
and
presentation.
Presentation
has three
misspellings
and/or
grammatical
errors.
Student
presents
information in
logical,
interesting
sequence which
audience can
follow.
Student
demonstrates
full knowledge
(more than
required) by
answering all
class questions
with
explanations
and elaboration.
Student’s
graphics
explain and
reinforce screen
text and
presentation.
Group
Dynamics
Multiple group
members not
participating.
Evident lack of
preparation/rehearsal.
Dependence on
slides.
Significant
controlling by
some members
with one
minimally
contributing.
Primarily
prepared but
with some
dependence on
just reading off
slides.
Student’s
graphics
relate to text
and
presentation.
Presentation
has no more
than two
misspellings
and/or
grammatical
errors.
Slight
domination of
one presenter.
Members
helped each
other.
Very well
prepared.
Presentation has
no misspellings
or grammatical
errors.
All presenters
knew the
information,
participated
equally, and
helped each
other as needed.
Total (5)
Did you find the title appropriate? Would you say that the subject matter in Jellyfish is bleak?2. The film is set in Tel Aviv. However, some critics say that Jellyfish is not an “Israeli film.” Do you agree with this statement? Did you find anything particularly Israeli in the film?3. How is Joy different from Keren and Batya? Which character did you find compelling?4. Water is a recurring visual theme in the film. What is its symbolic meaning?5. Magical realism in cinema uses a strong dose of reality mixed in with the magic. Discuss one or two scenes that best reflect this storytelling technique.6. Jellyfish is about loneliness, missing persons, and the luck of connection between people. Discuss specific examples from the film.7. What do you think of the filmmakers’ use of flashbacks, especially to Bathya’s childhood?8. Jellyfish has very little conventional linear plot development. What effect does it have on the viewers?9. The film opens and ends with a Hebrew rendition of Edith Piaf’s “La Vie En Rose.” What’s your understanding of this decision? https://www.youtube.com/watch?v=rzeLynj1GYM
Unformatted Attachment Preview
Jellyfish
(Meduzot)
By Etgar Keret and Shira
Geffen
Israel, 2007, 1h18min
https://www.aa.com.tr/en/middle-east/israels-population-hits-92m-including193m-arabs/1820022
• Israel’s current population: 9.2 million
• 6.8 million Jews (74%), 1.93 million Arabs (21%), and
454,000 non-Arab Christians or adherents of other faiths
(5%), according to the Israeli Central Bureau of Statistics
(CBS).
• 3.3 million Jewish people have immigrated to Israel since the
founding of the state, 44% of whom came after 1990, many or
most of them immigrants from the former Soviet Union.
• At present, 45% of the global Jewish population lives in
Israel.
Orly Iubin, Body and Territory: Women in Israeli Cinema
• Early Israeli women’s cinema emerged at the end of the 1960s with Alida
Gera’s first feature film, Before Tomorrow, and gathered momentum in
the 1970s and 1980s with Michal Bat Adam’s Moments, Thin Line,
and Boy Meets Girl; Mira Recanati’s A Thousand Little Kisses; Idit
Shehori’s Weekend Circles; and Tzipi Trope’s Tell Me That You Love Me.
• Inspired by feminist European cinema of the same period (such as the
films of Dianne Kurys and Agnes Varda), early women’s films
challenged the exclusion and constructed otherness of women on the
Israeli screen.
• Simone de Beauvoir, The Second Sex: “One is not born, but rather
becomes, a woman.” Biology does not determine what makes a woman a
woman—a woman learns her role from man and others in society.
Orly Iubin, Body and Territory: Women in Israeli Cinema
• Early women’s films were produced alongside modernist Israeli cinema,
known as the New Sensibility or Personal Cinema (Ne’eman).
• The New Sensibility films were influenced by the avant-garde aesthetic of
1960s French New Wave cinema (La Nouvelle Vague)
https://www.masterclass.com/articles/french-new-wave-guide#the-3-primary-characteristics-of-frenchnew-wave-cinema
• The New Sensibility films focused on existential questions related to the world
of the individual and on universal themes of love, sexuality, and friendship that
are cut off from the wider social and regional context—were directed by men
who explicitly
– ignored the woman and her look, or alternatively
– depicted her as a spectacle for the voyeuristic male gaze
Yossef Raz, Conditions of Visibility: Trauma and contemporary
israeli women’s cinema (2017)
• The past decade has marked a renaissance of women’s cinema in
Israel.
• A new generation of female filmmakers is seeking to redefine the
conditions of women’s representability in Israeli society and cinema.
• In their films, they deal with current problems in the lives of
• women in Israel, or with
• issues that have been excluded from the public agenda.
Yossef Raz, Conditions of Visibility: Trauma and
contemporary israeli women’s cinema (2017)
• Most of the women’s films deal with the catastrophic event of rape as
well as with losses entailed by experiences of immigration and
displacement, traumas of racism and ethnic discrimination, and injured
subjectivities of the memory of the Holocaust and of war and military
occupation.
• Feminist film theorist Claire Johnston [construction of ideology in
mainstream cinema] defines women’s cinema as a “counter-cinema”
(1973) that disrupts the traditional formal and narrative practices
responsible for the objectification, stereotyping, and mythologization
of women in film.
Yossef Raz, Conditions of Visibility: Trauma and
contemporary Israeli women’s cinema (2017)
• Teresa de Lauretis [film theory], proposes a different approach to
women’s cinema that is reconstructive rather than deconstructive: “The
present task of women’s cinema may not be destruction of narrative
and visual pleasure, but rather construction of another frame of
reference, one in which the measure of desire is no longer just the
male subject.” (1985)
• What is at stake is not so much how to ‘make visible the invisible’ but
how to produce the conditions of representability of another social
subject.
• According to de Lauretis, women’s cinema produces new images of
women while addressing the female rather than the male viewer.
Etgar Keret
Born in Israel, 1967. He teaches film at Ben Gurion
University.
A contributor to the New Yorker:
https://www.newyorker.com/contributors/etgar-keret
Etgar Keret is an Israeli writer known for his short stories,
graphic novels, and scriptwriting for film and television. His
books had been published in more than 45 languages.
His short film Malka Lev Adom (Skin Deep, 1996) won an
Israel Film Academy award and first place in the Munich
International Festival of Film Schools.
The film Jellyfish received the Camera d’Or prize at the 2007
Cannes Film Festival.
Shira Geffen
Born in Israel, 1971. Daughter of
poet and author Yonatan Geffen.
Actress, screenwriter, film director
and children’s book writer.
She has acted in a television series
and has written and directed
Jellyfish with her husband Etgar
Keret.
The French Artists’ and Writers’
Guild also gave Geffen and Keret
its Best Director Award (2007).
Interview with the filmmakers:
Plot: https://www.kanopy.com/en/laguardia/video/5263750
• Winner of three prizes at the Cannes Film Festival. Official Selection at
the Toronto International Film Festival.
• JELLYFISH tells the story of three very different Tel Aviv women whose
intersecting stories weave an unlikely portrait of modern Israeli life.
• Batya, a catering waitress, takes in a child apparently abandoned at a
local beach. Batya is one of the servers at the wedding reception of
Keren, a bride who breaks her leg escaping a locked toilet stall, ruining
her chance at a dream Caribbean honeymoon. And attending the event
with an employer is Joy, a non-Hebrew-speaking domestic worker who
has guiltily left her son behind in her native Philippines.
A film with neither politics nor religion
• Each character has to face a challenge.
• 3 episodes painting states of mind rather then telling stories.
• 3 women at crossroads in need of making decisions but feeling
somewhat ambivalent about their choices. Why?
• The characters are at the mercy of the currents and tides and seem
incapable of controlling their own fates.
• Any link with the title?
Themes
Drab fabric of
modern existence
Lack of control over
our lives (wander)
Loneliness of city
dwellers, isolation
Disappointment
Sense of the absurd
Elusive nature of
happiness
Dysfunctional
families and
wretched personal
lives
Sense of waiting for
something
Magic Realism – The Magical Realism Genre/Style
Looking through an entirely different lens
• Term used in literature, art, theater (1925): acceptance of
magic and irrational as natural in the real world. >Reality mixed with magic
• Genre that features everyday life events that are made
livelier with some magic.
• Why? This technique can help us to derive deeper
understanding of otherwise mundane events.
• Deliver a more clearly refined world that reflects a mix
of both the familiar and the irrational/supernatural.
• Short introduction:https://www.vox.com/2014/4/20/5628812/11questions-youre-too-embarrassed-to-ask-about-magical-realism
• Short videos: https://www.youtube.com/watch?v=Od3A6Mc8Lao
• https://www.youtube.com/watch?v=4vn4X6J7TT8
• 1. Did you find the title appropriate? Would you say that the subject matter in Jellyfish is
bleak?
Film
Discussion
Questions
• 2. The film is set in Tel Aviv. However, some critics say that Jellyfish is not an “Israeli
film.” Do you agree with this statement? Did you find anything particularly Israeli in the
film?
• 3. How is Joy different from Keren and Batya? Which character did you find
compelling?
• 4. Water is a recurring visual theme in the film. What is its symbolic meaning?
• 5. Magical realism in cinema uses a strong dose of reality mixed in with the magic.
Discuss one or two scenes that best reflect this storytelling technique.
• 6. Jellyfish is about loneliness, missing persons, and the luck of connection between
people. Discuss specific examples from the film.
• 7. What do you think of the filmmakers’ use of flashbacks, especially to Bathya’s
childhood?
• 8. Jellyfish has very little conventional linear plot development. What effect does it have
on the viewers?
• 9. The film opens and ends with a Hebrew rendition of Edith Piaf’s “La Vie En Rose.”
What’s your understanding of this decision?
For this Performance Task Assessment, you will develop a practice statement that explains the importance of standardized nursing terminologies and the benefits and challenges of implementation in nursing practice.
Submission Length: 3 pages in practice statement.
Your response to this Assessment should:
Reflect the criteria provided in the Rubric.
Adhere to the required assignment length.
Instructions
Access the following to complete this Assessment:
SON Writing TemplateThe Impact of Standardized Nursing Terminology Practice Statement
In a 3-page Practice Statement, address the following:
Explain how data and information contribute to the formation of knowledge for nursing practice. (1/2 page)
Explain how knowledge for nursing practice might differ between healthcare organizations. (1/2 page)
Explain how these differences might contribute to standards for nursing. Be specific and provide examples. (1/2 page)
*NOTE: The response must synthesize and integrate at least two outside resources and two competency-specific resources that fully support the responses provided.
Explain the importance of standardized nursing terminologies. (1/2 page)
Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples. (1 page)
*NOTE: The response must synthesize and integrate at least two outside resources and two competency-specific resources that fully support the responses provided.
Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Walden Library.
The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare:
By Day 1 of this week, you will be assigned to one of the following specific case studies for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.
Review the following case studies:
Case 2: Ankle Pain
I-Q( last names)
A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: When you submit your initial post, please include a header as the first line indicating your assigned case study. For example, “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.
BY DAY 3 OF WEEK 8
Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
Hello I am doing a power point with a group and my part is to do interventions for sleep disorder we can do like 4 slides keep it short like 8 min speech for my slides. Thank you keep the powerpoint simple because I will copy and paste the work.ex black and white okay You can check this book for class is psych chapter 19 or external resources. let me know what I can do to help.
hello im applying for graduate school and need to do a personal statement, I will attach the requirements and my resume so you know more about myself to write on and my work history. can you please mention some sort of reason for a lower GPA count maybe due to because I was working full time and attending school I had to pay a lot out of my own pocket and rent etc etc. I also need three reference letters, I can fill the names and numbers after. one will be from my manager from my work place at tory burch ( its on my resume) one from my internship site SF VA (on my resume as well) and can you make the last one from my professor point of view at my school San Jose state university
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SABREEN
MALHI
SALES MANAGER
CONTACT
EXPERIENCE
September 2019 – Present
Sales Associate
Tory Burch, Santa Clara, CA ……………………………………………….
•
(530)443-0099
sabreenmalhi@yahoo.com
Santa Clara , ca 95112
CAREER OBJECTIVE
An experienced and skilled
June 2022 – August 2022
Internship Patient Service Specialist
San Fransisco Veterans Affair, San Fransisco , Ca
•
administrative professional seeking
•
knowledge and experience can be
•
a challenging role where their skills,
utilized. Interested in Public Health
•
upon skills gained from B.S. in Public
•
abilities to successfully fill the
•
administrative roles to further build
Health. Aiming to leverage my
vacancy on your team. Frequently
praised as detail-oriented by my
peers, I can be relied upon to help
your team achieve its goals.
Front facing, initial point of contact for customers over phone as well
as in person – Managing cash inventory and running reports for daily
income – Organizing and tracking inventory, updating spreadsheets
as needed – Completed daily tasks, such as stocking and replenishing
merchandise per store merchandising layouts – Assisting with sales
to meet service standards – Assisting with administrative tasks where
needed
•
•
Created and managed spreadsheets and databases to improve data
collection and organization.
Liaised between multiple departments for updates on advancement
of various projects.
Evaluated project advancement and recommended improvements
or changes to team to create solutions.
Developed thorough knowledge of project management by
completing assigned tasks and observing co-workers.
Documented team activities by recording meeting notes, creating
agendas and writing status reports.
Confirmed meeting of deadlines and goals throughout project,
preventing overdue deliverables.
Monitored costs incurred by project staff to identify budget issues.
Maintained strict confidentiality of protected health Information to
comply with HIPAA regulations.
January 2021 – August 2021
Medical Assistant
Action Urgent Care, San Jose, CA ……………………………………………
•
Providing high level administrative support for medical staff in the
Action Urgent Care clinic – Interacting with Physician Assistants,
Medical Assistants, and various admins on a daily basis – Providing
excellent customer service to both internal and external customers
for the clinic – Serving as a medical scribe, note taking, recording, and
maintaining notes as directed by medical staff – Serving as a
resource for all staff for clerical and public health information Knowledge of HIPAA rules and regulations, adhering to the health
care policies of the clinic – Front facing, initial point of contact for
patients over phone as well as in person – Completing insurance
•
forms as well as scheduling appointments for patients – Collecting
patient medical history information and entering it into the Dr
Chrono medical system – Updating and filing patient medical records
as requested by medical staff
June 2018 – January 2020
Aide / Receptionist
One on, Yuba Skilled Nursing Center, Yuba City, CA ………………..
•
Updating calendars and scheduling meeting for higher level
administrative staff – Serving as a resource for all staff for clerical and
public health information – Knowledge of HIPAA rules and
regulations, adhering to the health care policies of the clinic – Front
facing, initial point of contact for patients over phone as well as in
person – Preparing charts for patients, creating plans according to
their daily diet and exercise – Providing high level administrative
support for medical staff – Interacting with Doctors, nursing staff and
various admins (DONs etc) on a daily basis – Providing excellent
customer service to both internal and external customers for the
clinic
EDUCATION
December 2022
Bachelors Of Science In Public Health and Psychology
San Jose State University, San Jose, CA
Relevant Coursework
•
•
•
•
Epidemiology
Biostatistics
Health and Human Services
Community Health/ Health Promotion
SKILLS
•
•
•
•
•
•
•
•
HIPAA Regulations
Behavioral Health Services
Quality Control
Administration and Management
Team Leadership
Health Care System
Microsoft Office Proficiency
Public Health and Safety
•
Patient Data Management Systems
Title: “The Benefits and Challenges of Breastfeeding: Exploring Breastfeeding Resources for Empowered Mothers and Healthy Infants”
Guidelines:
APA Format
MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.
Research paper must be 650-1000 words.
3 or more scholarly sources must be utilized
Sources must be within the last 5 years
Must have a minimum of 3 Sources
All article sources must be cited by including them in reference sheet (separate).
For Chapters 10 and 11, you’ll create a “personal discussion.” This is your time to shine. You can say what you want without fear of judgment. Your “discussion” is in the form of a quiz.
1. Read Chapters 10 and 11 in your textbook.
2. Read the Chapters 10 and 11 handout.
3. Watch the videos in the handout.
4. Complete the Assess Yourself about Mindful Eating (296–page 297 in eText).
Q1
What are THREE HEALTHY FOODS you LIKE to eat -and- What is ONE HEALTHY FOOD that you
НАТЕ?
Q2
Write about ONE of these topics.
Please indicate your sources (book, video, handout) so I can at least pretend you did the work before answering this question.
SAFE FOOD! Using the videos and materials provided:
What causes food poisoning? (keep it simple, no need to be scientific)
What are some symptoms of food poisoning›
How can you avoid getting food poisoning?
-OR-
MINDFUL EATING. Evaluate yourself. Using info in Chapter Ten materials, as well as ASSESS YOURSELF on page 296 (297 in Text), answer these questions about mindful eating:
What is mindful eating?
Are you a mindful eater?
What changes could you make to improve your mindfulness at meal times?
-OR-
BODY IMAGE: Share your thoughts, feelings, opinions and/or challenges as related to body image.
Use Textbook FOCUS ON Enhancing your body imagine AND one of the videos in the handout (Mary Lambert Video; the Weather Lady Video; Lizzo Video) to determine your view of body image.
-OR-
NUTRITION. Using the provided materials, please indicate:
Do you read food labels? Why or why not? What kind of stuff is on a food label?
Do you think it’s healthier to be vegan/vegetarian or to be a meat-eater?
What are three things could you do to improve your food choices/nutritional level?
For your Competency Discussion, respond to the following prompts within the Discussion area to engage with your faculty and prepare to begin this Competency.What do you believe represents the biggest opportunity or challenge with regards to Big Data? Why?What do you believe is most important, in your role as a nurse leader, when engaged in the formation of knowledge in nursing practice? Why?
Consider two types moral reasoning: Consequentialist and Non-Consequentialist approaches (and the specific theories involved).1) define Consequentialism, using your own words and the textbook.2) define non- Consequentialism, using your own words and the textbook. 3) Which of these theories, if any, do you find most reasonable, and why?4) Provide a clear example to demonstrate your thinking. Must be able to respond to a peer
Select two Massachusetts Nurse of the Future Nursing Core Competencies that you believe will have the most impact on your future professional nursing practice. Why are these the most important ones for you?Identify one AACN BSN Essential that will be most important in improving quality in your future nursing practice. Explain why you selected that essential and how your practice will be improved by its use.
I am in my bachelor program and i what support in my homework. its two diffrent assignment asessment 1 and assement 2, both have a documts with instructions. I only have an example for asessment 2 and is attchached with a template to use as a guide if you need to.
The poster should include:Explanation of the nursing issue significance with three statementsDescription of your position on the issue and three statements on how a nurse can impact this issueInclude only the two approved journal sources used in your Week 6 appraisals to support your position.attached are examples of how the poster should look like
Unformatted Attachment Preview
NURS 350
TITLE
Name
How Nurses Can Impact this Issue
You can add some clip
art here – remember not to take images
from anywhere, but clip art (make it
professional) is okay
SIGNIFICANCE
OF THE ISSUE
• Make three bullet points here
from the information you learned
from the articles you used in Week 4
• Be sure to cite the source for
each intervention
• Make it scholarly – what does
the evidence say?
In this section, you will discuss the
issue. This is a good place to get
information from your initial Week 2
paper where you described the
background and the importance to
nursing (APA citation). Make 1-2
sentences about the background and
then the significance in bullet points
POSITION STATEMENT
Significance to Nursing
•
•
•
Most newly graduated nurses
will join the workforce through
a Nurse Residency Program
(APA citation)
Nurse Residency Programs
focus on evidence-based
practice (APA Citation)
Newly graduated nurses will
need to present evidencebased practice in poster
format (APA citation)
DON’T USE “I”
STATEMENTS, JUST
GIVE A SCHOLARLY
EXPLANATION:
NEWLY GRADUATED
NURSES NEED TO BE
ABLE TO USE AND
PRESENT EVIDENCEBASED PRACTICE TO
CARE FOR PATIENTS IN
THE CURRENT
HEALTHCARE
ENVIRONMENT
References
PUT YOUR REFERENCES
HERE – ALL THREE
ARTICLES IN APA
FORMAT – the three you
used in Week 4
NURS 350
Title
DESCRIPTION OF THE
ISSUE
NAME
In this section, you will discuss the issue.
This is a good place to get information
from your initial Week 2 paper where you
described the background and the
importance to nursing (APA citation).
Make 1-2 sentences about the background
and then the significance in bullet points
SIGNIFICANCE TO NURSING
•
•
•
Most newly graduated nurses will
join the workforce through a Nurse
Residency Program (APA citation)
Nurse Residency Programs focus
on evidence-based practice (APA
Citation)
Newly graduated nurses will need to
present evidence-based practice in
poster format (APA citation)
POSITION STATEMENT
DON’T USE “I” STATEMENTS, JUST
GIVE A SCHOLARLY EXPLANATION:
NEWLY GRADUATED NURSES
NEED TO BE ABLE TO USE AND
PRESENT EVIDENCE-BASED
PRACTICE TO CARE FOR PATIENTS
IN THE CURRENT HEALTHCARE
ENVIRONMENT
YOU CAN ADD A DESIGN OR CLIPART
BELOW. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
YOU CAN ADD A DESIGN OR CLIPART
HERE. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
How Nurses Can
Impact this Issue
• Make three bullet points
here from the
information you learned
from the articles you
used in Week 4
• Be sure to cite the
source for each
intervention
• Make it scholarly – what
does the evidence say?
References
PUT YOUR REFERENCES HERE – ALL
THREE ARTICLES IN APA FORMAT
NURS 350
Title
DESCRIPTION OF THE
ISSUE
NAME
In this section, you will discuss the issue.
This is a good place to get information
from your initial Week 2 paper where you
described the background and the
importance to nursing (APA citation).
Make 1-2 sentences about the background
and then the significance in bullet points
SIGNIFICANCE TO NURSING
•
•
•
Most newly graduated nurses will
join the workforce through a Nurse
Residency Program (APA citation)
Nurse Residency Programs focus
on evidence-based practice (APA
Citation)
Newly graduated nurses will need to
present evidence-based practice in
poster format (APA citation)
POSITION STATEMENT
DON’T USE “I” STATEMENTS, JUST
GIVE A SCHOLARLY EXPLANATION:
NEWLY GRADUATED NURSES
NEED TO BE ABLE TO USE AND
PRESENT EVIDENCE-BASED
PRACTICE TO CARE FOR PATIENTS
IN THE CURRENT HEALTHCARE
ENVIRONMENT
YOU CAN ADD A DESIGN OR CLIPART
BELOW. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
YOU CAN ADD A DESIGN OR CLIPART
HERE. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
How Nurses Can
Impact this Issue
• Make three bullet points
here from the
information you learned
from the articles you
used in Week 4
• Be sure to cite the
source for each
intervention
• Make it scholarly – what
does the evidence say?
References
PUT YOUR REFERENCES HERE – ALL
THREE ARTICLES IN APA FORMAT
For Part 2 of the Leadership and Followership Project, you are to prepare an APA-formatted
analysis paper of at least 2,000 words that addresses the following:
1. First, based upon your research from Unit 1 and any additional research suggested in your instructor’s feedback or needed to deepen your analysis, identify your major program of study at Southwestern College and then describe in some depth, supported by your research, the desirable: 1) Followership styles; 2) Followership traits; 3) Leadership styles; and 4) Leadership traits that are directly applicable to your major
program of study. 2. Second, develop at least four (4) conclusions from your research and analysis regarding
how your research study of Leadership and Followership has informed your understanding of the roles of leaders and followers working in fields associated with your major program of study. Describe how this understanding has shaped your goals and career aspirations that you will pursue upon your graduation from
Southwestern College. 3. Third, conclude your analysis by explaining why the Leadership and Followership styles and traits you identified are of importance to your future career success in your major
program of study, citing your research sources as appropriate. For this research, use only peer-reviewed and credible sources. News sources, general information Websites, encyclopedias, or other similar sources may not be used.
Requirements for the Analysis Paper:
Prepare a quality, substantive paper that addresses the objectives of the assignment
and the expectations set forth in the grading rubric.
A minimum of 2,000 words excluding the title page and references is required.
Use APA style: Refer to APA Resources and the Online Tutoring Center resources in
Academic Resources (see SC College Resources Links) for guidance on writing style and page and citation formatting A minimum of 10 sources of credible evidence in addition to course resources that have
been published within the past 10 years is required
all information will be in the photos https://usflearn.instructure.com/courses/1811486/files/155290208?verifier=KfKJHEiJ23SJaRtgTbsMrlZidJTVqauLDb8lO46w&wrap=1
Research Topic: “The Impact of Teletherapy on Access to Mental Health Services Among Vulnerable Populations.”
Research Question: “How does Teletherapy affect access to mental health services for vulnerable populations?”
Sampling Design: Thinking of a purposive sampling design any another recommendation is accepted.
Requirements
Review the Course Outcomes for this assignment, which are listed above.
Using the attached worksheet fill in the components necessary for the development of a data analysis plan. The first part of the plan is focused on using statistical procedures to describe the sample for your study. The second part of the plan is where you will specify the analytic procedures to answer your research question and test the study’s hypotheses.
As you work on the research plan, keep in mind the criteria for selecting a statistical procedure—the level of measurement of the variable in all cases. The nature of the research question and design for the plan related to answering the research question.
There is no data provided for this plan. It is just a plan in the same manner that you developed a plan for sampling and data collection.
You will submit the attached template with the information requested as part of this assignment.
I will send you 3 documents which are:The assignment 1 & 2 you previously did and question outline to guide your writing.
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GLOBAL NUTRITION AND FOOD SECURITY
QUESTION
Development of Intervention Strategy
In Assignment 1 you selected and described a population nutrition deficiency/disease. In
Assignment 2 you critiqued an existing intervention that addresses the condition, where you
would have identified limitations/gaps in the existing intervention. For example, this may
have been in relation to unreached population groups, a lack of sustainability, or other
constraints.
For this assignment 3, you are to develop an intervention strategy designed to address
the limitations/gap that you identified from Assignment 2. Your proposed intervention
should be written as a structured report.
Your Intervention report should have:
1. Introduction
Concise introduction to your topic and report.
2. Background (10 marks)
Your report is to first present the background and justification for your intervention strategy
•
•
•
Summary/overview of the diet-related disease/deficiency from your Assignment 1
Summary/overview of the critique of the existing intervention from your Assignment 2
Gap/limitation you identified from your AT2 critique. Identify target population, food source,
etc. as appropriate
In this section you will need to summarise key points from your Assignment 1 and
Assignment 2 to provide enough information to introduce and discuss your proposed
intervention. Do not copy and paste sections from your Assignment 1&2.
Note that the main body of this report are the proposed intervention and evaluation
framework sections. You have previously detailed the background section from your
Assignment 1&2, so this section needs to be a paraphrase of what you have previously
presented.
3. Proposed intervention (20 marks)
Having previously (in Assignment 2) critically analysed an existing intervention that has
already been implemented, you need to consider both the strengths and weaknesses of the
intervention. You are then to develop another intervention that addresses these limitations.
Your response here should include:
•
•
•
•
•
•
Aim of the intervention strategy
Significance of the proposed intervention
A description of the proposed intervention – including population and intervention type
An outline/description of the method of delivery
An acknowledgement of the strengths of the intervention analysed in Assignment 2 that
you would retain in the proposed intervention
A description of the weaknesses that are being addressed in the proposed intervention
e.g. including community involvement, engagement or cultural relevance as appropriate
4. Evaluation (10 marks)
You are then to describe an evaluation of your proposed intervention.
•
Identify the type of evaluation and select an appropriate evaluation framework tool, e.g.,
Program logic, RE-AIM, AIFS evaluation guide
•
•
Links to an external site.
Use the parameters of the tool to describe and discuss how the evaluation will determine
effectiveness of the intervention according to the aim of your intervention strategy
5. Conclusion & References
Finally, your report will provide a brief conclusion in which you should concisely summarise
the key points of your report; all references used should be relevant to the topic.
Length: 2,500 words +/- 10% (including in-text references, but excluding the end
reference list). Referencing style: APA 7, a citation should be provided
upon every mention of an idea, statistic, concept, argument, etc. that has
come from someone other than yourself.
Formatting:
•
•
•
•
•
Microsoft Word document (not PDF)
Report writing
1.5 line spacing
Normal margins
Font 12/ Times New Roman
PLEASE STRICTLY FOLLOW THE CRITERION 1-7 STATED BELOW WHEN
WRITING YOUR REPORT.
CRITERION 1- SUCCINCT
INTRODUCTION
TO
THE
REPORT
(APPROX. 100 WORDS)
–
Please excellently write a concise and informative introduction
•
–
Underpinned by the scientific literature
Please, include citations for all key statement
CRITERION 2- BACKGROUND: SUMMARY OF DIETARY RELATED
ISSUE; SUMMARY OF INTERVENTION CRITIQUE. LIMITATION TO
ADDRESS. (APPROX. 600 WORDS)
–
Please excellently write an informative and clear background.
Excellently present a considered argument
Excellently support argument by adequate and appropriate evidence.
•
Underpinned by the scientific literature
– Please, include citations for all key statement
CRITERION 3- PROPOSED INTERVENTION: INTERVENTION AIM
AND SIGNIFICANCE. DESCRIPTION OF INTERVENTION, TARGET
POPULATION, METHOD OF DELIVERY, STRENGTHS
ACKNOWLEDGED AND WEAKNESSES ADDRESSED. (APPROX. 1,200
WORDS)
•
Please excellently write a Clear and appropriate aim & significance.
Excellently describe the intervention
Excellent consideration of the target population
What is the intervention type and method of delivery?
Excellently consider the strengths and weaknesses with higher-order critical thinking
and analysis.
Underpinned by the scientific literature
–
Please, include citations for all key statement
CRITERION 4- EVALUATION FRAMEWORK (e.g. RE-AIM, Program
Logic, etc.): CHOOSE APPROPRIATE FRAMEWORK; CLEAR
DISCUSSION OF OUTCOMES AND EFFECTIVENESS.
–
Please write an excellent evaluation framework; Very clear, with higher-order
critical thinking and analysis.
Underpinned by the scientific literature
CRITERION 5- SUCCINCT CONCLUSION AT END OF REPORT.
(APPROX. 100 WORDS)
•
Please excellently provide a concise and informative conclusion.
Underpinned by the scientific literature
CRITERION 6- SCIENTIFIC WRITING, FORMATTING, GRAMMAR,
PUNCTUATION, AND SPELLING:
•
Very high quality of scientific writing, logical, clear and eloquent; and meets word limit
and formatting requirements. There are no errors with grammar, spelling, punctuation, and
meaning is easily discernible. The essay should read without interruption.
-Avoid padding (‘each and every…’ …’both positive and negative’’)
CRITERION 7- REFERENCES AND REFERENCING:
•
References used should be credible, relevant, and of high quality. Mixed use of published
books, peer-reviewed scientific journal articles, high quality databases, and/or
reports. APA 7 referencing should be accurate in all instances. All statements of fact and
ideas taken from elsewhere should be referenced. Use Wide range of references, at least
up to 45 references and above.
-A Citation per Key Statement.
SUMMARY
The Report must contain:
•
Introduction
o
Background including summarised key points from your Assignment 1&2 to
provide enough information to introduce and discuss your proposed intervention
o
Proposed intervention: including an intervention that addresses the limitations
pointed out in assignment 2.
Evaluation: Including selecting an appropriate evaluation framework tool, e.g
RE-AIM or program logic
Conclusion
References
•
•
•
• High quality presentation, in terms of format, meeting general requirements for
task; coherence of expression; and adherence to conventions of writing (spelling,
grammar, length) and referencing
Tips:
(1) Where appropriate, use sub-headings that align with the criterion.
(2) You can also include graph, image or statistical data if need be.
(3) Gauge the number of words and emphasis to use for each section.
ASSIGNMENT 1
TITLE:
A WRITTEN REPORT ON A CHOSEN
DIET-RELATED DISEASE
Introduction
Iodine deficiency is when a person’s mineral intake falls short of what their body
requires (Bashar & Begam, 2020). Iodine is essential for producing thyroid hormones, which
regulate metabolism, growth, and development. Iodine shortage can impair the thyroid’s ability
to produce hormones and result in several other illnesses (Triggiani et al., 2009). This report
will explore iodine deficiency, its aetiology, epidemiology, and determinants of the diet-related
condition, along with critical dietary sources, at-risk populations, and factors.
Aetiology of the Deficiency
The fundamental factors and systems responsible for the body’s insufficient iodine
availability are referred to as the aetiology of iodine deficiency. It is typically brought on by
consuming too few or too many iodine-deficient meals (Hatch-McChesney & Lieberman,
2022). Iodine is a crucial ingredient for synthesizing thyroid hormones; therefore, a deficiency
can affect the thyroid’s functionality and cause various health issues (Sabatino et al., 2021).
The primary dietary supply of iodine is iodized salt (Medin et al., 2020). Physical location, the
amount of iodine in the soil, the supply of food, food choices, and customs are all aspects that
might contribute to iodine scarcity.
Epidemiology of the Deficiency
The extent of iodine shortage determines how frequently goiters occur (Winder et al.,
2022). Goiter occurs 5% to 20% of the time in people with modest iodine insufficiency (Gizak
et al., 2017). According to Hatch-McChesney and Lieberman (2022), moderate insufficiency
ranges from 20% to 30%, while severe deficiency is over 30%. Iodine deficiency constitutes
one of the most prevalent nutritional deficits, affecting 35–45% of the global
demographic (Hatch-McChesney & Lieberman, 2022). These epidemiological markers aid in
pinpointing areas with the highest rates of iodine shortage and directing measures to lessen its
effects (Awuchi et al., 2020).
Iodine deficiency is still a significant problem for worldwide overall health, especially
in specific areas (Toloza et al., 2020). The regions with the fewest options for iodine-rich foods
are frequently impacted. Examples of sub-Saharan African nations with high prevalence rates
of iodine deficiency include Ethiopia, Kenya, and Nigeria (Harika et al., 2017). The main focus
in these areas is the implementation of salt iodization initiatives, which entail iodizing table
salt to guarantee that the populace consumes enough of it (Lei et al., 2023). Tracking the
frequency and severity of iodine deficiency in these locations aids in evaluating the success of
such solutions and directing additional problem-solving tactics (Zimmermann & Andersson,
2011).
The prevalence of iodine insufficiency is considerably lower in more developed nations
due to the better availability of foods high in iodine and the adoption of effective public health
initiatives (Vanderpump, 2019). Nevertheless, there might still be some areas of iodine deficit,
especially in smaller populations (Hatch-McChesney & Lieberman, 2022). Owing to the
heightened iodine need for developing the fetus’s brain, pregnant women are, for example,
regarded as a vulnerable category in the United Kingdom (Hatch-McChesney & Lieberman,
2022). Iodine deficiency in these groups is being monitored, allowing for specific approaches
such as encouraging iodine supplements during pregnancy or increasing public knowledge of
iodine-rich dietary sources (Kayes et al., 2022).
Food Sources Which Contribute To the Presentation of the Deficiency
Iodine shortage can manifest itself from several dietary sources. Iodine deficiency in
some dairy and plant-centered diets is one cause for this (Alzahrani et al., 2023). According to
Kumar and Hemantaranjan (2017), vegetables cultivated on iodine-deficient soil may have low
iodine concentrations. Furthermore, if cows are not provided iodine-rich nutrition, dairy
products like milk and cheese may not be suitable suppliers of the mineral (Witard et al., 2022).
Consuming foods that cause goiter, which obstructs the ingestion of iodine, is another source.
These meals include soy-based items along with cruciferous vegetables (Wojtas et al., 2019).
Groups Most At Risk of the Deficiency
Pregnant women are the first group to be at risk for iodine deficiency (Kanike et al.,
2020). The need for iodine rises markedly throughout pregnancy to sustain fetal brain
development (Delshad & Azizi, 2020). Iodine deficiency at this time might cause cognitive
problems in the kids, resulting in lower intelligence levels and learning difficulties (Bailote et
al., 2022). Making dietary changes or adding iodine supplements is essential (Brown et al.,
2020). Individuals living in areas with low soil and water iodine concentration make up the
second category of people at risk. Soils in some places are frequently poor in iodine, especially
those that are inland or hilly (Hastuti et al., 2021). As a result, the native livestock and crops
may have less iodine in these regions (Kumar & Hemantaranjan, 2017). Individuals who rely
primarily on locally produced foods from these areas are more likely to have iodine
deficiencies. Adopting iodine fortification initiatives, like encouraging the consumption of
iodine-rich foods or iodized salt, can help reduce this danger while boosting these people’s
iodine levels (Iacone et al., 2021).
Determinants of Deficiency
Iodine deficiency determinants are the various factors that affect the prevalence and
occurrence of iodine deficiency in a community (Torheim et al., 2005). Social, cultural,
economic, and environmental elements can be used to classify these influences reasonably
(Yevglevsky & Gostev, 2021). Regarding social and cultural influences, a lack of
understanding of the value of iodine in the food we consume might cause iodine insufficiency;
this can be ascribed to a lack of accessibility to medical care and educational programs, along
with cultural norms and behaviors that place a low priority on iodine-rich dietary sources (Bath,
2019).
Financial limitations may prevent people or groups from buying iodine-rich meals or
iodized salt, which is a problem from an economic standpoint. Economic variables like
joblessness or poor income may impact the pricing and accessibility of these iodine sources
(Gatseva & Argirova, 2011). Iodine accessibility in the environment, which has an immediate
influence on its inclusion in the food chain, is the fundamental concept (Delange, 2002).
Consuming iodine-rich meals cultivated in iodine-rich soil is the major way to get iodine (Rami
et al., 2022). Iodine deficiency in the soil causes low iodine levels in the grown plants, which
affects the area’s demographics’ iodine consumption (Kumar & Hemantaranjan, 2017).
Conclusion and Intervention Statement
In conclusion, iodine insufficiency is mainly caused by inadequate ingestion of foods
high in iodine. Iodine deficiency must be addressed using an extensive plan incorporating
social groups and people. Table salt is now fortified with iodine in the United Kingdom to
prevent iodine deficiency (World Health Organization, 2014). It guarantees that those who
routinely use salt get this vital mineral properly by reinforcing salt with iodine (Shields &
Ansari, 2021). Because it provides a practical and affordable method to boost iodine
consumption, this intervention successfully avoids and treats iodine insufficiency in people.
References
Alzahrani, A., Ebel, R., Norton, G., Raab, A., & Feldmann, J. (2023). Iodine in plant-based
dairy products is not sufficient in the UK: A market survey. Journal of Trace Elements
in Medicine and Biology, 79, 127218. https://doi.org/10.1016/j.jtemb.2023.127218
Awuchi, C. G., Igwe, V. S., & Amagwula, I. O. (2020). Nutritional diseases and nutrient
toxicities: A systematic review of the diets and nutrition for prevention and treatment.
International Journal of Advanced Academic Research, 6(1), 1-46.
Bailote, H. B., Linhares, D., Carvalho, C., Prazeres, S., Rodrigues, A. S., & Garcia, P. (2022).
Iodine Intake and Related Cognitive Function Impairments in Elementary
Schoolchildren. Biology, 11(10), 1507. https://doi.org/10.3390/biology11101507
Bashar, M. A., & Begam, N. (2020). Role of dietary factors in thyroid disorders: Current
evidences and way forwards. Thyroid Research and Practice, 17(3), 104-109.
https://doi.org/ 10.4103/trp.trp_7_20
Bath, S. C. (2019). The effect of iodine deficiency during pregnancy on child development.
Proceedings
of
the
Nutrition
Society,
78(2),
150-160.
https://doi.org/10.1017/S0029665118002835
Brown, K., von Hurst, P., Rapson, J., & Conlon, C. (2020). Dietary choices of New Zealand
women
during
pregnancy
and
lactation.
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12(9),
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https://doi.org/10.3390/nu12092692
Delange, F. (2002). Iodine deficiency in Europe and its consequences: an update. European
Journal
of
Nuclear
Medicine
and
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Molecular
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Delshad, H., & Azizi, F. (2020). Iodine nutrition in pregnant and breastfeeding women:
sufficiency,
deficiency,
and
supplementation.
Hormones,
19(2),
179-186.
https://doi.org/10.1007/s42000-019-00160-2
Gatseva, P. D., & Argirova, M. (2011). Public health: the science of promoting health. Journal
of Public Health, 19, 205-206. https://doi.org/10.1007/s10389-011-0412-8
Gizak, M., Gorstein, J., & Andersson, M. (2017). Epidemiology of iodine deficiency. Iodine
deficiency disorders and their elimination, 29-43. https://doi.org/10.1007/978-3-31949505-7_3
Harika, R., Faber, M., Samuel, F., Mulugeta, A., Kimiywe, J., & Eilander, A. (2017). Are low
intakes and deficiencies in iron, vitamin A, zinc, and iodine of public health concern in
Ethiopian, Kenyan, Nigerian, and South African children and adolescents?. Food and
nutrition bulletin, 38(3), 405-427. https://doi.org/10.1177/0379572117715818
Hastuti, P., Sadewa, A. H., Farmawati, A., Rubi, D. S., & Pramana, A. A. C. (2021).
Hypothyroidism and stunting around the Merapi Volcano. Journal of Community
Empowerment for Health, 4(2), 103-107. https://doi.org/10.22146/jcoemph.61025
Hatch-McChesney, A., & Lieberman, H. R. (2022). Iodine and Iodine Deficiency: A
Comprehensive Review of a Re-Emerging Issue. Nutrients, 14(17), 3474.
https://doi.org/10.3390/nu14173474
Iacone, R., Iaccarino Idelson, P., Russo, O., Donfrancesco, C., Krogh, V., Sieri, S., … &
Minisal-Gircsi Study Group. (2021). Iodine Intake from food and iodized salt as related
to dietary salt consumption in the italian adult general population. Nutrients, 13(10),
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Kanike, N., Groh-Wargo, S., Thomas, M., Chien, E. K., Mhanna, M., Kumar, D., & Shekhawat,
P. S. (2020). Risk of iodine deficiency in extremely low gestational age newborns on
parenteral nutrition. Nutrients, 12(6), 1636. https://doi.org/10.3390/nu12061636
Kayes, L., Mullan, K. R., & Woodside, J. V. (2022). A review of current knowledge about the
importance of iodine among women of child-bearing age and healthcare professionals.
Journal of Nutritional Science, 11, e56. https://doi.org/10.1017/jns.2022.50
Kumar, P., & Hemantaranjan, A. (2017). Iodine: a unique element with special reference to
soil-plant-air system. Advances in Plant Physiology, 17, 314.
Lei, C., Tao, X., & Xiao, Y. (2023, May). Dietary Iodine Intake and Related Factors among
Secondary School Students in Macao. In Healthcare (Vol. 11, No. 10, p. 1472). MDPI.
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Medin, A. C., Carlsen, M. H., & Andersen, L. F. (2020). Iodine intake among children and
adolescents in Norway: Estimates from the national dietary survey Ungkost 3 (20152016). Journal of Trace Elements in Medicine and Biology, 58, 126427.
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Rami, A., Saeid, N., El Mzibri, M., El Kari, K., Idrissi, M., Lahmam, H., … & Aguenaou, H.
(2022). Prevalence of iodine deficiency among Moroccan women of reproductive age.
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Sabatino, L., Vassalle, C., Del Seppia, C., & Iervasi, G. (2021). Deiodinases and the three types
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Shields, A., & Ansari, M. A. (2021). Review of experience of the production of salt fortified
with iron and iodine. The Journal of Nutrition, 151(Supplement_1), 29S-37S.
Toloza, F. J., Motahari, H., & Maraka, S. (2020). Consequences of severe iodine deficiency in
pregnancy:
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Torheim, L. E., Granli, G. I., Sidibé, C. S., Traoré, A. K., & Oshaug, A. (2005). Women’s
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ASSIGNMENT 2
TITLE:
CRITICAL ANALYSIS OF A CHOSEN
INTERVENTION.
Introduction
Public health issues like iodine deficiency affect worldwide nutrition and health. Iodine
shortage occurs when a person’s mineral intake falls below the body’s needs. Iodine is needed
to make thyroid hormones, which control growth, metabolism and development (Sorrenti et
al., 2021). Thus, iodine deficiency may significantly damage the thyroid glands hormone
production, causing several health problems. As mentioned in assessment 1, iodine
insufficiency is caused by dietary choices, geography, soil iodine levels, and cultural traditions.
It is caused by eating iodine-deficient foods or not enough iodized salt, a vital nutritional supply
(Shanahan et al., 2019). The epidemiological aspect of iodine deficiency examines its
prevalence, causes, and impact on communities. Assessment 1 underscored the global
prevalence of iodine deficiency, affecting a substantial percentage of the world’s population,
particularly in regions with limited access to iodine-rich foods. This epidemiological context
helps identify areas with the highest rates of deficiency, guiding targeted interventions.
Furthermore, determinants of iodine deficiency encompass social, cultural, economic,
and environmental factors that influence its occurrence (Abebaw and Oumer, 2020). As
explored in assessment 1, these determinants can range from a lack of awareness about iodine’s
importance to economic constraints that hinder access to iodine-rich sources. This assessment
2 delves deeper into the critical analysis of an intervention aimed at mitigating iodine
deficiency, building upon the foundational knowledge presented in assessment 1.
Description of the Chosen Intervention
The chosen intervention to address iodine deficiency is iodized salt fortification. This technique
adds iodine to table salt, making it a vital mineral supply.
Aims and Objectives: Iodized salt fortification aims to maintain a constant and adequate
iodine consumption. Increasing diet iodine levels prevents iodine deficient illnesses including
goiter and intellectual deficits (Pearce and Zimmermann, 2023). The intervention aims:
1. Improve thyroid function: Iodized salt supports thyroid hormone production, which is
essential for metabolism and wellness.
2. Goiter, a visible sign of severe iodine deficiency that may cause physical pain and
health issues, can be reduced by iodized salt fortification.
Target Population: The whole community is targeted for iodized salt fortification since iodine
deficiency affects all ages and ethnicities (Vatandoust & Diosady, 2022). However, pregnant
women and children are at greater risk of iodine shortage owing to increased iodine needs
during pregnancy and development.
Type/Design of the Intervention and Method of Delivery: Iodized salt fortification is a
passive intervention that integrates easily into existing dietary habits (Farebrother et al., 2019).
It involves the following key components:
1. Iodization Process: Salt producers or manufacturers add a predetermined amount of
iodine to table salt during the production process. Iodine is commonly supplied as
potassium iodide or iodate.
2. Packaging: Iodized salt is packaged and sold via retail channels, making it accessible
to customers.
3. Public Awareness Campaigns: Public health authorities also promote iodized salt and
its use in cooking.
4. Monitoring and Regulation: Government agencies and health organizations monitor
the quality and iodine content of salt in the market to ensure compliance with
recommended standards.
Effectiveness of the Chosen Intervention
Iodized salt fortification has proven to be an effective and globally recognized intervention in
addressing iodine deficiency (Desta et al., 2019). Iodized salt fortification is a cost-effective,
durable, and scalable population-level strategy that prevents and controls iodine deficiencyrelated health concerns.
1. Significant Iodine Deficiency Reduction: Iodized salt fortification has reduced iodine
deficiency in several research and public health reports. The strategy enhanced thyroid
function by increasing iodine consumption.
2. Improved Thyroid Health: Iodized salt fortification has led to a significant decrease
in the prevalence of goiter, a visible indicator of severe iodine deficiency (AguilarPérez et al., 2023). By ensuring an adequate iodine supply, the intervention has
contributed to healthier thyroid function and, by extension, overall well-being.
3. Ease of Implementation: Iodized salt fortification is relatively straightforward to
implement, as it utilizes existing salt production and distribution channels (Larson et
al., 2021). This simplicity facilitates widespread adoption and ensures that the
intervention reaches a broad segment of the population.
4. Cost-Effective: The cost of adding iodine to salt is minimal, making it an economically
viable intervention (Shields, and Ansari, 2021). It does not substantially increase the
price of salt for consumers, ensuring affordability.
Community Involvement, Engagement, and Cultural Relevance
Community Involvement and Engagement: Community participation is crucial to iodized
salt fortification projects. Community engagement varies by geography and public health
program efficacy (Patel et al., 2022). The intervention works better in communities with
significant involvement. Local health professionals and leaders may promote iodized salt,
provide educational seminars, and advocate for its usage (Vatandous et al., 2023). Community
monitoring and reporting of iodized salt non-compliance may assist assure its supply.
Cultural Relevance: The cultural relevance of iodized salt fortification is a critical
consideration, as cultural norms and practices related to salt consumption can vary significantly
across regions (Arab, 2022). In some cultures, salt holds symbolic or traditional importance in
rituals or culinary practices (Ilie, 2023). Therefore, introducing iodized salt must be done with
sensitivity to these cultural nuances. Public awareness campaigns should address these cultural
aspects, emphasizing that iodized salt does not alter the taste or culinary traditions.
Additionally, some cultures may have specific dietary preferences or taboos related to
salt sources (Krasteva and Bogueva, 2021). Understanding these cultural intricacies and
incorporating them into educational materials and communication strategies can enhance the
intervention’s cultural relevance. This approach fosters acceptance and encourages the adoption
of iodized salt while respecting local customs.
Strength of the Evaluation Framework
The evaluation framework employed to measure the impact of iodized salt fortification
interventions has several strengths, but it also presents areas for potential enhancement.
Strengths:
1. Comprehensive Monitoring: The evaluation framework typically includes regular
monitoring of salt iodine content at the production and distribution levels (Ittermann et
al., 2023). This ensures that iodized salt meets the recommended standards,
contributing to the intervention’s effectiveness.
2. Health Outcome Assessment: Many evaluations assess health outcomes such as goiter
prevalence and thyroid function in the target population (Olson et al., 2021). This
allows for a direct measurement of the intervention’s impact on public health.
3. Surveillance Systems: In some regions, surveillance systems have been established to
track iodine status in populations. These systems provide valuable data for evaluating
the intervention’s effectiveness over time (Vargas et al., 2019).
Reliability and Validity:
1. Reliability: The evaluation methods used, such as salt iodine content analysis and
health assessments, are generally reliable when conducted with appropriate quality
control measures (Zimmermann, 2023). However, challenges related to inconsistent
sampling or laboratory procedures may sometimes affect reliability.
2. Validity: The validity of the evaluation framework largely depends on the accuracy of
the measurement tools and indicators. Health outcomes like reduced goiter prevalence
are valid indicators of iodine sufficiency (Gorstein et al., 2022). However, ensuring the
validity of iodine intake assessments in individuals can be more challenging.
Suggestions for Improvement:
1. Long-Term Impact Assessment: Enhancements can be made by conducting longterm impact assessments to measure the sustainability of iodine sufficiency beyond
short-term gains.
2. Community Feedback: Collecting feedback from communities about their
experiences with iodized salt and any challenges they face can inform improvements in
distribution and communication strategies.
3. Regular Quality Control: Ensuring consistent quality control measures in salt
production and iodine content analysis is essential to maintain the reliability of the
evaluation methods.
Intervention Sustainability and Limitations
Sustainability of the Iodized Salt Fortification Intervention: Iodized salt fortification
demonstrates a reasonable degree of sustainability due to several factors:
1. Cost-Effective: The intervention is cost-effective, requiring minimal financial
resources for iodine addition during salt production (Brewer et al., 2020). This
affordability facilitates long-term sustainability, as it does not pose a significant
financial burden on governments or consumers.
2. Integration into Existing Systems: Iodized salt can be easily integrated into existing
salt production and distribution systems. This integration ensures that the intervention
becomes a routine part of the salt supply chain, reducing the risk of discontinuation.
3. Public Acceptance: Over time, public acceptance of iodized salt has grown, leading to
increased demand. As consumers become accustomed to iodized salt, the market
demand for such products remains stable (Pandav, 2019).
4. Health Impact: The demonstrable health benefits of the intervention, such as reduced
goiter prevalence and improved thyroid function, motivate ongoing support from health
authorities and the public (Outzen et al., 2022).
Limitations and Drawbacks: Despite its strengths, the iodized salt fortification intervention
faces certain limitations and challenges:
1. Monitoring and Compliance: Ensuring consistent iodine
Cultural Diversity Worksheet
As a healthcare provider, it is important to care for a patient and maintain their culture as much as possible. Using this worksheet, fill out the boxes for specific
cultures (listed below). Different cultures have different values, beliefs and practices. A woman’s cultural background can affect her needs and expectations
during pregnancy and childbirth, as well as how she and her family raise children.
**This worksheet was created in Microsoft Word. Please download to your computer, adjust the size of the boxes, print out, write legibly
For example:
•
•
•
•
•
During pregnancy, women from some cultures do not eat certain foods.
During labor, women from some cultures avoid moving too much; some stay lying down, some prefer to sit or squat.
In some cultures, the father does not attend the birth, but the mother or mother-in-law of the woman does.
After childbirth, some women follow strict rules, such as staying in bed for several days.
****Do your own work!!
Prenatal Care/Habits
or rituals once they
are pregnant
United States
Mexico
Antepartum (during
labor) i.e. hospital vs
home; birthing
process, etc.
Pain management
during labor;
Emotions/How do
they act during labor
(loud, quiet)
Birth rituals when
child is born;
preferred method of
feeding
(breast/bottle)
What is typically
done with the
placenta?
Cultural rituals for
the mother after
delivery
Cultural rituals for
the newborn after
delivery
Saudi Arabia
China
Turkey
Sweden
Community Connectivity: 84 million are displaced people worldwide. See resources websites.
https://www.migrationdataportal.org/themes/migrati…
(https://www.unhcr.org/asylum-and-migration.html)
Instructions:
Using a map, please describe local, regional, and international movement patterns of the population you choose.
Discuss briefly who, why, to/from, when, how, what, and how many people are moving in, around, and beyond the area of interest by answering the questions below.
Choose and research only one of the following populations to report on: (Ukraine, Bangladesh, Somalia, Myanmar).
Who: Characteristics of Mobile Population: Who is this population? Please discuss their characteristics (for example, age, profession, cultural identity, residential area including areas in bordering countries, etc.).
Why: Reasons for Population Movement: Why do people move and the history behind it? (For example, asylum, seeking healthcare, selling or buying goods, religious reasons, professional opportunities, education, family connections, other)?
How: Mode of Transportation: What type of transportation do people take to reach the area of interest and why? (for example, train, car, bus, boat, ride share, bicycle, by foot)?
When: Duration of Movement: How long do people stay when they move to another locale or country and why? (For example, a few hours, a day, a few days, months)?
Where: Border Crossing: Where do people routinely cross the border (official and unofficial POE)? Why do they choose that specific crossing point?
Infectious Disease Questions: How have patterns of mobility changed with infectious diseases or the COVID-19 pandemic? Has the average wait time at the nearest POE changed during COVID-19? If so, how? Where in this area of interest are people required to undergo screening (for example, temperature screening, COVID-19 testing, proof of vaccination, etc.)?
What interventions: What interventions would you employ to assist the population you chose? How would you apply this to a nurse’s role? (For example, advocacy, community organizing, outreach, screening, etc.)?
Your poster should include:Explanation of the nursing issue significance with three statementsDescription of your position on the issue and three statements on how a nurse can impact this issueInclude only the two approved journal sources used in your Week 6 appraisals to support your position.Attached below is an example of a poster and the documents that should be used to complete the poster project.
Unformatted Attachment Preview
NURS 350
Title
DESCRIPTION OF THE
ISSUE
NAME
In this section, you will discuss the issue.
This is a good place to get information
from your initial Week 2 paper where you
described the background and the
importance to nursing (APA citation).
Make 1-2 sentences about the background
and then the significance in bullet points
SIGNIFICANCE TO NURSING
•
•
•
Most newly graduated nurses will
join the workforce through a Nurse
Residency Program (APA citation)
Nurse Residency Programs focus
on evidence-based practice (APA
Citation)
Newly graduated nurses will need to
present evidence-based practice in
poster format (APA citation)
POSITION STATEMENT
DON’T USE “I” STATEMENTS, JUST
GIVE A SCHOLARLY EXPLANATION:
NEWLY GRADUATED NURSES
NEED TO BE ABLE TO USE AND
PRESENT EVIDENCE-BASED
PRACTICE TO CARE FOR PATIENTS
IN THE CURRENT HEALTHCARE
ENVIRONMENT
YOU CAN ADD A DESIGN OR CLIPART
BELOW. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
YOU CAN ADD A DESIGN OR CLIPART
HERE. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
How Nurses Can
Impact this Issue
• Make three bullet points
here from the
information you learned
from the articles you
used in Week 4
• Be sure to cite the
source for each
intervention
• Make it scholarly – what
does the evidence say?
References
PUT YOUR REFERENCES HERE – ALL
THREE ARTICLES IN APA FORMAT
APPENDIX C
Appraisal Guide
Conclusions of a Systematic Review with Narrative Synthesis
Citation:
____________________________________________________________________________
Patel, P., Patel, P., Bhatt, M., Braun, C., Begum, H., Nieuwlaat, R., … & Mustafa, R. A. (2020).
Systematic review and meta-analysis of outcomes in patients with suspected deep vein
thrombosis. Blood Advances, 4(12), 2779-2788.
https://doi.org/10.1182/bloodadvances.2020001558
____________________________________________________________________________
____________________________________________________________________________
Synopsis
What organization or persons produced the systematic review (SR)?
The systematic review “Systematic review and meta-analysis of outcomes in patients with
suspected deep vein thrombosis” was produced by Patel et al. (2020).
How many persons were involved in conducting the review?
Seven people were involved.
What topic or question did the SR address?
The results of patients with suspected deep vein thrombosis were the subject of the systematic
review. Its specific goal was to examine and compile the information on this condition’s impacts
that was currently accessible.
How were potential research reports identified?
The paper “Systematic review and meta-analysis of outcomes in patients with suspected deep
vein thrombosis” describes systematic searches on electronic databases like PubMed, EMBASE,
and Cochrane Library as well as manual searches for relevant journals’ content pages or
conference abstracts that could be research reports. To find any other studies, professional
consultations were used to identify them.
What determined if a study was included in the analysis?
The inclusion of studies was based on certain factors. The primary one was predefined eligibility
criteria that were generally related to study design, patient population, and relevant outcomes.
How many studies were included in the review?
The total number of studies that were included in the review process was 39.
What research designs were used in the studies?
Brown
APP C-1
Patel et al. (2020) article “Systematic Review and Meta-analysis of Outcomes in Patients with
Suspected deep vein thrombosis” used observational research designs, including cohort studies
and case-control studies, to explore the outcomes associated with patients having suspected deep
venous thrombosis.
What were the consistent and essential across-studies conclusions?
The dependable and significant across-study conclusions in the systematic review revealed a
significant limitation based on the small population size (Patel et al., 2020).
Credibility
Was the topic clearly defined?
Yes
No
Not clear
Was the search for studies and other
Is evidence comprehensive and unbiased?
Yes
No
Not clear
Was the screening of citations for
Inclusion based on explicit criteria?
Yes
No
Not clear
*Were the included studies assessed
For quality?
Yes
No
Not clear
Were the design characteristics and
findings of the included studies displayed
Or discussed in sufficient detail?
Yes
No
Not clear
*Was there a true integration (i.e., synthesis) of the findings—not
merely reporting of findings from
Each study individually?
Yes
No
Not clear
*Did the reviewers explore why differences
In findings might have occurred?
Yes
No
Not clear
Did the reviewers distinguish between
conclusions based on consistent findings
from several good studies, and those
Based on inferior evidence (number or quality)?
Yes
No
Not clear
Which conclusions were supported by
consistent findings from two or more
good or high-quality studies?
List
____________________________________________________________________________
•
•
•
APP C-2
The research discovered congruent findings from numerous good or high-quality studies.
These findings included that patients with low pretest probability
It also included a negative D-dimer at three months and had a similar risk of VTE (1%)
as individuals with a negative US ultrasound (Patel et al., 2020).
Brown
.____________________________________________________________________________
____________________________________________________________________________
ARE THE CONCLUSIONS
CREDIBLE?
Yes All
Yes Some
No
Clinical Significance
*Across studies, is the size of the
treatment or the strength of the
The association found or the
meaningfulness of qualitative findings
strong enough to make a difference
in patient outcomes or experiences of care?
Yes
No
Not clear
Are the conclusions relevant to the
Care the nurse gives?
Yes
No
Not clear
ARE THE CONCLUSIONS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
No
Applicability
Does the SR address a problem,
What situation or decision we are addressing in our setting?
Yes
No
Not clear
Are the patients in the studies or a
subgroup of patients in the studies
Similar to those we see?
Yes
No
Not clear
What changes, additions, training, or
Purchases would be needed to implement
And sustain a clinical protocol-based
on these conclusions?
Specify and list
____________________________________________________________________________
According to the article, healthcare systems must invest in certain aspects. They include:
•
Standardized training programs and strong medication reconciliation processes.
•
Adopting cutting-edge technology solutions for medication management and creating a
safety culture that encourages reporting and learning to implement and maintain a clinical
protocol based on their findings (Patel et al., 2020).
This ensures the region improves patient safety and reduces effects of the
condition______________________________________________________________________
______
Is what we will have to do to implement
Brown
APP C-3
the new protocol realistically achievable
by us (resources, capability, commitment)?
How will we know if our patients are
benefiting from our new protocol?
Yes
No
Not clear
Specify
____________________________________________________________________________
The outcomes could be evaluated by recording patient health changes, fewer side effects, quicker
recovery periods, and lower complication rates (Patel et al., 2020). Furthermore, regular
assessments, data analysis, and patient and healthcare professional feedback can yield insightful
information.
____________________________________________________________________________
ARE THESE CONCLUSIONS
APPLICABLE TO OUR SETTING?
Yes All
Yes Some
No
SHOULD WE PROCEED TO DESIGN
A PROTOCOL INCORPORATING
THESE CONCLUSIONS?
Yes All
Yes Some
No
* = Important criteria
Comments
Without a doubt, the paper is pertinent to the discussion of venous thromboembolism. This is
because it entails a systematic evaluation and meta-analysis of the results in individuals with
suspected deep vein thrombosis (DVT). Such research is essential because it can assist in
synthesizing earlier investigations into vein thrombosis, look for the most effective approaches
for diagnosis and treatment, and provide an overview of the general prognosis for persons who
frequently express suspicions about DVT. Findings from these studies may help guide clinical
judgments that healthcare providers should use when handling instances involving the
management of
VTE._________________________________________________________________________
___
APP C-4
Brown
References
Patel, P., Patel, P., Bhatt, M., Braun, C., Begum, H., Nieuwlaat, R., … & Mustafa, R. A. (2020).
Systematic review and meta-analysis of outcomes in patients with suspected deep vein
thrombosis. Blood Advances, 4(12), 2779-2788.
https://doi.org/10.1182/bloodadvances.2020001558
Brown
APP C-5
APPENDIX E
Appraisal Guide
Findings of a Qualitative Study
Citation:
___________________________________________________________________________
Hernandez‐Nino, J., Thomas, M., Alexander, A. B., Ott, M. A., & Kline, J. A. (2021). The use of
qualitative methods in venous thromboembolism research. Research and Practice in Thrombosis
and Haemostasis, 5(6), e12593.
https://doi.org/10.1002/rth2.12593__________________________________________________
_________________________
___________________________________________________________________________
Synopsis
What experience, situation, or subculture does the researcher seek to understand?
The researchers intend to delineate the lived experiences and unique realities of persons who
have been diagnosed with venous thromboembolism (VTE), a condition that encompasses blood
clots in the veins, hence providing insights into patients’ illness trajectory, treatment adherence,
and quality of life within this health subculture (Hernandez‐Nino et al., 2021). Their qualitative
research design.
Does the researcher want to produce a description of an experience, a social process, or an
event, or is the goal to generate a theory?
Instead of developing a theory in this paper, the researchers want to explain an experience, a
social process, or an event (Hernandez-Nino et al., 2021).
How was data collected?
Generally, a qualitative research method involves in-depth interviews and focus group
discussions of participants to provide rich insights into the experiences and views of the people
relating to venous thromboembolism (Hernandez‐Nino et al., 2021). The description did not
indicate whether data collection was obtained through semi-structured interviews or focus group
discussions for the case at hand or other techniques such as thematic analysis and content
analysis. However, these are common techniques employed during qualitative research studies
while collecting and analyzing their study participants’ qualitative data.
How did the researcher control their biases and preconceptions?
The researcher controlled biases and preconceptions by employing rigorous qualitative research
methods, such as thematic analysis or constant comparative analysis, which involve systematic
data collection and interpretation to ensure that personal biases do not unduly influence the
research findings (Hernandez‐Nino et al., 2021). Additionally, the researcher may have utilized
reflexivity, acknowledging their perspectives and potential biases and engaging in ongoing
Brown
APP E-1
critical self-examination throughout the research process to minimize the impact of
preconceptions on the study.
Are specific pieces of data (e.g., direct quotes) and more generalized statements (themes,
The article by Hernandez-Nino et al. (2021) titled “The Use of Qualitative Methods in Venous
Thromboembolism Research” undoubtedly offers a variety of elements, including themes and
theories that are generalized statements in addition to direct quotes, as one of the data it offers for
the conclusions from its qualitative research.
What are the main findings of the study?
The key conclusion of the study was the fact that video interviews were at least as successful as
in-person interviews. Interviews revealed that each participant had a different post-VTE
experience, with varying effects on quality of life. The impressions of medical communication,
the fear of a recurrence, and worries about death were the most prevalent themes.
Credibility
Is the study published in a source?
That required peer review?
Yes
No
Not clear
Were the methods used appropriate
to the study purpose?
Yes
No
Not clear
Was the sampling of observations or
interviews appropriate and varied
enough to serve the purpose of the study?
Yes
No
Not clear
*Were data collection methods
effective in obtaining in-depth data?
Yes
No
Not clear
Did the data collection methods
avoid the possibility of oversight,
underrepresentation, or
overrepresentation from certain
types of sources?
Yes
No
Not clear
Were data collection and analysis
intermingled dynamically?
Yes
No
Not clear
*Is the data presented in ways that
provide a vivid portrayal of what was
experienced or happened, and its
context?
Yes
No
Not clear
*Does the data provided justify
generalized statements, themes,
or theory?
Yes
No
Not clear
ARE THE FINDINGS CREDIBLE?
Yes All
APP E-2
Brown
Yes Some
No
Clinical Significance
*Are the findings rich and informative?
Yes
No
Not clear
*Is the perspective provided
potentially useful in providing
insight, support, or guidance
for assessing patient status
or progress?
Yes
Some
No
ARE THE FINDINGS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
Not clear
No
* = Important criteria
Comments
___________________________________________________________________________
This article explores the qualitative research methods for exploring venous thromboembolism. It
looks at how some knowledge about patients’ experiences and views on venous
thromboembolism could be a rich source of information that could help towards patient-centered
care and improve treatment outcomes for this condition (Hernandez‐Nino et al., 2021). The
article stresses promoting the use of qualitative research within the wider discipline of venous
thromboembolism research with quantitative approaches, which would support one another to
result in more rounded strategies for patients’
care.__________________________________________________________________________
_
Brown
APP E-3
References
Hernandez‐Nino, J., Thomas, M., Alexander, A. B., Ott, M. A., & Kline, J. A. (2021). The use of
qualitative methods in venous thromboembolism research. Research and Practice in
Thrombosis and Haemostasis, 5(6), e12593. https://doi.org/10.1002/rth2.12593
APP E-4
Brown
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Volume 4, Issue 12
SYSTEMATIC REVIEW | JUNE 22, 2020
Systematic review and meta-analysis of outcomes in patients with suspected
deep vein thrombosis
Payal Patel, Parth Patel, Meha Bhatt, Cody Braun, Housne Begum, Robby Nieuwlaat, Rasha Khatib, Carolina C. Martins,
Yuan Zhang, Itziar Etxeandia-Ikobaltzeta, Jamie Varghese, Hani Alturkmani, Waled Bahaj, Mariam Baig, Rohan Kehar,
Ahmad Mustafa, Rakesh Ponnapureddy, Anchal Sethi, Merrill Thomas, David Wooldridge, Wendy Lim, Shannon M. Bates,
Eddy Lang, Grégoire Le Gal, Marc Righini, Wojtek Wiercioch, Holger J. Schünemann, Reem A. Mustafa
June 23 2020
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Blood Adv (2020) 4 (12): 2779–2788.
https://doi.org/10.1182/bloodadvances.2020001558
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Abstract
After deep vein thrombosis (DVT) is diagnosed, prompt evaluation and therapeutic intervention are of
paramount importance for improvement in patient-important outcomes. We systematically reviewed patientimportant outcomes in patients with suspected DVT, including mortality, incidence of pulmonary embolism (PE)
and DVT, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane
Central Register of Controlled Trials, Ovid Medline, Embase for eligible studies, references lists of relevant
reviews, registered trials, and relevant conference proceedings. Two investigators screened and abstracted data.
Nine studies with 5126 patients were included for lower extremity DVT. Three studies with 500 patients were
included for upper extremity DVT. Among patients with lower extremity DVT, 0.85% (95% confidence interval
[CI], 0% to 2.10%) and 0% developed recurrent DVT and PE, respectively, at 3 months. Among patients with
upper extremity DVT, 0.49% (95% CI, 0% to 1.16%) and 1.98% (95% CI, 0.62% to 3.33%) developed recurrent DVT
and PE, respectively, at 3 months. No major bleeding events were reported for those anticoagulated, which is
lower than in other systematic reviews. For both upper and lower extremity DVT, low pretest probability patients
with a negative D-dimer had a comparable incidence of VTE at 3 months (∼1%) as patients with a negative
ultrasound (US). At higher pretest probabilities, negative US testing with or without serial US appears to be the
safer option. In this review, we summarized the outcomes of patients evaluated by various diagnostic pathways.
In most instances, there was significant limitation due to small population size or lack of direct evidence of
effects of using a specific pathway. This systematic review was registered at PROSPERO as CRD42018100502.
Potential Articles of Interest
Systematic review and meta-analysis of outcomes
in patients with suspected pulmonary embolism
Parth Patel et al., Blood Advances, 2021
Diagnosis of deep vein thrombosis of the lower
extremity: a systematic review and meta-analysis
of test accuracy
Subjects: Health Services and Outcomes, Systematic Review, Thrombosis and Hemostasis
Meha Bhatt et al., Blood Advances, 2020
Topics: deep vein thrombosis, deep venous thrombosis of upper extremity, venous thromboembolism, leg,
hemorrhage, fibrin fragment d substance, intracranial hemorrhages
Introduction
American Society of Hematology 2020 guidelines
for management of venous thromboembolism:
treatment of deep vein thrombosis and pulmonary
embolism
Thomas L. Ortel et al., Blood Advances, 2020
The annual incidence of deep vein thrombosis (DVT) in the general population is 48 per 100 000 and can be
associated with significant morbidity and mortality.1 Prompt evaluation and expeditious therapeutic intervention
Disease profile and plasma neutralizing activity of
post-vaccination Omicron BA.1 infection in Tianjin,
China: a retrospective study
when DVT is confirmed is of paramount importance for optimal patient management. Various strategies are
Hong Zheng et al., Cell Research, 2022
currently used for the evaluation of suspected DVT. The first step involves determining the pretest probability
Long-Term Use of Insomnia Medications: An
Appraisal of the Current Clinical and Scientific
Evidence
(PTP) of DVT, either formally using a clinical decision rule or informally through clinical judgment, prior to
diagnostic testing. Following this, options for diagnostic tests include compression ultrasound (US) with or
without Doppler US of the proximal leg veins (duplex US), whole-leg US, serial US, and D-dimer assays. These
Phyllis C. Zee et al., Journal of Clinical Medicine,
2023
The MDM2–p53 Antagonist Brigimadlin (BI
907828) in Patients with Advanced or Metastatic
Solid Tumors: Results of a Phase Ia, First-inHuman, Dose-Escalation Study
tests can be used alone or in sequence, depending on the pre-test probability.
While the diagnostic pathway is an important consideration in determining the optimal strategy for the
evaluation of suspected DVT, this review focuses on patient-important outcomes. These outcomes assess the
Patricia LoRusso et al., Cancer Discovery, 2023
consequences of missed or incorrect diagnoses when anticoagulant treatments are mistakenly withheld or
administered unnecessarily. Anticoagulant treatment of DVT is associated with risks of bleeding, with major
Powered by
bleeding (bleeding requiring red cell transfusion or intervention to stop bleeding or bleeding into a critical area,
such as intracranial hemorrhage) being the most clinically relevant. Missed diagnoses can be associated with an
increased risk of recurrent DVT, development of pulmonary embolism (PE), and postthrombotic syndrome. We
conducted a systematic review and meta-analysis to evaluate the outcomes of patients with suspected DVT
View Metrics
evaluated by various diagnostic pathways to determine the frequency of such outcomes. This systematic review
was performed in conjunction with upper and lower extremity DVT test accuracy reviews that evaluated optimal
diagnostic pathways based on PTP to inform an overall guideline on management of venous thromboembolism,
Cited By
detailed further in “Methods.”2-4
Web Of Science (8)
Methods
Google Scholar
Determining outcomes of interest
This systematic review was undertaken for the purposes of informing the American Society of Hematology
Guidelines on Management of Venous Thromboembolism, specifically diagnosis of venous thromboembolism
(VTE). The review process began with a multidisciplinary panel coordinated by the American Society of
Hematology Venous Thromboembolism Guideline Coordination Committee consisting of physicians with clinical
and research expertise on the guideline topic, methodologists with expertise in evidence appraisal and guideline
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development, and patient representatives. These panel members developed clinical questions of interest
regarding the diagnosis of VTE. The process is briefly described below; however, for detailed information, refer
to the original guideline publication.2
After the primary questions were developed, the panel chairs developed diagnostic pathways that were refined
through an iterative process with input from the panel (supplemental Material 1). The diagnostic strategies for
DVT are based on the PTPs for individual patients, which provide an estimate of the expected prevalence of DVT
at a population level. PTP can be determined using validated clinical decision rules, such as the Wells criteria.5
The original Wells criteria divided outpatients into 3 categories (low, intermediate, and high), and the
dichotomized Wells criteria divided patients into 2 categories (unlikely and likely). In patients with suspected
lower extremity DVT, the guideline assumed the prevalence in patients with low, intermediate, and high PTP to
be 10%, 25% to 35%, and >50%, respectively. In patients with suspected upper extremity DVT using the
Constans score,6 the guideline assumed the prevalence in patients with unlikely and likely PTP to be 10% and
40%, respectively. Therefore, when possible, outcomes were also further classified by PTP.
The panel then selected outcomes of interest for each question a priori, following the approach described in
detail elsewhere.7 The panel brainstormed all possible outcomes and then rated their relative importance for
decision making following the Grading of Recommendation, Assessment, Development and Evaluation (GRADE)
approach.8 During this rating process, the panel used definitions of the outcomes (“marker states”) that were
developed for these guidelines by the McMaster Grading of Recommendations, Assessment, Development and
Evaluation (GRADE) Center. Rating outcomes by their relative importance can focus attention on those
outcomes that are considered most important and help to resolve or clarify potential disagreements. The panel
rated the following outcomes as critical for decision making across the DVT diagnosis questions: all-cause
mortality, mortality from VTE, development of PE, development of DVT, development of recurrent DVT,
development of postthrombotic sequelae, major bleeding, and intracranial hemorrhage; in addition to the
diagnostic accuracy outcomes (false positive [FP], false negative [FN], true positive [TP], and true negative [TN]
test results).
Data sources and searches
We conducted this systematic review in accordance with a prespecified registered protocol available on the
International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42018100502).
We reported the results according to preferred reporting items for systematic reviews and meta-analyses
(PRISMA) guidelines.9 The primary source of information was obtained from the studies that were included for
the analysis of test accuracy, represented in Figure 1 and discussed in a separate paper.3,4 The secondary
source included studies identified as having potential information for outcomes when the initial search was
completed, regardless of whether the study contained test accuracy information. The final source was any
additional studies suggested by experts in the field or other guidelines.
Figure 1.
VIEW LARGE
DOWNLOAD PPT
Flowchart of the article selection process for included studies.
We performed an electronic search of CENTRAL (until May 2019), Ovid Medline (from 1976 to May 2019), and
EMBASE (from 1974 to May 2019). A methodological filter was applied to limit retrieval of studies with data for
test accuracy (prospective studies, cross-sectional studies, cohort studies, or abstracts and conference posters
after 2014, limited to humans); a detailed search strategy provided in supplemental Material 2. We also reviewed
the reference lists of relevant articles and reviews.
Study selection
We used the following eligibility criteria for the outcomes studies:
Study design.
Prospective studies, cross-sectional studies, cohort studies from January 1974 to May of 2019, or abstracts and
conference posters after 2014 were used.
Participants.
All adult patients (age ≥18 years) suspected of having a symptomatic first or recurrent DVT were included.
Outcomes.
Studies assessing all-cause mortality, mortality from VTE, development of PE or DVT, development of recurrent
DVT, or postthrombotic sequelae, major bleeding, and intracranial hemorrhage in patients with suspected first or
recurrent episode of symptomatic DVT were included.
Language.
We included studies published in any language.
Publication status.
We reviewed all published and unpublished studies. Abstracts with relevant information were also reviewed.
Exclusion criteria.
Studies that did not assess or provide information on the outcomes of interest (eg, narratives, letters to editor
without primary data), abstracts before 2014, duplicate populations, and studies with missing or incomplete
outcomes results were excluded.
We used the following eligibility criteria for the studies with test accuracy information3,4 :
Study design.
Prospective studies, cross-sectional studies, cohort studies from January 1974 to May 2019, or abstracts and
conference posters after 2014 were included.
Participants.
All adult patients (age ≥18 years) suspected of having a symptomatic first or recurrent DVT were included.
Outcomes.
Studies assessing test accuracy of whole leg US, compression US, serial US, and high-sensitivity quantitative Ddimer (Vidas, STA Liatest, TinaQuant, Innovance, and HemoSIL) to diagnose a first or recurrent symptomatic
DVT were included.
Language.
We included studies published in any language.
Publication status.
We reviewed all published and unpublished studies. Abstracts with relevant information were also reviewed.
Exclusion criteria.
We excluded studies that did not assess test accuracy or had missing data (eg, narrative reviews, letters to the
editor without primary data), abstracts before 2014, duplicate populations, and studies that included
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dress the following questions: Consider how the setting in which you see clients may impact your recommendations for medications, treatments, or follow-up care. How would your recommendations have changed for this client (Client has arthritis and bilateral knee pain) if she was underinsured? What about if the encounter had occurred at a mobile clinic for unhoused clients? Include the following components: APA citationsAnswer all questions in the reflection prompt
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Chronic Disease Epidemiology
Course Code & CRN:
PHC331 -12653
The tobacco epidemic is one of the biggest public health threats the world has
ever faced. Being a leading cause of preventable diseases and deaths necessitates
actions through international collaboration.
Consequently, the World Health Organization (WHO) adopted the WHO
Framework Convention on Tobacco Control (WHO FCTC) in 2003 through
collaboration between 182 countries, and Saudi Arabia is a great party in this
convention, which developed MPOWER policies to face this rising epidemic.
Assignment title or
task:
(You can write a
question.)
In the light of this statement, read the attached documents carefully and
answer the following two questions: •
Use the WHO tobacco factsheet (link attached) to explore the WHO FCTC
and its MPOWER policies. (5 grades)
https://www.who.int/news-room/fact-sheets/detail/tobacco
•
Use the attached Saudi Arabia factsheet (PDF file) to explore the smoking
prevalence and the implemented tobacco control policies in Saudi Arabia.
(5 grades)
Student name:
XXXXX
Student ID:
XXXXX
Submission date:
XXXXX
Instructor name:
Dr. Samiha Ramadan
Grade:
……. Out of 10
Release Date: Sunday – (1-10-2023) at 12:00 p.m.
Due Date: Thursday – (9-11-2023) at 11:59 p.m.
Instructions:
•
•
•
•
•
•
•
•
•
Length of the write-up should be at least 500 words or two pages.
The font should be Times New Roman, and the size should be 12.
Heading should be Bold.
The text color should be Black.
Line spacing should be 1.5.
Proper headings with numbers should be given for each segment
Avoid Plagiarism
Assignments must be submitted with the filled cover page (NO image format)
All assignments must carry the references using APA style using at least three
references.
Mr. X, a 42-year-old male presents to your primary care practice today complaining of low back pain.
History – Mr. X states that he has had chronic low back pain since he had a skiing accident about 10 years ago. Three days ago, he felt a pulling sensation in his lower back after moving some boxes. The pain intensity increased over the subsequent 24 hours and is now steady, aching in nature, at 3-4 out of 10. Mr. X also has Type2 diabetes, which is well controlled on metformin with a HGA1c of 5.6. He has a history of DVT 4 months ago for which he takes Coumadin, INR is WNL. He is followed by a specialist for this problem. He recently started taking two OTC products; kava kava for what he describes as “anxiety” and CoEnzyme Q10 on the advice of a friend.
Social – Mr. X is a smoker, 1 pack per week for 15 years. No alcohol or drug use. He is employed as an accountant and has medical insurance. He is divorced.
PE/ROS – Complains of low back stiffness and pain on movement with occasional spasms related to moving in certain directions. You note he has mild difficulty getting onto the exam table but gait is normal. He denies weakness/numbness/tingling of legs, no radiation, no change in bowel or bladder habits. BMI 27. All range of motion of the back is decreased by 25%. Straight leg lift is negative bilaterally, DTR intact. All other systems WNL.
Medications:
Metformin 1000mg ER one tab daily – Type II Diabetes controlled
Coumadin 5 mg. daily – Hx of DVT – Controlled
Kava Kava 50 mg. tid – Self-medication for anxiety
CoQ10 – 200 mg. daily. – Self-medication for unknown reason
Provide a diagnosis for the patient and your rationale for the diagnosis
Provide a treatment plan specifically for this patient, pharmacologic and non-pharmacologic.
Comment on the use of OTC products in relation to Mr. X’s current chronic and acute disease diagnoses and medications. Include drug-drug interactions and side effect profiles.
Provide an education plan for Mr. X
Present this Assignment as a PowerPoint presentation with between 12 and 16 slides (not including opening slide and resource slide).
You will use the Narrative notes section of the presentation to include the majority of your evidentiary support of your treatment choices and education of family complete with in-text citations using APA formatting,
Due by the last day of Unit 9 at 11:59 p.m.
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Submit to and review results of Turnitin. Purdue University Global Student Conduct policy as it relates to plagiarism will be adhered to in this course.
Your writing Assignment should:
follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
utilize APA 7th edition formatting.
PLEASE PROVIDE NOTES ON EACH SLIDE SO I CAN NARRATE IT, THANK YOU!
You are designing an executable population-based change project addressing identified practice-related problems or questions. This strongly emphasizes collaboration between advanced practice nurses and community agencies and includes working with an agency using practice data to provide answers, which are responsive to the needs of clinicians, administrators, and policy makers for improvement of programs or practices.
This section of the change project should include a discussion of key concepts.
Clarify the issue under study.
Propose solutions or interventions based on the literature review.
Compare other views on the problem and solutions.
Address the APRN role in the intervention and discuss implications for clinical practice.
Discuss the implications of your change project.
Some important things to consider and address:
Does your intervention have a clear connection to your research problem?
What are the specific methods of data collection you are going to use, such as surveys, interviews, questionnaires, or protocols?
How do you intend to analyze your results?
Provide a justification for subject selection and sampling procedure.
Describe potential limitations. Are there any practical limitations that could affect your data collection? How will you attempt to control the limitations?
How will your change project help fill gaps in understanding the research problem?
This section should be 6–7 pages in length, not including the cover or reference page. You must reference a minimum of 5 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
This criterion is linked to a Learning OutcomeContent
64 to >52.48 pts
Meets Expectations
Succinctly clarifies the issue under study. Provides a brief summary of the project including main points and anticipated findings. Provides keen insight into obstacles and proposes sound, creative solutions or interventions based on the literature review findings. Expertly compares other views on the problem and solutions with detail. Uses examples to thoroughly address the FNP role in the intervention and discusses implications for clinical practice. Thoughtfully discusses the implications of the change project and its significance to the nursing profession and filling gaps in knowledge. Accurately categorizes and thoroughly explains specific methods of data collection to be used. Explains in detail how data will be analyzed and used. Provides a sound justification for subject selection and sampling procedure. Accurately and thoroughly describes potential limitations to data collection and control. Meets all of the criteria of the written assignment.
52.48 to >48.0 pts
Approaches Expectations
Provides an unclear explanation of the issue under study. Provides a brief summary of the project including main points and anticipated findings. Identifies some obstacles and proposes some solutions or interventions based on the literature review but few connections are made. Minimally compares other views on the problem and solutions. Minimally, addresses the FNP role in the intervention and discusses implications for clinical practice. Briefly discusses the implications of the change project and its significance to the nursing profession but may lack detail or specifics. Explains which methods of data collection will be used, and explains how data will be used. May be lacking analysis and accuracy in the explanation. Provides a general justification for subject selection and sampling procedure. Only briefly describes potential limitations to data collection and control. Meets most of the criteria of the written assignment.
48 to >37.76 pts
Falls Below Expectations
Provides no clarification of the issue under study. Provides little or no project summary or anticipated findings. Identifies few if any obstacles and proposes few if any solutions or interventions based on the literature review Minimal to no comparison to other views on the problem and solutions. Only suggests implications of the change project and its significance to the nursing profession or draws unreasonable conclusions. Identifies some methods of data collection to be used but may fail to explain how data will be used. Data collection methods are unsound, or unjustified for the change project. Justification for subject selection and sampling procedure may be missing or is unsound. Fails to describe potential limitations to data collection and control. Meets only a few of the criteria of the written assignment.
37.76 to >0 pts
Does Not Meet Expectations
No obstacles, opposing views, or comparisons are made to support the project. Data collection methods are not explained, analyzed, or discussed. Does not meet the assignment criteria.
64 pts
This criterion is linked to a Learning OutcomeOrganization
8 to >6.56 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.56 to >6.0 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
6 to >4.72 pts
Falls Below Expectations
Content is disorganized in many places and lacks clarity.
4.72 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized. May be an outline or a list.
8 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
8 to >6.56 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. The assignment is free of spelling and grammatical errors.
6.56 to >6.0 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. The assignment is mostly free of spelling and grammatical errors.
6 to >4.72 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. The assignment contains some spelling and grammatical errors.
4.72 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. The assignment contains many spelling and grammatical errors.
Consider the use of communication tools and checklists in your clinical area.Identify areas for improvement in communicating critical patient information to the appropriate provider.Discuss errors or near misses in your clinical area and how it was handled.Identify education that would support improved teamwork and decrease the chance of near misses or errors.Please be sure to validate your opinions and ideas with citations and references in APA format.
In no less than 250 words: Identify at least 6 examples of bullying in nursing (be as specific as possible). Discuss and reference (citations/references required).Part 2-In no less than 250 words: Now that you are about to graduate, what challenges/barriers are you anticipating as a new nurse and how do you plan to meet these challenges or overcome these barriers? (citations/references required).
There are several antipsychotics available for patients with psychotic disorders:Select an antipsychotic medication from your readings and discuss its use, potential side effects, dosing, mechanism of action, and the receptors it affects in the brain. (Quetiapine )Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.Submission InstructionsYour initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 evidence-based sources.
The use of spirituality in nursing practice is not new. However, it is more studied and utilized in a more structured format in nursing. Identify and discuss tools used to evaluate spirituality. The discussions require 400 words, with 2 scholarly references. Policies require plagiarism to be lower than 21%. I need the discussion by 10/21/2023.
For the 2nd powerpoint for the Lab (CBC- Complete Blood Count) you’re only using that for the Lab (CBC- Complete Blood Count) don’t worry about all the other lab test, just the Lab (CBC- Complete Blood Count)I will attach the documents and the rubric
Provide an example of interprofessional collaboration that was or might be utilized to improve patient outcomes.Discuss why interprofessional collaboration is important for the improvement of patient outcomes.As a nurse, you may encounter incivility, lateral violence, or outright bullying in the workplace. Provide an example of these behaviors from your experience or a news story.Discuss the nurse’s role and a leader’s role in the incivility example.Please be sure to validate your opinions and ideas with citations and references in APA format.
In 8 – 12 pages, answer the following questions:What is motivational interviewing (MI)?What is the righting reflex? What are two examples of the righting reflex?What is client discord and how is it different from resistance?What is the spirit of MI? Briefly describe each domain.What are the four processes of MI?What are reflections? What are two types of reflections?What are the core skills used in MI?What is change talk and why is it important?
Length: A minimum of 180 words, not including references
Relate to another study/journal
Citations: At least two high-level scholarly reference in APA from within the last 5 years
A healthy 2-month-old child was brought to your clinic by her parents. The child is a full-term infant with no concerns. Her exam is normal, and she received her Hep B #1 in the nursery.
Q1. What vaccines does she get? What combinations are available at your clinic?
According to the CDC, a 2-month-old infants should be getting rotavirus (RV1), diphtheria, tetanus & acellular pertussis (DTaP), haemophiles influenzae type b (Hib), pneumococcal conjugate (PCV13), inactive poliovirus (IPV) (2023). Vaxelis, is a combination of 6 vaccines, which are, DTaP, IPV, Hib, and Hep B (2019). This will mean the baby will only need to get the RV1 and the PCV13 which means 3 pokes instead of 6 which is much better for the child and the parents.
Q2. The child returns at 12 months after completing her primary series of vaccines at 2, 4, and 6 months of age. Her vaccines are right on schedule, her parents have no concerns, she is developing normally, and her exam is normal. What vaccines can she get today?
The child can get the 3rd dose of the HepB, 3rd dose of Hib, 4th dose of PCV13, and the 3rd dose of IPV, according to the CDC vaccination schedule (2023). Optional vaccines include COVID 19 vaccination and the yearly flu vaccine if the parents want to take the additional vaccinations (2023).
Q3. Which groups of patients are at higher risk for pneumococcal disease, and need PPSV23 early starting at 2-years old?
According to Kobayashi et al., children with any immunocompromised conditions: dialysis, nephrotic syndrome, congenital asplenia/splenic dysfunction, immunodeficiency, treatments with immunosuppressants, HIV, sickle cell diseases, heart disease, CKD, liver disease, lung disease, cochlear implants, DM, cerebrospinal fluid leaks or any decreased immune function (2022). They need two additional doses of the PPSV23 one at two years old and then 8 weeks later (2023).
A 25-year-old woman comes to your office asking for oral contraceptive refills. She stated that she was feeling depressed and heard about St. John’s wort used in depression which she started taking a week ago.
Q4. How might concomitant administration of St. John’s wort affect the efficacy of drugs this patient is taking such as the oral contraceptives? Discuss another example of a possible drug interaction that might occur with St. John’s wort?
According to Canenguez Benitez et al., St. John’s wort has proven very effective treating mild to moderate depression but can have interactions with several other medications such as with oral contraception (2022). SJW can make oral contraception less effective, and she should expect more breakthrough bleeding and could possibly decrease the (Canenguez Benitez, 2022). Nicolussi et al., state almost 70% of the medications on the market will have interactions with SJW because they are metabolized by the liver, on example is Xanax (2020). They go on to say it causes an increase in Xanax clearance in the body and it will be less effective and need higher doses of the medication for it to be effective (Nicolussi et al., 2020).
The 25-year-old woman stated that her 4-year-old child has been coughing and sounds congested. She wants to know if echinacea might help her child.
Q5. What is echinacea used for and how is it taken?
Echinacea is an anti-inflammatory herb used to treat upper respiratory infections in children and adults. Weishaupt et al., did a study on children taking echinacea tabs and how it impacted their cold symptoms, the study showed a reduction of symptoms of 2 to 3 days (2020). Echinacea can be used to treat many different types of illnesses or inflammatory conditions. It can be found in tea, liquid, cough/cold medicines, and pills depending on how the patient wants to take the herb.
Q6. Is it safe for this mother to give her child echinacea?
It is safe for her child to taken echinacea, but she needs to be educated on dosing and making sure she is using “children” dosing and medications. Herbs and other herbal supplements are not regulated by the FDA and can contain other ingredients that cannot be proven to be safe for children so herbal supplements should be closely evaluated and taken for short terms and with great caution. As long as the patient’s mother is aware of the risks and has been properly educated, echinacea can be used with great effect at reducing cold symptoms for her child.
References
Canenguez Benitez, J. S., Hernandez, T. E., Sundararajan, R., Sarwar, S., Arriaga, A. J., Khan, A. T., Matayoshi, A., Quintanilla, H. A., Kochhar, H., Alam, M., Mago, A., Hans, A., & Benitez, G. A. (2022). Advantages and Disadvantages of Using St. John’s Wort as a Treatment for Depression. Cureus, 14(9), e29468. https://doi.org/10.7759/cureus.29468
Centers for Disease Control and Prevention. (2019, August 1). About combination vaccines for children. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/parents/why-vaccinate…
Centers for Disease Control and Prevention. (2023, April 27). Birth-18 years immunization schedule – healthcare providers. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/schedules/hcp/imz/chi…
Kobayashi, M., Farrar, J. L., Gierke, R., Britton, A., Childs, L., Leidner, A. J., Campos-Outcalt, D., Morgan, R. L., Long, S. S., Talbot, H. K., Poehling, K. A., & Pilishvili, T. (2022). Use of 15-valent pneumococcal conjugate vaccine and 20-valent pneumococcal conjugate vaccine among U.S. adults: Updated recommendations of the Advisory Committee on Immunization Practices — United States, 2022. MMWR. Morbidity and Mortality Weekly Report, 71(4), 109–117. https://doi.org/10.15585/mmwr.mm7104a1
Nicolussi, S., Drewe, J., Butterweck, V., & Meyer Zu Schwabedissen, H. E. (2020). Clinical relevance of St. John’s wort drug interactions revisited. British journal of pharmacology, 177(6), 1212–1226. https://doi.org/10.1111/bph.14936
Weishaupt, R., Bächler, A., Feldhaus, S., Lang, G., Klein, P., & Schoop, R. (2020). Safety and dose-dependent effects of echinacea for the treatment of acute cold episodes in children: A multicenter, randomized, open-label clinical trial. Children, 7(12), 292. https://doi.org/10.3390/children7120292
(minimum 300 words) Please consider and describe the influence of American values and ideology on a specific area of health care delivery. In your response, please describe 1) your chosen health reform topic and 2) the American values and 3) how those values influence that topic.Potential topics range across the healthcare “library.” Examples of topics include: Medicare for All, accessibility of contraception, reduction of disparities in prenatal care, child healthcare in immigration detention centers, free COVID-19 testing, private health care for Veterans, personable and portable health insurance, surprise medical billing, reducing pharmaceutical costs, health insurance subsidies for individuals unemployed as a result of the COVID-19 pandemic. Or you may select another topic and write about that.
For this assignment, you will be developing and presenting an Educational, Narrative PowerPoint. In the presentation of your chosen topic, be sure to examine the pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan (MN551-3).
Narrative, PowerPoint Assignment Requirements
Make sure all of the content topics of the assignment have been addressed.
Cite at least three references in your PowerPoint; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Design and develop a 8- to 12-slide PowerPoint presentation using voice/narrative feature on each slide (the title and reference slides do not count in the slide count, but must be included in the assignment), that will be used to educate the community about one of the following topics:
Type II Diabetes
Atherosclerosis
Hypertension
Depression
Urinary Tract Infection
Narrative, PowerPoint Contents to include, but not be limited to:
Risk factors and causes
Possible consequences
Prevention Strategies
Treatment Modalities
PowerPoint Format:
Follow APA 7th edition format for PowerPoint presentations.
Use the slide notes section in the presentation to include information that follows your narration, being sure to follow the conventions of Standard English.
Slide content should include brief points that identify the areas that will be addressed in the narration.
In-text citations should be included with any brief points that were researched from outside sources, and the narration should fully explain the points.
Reference all sources on a separate reference slide at the end of the presentation and cite each source in the body of the presentation using 7th edition APA format.
Identify the sources of any pictures you use, being sure to cite them correctly in 7th edition APA style, using in-text citations.
Narration Guidelines:
Maintain a professional tone by summarizing observations and evaluations for each slide.
Ensure that your presentation is highly ordered, logical, and unified.
Words should be clearly enunciated and professional tone should be sustained throughout the presentation narration.
Audio recording should be free of background noise and interruptions.
Before finalizing your work, it is important to:
Review Narrative PowerPoint Assignment Requirements (described above) and the Narrative PowerPoint Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
Make sure to review your chosen topic carefully to make sure you have answered all content effectively.
Utilize spelling and grammar checks to minimize errors.
Follow the conventions of Standard English (correct grammar, punctuation, etc.).
Make sure your presentation is original, insightful, and utilizes your logic and critical thinking skills; that your presentation is well-organized, with superior content, style, and mechanics.
Utilize APA 7th edition format.
Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
PLEASE PROVIDE NOTES ON EACH SLIDE, SO I MAY DO A VOICE OVER. THANK YOU!
A 28-year-old female with a history of type 1 diabetes mellitus. She presents to the clinic reporting a sudden onset of dizziness. She is morbidly obese. Vital signs are pulse 98 bpm, respirations 18, and blood pressure 170/90 mm Hg. Her dorsalis pedis pulse is weak bilaterally; she has bilateral carotid bruits. Neurologically she is intact.Answer the following in at least 600 words. Use 2 outside reliable scholarly sources and cite using APA format.What might be a cause of the client’s dizziness?Which factors put her at risk for stroke?What educational topics would be appropriate client education?
Compose a brief memo. Include all of the elements of a memo.Imagine that you are President of GMU, Gregory Washington, and you are sending a memo to the entire GMU community–staff, faculty, students. The topic of your memo should be: GMU’s Automated External Defibrillator Program.Information is available here: GMU’s Automated External Defibrillator Program
For this discussion, you will use information from your assigned readings, the self-paced tutorial and leaders in your organization. Discuss the following:How are quality outcomes measured in your organization? Describe the process of data collection, variance investigations, changes in protocols and service delivery, the implementation process, and post-implementation monitoring. Include personnel involved in each step of the process.Give an example of a continuous improvement project that occurred in your work area. What worked well? What did not work well? How could the process be improved? Your initial post must be posted before you can view and respond to colleagues, must contain minimum of two (2) references, in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussioInitial Post: Minimum of two (2) total references: one (1) from required course materials and one (1) from peer-reviewed references.Initial Post: Minimum 200 words excluding references (approximately one (1) page)
Part 1:
With a word count of >500 words, select ONE of the neglected tropical diseases NOT malaria from this week’s chapter (Chapter 10 [attached]). First, briefly describe this disease, where it is located geographically, affected population, its transmission, and signs and symptoms. Next, imagine yourself as a health professional working in an affected community. Discuss how you would go about letting the people in the community know about this disease, signs and symptoms, and how they can prevent (avoid) getting this disease. Then discuss any other key points.
Part 2:
select ONE of the diseases below.
anthrax
bartonellosis
brucellosis
leptospirosis
oropouche virus
leishmaniasis
cyclosporiasis
strongyloidiasis
cysticercosis
echinococcosis
paragonimiasis
diphyllobothriasis
fasciolasis
histoplasmosis
sporotrichosis
paracoccidioidomycosis
chromomycosis
Then create 4 PowerPoint slides:
First slide with several clear and concise bulleted points About the Disease (than includes transmission – how people get it)
Second slide with Signs & Symptoms (bulleted points and including images)
Third slide with the Lifecycle diagram, and including additonal images of vectors, intermedidate hosts, or other applicable components
Fourth slide with bulleted points on Prevention – how people can prevent getting this disease
Need discussion response to 2 peers. Initial discussion question: After reading chapters 15,17 answer the next question.Which level of measurement would you prefer to utilize for quantitative research? Defend your answer.
Unformatted Attachment Preview
In nursing research, the rigorous analysis of data is instrumental in deriving accurate conclusions and
formulating evidence-based interventions. The ratio level of measurement, recognized as the most
precise among measurement scales, offers unparalleled advantages in this domain. Ratio scales provide
all the properties of nominal, ordinal, and interval scales, with the added benefit of a true zero point.
This zero point signifies the absence of the attribute being measured, making mathematical operations
like multiplication and division meaningful (Malhotra, 2007). A common example in nursing would be
the measurement of a patient’s weight, where zero signifies the complete absence of weight.
The distinct strength of ratio scales lies in their ability to capture exact quantities and facilitate a broad
range of statistical analyses. In nursing research, this precision is crucial when monitoring variables such
as medication dosages, blood pressure readings, or fluid intake and output. The presence of a true zero
allows for the calculation of ratios, providing deeper insights into relative differences. For instance,
understanding that one patient’s blood pressure is twice as high as another’s can be vital in determining
the urgency and nature of interventions (Burns & Grove, 2005).
However, it’s essential to acknowledge that not all variables in nursing research can be measured at the
ratio level. Some attributes, especially subjective ones like pain perception or mood, might not have a
true zero or may be more appropriately measured using other scales. Nevertheless, when the research
objective demands precise quantitative assessments and the ability to calculate proportional
differences, the ratio level of measurement stands out as the gold standard in nursing research.
References:
Malhotra, N. K. (2007). Marketing Research: An Applied Orientation (5th ed.). Prentice Hall.
Burns, N., & Grove, S. K. (2005). The practice of nursing research: Conduct, critique, & utilization (5th
ed.). Elsevier Saunders.
Levels of measurement in quantitative research are referred to as the different ways in which a variable
can be calculated. There are some limitations to consider when selecting what level of measurement to
use for a study, as some of them do not have the capacity to compute outside certain barriers. My
preferred level of measurement would be ratio measurement, due to the fact that it provides the most
precise answer.
According to an article by the Surveysparrow, It tells you about the order and the equal distance
between two adjacent values. The zero in the ratio scale also has a lot of relevance. It tells the difference
between “how much” (Williams, 2022). Ratio measurement allows for the estimation of a range
between 2 variables, such as height, weight, and age. It uses a true zero, which aids in the
representation of intervals between variables by not recognizing negative numbers.
Finally, an article by the Research Prospect states since ratio scales have an absolute zero, variables in
this type of data can be added, subtracted, multiplied, or divided (Ingram, 2023). The fact that the
variables used in a ratio measurement can be added, subtracted, or divided provides a more analytical
approach to a study, and thus making it the most detailed measurement level there is. For these
reasons, and many more, it is my level of measurement of choice for conducting a quantitate research.
References:
Williams, K. (2022). Ratio scale: Definition, characteristics & examples. SurveySparrow.
https://surveysparrow.com/blog/ratio-scale/
Ingram, O. (2023). Ratio Data: Definition, examples, and analysis. Research Prospect.
Discuss the interrelationship among theory, practice, and research.Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
The aim of this discussion assignment is to facilitate a deeper understanding of key issues in mental health nursing, engage in collaborative learning, and encourage the application of theoretical knowledge to real-world clinical scenarios.
Discussion Topic:
A key to being a healthy individual includes managing the effects of stress. Discuss positive ways of managing stress.
Instructions
Initial Post: In your own words, create an initial post addressing the discussion question. Your initial post must be at least 300 words long and include citations in APA format.
Peer Responses: Reply to at least one classmate’s posts. Each reply should be substantive, adding value to the discussion, and be at least 150 words long.
Citations: Use at least one scholarly source (not including the textbook) to support your points. Make sure to use APA format for your citations. You can support your statement using credible data sources such as CINAHL, MEDLINE, Embase, Clinical Key, and Cochrane Library (Accessed from the library page at the fnu.edu website).
Originality: All work must be original and in your own words. Plagiarism will result in a zero for the assignment and may have additional academic consequences.
This assignment aims to deepen your understanding of mental health conditions, therapeutic interventions, and ethical considerations in mental health nursing. You will be provided with a case study featuring a patient with a mental health condition. Your task is to analyze the case and answer the corresponding question.
Case Scenario:
A woman is admitted to the adult inpatient behavioral health unit after experiencing flashbacks to her rape that occurred when she was a 12-year-old girl while at her babysitter’s. She was raped by the babysitter’s 15-year-old son and three of his friends. Upon admission, the client is quiet, curled on her side in the fetal position on the bed, and rejecting of others who enter her room, shrinking to the far side of the bed whenever any person opens her door. Her sister, who accompanied her to the hospital, tells you that the client has been like this since a news story appeared last week about a young girl being abducted from a mall and beaten and raped by several teenage boys. The client has not eaten, slept, or gone to work since hearing the news account. (Learning Objective: 2, 3, 4, 5)
a. What trauma/stress-related disorder is this client experiencing? What risk factors does she exhibit?
b. List at least two treatment interventions that are viable options to assist the client at this time.
Instructions
Read Thoroughly: Familiarize yourself with the case, noting key elements like symptoms, medical history, and social factors affecting the patient.
Research: Conduct scholarly research to better understand the condition presented in the case study. Use at least five peer-reviewed articles to support your analysis.
Ethical Considerations: Examine any ethical considerations associated with the case. For example, consider patient consent, confidentiality, and duty of care.
Reflection: Write a 300-word reflection on what you have learned from this assignment and how it will impact your future practice.
Due Date: The initial post and peer responses are due every Saturday at 11:30 p.m.
Academic Integrity
Plagiarism will not be tolerated. Ensure that all sources are correctly cited and that you have not copied material from other sources unless appropriately cited.
Questions?
If you encounter any issues or have questions about this assignment, please email me or post them under the ‘Class Questions’ forum.
Question 1
See attached file and answer it saperatly Question 2
In separate file answer the following
Nowadays, obesity has become a serious health problem among university students. What are the factors that contribute to obesity among university students? In your
opinion what is the best strategies to reduce or prevent ?obesity among university students
:Instructions for Completing the Discussion Questions
Please post your original response by Wednesday at • 11:59 pm. Your response should not exceed 250 words.
Appropriately cite any of the references that you use
to fully answer the questions
Respond to at least one of your classmates by •Saturday at 11:59 pm
AllCEUs Counseling Education. (2017, November 4). 187 models of treatment for addiction | Addiction counselor training seriesLinks to an external site. [Video]. YouTube.
Medmastery. (2022, March 8). How to use motivational interviewing in addiction medicineLinks to an external site.. [Video]. YouTube.
AllCEUs Counseling Education. (2017, November 4). 187 models of treatment for addiction | Addiction counselor training seriesLinks to an external site. [Video]. YouTube.
Medmastery. (2022, March 8). How to use motivational interviewing in addiction medicineLinks to an external site.. [Video]. YouTube.
AllCEUs Counseling Education. (2017, November 4). 187 models of treatment for addiction | Addiction counselor training seriesLinks to an external site. [Video]. YouTube.
Medmastery. (2022, March 8). How to use motivational interviewing in addiction medicineLinks to an external site.. [Video]. YouTube.
PSYCHOTHERAPY FOR CLIENTS WITH ADDICTIVE DISORDERS
Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare:
Review this week’s Learning Resources and consider the insights they provide about diagnosing and treating addictive disorders. As you watch the 187 Models of Treatment for Addiction video, consider what treatment model you may use the most with clients presenting with addiction.
Search the Walden Library databases and choose a research article that discusses a therapeutic approach for treating clients, families, or groups with addictive disorders.
THE ASSIGNMENT
In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit.
Provide an overview of the article you selected.
What population (individual, group, or family) is under consideration?
What was the specific intervention that was used? Is this a new intervention or one that was already studied?
What were the author’s claims?
Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?
Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.
Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides.
Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.
BY DAY 7
Submit your Assignment.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK8Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6645_Week8_Assignment_Rubric
NRNP_6645_Week8_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDevelop a 5- to 10-slide PowerPoint presentation on your selected research article discussing a therapeutic approach for treating clients, families, or groups with addictive disorders.•Provide an overview of the article you selected, including:What population (individual, group, or family) is under consideration?What was the specific intervention that was used? Is this a new intervention or one that was already used?What were the author’s claims?
20 to >17.0 pts
Excellent 90%–100%
The presentation thoroughly and accurately defines the considered population…. The specific intervention used is fully and accurately described. The description clearly indicates whether the intervention is new or whether it was already studied…. The response includes a thorough and accurate description of the author’s claims.
17 to >15.0 pts
Good 80%–89%
The presentation defines the considered population…. The specific intervention used is described. The description indicates whether the intervention is new or whether it was already studied…. The response includes a description of the author’s claims.
15 to >13.0 pts
Fair 70%–79%
There is an incomplete definition of the considered population…. The specific intervention used is partially or inaccurately described…. The response includes a partial or inaccurate description of the author’s claims.
13 to >0 pts
Poor 0%–69%
There is an incomplete definition of the considered population, or it is missing…. The specific intervention used is partially or inaccurately described, or is missing…. The response includes a partial or inaccurate description of the author’s claims, or is missing.
20 pts
This criterion is linked to a Learning Outcomeo Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your clients. If so, how? If not, why?
25 to >22.0 pts
Excellent 90%–100%
The presentation includes a thorough and accurate review of the findings of the selected article…. The response fully addresses whether or not the outcomes will translate into practice with clients.
22 to >19.0 pts
Good 80%–89%
The presentation includes a review of the findings of the selected article…. The response addresses whether or not the outcomes will translate into practice with clients.
19 to >17.0 pts
Fair 70%–79%
The presentation includes a somewhat inaccurate or incomplete review of the findings of the selected article…. The response partially or inaccurately addresses whether or not the outcomes will translate into practice with clients.
17 to >0 pts
Poor 0%–69%
The presentation includes an inaccurate and incomplete review of the findings of the selected article, or is missing…. The response partially or inaccurately addresses whether or not the outcomes will translate into practice with clients, or is missing.
25 pts
This criterion is linked to a Learning Outcome• Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.
25 to >22.0 pts
Excellent 90%–100%
The presentation includes a thorough and accurate explanation of the whether the limitations of the study might impact your ability to use the findings presented in the article.
22 to >19.0 pts
Good 80%–89%
The presentation includes an explanation of the whether the limitations of the study might impact your ability to use the findings presented in the article.
19 to >17.0 pts
Fair 70%–79%
The presentation includes a somewhat inaccurate or incomplete explanation of the whether the limitations of the study might impact your ability to use the findings presented in the article.
17 to >0 pts
Poor 0%–69%
The presentation includes an inaccurate or incomplete explanation of the whether the limitations of the study might impact your ability to use the findings presented in the article, or is missing.
25 pts
This criterion is linked to a Learning Outcome•Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides.
10 to >8.0 pts
Excellent 90%–100%
The Notes function of the presentation is appropriately used to comprehensively expand upon the presentation slides.
8 to >7.0 pts
Good 80%–89%
The Notes function of the presentation is adequately used to expand upon the presentation slides.
7 to >6.0 pts
Fair 70%–79%
The Notes function of the presentation is utilized but notes are vague or contain small inaccuracies.
6 to >0 pts
Poor 0%–69%
The Notes function of the presentation partially or inaccurately expands upon the presentation slides, or is not included.
10 pts
This criterion is linked to a Learning Outcome• Support your response with at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is scholarly. References are included on your last slide.
10 to >8.0 pts
Excellent 90%–100%
The presentation is strongly supported with at least three peer-reviewed, evidence-based, scholarly sources. References are included on the last slide.
8 to >7.0 pts
Good 80%–89%
The presentation is supported with at least three peer-reviewed, evidence-based, scholarly sources. References are included on the last slide.
7 to >6.0 pts
Fair 70%–79%
The presentation is supported with two or three peer-reviewed, evidence-based, scholarly sources. Accurate references may not be included on the last slide.
6 to >0 pts
Poor 0%–69%
The presentation is not supported with resources peer-reviewed, evidence-based, scholarly sources, and/or the reference list is missing.
10 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Style and Organization: Slides are clear and not overly crowded. Sentences in presenter notes are carefully focused—neither long and rambling nor short and lacking substance.
5 to >4.0 pts
Excellent 90%–100%
Slides are clear, concise, and visually appealing. Sentences in presenter notes follow writing standards for flow, continuity, and clarity.
4 to >3.5 pts
Good 80%–89%
Slides are clear and concise. Sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.5 to >3.0 pts
Fair 70%–79%
Slides may be somewhat unorganized or crowded. Sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
3 to >0 pts
Poor 0%–69%
Slides are unorganized and/or crowded. Sentences follow writing standards for flow, continuity, and clarity < 60% of the time.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.5 pts
Good 80%–89%
Contains 1 or 2 grammar, spelling, and punctuation errors.
3.5 to >3.0 pts
Fair 70%–79%
Contains 3 or 4 grammar, spelling, and punctuation errors.
3 to >0 pts
Poor 0%–69%
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
Total Points: 100
PreviousNext
LEARNING RESOURCES
Required Readings
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u… and Psychiatric Diagnosis”
Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.Chapter 9, “Motivational Interviewing”
Chapter 19, “Psychotherapeutic Approaches for Addictions and Related Disorders”
Mr. X, a 42-year-old male presents to your primary care practice today complaining of low back pain.
History – Mr. X states that he has had chronic low back pain since he had a skiing accident about 10 years ago. Three days ago, he felt a pulling sensation in his lower back after moving some boxes. The pain intensity increased over the subsequent 24 hours and is now steady, aching in nature, at 3-4 out of 10. Mr. X also has Type2 diabetes, which is well controlled on metformin with a HGA1c of 5.6. He has a history of DVT 4 months ago for which he takes Coumadin, INR is WNL. He is followed by a specialist for this problem. He recently started taking two OTC products; kava kava for what he describes as “anxiety” and CoEnzyme Q10 on the advice of a friend.
Social – Mr. X is a smoker, 1 pack per week for 15 years. No alcohol or drug use. He is employed as an accountant and has medical insurance. He is divorced.
PE/ROS – Complains of low back stiffness and pain on movement with occasional spasms related to moving in certain directions. You note he has mild difficulty getting onto the exam table but gait is normal. He denies weakness/numbness/tingling of legs, no radiation, no change in bowel or bladder habits. BMI 27. All range of motion of the back is decreased by 25%. Straight leg lift is negative bilaterally, DTR intact. All other systems WNL.
Medications:
Metformin 1000mg ER one tab daily – Type II Diabetes controlled
Coumadin 5 mg. daily – Hx of DVT – Controlled
Kava Kava 50 mg. tid – Self-medication for anxiety
CoQ10 – 200 mg. daily. – Self-medication for unknown reason
Provide a diagnosis for the patient and your rationale for the diagnosis
Provide a treatment plan specifically for this patient, pharmacologic and non-pharmacologic.
Comment on the use of OTC products in relation to Mr. X’s current chronic and acute disease diagnoses and medications. Include drug-drug interactions and side effect profiles.
Provide an education plan for Mr. X
Present this Assignment as a PowerPoint presentation with between 12 and 16 slides (not including opening slide and resource slide).
You will use the Narrative notes section of the presentation to include the majority of your evidentiary support of your treatment choices and education of family complete with in-text citations using APA formatting,
utilize APA 7th edition formatting.
Over the past five weeks, you have read how the public health system in the United States is failing in many respects. In this week’s assignment, create a narrated PowerPoint presentation with a minimum of 10 slides (excluding title and reference slides). Your presentation should compare the public health systems of two non-US countries with different health care systems. This activity aims to identify the strengths and weaknesses of the non-US health systems and to increase your knowledge of various health systems worldwide.
Health disparities and social determinant of health Analyze health disparities in your own county and neighborhood. Discuss any social determinants of health and other factors that directly or indirectly affect your community’s health with clear examples. Discuss the area deprivation index and use the policymap to include maps of your area. This paper needs to be 2-3 pages excluding cover page, maps and references, and be written following current APA style guidelines.Learning Objectives:1. Analyze health disparities found in your own county and neighborhood.2. Connect social determinants of health and other factors that directly or indirectly affect your community’s health.
Describe how the role of advanced registered nurse transformed over time. Consider shifts in scope and expectations in the 20th and 21st centuries. In what ways will the advanced registered nurse role and responsibilities continue to evolve and emerge as the American health care system changes? I need at least 3 paragraphs and an APA reference.
The Nursing Plan of Care is used to organize patient data which enables nursing personnel to deliver safe and effective care for a client. Students need to complete a care of plan for semester
NURSING 300 and 305
DISCUSSION BOARD 1A
This week we reviewed the roles that technology plays in healthcare and nursing
practice. For this week’s discussion, please address each of the following prompts:
•
What does the term informatics mean to you in your professional nursing
practice?
•
How do you interface with informatics in nursing practice?
Please support your response with a scholarly source. Please be sure to respond
to at least two peers each week
This activity aligns with Course outcomes:
•
Describe the role of technology and informatics in healthcare and nursing
(Essential IV.1, IV.4, IV.5, and IV.7)
=========================================================
DISCUSSION BOARD 1B
This week, we discussed nursing theory and theorists. For this week, you will
need to select a theory and a theorist to discuss. Visit Nurses Labs to review each
of the theorists and their theories by clicking this link: Nurseslabs https://nurseslabs.com/nursing-theories/
(Clicking this link will take you out of the learning management system.)
Address each of the following prompts in your discussion:
1. Identify and describe the theorist and theory you have chosen to discuss.
2. What level of nursing theory does the theorist fall under?
3. How would you apply this theory to practice?
Discussion guidelines: Create at least two full paragraphs in response to this
discussion prompt. Build paragraphs that are 5–7 sentences in length. Use
appropriate in-text citations and references.
NURSING 300 and 305
This discussion activity aligns with:
Course Outcome 2. Critically appraise current evidence-based research to
determine the validity and reliability of the findings as it applies to nursing
practice.
AACN BSN Essential III.2: Demonstrate an understanding of the basic elements
of the research process and models for applying evidence to clinical practice.
AACN BSN Essential III.4: Evaluate the credibility of sources of information,
including but not limited to databases and Internet resources.
Discussion Participation
Course: NURS 300 7380 Science and Research in Nursing (2238)
Criteria
Quantity and
Timelines
Knowledge of
discussion topic,
course content
and applicability
to professional
practice.
Level 3
Level 2
Level 1
Criterion Score
10 points
8 points
4 points
/ 10
Completes original
Completes original
Does not complete
posting and
posting late, or
original posting,
responds to two
does not respond
responds to one or
peer postings
to 2 peer postings
two peer postings
10 points
8 points
4 points
Posting
Fair response to
Poor response to
demonstrates
clear evidence of
conference topic
—missing
conference topic –
knowledge of
discussion topic
important details
that leave the
response that is
and course
content. Post is
response
incomplete.
topic. Does not
applicable to
professional
Demonstrates
some evidence of
evidence of
nursing practice
discussion topic
course content.
Post is applicable
to professional
nursing practice.
Clarity and
Coherence
/ 10
provides a
irrelevant or offdemonstrate
knowledge of
discussion topic or
course content.
Post is not
applicable to
professional
nursing practice.
5 points
4 points
3 points
Few or no
grammatical
Response
contains several
Poor writing and
mistakes, and
cites references
grammatical or
mechanical errors
is
appropriately as
required
that may impact
readability but is
No references cited
/5
grammar, response
incomprehensible.
when required.
mostly
comprehensible.
References are
not cited
appropriately
when required
Total
/ 25
Overall Score
Level 3
Level 2
Level 1
29.166666667 points minimum
16.666666667 points minimum
4.166666667 points minimum
Discussion Participation
Course: NURS 300 7380 Science and Research in Nursing (2238)
Criteria
Quantity and
Timelines
Knowledge of
discussion topic,
course content
and applicability
to professional
practice.
Level 3
Level 2
Level 1
Criterion Score
10 points
8 points
4 points
/ 10
Completes original
Completes original
Does not complete
posting and
posting late, or
original posting,
responds to two
does not respond
responds to one or
peer postings
to 2 peer postings
two peer postings
10 points
8 points
4 points
Posting
Fair response to
Poor response to
demonstrates
clear evidence of
conference topic
—missing
conference topic –
knowledge of
discussion topic
important details
that leave the
response that is
and course
content. Post is
response
incomplete.
topic. Does not
applicable to
professional
Demonstrates
some evidence of
evidence of
nursing practice
discussion topic
course content.
Post is applicable
to professional
nursing practice.
Clarity and
Coherence
/ 10
provides a
irrelevant or offdemonstrate
knowledge of
discussion topic or
course content.
Post is not
applicable to
professional
nursing practice.
5 points
4 points
3 points
Few or no
grammatical
Response
contains several
Poor writing and
mistakes, and
cites references
grammatical or
mechanical errors
is
appropriately as
required
that may impact
readability but is
No references cited
/5
grammar, response
incomprehensible.
when required.
mostly
comprehensible.
References are
not cited
appropriately
when required
Total
/ 25
Overall Score
Level 3
Level 2
Level 1
29.166666667 points minimum
16.666666667 points minimum
4.166666667 points minimum
NURSING 300 and 305
DISCUSSION BOARD 1A
This week we reviewed the roles that technology plays in healthcare and nursing
practice. For this week’s discussion, please address each of the following prompts:
•
What does the term informatics mean to you in your professional nursing
practice?
•
How do you interface with informatics in nursing practice?
Please support your response with a scholarly source. Please be sure to respond
to at least two peers each week
Discussion guidelines: Create at least two full paragraphs in response to this
discussion prompt. Build paragraphs that are 5–7 sentences in length. Use
appropriate in-text citations and references.
This activity aligns with Course outcomes:
•
Describe the role of technology and informatics in healthcare and nursing
(Essential IV.1, IV.4, IV.5, and IV.7)
=========================================================
DISCUSSION BOARD 1B
This week, we discussed nursing theory and theorists. For this week, you will
need to select a theory and a theorist to discuss. Visit Nurses Labs to review each
of the theorists and their theories by clicking this link: Nurseslabs https://nurseslabs.com/nursing-theories/
(Clicking this link will take you out of the learning management system.)
Address each of the following prompts in your discussion:
1. Identify and describe the theorist and theory you have chosen to discuss.
2. What level of nursing theory does the theorist fall under?
3. How would you apply this theory to practice?
NURSING 300 and 305
Discussion guidelines: Create at least two full paragraphs in response to this
discussion prompt. Build paragraphs that are 5–7 sentences in length. Use
appropriate in-text citations and references.
This discussion activity aligns with:
Course Outcome 2. Critically appraise current evidence-based research to
determine the validity and reliability of the findings as it applies to nursing
practice.
AACN BSN Essential III.2: Demonstrate an understanding of the basic elements
of the research process and models for applying evidence to clinical practice.
AACN BSN Essential III.4: Evaluate the credibility of sources of information,
including but not limited to databases and Internet resources.
NURSING 300 and 305
DISCUSSION BOARD 1A
This week we reviewed the roles that technology plays in healthcare and nursing
practice. For this week’s discussion, please address each of the following prompts:
•
What does the term informatics mean to you in your professional nursing
practice?
•
How do you interface with informatics in nursing practice?
Please support your response with a scholarly source. Please be sure to respond
to at least two peers each week
Discussion guidelines: Create at least two full paragraphs in response to this
discussion prompt. Build paragraphs that are 5–7 sentences in length. Use
appropriate in-text citations and references.
This activity aligns with Course outcomes:
•
Describe the role of technology and informatics in healthcare and nursing
(Essential IV.1, IV.4, IV.5, and IV.7)
=========================================================
DISCUSSION BOARD 1B
This week, we discussed nursing theory and theorists. For this week, you will
need to select a theory and a theorist to discuss. Visit Nurses Labs to review each
of the theorists and their theories by clicking this link: Nurseslabs https://nurseslabs.com/nursing-theories/
(Clicking this link will take you out of the learning management system.)
Address each of the following prompts in your discussion:
1. Identify and describe the theorist and theory you have chosen to discuss.
2. What level of nursing theory does the theorist fall under?
3. How would you apply this theory to practice?
NURSING 300 and 305
Discussion guidelines: Create at least two full paragraphs in response to this
discussion prompt. Build paragraphs that are 5–7 sentences in length. Use
appropriate in-text citations and references.
This discussion activity aligns with:
Course Outcome 2. Critically appraise current evidence-based research to
determine the validity and reliability of the findings as it applies to nursing
practice.
AACN BSN Essential III.2: Demonstrate an understanding of the basic elements
of the research process and models for applying evidence to clinical practice.
AACN BSN Essential III.4: Evaluate the credibility of sources of information,
including but not limited to databases and Internet resources.
My topic is diabetes in older adult. attach is the rubric.
Unformatted Attachment Preview
NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Paper Guidelines
Purpose
This assignment allows the learner to apply knowledge gained about health promotion concepts and strategies,
enhance written communication skills, and demonstrate a beginning understanding of cultural competency.
Course outcomes: This assignment enables the student to meet the following course outcomes:
1. Discuss the professional nurse’s role in health promotion activities. (PO 1 and 2)
3. Discuss health promotion, illness prevention, health maintenance, health restoration, and rehabilitation in
relation to the nurse’s role in working with various populations. (PO 1, 2, and 8)
7. Identify health promotion strategies throughout the life span. (PO 1, 2, and 4)
Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies
to this assignment.
Total points possible: 100 points
Preparing the assignment
Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
1) Identify a health problem or need for health promotion for a particular stage in the life span of a population
from a specific culture in your area.
2) Choose one of the Leading Health Indicator (LHI) priorities from Healthy People.
https://health.gov/healthypeople/objectives-and-data/leading-health-indicators
3) Research a topic related to health and wellness associated with one of the Healthy People topic areas.
4) Submit your topic to the instructor for approval at least 2 weeks prior to the final assignment due date, but
earlier if desired. All topics must be approved.
5) You will develop an educational health promotion project addressing the population/culture in your area.
6) Use TurnItIn in time to make any edits that might be necessary based on the Similarity Index prior to submitting
your paper to your faculty. Consult with your faculty about the acceptable Similarity Index for this paper.
7) For writing assistance, visit the Writing Center page
https://mychamberlain.sharepoint.com/sites/StudentResourceCenter/WC.
8) Include the following sections (detailed criteria listed below and in the Grading Rubric).
a. Introduction and Conclusion- 15 points/15%
• Introduction establishes the purpose of the paper and describes why topic is important to health promotion
in the target population in your area.
• Introduction stimulates the reader’s interest.
• Conclusion includes the main ideas from the body of the paper.
• Conclusion includes the major support points from the body of the paper.
b. Relate Topic to Target Population- 25 points/25%
• Describes the topic and target cultural population.
• Includes statistics to support significance of the topic.
• Explains how the project relates to the selected Healthy People topic area.
• Applies health promotion concepts.
c. Summary of Articles- 25 points/25%
• A minimum of three (3) scholarly articles, from the last 5 years, are used as sources.
• Articles meet criteria of being from scholarly journals and include health promotion and wellness content.
• At least one article is related to the chosen cultural group.
• Summaries all key points and findings from the articles.
NR222 Health Promotion Project Guidelines V6.docx
®2022 Chamberlain University. All Rights Reserved
1
11
NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Paper Guidelines
•
•
Includes statistics to support significance of the topic.
Discusses how information from the articles is used in the Health Promotion Project, including specific
examples.
d. Health Promotion Discussion – 25 points/25%
• Describes approaches to educate the target population about the topic.
• The approaches are appropriate for the cultural target population.
• Identifies specific ways to promote lifestyle changes within the target population.
• Applies health promotion strategies.
e. APA Style and Organization – 10 points/10%
• TurnItIn is used prior to submitting paper for grading.
• Revisions are made based on TurnItIn originality report.
• References are submitted with assignment.
• Use current APA format and is free of errors.
• Grammar and mechanics are free of errors.
• Paper is 3-4 pages, excluding title and reference pages.
• Information is organized around required components and flows in a logical sequence.
NR222 Health Promotion Project Guidelines V6.docx
®2022 Chamberlain University. All Rights Reserved
2
21
NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Project Guidelines
Grading Rubric
Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment.
Assignment Section and
Required Criteria
(Points possible/% of total points available)
Introduction and Conclusion
(15 points/15%)
Required criteria
1. Introduction establishes the purpose of the paper
and describes why topic is important to health
promotion in the target population in your area.
2. Introduction stimulates the reader’s interest.
3. Conclusion includes the main ideas from the body of
the paper.
4. Conclusion includes the major support points from
the body of the paper.
Relate Topic to Target Population
(25 points/25%)
Required criteria
1. Describes the topic and target cultural population.
2. Includes statistics to support significance of the
topic.
3. Explains how the project relates to the selected
Healthy People topic area.
4. Applies health promotion concepts.
Summary of Articles
(25 points/25%)
Required criteria
1. A minimum of three (3) scholarly articles, from the
last 5 years, are used as sources.
2. Articles meet criteria of being from scholarly
journals and include health promotion and wellness
content.
3. At least one article is related to the chosen cultural
NR222 Health Promotion Project Guidelines V6.docx
Highest Level of
Performance
High Level of
Performance
Satisfactory
Level of
Performance
Unsatisfactory
Level of
Performance
Section not
present in
paper
15 points
13 points
12 points
8 points
0 points
Includes no fewer
than 4 requirements
for section.
Includes no fewer
than 3 requirements
for section.
Includes no fewer
than 2 requirements
for section.
Includes 1 or fewer
requirements for
section.
No requirements
for this section
presented.
25 points
20 points
15 points
10 points
0 points
Includes no fewer
than 4 requirements
for section.
Includes no fewer
than 3 requirements
for section.
Includes no less
than 2 requirements
for section.
Includes 1 or fewer
requirements for
section.
No requirements
for this section
presented.
25 points
23 points
21 points
10 points
0 points
Includes no fewer
than 6 requirements
for section.
Includes no fewer
than 5 requirements
for section.
Includes no fewer
than 4 requirements
for section.
Includes 1-3
requirements for
section.
No requirements
for this section
presented.
®2022 Chamberlain University. All Rights Reserved
31
NR222 Health and Wellness
Required Uniform Assignment: Health Promotion Project Guidelines
group.
4. Summaries all key points and findings from the
articles.
5. Includes statistics to support significance of the
topic.
6. Discusses how information from the articles is used
in the Health Promotion Project, including specific
examples.
Health Promotion Discussion
(25 points/25%)
Required criteria
1. Describes approaches to educate the target
population about the topic.
2. The approaches are appropriate for the cultural
target population.
3. Identifies specific ways to promote lifestyle changes
within the target population.
4. Applies health promotion strategies.
APA Style and Organization
(10 points/10%)
Required criteria
1. TurnItIn is used prior to submitting paper for
grading.
2. Revisions are made based on TurnItIn originality
report.
3. References are submitted with assignment.
4. Uses current APA format and is free of errors.
5. Grammar and mechanics are free of errors.
6. Paper is 3-4 pages, excluding title and reference
pages.
7. Information is organized around required
components and flows in a logical sequence.
25 points
23 points
21 points
10 points
0 points
Includes no fewer
than 4 requirements
for section.
Includes no fewer
than 3 requirements
for section.
Includes no fewer
than 2 requirements
for section.
Includes 1 or fewer
requirement for
section.
No requirements
for this section
presented.
10 points
9 points
8 points
4 points
0 points
Includes no fewer
than 7 requirements
for section.
Includes no fewer
than 6 requirements
for section.
Includes no fewer
than 5 requirements
for section.
Includes 1-4
requirements for
section.
No requirements
for this section
presented.
Total Points Possible = 100 points
NR222 Health Promotion Project Guidelines V6.docx
®2022 Chamberlain University. All Rights Reserved
41
Review the Focused Note Checklist provided in this week’s Learning Resources and consider how you will develop your Focused Note for this week’s Assignment. Use the Focused SOAP Note Template found in the Learning Resources for this week to complete this Assignment. Select a patient with gastrointestinal or genitourinary condition that you examined during the last 3 weeks. With this patient in mind, address the following in a Focused Note. Assignment Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent as well as possible reasons for these discrepancies. Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues. Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority and include their ICD-10 codes for the diagnosis. What was your primary diagnosis and why? Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?
Purpose: The purpose of this assignment is to learn how to identify a problematic health behavior, to develop a behavioral intervention to modify this behavior, and to evaluate its effectiveness. By doing this assignment, you will be doing something to help yourself as well as learning how to develop a behavior change intervention.
Description of the assignment:
You will develop a personal behavior change plan, implement it, and then write a progress report.
You can focus on any health-related issue (including emotional health) that is of interest to you. You may choose to focus on yourself and a health behavior that affects you personally or you may do this assignment on someone else.
You must incorporate at least two behavior change theories in your plan.
The complete assignment must be 7-10 pages long excluding cover page, appendix etc, and be double-spaced, with Times New Roman, 12pt font only. Feel free to write more but remember it is quality that counts, not quantity. Please choose your words carefully and thoughtfully and consider each paper as an opportunity to improve your writing skills.
No large gaps between paragraphs. Each paragraph should be joined to the next paragraph. Begin each paragraph by indenting it 0.3″.
Make sure you number your pages.
Above you will see that I have attached several sample papers from students who took this course before. These sample papers should give you a good sense of how to do this assignment and what you need to do if you are striving for excellence.
Instructions:
Complete any health assessments. There are tons on the web. Discuss what you have learned from doing these assessments.
Based on the information obtained from these assessments as well as your self-awareness project, identify the behavior/s you wish to target for change, reasons for wanting to change or establish these behaviors, motivation level or readiness to change, and factors that you believe are responsible for the behavior that you wish to change.
Write a specific goal for the target behavior. You can have more than one goal but I would not recommend more than two. Knowing how to write a goal is extremely important. Above you will see an attached file called “How to set goals”. It shows how to write a goal based on a person’s stage of readiness to change a behavior
Select an observation procedure that is appropriate for the behavior you have chosen to change. Include forms on which the data will be recorded. Choose a recording strategy that is convenient to use.
Record baseline data for two weeks.
Once this is done, design an intervention. In other words, develop an appropriate behavior change procedure for a two week period. Select an intervention that is tied to a review of the research literature and is tailored to what you hope to accomplish. Identify some possible reinforcers that you might use to modify the behavior of interest. Specify when data will be collected, and when consequences will be delivered. Include one or two alternative strategies for changing the behavior in case the one you initially implement does not work. This section is the most important piece of the assignment as it will reflect your understanding of behavior change theories and your ability to apply them in practice.
Record data for two weeks post-intervention.
Finally, assess the overall effectiveness of the intervention.
Note: You will not be graded on your success at changing your behavior. Rather, you will be graded on how well you design your intervention, track your behavior (as well as your reflections) and present your results in your paper.
Things to remember:
Your final report must contain information on all the steps above.
Make sure you follow the APA format.
Every semester, a couple of students will submit this assignment and it will be obvious they completed the assignment at the last minute and just made up data. In other words, they did not observe their behavior for two weeks, do an intervention, and then observe their behavior for the next two weeks. I will know if you are fudging this assignment. You will be doing yourself a disservice (not me) if you choose to go down this path. This assignment is meant to provide you with an opportunity to change something about yourself and thus improve your quality of life. Please take advantage of this opportunity!
Plagiarism will not be tolerated and will result in a zero grade. Please click on the ACADEMIC RESOURCES button on the left for information and policies about plagiarism.
This report should not just consist of pages of logs, menus, or other lists of daily activities- that belongs in the appendix section of your report.
Every semester, most students choose weight loss (diet or exercise) as their target behavior. I would like to see students expand their horizons and identify other areas of one’s life that could be enhanced and it does not just have to be physical health. Remember, health is not just physical – it is also emotional, social, intellectual, spiritual and environmental. In health education, often we tend to emphasis physical health over the other dimensions of health. This is something I want you to consider when doing this assignment.
To learn more about your personal health status and risk and to help you identify a personal health problem/issue to work on, you can visit any of the websites below:
http://www.realage.com/
http://www.menshealth.org/code/selfcare.html
http://www.health.state.nd.us/ndhd/quiz.htm
Feel free to locate other websites and assessment tools that can help you with this assignment.
Please make sure you read the grading rubric that is attached before you submit your assignment. It is intended to help you identify which areas of your assignment are good and which areas are weak. You can see how well you have completed this assignment before you submit your work. I want you to get into the habit of assessing your own performance before you submit your work rather than waiting for someone else to give you a grade and feedback. When you finally get your grade and feedback, there should be no surprises.
Above you will see that I have attached several sample papers from students who took this course before. These papers are extremely thorough and well written. These sample papers should give you a good sense of how to do this assignment and what you need to do if you are striving for excellence.
Write your report in a Microsoft Word file only (no other types of files or pdfs) and save your file as “(Your last name)ProfessionalPracticeProject”. For example: SmithProfessionalPracticeProject.
Unformatted Attachment Preview
Background
(evidence of having
completed the health
assessments to help
identify a behavior to
change)
Behavior/s you wish
to target for change
and reasons for
wanting to change
Motivation level or
readiness to change
and factors
responsible for the
behavior
Statement of goal/s
Exceeds
expectations
Provided extensive and
detailed evidence of
having completed a
variety of assessments
to help identify a
behavior to change
Did a thorough job
identifying behavior/s
to change and reasons
for wanting to change
Meets expectations
Provided clear
evidence of having
completed a variety of
assessments to help
identify a behavior to
change
Clearly identified
behavior/s to change
and reasons for
wanting to change
Approaching
expectations
Provided evidence of
having completed
some assessments to
help identify a behavior
to change
Did a fair job
identifying behavior/s
to change and reasons
for wanting to change
Described in detail the
motivation level or
readiness to change
and factors responsible
for the behavior
Goal/s were well
formulated. Goals were
very clear, concrete,
measurable and
realistic
A detailed and well
thought out plan is
presented for collecting
pre- and postintervention data
Clearly described the
motivation level or
readiness to change
and factors responsible
for the behavior
Goal/s were clear,
concrete, measurable
and realistic
Baseline data are
provided in a clear,
detailed, and creative
manner
Charts or graphs or
tables are provided
and data are presented
in a clear manner
Intervention (guided
by the principles of
two behavior change
models)
Excellent
understanding and
application of behavior
change models in the
design of the
intervention
Intervention reflects
good understanding
and application of
behavior change
models
Evidence of data for
two weeks (postintervention)
Post-intervention data
are provided in a clear,
detailed, and creative
manner
Charts or graphs or
tables are provided
and data are presented
in a clear manner
Assessment of the
overall effectiveness
of the intervention
and lesson gained
from this experience
Quality of writing
(scholarly, clarity of
writing, punctuation
and grammar,
adherence to APA
format)
Overall quality of
report
A thoughtful and
detailed analysis of the
project and
recommendations for
the future
Extremely well written
and adheres to APA
format
A solid analysis of the
project with
recommendations for
the future
Well written and
adheres to APA format
Fairly well written with
some minor grammar
or spelling mistakes
and/or minor problems
with APA format
Many grammar or
spelling mistakes, not
well written, and/or
several problems with
APA format
Exceeds expectations.
Shows considerable
effort in the design and
execution and nicely
presented
Good effort. Nicely
executed and well
written.
Fair effort overall.
Some strong areas
and some areas that
could be improved
Not well thought or
adequately written and
not up to standard
overall
Observation
procedure and data
collection system
that will be used to
document the target
behavior
Evidence of baseline
data for two weeks
(pre-intervention)
A clear plan is
presented for collecting
pre- and postintervention data
Did an adequate job
describing the
motivation level and
factors responsible for
the behavior
Goal/s were somewhat
clear, concrete,
measurable and
realistic but room for
improvement
A plan is presented for
collecting pre- and
post- intervention data
but it could benefit
from more detail
Does not meet
expectations
Provided inadequate
evidence of having
completed
assessments to help
identify a behavior to
change
Not enough
information on
behavior/s to change
and reasons for
wanting to change
Not enough
information on
motivation level and
factors responsible for
the behavior
Goal/s were not clear,
concrete, measurable
and/or realistic
Charts or graphs or
tables are provided but
are simplistic and data
are presented in a
satisfactory manner
Intervention is
somewhat grounded in
theoretical principles
and reflects fair
understanding of
behavior change
models
Charts or graphs or
tables are provided but
are simplistic and data
are presented in a
satisfactory manner
An analysis of the
project is provided but
lacks detail or depth
A plan is missing for
collecting pre- and
post- intervention data
or it is too brief
Charts or graphs or
tables are absent or
inadequate to describe
data
Inadequate application
of behavior-change
models in the design of
the intervention and
reflects little or no
understanding of
behavior change
models
Charts or graphs or
tables are absent or
inadequate to describe
data
An analysis of the
project is not provided
or is inadequate
Your overall grade for the report will be based on how well you addressed each component in your report. Please note that the
components are not weighted equally.
Analyze the potential effectiveness resulting from professional or nurse-provided social support versus enhancement of social support provided by personal relationship and social networks for parents of children with chronic mental illness.APA style, 500 words, no less than 2 references . No plagiarism
1. Reflects on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Synthesizes theories and concepts from liberal education to build an understanding of the human experience. 3. Uses skills of inquiry and analysis to address practice issues 4. Applies knowledge of social and cultural factors in the care of populations encountered in this course.
1. Reflects on providing holistic patient care to populations encountered in this course. 2. Describes inter-collaborative involvement (i.e. Interprofessional rounds; consultations and interaction with PT/OT; Respiratory Therapy, Pharmacist consultation—describe their role/ contribution.
1. Describe an event that demonstrates: · application of leadership concepts, skills and decision making in the provision of high quality nursing care, · healthcare team coordination · the oversight and accountability for care delivery 2. Describe an event that demonstrates leadership, appropriate teambuilding and collaborative strategies to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team
Current paper.
As this term ends, reflecting on these past weeks has made me notice how our lecture class has been tightly knitted to the off-campus clinical. Learning different systems week by week in lectures has helped me understand while putting them into practice during clinical. One of the concepts we touched on was blood administration. It taught us the importance of safety during this procedure and the need to follow each protocol to the letter. During one of the clinical days, we saw a patient having a blood transfusion, and it showed how what we had learned in the lecture correlated to real-life experience.
A great learning experience at clinical was how different departments collaborated to benefit the patient. An essential aspect of care is medication management, which is possible with the pharmacy department.The nurses rely on them to provide what the patient needs and what will help them get better. During one rotation in the Emergency Department, a patient came in with an acute asthma attack. The nurses and on-call doctors worked together in a symphony to provide the much-needed care the patient required. The nurses knew how to react quickly, and the doctor knew he needed to give the orders immediately to ensure the nurse had it available. It was a great thing to experience as a student.
I had many opportunities to learn from everyone around me, but one that stuck the most was when the nurse I was shadowing asked me to assess a patient and provide medications. Interacting one-on-one with the patient made me see how different it is to only watch the nurse from speaking directly to the patient. The focus is needed, and attention to detail is integral to this career.
Assignment 1- Comprehension questions about the SDH
Instructions:
1. You have to use current literatureevidence to support your ideasresponses.
2. You may need to visit the World Health Organisation website or other reliable resources to
understand the following terms.
3. Words count- At least 350 words and do not exceed 1000 words.
4. You should use your own language. Do not copy and paste from google. You will get zero point for
it.
5. Please list all of your references at the end using any referencing style.
6. This assignment is individual based.
7. You have to submit your assignment through BlackBoard on the due date.
Terms
Comprehension and discussion questions
What does the term ‘determinant’ mean?
What is meant by an ‘economic system’? How are
economic systems linked with health?
Think about the way poverty is linked with health and
therefore how economic systems impact health.
Social norms
If we think of social norms as cultural attitudes, values
and practices…How are cultural (or subculture)
attitudes, values, beliefs and practices in some way a
‘force’ that contributes to people’s health outcomes –
their own or others? Use examples to illustrate your
ideas.
Social policies
What sorts of policies are ‘social policies’? Give
examples of a range of policies that might be called
‘social policy’. How are they related to health?
Distribution of resources
When it comes to health and reducing poverty, what
‘resources’ are going to be important?. Explain why
they are important.
Health inequities are the
What does ‘equity’ mean and how is it different to
unfair and avoidable
equality? Therefore, what is ‘inequity’?
differences in health status How and why are these health inequities ‘unfair’?
seen within and between
How and why are these health inequities ‘avoidable’?
countries
Why do these differences exist within countries?
Why do they exist between countries?
Determinant
Economic systems
Your
ideasresponse
Assignment rubric
Criteria
Excellent
Response 10% Follow all
instructions and
cover all
questions and
details (word
count, plagiarism)
Understanding
of the
following
terms: 60%
• Determinant
• Economic
systems
• Social norms
• Social policies
• Distribution
of resources
• Health
inequities
Abstract
thinking about
own
community
20%
Writing,
grammar and
use of external
resources 10%
Good
Follow most
instructions and
cover most
questions and
details (word
count, plagiarism)
Average
Follow some
instructions and
cover some
questions and
details (include
less than the
suggested words
length)
Show complete
Show complete
Show little
understanding
understanding
understanding
and
and
and
comprehension of comprehension of comprehension of
the terms
the terms with
the terms with
minor issues
minor issues
Ineffective
Total
Follow few
instructions and
cover few
questions and
details (include
less than the
suggested words
length)
Show no
understanding
and
comprehension of
the terms with
major issues
Write clear three
examples of local
social
determinant of
health along with
more than two
strategies to
improve situation
No spelling,
grammar and
conventions
errors.
All resources are
reliable and
support all
arguments.
Write incorrect
example of local
social
determinant of
health along with
no or incorrect
strategy to
improve situation
3-4 spelling,
grammar and
conventions
errors are found.
Few resources are
reliable and
support few
arguments.
Write clear two
examples of local
social
determinant of
health along with
two strategies to
improve situation
Write one
example of local
social
determinant of
health along with
one strategy to
improve situation
1-2 spelling,
grammar and
conventions
errors are found.
Most resources
are reliable and
support most
arguments.
3-4 spelling,
grammar and
conventions
errors are found.
Some resources
are reliable and
support some
arguments.
Attached is a worksheet that needs to be done asap.
Unformatted Attachment Preview
GCH 412
Homework 6 (Case-Control Studies)
Homework 7 (Cohort Studies)
1. Among older adults (those 65 or older), falls are the leading cause of injury and death.
They are also the most common cause of nonfatal injuries and hospital admissions for
trauma. Researchers were interested in the association between hip fractures from falls
and living alone. They recruited women in the Boston metropolitan area between the ages
of 65 and 85 for the study. Specifically, they recruited 236 women who had broken a hip
in a fall in the last 6 months and 414 women who did not have a broken hip. They were
then asked whether they lived alone or not. Of those with a broken hip, 125 lived alone.
Of those without a broken hip, 369 lived with a spouse, other family member or in
assisted living. Complete the 2×2 table and answer the following questions based on this
information.
a. What is the exposure and what is the outcome?
b. What type of study design is this? How do you know?
c. Calculate the odds of exposure in the disease group.
d. Calculate the odds of exposure in the non-disease group.
e. What is the proper measure of association for this study design? Calculate it and interpret
what that specific association means in words.
f. If appropriate, calculate the AR% and interpret what it means. If it is not appropriate,
explain your answer.
2. A study was conducted to assess the association between benzene exposure and
leukemia. The investigators selected 2000 workers who were occupationally exposed to
benzene and 5000 workers who had no occupational benzene exposure and followed
them all for 10 years. No one had leukemia at the beginning of the study. At the end of
the study period, there were 42 cases of leukemia among the benzene exposed workers
and 18 among the non-exposed workers. Complete the 2×2 table, labeling the exposure
and disease boxes with the proper information. Show all your work for the calculations.
a. What type of study design is this? How do you know?
b. Calculate the incidence of disease in the exposed group.
c. Calculate the incidence of disease in the unexposed group.
d. State the appropriate measure of association, calculate it, and interpret this association
in words.
e. If appropriate, calculate the AR% and interpret what it means. If it is not appropriate
to calculate the AR%, explain your answer.
f. If you calculated the AR% answer the following: How many cases of leukemia in this
study could have been prevented by protecting workers against benzene exposure?
How many cases of leukemia in the exposed group were not due to benzene
exposure?
3. Fungal meningitis can develop after a fungus spreads through the bloodstream from
somewhere else in the body, as a result of the fungus being introduced directly into the
central nervous system, or from an infected body site infection next to the central nervous
system. You may also get fungal meningitis after taking medications, including steroids
such as prednisone that weakens the immune system. Fungal meningitis is not
contagious. CDC is coordinating a multistate investigation of meningitis to determine if
those with this form of meningitis received epidural steroid injections (medication
injected into the spine). A total of 500 cases of possible meningitis were reported to the
CDC in the month of September. Of those 500 cases, 227 were fungal meningitis; the
remainder were bacterial or viral meningitis. Of the 227 cases of fungal meningitis, 152
people had received epidural steroid injections. Of those without fungal meningitis, 79
had received epidural steroid injections. Complete the 2×2 table and answer the following
questions based on this information
a. What kind of study design is this and how do you know?
b. What is the proper measure of association for this study design?
c. Calculate the measure of association and interpret what your results mean in words.
d. Can you calculate the AR% from the information provided? If so, calculate it and explain
what it means. If not, explain why it cannot be calculated.
4. Suppose that 2000 pregnant women were identified during their 1st trimester and
completed questionnaires about health behaviors, including alcohol consumption. Among
the 800 women who drank alcohol during pregnancy, 200 delivered low birth weight
(LBW) infants. Among the 1200 who did not drink alcohol during pregnancy, 150
delivered low birth weight babies. Complete the 2×2 table, labeling the exposure and
disease boxes with the proper information. Show all your work for the calculations.
a. What type of study design is this? How do you know?
b. What is the appropriate measure of association?
c. Calculate the proper measure of association. Interpret your results in words.
d. Can you calculate the AR% from the information provided? If so, calculate it and explain
what it means. If not, explain why it cannot be calculated.
Read the What Happened to Alex? Case StudyIn APA format, complete a Case Study Analysis. Please see the below Case Study Rubric for criteria.AttachmentsWhat Happened to Alex_ _ IHI.pdf(244.25 KB)
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In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit. Provide an overview of the article you selected.What population (individual, group, or family) is under consideration?What was the specific intervention that was used? Is this a new intervention or one that was already studied?What were the author’s claims?Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides. Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.
For this assignment, you will work on setting goals for yourself using the SMART method. You will find an explanation of
this method in the module that will guide you in your goal-setting process. You will list a minimum of five professional goals
that you would like to accomplish during the clinical experience in this term. For each goal, you must provide an
explanation of how the goal is representative of each of the SMART characteristics: Specific, Measurable, Attainable,
Realistic, Timely. Be sure to answer the following questions for each goal summary: Can you measure it? Is it attainable? Is
it realistic? What is the time frame you have set for completing that goal?
Format: Each goal summary should be at least 100 words – totaling 500 words for this assignment (added to the speaker
notes). The presentation is original work and logically organized, formatted, and cited in the current APA style, including
citation of references. The presentation should consist of 10-15 slides (excluding the introduction and reference page).
SMART Goals Rubric
Criteria
Ratings
Specific
To set a specific goal you must answer
the 6 Ws:
Who? Who is involved?
What? What would I like to accomplish?
Where? Where is this happening?
When? When do I start/finish?
Which? Identify requirements and
constraints
Why? Why am I doing this? Specific
reasons, purpose or benefits!
Exemplary – 6-8 points
Distinguished – 4-5 points
The goal is personal and identifies The goal is personal and
areas of weakness in clinical
identifies areas of weakness in
practice. The goal is detailed and clinical practice. There is a lack
clearly focused on the specific
of focus and detail on the
skills, behaviors, and/or
specific skills, behaviors,
knowledge outlined in the course and/or knowledge outlined in
objectives.
the course objectives.
Measurable
Goals may have several short-term and
on-going measurements so that you can
see how you are doing in your aim to
achieve your goal.
A non-measurable goal: I want to learn
how to sing.
Exemplary – 6-8 points
Measures have been identified
that will demonstrate learning,
results, and/or progress as
related to the described goal.
Developing – 1-3 points
Novice – 0 points
The goal is personal and
The goal is general and do
identifies areas of weakness not address areas of
in clinical practice. Details on weakness in clinical
the specific skills, behaviors practice. The goal display
and/or knowledge outlined in no specificity, is general a
the course objectives are not vague.
provided.
Distinguished – 4-5 points
Developing – 1-3 points
The method listed for
A method of measuring has
been identified but it does not measurement is rather
directly link to or connect with general and does not directly
link to or connect with the
the described go.
described goal.
Novice – 0 points
Not at all measurable – n
method of measurement
indicated.
A measurable goal: I want to learn 5 arias
by Friday, November 12th
Achievable/Ambitious
Exemplary – 6-8 points
Distinguished – 4-5 points
Developing – 1-3 points
A goal should stretch you slightly so you The goal set forth is realistic,
The goal set forth is realistic; The goal is realistic, however
feel you can do it, and it will need a real motivating, challenging, and can however, the achievability may the time frame does not
commitment
be achievable within the term.
not require much challenge, or support success. There is no
from you. Think about what is achievable There is a clear process described the achievability may be
process that supports
and what you want to do.
achievability.
to support achievability.
incredibly challenging to
achieve within the term. The
process is mentioned but lacks
clarity.
Novice – 0 points
The goal is not at all with
reason and cannot be
achieved.
Relevant
Exemplary – 6-8 points
Distinguished – 4-5 points
Developing – 1-3 points
Realistic goals should have you push you, The goal has a strong connection The goal has some connection The goal has only a slight
but not break you!
to the course objectives, the
connection to the course
to the course objectives, the
student’s history, current
objectives, the student’s
student’s history, current
interests, and/or demonstrated interests and/or demonstrated history, current interests
abilities.
and/or demonstrated
abilities.
abilities.
Novice – 0 points
The goal has no connecti
to the course objectives.
Timely
What is your time frame? Putting an end
to your goal, or target dates to work
towards, gives you a sense of
accomplishment as you move toward
achieving your goal. With a time frame
comes more commitment to
achievement!
Exemplary – 8-9 points
Distinguished – 6-7 points
Developing – 1-5 points
Novice – 0 points
Has no dates and/or is ov
The goal has a definite date of
The goal has an indefinite date The goal has an indefinite
a period far beyond this
what will be accomplished by this of what will be accomplished date of what will be
accomplished by this date but term.
date and is linked to the
by this date and is linked to
does not link to the
measurables. Is within the time the measurables. It is within
measurables.
frame of this term.
the time frame of this term.
Exemplary – 4-5 points
References page contains more
than required current scholarly
academic reference and text
reference.. Follows APA
Use of Citations, Writing Mechanics and
guidelines of components:
APA Formatting Guidelines
double space, 12 pt. font,
abstract, level headings, hanging
indent. Rules of grammar, usage
and punctuation are followed;
spelling is correct.
PowerPoint Slides
Distinguished – 3 points
Developing – 1-2 points
Novice – 0 points
References page contains one References page contains one References page contains
current or outdated scholarly no current scholarly
current scholarly academic
academic resource. Many
academic resources, only
resource and text reference.
internet webpages or no
Follows most APA guidelines errors of APA guidelines:
reference page. Lack of A
of components: double space, double space, 12 pt. font,
abstract, level headings,
guidelines for references
12 pt. font, abstract, level
provided. Paper contains
headings, hanging indent. Few hanging indent. Paper
contains few grammatical,
numerous grammatical,
grammatical errors, but
punctuation, and spelling
sentences could be clearer and punctuation and spelling
errors.
errors.
more precise.
Exemplary – 4-5 points
Distinguished – 3 points
Developing – 1-2 points
Novice – 0 points
PowerPoint presentation
PointPoint presentation
PowerPoint presentation
PowerPoint presentation
contains 10-15 slides. All parts of contains 10-15 slides. All parts contains fewer than 10 slides, contains fewer than 10
the assignment are completed
of the project are completed or some slides are incomplete slides and /or is missing
several parts of the requi
fully and described in the
partially and described in the or not relevant to the
required content of the
content.
PowerPoint presentation in
PowerPoint presentation.
presentation.
detail.
Find a literature that supports that in the US. Write a paper 2 pages long in APA format.
Unformatted Attachment Preview
1
Cultural Diversity Literature Review Paper:
Your Name
Miami Regional University
Cultural Diversity in Health Care
Professor Name and Credentials
Date of:
2
Abstract
Hook
Background Information
Problem Statement
Research Question
Hypothesis
.
Thesis Statement
Literature Review
Gaps In the Literature
Methodology
Purpose
3
Description of Participants
Data Collection
Data Analysis
4
References
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
Choose one of the scenarios in episodes 1 through 7. Create a presentation in which you examine the effectiveness of advanced practice nursing in the scenario.
Introduction (1 slide)
Reflect on the ethics of the workplace (2-3 slides)
What ethics theory was mainly followed: utilitarianism, duty, deontology, egalitarianism, right, and virtues?
What ethical principle (justice, beneficence, non-maleficence, autonomy) influenced the practice?
How did the practiced ethics affect the patient’s outcomes?
How would you handle the scenario ethically? Similarly or differently?
Reflect on the financial management (2-3 slides)
How did the finances affect the healthcare decision in the scenario?
What financial, billing, or reimbursement practices would you support or disagree with, and why?
Reflect on the politics and policies (2-3 slides)
Identify a practice you would want to change and describe how you would propose and lead collaborative/interprofessional effort using one of the leadership models to create the desired change.
References (1 slide)- Include 2–3 scholarly resources in APA Style. Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations published within the last five years.
*PRO TIP*: Be succinct. Your presentation should be 8-10 slides, each lasting at most 2 minutes.
A 65-year-old female patient is seen your office for an annual physical examination. The patient states that she has not seen a healthcare provider for the past 10 years because she has been feeling well. She has no past medical or surgical history. She reports no complaints. The patient is new to your practice. You completed a comprehensive history and physical examination on the patient. The patient states that she does not know her family history because she was adopted and never had a chance to meet or speak to her biological families. The history and physical exam are unremarkable.Discuss the following:Considering the patient age and gender, what preventive health and screenings would you consider for this patient based on the current guidelines. Initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Goals and Objectives PaperCompose a paper to analyze the public health issue you identified during Modules 1 and 2. Provide background information on the issue, specifically detailing the community affected by your proposed program. Take into consideration socioeconomic status, cultural values and practices, and other determinants of health in your discussion. Include a minimum of two goals and two measurable objectives (SMART objectives) for each goal.This 2-3 page paper should follow current APA guidelines. Provide 3 references, with 1 reference not included in the course materials.Learning Objectives:1. Define an issue and a program or project to address that issue.2. Write two goals and two SMART objectives for each goal related to a program or project in public health.
Part 1 NUR 500 Discussion 1 (For this part, I’m going to need an initial response with 250-300 words and 1 reference as well as 2 peer responses with 100 words and 1 reference)
Review some nursing journals that deal primarily with education, research, or administration, such as the Journal of Nursing Education, Nursing Research, or the Journal of Nursing Administration, and discuss the current topics that are emphasized in these journals.
Part 2 NUR 510 Discussion 1 (For this part, I’m going to need an initial response with 250-300 words and 1 reference as well as 2 peer responses with 100 words and 1 reference)
What is the difference between a protocol, standard of care delivery, and policy at the practice, state, and federal level? Briefly outline each. What are the perceptions of the health care delivery system from the perspectives of patients, providers, payers, and policy makers? Discuss at least one perception from one of the populations listed: patient, provider, payer, and policy maker.
Part 3 NUR 510 Assignment (I attached a sample paper for reference)
Review of a Bill Assignment
Select an active bill at the state or federal level that impacts the professional practice of nursing. In a 3-4 page paper (excluding the title and reference pages), summarize the provisions of the bill and clearly explain what the bill will accomplish. The paper should be no more than 4 pages, typed in Times New Roman using 12-point font, and double-spaced with 1″ margins.
Your review of a bill paper should:
Discuss the major provisions of the bill.
Demonstrate an in-depth understanding of the legislation by explaining the background and all relevant facts.
Discuss any relevant history related to the legislation, pertinent votes, and issues that are stalling the legislation, etc.
Use primary sources for this information.
Identify key supporters and those who do not support the bill. Explain why some of these individuals support the bill and why some do not.
Explore the positions of the key stakeholders in the bill, both pros and cons. Do not make assumptions about potential key stakeholders. Examine this area carefully so you are correctly reflecting the stakeholders positions.
Discuss how the bill would impact a nurse’s ability to provide safe and quality care or to practice to the highest scope of the nursing license.
Explain specific actions that nurses can take to assist with the passage or defeat of the legislation
Use Current APA Style, headings and references as appropriate.
Due Sunday, 11:59 p.m. (Pacific time)
Hints from instructor
The first words of the Assignment Instructions for the Review of a Bill assignment are, “Select an active bill…”
Be sure you know the definition of an “active bill.” You cannot complete the assignment if the bill you chose has already been passed (signed into law) or died in Congress. [Did you pick up on that hint??]
A bill that died in Congress is not an “active bill.”
Don’t just make up the APA formatting for the bill you chose. Do a simple DuckDuckGo internet search for “how to cite bill APA” and find examples. Note that the reference should not include the bill’s author.
Rubric
NURS_510_DE – Review of a Bill
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeSummary of a Bill
22.5 to >18.45 pts
Accomplished
Clearly summarizes the bill’s major provisions and what the bill will accomplish.
18.45 to >16.88 pts
Emerging
The bill’s major provisions and what the bill will accomplish are included, but lacks clarity.
16.88 to >0 pts
Unsatisfactory
The bill’s major provisions and what the bill will accomplish are absent or severely lacking in detail
22.5 pts
This criterion is linked to a Learning OutcomeLegislation
30 to >24.6 pts
Accomplished
Demonstrates a clear understanding of the legislation by explaining relevant facts and background information.
24.6 to >22.5 pts
Emerging
Relevant facts and background regarding legislation are included, but lacks clarity.
22.5 to >0 pts
Unsatisfactory
Relevant facts and background regarding legislation are absent or severely lacking in detail.
30 pts
This criterion is linked to a Learning OutcomeHistory
22.5 to >18.45 pts
Accomplished
Relevant history related to the legislation, pertinent votes, and issues related to the legislation is clearly identified.
18.45 to >16.88 pts
Emerging
Relevant history related to the legislation, pertinent votes, and issues related to the legislation is included but lacks clarity.
16.88 to >0 pts
Unsatisfactory
Relevant history related to the legislation, pertinent votes, and issues related to the legislation is absent or severely lacking in detail
22.5 pts
This criterion is linked to a Learning OutcomeKey Supporters & Stakeholders
30 to >24.6 pts
Accomplished
Key supporters and stakeholders are identified. Position of stakeholders and key supporters is clearly and accurately explained.
24.6 to >22.5 pts
Emerging
Key supporters and stakeholders are identified, and positions are explained. Explanations lack clarity.
22.5 to >0 pts
Unsatisfactory
Key supporters and stakeholders are either absent or incorrectly identified. Positions are absent or incorrectly explained.
30 pts
This criterion is linked to a Learning OutcomeQuality Care Discussion
30 to >24.6 pts
Accomplished
Informative discussion on how the bill might impact a nurse’s ability to provide care is included. Nursing specific actions that can be taken to assist with the passage or defeat of the legislation are clearly explained.
24.6 to >22.5 pts
Emerging
Basic discussion on how the bill might impact a nurse’s ability to provide care is included, but lacks details and or clarity. Nursing specific actions that can be taken to assist with the passage or defeat of the legislation are explained but lack clarity.
22.5 to >0 pts
Unsatisfactory
Basic discussion on how the bill might impact a nurse’s ability to provide care is absent or severely lacking in clarity. Nursing specific actions that can be taken to assist with the passage or defeat of the legislation are absent or incorrectly explained.
30 pts
This criterion is linked to a Learning OutcomeOrganization, Writing & APA
15 to >12.3 pts
Accomplished
APA format is followed. Written in a clear, concise, formal, and organized manner. Information from sources is paraphrased appropriately and accurately cited.
12.3 to >11.25 pts
Emerging
APA format is mostly followed. Writing is generally clear and organized but is not concise or formal in language. Multiple errors exist in spelling and grammar with minor interference with readability or comprehension. Most information from sources is paraphrased and cited correctly.
11.25 to >0 pts
Unsatisfactory
APA format may not be followed. Writing is generally unclear and unorganized. Errors in spelling and grammar detract from readability and comprehension. Sources are missing or improperly cited.
Case Study 1: The Patient Right to Know Drug Prices Act of 2018
Introduction
The Patient Right to Know Drug Prices Act and its partner bill, The Know the Lowest Price Act, were enacted in
2018 to stop health insurance plans and pharmacy benefits managers from restricting pharmacists from telling
patients they could pay less for a prescription if they paid the full price out of pocket instead of using their
insurance and paying a co-pay or other cost-sharing fee. For example, a pharmacist would no longer face
penalties from letting a patient know that the cost of Lipitor would only be $10 out of pocket, as opposed to $60
under insurance, toward deductible.
Instructions
1. Review the original legislation:
Patient Right to Know Drug Prices Act, 42 U.S.C. § 300 (2018).
https://www.congress.gov/115/bills/s2554/BILLS-115s2554enr.pdf
2. Watch the Congressional debate:
United States Senate Session, 115th Congress (2018). https://www.c-span.org/video/?451454-1/ussenate-debates-opioid-legislation
3. Produce a written report examining the factors and stakeholders that led to the policymaking process,
from agenda setting through legislative development.
Required Elements
1. Discuss the history of the legislation, from the agenda setting to development of the legislation.
2. Identify interest groups who were involved in getting this legislation passed and their positions on the
legislation. Also identify the interest groups who were not supportive of this legislation and their
positions on this Act.
3. Present your point of view, identify key legislators supporting this, and discuss why they supported/did
not support this legislation.
4. Identify and incorporate references from opinion pieces, news articles, and/or peer reviewed journal
articles both supporting and not supporting this legislation.
5. Discuss any budgetary implications that may result from this legislation for all relevant stakeholders.
Determine which, if any, health programs will be financially affected (positively or negatively) by this
legislation.
Specifications
Format:
12-point font, double spaced, 1-inch margins use APA format for scholarly papers including
page numbers
Page Limit: 5-7 pages
References: Utilize APA 7th Edition for in-text citation and reference list formatting
Additional Resources
1. Know the Lowest Price Act of 2018, 42 U.S.C. § 1305 (2018).
https://www.congress.gov/115/plaws/publ262/PLAW-115publ262.pdf
EEH536 Health Policy Fall 2023
Case Study 1: The Patient Right to Know Drug Prices Act of 2018
2. Caffrey, M. (11 May 2018). Trump offers blueprint to drive down prescription drug prices; target
rebates, middlemen. American Journal of Managed Care. Online publication.
https://www.ajmc.com/view/-trump-offers-blueprint-to-drive-down-prescription-drug-prices-targetsrebates-middlemen
3. National Community Pharmacists Association (NCPA). Homepage. https://ncpa.org/
For this assignment, you will be developing and presenting an Educational, Narrative PowerPoint. In the presentation of your chosen topic, be sure to examine the pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan (MN551-3).
Narrative, PowerPoint Assignment Requirements
Make sure all of the content topics of the assignment have been addressed.
Cite at least three references in your PowerPoint; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Design and develop a 8- to 12-slide PowerPoint presentation using voice/narrative feature on each slide (the title and reference slides do not count in the slide count, but must be included in the assignment), that will be used to educate the community about one of the following topics:
Type II Diabetes
Atherosclerosis
Hypertension
Depression
Urinary Tract Infection
Narrative, PowerPoint Contents to include, but not be limited to:
Risk factors and causes
Possible consequences
Prevention Strategies
Treatment Modalities
PowerPoint Format:
Follow APA 7th edition format for PowerPoint presentations.
Use the slide notes section in the presentation to include information that follows your narration, being sure to follow the conventions of Standard English.
Slide content should include brief points that identify the areas that will be addressed in the narration.
In-text citations should be included with any brief points that were researched from outside sources, and the narration should fully explain the points.
Reference all sources on a separate reference slide at the end of the presentation and cite each source in the body of the presentation using 7th edition APA format.
Identify the sources of any pictures you use, being sure to cite them correctly in 7th edition APA style, using in-text citations.
Then you would like to select Spillett Leadership Academy
Under “My Training” you are going to want to select “ you are going to select “Open Curriculum”
I need you to complete all the trainings and assessments starting with “Orientation to the Boys& Girls Club Movement” and ending with “Emotional Safety
I have also attached a YouTube link on how to access the Trainings if you need visual directions
Rural Hospitals Can’t Find the Nurses They Need to Fight COVID | The Pew Charitable Trusts (pewtrusts.org)After reviewing the article:Suggest a reason as to why you think medical staff are reluctant to seek jobs in the rural areas.Suppose you are the Nursing Director of a rural hospital that is facing a significant shortage of nursing staff. Given the information provided in the article and you own knowledge, describe, in detail, one potential solution that you could develop to alleviate the current and future staff shortage. Make sure to include in the discussion why you think that your solution is a viable option
Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.Summarize the facts in the selected case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.Identify who is involved or affected by the ethical problem or issue.Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.Apply the three components outlined in the Ethical Decision-Making Model media.Analyze the factors that contributed to the ethical problem or issue identified in the case study.Describe the factors that contributed to the problem or issue and explain how they contributed.Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
Unformatted Attachment Preview
Assessment 03 – Applying Ethical Principles
For this assessment, you will develop a solution to a specific ethical dilemma faced by a health
Care professional. Before you complete the instructions detailed in the course room, first select
One of the ethical dilemmas below to be the focus of your assessment.
After you have selected one of the ethical dilemmas from below, return to the detailed
Instructions in the course room to complete your assessment.
Case Study: End-of-Life Decision Making
Eleanor Thompson, a 72-year-old woman, has been battling an aggressive form of ovarian
Cancer for the past three years. Despite undergoing multiple rounds of chemotherapy and
Radiation, her condition has deteriorated, and she is now experiencing severe pain and
Suffering. Eleanor’s oncologist, Dr. Samuel Martinez, has presented the family with the option of
Another experimental treatment, but he has also suggested considering transitioning to palliative
Care.
Eleanor’s family is deeply divided on the decision. Her eldest daughter, Maria, believes that
Every possible treatment should be pursued, holding onto hope for a miracle. She argues that
Her mother has always been a fighter and would want to continue the battle against her illness.
On the other hand, Eleanor’s son, Michael, feels that his mother has suffered enough. He
Believes that transitioning to palliative care would allow her to spend her remaining days in
Comfort and peace. Caught in the middle is Eleanor’s husband of 50 years, Robert. He is torn
Between wanting to honor his wife’s fighting spirit, desiring to ease her pain, and the painful
Finality of either decision.
The healthcare team must navigate a complex ethical landscape. Beneficence, the principle of
Doing good, pushes the team to consider what would truly benefit Eleanor in terms of quality of
Life. Non-maleficence, or “do no harm,” raises questions about the potential suffering Eleanor
Might endure with further aggressive treatments. Lastly, the principle of justice requires the
Team to treat Eleanor fairly and equitably, ensuring her needs are met regardless of family
Disagreements.
Case Study: Informed Consent and Cultural Competence
Dr. Emily Clark, a seasoned cardiologist at Mercy General Hospital, is presented with a
Challenging case involving Mr. Rajan Patel, a 58-year-old man who recently immigrated from
India. Mr. Patel has been diagnosed with a significant heart condition that requires a surgical
Procedure. While the surgery has a high success rate, like all medical procedures, it comes with
Its own set of risks and benefits.
Mr. Patel, whose primary language is Gujarati, has limited proficiency in English. He nods and
Smiles politely during consultations, giving Dr. Clark the impression that he understands.
However, when asked to explain the procedure back to her, it becomes evident that he does not
Fully grasp the intricacies of the surgery or its potential complications.
Dr. Clark recognizes the importance of informed consent and wants to ensure that Mr. Patel
Truly understands the procedure, its risks, and its benefits. She believes in the ethical principle
Of autonomy, which dictates that every patient has the right to make decisions about their own
Body and health. However, she also acknowledges the principle of beneficence, which compels
Her to act in the best interest of her patient.
BIO/291 v3
Hematology Lab Reporting Worksheet
In science, reporting what has been done in a laboratory setting is incredibly important for
communicating, replicating, and validating findings. However, writing scientific reports can be a little
overwhelming. There are a set of agreed upon components that the scientific community requires when
reporting scientific experimentation. Answer the following questions to describe what occurred during the
lab you conducted in Labster. Be sure to use complete sentences and descriptions that fully represent
what you experienced. Writing a lab report is less about being correct or incorrect, than it is accurately
reporting what happened and why. So, do not worry about reporting data that might seem counterintuitive
or unexpected. Focus on clearly communicating what you did and what you observed.
TITLE:
What was the title of the lab you completed?
Click or tap here to enter text.
PROBLEM:
What was the problem you were trying to resolve in the Lab?
Click or tap here to enter text.
HYPOTHESIS:
What information from the textbook and classroom is relevant for the problem you were trying to resolve
in the lab? Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
During the lab, what information from the THEORY section provided additional background information
about the problem? (To review the theory section, launch the Lab and click the “Theory” tab on the top of
the data pad). Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
Most scientific experimentation involves examining variables and their relationships. A variable is a
construct that can be changed and studied. Examples of variables are a condition or measurable quantity.
What are the variables you examined in the lab? Which one were you controlling and changing? Which
one were you observing was impacted by your change?
Click or tap here to enter text.
Developing a hypothesis requires understanding relevant background knowledge. Now that you have
described relevant background information, it is time to develop a hypothesis. A hypothesis is a simple
statement (not a question), grounded in previous research, that predicts the relationship between the
Copyright 2021 by University of Phoenix. All rights reserved.
Hematology Lab Reporting Worksheet
BIO/291 v3
Page 2 of 3
variables being studied. Please make a statement that predicts the relationship between the variables
being studied.
Click or tap here to enter text.
METHOD:
Describing what you did during a lab supports other scientists in replicating your work. It is through this
consistent replication that scientists are able to see repeating patterns and develop ideas that help move
science forward. When you discuss your data, in a later section, you will have to describe what choices
you made, why you made them, and any concerns about things that occurred that were unexpected. In
order to have enough information to do this, you need to keep very detailed notes. What doesn’t seem
important in the moment may end up being something that explains your findings later. A benefit of
conducting virtual labs when learning science, is that many potential errors are controlled for you. The
virtual lab environment often will alert you if something is not going the way it should. This does not occur
non-virtual settings. The virtual lab setting can be very helpful to learners for this reason. However, we still
have to practice documenting so that those skills are practiced for the lab experiences when technology
will not be there as a coach.
You have already, identify the variables that you studied in the lab in the previous section. Now, take
some time to fully define and describe what each variable is and how it was changed throughout the lab.
Click or tap here to enter text.
In 3-5 sentences summarize what you did during the lab not including your process of logging into the
system. This section would be much more robust for a non-virtual lab. For this virtual lab, a short, highlevel summary will suffice.
Click or tap here to enter text.
Describe some of the observations you made. What numbers did you write down or keep track of? What
did each of your senses observe during the lab process? What did you see (ex: changes in colors,
movement, shapes, sizes, patterns)? What did you hear (ex: sounds from reactions, collisions, error
messages)? What did you lab character touch? Did you notice anything that seemed unexpected? Did
you notice anything that you did expect to observe?
Click or tap here to enter text.
Which parts of the lab required you to think more than others and required more time? Which parts were
simple and completed easily?
Click or tap here to enter text.
DATA & RESULTS:
Many lessons learned as a result of scientific experiment come from the reporting and analysis of data.
This part of scientific reporting requires detailed descriptions of technical information and quantities as
well as high-level synthesis of information. High-level synthesis requires a mastery of foundational
content in the related scientific field and a complimentary mastery in some field of quantitative and/or
qualitative analysis. For this report, let’s focus on big picture patterns.
Copyright 2021 by University of Phoenix. All rights reserved.
Hematology Lab Reporting Worksheet
BIO/291 v3
Page 3 of 3
What relationships did you notice between the variables you examined? When you changed the
variable(s), how did the other(s) change?
Click or tap here to enter text.
Did you notice any patterns in your data? Any patterns between the variables?
Click or tap here to enter text.
DISCUSSION:
The discussion section is used to explain why things might have happened the way that they did in your
experiment. Here, scientists describe any potential anomalies or mistakes and why they think they may
have occurred.
During your lab, what happened that might have impacted the accuracy of your data? Did the simulation
alert you that an error was occurring? If so, how did you resolve it?
Click or tap here to enter text.
CONCLUSION:
The conclusion section of a lab report describes how the learnings from the lab experimentation fit in to
prior scientific knowledge. This is done by comparing new information to previously known information
that was identified in the section of your report that discusses background information.
Review the hypothesis section of your report from above and describe how the results of your lab
compare to the background information that you discussed before.
Click or tap here to enter text.
Once scientists have identified how the new knowledge fits into the old knowledge, they discuss the
implications of the new information for moving forward. In this class, the purpose of study is to learn some
foundational science ideas represented by the course student learning outcomes. Review the course
student learning outcome aligned to this lab in the assignment directions in Blackboard. How is the
information from this lab related to the course student learning outcome? What knowledge has the lab
supported you with learning that is related to this course student learning outcome?
Click or tap here to enter text.
Following scientific experimentation, scientists usually come up with new questions that result from what
they learned. These new questions often end up leading to new experiments in the future. What
additional scientific things do you wonder about after completing and writing about your lab experience?
Click or tap here to enter text.
Copyright 2021 by University of Phoenix. All rights reserved.
BIO/290 v3
Lab Reporting Worksheet – The Sensory
Transduction Lab
In science, reporting what has been done in a laboratory setting is incredibly important for
communicating, replicating, and validating findings. However, writing scientific reports can be a little
overwhelming. There are a set of agreed upon components that the scientific community requires when
reporting scientific experimentation. Answer the following questions to describe what occurred during the
lab you conducted in Labster. Be sure to use complete sentences and descriptions that fully represent
what you experienced. Writing a lab report is less about being correct or incorrect, than it is accurately
reporting what happened and why. So, do not worry about reporting data that might seem counterintuitive
or unexpected. Focus on clearly communicating what you did and what you observed.
TITLE:
What was the title of the lab you completed?
Click or tap here to enter text.
PROBLEM:
What was the problem you were trying to resolve in the Lab?
Click or tap here to enter text.
HYPOTHESIS:
What information from the textbook and classroom is relevant for the problem you were trying to resolve
in the lab? Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
During the lab, what information from the THEORY section provided additional background information
about the problem? (To review the theory section, launch the Lab and click the “Theory” tab on the top of
the data pad). Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
Most scientific experimentation involves examining variables and their relationships. A variable is a
construct that can be changed and studied. Examples of variables are a condition or measurable quantity.
What are the variables you examined in the lab? Which one were you controlling and changing? Which
one were you observing was impacted by your change?
Click or tap here to enter text.
Developing a hypothesis requires understanding relevant background knowledge. Now that you have
described relevant background information, it is time to develop a hypothesis. A hypothesis is a simple
statement (not a question), grounded in previous research, that predicts the relationship between the
variables being studied. Please make a statement that predicts the relationship between the variables
being studied.
Click or tap here to enter text.
Copyright 2021 by University of Phoenix. All rights reserved.
The Sensory Transduction Lab
BIO/290 v3
Page 2 of 3
METHOD:
Describing what you did during a lab supports other scientists in replicating your work. It is through this
consistent replication that scientists are able to see repeating patterns and develop ideas that help move
science forward. When you discuss your data, in a later section, you will have to describe what choices
you made, why you made them, and any concerns about things that occurred that were unexpected. In
order to have enough information to do this, you need to keep very detailed notes. What doesn’t seem
important in the moment may end up being something that explains your findings later. A benefit of
conducting virtual labs when learning science, is that many potential errors are controlled for you. The
virtual lab environment often will alert you if something is not going the way it should. This does not occur
non-virtual settings. The virtual lab setting can be very helpful to learners for this reason. However, we still
have to practice documenting so that those skills are practiced for the lab experiences when technology
will not be there as a coach.
You have already, identify the variables that you studied in the lab in the previous section. Now, take
some time to fully define and describe what each variable is and how it was changed throughout the lab.
Click or tap here to enter text.
In 3-5 sentences summarize what you did during the lab not including your process of logging into the
system. This section would be much more robust for a non-virtual lab. For this virtual lab, a short, highlevel summary will suffice.
Click or tap here to enter text.
Describe some of the observations you made. What numbers did you write down or keep track of? What
did each of your senses observe during the lab process? What did you see (ex: changes in colors,
movement, shapes, sizes, patterns)? What did you hear (ex: sounds from reactions, collisions, error
messages)? What did you lab character touch? Did you notice anything that seemed unexpected? Did
you notice anything that you did expect to observe?
Click or tap here to enter text.
Which parts of the lab required you to think more than others and required more time? Which parts were
simple and completed easily?
Click or tap here to enter text.
DATA & RESULTS:
Many lessons learned as a result of scientific experiment come from the reporting and analysis of data.
This part of scientific reporting requires detailed descriptions of technical information and quantities as
well as high-level synthesis of information. High-level synthesis requires a mastery of foundational
content in the related scientific field and a complimentary mastery in some field of quantitative and/or
qualitative analysis. For this report, let’s focus on big picture patterns.
What relationships did you notice between the variables you examined? When you changed the
variable(s), how did the other(s) change?
Click or tap here to enter text.
Did you notice any patterns in your data? Any patterns between the variables?
Click or tap here to enter text.
DISCUSSION:
The discussion section is used to explain why things might have happened the way that they did in your
experiment. Here, scientists describe any potential anomalies or mistakes and why they think they may
have occurred.
Copyright 2021 by University of Phoenix. All rights reserved.
The Sensory Transduction Lab
BIO/290 v3
Page 3 of 3
During your lab, what happened that might have impacted the accuracy of your data? Did the simulation
alert you that an error was occurring? If so, how did you resolve it?
Click or tap here to enter text.
CONCLUSION:
The conclusion section of a lab report describes how the learnings from the lab experimentation fit in to
prior scientific knowledge. This is done by comparing new information to previously known information
that was identified in the section of your report that discusses background information.
Review the hypothesis section of your report from above and describe how the results of your lab
compare to the background information that you discussed before.
Click or tap here to enter text.
Once scientists have identified how the new knowledge fits into the old knowledge, they discuss the
implications of the new information for moving forward. In this class, the purpose of study is to learn some
foundational science ideas represented by the course student learning outcomes. Review the course
student learning outcome aligned to this lab in the assignment directions in Blackboard. How is the
information from this lab related to the course student learning outcome? What knowledge has the lab
supported you with learning that is related to this course student learning outcome?
Click or tap here to enter text.
Following scientific experimentation, scientists usually come up with new questions that result from what
they learned. These new questions often end up leading to new experiments in the future. What
additional scientific things do you wonder about after completing and writing about your lab experience?
Click or tap here to enter text.
Copyright 2021 by University of Phoenix. All rights reserved.
Translating knowledge into practice establishes evidence-based practice (EBP) within the nursing profession. Nurse practitioners participate in the dissemination of research evidence to support the creation of practice interventions. The purpose of this assignment is to prepare students to disseminate evidence to support practice. Students will synthesize the information they have gathered during the course to formulate a presentation advocating for a practice change in relation to an area of interest to NP practice.
students will create a PowerPoint slide show with notes pages discussing their PICOT question, literature review, and recommendations for change. In Week 8, students will create a Kaltura recording of the presentation for the Peer Discussion thread.
CRITERIA FOR CONTENT
Students will synthesize the information they have gathered during the course to formulate a presentation advocating for a practice change in relation to an area of interest to NP practice.
In a PowerPoint Presentation, address the following.
Title Slide
Introduction (1 slide): Slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered.
Practice Issue (1-3 slides): Describe the area of interest and practice issue/problem related to NP practice selected in week 2. Explain why the issue/concern is important to nurse practitioner practice and its impact on health outcomes. Provide speaker notes. Provide scholarly references to support your ideas.
PICOT Question (1 slide): Provide the PICOT question developed in week 2. Describe each element of your PICOT question in one or two sentences, being sure to address all the following:
P-Population and problem – What is the nursing practice concern or problem and whom does it affect?
I–Intervention – What evidence-based solution for the problem would you like to apply?
C–Comparison – What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.
O–Outcome – Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome.
T–Time frame – What is the Timeframe involved for the EBP initiative or the target date of completion?
Literature review (2-4 slides):Summarize the literature review completed in week 5. Discuss themes and special concerns. Discuss any unique insight or perspective offered from the literature. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented.
Recommendations (3 slides):
Slide 1: Identify the evidence-based recommendation for the identified practice change. Speaker’s notes should fully explain the recommended change and rationale for the change. Provide support from scholarly references to support the recommendation.
Slide 2: Identify the key stakeholders impacted by the recommended change. Speaker’s notes add detail.
Slide 3: Analyze the recommendation in terms of fit, feasibility, and appropriateness as discussed by Dang and Dearholt (2018), Ch. 8. Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
Conclusion: (1 slide)Slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.
References: Reference elements provided in APA format, may use bullets. Hanging indents not required.
PREPARING THE PRESENTATION
Submission Requirements
Application: Use Microsoft Power Point to create the presentation. Submit as a .ppt or .pptx file.
Length: The PowerPoint presentation should be between 9-13 total slides (excluding title and reference slides).
Speaker notes should be used and include in-text citations when applicable. Use the Notes Page view feature in PowerPoint to include speaker notes.
ASSIGNMENT CONTENT
Category Points % Description
Introduction(1 slide) 10 5% Introduction includes concepts to be addressed. Identify sections of the PowerPoint presentation. Speaker notes include details of what will be covered in the presentation.
Nursing Practice Issue/Problem 20 10% Describes one specific issue or concern within the selected area of advanced practice nursing. Explanation of the impact of this issue or concern on health outcomes. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern.*The nursing practice issue/problem description may be reused from the Week 2 worksheet
PICOT question 20 10% Includes the PICOT question in the standard PICOT question format with each letter separately, such as:
P =
I =
C =
O =
T =
PICOT question =
Speaker notes accurately and clearly describe each of the PICOT elements.*The PICOT question and explanation may be reused from the Week 2 worksheet
Literature Review 50 25% Summarize the literature review completed in week 5. Discuss themes and special concerns. Discuss any unique insight or perspective offered from the literature. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented.
Recommendations Slide 1: Identify EBP change 20 10% Slide 1: Identify the evidence-based recommendation for the identified practice change. Speaker’s notes should fully explain the recommended change and rationale for the change. Provide support from scholarly references to support the recommendation.
Recommendations Slide 2: Identify key stakeholders 20 10% Slide 2: Identify the key stakeholders impacted by the recommended change. Speaker’s notes add detail.
Recommendations Slide 3: Analyze fit, feasibility, and appropriateness 20 10% Slide 3: Analyze the recommendation in terms of fit, feasibility, and appropriateness as discussed by Dang and Dearholt (2018), ch. 8. Speaker’s notes add detail.*Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
Conclusion(1 slide) 10 5% Summarize key information presented in PowerPoint presentation. Provide speaker notes.
170 85% Total CONTENT Points= 170 pts
ASSIGNMENT FORMAT
Category Points % Description
APA Format 10 5% Ideas and information that come from scholarly sources must be cited and referenced correctly. In-text and parenthetical citations must be used and may be provided on the slide or within the speaker notes. Slides, speaker notes, and reference elements are consistent with current APA format. May use bullets on the reference slide. Hanging indents not required.
Presentation of Slides 10 5% PowerPoint presentation includes title slide, 9-13 content slides, and reference slide(s). Presentation of slides is professional in appearance and tone. Balance among space, words and graphics, and color is effective.
Writing Mechanics 10 5% Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal written work as found in the current APA manual.
30 15% Total FORMAT Points = 30 pts
ASSIGNMENT TOTAL = 200 points
After viewing Loretta’s story, I would like for you to explore what you think might be the greatest challenges of raising a child or teenager with an intellectual disability.Let’s Talk About Intellectual Disabilities: Loretta Claiborne at TEDxMidAtlanticLinks to an external site.Each week I will be posting a mini podcast/video/ mini lecture. You are required to view the weekly videos that I post and submit a 250 word reflection. You are to reflect on any specific questions that I may ask as well as the content of the video itself. It is important that you integrate evidence and information from the textbook and readings to support the ideas in your reflection. Reflections are due every Sunday evening by 11:59 p.m. Late submissions will be deducted by half. You will be graded based on the quality of your reflection, including appropriate content, proper grammar and spelling and thoughtful consideration of the ideas and concepts.
InstructionsConduct a mini review of the literature on the effects of poverty on child welfare. Locate, summarize and synthesize at least four articles (at least 2 should be scholarly articles/peer reviewed while others can be varied) in an essay that addresses the role of social inequality, poverty, and racism in the entrée into the child protection system. Include details on the prevalence of poverty and child outcomes for various American minority groups and conclude with ways to improve outcomes for children of color in the child welfare system. Using APA format, cite your sources and integrate material from the text where appropriate.This paper should be at least 2-4 pages in length and submitted as a Microsoft Word document with double spacing, Times New Roman or Calibri font, 12-point font size, and one-inch margins.
You will be placed randomly in pairs. You will communicate with the other student and find and research a medical malpractice case. Collaboratively you will choose sides in the case. One student will argue for the patient (Plaintiff ) and the other student will argue for the provider/physician/hospital (Defendant).
Please argue for the provider/physician/hospital.link above
Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
Reflect on which type of dissemination strategy you might use to communicate EBP.
Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.
Discussion_Rubric
Criteria
Main Posting
Ans.
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. … Supported by at least three current, credible sources. … Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Please respond to discussion below using current APA edition and 2 scholarly references. Must be atleast 150 words. The Affordable Care Act (ACA) aims to make preventive services accessible and affordable for all Americans by requiring that insurance plans cover some suggested preventive services without requiring copayments. Before the ACA, one in three women who attempted to enroll in health insurance plans on the individual market were denied insurance, charged higher premiums than men, or had female-specific conditions (for example, pregnancy) excluded from their coverage (Lee et al., 2020). Various health insurance plans must include preventive services believed to improve the patient’s health. Providing preventative services through network providers is not subject to insurance companies’ deductibles, copayments, or coinsurance charges.The Affordable Care Act requires various private health insurance providers to cover women’s preventative healthcare without co-paying. Some of the prevention essential health benefits for women that need to be covered under the Affordable Care Act include screening for cervical cancer. The age group 21-65 is considered to be high-risk. Women aged 21 and 29 should be screened using a Pap test every three years. Breast cancer screening for average-risk women should be covered under the Affordable Care Act, as it is recommended that they start screening at age 40 and not later than 50. Obesity prevention in midlife women should also be covered under the ACA to ensure that women at risk of obesity can maintain or lose weight to prevent obesity (Lee et al., 2020). Contraception should be covered under the ACA to ensure that adult women have easy access to contraceptive services to avoid unintended pregnancies and enhance birth outcomes.During early adulthood, individuals experience numerous changes related to psychosocial development. Women during early adulthood often experience psychosocial effects such as a burst of new energy. During early adulthood, women often focus on attaining new skills, developing new interests, and spending most of their time creating friends or enjoying the company of friends and family members. Due to their need for independence, their ability to alternate care with success, and conflicts over competitive achievement, women may also face many challenges during early adulthood. Women often address the challenges they experience during early adulthood by understanding their needs and experiences according to their relationships.A patient in early adulthood would benefit from cognitive behavioral therapy as part of their clinical education and intervention. Cognitive Behavioral Therapy (CBT) aims to assist individuals with addressing various behavioral challenges. CBT sessions enable individuals to learn strategies that they can use to recognize, explore, and modify connections existing between negative thinking and depressed mood (Betchen et al., 2020). Young adults from low-income neighborhoods with depression and anxiety may benefit more from CBT approaches incorporating resilience-focused elements and addressing challenges associated with depression and anxiety. Interventions that do not address environmental aspects are less effective.A primary prevention program involves health education on women’s health, including nutrition, information about women’s bodies and illnesses, and sex education. Screening for breast cancer is a secondary prevention strategy for women. Breast cancer screening helps patients detect cancer during the initial stages when it is most curable (Betchen et al., 2020). A tertiary prevention involves treating cardiovascular disease with medications or other methods, such as enhancing blood flow, which helps to strengthen blood flow. Treatment helps patients decrease the risk of the illness getting worse or recurring and prevents complications like stroke, heart failure, or death.
Locate and read three research articles on the topic of systems for managing quality improvement across healthcare organizations (e.g., Six Sigma, Lean manufacturing, Malcolm Baldridge National Quality Award [MBNQA], Benchmarking, ISO 9000). Two articles must be quantitative studies, and the third article must be a qualitative study.Create a concept map that compares and contrasts the characteristics of the quality improvement systems represented in each article. Your concept map may include graphics such as diagrams, tables, or charts and must provide an evaluation of the effectiveness of the systems.Your concept map should meet the following requirements:Clear and concise visual representation of the key strengths and weaknesses of each quality improvement system with cited support from the selected articles.Graphic representation of similarities and differences between each system.Evaluation of situations in which each system can and should be effectively applied.Full APA citations for articles under review. Tools you may wish to consider using to create your concept map include:MindMapleLinks to an external site.,Bubbl.usLinks to an external site., orEdrawSoftLinks to an external site..Requirements:Review the grading rubric to make sure submission/assignment is aligned.
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1
Title of Paper
Student Name
University
Course Code: Course Name
Instructor
Due Date
2
Title of Paper
Academic essays should begin with an introduction, but do not begin your paper with an
“Introduction” heading. The introduction will provide readers with the context necessary for
understanding your argument and the body of your paper. When composing the introduction,
think about what context or background information the reader would benefit from knowing.
Once your context is established, transition from that context into your thesis statement. The
thesis statement generally comes at the end of your introduction and usually consists of a few
sentences that sum up the argument for your paper overall. Thesis statements should also provide
a roadmap for the reader so that they can navigate through the ideas present in the rest of your
paper.
Level 1 Header
Headers are useful for organizing your paper. Level 1 headers are used with broad or
general topics in your paper. Depending on the topic, length, and genre of your assignment, you
might use only Level 1 headers. Level 1 headers should be bolded and centered. The longer and
more complex your argument is, the more you might benefit from using Level 2 and Level 3
headers. Level 2 headers should be bolded and aligned with the left margin. Level 3 headers
should be bolded, italicized, and aligned with the left margin. Level 4 and Level 5 headers exist,
but they should only be used in manuscripts with many topics and subtopics. If you choose to use
headers in your paper, you should have at least two sections for each level of header. For more
information on how to use headings in your paper, see the APA Style website.
Level 2 Header
Body paragraphs should follow the MEAL structure. This structure will help your ideas
build on one another in order to support your thesis statement and to develop your argument over
the course of your essay. Each body paragraph should consist of a claim, which also functions as
3
the topic sentence or the main idea of a paragraph. The claim should then be followed by
evidence. Evidence is typically source material that you either paraphrase or quote directly.
Remember, APA style guidelines prefer paraphrasing to directly quoting a source. Evidence
should provide support for your main idea in the form of examples, statistics, facts, anecdotes,
etc. Next, your paragraph should include analysis. Analysis is your explanation of the preceding
evidence and its significance. In other words, you should not let the evidence speak for itself.
Through analysis, you can show the reader exactly how you interpret the evidence, how it
supports your claim for the paragraph, and how it supports your thesis statement. Finally, each
body paragraph should end with a sentence that functions as a conclusion for the paragraph. This
sentence can rephrase the claim for the paragraph, tie back to the thesis statement, or transition to
the idea you present in the next paragraph.
Level 2 Header
Whenever you use a source, it must be cited both in text and in the references. However,
there is one exception: Personal communications that do not produce recoverable data and
cannot be located by the reader should only be cited in text and do not need to be included on the
References page. Examples of personal communications include emails, text messages, direct
messages, personal interviews, telephone conversations, letters, etc. Both your in-text citations
and references should follow APA style. In academic writing that follows APA style, it is
important to paraphrase source material whenever possible, as opposed to quoting the source
directly. When paraphrasing source material, you can use page numbers to point the reader to a
specific portion of the source, but this is optional. When paraphrasing, you should follow the
paraphrased material with an in-text citation that contains the author’s last name and the source’s
year of publication (Author, Year) or use a signal phrase to introduce the paraphrased material
4
with the author and year (ex: “According to Eriksson (2015)…”). When quoting source material
directly, a page number (p. ) or page range (pp. ) is always required. When your source does not
have page numbers, you can use other information to point the reader to the part of the source
where the quotation can be found. You can use information like paragraph numbers, section
headings/names/numbers, slide numbers, and more, depending on what kind of source you are
using and how the source is organized. When citing in text, parenthetical citations should appear
as close to the source material as possible. The author’s name should never be separate from the
year of publication.
In-text citations point readers to the References page, which is a list of all the sources
used in your assignment. When formatting the References page, start a new page. At the top of
the new page, the word References should be bolded and centered. Alphabetize the references
according to the first author’s last name or by the name of the organization if there is no
individual author for a text. All references should have a hanging indent: The first line of each
reference should be aligned with the left margin, and subsequent lines should be indented.
Finally, each reference should follow APA style, and the proper formatting will change
depending on the type of source.
Level 2 Header
When writing a research essay, you may want to include visual aids such as tables or
figures. There are two different options for including these—either right after the text that
mentions the visual aid or at the end of your essay after the References Page. If you choose to
include your visual aids at the end of your essay, you should place each one on a separate page.
In this template, the example visual aid will be formatted within the text right after mentioning it.
Please look at the Table 1 below.
5
Table 1
Clarkson and Associates; Income Statement; Year Ending December 31, 2012
Note. Adapted from Module 4: Introduction to Team Building, by State University, 2020,
(https://portal.university.edu). Copyright 2020 by State University.
Each table or figure should be given a number and title, as demonstrated in Table 1.
The figure or table number should be bolded and placed above the title. The title should be one
space below the table or figure number and italicized. Under the table or figure, a note is
typically included. There are three different types of notes. The first is a general note, which
may include citation information or information about abbreviations, units of measurement, or
symbols. The second type of note is called a specific note. Specific notes point out information
that is specific to one area of the figure or table. Finally, probability notes include information
about statistical significance. When including notes under your table or figure, you should type
the word “Note” with a period and italicize it. Then, you can begin writing your note directly
after that.
If you would like more information about including tables and figures in your APA
paper, please refer to the Writing Center’s page that discusses this topic. There is an additional
APA Template Paper that includes information about placing tables and figures at the end of
your essay. Be sure to remember to cite any visual aids that you use on the References Page!
Conclusion
6
The last section or paragraph of your paper should be the conclusion. If you are using
headers in your paper, use a “Conclusion” heading. A conclusion should reiterate the major
points of your argument. To do this, think about developing your thesis by adding more detail or
by retracing the steps of your argument. You can recap major sections for the reader. You can
also summarize the primary supporting points or evidence you discussed in the paper. The
conclusion should not introduce any new information in order to avoid confusing the reader. To
end the paper, think about what you want your reader to do with all the information you just
presented. Explain what logical next steps might be taken in order to learn more about this topic.
Use the conclusion to establish the significance and importance of your work, motivate others to
build on what you have done in this paper, and encourage the reader to explore new ideas or
reach other conclusions.
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References
State University. (2020a). Module 4: Introduction to Team Building, Canvas.
https://portal.university.edu
State University. (2020b). Module 5: Role of ethical communication and influence in leadership
[Interactive lecture]. Canvas. https://portal.university.edu
Writing Center. (n.d.). Writing consultations.
https://university.libguides.com/writingcenter/writing_consultations
Darlin, D. (2014, August 5). How to talk about America’s newest arrivals. The New York Times.
https://www.nytimes.com/2014/08/06/upshot/how-to-talk-about-americas-newestarrivals.html
Devereaux, A. (2015). Pandemic influenza: An evolutionary concept analysis. Journal of
Advanced Nursing, 71(8), 1787–1796. https://doi.org/10.11111/jan.12654
Kinderman, P. (2019). A manifesto for mental health: Why we need a revolution in mental health
care. Palgrave Macmillan. https://doi.org/10.1007/978-3-030-24386-9
Lundgren, B., & Holmberg, M. (2017). Pandemic flus and vaccination policies in Sweden. In C.
Holmberg, S. Blume, & P. Greenough (Eds.), The politics of vaccination: A global
history (pp. 260–287). Manchester University Press.
McWilliams, K. (2020, March 30). What’s an appendix for anyways? Writing Center Blog.
https://medium.com/@writingcenter/whats-an-appendix-for-anyways-ac73d89e8423
Wu, J., Cai, W., Watkins, D., & Glanz, J. (2020, March 22). How the virus got out [Interactive
infographic]. The New York Times.
https://www.nytimes.com/interactive/2020/03/22/world/coronavirus-spread.html
HCM520 Mod 2 CT
HCM520 Mod 2 CT
Criteria
This criterion is
linked to a
Learning
Outcome
Requirements
This criterion is
linked to a
Learning
Outcome
Content
This criterion is
linked to a
Learning
Outcome
Synthesis and
Evaluation
Ratings
15 to >12.0 pts
Meets Expectation
Includes all of the
required components,
as specified in the
assignment.
Pts
12 to >9.0 pts
Approaches Expectation
Includes most of the
required components,
as specified in the
assignment.
9 to >6.0 pts
Below Expectation
Includes some of the
required components,
as specified in the
assignment.
6 to >0 pts
Limited Evidence
Includes few of the
required components,
as specified in the
assignment.
20 to >16.0 pts
Meets Expectation
Demonstrates strong or adequate
knowledge of systems for managing
quality improvement across
healthcare organizations; correctly
represents knowledge from the
readings and chosen articles.
16 to >12.0 pts
Approaches
Expectation
Some significant but
not major errors or
omissions in
demonstration of
knowledge.
12 to >8.0 pts
Below Expectation
Major errors or
omissions in
demonstration of
knowledge.
8 to >0 pts
Limited Evidence
Fails to
demonstrate
knowledge of
the materials.
25 to >20.0 pts
Meets Expectation
Demonstrates strong or adequate
synthesis and evaluation of course
concepts in systems for managing
quality improvement across
healthcare organizations.
20 to >15.0 pts
Approaches
Expectation
Some significant but
not major errors or
omissions in synthesis
and evaluation.
15 to >10.0 pts
Below Expectation
Major errors or
omissions in
synthesis and
evaluation.
10 to >0 pts
Limited Evidence
Fails to
demonstrate
synthesis and
evaluation.
15 pts
20 pts
25 pts
HCM520 Mod 2 CT
Criteria
This criterion is
linked to a
Learning
Outcome
Sources /
Examples
Ratings
20 to >16.0 pts
Meets Expectation
Sources meet required
criteria (two quantitative
and one qualitative articles)
and are well chosen to
provide substance and
perspectives on the issue
under examination.
Pts
16 to >12.0 pts
Approaches Expectation
Sources or examples meet
required criteria but are
less‐than adequately
chosen to provide
substance and
perspectives on the issue
under examination.
12 to >8.0 pts
Below Expectation
Sources or examples
meet required criteria
and are poorly chosen to
provide substance and
perspectives on the
issue under
examination.
8 to >0 pts
Limited Evidence
Source or example
selection and
integration of
knowledge from
the course is
clearly deficient.
20 pts
HCM520 Mod 2 CT
Criteria
This criterion is
linked to a
Learning
Outcome
Demonstrates
college‐level
proficiency in
organization,
grammar and
style.
This criterion is
linked to a
Learning
Outcome
Demonstrates
proper use of
APA style
Total Points: 90
Ratings
Pts
5 to >4.0 pts
Meets Expectation
Project is clearly
organized, well written,
and in proper format as
outlined in the
assignment. Strong
sentence and paragraph
structure; few errors in
grammar and spelling.
Concept Map: Clear,
organized visual
representation of
concepts.
4 to >3.0 pts
Approaches Expectation
Project is fairly well
organized and written, and
is in proper format as
outlined in the
assignment. Reasonably
good sentence and
paragraph structure;
significant number of
errors in grammar and
spelling.
Concept Map: Reasonably
good visual representation
of concepts.
3 to >2.0 pts
Below Expectation
Project is poorly
organized; does not
follow proper paper
format. Inconsistent to
inadequate sentence
and paragraph
development; numerous
errors in grammar and
spelling.
Concept Map: Unclear
visual representation of
concepts.
5 to >4.0 pts
Meets Expectation
Project contains proper
APA formatting, with no
more than one significant
error.
4 to >3.0 pts
Approaches Expectation
Few errors in APA
formatting, with no more
than two to three
significant errors.
3 to >2.0 pts
Below Expectation
Significant errors in
APA formatting, with
four to five significant
errors.
2 to >0 pts
Limited Evidence
Project is not
organized or well
written, and is not in
proper paper format.
Poor quality work;
unacceptable in
terms of grammar
and spelling.
2 to >0 pts
Limited Evidence
Numerous errors in
APA formatting, with
more than five
significant errors.
5 pts
5 pts
Chronic Disease Health Promotion and Maintenance/for adults age 35–65
Chronic Disease
Pick One chronic disease from the list below. Write a 2–3-page paper discussing the concepts of health promotion, health maintenance, health restoration and health teaching to an adult patient with this chronic disease. Be sure to integrate Evidence Based Practice into your discussion.
Read “Nurses’ Stages of Political Engagement” in Porche (2019) pages 280-281.
Assignment Criteria:
1. Research and choose a state or federal bill related to a health care policy issue of interest.
o This bill will be used for all course assignments
o The issue can be a bill that was passed in a recent legislative session, an issue currently in the legislature, or an issue presented in the legislative session but ‘died’ in committee
o No duplicate bills unless approved by the instructor
2. Place the title of the bill in the subject line of the discussion post.
3. Post a brief description of the bill on the discussion board. Use bulleted format.
o Identify if it is a state or federal bill
o Include the bill’s number (H.R.# or S#), title, purpose, intended group/population, and outcome (if already determined)
Participate in your entity/department Journal Club discussion by formally responding (in 150 words or more) to at least one of the following questions: ( you will answer one different question on each one of the articles)
Question 1: What is the key issue or question pertaining to the nursing practice identified in the article and why is it important?
Question 2: How do the author’s recommendations compare with the current clinical practice, education, Administration and/or research policies and procedures in your setting? ( setting is an outpatient urology oncology procedures clinic)
Question 3: Which of the recommendations based on the evidence presented in the article would you consider implementing in your setting? Why or why not? (again setting is an outpatient urology oncology procedure clinic)
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ONCOLOGY LETTERS 23: 124, 2022
Anticoagulation for atrial fibrillation in active cancer (Review)
DIMITRIOS FARMAKIS1, PAVLOS PAPAKOTOULAS2, ELENI ANGELOPOULOU3, THEODOROS BISCHINIOTIS4,
GEORGE GIANNAKOULAS5, PANAGIOTIS KLIRIDIS6, DIMITRIOS RICHTER7 and IOANNIS PARASKEVAIDIS8
1
Department of Physiology, University of Cyprus Medical School, Nicosia 2029, Cyprus;
First Department of Clinical Oncology, ‘Theagenio’ Anticancer Hospital, Thessaloniki 546 39;
3
Department of Cardiology, ‘Agioi Anargyroi’ General Oncology Hospital, Athens 145 64; 4Department of Cardiology,
‘Theagenio’ Anticancer Hospital, Thessaloniki 546 39; 5Department of Cardiology, AHEPA General Hospital,
Aristotle University of Thessaloniki, Thessaloniki 546 21; 6Department of Cardiology, ‘Agios Savvas’
General Anti‑Cancer Hospital, Athens 115 22; 7Department of Cardiology, Athens Euroclinic, Athens 115 21;
8
Department of Therapeutics, ‘Alexandra’ General Hospital,
National and Kapodistrian University of Athens Medical School, Athens 115 28, Greece
2
Received November 9, 2021; Accepted February 2, 2022
DOI: 10.3892/ol.2022.13244
Abstract. Atrial fibrillation (AF) may often pre‑exist
in patients with newly diagnosed cancer or occur with
increased frequency shortly after cancer diagnosis. Patients
with active cancer and AF have a particularly high risk of
thromboembolic complications, as both conditions carry
a risk of thrombosis. Thromboembolic risk is determined
by several factors, including advanced age, sex (females),
cancer histology (adenocarcinomas), location (e.g., pancreas,
stomach), advanced stage, anticancer regimens (e.g., platinum
compounds, anti‑angiogenic therapies, immune modulators),
comorbidities (e.g., obesity, kidney disease) and concurrent
therapies (e.g., surgery, central catheters). Physicians are often
reluctant to prescribe anticoagulants to patients with active
cancer and AF, mainly due to fear of bleeding complications,
which is partly related to the paucity of evidence in the field.
Decision making regarding anticoagulation for the prevention
of ischemic stroke and systemic embolism in patients with
active cancer and AF may be challenging and should not
simply rely on the risk prediction scores used in the general
AF population. By contrast, the administration and choice of
anticoagulants should be based on the comprehensive, indi‑
vidualized and periodic evaluation of thromboembolic and
bleeding risk, drug‑drug interactions, patient preferences and
access to therapies.
Correspondence to: Professor Dimitrios Farmakis, Department
of Physiology, University of Cyprus Medical School, Shakolas
Educational Center for Clinical Medicine, Palaios Dromos Lefkosias
Lemesou 215/6, Aglantzia, Nicosia 2029, Cyprus
E‑mail: farmakis.dimitrios@ucy.ac.cy; dimitrios_farmakis@yahoo.com
Key words: cancer, atrial fibrillation, anticoagulation, low molecular
weight heparins, direct oral anticoagulants
Contents
1. Introduction
2. Thrombosis in active cancer: An overview
3. Atrial fibrillation in cancer
4. Anticoagulation strategies for atrial fibrillation in cancer
5. Conclusions
1. Introduction
Cancer‑associated thrombosis (CAT), including venous and
arterial thromboembolic events, is a frequent complication in
cancer that has a significant impact on patients’ morbidity and
mortality and often renders their management challenging (1).
The risk of CAT is increased in patients with active cancer, in
whom the bleeding complications of anticoagulation therapy
may also be frequent (2). Cancer is further associated with
atrial fibrillation (AF) (3). Some cancer patients, particularly
elderly ones, have prevalent AF at the time of cancer diagnosis,
while others will develop AF in the course of the malignancy,
partly because of cancer and its therapy. AF carries per se
a 5‑fold risk of stroke and systemic thromboembolism (4).
Consequently, it has been shown that the coexistence of
AF increases the risk of thromboembolism in patients with
cancer (5).
The present report, derived by a meeting of an inter‑
disciplinary panel of experts held in September 2020 in
Athens, Greece, addresses the issue of anticoagulation for
cancer‑associated AF. Focusing on patients with active
malignancies, the paper describes the difficulties in decision
making that result from the particular features of cancer
patients and the relative paucity of evidence and proposes
an approach to anticoagulation based on the existing data,
where available, the current practice concerning anticoagu‑
lation for cancer‑associated venous thromboembolism and
the limitations of different anticoagulants in the setting of
active cancer.
2
FARMAKIS et al: ATRIAL FIBRILLATION IN ACTIVE CANCER
2. Thrombosis in active cancer: An overview
Active cancer. There is not a widely accepted definition of
active cancer. The term is generally used to describe patients
with recent cancer diagnosis (i.e., within 6 months), those
being currently or having been recently treated with anti‑
cancer therapies and those with metastatic, locally advanced,
recurrent, inoperable or end‑stage disease (6,7). Patients with
active cancer are more prone to disease‑related complica‑
tions, including a high risk of thromboembolic and bleeding
complications (2,6,8). As a result, decision making for antico‑
agulation treatment and prophylaxis in these patients may be
challenging.
Epidemiology. Cancer‑associated thrombosis (CAT) is the
second‑leading cause of death in patients with malignancies,
after cancer progression, accounting for 9% of deaths in a
cohort of 4,466 patients (9). In addition to increased morbidity
and mortality, CAT further affects ongoing anticancer thera‑
pies, escalates patients’ psychological burden and distress and
increases healthcare costs (10‑14).
Cancer‑associated venous thromboembolism (VTE),
including deep vein thrombosis and pulmonary embolism,
represents 30% of all VTE cases, while cancer increases the
age‑ and sex‑adjusted risk of VTE by 5‑fold (9,15,16). VTE, in
turn, confers a 4‑fold risk of death in patients with cancer (17).
Although the term CAT has previously been used to describe
VTE, thromboembolic complications in cancer also arise in
arterial sites, including myocardial infarction, ischemic stroke
and peripheral arterial embolism (18). A new cancer diagnosis
carries a 2‑fold risk of arterial events. In a large dataset of
279,719 pairs of cancer patients and matched controls, the
cumulative incidence of arterial thromboembolism within
6 months from cancer diagnosis was 4.7% compared to
2.2% in controls (19).
Pathophysiology. The pathophysiology of CAT is defined by
the interaction among three main factors, the thrombogenic
effects of cancer, the procoagulant properties of anticancer
treatment and patient‑related factors. More specifically,
cancer cells may directly activate coagulation by the expres‑
sion of tissue factor (TF) and the release of TF‑expressing
microparticles and cancer procoagulant factor (20). At the
same time, cancer may lead to indirect activation of the
coagulation cascade and platelets and inhibition of antico‑
agulant pathways and fibrinolysis through the induction of a
systemic inflammatory reaction (20). The risk of thrombosis
is diverse in different cancer types; pancreatic and stomach
adenocarcinomas are associated with the highest risk, while
haematological malignancies and lung, gynaecological, brain,
renal and bladder cancer also confer an increased risk (21).
Certain anticancer therapies also bear procoagulant properties
resulting from endothelial cell injury or systemic inflam‑
mation (21). Anticancer drugs with increased risk of venous
or arterial thromboembolism include platinum compounds
(cisplatin), anti‑angiogenic agents (e.g., bevacizumab, sunitinib,
pazopanib), BCR‑ABL inhibitors (e.g., nilotinib, ponatinib),
immune modulators (e.g., thalidomide, lenalidomide),
proteasome inhibitors (e.g., carfilzomib), antimetabolites
(e.g., 5‑fluorouracil) and hormonal agents (e.g., tamoxifen and
aromatase inhibitors) (22). Besides specific anticancer agents,
surgery, central venous catheters and supportive therapies
such as blood transfusions and erythropoietin‑stimulating
agents are also associated with increased thromboembolic
risk (21). Patient‑related risk factors for thromboembolism
include female sex, advanced age, obesity, previous history
of arterial or venous thromboembolism, comorbidities such
as infection, renal or pulmonary disease, prolonged bed
rest, poor performance status and hereditary prothrombotic
defects (e.g., factor V Leiden) (23). A number of biomarkers
have further been associated with an increased risk of CAT,
including general haematological or biochemical markers
such as white blood cell and platelet counts and C‑reactive
protein, thrombosis‑related markers such as D‑dimers and
tissue factor (activity or antigen) and adhesion molecules such
as P‑selectin (23). As previously brought out, AF may often be
encountered in patients with active cancer, hence increasing
further the risk of stroke and systemic thromboembolic
events (3). The risk factors for CAT are summarized in Fig. 1.
3. Atrial fibrillation in cancer
Atrial fibrillation (AF). AF is defined as ‘a supraventricular
tachyarrhythmia with uncoordinated atrial electrical activation and consequently ineffective atrial contraction’ (24). The
electrocardiographic characteristics of AF include i) irregu‑
larly irregular R‑R intervals (when atrioventricular conduction
is not impaired); ii) absence of distinct repeating P waves;
iii) irregular atrial activations (24). AF is the most common
sustained arrhythmia posing a significant burden to patients
and healthcare systems worldwide.
Epidemiology. The coexistence of AF and cancer has lately
attracted the attention of clinicians treating patients with
malignancies (3,25). In a large cohort of 833,520 patients from
26 major healthcare systems in US, a new cancer diagnosis
was followed by a 4.4‑fold age‑adjusted risk of incident AF
within the first year (26). The risk ratio fell significantly to
1.22‑1.30 beyond the first year of cancer diagnosis, indicating
a stronger association of AF with active cancer. A particularly
common form of AF in patients with cancer is peri‑operative
AF (3). In a cohort of 13,906 patients undergoing pulmonary
resection for lung cancer, perioperative AF occurred in
12.6% of patients (27). Peri‑operative AF seems to occur more
frequently in patients with advanced age and cancer stage and
coexistence of cardiovascular comorbidities and in association
with prolonged operation and extensive tissue resection (3).
It has further been suggested that there is a reciprocal
relationship between AF and cancer. This is supported by
evidence showing an increased incidence of cancer diagnosis
in patients with prevalent AF of recent onset, indicating that
AF might be a potential marker of occult cancer. In a large
cohort of 269,742 individuals, there was a 5‑fold standardized
risk for cancer within the first 3 months of AF diagnosis (28)
further confirmed by other studies (26,29,30). Although
causality cannot be supported by such epidemiological data,
this reverse relationship stresses at least the common risk
factors that the two entities share, such as ageing, obesity or
smoking, on a background of a systemic low‑level inflamma‑
tion (31). A recent systematic review and meta‑analysis showed
ONCOLOGY LETTERS 23: 124, 2022
3
Figure 1. Risk factors for thrombosis in patients with cancer (content modified from ref. 23).
that bleeding under a direct oral anticoagulants (DOAC), was
associated with 6‑fold risk of cancer detection, while bleeding
under a vitamin K antagonist (VKA) with a 15‑fold risk (32).
Similarly to non‑cancer patients, prevalent or new‑onset AF
increases the risk of thromboembolic events in patients with
a malignancy. In a retrospective cohort of 24,125 patients
with newly diagnosed malignant disease, 2.4% of patients had
prevalent AF at the time of cancer diagnosis, while another
1.8% developed AF after cancer diagnosis; both baseline and
new‑onset AF were associated with a significantly higher inci‑
dence of thromboembolism compared to the absence of AF,
even after adjustment for age, sex and comorbidities (5).
Pathophysiology. Several mechanisms have been proposed
for the pathogenesis of AF in patients with malignancies (33).
Cancer may induce AF directly through the invasion of the
heart by primary or metastatic cardiac tumours or tumours
of adjacent or remote organs. More commonly, cancer may
indirectly cause AF through a series of potential mechanisms
such as fluid imbalance, hypoxia, electrolyte and metabolic
abnormalities, infection, anaemia, autonomic nervous system
dysregulation and paraneoplastic manifestations.
Anticancer drugs and other supportive therapies have
further been associated with AF. An analysis of the World
Health Organization’s pharmacovigilance database VigiBase
identified a long list of systemic anticancer therapies associ‑
ated with AF including alkylating agents (e.g., cisplatin,
dacarbazine), anthracyclines (e.g., doxorubicin, idarubicin,
daunorubicin), antimetabolites (e.g., gemcitabine, clofara‑
bine), taxanes (e.g., docetaxel), bruton kinase inhibitors
(e.g., ibrutinib), BCR‑Abl inhibitors (e.g., nilotinib, ponatinib),
proteasome inhibitors (e.g., bortezomib), immune checkpoint
inhibitors (e.g., ipilimumab), immunomodulatory agents
(e.g., aldesleukin, pomalidomide, lenalidomide), monoclonal
antibodies (e.g., rituximab) and androgen deprivation agents
(e.g., abiraterone) (34,35). Anticancer drug‑induced AF may
manifest during or shorty (within 24 h) after drug adminis‑
tration, as in the case of cisplatin or gemcitabine, or develop
several days or even months later, as, for example, with ibru‑
tinib (36).
In addition, surgery, particularly pulmonary resection or
other extensive operations are often followed by peri‑operative
AF (3).
Besides cancer and anticancer therapies, more importantly,
as previously implied, cancer and AF share common risk
factors that could pave the way simultaneously to the two
conditions.
As in the case of VTE, AF‑associated thrombosis can be
explained by the Virchow’s triad. AF is associated with stasis
due to stagnant blood flow in the atria, wall changes due to
atrial remodelling and endothelial injury, and hypercoagula‑
bility due to the activation of platelets and coagulation factors
and inflammation (33,37). The interaction among cancer,
anticancer therapy and AF is outlined in Fig. 2.
Inflammation seems to be a common denominator
underlying cancer, AF and thrombosis. It seems to play an
important role in tumour survival, proliferation, angiogenesis
and metastasis (38). As previously stated, inflammation is
believed to be involved in CAT (39,40), while there is evidence
for a pathogenic role of blood coagulation in tumour growth
and metastasis (41,42). An intrinsic pathway of inflamma‑
tion (driven in tumour cells), as well as an extrinsic pathway
4
FARMAKIS et al: ATRIAL FIBRILLATION IN ACTIVE CANCER
Figure 2. The complex interplay among cancer, anticancer therapy and AF. Cancer and its therapy may lead to AF. At the same time, cancer and AF share
common risk factors, including aging, cardiometabolic comorbidities such as hypertension, diabetes mellitus and obesity, and genetic predisposition. All the
above, cancer, anticancer therapy, AF and their common patient‑related risk factors, are predisposing factors for thromboembolic complications including
stroke. AF, atrial fibrillation.
(in tumour‑infiltrating leukocytes) both seem to contribute to
tumour progression (43). Inflammation, activated by cardio‑
metabolic risk factors and comorbidities is further believed to
hold a key role in the pathogenesis of atrial disease, a constel‑
lation of structural, electrical and functional atrial changes
that underlies the development of AF (44). The production
of reactive oxygen species (ROS), which are by‑products of
cellular metabolism and oxygen use and have been associated
with an increased risk of cancer development via DNA damage
and genetic destabilization (43,44), seems to be an important
player in the association between inflammation on one hand
and AF and cancer on the other (45). An increase in inflam‑
matory markers such as C‑reactive protein, tumour necrosis
factor‑a and interleukins 2, 6, and 8 has actually been found
in patients with AF (3). Additionally, inflammation can be
both a cause as well as a consequence of VTE. VTE‑induced
inflammation leads to the impaired thrombus recovery and
the increased risk of VTE‑related complications (46). VTE
and AF share many common risk factors, including old age,
obesity, heart failure, and inflammatory states. Moreover, VTE
and more specifically pulmonary embolism (PE) may lead to
AF through right‑sided pressure overload. Epidemiological
studies indicate that AF can be seen as a presenting sign,
during the early phase of PE, or develop later in the course of
recovery from PE (47).
4. Anticoagulation strategies for atrial fibrillation in cancer
The management of AF in patients with malignancies in terms
of rhythm and rate control follows the strategies that apply to
the general AF population, taking under consideration cancer
prognosis and the potential interactions of cardioactive medi‑
cations with anticancer agents and supportive therapies (4).
Challenges. There are important challenges in decision
making regarding anticoagulation therapy for stroke and
systemic embolism prevention in AF patients with malignan‑
cies. Patients with AF and active cancer may have a higher
thrombotic risk compared to those with AF due to specific
cancer histology and location and specific anticancer therapies,
as previously noticed. On the other hand, patients with active
cancer may also have a higher risk of bleeding, also associ‑
ated with cancer or anticancer therapies (2,8,48). Patients with
increased risk of bleeding include those with intracranial
tumours, gastrointestinal or genitourinary cancer or haema‑
tological malignancies, and those having thrombocytopenia
either due to bone marrow invasion or due to myelotoxicity
from systemic anticancer therapy or irradiation. In a prospec‑
tive cohort study on 2,288 patients with AF treated with DOAC,
the risk of both thromboembolic events and major bleeding
was 4‑fold higher in patients with active cancer compared to
those without cancer or those with non‑active cancer [adjusted
hazard ration (HR) of thromboembolism, 4.03 (1.35‑12.03);
adjusted HR for major bleeding, 3.87, 95% CI, 2.16‑6.94)].
It has been previously highlighted that patients with
prevalent AF may have an increased probability of being diag‑
nosed with cancer, particularly during the first months of AF
diagnosis. Furthermore, because of advancing age and accu‑
mulation of other comorbid conditions, the incidence of cancer
is steadily increasing with time after AF diagnosis. In a Danish
population cohort of 55,100 individuals, up to one fourth of
individuals who developed AF were subsequently diagnosed
ONCOLOGY LETTERS 23: 124, 2022
with cancer over a 12‑year period following AF diagnosis (29).
In these patients, the decision to continue or modify their
previous anticoagulation regimen before the initiation of anti‑
cancer therapy and during the active phase of cancer may pose
an additional challenge.
Scores that are widely recommended and used for the
prediction of thromboembolic or haemorrhagic risk in the
general AF population have not been sufficiently validated
in patients with cancer, including the CHA 2DS2VASc score
(Congestive heart failure, Hypertension, Age ≥75 years,
Diabetes mellitus, prior Stroke or transient ischemic attack
or thromboembolism, Vascular disease, Age 65-74, Sex
category). Similarly, the HAS‑BLED score (Hypertension,
Abnormal renal or liver function, Stroke, Bleeding history or
predisposition, Labile INR, Elderly, Drugs or alcohol), used
for the estimation of bleeding risk in the general AF popula‑
tion, seems to underestimate this risk in patients with AF and
concomitant cancer, according to a large cohort study (49).
At the same time, anticoagulants may interact with anti‑
cancer medications and other supportive therapies prescribed
in patients with cancer that may either attenuate or intensify the
anticoagulant effect, thus increasing the risk of thromboem‑
bolic or bleeding complications, respectively (50). Drug‑drug
interactions (DDI) are a growing concern in patients with
cancer (51). It has been reported that at least 46% of cancer
patients were exposed to at least one DDI (52); 84% of these
DDIs were associated with a deterioration of patients’ status
and required treatment while 14% were even life‑threatening
or exposed patients to permanent damage. The risk of DDI is
even more pronounced in elderly patients (53). On the other
hand, among 115,362 patients with AF or VTE who were
newly prescribed DOACs, one third of patients presented one
potential DDI and 12.6% had at least 2 DDIs (54); patients
with bleeding had an 85% higher occurrence of DDIs when
compared to those without. It appears that a regular assess‑
ment of potential DDI should be implemented, and therapies
need to be adequately adjusted.
Finally, cancer patients are often elderly and fragile indi‑
viduals, suffering from additional conditions and receiving
additional medications. Frailty, comorbidities and polyphar‑
macy may impair drug tolerance and safety and complicate
DDI. As previously spotlighted, AF may be prevalent at the
time of cancer diagnosis and these patients may have already
been prescribed a certain anticoagulation regimen that might
not be appropriate for a given cancer type or anticancer therapy
plan (29).
In this context, oncology clinicians need to monitor the
anticoagulant effect and make dose adjustments. Though,
clinical studies are conducted with a fixed dose of DOACs and
do not assess clinical outcomes based on DDI or coagulation
assays. Therefore, no evidence based recommendation for
drug concentration measurements, coagulation tests, assay
standardization, or target therapeutic ranges has been clearly
established for DOAC (55).
According to an international questionnaire‑based survey
addressing the concerns and prescribing preferences of
960 cardiologists regarding AF in cancer, the most important
limitations in the prescription of anticoagulants for stroke and
systemic embolism prevention included the lack of dedicated
clinical trials (34%), DDI with anticancer agents (32%) and the
5
need to monitor the anticoagulant effect and make dose adjust‑
ments (19%) (56). In accordance to these findings, there seems
to be a gap in the treatment of AF in cancer patients, with
low usage of thromboembolic therapy that is not prescribed
in 44% of patients despite a high thromboembolic risk and an
acceptable bleeding risk (57).
Advantages and disadvantages of available anticoagulants
Vitamin K antagonists. Vitamin K antagonists [VKA] bear
many disadvantages in the setting of cancer. They have
multiple interactions with numerous anticancer agents (58)
and a narrow therapeutic window with a low likelihood to
achieve optimal TTR due to gastrointestinal complication
such as vomiting, malnutrition and hepatic dysfunction (59).
In a study of patients with prevalent AF and newly diagnosed
cancer, there was no benefit from VKA therapy mainly due
to suboptimal INR control, as only 12% of patients were in
optimal INR range (60). VKA has also been associated with a
6‑fold higher risk of bleeding in patients with cancer compared
to those without (61). These drugs are also difficult to handle
peri‑operatively. However, VKA remain the only anticoagu‑
lants currently indicated for valvular AF, including patients
with moderate or severe mitral valve stenosis and those with
mechanical valve prosthesis (4).
Low molecular weight heparins. Low molecular weight
heparins [LMWH] have long been the preferred agents for
the primary and secondary prevention of VTE in patients
with cancer and there is considerable accumulated experi‑
ence with their use in this setting (62,63). LMWH further
lack notable interactions with anticancer drugs and they are
administered parenterally and therefore their absorption is not
affected by gastrointestinal complications such as vomiting.
It has also been suggested that LMWH may bear anti‑tumour
properties, including anti‑proliferative, anti‑angiogenic and
anti‑metastatic actions along with favourable effects on cellular
adhesion, epithelial‑mesenchymal transition [EMT], extracel‑
lular matrix heparinase and metalloproteinases, cancer‑drug
resistance and tumour micro‑environment (64‑66). The poten‑
tial anti‑inflammatory effects of LMWH may also be relevant,
given the key pathogenetic role of inflammation in cancer,
AF and thrombosis (67). These additional properties may be
related to the survival advantage associated with LMWH in
cancer patients without thromboembolic events in a small
clinical study (68).
There is no clear evidence on the effectiveness of LMWH in
stroke or systemic embolism prevention in AF, although these
drugs are often used as alternatives to oral anticoagulants in AF
patients in different settings including peri‑procedural bridging
and transoesophageal echocardiography‑guided cardiover‑
sion (69‑71). The parenteral route of administration may impair
patients’ compliance, although evidence suggests that LMWH
are acceptable by patients in the context of cancer (72).
Direct oral anticoagulants. Direct oral anticoagulants [DOAC]
are currently indicated as first‑line agents for stroke or systemic
embolism prevention in the general AF population (4). DOAC
have a lower risk of intracranial bleeding compared to VKA,
while there is also the possibility of a reversal agent, currently
for dabigatran and soon for the rest of DOAC. In patients with
6
FARMAKIS et al: ATRIAL FIBRILLATION IN ACTIVE CANCER
cancer, recent evidence from randomized controlled trials
have shown that DOAC are viable alternatives to LMWH for
VTE with a higher efficacy in preventing VTE recurrence but
with worse safety in terms of bleeding complications (73‑77).
Concerning AF in cancer, evidence derived by secondary
analyses of randomized trials or observational studies shows
that DOAC, and more specifically rivaroxaban, apixaban and
edoxaban, seem to have preserved efficacy and safety over
VKA for stroke and systemic embolism prevention in patients
with AF and cancer (78‑82). In addition, two meta‑analyses
including the above secondary analyses along with observa‑
tional retrospective studies have further advocated for better
outcomes in terms of thromboembolic and bleeding risks
with DOAC vs. VKA in patients with AF and cancer (83,84).
However, patients with cancer, particularly those with an active
malignancy, were considerably underrepresented in these
trials. In ROCKET‑AF that assessed the efficacy and safety
of rivaroxaban vs. warfarin in AF, any history of cancer was
present in 4.5% of patients, while metastatic cancer was present
in less than 0.1% of cases (78). Similarly, in ARISTOTLE on
apixaban, 6.6% of patients enrolled had a history of cancer,
while only 0.7% had an active malignancy (79). Finally, in
ENGAGE‑AF on edoxaban, patients with cancer were gener‑
ally excluded, yet a 5.5% of the study population developed
active cancer in the course of the trial after a variable time
period from study onset (80). Furthermore, cancer populations
across studies included in the meta‑analyses were heteroge‑
neous, which might have led to uncontrolled confounding.
All four licensed DOAC are substrates for P‑glycoprotein
and therefore should be avoided with drugs that are potent
inhibitors or inducers of P‑glycoprotein (50). In addition,
rivaroxaban and apixaban are also metabolized by cytochrome
P450 (CYP3A4) and should be used with extreme caution with
other inducers or inhibitors of CYP3A4 (85). DOAC may
therefore have significant interactions with anticancer agents,
other supportive therapies prescribed in patients with cancer,
but also food, herbs and over‑the‑counter [OTC] drugs. In a
recent report, 33% of patients receiving apixaban had at least
one OTC product with potentially serious apixaban interac‑
tions daily or most of the days (86). The different DOAC have
variable degrees of renal clearance and their activity can be
affected in patients with cancer and chronic kidney disease
or worsening renal function (44). Due to their oral route of
administration, DOAC have an unpredictable absorption in the
case of gastrointestinal complications such as vomiting.
Current practice and recommendations. The available
guidelines, position statements or other documents on anti‑
coagulation for AF in cancer recommend the use of general
scores such as CHA2DS2VASc and HAS‑BLED (hypertension,
abnormal renal or liver function, stroke, bleeding, labile inter‑
national normalized ratio, elderly, drugs or alcohol) (3,87,88).
In addition to these scores, it is, however, reinforced that
supplementary parameters should be taken under consid‑
eration, mainly for safety reasons, such as platelet count or
tumour location (3,87,88).
Patients with cancer are often elderly with multiple
comorbidities and therefore are classified as individuals with
increased risk of thromboembolism by the general predic‑
tion scores. In a recent retrospective analysis on 472 cancer
patients with AF or atrial flutter, the mean CHA 2DS2‑VASc
was 2.8 (89); 44% did not receive anticoagulation, despite
the fact that only 18% had platelet counts 60 ms from baseline) in clinical trials.42 The
HDAC inhibitors romidepsin, panobinostat, and
vorinostat are also associated with substantial
QT prolongation.41 Finally, hormonal therapies,
such as selective estrogen receptor modifying
(SERM) agents and androgen deprivation therapy,
have been shown to have QT-prolonging effects.43
The clinical relevance of QTc prolongation has
yet to be specifically determined for many cancer
therapeutics. In one retrospective study of 113 patients treated with ATO, only 1 patient developed
torsade’s de pointes (in the setting of marked hypokalemia and hypomagnesemia) despite 65%
having a Bazett corrected QT interval of greater
than 500 ms.39 Nevertheless, there is still need
for caution when initiating these medications or
adjusting their dose. Frequent ECG monitoring is
a mainstay of safe administration, along with careful monitoring and repletion of electrolytes. During
induction chemotherapy, many patients require
the use of antiemetics and antibiotics, and careful
attention should be made in selecting agents that
do not further lengthen the QT interval. There is a
largely additive, if not synergistic effect, of
combining QT-prolonging agents as part of a
chemotherapy regimen.24,44 Adjustment and or
cessation of noncancer agents with QTprolonging potential should be prioritized over
altering the cancer treatment. Should TdP
develop, prompt administration of magnesium sulfate is essential. In addition, the heart rate should
be maintained at greater than 100 bpm with either
isoproterenol or transvenous pacing.45
Ventricular Arrhythmias
Most cases of VT/VF in cancer are directly attributed to the physiologic burden of the disease itself,
as VT/VF are more common in patients with widely
metastatic disease. Metastasis to the heart itself,
although rare, has also been implicated in the
development of VAs.46 Ventricular arrhythmias in
the setting of cancer treatment are most
commonly due to QT-prolonging effects as discussed above, or secondary to another primary
cardiotoxicity (such as ischemia or LV dysfunction), though the BTK inhibitor ibrutinib likely has
a direct arrhythmogenic effect with ventricular arrhythmias identified rare yet lethal side effect of
this class of drugs.47–49 The arrhythmogenic complications of antimetabolites such as 5-fluorouracil
can be readily ascribed to ischemia from vasospasm,50,51 while anthracyclines and anti-HER2targeted therapies such as trastuzumab are known
to induce cardiomyopathies from which ventricular
arrhythmias can sometimes arise. Myocarditis is
estimated to occur in 1.14% of all patients
receiving immune checkpoint inhibitor therapy,
with greater prevalence among anti-CTLA4 therapies over anti-PD1/PDL1. Ventricular arrhythmias
frequently occur in the setting of fulminant
disease.52
There are few studies that have specifically
addressed the management of ventricular arrhythmias due to chemotherapy. Current guidelines are
more general, recommending implantable
cardioverter-defibrillator in patients with LVEF
less than 35% refractory to guideline-directed
medical therapy, NYHA class II–III symptoms,
and life expectancy great
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words. Coverage of essential health benefits is mandated by the Affordable Care Act (ACA), guaranteeing women’s access to complete healthcare. Firstly, early diagnosis of illnesses like breast and cervical cancers is critical for timely intervention and improved outcomes. Preventive treatments and screenings, such Pap tests and mammograms, play a major role in this regard. In addition, the availability of contraceptives helps women make educated decisions regarding their reproductive health and makes family planning easier (Bossick et al., 2021). To promote general well-being and economic stability, access to a variety of FDA-approved birth control options is essential. Thirdly, maternity and newborn care promotes healthy pregnancies and the development of young children by providing all-encompassing support during pregnancy, labor, and the postpartum period. This promotes healthier families and communities by covering prenatal appointments, childbirth, and postpartum care. In conclusion, mental health and drug addiction services are essential because they cater to the particular mental health requirements of women and guarantee that they have access to proper care, therapy, and treatment for substance misuse, all of which are critical for improving mental health and general quality of life (Bossick et al., 2021). These crucial advantages highlight the ACA’s dedication to improving women’s healthcare and promoting social well-being. People go through a substantial psychosocial development period throughout early adulthood, which usually spans from late teens to mid-30s. This phase is marked by the development of a strong sense of identity and the building of interpersonal relationships. This stage highlights the necessity of developing close relationships while preserving a sense of self and is sometimes referred to as Erikson’s stage of intimacy vs. solitude (Marchi et al., 2021). At this point in their lives, young women are juggling expectations from society, personal values, and professional and educational options. Establishing a healthy self-identity requires striking a balance between these factors. During this time, peer pressure, romantic relationship exploration, and the desire for independence from family are all prevalent occurrences. They may also have to negotiate social norms around marriage, parenthood, and duties and obligations. Customizing clinical education and interventions for women in this age range is essential as a Nurse Practitioner with a focus on women’s health. It is essential to provide thorough information on sexual and reproductive health, covering family planning, STIs, and contraception alternatives. Since this age group may experience stress from relationships, societal demands, and academic or professional aspirations, it is equally crucial to address mental health (Marchi et al., 2021). Giving advice on coping strategies, stress reduction techniques, and mental health resources can be very helpful. Their healthcare programs should include regular STI exams as well as mental health evaluations. Addressing eating disorders, substance addiction, and domestic violence becomes crucial in pathological conditions. Young women’s physical and mental health can be severely impacted by these problems, making early detection and proper referrals to professional care necessary. Preventive care can benefit from educational initiatives that focus on nutrition, exercise, and healthy lifestyle choices (Marchi et al., 2021). In addition, empowering women to identify and confront abusive circumstances requires promoting an honest conversation about consent and healthy relationships. A holistic approach to healthcare is ensured by offering a secure venue for them to voice problems and information about community services, with the goal of improving their general well-being during this crucial time of life. In order to prevent the start of health difficulties, primary prevention in women’s health entails proactively promoting healthy behaviors and offering education, such as encouraging regular exercise and a balanced diet. One such would be teaching women the value of a healthy diet and frequent exercise to lower their risk of obesity and related diseases. In order to effectively treat diseases in their early stages, secondary prevention focuses on early diagnosis and intervention through the use of screenings and tests (Lee et al., 2020). For example, routine mammograms for breast cancer screening contribute to early identification and prompt treatment, which enhances results. The goal of tertiary prevention is to enhance the quality of life for individuals who have already received a diagnosis, frequently through management and rehabilitation techniques. Giving a lady who has had breast cancer surgery rehabilitation and support services following the procedure is one example, with an emphasis on improving her post-treatment well-being and avoiding long-term consequences.
The aim of this discussion assignment is to facilitate a deeper understanding of key issues in mental health nursing, engage in collaborative learning, and encourage the application of theoretical knowledge to real-world clinical scenarios.
Discussion Topic:
A key to being a healthy individual includes managing the effects of stress. Discuss positive ways of managing stress.
Instructions
Initial Post: In your own words, create an initial post addressing the discussion question. Your initial post must be at least 300 words long and include citations in APA format.
Peer Responses: Reply to at least one classmate’s posts. Each reply should be substantive, adding value to the discussion, and be at least 150 words long.
Citations: Use at least one scholarly source (not including the textbook) to support your points. Make sure to use APA format for your citations. You can support your statement using credible data sources such as CINAHL, MEDLINE, Embase, Clinical Key, and Cochrane Library (Accessed from the library page at the fnu.edu website).
Originality: All work must be original and in your own words. Plagiarism will result in a zero for the assignment and may have additional academic consequences.
For this assignment, you will research Hispanic populations and the Lost Boys of Sudan, immigrant refugees. Create a 1250-1500-word essay based on your research.
According to the Pew Research Center (2016), the Hispanic population became the largest ethnic group in America, comprising 57 million people, or more than 18% of the population. In 2019, the population reached a record of 60.6 million in the U.S. (Pew Research Center, 2020). For this assignment, select 3 states that have the most Hispanic/Latinx populations. Name each state and discuss the Latinx/Hispanic population that is most represented in each state.
Part 1. Answer the following questions and/or discuss the following about either the Hispanic population or the Lost Boys of Sudan, immigrant refugees population:
Describe health-related problems encountered by the poor and uninsured in your selected population.
What socio-economic factors impact healthcare decision making and outcomes in your selected population?
Discuss the cultural diversity that exists between and among immigrant populations and the implications for nurses
How do cultural differences, language barriers, and poverty impact healthcare access for your selected population?
Part 2. Research the Lost Boys of Sudan and answer the followings questions:
What are some health challenges a nurse may encounter refugees? Include in your answer communicable and non-communicable diseases you may find in this population.
What are some cultural considerations a nurse should consider when caring for patients from this population?
Explain the role of the nurse in providing resources when caring for members of this population.
Start by reading and following these instructions:
Study the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
Consider the discussion and the any insights you gained from it.
Review the assignment rubric and the specifications below to ensure that your response aligns with all assignment expectations.
Create your assignment submission and be sure to cite your sources, use APA style as required, and check your spelling.
The following specifications are required for this assignment:
Length: 1250–1500 words; answers must thoroughly address the questions clearly and concisely.
Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment. Be sure to use Level 1 and/or Level 2 heading titles to separate the sections you discuss.
References: Use the appropriate APA style in-text citations and references for all resources to answer the questions. Include at least three (3) scholarly sources to support your claims.
Background
According to the American Dental Association (2023):
In 2000, the Surgeon General issued a report on the status of oral health in the US,
recognizing an association between periodontal diseases and cardiovascular health,
stroke, diabetes, and adverse pregnancy outcomes, and calling for more research to
determine whether causation may be established.
Instruction
For this project, you will be answering the call to action placed by the Surgeon General. Your
group will choose which topic/objective you would like to research to determine whether
causation between oral health and systemic health may be established. You will pick an
objective from the Healthy People 2030 website:
https://health.gov/healthypeople/objectives-and-da… that correlates with a
topic we are learning from your textbook: Dental Management of the Medically Compromised
Patient. 9th edition. Little, Falace, Miller, Rhodus. Elsevier 2018. ISBN 978-0-323-44355-5.
First Part of Project
Once your topic has been chosen, you and your partner will conduct the research to gather the
appropriate data necessary to draw a conclusion. You will then individually write a 3-5 (not
including title and reference) page paper. APA 7 format with at least 3 references (1 reference
may be your course textbook).
Second Part of Project
Once your research has concluded, you will create an infographic to help your audience
understand the complex concepts between the systemic disorder and oral health based on your
research findings. You and your partner will also create 10 national board style questions on your
topic. You will provide the correct answer for each question along with the rationale for the
answer. The rationale MUST be properly cited to include the source information. The question
must be well written, and appropriate questions. Please limit the amount of easy/simple questions
and strive to develop questions that are challenging , detailed, and will require applied,
developed, and critical thinking.
Putting the Project Together
You and your partner are free to decide how you would like to finalize your project for your in
class presentation. Whether you use PowerPoint, PDF file, a file for your infographic and a
flashcard style presentation for your 10 questions etc that is your choice, but it must be agreed
upon. On your presentation day, your group will have 15 minutes to present. Once you have
completed your presentation, one of you will post the 10 board style questions on the discussion
board titled “10 National Board Style Questions.”Please submit your Research Paper, Infographic presentation slide/document etc., and your 10 National Board Style Question here. Please do not submit it in Apple settings (pages, keynote etc) the campus system is Windows.
Medically Compromised Special Needs Project
Medically Compromised Special Needs Project
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeWRITTEN:Complete description of pathophysiology of medical conditions including a brief anatomy and physiology and clinical manifestations, both intraorally and extraorally
50 pts
This criterion is linked to a Learning OutcomeWRITTEN:List of common medications (classifications and specifics) that patient may be on
10 pts
This criterion is linked to a Learning OutcomeWRITTEN:Needs assessment (problems that may require treatment interventions) and interventions to meet those needs
25 pts
This criterion is linked to a Learning OutcomeWRITTEN:Spelling and Grammar, format size and font size 24 (for presentation or larger). For your paper: APA 7 format. Font and size: Arial or Times New Roman and 12pt. Double spaced. At least 3 credible references. 1 reference can be your textbook.
10 pts
This criterion is linked to a Learning OutcomeWRITTEN:Provide 10 National Board Style test questions with rationale and references, answers must be in bold
10 pts
This criterion is linked to a Learning OutcomePRESENTATION:Presentation clear, concise, accurate and professional
15 pts
This criterion is linked to a Learning OutcomePRESENTATION:Presenter prepared, organized, covers all material listed in written requirements and understands topic
15 pts
This criterion is linked to a Learning OutcomePRESENTATION:Presenter prepared to answer questions from colleagues (classmates/peers) and instructor
10 pts
This criterion is linked to a Learning OutcomePRESENTATION:Presentation is within the 15 minute maximum (this 15 minute maximum includes your 10 questions/answer/rationale and time for any Q&A)
**one point deduction for every 2 minutes over time, or under 7 minutes.
For example – your infographic presentation may only take you 3 minutes, your 10 questions may take you 2 minutes, and time for Q&A is 1 minute = 6 minutes total = Your group will receive -1 point deduction. If it goes over to 16 minutes, your group will receive -1 minute deduction. So aim to reach the sweet spot at 7-10 minutes.
5 pts
This criterion is linked to a Learning OutcomeINFOGRAPHIC: ORAL HEALTH EDUCATION (OHE) AWARENESSOHE awareness strategies well developed and concise. Easily able to understand the complex concepts between the systemic disorder and oral health connection.
DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS
For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.
RESOURCES
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 11, “Basic Principles of Neuropharmacology” (pp. 67–71)
Chapter 12, “Physiology of the Peripheral Nervous System” (pp. 72–81)
Chapter 12, “Muscarinic Agonists and Cholinesterase Inhibitors” (pp. 82–89)
oChapter 30, “Management of Anxiety Disorders” (pp. 243–247)
oChapter 31, “Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder” (pp. 248–254)
oChapter 59, “Drug Therapy of Rheumatoid Arthritis” (pp. 513–527)
oChapter 60, “Drug Therapy of Gout” (pp. 528–536)
oChapter 61, “Drugs Affecting Calcium Levels and Bone Mineralization” (pp. 537–556)
oAmerican Academy of Family Physicians. (2019). DementiaLinks to an external site.. Retrieved from https://www.aafp.org/pubs/afp/topics/by-topic.deme…
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.
oLinn, B. S., Mahvan, T., Smith, B. E. Y., Oung, A. B., Aschenbrenner, H., & Berg, J. M. (2020). Tips and tools for safe opioid prescribing: This review–with tables summarizing opioid options, dosing considerations, and recommendations for tapering–will help you provide rigorous Tx for noncancer pain while ensuring patient safetyLinks to an external site.. Journal of Family Practice, 69(6), 280–292.
To Prepare:
Review the interactive media decision tree exercise about the patient with “Complex Regional Pain Disorder” You can find the interactive media piece under week 6 resources, required media, click on the case titled “Complex Regional Pain Disorder”.
oWalden University, LLC. (Producer). (2019e). Complex regional pain disorder Links to an external site. [Interactive media file]. Baltimore, MD: Author.
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.
2.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.
Assignment_Rubric
Criteria
Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Be specific.
Ans.
The response accurately and thoroughly summarizes in detail the patient case study assigned, including specific and complete details on each of the three decisions made for the patient presented.
Criteria
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.
Ans.
The response accurately and thoroughly explains in detail how the decisions recommended for the patient case study are supported by the evidence-based literature. … The response includes specific and relevant outside reference examples that fully support the explanation provided.
Criteria
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.
Ans.
The response accurately and thorough explains in detail what they were hoping to achieve with the decisions recommend for the patient case study assigned. … The response includes specific and relevant outside reference examples that fully support the explanation provided.
Criteria
Explain any difference between what you expected to achieve with each of the decisions and the results of the decisions in the exercise. Describe whether they were different. Be specific and provide examples.
Ans.
The response accurately and clearly explains in detail any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise. … The response provides specific, accurate, and relevant examples that fully support whether there were differences between the decisions made and the decisions available in the exercise.
Criteria
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
Ans.
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Criteria
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
Ans.
Uses correct grammar, spelling, and punctuation with no errors
Criteria
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
The Complementary and Alternative Medicine (CAM) I chose to do my research paper on is Megestrol Acet (Appetite stimulant) and Edibles (marijuana). In this paper I will be discussing what complementary and alternative medicine is along with some of the reasons why some cancer patients prefer CAM (edible) over traditional prescription drugs. I will be discussing what appetite stimulants do and elaborate on the use of Megestrol Acetate vs edibles as an appetite stimulant. I will also be discussing the side effects, adverse effects, and drug interactions along with the body systems that become affected as a result of using these drugs. With this research I would like to decide which approach would be the best for a cancer patient. I would believe that the one that causes the least amount of side effect and or the one that shows a bigger increase in appetite evidence by weight gain or food consumption.
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A basic Research Paper Out
Research Topic Intro.
The Complementary and Alternative Medicine (CAM) I chose to do my research paper
on is Megestrol Acet (Appetite stimulant) and Edibles (marijuana). In this paper I will be
discussing what complementary and alternative medicine is along with some of the reasons why
some cancer patients prefer CAM (edible) over traditional prescription drugs. I will be discussing
what appetite stimulants do and elaborate on the use of Megestrol Acetate vs edibles as an
appetite stimulant. I will also be discussing the side effects, adverse effects, and drug interactions
along with the body systems that become affected as a result of using these drugs. With this
research I would like to decide which approach would be the best for a cancer patient. I would
believe that the one that causes the least amount of side effect and or the one that shows a bigger
increase in appetite evidence by weight gain or food consumption.
What is Megestrol Acetate
•
A oral suspension synthetic substance, which is similar to the female hormone
progesterone, is used to treat disease-related weight loss and appetite loss. It is also used
to treat advanced breast cancer and endometrial cancer
Effects on the body
•
Megestrol is used to improve appetite and to increase weight in cancer(associated
anorexia)
[SHORTENED TITLE UP TO 50 CHARACTERS]
2
What is Edible (marijuana)
•
Food products infused with cannabis extract are known as edibles. Edibles can be made
at home or bought commercially for dispensaries and come in a variety of flavors and
shapes, including baked goods, candies, gummies, chocolates, lozenges, and beverages
Effects on the body
•
Medicinal cannabis has shown promise in improving appetite-related symptoms in people
with cancer. The active ingredient in marijuana, called delta-9-tetrahydrocannabinol
(THC), increases the appetites of advanced cancer patients.
Research Paper Guidelines
Guidelines:
•
•
•
•
Write a 4-page paper in APA format (in addition to a cover page and a reference page) using
at least two heading levels on a topic of your choosing but must be related to complementary
and alternative medicine (CAM).
Students must use at least three (3) peer reviewed articles and at least two (2) Professional
Organizations or Regulatory Agencies as references.
o Your textbooks do not count as part of your required resources.
o Resources should be limited to articles within the last 5 years.
The Research paper will be submitted through Canvas using a plagiarism, Turnitin, program.
Should be less than 20%
Submission can be word or PDF.
Guidelines for Paper
•
•
•
•
•
•
•
•
•
Pick a medication and find a comparable CAM and compare how they affect the body
Discuss what systems are affected
Compare and contrast how are the two alike and how they are different
Compare and contrast side effects of both
Compare and Contrast adverse effects of both
Discuss medication interactions
Compare and contrast dosage differences
Explore professional organizations and what they have to say about the CAM.
After you have discussed the above information provide a synopsis of what you learned and
which one you think is more beneficial and why. Must be evidence-based decision.
[SHORTENED TITLE UP TO 50 CHARACTERS]
Rubric
CAM Research Paper
Criteria
Medication and
Comparable CAM
Identified a medication
and a CAM. Discussed how the
medication and the CAM work
on the body systems.
Compare and Contrast
Medication and CAM
Detail how the
medication and CAM are
similar. Describe the
differences between the
medication and CAM.
5 pts
Compare and Contrast
Side Effects
Provides a comparison
or differences in adverse effects
of the medication and CAM.
There may not be any
similarities or differences in
side effects, but covers the side
effects of both the CAM and
medication. Demonstrates an
understanding of similarities
and differences regarding
adverse effects of medication
and CAM.
2 pts
Discuss Possible
Interactions
Provides discussion of
any possible interactions the
patient should be aware of
when using the medication and
CAM.
3 pts
Dosing
Provides standard
dosing information for
medication and CAM.
1 pts
Professional
Organizations
Explore a professional
organization (2). Discuss the
results of what the
2 pts
3
[SHORTENED TITLE UP TO 50 CHARACTERS]
Criteria
organizations have to say
regarding the use of the CAM.
Synopsis
Provides a synopsis of
findings regarding use of
medication and CAM. Uses
research to support which one
is more beneficial to the patient.
3 pts
Grammar, Spelling
APA
Paper is presented
with APA formatting and is
clearly written, free from
spelling and grammatical
errors.
4 pts
4
Alfredo, his wife, and two children live in a lower-middle income neighborhood situated in a rural community of 800 people. The main source of income for the community is farming commodity crops, with yearly swings in value and profits. Very few high school graduates attend college, with the majority of children taking over farming duties from aging parents. Those that do leave for college rarely return to the community. The nearest state college is 300 miles away. There is a local branch of the regional community college system that two dozen recent college graduates and other adults attend throughout the year. Within this community there are four churches, one small grocery store with limited availability of fresh fruit and vegetables, a high variety of canned and processed foods, and a large selection of sugar-sweetened and alcoholic beverages. There are very few sidewalks in the neighborhoods, and only a few sidewalks lining the downtown main street in the business district. There is no gym and one city park that is crowded with teenagers after school hours. There are four hiking trails within a 10-minute drive from the center of town (two trails are beginner trails, one is for intermediate hikers, and the last is rated as difficult). The rate of obesity in town is higher than the state average for adults and children. Alfredo’s two teen children—David, 16, and Paula, 14—are both overweight, drink one–two sugar-sweetened beverages per day, and eat mostly processed foods. Alfredo’s wife, Gina, who works as a teacher at the local elementary school, has type 2 diabetes, a BMI of 36, and chronic right knee pain. Gina, who you see in the clinic, has been reducing the amount of processed foods that are high in calorie density in her diet and replacing them with fresh fruit and vegetables as much as possible or as available at the local grocery store.
The rural town that Alfredo, Gina, and their children live in is situated in the northwestern part of the state. The state capital is over 500 miles to the southeast. The state senator who represents the town lives in a larger town 200 miles away. The representative of the state house who represents the town lives 60 miles away in a larger town. The towns in which the state senator and representative live in are similar to Alfredo’s town, although due to their slightly larger size, they have increased amenities that include a larger grocery store, local gyms, and small health-promotion programs sponsored by the state leaders. The state in general has higher obesity (10th highest in the nation), poverty (15th highest in the nation), and lower literacy rates (25th lowest in the nation) than most states. The state economy is driven by commodity farming and mining. Mining’s impact on the state economy is diminishing due to reduced demand for coal and other mined minerals. The state government has severely underfunded the state retirement system and is looking to increase taxes as a mechanism of balancing the state budget. Additionally, social systems programs are seeing funding cut or frozen until state funds stabilize.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. The originality report that is provided when you submit your task can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Tasks may not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc., unless specified in the task requirements. All other submissions must be file types that are uploaded and submitted as attachments (e.g., .docx, .pdf, .ppt).
Select one of the following three options to create for this task:
community action plan
community health policy proposal
innovative business plan
A. Identify the priority community health issues for the community in the scenario by doing the following:
1. Explain how using community health data allows you to identify priority community health issues.
2. Describe the process of determining the priority community health issues from the community’s perspective.
3. Propose how you would assess the available community resources to address the priority community health issues.
B. Analyze a priority community health issue from part A by doing the following:
1. Explain the process by which you will engage with key community stakeholders to create the community action plan, community health policy proposal, or innovative business plan that is focused on the priority health issue.
2. Describe the sequential steps needed to take your idea from community engagement to project completion.
C. Describe how you will measure the progress of your community action plan, community health policy proposal, or innovative business plan by doing the following:
1. Describe the specific metrics you will use to measure change for your chosen priority community health issue.
2. Explain how you would use the data from the community action plan, community health policy proposal, or innovative business plan in the quality improvement process of community healthcare.
3. Explain the importance of the iterative process in delivering community health activities.
D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.
Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:
Describe the health care organization or network.
Describe the organization’s overall readiness based on your findings.
Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment 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.
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. A link to
You have created a policy brief presentation that has theoretically caught the attention of a lawmaker. He/she would like more information about this. Write a formal paper, including title page, table of contents, executive summary, topic headings, in-text citations, and references about your selected health issue. Using the outline that you created last week for the presentation, write a formal Policy Brief with the sections outlined below as APA headings. Be sure each section is well developed and supported with in-text citations and logical discussion. Again, remember that your audience is a policymaker, not a medical professional.
Title Page
Table of Contents
Executive Summary
Introduction
Background of the Problem
Impact of the Problem
Approaches/Options
Proposed Solution to the Problem
SWOT Analysis
Results of the Analysis
Recommendations
Conclusion
References
The paper should be 8-10 pages with at least 6 references. Length does not include the title and references pages.
Please use your own word, my school is so strict about plagiarism. Make it in simple English.
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Cultural Diversity Worksheet
As a healthcare provider, it is important to care for a patient and maintain their culture as much as possible. Using this worksheet, fill out the boxes for specific
cultures (listed below). Different cultures have different values, beliefs and practices. A woman’s cultural background can affect her needs and expectations
during pregnancy and childbirth, as well as how she and her family raise children.
**This worksheet was created in Microsoft Word. Please download to your computer, adjust the size of the boxes, print out, write legibly
For example:
•
•
•
•
•
During pregnancy, women from some cultures do not eat certain foods.
During labor, women from some cultures avoid moving too much; some stay lying down, some prefer to sit or squat.
In some cultures, the father does not attend the birth, but the mother or mother-in-law of the woman does.
After childbirth, some women follow strict rules, such as staying in bed for several days.
****Do your own work!!
Prenatal Care/Habits
or rituals once they
are pregnant
United States
Mexico
Antepartum (during
labor) i.e. hospital vs
home; birthing
process, etc.
Pain management
during labor;
Emotions/How do
they act during labor
(loud, quiet)
Birth rituals when
child is born;
preferred method of
feeding
(breast/bottle)
What is typically
done with the
placenta?
Cultural rituals for
the mother after
delivery
Cultural rituals for
the newborn after
delivery
Saudi Arabia
China
Turkey
Sweden
Write a 1- to 2-page summary paper that addresses the following: (APA Style)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.
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Case Study:
This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is
assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the
client reports that his family doctor sent him for psychiatric assessment because the doctor felt
that the pain was “all in his head.” He further reports that his physician believes he is just making
stuff up to get “narcotics to get high.”
SUBJECTIVE
The client reports that his pain began about 7 years ago when he sustained a fall at work. He
states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done
(x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the
cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock
position). He reports that none of the surgeons he saw would operate because they felt him too
young for a total hip replacement and believed that the tissue would repair with the passage of
time. Since then, he reported development of a strange constellation of symptoms including
cooling of the extremity (measured by electromyogram). He also reports that he experiences
severe cramping of the extremity. He reports that one of the neurologists diagnosed him with
complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD).
However, the neurologist referred him back to his family doctor for treatment of this condition.
He reports that his family doctor said “there is no such thing as RSD, it comes from depression”
and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few
years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no
need for a wheelchair, I can beat this!”
The client reports that he used to be a machinist where he made “pretty good money.” He was
engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she
thought I was just turning into a junkie.”
He reports that he does get “down in the dumps” from time to time when he sees how his life has
turned out, but emphatically denies depression. He states “you can’t let yourself get depressed…
you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I
can beat it.”
During the client interview, the client states “oh! It’s happening, let me show you!” this prompts
him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you
his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible
cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last
about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the
color begins to return and the cramping in the foot/toes appears to be releasing. The client states
“if there is anything you can do to help me with this pain, I would really appreciate it.” He does
report that his family doctor has been giving him hydrocodone, but he states that he uses is
“sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also
reports that the medication makes him “loopy” and doesn’t really do anything for the pain.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the
weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed,
and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood
and content of conversation. He denies visual/auditory hallucinations. No overt delusional or
paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He
denies suicidal/homicidal ideation and is future oriented.
Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)
3 Decisions to Make:
1. Savella 12.5mg orally once daily on day 1; followed by 12.5mg BID on day 2 and 3;
followed by 25mg BID on days 4-7; followed by 50mg BID thereafter.
2. Amitriptyline 25mg po QHS and titrate upward weekly by 25mg to a max dose of
200mg per day
3. Neurontin 300mg po Bedtime with weekly increases of 300mg per day to a max of
2400mg if needed.
You are a nurse practitioner practicing in a nurse-led primary care clinic in a rural community. You are providing care for Alfredo Garcia, a 50-year-old Hispanic male who comes to the clinic for a work physical. Alfredo does not have a regular primary care provider and has no health complaints today.
PMH: Alfredo’s past medical history includes a fractured right ankle that occurred when he was 28 years old. He has no previous surgical history or history of hospitalization.
FH: Alfredo’s father, paternal grandfather, and maternal grandmother all have diabetes. His paternal grandmother has osteoporosis and hypertension. His maternal grandfather died at 67 from colon cancer. Alfredo’s three siblings and his two children are alive and with no serious medical history.
SH: Alfredo smokes half a pack of filtered cigarettes per day, drinks two energy drinks per day, and drinks four alcoholic drinks per meal three times per week. He does not exercise regularly and eats fast food for breakfast and lunch five days a week, and dinner at home with his family. Dinner usually consists of meat (chicken, beef, or pork), tortillas, rice and beans, and one vegetable. He consumes one–two fruits or vegetables per day as part of dinner or as a snack. Alfredo is married and has two children who are in high school. Alfredo works as a construction foreman for a local construction company. He has a high school diploma.
Health promotion: He wears his seatbelt 100% of the time. Has not had a colonoscopy nor has one scheduled. Last vaccination over 10 years ago. Last dental exam two years ago.
Meds: Tylenol for back pain once per week, 1 gram per dose for two doses.
Allergies: No known drug, food, or environmental allergies.
ROS: Negative except for increased thirst and urination.
PE: Well groomed, in no apparent distress. Head normocephalic, cranial nerves intact. Eyes PERRLA, EOMs intact. Optic disc margins sharp. TMs intact, pearly gray. Buccal mucosa pink, moist, and intact. Proper dentition. Lungs clear to auscultation bilaterally. S1S2 no murmurs. Pulses +2 throughout. No edema. Abdomen round with striae, tympanic throughout, soft, nontender. Liver span percussed at 15 cm. Uncircumcised, testis rubbery, smooth. No hernia.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. The originality report that is provided when you submit your task can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Tasks may not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc., unless specified in the task requirements. All other submissions must be file types that are uploaded and submitted as attachments (e.g., .docx, .pdf, .ppt).
SOAP Note with Health Promotion Focus
A. Analyze Alfredo’s potential health promotion activities by doing the following:
1. Describe six patient- and family-centered areas of potential health promotion for Alfredo and his family.
2. Explain how using motivational interviewing elicits patient-driven health promotion priorities. Include supporting scholarly literature to provide an evidence-based foundation for your explanation.
3. Describe five potential allies and five potential barriers to change for Alfredo and his family that you foresee.
4. Explain how incorporating the social ecological model and the readiness to change theory influences the health promotion plan, including supporting literature to provide an evidence-based foundation for your explanation.
5. Describe the steps that will be used to support Alfredo in developing a patient- and family-centered health promotion plan.
6. Describe the steps that will be used to assist Alfredo in creating SMART (specific, measurable, actionable, relevant, and timely) goals directly related to one of his priority health promotion areas.
7. Provide a sample SOAP note that includes each of the following aspects:
the subjective and objective data provided
the assessment portion (diagnoses you would provide)
the plan portion with one health promotion item expanded to include actionable goals
B. Create a written follow-up plan by doing the following:
1. Describe the known allies and barriers to change for Alfredo and his family.
Note: Please see part A3 to choose from the 10 potential allies and barriers identified there.
2. Explain how involving the family and close contacts in health promotion can facilitate positive change.
3. Describe the steps used to support Alfredo in modifying a patient- and family-centered health promotion plan.
C. Analyze the progress of the plan by doing the following:
1. Describe the process of determining patient-centered measures of progress.
2. Describe the process of measuring patient-centered progress.
3. Describe the importance of recognizing progress that is patient-directed.
D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
Choose a public health organization or company to evaluate. How do they market themselves (specifically online and on social media)? Post a link to their website. Provide a critique of their use of marketing and social media.
CO 2. Identify characteristics of professional behavior including emotional
intelligence, communication, and conflict
resolution.
Preparing the assignment
There are three parts to this assignment.
1. Letter for Graduation
1. Write a letter to yourself on your graduation day.
2. Consider the following questions as you compose your letter.
i. How do you hope you have changed in terms of knowledge and skills, and
personally?
ii. What would you like to remind yourself about your inspiration for choosing this
career?
iii. You will be preparing to take the NCLEX-RN® exam and to start your first job as a
baccalaureateprepared nurse. Are there any words of encouragement that you would like to tell
your future self?
iv. Are there any words of caution you want to tell yourself—pitfalls to avoid?
v. What kind of nurse do you hope you become? What further growth and change do
you envision for
yourself?.
2. Inspiration
1. Creates a one-page vision board that reflects own inspiration and motivation for
becoming a nurse. The
format may be a PowerPoint slide, word document, infographic etc.
2. Includes pictures, a collage, a series of quotes, etc. Choose words and images
that are meaningful to you.
This should be a page that you can post somewhere, perhaps where you study, to
motivate yourself as
you move forward on your journey to become a nurse.
3. Presentation
1. Presents the inspiration to the class.
2. Describes the inspiration and the relationship of the inspiration to being a nurse.
3. Answers the following questions during presentation:
i. What does your inspiration mean?
ii. What concept challenged you during this course?
iii. What has been the greatest lesson you have learned?
iv. How will what you have learned help you be successful at Colombia University
Please respond to discussion below using current APA edition and 2 scholarly references. Must be at least 150 words. This week, my clinical experience entailed both challenges and success. First, I was so nervous as I had to meet with my preceptor. I was filled with many emotions leading up to the day, but once I arrived, all the nerves went away, and I was ready to learn. I was able to meet with my preceptor for a short visit and was oriented to the clinic and staff. The preceptor provided me with the Do’s and Don’ts. The preceptor gave me her expectations and informed me to ask questions no matter what. The preceptor asked me about my plans and to share some goals I had while in clinical. This was a success for me as I was filled with questions, and my preceptor answered all my questions with a smile. Next, I was educated on the system used and the amount of access I would have to the patient’s chart.This week, I was unable to start clinical; however, I will begin to see patients next week. My plan for success in this course is to ensure that I am focused and reviewing my patient’s notes to understand my patients and their needs. I look forward to learning medications and understanding the selection of choice and what makes this selection appropriate. I want to ensure that I master the plan of care, be empathic to patients, and be functional in the practice. I plan to communicate with my preceptor about any challenges I may encounter as a student clinician under the preceptor’s supervision.Women’s health is intricate as many women will or have faced diverse health concerns across their lifetime, which can affect their overall quality of health (Pitts et al., 2019). Therefore, as student clinicians, it is imperative that women are not just treated for their health conditions but also educated on preventing illnesses and diseases that can lead to poor health outcomes (Gonzales et al., 2020). This clinical experience is essential as there is a need to decrease morbidity and mortality rates for women (Gonzales et al., 2020). This includes appropriate education in women’s health and guidance when applicable. Therefore, the student must understand how to listen to the patients and take the preceptor’s advice and suggestions (Gonzales et al., 2020). This type of experience will aid in ensuring that the skills are learned and will allow the student to be sufficient and competent in the clinical setting (Pitts et al., 2019). Also, the student must be engaging while learning to succeed in the practice (Pitts et al., 2019). The student must ask questions and remain open to learning, as learning can be challenging when learning a new skill set.While there were many more successes than challenges this week, it was appropriate as my preceptor wanted to meet with me and better understand myself and what to expect during the clinical experience. Women’s health is critical, and I plan to follow the instructions provided by my preceptor and apply what is taught in the lecture course to enhance my clinical skills and experience further (Pitts et al., 2019). I am looking forward to next week in the women’s health clinical journey, learning new skills, and meeting patients.
The first step to national certification through the American Academy of nurse practitioners (AANPCB), with which is the certifying board that I chose, is to create a profile and gain a free student membership to the certifying board via the AANP website. After becoming a member of the AANP the next step is to send unofficial transcripts by e-mail to certification@aanpcert.org (AANP, 2023).
The transcripts that are sent must indicate that the applicant has completed Advanced Physiology, Advanced pharmacology, Advanced Health Assessment, clinical hours, coursework completed, and the practice site and preceptor information for all clinical sites of the applicant. A nursing license number and expiration date must be included in the application.
The Application to test must be filled out thoroughly at www.aanpcert.org. After becoming a member of the AANP, filling out the application and all required data, the next step is to then pay for the exam. Because you have become a member, you are eligible for a discounted rate for the exam, which is $240.00 as opposed to $315.00 for non-members (AANP, 2023).
In preparation for the exam, I will be using the Barkley review Recommended by Purdue University Global. I will also be using the FNP certification intensive review app, by Maria Leik.
I will await my e-mail from the AANP following my final transcripts being sent to certification@aanpcert.org, I should then receive an e-mail clearing me to schedule my exam at an approved testing site. Once I have obtained a date and scheduled I will bring two forms of ID with me to the exam. For a passing score on the NP exam, you must score 500/800 minimum.
NPI Number and DEA
An NPI number is necessary and mandatory if you are a provider that will be accessing HIPAA information, referring patients, or writing prescriptions for patients. You can get access to the NPI application on cms.gov if it is electronically sent and filled out correctly, it could be back in as little as 10 days (CMS.gov, 2023).
Following the provision of the NPI number, the provider will need to go to the DEA website and apply for a DEA number. The DEA number allows a provider to prescribe controlled substances to patients. DEA numbers are $888.00 and are due to be renewed every three years in the state of Indiana from the date on the original card.
Prescription Drug Monitoring
The prescription drug monitoring program in the state of Indiana is called INSPECT. A registered provider can perform a look up request at any time (INSPECT, 2023). The Indiana prescription monitoring program or (PDMP) is designed to give providers the ability to monitor controlled drug use by patients using a statewide platform. To create an account, you will need first name, last name, date of birth, individual address, your DEA number, your professional license number, and your driver’s license number. The Indiana inspect keep providers safe when needing to prescribe controlled substances by ensuring that they are not providing a patient with a substance that has been abused or overused. Using the Indiana INSPECT will help all providers in that it is statewide integrated, and they can see all controlled substances prescribed by any providers to that patient.
Recertify
With the AANP you must recertify every five years. To recertify you must have 1000 clinical hours practiced and you must earn 100 continuing education credits 25 of those credits must be in advanced pharmacology, and you must hold current RN licensure. If you do not meet the recertifying criteria listed above, you must retest for certification while maintaining your RN licensure (AANP, 2023).
References
Advanced Solutions International, Inc. (2023). Physician licensure and registrations. ISMA Indiana State Medical Association. https://www.ismanet.org/ISMA/Legal/Compliance/licensure_and_registrations/ISMA/Legal/physician_license_registrations.aspx?hkey=b46242db-135f-4224-be82-6e7e24a1286b#:~:text=DEA%20numbers%20must%20be%20obtained,Renewal%20fees%20are%20%24888.
American Association of Nurse Practitioners (AANP). (2023). Nurse Practitioner certification https://www.aanp.org/student-resources/np-certification.
I need reserch article about11-16 reserch about building and managing team in nursing by all components abstract introduction methodology etc and should be plagiarism 0 %and you can make a references in table references and also normal references . And I need from you to attach reserch article that you will do And soft copy for each article you used Thanks
Please open the attached question and respond accordingly. Thanks
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Assignment:
Respond to at least two of your colleagues who were assigned different
case studies than you. Analyze the possible conditions from your
colleagues’ differential diagnoses. Determine which of the conditions you
would reject and why. Identify the most likely condition and justify your
reasoning using current resources. Remember to include outside resources.
Case study: Back Pain
A 42-year-old male reports pain in his lower back for the past month. The
pain sometimes radiates to his left leg. In determining the cause of the back
pain, based on your knowledge of anatomy, what nerve roots might be
involved? How would you test for each of them? What other symptoms
need to be explored? What are your differential diagnoses for acute low
back pain? Consider the possible origins using the Agency for Healthcare
Research and Quality (AHRQ) guidelines as a framework. What physical
examination will you perform? What special maneuvers will you perform?
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1) Post by: Mar An Elli
Episodic/Focused S OAP Note
Patient Information:
D.J., 42, Male, Caucasian
S.
CC: Low back pain
HPI: Patient D.J. is a 42- year-old Caucasian male presenting to the clinic with low back
pain with onset beginning one month ago. Patient states the pain feels “achy and dull”
and at times radiates to his left leg stating it is worse behind his knee. Patient states the
pain is constant and is exacerbated by standing and walking and is relieved by laying
supine and sitting. Patient states some relief from PRN Ibuprofen. Pain is currently 8/10
on the pain scale.
Current Medications: Patient takes no regular prescription medications or supplements.
Patient takes Ibuprofen 600mg PO Q6 PRN for pain.
Allergies: Patient states no drug allergies. No food, environmental or latex allergies
reported.
PMHx: Patient has no Hx of major illnesses or hospitalizations- no surgeries. Patient had
influenza vaccine one month ago and covid booster in June 2023. Patient is up to date
on immunizations.
Soc Hx: Patient is currently a tow truck driver with Superior Towing for the past 18
months. Prior to this, the patient worked on a loading dock – loading trailers and lifting
50-75lbs at a time 40 hours a week for 12 years. Patient hobbies are restoring vintage
furniture for resale and attending car shows. Patient is single and heterosexual, patient
denies being currently sexually active. Denies Hx of STD’s- no children. Patient vapes
nicotine 2-3 times per week. Patient denies ever using illicit drugs or alcohol. Patient
states he uses his seat belt when driving and has 4 smoke detectors and one carbon
monoxide detector in his home. The patient lives alone in a 2-bedroom apartment and
states his mother lives next door. Patient states he is active in the community and helps
at the local boys and girls club. Patient states he has many friends he often visits.
Fam Hx:
Mother: Hx of obesity and hypertension.
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Father: deceased at 46 in an MVA- Hx of hypertension.
Maternal GM: Died at age 40 in childbirth- no medical Hx.
Maternal GF: Died of Alzheimer type dementia at 92- Hx of hyperlipidemia and
hypertension.
Maternal GM: Deceased at 88 from MI- Hx hypertension.
Maternal GF: Died of colon CA at 78. Hx of obesity and DMII
No siblings or children
ROS
GENERAL: Denies fatigue- denies weight loss. Patient A&Ox3 – states pain in lower
back currently 8/10.
HEENT: Denies change in LOC or headache. Patient wears glasses to read with his last
eye exam 6 months ago. No Hx of eye trauma or eye disease. Pt. denies ear pain or loss
of hearing- denies vertigo, denies infection. Denies epistaxis or rhinorrhea- denies Hx of
obstruction or issues sense of smell. Denies sore throat and no issue with swallowing- no
hoarseness or loss of voice. Patient has tonsils intact. No Hx strep infections, Dental
exam one month ago.
NECK: Denies pain or tenderness.
SKIN: Denies itching or rash.
CARDIOVASCULAR: Denies history of hypertension- denies CP. Denies palpitation or
Hx of edema.
RESPIRATORY: Denies cough or SOA. Denies orthopnea.
GASTROINTESTINAL: Denies nausea, vomiting or diarrhea. Denies pain.
GENITOURINARY: Denies burning with urination or incontinence.
NEUROLOGICAL: States some numbness to left great toe- denies Hx headache- Denies
change in bowel or bladder.
MUSCULOSKELETAL: States pain in lower back and radiation down back of left leg to
below the knee. Denies Hx of injury or trauma. Denies Hx of gout.
HEMATOLOGIC: Denies bruising easily or bleeding. Denies anemia.
LYMPHATICS: Denies lymph node swelling – denies Hx splenomegaly or splenectomy.
PSYCHIATRIC: Denies SI/ HI or Hx of anxiety. Denies depression.
ENDOCRINOLOGIC: Denies heat/ cold intolerance – denies polydipsia or polyuria.
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ALLERGIES: Denies seasonal allergies or asthma. Denies eczema.
O.
Physical exam:
General: Patient is an appropriately dressed Caucasian male – Patient appears
uncomfortable- shifting weight from side to side while sitting in chair. Patient grimaces
when moving.
VS: B/P: 138/78 P: 86 R: 16 O2: 99% HT: 5’10” WT:196
Cardiovascular: s1, s2 auscultated / no murmurs or rubs- no clicks or gallops- HR 86
Respiratory: clear all quadrants with no adventitious sounds present.
Musculoskeletal: Spine vertically aligned/ symmetrical scapula bilaterally. Normal Scurve noted.
No masses or abnormal hair growth noted. No tenderness noted on palpation. Lower
extremities symmetrical in length. No muscle atrophy is noted.
Abnormal gait- listing to the left. Negative FABER test. +SLR with pain present when
raised at 50% to below the knee. ROM normal bilateral hips.
Lymph: No node enlargement noted upon palpation.
Diagnostic results: SED rate and C-reactive protein to R/O chronic inflammation or
infectious cause; as these are inflammatory markers (Al Qaraghli & De Jesus, 2023). MRIdeferred – see patient again in two weeks to see if pain improves with treatmentStatistically, most lower back pain will. Improve within six weeks. MRI imaging. Is. Often
unnecessary in suspected cases of sciatica., and often areIcontraindicated due to the
high levels of radiation that the patient would possibly be exposed to unnecessarily.
(Hall, A.M. et al. 2021). If pain persists- an MRI would be performed at that time. Also, if
pain persists- a physical therapy consultation may be useful.
A.
Differential DX:
•
•
Sciatica- is a debilitating condition that causes pain and possible paresthesia
or numbness in lower extremity. The sciatic nerve is made up of L4-S1 nerve
roots. The most common cause of Sciatica is a bulging or herniated lumbar
intervertebral disk. It is common to have radiating pain to the lower
extremity usually on one side. This patient had a + SLR test which is used to
help definitively diagnose sciatica (Pesonen, J. et al. 2021).
Spondylolisthesis- Spondylolisthesis happens when one vertebra slips out of
place onto the vertebra below it. This happens to 4 to 6% of the population
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•
•
•
and can be a degenerative change. Vertebral slipping puts pressure on the
bone below it and can cause pinching of nerve roots and can cause leg pain.
Most grade I and grade II. types require no surgery. Almost all cases of
degenerative spondylolisthesis are in this category (2023).
Spinal Stenosis- stenosis is a condition where nerve roots are compressed by
a pathologic factor causing pain, numbness, and weakness. It can be acquired
or congenital. Acquired stenosis Occurs from degenerative changes or
trauma. Degenerative changes occur when there is a narrowing of the central
canal and lateral recess from post disc herniation, ligamentum, flaven
hypertrophy and spondylolisthesis (Avais et al., 2023).
Lumbar Disk Herniation- 80% of the population experience low back pain. In
their lifetime. Intervertebral degeneration is the most common reason for
lower back pain. Intervertebral degeneration disease leads to lumbar disc
herniation. This becomes more common with aging. In lumbar disc herniation,
signs and symptoms can include radicular pain, low back pain, limited trunk
flexion, exacerbation of pain with strain, pain more intense when seated (Al
Qaraghli & De Jesus, 2023).
Degenerative Disk Disease – Degenerative disc disease is characterized by
breakdown of one or more discs separating bones of the spine, causing neck
or back pain. This can happen any time after 40 years of age and can be mild
or severe. Obesity can play a part in degenerative disc disease and one of the
main ways it is treated is maintaining healthy weight and exercising (Donnally
et al., 2023).
References
Al Qaraghli, M. I., & De Jesus, O. (2023, August 14). Lumbar disc herniation – statpearls NCBI bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK560878/
Avais, R., Hoang, S., Patel, P., & Mesfin, F. (2023, June 12). Spinal Stenosis – StatPearls NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK441989/
Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available
from: https://www.ncbi.nlm.nih.gov/books/NBK507908/Links to an external site.
Donnally, C., Hanna, A., & Varallo, M. (2023, August 4). Lumbar degenerative disk disease statpearls – NCBI bookshelf. Lumbar Degenerative Disk Disease.
https://www.ncbi.nlm.nih.gov/books/NBK448134/
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Hall AM, Aubrey- Bassler K, Thorne B, Maher CG. Do not routinely imaging for
uncomplicated low back pain. BJM. 2021 PMID:33579691; PMCID: PMC8023332
Jensen R K, Kongsted A, Kjaer P, Koes B. Diagnosis, and treatment of
sciatica BMJ 2019; 367 :l6273 doi:10.1136/bmj.l6273
Pesonen, J., Shacklock, M., Suomalainen, J. S., Karttunen, L., Mäki, J., Airaksinen, O., &
Rade, M. (2021). Extending the straight leg raise test for improved clinical evaluation of
sciatica: validity and diagnostic performance with reference to the magnetic resonance
imaging. BMC musculoskeletal disorders, 22(1), 808. https://doi.org/10.1186/s12891-02104649-zLinks to an external site.
Professional, C. C. medical. (2023). Spondylolisthesis: What is it, causes, symptoms &
treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10302spondylolisthesis#What%20Is%20Spondylolisthesis?
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2) Post by: Ed Bayi
Patient Information: Age: 42 Gender: Male
Chief Complaint: Lower back pain with radiating left leg discomfort.
History of Present Illness: The patient, a 42-year-old man, has been complaining of
lower back discomfort for the last month and has decided to visit a doctor about it. He
claims that sometimes, the discomfort travels down his left leg. The patient describes the
discomfort as ongoing and says that it has considerably decreased both his daily
activities and quality of life. He reports pain is worsened by physical activity and relieved
by resting. He reports the pain shooting down his leg and pain scale as of now 3/10. He
has been taking Tylenol 650 mg for the pain and reports minimal relief. He denies fever,
flank pain, denies nausea or vomiting. He denies having anxiety or depression.
Medications: Tylenol 650 mg twice a day OTC for pain
Allergies: No known drug allergies, no food allergies, denies latex and environmental
allergies.
Past Medical History (PMH): HTN.
Past Surgical History (PSH): Denies prior surgical procedures.
Sexual/Reproductive History: Declines to discuss.
Personal/Social History: The patient reveals that his job title is office manager. Denies
smoking or use of illicit drugs. Drinks a little beer now and again. His present medical
state is not related to any previous trauma or injury.
Health Maintenance: Walks two to three days a week. Tries to have a healthy diet.
Immunization History: Immunizations are up to date based on recommended agerelated protocols.
Significant Family History: No noteworthy family history of conditions pertinent to the
patient’s present complaint exists.
Review of Systems:
General: The patient denies experiencing any generalized symptoms such as fever,
unintentional weight loss, or fatigue. There are no constitutional symptoms.
HEENT (Head, Eyes, Ears, Nose, Throat): Denies specific symptoms related to the head,
eyes, ears, nose, or throat. Denies headaches, visual disturbances, hearing problems,
sinus congestion, or sore throat.
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Respiratory: There are no complaints or signs of respiratory symptoms. Denies cough,
shortness of breath, wheezing, or chest pain.
Cardiovascular/Peripheral Vascular: Denies any cardiovascular or peripheral vascular
symptoms. Denies chest pain, palpitations, leg swelling, or changes in skin color or
temperature in the extremities.
Gastrointestinal: Denies abdominal pain, nausea, vomiting, diarrhea, constipation, or
changes in bowel habits.
Genitourinary: Denies urinary frequency, urgency, dysuria, hematuria, or changes in
urine color or odor.
Musculoskeletal: Reports lower back pain, which he describes as radiating to the left leg.
He does not complain of any other musculoskeletal issues such as joint pain, muscle
weakness, or limited range of motion in other parts of the body.
Neurological: Apart from the pain radiating to the left leg, there are no neurological
symptoms reported. No headache, dizziness, syncope, paralysis, ataxia, numbness or
tingling in the extremities. No change in bowel or bladder control.
Psychiatric: He denies symptoms related to mood, cognition, anxiety, or other mental
health concerns.
Skin/Hair/Nails: Denies specific symptoms or abnormalities related to the skin, hair, or
nails. Denies rashes, itching, hair loss, or changes in nail color or texture.
OBJECTIVE DATA:
Physical Exam:
•
Vital signs: Temp 98.0, Pulse 87, Resp 18, Bp 132/78
General: Alert and oriented, in no acute distress
HEENT: No abnormalities noted.
Neck: Supple, No stiffness or masses
Chest/Lungs: Clear to auscultation
Heart/Peripheral Vascular: Regular rate and rhythm, no murmurs
Abdomen: Soft, non-tender, no masses or organomegaly, norm active bowel sounds in
all 4 quadrants.
Genital/Rectal: Examination not relevant to the chief complaint
Musculoskeletal: Tenderness noted in the lumbar region; limited range of motion in the
lumbar spine; pain on straight leg raising test on the left leg.
9
Neurological: Normal motor strength and sensory function in upper and lower
extremities; deep tendon reflexes are intact.
Skin: No rashes, lesions, or abnormalities noted.
Diagnostic Results:
Complete Blood Count (CBC): Hemoglobin: 14.2 g/dL, Hematocrit: 42%
ASSESSMENT:
Differential Diagnoses:
1. Lumbar Disc Herniation: The manifestation of lower back discomfort that
extends to the left leg in the patient is strongly suggestive of lumbar disc
herniation. The problem arises when the nucleus pulposus, which is the
gelatinous core of an intervertebral disc, protrudes beyond the annulus
fibrosus, the outer ring of the disc. This protrusion can exert pressure on
adjacent nerves, resulting in symptoms such as leg discomfort, numbness, or
muscular weakness (Jiang et al., 2022). Lumbar disc herniation may arise due
to a range of circumstances, including age-related degeneration, traumatic
incidents, or the exertion of excessive force during the lifting of substantial
things. The manifestation of pain that extends down the leg, sometimes
accompanied by sensations of tingling or weakness, is a characteristic
indication of this medical disease. The confirmation of this diagnosis
necessitates a comprehensive physical examination and the use of imaging
procedures, such as magnetic resonance imaging (MRI).
2. Sciatica: The occurrence of pain in the left leg may be ascribed to sciatica, a
medical ailment often resulting from the compression or irritation of the
sciatic nerve, which originates from the lumbar region and runs distally down
the lower extremity. The symptomatology, including sharp pain, tingling
sensations, and loss of sensation, aligns with the patient’s reported discomfort
(Jungen et al., 2019). Sciatica often manifests as a clinical manifestation of an
underlying etiology, such as a herniated intervertebral disc or spinal stenosis.
The diagnostic procedure will include the identification of the underlying
etiology of sciatic nerve compression by a comprehensive physical
examination and, if necessary, the use of imaging modalities.
3. Muscular Strain: The potential association between the patient’s profession as
a forklift operator and the development of lower back discomfort resulting
from muscle tension or overuse should not be disregarded. Muscular strain
often serves as a prevalent etiological factor for the onset of acute low back
pain, frequently arising from tasks involving lifting or repeated motions (Shaikh
et al., 2021). The potential validity of this diagnosis may be substantiated by
10
the presence of discomfort in the muscle under consideration, as well as the
patient’s work, which entails engaging in physically strenuous activities. In
order to exclude other underlying illnesses, it may be necessary to use
diagnostic techniques such as X-rays or MRI.
4. Spinal Stenosis: The patient’s reported discomfort, which intensifies while
assuming an upright position or engaging in ambulation, corresponds with the
possible diagnosis of spinal stenosis. Spinal stenosis is characterized by the
constriction of the spinal canal, often attributable to degenerative alterations
or structural irregularities. The condition has the potential to exert pressure on
the spinal cord or nerve roots, hence causing back pain and leg discomfort,
particularly while engaging in weight-bearing activities (Lee et al., 2020).
Accurate diagnosis and effective distinction from other disorders, such as disc
herniation, are crucial for the implementation of personalized treatment
strategies.
5. Spondylolisthesis: Spondylolisthesis is a plausible etiology for the patient’s
lumbar pain and accompanying leg discomfort. The issue pertains to the
anterior displacement of a vertebra in relation to another, which may lead to
the compression of nerves and the subsequent manifestation of
accompanying symptoms. According to Chan et al. (2023), individuals may
encounter symptoms such as lumbar discomfort, leg pain that spreads, and a
decline in muscular strength. The precise identification and classification of
spondylolisthesis are of utmost importance in order to establish the most
suitable course of therapy, which may vary from conservative measures to
surgical procedures.
Probable Diagnosis:
Based on a comprehensive evaluation including the patient’s medical records, clinical
manifestation, and diagnostic findings, it is very likely that the diagnosis for this 42-yearold male who exhibits lower back pain that extends to the left leg is a lumbar disc
herniation. The patient’s account of persistent pain that sometimes radiates to the leg
provides corroborating evidence for the diagnosis of lumbar disc herniation, since it is
consistent with the characteristic symptoms associated with this condition. The disorder
arises when the central nucleus pulposus of an intervertebral disc herniates through its
annulus fibrosus, possibly causing compression of adjacent nerves, notably the sciatic
nerve, resulting in symptoms such as pain, paresthesia, dysesthesia, and myasthenia (Yu
et al., 2022). Several other possible diagnoses, such as sciatica, muscle strain, spinal
stenosis, and spondylolisthesis, were taken into account owing to the presence of similar
symptoms. Nevertheless, based on the comprehensive patient history and clinical
examination, lumbar disc herniation emerges as the most probable etiology. Additional
diagnostic imaging, such as magnetic resonance imaging (MRI), may be required to
validate the diagnosis and assess the magnitude of the disc herniation, thereby informing
the formulation of an appropriate treatment strategy (Chu et al., 2021). The chosen
course of action may encompass conservative measures or surgical intervention,
11
contingent upon the severity of the condition and its impact on the patient’s daily
functioning.
Nerves Affected: Within the field of anatomy, it is important to ascertain the precise
nerve roots that are involved in this illness. The symptoms mentioned suggest potential
involvement of lumbar nerve roots, notably L4-L5 and L5-S1. The involvement of the L4L5 nerve root may present as pain that extends to the anterior aspect of the thigh, while
involvement of the L5-S1 nerve root may lead to pain that radiates to the posterior
aspect of the leg and further extends into the foot (Chu et al., 2021).
The evaluation of nerve root involvement necessitates the use of certain diagnostic
examinations. The Straight Leg Raise (SLR) test is a core diagnostic tool used to check
the status of the L5 and S1 nerve roots. During the examination, the patient assumes a
supine position, with one leg elevated while maintaining knee extension. If the individual
has discomfort that extends into the leg at an angle of less than 60 degrees, it indicates
the potential involvement of the nerve root. In addition, the use of the Femoral Nerve
Stretch Test may be performed as a means to evaluate the status of the L4 nerve root.
During the examination, the patient assumes a supine position while the leg is stretched.
The presence of pain experienced during leg elevation might potentially suggest the
involvement of the L4 nerve root.
The precise identification of the nerve roots implicated holds significant importance,
alongside the exploration of other symptoms that may be linked. This entails examining
the occurrence of numbness and tingling, as well as assessing the pattern and intensity
of sensory impairments in the lower extremity. It is important to evaluate muscular
weakness, paying particular attention to the specific muscle groups that are impacted.
Furthermore, it is essential to inquire with the patient on any instances of urinary or fecal
incontinence (Yu et al., 2022). The presence of this symptom may serve as a noteworthy
indicator, since it has the potential to indicate a more serious condition such as cauda
equina syndrome, necessitating prompt medical intervention.
The performance of a thorough physical examination is of utmost importance in order to
arrive at an accurate diagnosis. The comprehensive evaluation should include a
neurological assessment aimed at appraising the motor strength, reflexes, and feeling in
the lower limbs. In order to identify discomfort or muscular spasms, it is essential to do
palpation on the spine, muscles, and paraspinal regions. The evaluation of the patient’s
capacity to flex, extend, and rotate the lumbar spine is crucial, necessitating the use of
range of motion tests. In addition, it is recommended to do specific exercises, such as the
Straight Leg Raise Test and the Cross-Straight Leg Raise Test (Yu et al., 2022). The latter
procedure entails elevating the contralateral (right) leg in order to simulate the
occurrence of radiating pain on the symptomatic (left) side, hence aiding in the detection
of nerve root compression.
In summary, a comprehensive assessment of nerve root involvement and related
symptoms is necessary to accurately diagnose the patient’s lower back pain with
radiating symptoms. In accordance with the standards set out by the Agency for
12
Healthcare Research and Quality (AHRQ), it is essential to investigate a variety of
probable reasons and conduct a comprehensive physical examination, which may include
specialized testing, in order to arrive at a precise diagnosis and develop an effective
treatment strategy. Additional diagnostic imaging and meetings with specialized medical
professionals may be necessary to validate the diagnosis and develop an appropriate
treatment plan for the patient.
References
Chan, A. K., Bydon, M., Bisson, E. F., Glassman, S. D., Foley, K. T., Shaffrey, C. I., … &
Mummaneni, P. V. (2023). Minimally invasive versus open transforaminal lumbar
interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the
prospective multicenter Quality Outcomes Database registry. Neurosurgical focus, 54(1),
E2.
Chu, E. C. P., & Wong, A. Y. L. (2021). Chronic orchialgia stemming from lumbar disc
herniation: a case report and brief review. American Journal of Men’s Health, 15(3),
15579883211018431.
Jiang, H. W., Chen, C. D., Zhan, B. S., Wang, Y. L., Tang, P., & Jiang, X. S. (2022).
Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar
discectomy in the treatment of lumbar disc herniation: a retrospective study. Journal of
Orthopaedic Surgery and Research, 17(1), 30.
Jungen, M. J., Ter Meulen, B. C., Van Osch, T., Weinstein, H. C., & Ostelo, R. W. (2019).
Inflammatory biomarkers in patients with sciatica: a systematic review. BMC
musculoskeletal disorders, 20, 1-9.
Lee, B. H., Moon, S. H., Suk, K. S., Kim, H. S., Yang, J. H., & Lee, H. M. (2020). Lumbar
spinal stenosis: pathophysiology and treatment principle: a narrative review. Asian Spine
Journal, 14(5), 682.
Shaikh, S., Siddiqui, A. A., Alshammary, F., Amin, J., & Agwan, M. A. S. (2021).
Musculoskeletal disorders among healthcare workers: prevalence and risk factors in the
Arab World. Handbook of Healthcare in the Arab World, 2899-2937.
Yu, P., Mao, F., Chen, J., Ma, X., Dai, Y., Liu, G., … & Liu, J. (2022). Characteristics and
mechanisms of resorption in lumbar disc herniation. Arthritis Research & Therapy, 24(1),
205.
13
LEARNING RESOURCES
Required Readings
•
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2023). Seidel’s guide to physical examination: An interprofessional approach (10th
ed.). St. Louis, MO: Elsevier Mosby.
o Chapter 6, “Vital Signs and Pain Assessment” (Previously read in
Week 6)
o Chapter 22, “Musculoskeletal System”
This chapter describes the process of assessing the musculoskeletal
system. In addition, the authors explore the anatomy and
physiology of the musculoskeletal system.
•
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment
and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition
by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by
permission of Mosby via the Copyright Clearance Center.
o Chapter 22, “Lower Extremity Limb Pain”Download Chapter 22,
•
•
•
“Lower Extremity Limb Pain”
This chapter outlines how to take a focused history and perform a
physical exam to determine the cause of limb pain. It includes a
discussion of the most common tests used to assess
musculoskeletal disorders.
o Chapter 24, “Low Back Pain (Acute)” Download Chapter 24, “Low
Back Pain (Acute)”The focus of this chapter is the identification of
the causes of lower back pain. It includes suggested physical exams
and potential diagnoses.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA:
F. A. Davis.
o Chapter 2, “The Comprehensive History and Physical Exam”
(“Muscle Strength Grading”) (Previously read in Weeks 1, 2, 3, 4,
and 5)
o Chapter 3, “SOAP Notes”
This section explains the procedural knowledge needed to perform
musculoskeletal procedures.
Document: Episodic/Focused SOAP Note Exemplar (Word
document)Download Episodic/Focused SOAP Note Exemplar (Word
document)
Document: Episodic/Focused SOAP Note Template (Word
document)Download Episodic/Focused SOAP Note Template (Word
document)
14
Required Media
Musculoskeletal System – Week 8 (12m)
Online media for Seidel’s Guide to Physical Examination
In addition to this week’s resources, it is highly recommended that you access and view
the resources included with the course text, Seidel’s Guide to Physical Examination. Focus
on the videos and animations in Chapter 21 that relate to the assessment of the
musculoskeletal system. Refer to the Week 4 Learning Resources area for access
instructions on https://evolve.elsevier.com/Links to an external site.
•
Marquis, P. (2019, April 4). Orthopedic knee evaluation with Paul Marquis
PT [Video].Links to an external
site. YouTube. https://www.youtube.com/watch?v=YVx4BepjjiY&feature=yo
utu.be
Optional Resources
•
•
•
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic
examination (11th ed.). New York, NY: McGraw Hill Medical.
o Chapter 13, “The Spine, Pelvis, and Extremities”
In this chapter, the authors explain the physiology of the spine,
pelvis, and extremities. The chapter also describes how to examine
the spine, pelvis, and extremities.
Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P.,
Ferreira, P. H., Fritz, J. M., Koes, B. W., Peul, W., Turner, J. A., Maher, C. G.,
Buchbinder, R., Hartvigsen, J., Cherkin, D., Foster, N. E., Maher, C. G.,
Underwood, M., van Tulder, M., . . . Woolf, A. (2018). Prevention and
treatment of low back pain: evidence, challenges, and promising
directions.Links to an external site. The Lancet, 391(10137), 2368–2383.
https://doi.org/10.1016/s0140-6736(18)30489-6
Hicks, C., Levinger, P., Menant, J. C., Lord, S. R., Sachdev, P. S., Brodaty, H., &
Sturnieks, D. L. (2020). Reduced strength, poor balance and concern about
falls mediate the relationship between knee pain and fall risk in older
people.Links to an external site. BMC Geriatrics, 20(1), 94.
https://doi.org/10.1186/s12877-020-1487-2
Discuss about HIV or AIDS as the infectious disease
Unformatted Attachment Preview
• Epidemiology or extent of the condition
• Progression/history of the condition
• Anatomy & physiology related to the condition
• Pathophysiology (the functional changes that exist because of the
• Condition, complication once the condition is present)
• Clinical manifestations (signs & symptoms)
• Existing prevention & therapeutic measures·
• Presentation should have a minimum of 12 slides (NOT INCLUDING THE HEADER PAGE
OR REFERENCE PAGES)· PowerPoint should be substantive with references in APA 7th ed
format. References must be included and must be both listed and cited. Include clear images
and visuals throughout. 50-100 words speaker notes per slide.
Please respond to discussion below using current APA edition and 2 scholarly references. Must be at least 150 words. For this first week of our clinical rotation, I will start clinical this Friday due to having to work full-time at the beginning of the week and reading for our upcoming exam. I will say that I have experienced challenges in trying to balance working and going to clinical. However, now that I have completed my adult clinical, I know how to prepare for this rotation and how to better manage working & going to the clinic. Luckily, I will be completing my clinical rotation this semester at the same clinic site and with the same preceptor. This will be very helpful because I understand the office and the patient load that I will encounter. Also, my preceptor is very understanding of my work schedule, but still challenges me as a student which I very much appreciate. Another challenge I encountered was looking for a different clinical site. I knew that I could use my previous preceptor because of the vast number of women he saw as patients, so I kept that clinic site in mind. However, I did reach out to other clinics such as Planned Parenthood and Women’s clinics. Issues I encountered with those clinic sites is not receiving responses back or those clinical sites were already at their capacity of accepting students. When speaking to other students, they were encountering the same two issues. I can understand why so many sites were at capacity because not every Women’s center accepts students due to private practices and hospitals would usually have resident medical students occupying those spaces with physicians. According to Jassim et al. (2022), it is essential for nursing students to use their education and clinical experiences to become independent professionals & to ensure safe evidence-based care of good quality. This experience definitely showed me that there are less opportunities for clinical sites for Women in comparison to adults clinical, which was very challenging. I chose to complete this rotation at the same clinical site because to my surprise, quite many women go to this clinic for gynecological complaints. During my previous clinical rotation, I completed a pap smear and pelvic examination within my second week! I thought that was amazing and did not realize how difficult those actually are, but now I feel much more comfortable going into this next rotation The following week after that, I encountered a patient who had a cesarean delivery 7 weeks prior to her office visit and had concerns regarding her incision and if it was infected. According to Tesfaye et al. (2022), surgical site infections can be classified as superficial incisional surgical site infections which involve only the skin or subcutaneous tissue, deep incisional, which involve the fascia layer. I have 5 years of experience as a labor and delivery nurse, so I felt very comfortable addressing her concerns because assessing incision sites is something I have to do after surgery. I was very grateful for the opportunities I had to work and care for many women because I was exposed to obstetrical and gynecological patients earlier than anticipated.
Choose a disease or pathology, for example: gas exchange. Familiarize yourself with the rubric and the assignment requirements.
Gather the patient data and organize the information on the nursing process template of the Concept Map Worksheet. The nursing process template (located on page 1 of the assignment) will help you complete the concept map assignment located on page 2.
After completing the nursing process template, utilize this information to help you build the concept map assignment. The arrows in the map show you the order in which the map is intended to be completed. All boxes should be completed related to the concept you chose.
Give credit to your references. You do not need a separate ‘Reference Page’, but APA-style references should be identified at the bottom of the assignment.
Concept Mapping Spring 23 edits
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDisease Process and Pathophysiology Risk Factors
5 pts
Satisfactory
Learner performs a thorough review of the disease process pathophysiology; identifies risk factors.
3.5 pts
Beginning
There are critical aspects of pathophysiology missing. This entry is incomplete.
0 pts
Unsatisfactory
The pathophysiology information is missing.
5 pts
This criterion is linked to a Learning OutcomeRecognizing CuesWhat matters most?
5 pts
Satisfactory
Based on available patient data, the learner identifies at least four (4) critical cues that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
3.5 pts
Beginning
Based on available patient data, the learner identifies two (2) or three (3) critical cue(s) that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
0 pts
Unsatisfactory
Based on available patient data, the learner identifies zero (0) or one (1) critical cue(s) that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
5 pts
This criterion is linked to a Learning OutcomeAnalyzing CuesWhat could it mean?
5 pts
Satisfactory
Based on the identified cues, the learner is able to create three (3) – four (4) supporting connections between the relevant cues and client conditions/problems.
3.5 pts
Beginning
Based on the identified cues, the learner is able to create two (2) supporting connections between the cues and patient condition/problems.
0 pts
Unsatisfactory
Based on the identified cues, the learner is able to create one (1) or zero (0) supporting connection(s) between the cues and patient condition/problems.
5 pts
This criterion is linked to a Learning OutcomePrioritizing HypothesesWhere do I start?
5 pts
Satisfactory
Based on the identified connections between cues and patient conditions/problems, learner is able to identify and rank three (3) client conditions/problems critical to positive patient outcomes. These should be listed with most urgent problems first.
3.5 pts
Beginning
Based on the identified connections between cues and patient conditions/problems, learner is able to identify and rank two (2) client conditions/problems critical to positive patient outcomes. These should be listed with most urgent problems first. This point value is also chosen if client/problems are not listed with the priority concern(s) first.
0 pts
Unsatisfactory
Based on the identified connections between cues and patient conditions/problems, learner identifies zero (0) or one (1) client conditions/problems critical to positive patient outcomes.
5 pts
This criterion is linked to a Learning OutcomeGenerating SolutionsWhat can I do?
5 pts
Satisfactory
List five (5) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. Outcomes/goals are listed in the SMART format.
3.5 pts
Beginning
List three (3) to four (4) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. Outcomes/goals are listed in the SMART format.
0 pts
Unsatisfactory
List zero (0) to two (2) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. This point value is also chosen if outcomes/goals are not listed in the SMART format.
5 pts
This criterion is linked to a Learning OutcomeTaking ActionsWhat will I do?
5 pts
Satisfactory
Describe how each of the five (5) identified nursing interventions will be performed, implemented, administered, communicated, or taught.
3.5 pts
Beginning
Describe how three (3) to four (4) of the identified nursing interventions will be performed, implemented, administered, communicated, or taught.
0 pts
Unsatisfactory
Describe zero (0) to two (2) of the identified nursing interventions will be performed, implemented, administered, communicated, or taught.
5 pts
This criterion is linked to a Learning OutcomeEvaluating OutcomesDid it help?
2.5 pts
Satisfactory
Describe how you will determine the effectiveness of the five (5) priority nursing interventions you implemented. How will you know if your interventions are effective or not?
1.5 pts
Beginning
Describe how you will determine the effectiveness of three (3) to four (4) priority nursing interventions you implemented. How will you know if your interventions are effective or not?
0 pts
Unsatisfactory
Describe how you will determine the effectiveness of zero (0) to two (2) priority nursing interventions you implemented.
2.5 pts
This criterion is linked to a Learning OutcomeNursing Process template
2.5 pts
Satisfactory
Recognizing the completion of this template will assist the learner with the concept map assignment, all six (6) boxes are thoroughly completed. The SBAR information is thoroughly identified, and the chosen concept for the assignment is clearly identified.
1.5 pts
Beginning
Information is missing from one (1) to three (3) box(es). The SBAR information is thoroughly identified, and the chosen concept for the assignment is clearly identified.
0 pts
Unsatisfactory
Information is missing from four (4) to six (6) boxes. This point value is also chosen if the SBAR information is missing and/or the chosen concept for the assignment is not identified.
2.5 pts
Total Points: 35
Unformatted Attachment Preview
NIGHTINGALE COLLEGE
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
NURSING PROCESS TEMPLATE:
Assessment (Recognizing Cues)
Which patient information is relevant? What patient data is most
important? Which patient information is of immediate concern?
Consider signs and symptoms, lab work, patient statements, H & P,
and others. Consider subjective and objective data.
Analysis (Analyzing Cues)
Which patient conditions are consistent with the cues? Do the cues
support a particular patient condition? What cues are a cause for
concern? What other information would help to establish the
significance of a cue?
Analysis (Prioritizing Hypotheses)
What explanations are most likely? What is the most serious
explanation? What is the priority order for safe and effective care?
Planning (Generate Solutions)
What are the desirable outcomes? What interventions can achieve
these outcomes? What should be avoided? (SMART Planning- specific,
measurable, attainable, realistic/relevant, time-restricted- Goal
setting)
Implementation (Take actions)
How should the intervention or combination of interventions be
performed, requested, communicated, taught, etc.? What are the
priority interventions? (Mark with asterisk)
Evaluation (Evaluating Outcomes)
What signs point to improving/declining/unchanged status? What
interventions were effective? Are there other interventions that
could be more effective? Did the patient’s care outlook or status
improve?
Patient Information (SBAR, H&P)
Main Concept
(Should be focus of below map)
CONCEPT MAP TEMPLATE:
Recognizing Cues (S&S)
Disease Process/Pathophysiology/Risk Factors
Analyzing Cues/Concerns
Supporting
Prioritizing Hypotheses
1.
2.
Concerning
3.
Generate Solutions/Outcomes/Interventions
SMART Planning
Taking Action – (How To)
1.
1.
2.
3.
4.
5.
2.
3.
4.
5.
Evaluating Outcomes
1.
2.
3.
4.
5.
Page 2 of 2
You learned during your first week on the job as the newly hired Admitting supervisor that each departmental supervisor was expected to lead one of the hospital’s numerous quality improvement teams. It came as no surprise that the team to which you were assigned was the team your predecessor, the former Admitting supervisor, had served as leader. Your team, you soon learned, consisted of several of your department’s people plus employees from a scattering of other departments.
As you held individual meetings to become acquainted with both your Admitting employees and other members of your team, you were quickly inundated with complaints and other indications of discontent from both Admitting employees and quality team members. There were vocal complaints about the way the admitting department had been run and complaints about the “useless quality improvement team.” From a couple of the employees who served both in Admitting and on the quality team you received complaints about “those who shall remain nameless” who regularly “carry tales to Administration.”
You listened to all the complaints. You detected some common themes in what you were hearing, leading you to believe that perhaps some misunderstandings could be cleared up if some of the issues could be aired openly with each concerned group. So you scheduled two meetings, one for your Admitting staff and one for the quality improvement team. You felt encouraged because a number of individuals had told you they would be happy to speak up at such a meeting.
Your first meeting, held with the Admitting staff, was brief; nobody spoke up, even when urged to do so in the most non-threatening way possible. Your subsequent meeting with the quality team was no better. You had gotten zero discussion going with either group, although before and between the meetings you had been bombarded by complaints from individuals. This left you extremely frustrated because most of the complaints you heard were group issues, not individual problems.
Questions:
What do you believe can you do to get either or both groups to open up in a group setting about what is bothering them?
Can you suggest what might lie in the immediate past that could have rendered these employees unwilling to speak up?
Since you have two groups (with overlapping membership) to be concerned with, where would you initially concentrate your efforts?
What might you do concerning the charges that someone is “carrying tales to Administration?”
Chapter 15
CASE: SURPRISE!
When the business office employees arrived at the hospital Monday morning they immediately noticed the apparent absence of the office manager. This was not unusual; the manager was frequently absent on Monday. However, he rarely failed to call the department when he would not be there—but on this day he still had not called by noon.
Shortly after lunch, the two working supervisors in the business office were summoned to the administrator’s office. They were told that the office manager was no longer employed by the hospital. They, the two supervisors, were told to look after things for the current week and that a new manager, already secured, would be starting the following Monday. All that the two supervisors were told about the new manager was that it was someone from outside the hospital.
The supervisors were not told whether the former manager resigned or was discharged, nor were they told whether anyone within the department had been considered as a replacement.
Questions:
What do you suppose would be the reactions and attitudes of the business office staff upon hearing about this change?
What circumstances will most likely prevail during this interim week without a manager? Include in your comments consideration of both morale and productivity.
With what attitudes do you suppose the business office staff will receive the new manager?
Propose an evidence-based approach (or program) you could implement to address a substance use (alcohol, tobacco, or drug) issue. What is the target audience, what do you propose, and why?
additional information to help with answering the question
watch
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RESEARCH AND PRACTICE
Nuevo Amanecer: Results of a Randomized Controlled
Trial of a Community-Based, Peer-Delivered Stress
Management Intervention to Improve Quality of Life in
Latinas With Breast Cancer
Anna María Nápoles, PhD, MPH, Carmen Ortíz, PhD, Jasmine Santoyo-Olsson, MS, Anita L. Stewart, PhD, Steven Gregorich, PhD, Howard E. Lee,
MD, MPH, Ysabel Durón, BA, Peggy McGuire, MA, and Judith Luce, MD
Latinos are the fastest growing US racial/ethnic
group. With a population growth rate 4 times
that of the total US population (24.3% vs
6.1%), they accounted for half of the nation’s
growth between 2000 and 2006.1 Breast
cancer is the most frequently occurring cancer
and leading cause of cancer death among
Latinas.2 Latinas experience worse breast-cancerrecurrence-free survival than White women.3
Latinas are at higher risk for psychosocial and
physical sequelae of breast cancer than White
women and report higher rates of anxiety,
depression, fear of recurrence, fatigue, and
pain and worse health-related quality of life
(HRQOL).4—9 Limited English proficiency, employment, and insurance coverage; lack of
transportation; and problems paying for treatment increase their risk of distress.6 Anxiety
among Spanish-speaking patients is common
because they often do not understand the
diagnosis or treatment and are less involved in
patient-centered decision-making.10
These factors can chronically elevate stress
levels among Latinas after breast cancer. In fact,
disparities in HRQOL between Latinas and nonLatinas with breast cancer have been partially
explained by higher stress levels.5 Higher levels of
chronic stress and fatigue can cause hypothalamic–pituitary—adrenal axis dysregulation and inflammatory responses.3,11,12
Among breast cancer survivors, stress management interventions improve HRQOL, including increased positive affect and lifestyle
changes; decreased anxiety, stress, emotional
distress, and thought intrusion13—18; and improved sleep quality.14,19 These interventions
may also produce beneficial changes in biomarkers of the hypothalamic—pituitary—adrenal
axis14 and immune functioning.18 However,
Objectives. We evaluated a community-based, translational stress management program to improve health-related quality of life in Spanish-speaking
Latinas with breast cancer.
Methods. We adapted a cognitive–behavioral stress management program
integrating evidence-based and community best practices to address the needs
of Latinas with breast cancer. Spanish-speaking Latinas with breast cancer were
randomly assigned to an intervention or usual-care control group. Trained peers
delivered the 8-week intervention between February 2011 and February 2014.
Primary outcomes were breast cancer–specific quality of life and distress, and
general symptoms of distress.
Results. Of 151 participants, 95% were retained at 6 months (between May
2011 and May 2014). Improvements in quality of life from baseline to 6 months
were greater for the intervention than the control group on physical well-being,
emotional well-being, breast cancer concerns, and overall quality of life. Decreases from baseline to 6 months were greater for the intervention group on
depression and somatization.
Conclusions. Results suggest that translation of evidence-based programs
can reduce psychosocial health disparities in Latinas with breast cancer.
Integration of this program into community-based organizations enhances its
dissemination potential. (Am J Public Health. 2015;105:e55–e63. doi:10.2105/
AJPH.2015.302598)
such studies are lacking among Latinas with
breast cancer. Translation of evidence-based
Cancer Support and Resource Center; and
a coalition of community-based organizations
stress management interventions could help
and clinical partners.21,22
address this gap and reduce ethnic disparities
in psychosocial health of Latinas with breast
METHODS
cancer.
We present results of a randomized controlled trial of a peer-delivered cognitive—
In this 6-month randomized controlled trial,
we compared the Nuevo Amanecer intervention
behavioral stress management (CBSM) program called Nuevo Amanecer (“a new dawn”)
with a usual-care control group (control group
for Spanish-speaking Latinas with breast
trial). We examined the program’s effectiveness
cancer. The program was developed using
community-based participatory research
in improving several dimensions of HRQOL
participants were offered the program after the
and distress at 3 months and 6 months. We
methods for translating evidence-based inter-
selected the 3-month interval because benefits
ventions for underserved populations20
through a collaboration between the University
from these types of interventions in women
of California, San Francisco; Círculo de Vida
after 6 to 12 weeks.23—25
Supplement 3, 2015, Vol 105, No. S3 | American Journal of Public Health
with breast cancer have been demonstrated
Nápoles et al. | Peer Reviewed | Research and Practice | e55
RESEARCH AND PRACTICE
Assessed for study eligibility (n = 195)
Excluded (n = 44)
Not meeting inclusion criteria (n = 22)
Declined to participate (n = 22)
Randomized (n = 151)
76 Randomized to intervention group
75 Randomized to control group
70 Completed 3-month follow-up
4 Refused
2 Lost to follow-up
74 Completed 3-month follow-up
1 Deceased
71 Completed 6-month follow-up
4 Refused
1 Lost to follow-up
1 Returned to study
73 Completed 6-month follow-up
1 Lost to follow-up
76 Included in analysis
75 Included in analysis
FIGURE 1—Flow of participants from screening to completion of final follow-up assessment: Nuevo Amanecer study; San Francisco Bay Area, CA;
February 2011–May 2014.
Participants
The study population consisted of Spanishspeaking Latinas with breast cancer residing in
5 Northern California counties. Inclusion criteria were (1) 1 year or less since diagnosis with
stage 0 to stage IIIC primary breast cancer; (2)
living in Alameda, Contra Costa, San Francisco,
San Mateo, or Santa Clara County; (3) primarily
Spanish speaking or Spanish monolingual; and
(4) self-identifying as Latina. Exclusion criteria
were (1) previous cancer diagnosis except for
nonmelanoma skin cancer, (2) terminal illness,
or (3) stage IV breast cancer (distant metastasis). We excluded women with metastatic cancer because their survival rates decline dramatically compared with those of women
diagnosed at earlier stages, suggesting that their
psychosocial concerns differ (greater emphasis
on symptomatic relief, existential matters).26
Recruitment was conducted by trained
bilingual Latinas employed by the communitybased organization partners on the project.21
Nuevo Amanecer Intervention
The Nuevo Amanecer program and its
development are described in detail elsewhere.21,22 Program development emphasized
appropriate methods for translating evidencebased interventions for underserved populations20 to address known determinants of
HRQOL disparities in Latinas with breast cancer. Nuevo Amanecer integrates an evidencebased CBSM program,23 a community bestpractices intervention offered at Círculo de
Vida for Latinas, literature, and formative research. Our formative work identified several
unique needs of Latinas with breast cancer
(e.g., the intervention needs to address lack of
comprehensible cancer information, feelings of
powerlessness and fear of death) and optimal
e56 | Research and Practice | Peer Reviewed | Nápoles et al.
delivery mechanisms (e.g., culturally competent
peer support).22
Adaptations to address known determinants
and Latinas’ needs included translation into
low-literacy (sixth-grade-level) Spanish with
images, integration of culturally appropriate
content, delivery by trained Latina breast
cancer survivors rather than professionals,
emotional support, and simple information on
cancer and its treatment. Adaptations were
guided by our community advisory board,
Círculo de Vida staff, and the author of the
evidence-based program.
Social-cognitive theory served as the conceptual framework for the intervention.27 The
program emphasized cognitive—behavioral
coping skills training, coaching, and modeling
to actively manage stress and emotions. Because vulnerable populations typically reside
in high-stress environments and perceive
American Journal of Public Health | Supplement 3, 2015, Vol 105, No. S3
RESEARCH AND PRACTICE
TABLE 1—Baseline Characteristics of Spanish-Speaking Latina Participants With
Breast Cancer: Nuevo Amanecer Study; San Francisco Bay Area, CA; February 2011–
May 2014
Intervention
Group
(n = 76),
Mean 6SD or
No. (%)
Control
Group (n = 75),
Mean 6SD or
No. (%)
Pa
Total Sample
(n = 151),
Mean 6SD or
No. (%)
Age, y
50.8 611.9
50.2 69.9
.76
50.5 610.9
Acculturation (scale 1–5)b
1.4 60.6
1.3 60.5
.31
1.3 60.6
.78
100 (66)
Characteristics
Educational attainment
< sixth grade
50 (66)
50 (67)
Sixth grade to < high school
15 (20)
12 (16)
27 (18)
High school graduate
11 (14)
13 (17)
24 (16)
Health insurancec
Any private
11 (14)
10 (15)
Public insurance only
62 (82)
56 (82)
None
Employed full or part time
Any financial hardship in past y
.95
21 (15)
118 (82)
3 (4)
2 (3)
12 (16)
59 (79)
14 (19)
56 (77)
.64
.78
26 (17)
115 (78)
5 (3)
.6
102 (68)
Ethnicity
Mexican
50 (66)
52 (69)
Central American
20 (26)
15 (20)
South American
6 (8)
8 (11)
35 (46)
45 (60)
51 (67)
45 (62)
Married or living with a partner
Poor or fair self-rated health
Presence of chronic medical condition
37 (49)
40 (53)
Clinical and treatment characteristics
35 (23)
14 (9)
.09
80 (53)
.49
96 (64)
.57
77 (51)
Type of breast cancer
DCIS
20 (26)
20 (27)
Invasive
56 (74)
55 (73)
.96
40 (26)
0
20 (26)
20 (27)
1
12 (16)
11 (15)
23 (15)
2
3
31 (41)
13 (17)
26 (35)
18 (24)
57 (38)
31 (21)
Breast conserving
43 (57)
41 (55)
Mastectomy
33 (43)
34 (45)
33 (43)
27 (36)
111 (74)
Stage
.73
40 (26)
Surgery
.81
84 (56)
Data Collection
67 (44)
Adjuvant treatment
Both chemotherapy and radiation
.58
60 (40)
Only radiation
18 (24)
24 (32)
42 (28)
Only chemotherapy
No treatment
14 (18)
11 (15)
11 (15)
13 (17)
25 (17)
24 (16)
Physical well-being (scale 0–24)
Breast cancer-specific quality of lifed
15.29 65.78
16.76 65.02
.1
16.0 65.5
Social/family well-being (scale 0–20)
13.67 64.42
.15
13.2 64.4
12.66 64.25
Emotional well-being (scale 0–20)
12.07 64.91
12.86 65.14
.33
12.5 65.0
Breast cancer concerns (scale 0–28)
16.52 65.43
17.33 65.08
.34
16.9 65.3
Enjoyment of life (scale 0–16)
8.92 63.80
9.22 63.43
.61
9.1 63.6
Continued
Supplement 3, 2015, Vol 105, No. S3 | American Journal of Public Health
a limited sense of control, acquisition of stress
management skills constitutes a critical, practical intervention to enhance their abilities to
cope with stressful situations. Thus, program
components aimed to increase self-efficacy for
cancer coping, use of coping skills, and perceived social support, which could improve
HRQOL and reduce distress. Eight weekly
modules covered managing the initial impact of
cancer, finding cancer information, getting
support, identifying helpful and unhelpful
thoughts, managing thoughts and mood, stress
management techniques, managing activities
that affect mood, and goal setting.21 Modules
addressed 3 social-cognitive theory components: self-efficacy (e.g., accessing information,
managing thoughts and activities affecting
mood), outcome expectations (e.g., recognizing
and restructuring unhelpful thoughts about
cancer and the future), and self-regulation (e.g.,
self-monitoring and adapting behaviors and
cognitions until goals were met).
The program was delivered by trained
compañeras (companions). Compañeras were
bilingual or Spanish-monolingual Latina breast
cancer survivors who had completed active
treatment and were at least 3 years postdiagnosis with no recurrence. Compañeras participated in 3 consecutive 8-hour training sessions
conducted by academic and community partners.21 The Nuevo Amanecer program was delivered face to face in participants’ homes for 8
weeks. Each week, one 90-minute module was
presented using visuals and hands-on exercises
to teach and reinforce concepts and skills.
Control group participants received usual care
until after the 6-month assessment, at which
time they were offered the intervention.
Baseline, 3-month, and 6-month assessments corresponded with our aims of evaluating the 8-week intervention soon after completion and retention of benefits after program
termination. Recruiters conducted 60-minute
baseline assessments in person.
An experienced, bilingual research associate
blinded to participants’ group assignment conducted the 3- and 6-month 30-minute telephone surveys. Data were collected and managed using a secure Web-based tool, Research
Electronic Data Capture (Harvard Catalyst,
Boston, MA).28 Participants were compensated
Nápoles et al. | Peer Reviewed | Research and Practice | e57
RESEARCH AND PRACTICE
TABLE 1—Continued
Overall quality of life (scale 0–108)
66.46 616.92
68.83 615.33
.37
67.6 616.1
General symptoms of distresse
Anxiety (scale 0–4)
0.93 60.84
1.01 60.88
.58
0.97 60.86
Depression (scale 0–4)
0.93 60.84
0.75 60.76
.16
0.84 60.80
Somatization (scale 0–4)
0.93 60.78
0.75 60.59
.1
0.84 60.70
Intrusive thoughts scale (scale 0–35)
Breast cancer-specific distressf
7.96 68.46
8.65 68.91
.63
8.30 68.66
Note. DCIS = ductal carcinoma in situ.
a
Compares differences between intervention and control group at baseline.
b
Marin language scale; higher score indicates greater acculturation to English.
c
Totals do not add up because of missing data (n = 7).
d
Functional Assessment of Cancer Therapy–Breast scores, modified; higher scores indicate better quality of life.
e
Brief Symptom Inventory; higher scores indicate more distress.
f
Intrusive Thoughts Scale; higher score indicates more distress.
published scoring algorithm, we summed items
after recoding responses to 0, 1, 3, and 5
(possible range = 0---35); higher scores indicate
greater distress. Internal consistency reliability
was 0.89.
Other variables. Descriptive characteristics
included self-reported age, language acculturation (Marin short version32), education, health
insurance, employment status, financial hardship, ethnicity, national origin, US-born or
foreign-born, marital status, self-rated health,
and presence of other chronic medical conditions. Breast cancer characteristics verified
through medical records review included cancer type, stage at diagnosis, and type of surgery
and adjuvant treatment.
Randomization
$30 per assessment; all assessments were
completed in Spanish.
Measures
Using baseline data, we examined the psychometric properties of our primary outcome
measures.
Breast cancer---specific quality of life. The
Functional Assessment of Cancer Therapy--Breast (FACT-B) was our breast cancer---specific
quality-of-life outcome measure29; it has been
translated into Spanish.30 The FACT-B consists
of 5 subscale scores pertaining to 4 well-being
dimensions (physical, social---family, emotional,
functional) and additional breast cancer concerns. A total overall score is the sum of all
subscales. Women were asked the extent to
which statements applied to them during the
previous 7 days (response options: 0 = not at
all, 1 = a little bit, 2 = somewhat, 3 = quite a bit,
and 4 = very much).
Our psychometric analysis resulted in some
modifications; of 37 items, 8 were dropped
because of 1 or more problems: (1) low itemscale correlations (< 0.30 with other items in
the scale corrected for overlap), (2) being
conditional on having a partner and thus
having a large amount of missing data, and (3)
being conceptually different from other items
on that scale. Subscales were scored by summing items after reversing some items; higher
scores indicated greater well-being. Possible
score ranges are as follows: physical well-being,
0---24; social---family well-being, 0---20; emotional well-being, 0---20; breast cancer
concerns, 0---28; and enjoyment of life, 0---16.
The total FACT-B score was the sum of the 5
modified subscales (range = 0---108). In our
sample, internal consistency reliabilities ranged
from 0.69 to 0.84 for the subscales.
General distress symptoms. We used 3 scales
from the Brief Symptom Inventory31: anxiety
(e.g., feeling nervous, fearful), depression (e.g.,
feeling lonely, worthless), and somatization
(e.g., dizziness, feeling weak). Women were asked
how much each symptom had bothered them
during the previous 7 days (response options:
0 = not at all, 1= a little bit, 2 = moderately,
3 = quite a bit, or 4 = extremely). Scores were
the mean of nonmissing items (possible
range = 0---4); higher scores indicate more distress. In our sample, internal consistency reliabilities were 0.85 for anxiety, 0.83 for depression, and 0.76 for somatization.
Breast cancer---specific distress. We measured
breast cancer distress with the 7-item Intrusive
Thoughts Scale, a subscale of the revised
Impact of Event Scale that is sensitive to change
in women with breast cancer who are receiving
a cognitive---behavioral intervention.13 Items
were anchored to the breast cancer experience
(as intended by the authors of the scale) and
asked about ruminations related to their breast
cancer, such as: “I had trouble falling asleep or
staying asleep because of pictures or thoughts
about my breast cancer that came into my
mind.” Women were asked how often each
symptom had applied to them in the past 7
days (response options: 0 = not at all, 1= rarely,
2 = sometimes, and 3 = often). Using the
e58 | Research and Practice | Peer Reviewed | Nápoles et al.
The individual was the unit of randomization
with 1:1 allocation to experimental groups. Randomization was stratified by recruitment site.
Before initiating recruitment, stratumspecific sequential identification numbers were
generated and randomly preassigned in blocks
of random sizes. After the baseline assessment,
each participant was handed a sealed opaque
envelope preprinted with the next sequential
identification number from her stratum that
revealed her group assignment.
Statistical Analysis
Using intention-to-treat analyses, we used
repeated-measures linear regression models to
estimate the intervention effects on study outcomes across the baseline, 3-month, and
6-month assessments. Likelihood-based model
estimation assumed outcome responses were
missing at random.33 Explanatory variables
included an intervention group indicator, a categorical time indicator, and a group · time
interaction variable.
Custom contrasts estimated differences between treatment groups at each assessment
as well as 2 group · linear time interactions:
1 examining the change from baseline to
3-month assessment (immediately after intervention) and 1 examining the change from
baseline to 6 months. We compared experimental groups on primary outcomes of breast
cancer---specific quality of life, general distress
symptoms (anxiety, depression, somatization),
and breast cancer---specific distress (intrusive
thoughts).
American Journal of Public Health | Supplement 3, 2015, Vol 105, No. S3
RESEARCH AND PRACTICE
RESULTS
TABLE 2—Quality of Life and Symptoms of Distress Among Spanish-Speaking Latinas With
Breast Cancer, by Treatment Group at Baseline, 3 Months, and 6 Months: Nuevo Amanecer
Study; San Francisco Bay Area, CA; February 2011–May 2014
Intervention, Mean (SD)
Control, Mean (SD)
Pa
Breast cancer-specific quality of lifeb
Physical well-being (scale 0–24)
Baseline
15.29 (5.78)
16.76 (5.02)
.098
3 mo
6 mo
18.13 (4.81)
19.44 (4.26)
18.01 (4.44)
18.44 (4.58)
.923
.212
Treatment · time interaction (0–3 mo)
.151
Treatment · time interaction (0–6 mo)
.015
Social/family well-being (scale 0–20)
Baseline
13.67 (4.42)
12.66 (4.25)
.154
3 mo
13.57 (4.65)
13.74 (4.24)
.732
6 mo
13.72 (4.81)
14.47 (3.81)
.293
Treatment · time interaction (0–3 mo)
Treatment · time interaction (0–6 mo)
.071
.025
Emotional well-being (scale 0–20)
Baseline
12.07 (4.91)
12.86 (5.14)
.333
3 mo
15.93 (3.52)
14.73 (4.33)
.081
6 mo
16.39 (3.30)
14.89 (3.95)
.018
Treatment · time interaction (0–3 mo)
.018
Treatment · time interaction (0–6 mo)
.004
Breast cancer concerns (scale 0–28)
Baseline
16.52 (5.43)
17.33 (5.08)
.344
3 mo
19.91 (4.69)
19.20 (4.69)
.396
6 mo
21.31 (3.83)
19.92 (5.22)
.083
Treatment · time interaction (0–3 mo)
.08
Treatment · time interaction (0–6 mo)
.013
Enjoyment of life (scale 0–16)
Baseline
8.92 (3.80)
9.22 (3.43)
.61
3 mo
6 mo
9.70 (3.59)
9.79 (3.39)
8.72 (3.28)
9.30 (3.06)
.103
.41
Treatment · time interaction (0–3 mo)
.048
Treatment · time interaction (0–6 mo)
.267
Overall quality of life (scale 0–108)
Baseline
66.46 (16.92)
68.83 (15.33)
.37
3 mo
77.24 (15.13)
74.39 (15.34)
.37
6 mo
80.64 (13.64)
77.02 (15.62)
.174
Treatment · time interaction (0–3 mo)
Treatment · time interaction (0–6 mo)
.061
.03
General symptoms of distressc
Anxiety (scale 0–4)
Baseline
0.93 (0.84)
1.01 (0.88)
.577
3 mo
0.48 (0.66)
0.60 (0.73)
.32
6 mo
0.39 (0.53)
0.58 (0.76)
.09
Treatment · time interaction (0–3 mo)
.808
Treatment · time interaction (0–6 mo)
.465
Continued
Supplement 3, 2015, Vol 105, No. S3 | American Journal of Public Health
We invited 195 women to the study; 22
were ineligible, and 22 refused to participate.
We randomly assigned 151 women (77%) to
the intervention (n = 76) or to the control
group (n = 75) between February 2011 and
November 2013; follow-up assessments occurred from May 2011 through May 2014
(Figure 1). More than 80% were enrolled
within 6 months of diagnosis; almost half
(47%) were enrolled within 3 months.
The sample had a mean age of 50 years
(SD = 11), low levels of acculturation to English, low levels of educational attainment, and
mostly public health insurance and was mostly
unemployed; the majority had experienced
financial hardship in the previous year (Table 1).
All but 1 were immigrants; the majority were
of Mexican origin (68%), followed by Central
American (23%). About a third reported being
in poor or fair health, and about half reported
a comorbid chronic condition.
About three fourths of the women were
diagnosed with invasive breast cancer, and the
rest with ductal carcinoma in situ. The majority
had breast-conserving surgery; 44% had
a mastectomy. Almost 60% had chemotherapy, mostly followed by radiation therapy.
Only 28% had radiation only, and 16% had no
adjuvant treatment.
Baseline levels of breast cancer---specific
quality of life were low, indicating poor quality
of life. In general, symptoms of anxiety, depression, somatization, and intrusive thoughts
were also low, indicating low levels of general
distress (Table 1). We found no significant
differences between intervention and control
groups at baseline on demographics, clinical
characteristics, quality of life, or distress outcomes (Table 1), indicating that balance between treatment groups was achieved with
randomization.
Approximately 82% of intervention group
participants were minimally compliant, completing at least 6 of 8 weekly sessions. Sixmonth study retention was excellent: 71 (93%)
of the intervention group and 73 (97%) of the
control group.
From baseline to 3-month follow-up, there
were statistically significant treatment · time
interaction effects for emotional well-being
Nápoles et al. | Peer Reviewed | Research and Practice | e59
RESEARCH AND PRACTICE
intervention group than the control group,
indicating less distress (3.87 vs 6.27; P = .046).
TABLE 2—Continued
Depression (scale 0–4)
Baseline
0.93 (0.84)
0.75 (0.76)
.164
3 mo
0.46 (0.59)
0.52 (0.63)
.531
6 mo
0.38 (0.48)
0.46 (0.62)
.355
Treatment · time interaction (0–3 mo)
.06
Treatment · time interaction (0–6 mo)
Somatization (scale 0–4)
.045
Baseline
0.93 (0.78)
0.75 (0.59)
.104
3 mo
0.67 (0.65)
0.74 (0.63)
.558
6 mo
0.52 (0.51)
0.66 (0.60)
.162
Treatment · time interaction (0–3 mo)
.038
Treatment · time interaction (0–6 mo)
.005
Breast cancer-specific distressd
Intrusive thoughts scale (scale 0–35)
Baseline
7.96 (8.46)
8.65 (8.91)
.625
3 mo
5.46 (7.52)
7.04 (8.00)
.232
6 mo
3.87 (5.79)
6.27 (8.42)
.046
Treatment · time interaction (0–3 mo)
.589
Treatment · time interaction (0–6 mo)
.226
Group means were compared at each assessment. Treatment · time interaction from baseline to 3-month assessment is
shortly after completing the intervention; treatment · time interaction from baseline to 6-month assessment is 3 months
after intervention.
b
Functional Assessment of Cancer Therapy–Breast scores, modified; higher scores indicate better quality of life.
c
Brief Symptom Inventory; higher scores indicate more distress.
d
Intrusive Thoughts Scale; higher score indicates more distress.
a
(P = .018), enjoyment of life (P = .048), and
somatization (P = .038) and trends toward
significance for breast cancer concerns
(P = .08), the total score (overall quality of life;
P = .061), and depression (P = .06; Table 2).
From baseline to 3 months, the intervention
group improved significantly more than the
control group on quality of life and distress:
emotional well-being, +3.86 versus +1.87
points (range = 0---20; Figure 2); enjoyment
of life, +0.78 points vs –0.50 points (range =
0---16); and somatization, –0.26 vs –0.01
points (range = 0---4).
From baseline to 6-month follow-up (3
months after intervention), we found significant
treatment · time interaction effects for physical
well-being (P = .015), social---family well-being
(P = .025), emotional well-being (P = .004),
breast cancer concerns (P = .013), overall
quality of life (P = .03), depression (P = .045),
and somatization (P = .005). From baseline to
6 months, the intervention group improved
significantly more than the control group on quality
of life and distress: physical well-being, +4.15
versus +1.68 points (range = 0---24; Figure 2);
emotional well-being, +4.32 versus +2.03
points (range = 0---20; Figure 2); breast cancer
concerns, +4.79 points versus +2.59 points
(range = 0---28); overall quality of life, +14.18
versus +8.19 points (range = 0---108); depression, –0.55 versus –0.29 points (range = 0---4);
and somatization, –0.41 versus –0.09 points
(range = 0---4). All significant interaction effects
were in the hypothesized direction of better
quality-of-life improvements in the intervention than in the control group, except for
social---family well-being. From baseline to 6
months, the control group improved significantly more than the intervention group on
social---family well-being (+0.05 vs +1.81
points; range = 0---20).
Regarding group main effects, at 6 months
the group mean for emotional well-being was
significantly higher for the intervention than
the control group, indicating better quality of
life (16.39 vs 14.89; P = .018). Although we
observed no significant treatment · time interaction effects for anxiety or intrusive
thoughts, the group mean on intrusive thoughts
at 6 months was significantly lower for the
e60 | Research and Practice | Peer Reviewed | Nápoles et al.
DISCUSSION
In this community-based peer-delivered
translational trial of a CBSM intervention for
Spanish-speaking Latinas with breast cancer,
we achieved excellent study retention and
program participation and clinically significant
improvements in several HRQOL dimensions.
Compared with the usual-care control group,
women who received the intervention reported
significant improvements at 6 months in breast
cancer---specific physical well-being, emotional
well-being, breast cancer concerns, and overall
quality of life as well as significant reductions in
general symptoms of depression and somatization.
Minimally important differences for the
FACT-B measures of breast cancer---specific
quality of life, that is, differences that are
important to patients, have been estimated on
the basis of 2 studies of White women with
metastatic breast cancer.34 These estimates
suggest that improvements of 2 to 3 points on
breast cancer concerns and of 7 to 8 points on
FACT-B total scores are minimally important
differences. Differences in improvements from
baseline to 6 months between intervention and
control group women in our study were about
this magnitude, suggesting that minimally important differences were achieved if one can
extrapolate from these previous studies conducted in different ethnic and clinical populations.34 However, it would be preferable to
identify minimally important differences specifically for Latinas with breast cancer.
It is interesting that some of the greatest
improvements occurred in somatization. This is
an important outcome for Latinas because
somatization may be a more culturally acceptable way to express psychological distress
because of the stigma associated with mental
health issues. For example, a validation study of
the Patient Health Questionnaire-15, which
assesses somatic complaints in primary care,
found that among Latinos, the questionnaire
captured mostly psychiatric distress, whereas
among non-Latinos it was equally associated with
psychiatric distress and a history of medically
unexplained symptoms.35 Thus, for Latinos,
somatization measures may be especially sensitive
American Journal of Public Health | Supplement 3, 2015, Vol 105, No. S3
RESEARCH AND PRACTICE
a
20
Physical Well-Being Mean Score
19.4
18.0
18
18.4
16.8
18.0
16
15.3
14
12
10
Control
Nuevo Amanecer
0
Baseline
3 months
6 months
Time
b
Emotional Well-Being Mean Score
20
18
15.9
16
14.8
14
16.4
15.0
12.9
12
12.1
10
Control
Nuevo Amanecer
0
Baseline
3 months
6 months
Time
FIGURE 2—Mean differences between Nuevo Amanecer and control groups in (a) physical
well-being and (b) emotional well-being: San Francisco Bay Area, CA; February 2011–May
2014.
outcomes to include in intervention trials that aim
to improve quality of life and psychosocial health.
We found no significant differences between
treatment groups in changes over time in
intrusive thoughts about breast cancer; however, at 6 months, the treatment group
reported significantly less distress than the
control group. The lack of a significant interaction effect is counter to previous psychosocial intervention trials, including similar types
of cognitive---behavioral interventions conducted with samples of predominantly White
women with breast cancer, which found significant improvements on this outcome over
time.13,36 Cultural factors might help explain
why we did not observe such changes in our
Latina sample. It is well documented that
traditional Latinos have a strong tendency to
equate cancer with death.37,38 Fatalistic beliefs
may be so embedded among Latina women
Supplement 3, 2015, Vol 105, No. S3 | American Journal of Public Health
that stress management interventions are insufficient to achieve significant reductions in
intrusive thoughts over time without special
emphasis on managing fears of recurrence and
death. In fact, when we shared our results with
Latina breast cancer survivors, they stated that
this fear of death never goes away and manifests as ongoing fears of recurrence.
The intervention group unexpectedly demonstrated worse social---family well-being than the
control group. A potential explanation is that
women who were in the intervention group
became more confident in expressing their needs
and asking for help from partners, family members, and friends. The program included instruction in communicating with family and friends
about cancer, how to ask for help, and expressing
feelings and needs because our formative work
indicated the need to teach traditional Latinas to
be more assertive because they may defer to their
partners and hide their needs to protect their
families.22 If Latina women were more expressive
of their needs as a result of the intervention, this
may have disrupted customary social interactions
and might explain the lower ratings of social and
family well-being. Interventions that target the
family unit may perhaps help prevent these lower
ratings.
Using community-based participatory research methods and social-cognitive theory, we
designed the Nuevo Amanecer program to
enhance its cultural relevance for Spanishspeaking Latinas with breast cancer who suffer
disparities in HRQOL and psychosocial health
compared with White women. Nuevo Amanecer
is the only community-based translation of
a CBSM program for Spanish-speaking Latinas
with breast cancer, and it thus makes a substantial contribution to efforts to address these
disparities. Another study among 52 Latinas
with breast cancer tested a psychoeducational
intervention to facilitate posttreatment survivorship, but the investigators did not differentiate between English- and Spanish-speaking
Latinas and did not find significant improvements in quality-of-life outcomes.39 The
greater improvements in our study could be
the result of intervening earlier in the survivorship continuum of care, training in cognitive---behavioral stress management skills that
can be applied across quality-of-life domains,
intervention delive
Visit the Center for Disease Control (Links to an external site.) and World Health Organization (Links to an external site.)(Links to an external site.)websites and discover what is there.
Find and analyze the following sections at the CDC web site:
Diseases and Conditions (Choose 2 to examine further)
Data and Statistics (Choose 2 to examine further)
Global Health (Choose 2 to examine further)
Publications (Choose 1 to examine further)
Emerging Infectious Diseases
Please respond to the following prompt in full paragraphs, and support your statements with evidence from the CDC:
What were the three most interesting things that you learned by visiting each of these sections, and why?
Find and analyze the following sections at the WHO web site:
Health Topics (choose 2 specific topics to dive into)
Data, GHO themes (choose 2 specific themes to dive into)
Publications (Choose 2 to examine further)
The publication titled Ten Years in Public Health, 2007 – 2017
Please respond to the following prompt in full paragraphs, and support your statements with evidence from the WHO:
What were the three most interesting things that you learned by visiting each of these sections, and why?
SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The comprehensive SOAP note is to be written using the attached template below.
For all the SOAP note assignments, you will write a SOAP note about one of your female (women’s health) patients and use the following acronym:
S = Subjective data: Patient’s Chief Complaint (CC).
O = Objective data: Including client behavior, physical assessment, vital signs, and meds.
A = Assessment: Diagnosis of the patient’s condition. Include differential diagnosis.
P = Plan: Treatment, diagnostic testing, and follow up
Submission Instructions:
Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
Soap note template attached below.
The ability to communicate, interact with different cultures, and think critically is essential in the medical field. The interactive media scenario you will use for this assignment illustrates a situation that could easily arise when working in health care. To complete this assignment, access the “Allied Health Community” media link in the topic Materials and complete the following:
Click “Enter” to begin.
Click on the box that says “SCENARIOS.”
Click on “View Scenario” for the “Critical Decision Making for Providers.”
Examine how the described problem might happen in your facility and the impact it could have. Work through this situation by examining all of the choices presented in the scenario.
When you get to the end of the scenarios, one scenario will have the word “Transcultural” on the top right corner. Click on “Transcultural.” Read the scenario and answer the four questions that are provided.
While APA style is not required for 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.
Diversity has a significant influence on health care. Studying transcultural health care helps health professionals understand different cultures in order to provide holistic and individualized health care. Review the Purnell Model for Cultural Competence, including the theory, framework and 12 domains. Write 750-1,000-word paper exploring the Purnell Model for Cultural Competence. Include the following:
Explain culturally sensitive care and its application within health care.
Explain the theory and organizational framework of the Purnell Model, and discuss its relevance to transcultural health care.
Describe Purnell’s 12 domains of culture, and assess how each of these domains plays an active role in the diversity of health care in your specific field.
Discuss how this model can be applied when working with different cultures in order to become a more culturally competent health care provider.
Cite at least three references, including the course textbook.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Select 5 Chapter 11 questions and 5 Chapter 15 questions below to respond to by 11:59 pm Friday. Do not forget to respond to at least 2 other classmates’ posts on at least 2 different days by 11:59 pm Monday.
Chapter 11: Teams
What do you believe should be done concerning a team member who monopolizes every meeting? What if this monopolizer is the team leader?
Why is shared authority important to proper team functioning?
Fully explain why some conflict is essential to effective team problem-solving.
Many times we have heard that “A camel is a horse designed by a committee.” Why have so many committees and teams inspired such cynical descriptions?
What do you believe is the primary hazard or significant drawback of a permanent team?
What is the “situational leadership” mentioned in the discussion of leadership style? Explain.
If you have just inherited a team and must take over today as its leader, how would you go about quickly getting an understanding of the previous leader’s style?
How would you suggest that a generally well-functioning team handle a single non-productive member?
What are two significant disadvantages of team action? How can these disadvantages be surmounted?
What do you believe is meant by the claim that team power is based on credibility? How do a team and its leader go about acquiring this power?
Chapter 15 Questions
How have organizational mergers and other affiliations affected employee morale, and why do you believe they have had these effects?
How can a system for collecting and evaluating employee suggestions become a morale depressor rather than a morale booster?
It has been said that the time to think of conducting an employee attitude survey is not when there are obvious morale problems. Why is this so?
Under what circumstances could morale be high while the motivation to perform is weak or lacking?
It has been proven that many employees consider the opportunity for promotion and growth to be important in their organizational environment, and yet only a relative few employees take advantage of this opportunity. Why might this be so?
If an employee is continually doing an acceptable job, not excelling but “chugging along” and producing reasonable results, why should any form of reward or recognition be considered necessary?
Why is it considered necessary for recognition to be delivered as soon after the deserving behavior as possible?
Why is monetary compensation not necessarily a motivator of improved performance?
Describe the fundamental employee needs that reward and recognition processes primarily fulfill.
Explain your understanding of a “cafeteria” benefits plan, and describe how elements of such a plan can be construed as “rewards.
Reading : Umiker’s Management Skills for the New Health Care Supervisor 7th edition
Respond to the following in a minimum of 175 words: Find 2 to 3 tools or resources available to health care leaders to help guide their efforts toward sustainable operations and explain the benefits of these tools or resources.
Patient name: JR, 14years old male, No allergies
Primary concern: Gun shot wound
Hx; Gun shot injury in left buttock
Vitals signs: RR 21, pulse 61, BP: 128/71
SPO2 100 on the right finger
Heart: clear heart beats S1 S2 heard clearly
Lungs all clear all extremities
Patient complain of abdominal pain rate pain 9/10
Objective assessment: Neuro assessment: GCS 15, patient was alert and oriented to , pupils are equal,
round and reactive to light and accommodation. Skin is appropriate to ethnicity.
Vitals signs: RR 21, pulse 61, BP: 128/71
SPO2 100 on the right finger
Heart: clear heart beats S1 S2 heard clearly
Intervention: Given patient morphine 600mg every 4-6 hours PRN giving with apple juice. Reassess the
client but he was sleeping.
Change underwear soak with blood, change sheet
Demonstrate what you’ve learned in this course by creating:
one-week plan for a preschool class that meets 4 days per week
one-week plan for a toddler class that meets 4 days per week
Use the Lesson Planning Forms provided:
Download, save your files every time you work, fill in completely.
1240 Preschool Curriculum Project Form
1240 Infant/Toddler Curriculum Project Form
EXAMPLES & FURTHER INSTRUCTIONS:
Final Project: Weekly Planning Form EXAMPLE
Final Project Lesson Planning Form EXAMPLES
STEPS:
FIRST,
“Cut and paste” from all completed lesson plans so far in the course from modules 4-8. Make needed revisions along the way based on your grading feedback. This will give you a jump start on the project and surely have you earning full points! (You will only be able to “cut & paste” one section of the sheet at a time and not the whole page.)
THEN,
Create lessons needed during Modules 9-14.
LASTLY,
Fill in the first two pages: the Weekly Planning Form, and the Daily Planning Form. You will focus on the Interest Areas we have used in class. Briefly write “changes/additions” you will make to those centers/interest areas for the week. This means you will simply write in the activity name and give a clear description. These boxes directly match up to your completed lesson plans.
(Teachers like to use this to see their planned week at a glance without needing to refer to each lesson plan. You can write more as you wish, but you at least need the title of the activity & description that matches the attached lesson plan.
YES, you need to fill in every box with an activity!
GRADING CRITERIA:
[100 points TOTAL]
Infant/Toddlers Plan
[8 points] – Activity title & clear description in Weekly/Daily Planning boxes. [1/2 point] each box
[48 points]- 12 total lesson plans, 4 points each, Components are complete, correct & clear on each:
Materials Needed [1 point]
Teacher Role [1 point]
SMART Goal [2 points]
Preschoolers Plan:
[8 points] – Activity title & clear description in Weekly/Daily Planning boxes. [1/2 point] each box
[36 points]- 9 total lesson plans, 4 points each, Components are complete, correct & clear on each:
Materials Needed [1 point]
Individual Difference & Accommodation [1 point]
SMART Goal [2 points]
Frequently Asked Questions:
Do I need to have a theme for the week? No, a theme is not necessary. You may want to plan some activities related to your story or a topic you’re learning about as a class. You do not need to have every activity relate to a common theme.
May I create my own planning forms? For this assignment, no. Typically teachers can create their own forms, and there are many ways to plan a curriculum. You are just using and learning this one option.
May I use Lesson Worksheets that I have already completed for other assignments? Yes! That is one of the reasons for working on those! Cut and paste each section while making changes based on instructor feedback.
Where can I find ideas for activities? Use your text and resources posted in content as your primary resource. You can “copy” ideas you find from any resource online that is developmentally appropriate. Teachers usually “borrow” activity ideas and then make them fit their own goals and style of teaching.
What do I need to write in the boxes on the first two pages of the project? Take a look at the “Weekly Planning Form Example” posted above. This can be exactly what you also write in your “Activity Name & Description” on your lesson plan worksheet.
I ran out of time! What now? By the deadline, turn in what you have finished!
Please double-check that you have submitted the correct, completed document, as I can not accept assignments after the close date. I recommend saving your document with the word “DONE” at the end so you choose the correct one for sure!
Due on Nov 1, 2023 11:59 PM
Available until Nov 2, 2023 11:59 PM. Access restricted after availability ends.
Attachments
Chromebooks Only – 1240 Toddler Curriculum Plan… (2.1 MB)
Chromebooks Only – 1240 Preschool Curriculum Pl… (1.52 MB)WEEK 9 – NO NEW CONTENT (Oct. 16-20)/ Mod 16 ” FINAL PROJECT”
Hello I would like a tutor to add work history, and make corrections to my resume as well as to my cover letter to make it more professional and experienced.The tutor is responsbile for making it more professional, adding more details, enhancing the resume and cover letter with alot of details.
Unformatted Attachment Preview
DESTINY FERREIRA
516 Nazareth Pike, Nazareth PA 18064
Mobile number: 4845100785 ▪ Destinyferreirajasmine@gmail.com ▪ [Type your website]
Professional summary
A highly experienced and qualified healthcare management professional with impeccable skills in
handling healthcare practices such as management, administration, caregiving, finances, and customer
sales. The healthcare sector is rapidly changing, so adapting to evolving environments is vital. I am a
flexible healthcare professional who can adapt to diverse settings to enhance service delivery and patient
satisfaction.
Objectives
➢
To make a difference in the lives of patients through quality service delivery
➢
To be a successful healthcare leader with a strong desire to transform healthcare environments.
➢
To develop goals, strategies, and regulations necessary for change in the healthcare sector.
Work Experience
Personal Care Provider
03/2019-08/2020
Private Client
Job responsibilities
•
Assisted patient with medications, nutrition and basic needs
•
Provided companionship and assisted with mobility
•
Scheduled appointments and contact insurance provider to verify insurance coverage
•
Prepared and maintained records of client progress and services performed
•
Organize Activities
•
Experience helping resident that suffered through dementia
Obtained CPR and AED Certification
Car Salesperson/Receptionist
J.O Auto Sales
September 2020- June 2023
Greet clients
Organize paperwork and complete administrative duties such as making travel arrangements,scheduling
meetings and organizing filing system
Coordinates the financing for customers buying new or used vehicles, fill out car sale contracts, and set
payoff values
Supervise 1 Employee
3+ years of customer service experience
Obtained Sales License.
Self-employment
2022 to 2023
In March 2022, I founded Destiny’s pure Organics which is an Organics health and beauty line. The
product line includes the following;
•
Organic Healthcare products
•
Organic Soaps
•
Organic Candles
•
Essential oils
•
Adult Skin Care line
The company’s website is Destinyspureorganics.com, and through the platform, the ultimate goal is to
create and inspire others through organic soaps and related healthcare products. While there are
numerous brands of inorganic soaps today, Destiny Soaps offers a different experience of originality
through healing with herbs, oils, and color that helps focus on mind, body, and spirit.
Skills
•
Project management
DESTINY FERREIRA Page 2
•
Communication skills
•
Accountability
•
Obtained Certifications in organizational leadership October 2018 and human resource
management June 2021
•
Change management
•
Staff mentoring
•
Time Management
•
Job Knowledge
Education
January 2023 to present
Liberty University
Completing Doctorate degree in Business Administration specializing in Healthcare Management
Relevant coursework
•
Foundations of applied research methods
•
Strategic allocation of financial resources
•
Healthcare informatics
•
Legal and ethical issues for health professionals
•
Managing human capital in healthcare
2019 -2021
Colorado State University
Master’s degree in healthcare administration
Relevant course work
•
The US healthcare system
•
Health law and ethics
•
Quality and performance improvement in healthcare
•
Healthcare information systems
•
Managing human resource
•
Maximizing human capital and resources
•
Staffing and talent development
DESTINY FERREIRA Page 3
2014-2018
Colorado State University- Global Campus
Bachelor of Science in Healthcare Administration and Management
Relevant course work
•
Anatomy and physiology
•
Essentials of biology
•
Microbiology for allied health
•
Math for health science
•
Developmental psychology
•
Financial accounting
•
The economics of healthcare
•
Ethics and decision making in healthcare management
•
Economics of healthcare
•
Health law
•
Health and disease
High school
Graduation date was 2014
Renaissance High School for Musical Theater and the Arts
3000 East Tremont Avenue
Bronx NY 10461
DESTINY FERREIRA Page 4
Destiny Ferreira
516 Nazareth Pike, Nazareth PA 18064
Destinyferreirajasmine@gmail.com
Mobile number 4845100 785
Dear Hiring Manager,
It is with considerable interest and experience that I wish to submit my application for
the healthcare manager position in your facility. I hold a Bachelor’s degree in
Healthcare Administration and Management from Colorado State University- Global
Campus and have various job training in my area of expertise. I have my master’s
degree in healthcare administration and currently pursuing a doctorate degree in
Business Administration specializing in Healthcare Management at Liberty
University.
My experience as a caregiver, car sales person, receptionist, and entrepreneur has
equipped me with strong listening, time management, organizational, analytical, and
report-writing skills. It has given me the skills to nurture successful relationships with
clients and make them feel valued and loved through empathy and compassion. My
role has given me a complete understanding of how to deal with people from different
diversities.
Throughout my career, I have acquired impeccable interpersonal and communication
skills. I am compassionate when handling patients and all the stakeholders within the
hospital setting. Further, I possess outstanding problem-solving skills, which will help
me find tangible solutions that may emerge in the department. I also possess
experience handling finance, customer service, etc.
I will engage my expertise, vision and passion while utilizing my strengths which
encompass quality service delivery, time and stellar results. I will apply my
exceptional professional and team-building skills in developing a harmonious working
environment with partners and team members to drive quality service delivery to the
community.
Please give me substantial consideration in your decision-making process. I am
available for a face-to-face interview to discuss my capabilities in detail.
Thank you for your time and consideration.
Sincerely,
Destiny Ferreira
Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template, attached, to complete this assignment.You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
What are the three factors upon which evaluation and management codes are based? What are the three key components of patient services? What are the four contributing factors that could affect correct code selection? Please explain each factor or element listed out.Mrs. London, a 55-year-old woman with diabetes, is referred to a dietitian by her physician because her physician believes that she is not eating properly. The dietitian spends an hour in the initial assessment of Mrs. London. Why is it important for a diabetic to maintain a proper diet, and how might a dietitian assist in improving the diet of a diabetic patient? How should the dietitian’s services be coded [Tips- A dietitian’s services are coded with the medical, nutritional therapy codes (i.e., 97802) and are reported in increments of 15 minutes. Think about the types of codes the dietitian would use (a) medical nutrition therapy code, (b) initial assessment and intervention code, (c) individual, face-to-face with the patient code, etc.]
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Module 1 Question 2
Contains unread posts
Michael Wade posted Oct 18, 2023 12:30 AM
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1. Mrs. London, a 55-year-old woman with diabetes, is referred to a dietitian
by her physician because her physician believes that she is not eating
properly. The dietitian spends an hour in the initial assessment of Mrs.
London. Why is it important for a diabetic to maintain a proper diet, and
how might a dietitian assist in improving the diet of a diabetic patient?
How should the dietitian’s services be coded [Tips- A dietitian’s services are
coded with the medical, nutritional therapy codes (i.e., 97802) and are
reported in increments of 15 minutes. Think about the types of codes the
dietitian would use (a) medical nutrition therapy code, (b) initial
assessment and intervention code, (c) individual, face-to-face with the
patient code, etc.]
•
•
•
Maintaining a healthy diet is very important for individuals living with
diabetes. It helps them manage their weight and keep their blood sugar
levels in check, which, in turn, makes it easier to treat the condition
and prevent it from getting worse.
For someone with diabetes, seeking the guidance of a dietitian can be
incredibly beneficial in their effort to maintain a proper diet. Dietitians
possess valuable knowledge that allows them to advise individuals on
which foods are beneficial and which ones should be limited. They can
provide individuals with the essential building blocks to create meals
that not only align with their dietary needs but also seamlessly fit into
their daily lives.
When it comes to coding for nutritional therapy, specific codes like
97802 to 97804 are used. These codes are reported in increments of 15
minutes, meaning each 15-minute block of nutritional therapy is
assigned a code. For instance, if we take the case of Mrs. London, her
nutritional therapy was 1 hour so four 15-minute sessions, resulting in
the use of the nutritional therapy code x4 to accurately capture the
time and effort put into her nutritional counseling and support.
Module 1- Q2
Contains unread posts
Chailan Campbell posted Oct 16, 2023 11:56 AM
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1.
Mrs. London, a 55-year-old woman with diabetes,
is referred to a dietitian by her physician because her
physician believes that she is not eating properly. The
dietitian spends an hour in the initial assessment of Mrs.
London. Why is it important for a diabetic to maintain a
proper diet, and how might a dietitian assist in improving
the diet of a diabetic patient? How should the dietitian’s
services be coded [Tips- A dietitian’s services are coded
with the medical, nutritional therapy codes (i.e., 97802)
and are reported in increments of 15 minutes. Think
about the types of codes the dietitian would use (a)
medical nutrition therapy code, (b) initial assessment and
intervention code, (c) individual, face-to-face with the
patient code, etc.]
Maintaining a proper diet is important for individuals
with diabetes, as it directly impacts their health and wellbeing. Diabetes is a condition characterized by abnormal
blood sugar levels, and nutrition plays a central role in
regulating these levels. For diabetics, consistent blood
sugar control is essential to prevent complications such
as hyperglycemia and hypoglycemia. Proper nutrition can
also help with weight management, another critical
aspect for many diabetics. Obesity is a significant risk
factor for Type 2 diabetes, and maintaining a healthy
weight can improve insulin sensitivity, making it easier to
manage blood sugar levels effectively. Diabetics are at an
increased risk of heart disease, and a heart-healthy diet
can help reduce this risk. Such a diet can contribute to
controlling cholesterol and blood pressure, both of which
are essential for cardiovascular health. It’s worth noting
that diabetes-related complications, including kidney
disease, neuropathy, and retinopathy, can be prevented
or minimized with good nutrition. Therefore, a balanced
diet has the potential to improve overall health and
quality of life for individuals living with diabetes.
In addition, dietitians educate patients on how different
foods affect their blood sugar levels and provide
strategies for monitoring these levels effectively. This
education empowers patients to make informed dietary
choices independently. In addition to educational
support, dietitians also offer emotional support,
motivation, and ongoing guidance to ensure patients can
make sustainable changes to their diets over the long
term.
Now, in regard to healthcare billing, coding is used to
accurately reflect the services provided. When it comes to
dietitian services, Current Procedural Terminology (CPT)
codes are used. The specific code selected typically
depends on the nature of the visit and the services
provided during the appointment. For the initial
assessment, a common code used might be “97802”
(HMSA 2023). The total time spent with the patient
determines the number of units. The selection of the
specific code should be in accordance with the guidelines
of the healthcare facility or insurance provider. It’s
essential for the dietitian to maintain thorough
documentation of the services rendered to support
accurate coding and billing (AAPC 2023).
“E/M Coding History, Exam and MDM
Components.” AAPC, www.aapc.com/resources/evaluatio
n-management-history#. Accessed 16 Oct. 2023.
Provider Resource Center ,
prc.hmsa.com/s/article/Coding-Guidelines-for-MedicalNutrition-Therapy. Accessed 16 Oct. 2023.
Module 1 Question 2
Contains unread posts
Tara Sepe posted Oct 17, 2023 12:50 PM
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Mrs. London, a 55-year-old woman with diabetes, is
referred to a dietitian by her physician because her
physician believes that she is not eating properly. The
dietitian spends an hour in the initial assessment of Mrs.
London. Why is it important for a diabetic to maintain a
proper diet, and how might a dietitian assist in improving
the diet of a diabetic patient? How should the dietitian’s
services be coded?
There are many reasons as to why diabetics maintain a
proper diet. The first reason is physical reasons, such as
weight. Maintaining a proper and healthy diet can help
diabetics manage their weight. Being overweight comes
with many challenges including controlling blood sugar
and physical challenges. To go with that, controlling Mrs.
London’s blood sugar is essential to maintaining her
health. When eating healthy, your blood sugar is most
likely going to be at a “normal” rate. For example, Mrs.
London will not get sugar spikes and crashes, which
reduces the need for things like medication. Diabetics
are also at a high risk for heart disease. This, again, can
lead to more major issues, so it is essential that Mrs.
London maintains a healthy diet so she can avoid any
issues that come with heart disease.
Mrs. London’s dietitian must go over a few things and
educate her on how to maintain a proper diet for her
health. The dietitian should go over meal plans
specifically for Mrs. London. For example, the dietitian
should consider her age, activity level, etc. Another thing
the dietitian should really emphasize is portion
control/calorie counting. Portion control is an essential
step to making your health better, especially with Mrs.
London’s diabetes. The last thing the dietitian should
emphasize is how important exercise is, and the dietitian
can even come up with an exercise plan for her while
considering her age and other things.
While considering the codes for the dietitian’s services,
we must use Current Procedural Technology (CPT) codes.
A common code for medical nutrition therapy would be
97802-97804. CPT 97802 would be a code for
nutritional assessment; initial assessment. The dietitian’s
services are reported in increments of 15 minutes. For
example, if the patient spends an hour with the dietitian,
it would be reported as 97802 X 4, Medical nutritional
therapy, initial assessment and intervention, individual,
face-to-face with the patient, each 15 minutes.
Reference
Koesterman, J. L., & Buck, C. J. (2021). Buck’s the next
step: Advanced Medical Coding and Auditing,
2021/2022. Elsevier.
Module 1- Q1
Contains unread posts
Chailan Campbell posted Oct 16, 2023 11:31 AM
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1. What are the three factors upon which evaluation
and management codes are based? What are the
three key components of patient services? What are
the four contributing factors that could affect
correct code selection? Please explain each factor or
element listed out.
The three factors upon which E/M codes are based are
history, examination, medical decision making (MDM).
History includes the patient’s medical history, present
illness, review of systems and past family and social
history, this level of detail and complexity of the history
documented plays a role in code selection. Examination
is the extent and complexity of the physical examination
done by the healthcare provider is an important factor.
The exam can range from a straightforward evaluation to
a comprehensive assessment. Now, for MDM, it is the
process of analyzing the patient’s condition, making a
diagnosis, and determining the appropriate treatment
plan. It will consider the data collected and reviewed, the
risk of the complications, as well as the management
options chosen (AAPC 2023)
According to my searches, the three components of
patient services in regard to coding in healthcare are also
history, examination, and MDM. In the healthcare
industry, the three components are empathy, two- way
communication, and eye to eye contact according to
NEJM Catalyst (NEJM Catalyst 2017).
The four contributing factors that could affect the correct
code selection is counseling, coordination of care, the
nature of the presenting problem, and facetime (Provider
News 2020). For counseling, if a significant amount of
time was spent on this, it will have an influence on the
code selection. For coordination of care, if the healthcare
provider spends time coordinating with other providers
or services, it can affect code selection. For the nature of
the present problem, the complexity and severity of the
patient’s presenting problem, along with the data
reviewed and risk assessment, are important when
determining the appropriate code.
Overall, proper code selection is essential for accurate
billing, documentation, and reimbursement in healthcare.
It relies on a detailed assessment of these factors to
ensure that the level of service provided is properly
reflected in the code given.
“E/M Coding History, Exam and MDM
Components.” AAPC, www.aapc.com/resources/evaluatio
n-management-history#. Accessed 16 Oct. 2023.
Provider News,
providernews.empireblue.com/articles/evaluation-andmanagement-services-correct-coding. Accessed 16 Oct.
2023.
What Is Patient-Centered Care? | Nejm Catalyst ,
catalyst.nejm.org/doi/full/10.1056/CAT.17.0559.
Accessed 16 Oct. 2023.
Module 1 Question 1
Contains unread posts
Tara Sepe posted Oct 16, 2023 2:44 PM
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1. What are the three factors upon which evaluation
and management codes are based? What are the
three key components of patient services? What are
the four contributing factors that could affect
correct code selection? Please explain each factor or
element listed out.
The codes in the E/M section are based on place of
service, type of service, and patient status. Place of
service is the first step in choosing the correct E/M code.
Codes will vary based on the place of the service. For
example, as we learned in 368, there are different codes
for inpatient and outpatient settings. Next, the type of
service is the second step in choosing the correct E/M
code. Examples of types of service include consultation,
hospital admission, or an office visit. Lastly, patient
status has four types. First, there is new patient, and they
have not received professional services from a physician
within the past three years. Second, there is an
established patient. This is when they have received
services from a physician within the past three years. The
third is outpatient. Fourth, is inpatient.
The three key components are history, examination, and
medical decision-making. History includes the patient’s
medical history. Examination is when the extent is
determined by the physician while being medically
appropriate. This evaluates the patient and can include a
physical examination. Lastly, medical decision-making
includes the number and complexity of the problems that
are addressed at an encounter, as well as the amount of
data to be analyzed.
The four contributory factors are counseling,
coordination of care, the nature of the presenting
problem, and time. Counseling is a service that
physicians provide to patients and their families. It
involves a discussion of diagnostic results, impressions,
and recommended diagnostic studies. Coordination of
care is when a physician might arrange for other services
to be provided to the patient, such as arrangements for
admittance to a long-term nursing facility. The nature of
presenting the problem is described by the CPT as “a
disease, condition, illness, injury, symptom, sign,
finding, complaint, or other reason for the encounter,
with or without a diagnosis being established at the time
of the encounter”. There are also five types of presenting
the problem: minimal, self-limited, low severity,
moderate severity, and high severity. Lastly, time is
measured in two ways. There is face-to-face time and
unit/floor time.
Reference
Koesterman, J. L., & Buck, C. J. (2021). Buck’s the next
step: Advanced Medical Coding and Auditing,
2021/2022. Elsevier.
Module 1 Question 1
Contains unread posts
Katie Corcoran posted Oct 17, 2023 10:59 AM
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1. What are the three factors upon which evaluation
and management codes are based? What are the
three key components of patient services? What are
the four contributing factors that could affect
correct code selection? Please explain each factor or
element listed out.
Based on service location, service kind, and patient
status, the codes in the E/M sector are assigned. To
select the right E/M code, start with the location of the
service. Based on where the service is provided, different
codes will apply. For instance, the codes for inpatient
and outpatient settings differ, as we discovered in 368.
The next consideration when selecting the right E/M
code is the type of service. Consultation, hospital
admission, and office visit are a few examples of
different service types. Finally, there are four different
categories of patient status. The first case involves a new
patient who hasn’t sought medical advice from a
professional in the previous three years. Second, a
patient is already in place. They have worked within the
last three years as a doctor. Outpatient care is the third.
Inpatient is the fourth.
History, examination, and medical judgment are the
three main components. The patient’s medical
background is included in the history. When a doctor
performs an examination, they decide the extent in a way
that is proper for medicine. This assesses the patient and
could involve a physical examination. The quantity and
complexity of the issues addressed during an encounter
and the amount of data that needs to be examined are
also factors in medical decision-making.
The four contributing variables are counseling, care
planning, the type of problem being presented, and time.
Medical professionals offer counseling to patients and
their families. Discussions of the diagnostic findings,
opinions, and suggested diagnostic studies are included.
When a doctor coordinates care, additional services for
the patient may be provided, such as arrangements for
admission to a long-term nursing facility. The CPT
defines the problem’s nature as “a disease, condition,
illness, injury, symptom, sign, finding, complaint, or
other reason for the encounter, with or without a
diagnosis being established at the time of the
encounter.” The problem can be presented in one of five
ways: minimum, self-limited, low severity, moderate
severity, or high severity. Finally, there are two ways to
measure time. Face-to-face time and unit/floor time
both exist.
Reference
Koesterman, J. L., & Buck, C. J. (2021). Buck’s the next
step: Advanced Medical Coding and Auditing,
2021/2022. Elsevier.
Attached is a copy of the worksheet that needs to be done.
Unformatted Attachment Preview
GCH 412
Homework 8
Experimental Studies
(and maybe other designs)
Clostridium difficile, often called C. difficile or “C. diff,” is a bacterium that can cause a wide variety of
gastro-intestinal symptoms ranging from diarrhea to life-threatening inflammation of the colon. C. diff most
commonly affects older adults in hospitals or in long term care facilities and typically occurs after the use of
antibiotic medications. C. diff bacteria are passed in feces and spread to food, surfaces, and objects when
people who are infected don’t wash their hands thoroughly. The bacteria produce hardy spores that can
persist in a room for weeks or months, thus it is easily spread.
A local hospital noticed an increase in nosocomial infections of C. diff in their elderly patient population. A
study was conducted to determine whether a new anti-bacterial hand soap was more effective than the
current hand soap in preventing the occurrence of C. diff infections. Elderly patients on the cardiac intensive
care floor were assigned to the new hand soap intervention and elderly patients on the general intensive care
floor were assigned to the usual hand soap regimen. All staff members and visitors were instructed on
proper hand washing techniques before they were permitted to see patients. Over the 6-month span of the
intervention, there were 3 C. diff infections among the 212 patients in the new hand soap intervention. There
were 32 C. diff infections in the 243 patients in the usual hand soap group.
Complete the 2×2 table for these data. Be sure to label the boxes properly.
1. Is this an experimental study? Why or why not?
2. Is this a randomized controlled study? Why or why not?
3. What is the appropriate measure of association for this type of study? Calculate and interpret it in
words.
4. You should have some concerns with how this study was conducted. What concerns do you have
and how would you address them? Please provide two suggestions. This is an open-ended question
without definitively right and wrong answers; I just wanted to get you thinking about all the potential
issues with the conduct of this study.
Pertussis, or whooping cough, is a highly contagious bacterial disease caused by Bordetella pertussis or
Bordetella parapertussis bacteria that cause uncontrollable, violent coughing. The coughing can make it
hard to breathe. A deep “whooping” sound is often heard when the patient tries to take a breath. It is a
serious disease that can cause permanent disability in infants, and even death. When an infected person
sneezes or coughs, tiny droplets containing the bacteria move through the air, and the disease is easily
spread from person to person. An outbreak of pertussis recently occurred in the state of California, resulting
in the deaths of several infants. DTaP vaccination, one of the recommended childhood immunizations,
protects children against pertussis infection. DTaP vaccine can be safely given to infants. As the immunity
from vaccines wears off over time and pertussis booster vaccine rates in adolescents and adults continue to
be low, researchers wished to evaluate the efficacy of a new vaccine requiring only one booster at age 7
against the current vaccine which requires 5 doses at ages 2 months, 4 months, 6 months, 15-18 months, and
4-6 years and a booster at age 11.
The new vaccine was used to vaccinate 545 children with 26 children developing whooping cough over the
next five years. The current vaccine was used to vaccinate 550 children with 37 children developing
whopping cough over the next five years. Please complete the 2×2 table with these data. Be sure to properly
label your exposure and outcome.
1. What type of study is this? How do you know?
2. State and calculate the appropriate measure of association. Interpret this information in words.
3. Can you calculate AR%? If so, please calculate and explain your results. If not, explain why it cannot be
calculated.
Spasmodic dysphonia (SD) is an idiopathic, chronic, and disabling voice disorder. Researchers were
interested in investigating the relationship between SD and meningitis. 150 individuals suffering from SD
and 150 individuals without SD were identified for a study. Of those with SD, 16 had previously had
meningitis. Of those without SD, 3 had previously experienced meningitis. Complete the following 2×2 with
this information. Be sure to properly label your exposure and outcome.
1. What type of study is this? How do you know? Be precise.
2. State and calculate the appropriate measure of association. Interpret this information in words.
3. Can you calculate AR%? If so, please calculate and explain your results. If not, explain why it
cannot be calculated.
Researchers were interested in the relationship between hypertension (defined as blood pressure of 140/90
mm HG or higher) and coronary heart disease (CHD). Participants were recruited between 1995 and 1997
and consisted of 1,333 male and 1,661 female residents of Mason County aged 28-62 years old. Of these
participants, 1295 had high blood pressure; the rest did not. Participants did not have heart disease at the
beginning of the study and all participants were followed for six years. In the group that initially had high
blood pressure, 106 individuals developed coronary heart disease. In the group with normal blood pressure,
1655 showed no signs of CHD. Complete the following 2×2 with this information. Be sure to properly label
your exposure and outcome.
1. What type of study design is this? How do you know?
2. State the appropriate measure of association. Calculate it and interpret it in words.
3. Can you calculate an AR%? If so, calculate and explain it. If not, explain why it cannot be
calculated.
According to the CDC, kidney disease occurs when the kidneys become damaged and lose their ability to
filter the blood. Left untreated, kidney disease can lead to kidney failure. People with severe kidney failure
must undergo dialysis or have a kidney transplant to stay alive. More than eight million Americans have a
major loss in kidney function. Of those, nearly 400,000 require dialysis or a kidney transplant to stay alive.
Diabetes is the leading risk factor for kidney disease. Researchers went to a local diabetes awareness event
and asked participants whether they had ever been diagnosed with kidney disease and whether they
currently had diabetes. There were a total of 2,000 participants at the fair. Of these, 1280 had diabetes and
the rest did not. In the group with diabetes, 166 had kidney disease. In the group without diabetes, 677 did
not have kidney disease. Complete the following 2×2 with this information. Be sure to properly label your
exposure and outcome.
1. What type of study design is this? How do you know?
2. What is the appropriate measure of association? Compute it and interpret it in words.
3. Can you calculate an AR%? If so, calculate and explain it. If not, explain why it cannot be
calculated.
Describe the theory and relevant theoretical constructs that guide the selection of strategies and activities to address the health issue with the priority population. Drawing from the social-ecological perspective, this important section describes the level at which the framing theory of the program will be applied (i.e., intrapersonal, interpersonal, institutional/organizational, community, or policy level), the core constructs of the selected theory, and why this theory and level are appropriate for the situation the program proposes to address.
Although the program proposal requires a multi-level approach for this assignment, you are required to explain your theory at only one level.
PC theoretical framework draft instructions
Step 1: Determine the primary level of change for your program
Step 2: Select the most relevant theory to guide your rationale for change (according to the desired level of change and what you have learned about the problem).
Step 3: Develop an outline and write a 2-3 page draft for this section of the proposal.
Step 4: Use APA-level headings to organize your work. Start with an APA level I heading (Theoretical Framework) for the section as a whole and then use sub-headings (level II and possibly III) for the constructs that are associated with the theory.
Introduce the level of change and the appropriateness/relevance of the selection.
Describe the basic premise of the theory.
Introduce and explain all of the constructs of the theory
For each construct, explain (briefly) how the construct will be operationalized (turned into action) in your program proposal. For example. If you are going to be using the Diffusion of Innovation theory, explain the communication channels that you will be using and why (what makes the channels you have selected relevant to your population?).
Use Theory at a Glance as a source (or another resource as needed) to support your description and overview of the theory and the associated constructs.
ADDITIONAL REQUIREMENTS :
Length – 2-3 pages (not including cover page and references).
Format – Times New Roman, 1-inch margins, 12 point font, with citations in APA style (7th Edition).
References – cite the readings and or other sources, including outside resources (i.e. academic journal article).
Hi! I was assigned a draft for my class where we talk about the theories on my program. I recently wrote a paper on unhoused individuals in the Santa Clara County ages 18-30 that are hispanic. We now have to conduct a program for my priority population that is a selection of strategies and activities to address the health issue with the priority population. The health issue is substance use for the unhoused individuals in the Santa Clara County. Describe the level at which the framing theory of the program will be applied (i.e., intrapersonal, interpersonal, institutional/organizational, community, or policy level), the core constructs of the selected theory, and why this theory and level are appropriate for the situation the program proposes to address.
Based on “Case Study: Fetal Abnormality” and the required topic Resources, write a 750-1,000-word reflection that answers the following questions:
What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
How does the theory determine or influence each of their recommendations for action?
What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?
Remember to support your responses with the topic Resources.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Please respond to the following:Go to the American Hospital Association website, navigate to the Advocacy tab, and review at least three to five key advocacy issues in health care and the factors that influence shifts in cost and supply curves. Compare the health care-based factors in the issues that you reviewed that, in your opinion, cause the cost curve of health care to shift. In your response, provide at least one example showing the manner in which the cost curve shifts.
Review Article
Redesigning the Regulatory Framework
for Ambulatory Care Services in New York
D AV E A . C H O K S H I , ∗,† J O H N R U G G E , ‡
a n d N I R AV R . S H A H §
∗
New York City Health and Hospitals Corporation; † New York University
Langone Medical Center; ‡ Hudson Headwaters Health Network; § Kaiser
Permanente
Policy Points:
r The landscape of ambulatory care services in the United States is
rapidly changing on account of payment reform, primary care transformation, and the rise of convenient care options such as retail clinics.
r New York State has undertaken a redesign of regulatory policy for
ambulatory care rooted in the Triple Aim (better health, higherquality care, lower costs)—with a particular emphasis on continuity
of care for patients.
r Key tenets of the regulatory approach include defining and tracking
the taxonomy of ambulatory care services as well as ensuring that
convenient care options do not erode continuity of care for patients.
Context: While hospitals remain important centers of gravity in the health
system, services are increasingly being delivered through ambulatory care. This
shift to ambulatory care is giving rise to new delivery structures, such as retail clinics and urgent care centers, as well as reinventing existing ambulatory
care capacity, as seen with the patient-centered medical home model and the
movement toward team-based care. To protect the public’s interests, oversight
of ambulatory care services must keep pace with these rapid changes. With this
purpose, in January 2013 the New York Public Health and Health Planning
Council undertook a redesign of the regulatory framework for the state’s ambulatory care services. This article describes the principles undergirding the
framework as well as the regulatory recommendations themselves.
Methods: We explored and analyzed the regulation of ambulatory care services
in New York in accordance with the available gray and peer-reviewed literature
The Milbank Quarterly, Vol. 92, No. 4, 2014 (pp. 776-795)
c 2014 Milbank Memorial Fund. Published by Wiley Periodicals Inc.
776
Redesigning an Ambulatory Care Regulatory Framework
777
and legislative documents. The deliberations of the Public Health and Health
Planning Council informed our review.
Findings: The vision of high-performing ambulatory care should be rooted
in the Triple Aim (better health, higher-quality care, lower costs), with a
particular emphasis on continuity of care for patients. There is a pressing need
to better define the taxonomy of ambulatory care services. From the state
government’s perspective, this clarification requires better reporting from new
health care entities (eg, retail clinics), connections with regional and state
health information technology hubs, and coordination among state agencies.
A uniform nomenclature also would improve consumers’ understanding of
rights and responsibilities. Finally, the regulatory mechanisms employed—
from mandatory reporting to licensure to regional planning to the certificate of
need—should remain flexible and match the degree of consensus regarding the
appropriate regulatory path.
Conclusions: Few other states have embarked on a wide-ranging assessment of
their regulation of ambulatory care services. By moving toward adopting the
regulatory approach described here, New York aims to balance sound oversight
with pluralism and innovation in health care delivery.
Keywords: health policy, ambulatory care, primary care, regulation.
T
he health care system in the United States is
undergoing seismic shifts in insurance coverage, payment mechanisms, and modes of delivery—all at once. In 2014, millions
of uninsured Americans will receive health coverage from both the expansion of Medicaid and the health insurance marketplaces created by
the Affordable Care Act (ACA). Both government and private payers
are driving this transformation from volume-based reimbursement to
value-based purchasing through bundled payments, global budget contracts, accountable care organizations, and other new payment models.
And perhaps most important, the actual structures of the health care
delivery system are changing. That is, while hospitals remain important
centers of gravity in the health system, services are increasingly being
delivered through ambulatory care.
The ambulatory care system also is being affected by the changes taking place among practicing physicians. In New York State, the stresses
of the current environment are causing many private practitioners to
778
D.A. Chokshi, J. Rugge, and N.R. Shah
turn for employment to institutional providers, especially hospitals. At
the same time, hospitals are moving from identifying themselves solely
as acute-care facilities to comprehensive systems of care extending into
the community.
In addition, many physicians are joining large, multispecialty groups
offering a broad spectrum of services, often in multiple locations, thereby
gaining sufficient market power to compete with area hospitals. This
shift to ambulatory care is giving rise to new delivery structures, such as
retail clinics and urgent care centers, as well as reinventing ambulatory
care capacity, such as the patient-centered medical home model and
the movement toward team-based care. To protect the interests of the
public—that is, promote patient safety, quality, and judicious use of
resources—the oversight of ambulatory care services must keep pace
with these rapid changes.
Regulation of Ambulatory Care
Services: The Charge
In 2011, New York Governor Andrew Cuomo, seeing an opportunity
for both quality improvement and cost savings, undertook a fundamental reform of the state’s largest single program, Medicaid, through his
Medicaid Redesign Team. In January 2012, the New York Department
of Health charged the Public Health and Health Planning Council
(PHHPC) with developing a health planning framework that would
improve the health system, affecting both private and public providers
and payers. The PHHPC’s December 2012 report, titled Redesigning
Certificate of Need and Health Planning, examined changes in the organization of health care and tried to align the certificate of need (CON)
and health-planning processes with these changes. The PHHPC recommended that regional, multistakeholder collaboratives conduct deliberations on health planning. Accordingly, by recommending retaining
licensure requirements but eliminating need assessments for primary
care facilities, it anticipated the expansion of capacity needed for the up
to 1 million New Yorkers who would gain coverage under the ACA.
Additional recommendations dealt with requiring regulatory oversight
of physician practices, modifying the process of establishing new health
care facility and home care agency operators, strengthening the review of
Redesigning an Ambulatory Care Regulatory Framework
779
health system governance, supporting expanded access to hospice care,
and incorporating quality and population health factors into the CON
review. The December 2012 PHHPC report also laid the groundwork
for strategically aligning regulatory oversight with new models of health
care organization and payment.
In January 2013, the former New York commissioner of health (one
of this article’s authors, Nirav R. Shah) offered a new charge to the
PHHPC—to address the changing structure of the delivery system
itself. Through extensive consultation and deliberation, the PHHPC
built the framework for public oversight of ambulatory care services,
represented by a set of recommendations formally adopted by the
PHHPC in January 2014. A subset of recommendations would require
authorizing legislation not yet passed by the New York State legislature.
Other recommendations, which require only regulatory authorization,
have entered into the rule-making process (for a summary of regulatory
recommendations, see Table 1; full recommendations are available online at http://www.health.ny.gov/facilities/public_health_and_health_
planning_council/meetings/2014-01-07/docs/ambulatory_care_
services_recommendations.pdf).
Three principles guided the PHHPC’s work. First, the vision of highperforming ambulatory care should be rooted in the Triple Aim (better
health, higher-quality care, lower costs), with a particular emphasis on
continuity of care for patients, as we describe later. Second, there is a
need to better define the taxonomy of ambulatory care services. From
the state government’s perspective, clarification requires better reporting from the new health care entities (eg, retail clinics); connections
with regional and state health information technology hubs; and coordination among state agencies, including the Department of Health, the
Department of Mental Hygiene, the Department of Financial Services,
and the new Health Plan Marketplace. A uniform nomenclature would
also facilitate consumers’ understanding of rights and responsibilities.
Third, the regulatory mechanisms employed—from mandatory reporting to licensure to regional planning to CON—should remain flexible
and match the degree of consensus regarding the appropriate regulatory
path. For areas where there is considerable uncertainty about the consequences of any new regulation, incremental steps—often beginning
with reporting requirements—would help shed light on a prudent way
forward.
780
D.A. Chokshi, J. Rugge, and N.R. Shah
Table 1. Regulatory Recommendations From the New York Public
Health and Health Planning Council
Ambulatory Care
Setting
Retail clinics
Summary of Regulatory Recommendations
• Allow corporations to provide professional
services that are currently prohibited.
Private physician offices are not precluded
from providing professional services in a
retail setting.
• Retail clinics will be known as “limited
services clinics.” Must use the term “limited
services clinic” in their name at all sites and
in materials in order to help consumer
recognition of this model of care.
• Define scope of services to cover basic
services, including certain immunizations.
Prohibit the following:
• Prescription of controlled substances or
conduct of any laboratory testing except
for Clinical Laboratory Improvement
Amendments–waived tests.
• Services to patients 24 months of age or
younger.
• Childhood immunizations to patients
under 18 years of age (excluding
influenza vaccine and human papilloma
vaccine [HPV]).
• Secure third-party accreditation by a
national accreditation organization
approved by the Department of Health.
• Require disclosures to consumers, including
signage for consumers regarding services
that are and are not offered and disclosures
that prescriptions and over-the-counter
medication are not required to be purchased
on-site.
• Procedures that support the medical home
must be followed. A list of primary care
providers accepting new patients must be
provided to patients indicating that they do
not have a primary care provider and
encouraging the patient to establish a
relationship with a provider.
Continued
Redesigning an Ambulatory Care Regulatory Framework
781
Table 1. Continued
Ambulatory Care
Setting
Summary of Regulatory Recommendations
• Require health information technology
connections to the larger health care
delivery system through electronic health
records and other means.
Urgent care providers • Require private physician offices and
institutional providers (as defined by Article
28 of New York Public Health Law) to
apply to the Department of Health to use
the name “urgent care.” Only approved
providers may use the term “urgent care” in
their name.
• To be approved, private physician offices and
Article 28 providers need to be accredited
by a national organization approved by the
Department of Health and to offer required
minimum services.
• Urgent care providers cannot use the word
“emergency” or its equivalent in their
names.
• Requirements related to disclosures to
consumers, support of the medical home,
and health information technology also
apply (see Retail clinics).
Freestanding emergency • Referred to as “hospital-sponsored
departments
off-campus emergency department (ED)” in
regulation, but name given to the public
will be the name of the hospital that owns
the facility and “satellite emergency
department.”
• Restrict off-campus ED ownership to
hospitals and prohibit non-hospital-owned
off-campus EDs.
• Subject to the same standards and
requirements as a hospital-based ED and
must demonstrate compliance with Centers
for Medicare and Medicaid Services hospital
condition of participation.
• Hours of operation will generally be 24/7,
but part-time operation will be allowed.
• Need and approval methodology will be
developed.
Continued
782
D.A. Chokshi, J. Rugge, and N.R. Shah
Table 1. Continued
Ambulatory Care
Setting
Office-based surgery
(OBS) / office-based
anesthesia (OBA)
practices
Upgraded diagnostic
and treatment centers
Summary of Regulatory Recommendations
• Requirements related to disclosures to
consumers, support of the medical home,
and health information technology also
apply.
• Require all physician and podiatry practices
performing procedures (including
noninvasive procedures) utilizing more than
minimal sedation to become accredited and
file adverse-event reports.
• Limit both procedural time to 6 hours and
postprocedure time to discharge to 6 hours.
• Require registration with the Department of
Health of all new and existing practices
performing procedures with minimal
sedation.
• Require submission of practice, procedure,
and quality data as determined by the
department.
• Require accrediting agencies to share with
the department the outcomes of surveys and
complaint/referral investigations and other
requested information.
• Require accrediting agencies to survey
OBS/OBA practices and carry out
complaint/incident investigations at the
department’s request.
• Eliminate upgraded diagnostic and
treatment centers (UD&TCs) from statute
and regulation. UD&TCs were developed to
provide an alternative for communities that
need health care services, including limited
emergency care, but are not able to support
a hospital. There is now no need for this
model given the development of new
models of care, including urgent care and
hospital-based off-campus emergency
departments.
Redesigning an Ambulatory Care Regulatory Framework
783
The Triple Aim
The principles guiding the Affordable Care Act and the Medicaid Redesign Team’s initiatives—the Triple Aim—remain a useful polestar for
the changing health care services landscape, offering both a yardstick for
what has been accomplished and a set of aspirations for the future.1
Population Health
Ambulatory care should help shift the locus of health care from facilities
to communities, with a concomitant focus on long, healthy lives for
all (operationalized as health-adjusted life expectancy) as the metric of
interest. This approach adopts a comprehensive notion of health determinants spread across domains of behavioral risk, social and economic
circumstances, environmental exposures, and medical care.2 The balance
and effects of many of these determinants—for example, the availability of healthy foods, parks and other safe places to play and exercise,
exposure to environmental irritants, and safe housing—are specific to
geographic locale. Several key provisions of the ACA highlight population health, such as the Internal Revenue Service requirements for
tax-exempt hospitals to demonstrate meaningful efforts to improve the
health of the communities they serve.3 In New York, the State Prevention
Agenda (also known as the State Health Improvement Plan) includes
evidence-based practices for improving population health in each of 5
priority areas and provides guidance for local stakeholders in assessing
and improving community health and reducing health disparities. New
York State generally ranks in the second quartile on measures of healthy
living collated by the Commonwealth Fund and the United Health
Foundation.4,5 Improving population health will require the full participation of ambulatory care providers in the State Prevention Agenda.
Health Care Quality
New York has made progress in improving the quality of health care.
For example, in the Medicaid program, the National Committee for
Quality Assurance (NCQA) commended the state’s performance in increasing rates of childhood immunization, controlling blood pressure as
part of diabetes management, screening for colorectal cancer, and assisting with smoking cessation.6 New York’s 1115 Medicaid waiver could
help make even more progress. Yet health care quality improvement
784
D.A. Chokshi, J. Rugge, and N.R. Shah
efforts have not yet embraced the full spectrum of ambulatory care. The
majority of outpatient quality measures focus on preventive care, chronic
disease care, and patient experience, which, albeit important, leave out
equally important measures such as diagnostic accuracy, appropriateness
of testing, and rates of medication errors.7 Therefore, efforts to improve
ambulatory care must optimize quality metrics as well as refine the
methods of measurement.
Costs of Care
New York has traditionally performed poorly on evaluations of health
care efficiency, scoring 50th among all states on avoidable hospital use
and costs in the 2009 Commonwealth Fund state scorecard.4 Again,
Medicaid has been a bright spot, with reforms proposed by the Medicaid Redesign Team thus far saving between $5 billion and $10 billion.
Still more can be done, though, particularly with the Medicare and
commercially insured populations. A recent study by the Institute of
Medicine of geographic variation in US health care spending identified
2 major cost drivers, both of which affect the organization of ambulatory
care. Most of the variation in spending per beneficiary in the Medicare
population was in postacute care (services provided by skilled nursing
facilities, rehabilitation and long-term care hospitals, home health agencies, and hospices).8 In the commercially insured population, postacute
care was only a minor contributor to the variation in spending. Instead,
price variation was the predominant factor, accounting for about 70%
of the total expenditure variation.9 In both cases, postacute care variation and price variation, careful regulation to help shape the ambulatory
care market could make the broader health care system more efficient.
As another cross-cutting strategy, redirecting inappropriate visits from
emergency departments to other ambulatory care services would reduce
costs through lower service charges, fewer imaging and other tests, and
less likely admission to the inpatient unit. Per capita spending, with a
particular focus on high-cost individuals, must remain one of the Triple
Aim’s fundamental metrics of interest.
Another principle, continuity of care, is as important as those of the
Triple Aim when considering ambulatory services. Continuity of care
is a “Triple Aim home run,” as it helps bring about better health,
improves health care quality, and lowers costs.10 While some patients,
particularly younger patients with acute illnesses, may prefer better
access over greater continuity, many more prefer continuity of care,
Redesigning an Ambulatory Care Regulatory Framework
785
particularly older patients or those with multiple chronic conditions,
that is, those patients who are most vulnerable to serious illness and
whose care incurs the highest costs. For these people especially, their
continuing relationship with a caring professional provides the needed
context for shared decision making and responsibility to maintain and
improve their health. A growing corpus of evidence demonstrates the
systemic effects of continuity of care. For example, a study of more
than 3 million Medicare beneficiaries showed an inverse effect between
primary care continuity and preventable hospitalizations.11 To the extent
that new models of ambulatory care disrupt continuity of care, they may
have negative implications for cost, quality, and health. Accordingly, the
first step in resolving this may be for primary care practices to begin
measuring their patients’ continuity of care.
A Foundation of High-Performing
Primary Care
A simple premise led to a breakthrough in deliberations on regulatory
recommendations: High-quality ambulatory care depends on excellent
primary care. Therefore, new models of care must not erode—but should
bolster—high-quality primary care.12 New York must both improve and
extend primary care to accommodate the million New Yorkers who will
gain coverage via the Affordable Care Act. Because the new models
of ambulatory care may blur the boundaries of primary care, it was
useful to base our discussions on the Institute of Medicine’s definition of
primary care: “The provision of integrated, accessible health care services
by clinicians who are accountable for addressing a large majority of
health care needs, developing a sustained partnership with patients, and
practicing in the context of family and community.”13 While superlative
models of primary care are dependent on the particular community, they
all share a few main elements.
Patient-Centered Medical Home Model With
Team-Based Care Delivery
The Joint Principles of the Patient-Centered Medical Home, adopted in
2007 by the American Academy of Pediatrics, the American College of
Physicians, the American Academy of Family Physicians, and the American Osteopathic Association, and subsequently endorsed by dozens of
786
D.A. Chokshi, J. Rugge, and N.R. Shah
specialty societies, describe the importance of each patient having “an
ongoing relationship with a personal physician trained to provide first
contact, continuous and comprehensive care. . . . [T]he personal physician leads a team of individuals at the practice level who collectively
take responsibility for the ongoing care of patients.”14 The American
College of Physicians (ACP) recently defined team-based care further in
a position paper: “A clinical care team for a given patient consists of the
health professionals—physicians, advanced practice registered nurses,
other registered nurses, physician assistants, clinical pharmacists, and
other health care professionals—with the training and skills needed to
provide high-quality, coordinated care specific to the patient’s clinical
needs and circumstances.”15 Importantly, the ACP’s position paper also
advocates a cooperative, interprofessional approach to coping with the
looming shortage of physicians.
Population Health Management With
Sophisticated Risk Stratification
Taking responsibility for population health in primary care requires managing the health outcomes of a group of individuals, often organized into
patient panels. This perspective centers on deploying evidence-based interventions matched to patient care management categories in order to
allocate health care resources in a cost-effective manner. The US Department of Veterans Affairs, for example, risk-stratifies populations of
patients and tailors interventions to specific risks. Based on longitudinal
electronic health records (EHRs) covering up to 2 decades, a care assessment need (CAN) score, a statistical model, predicts a patient’s risk of
hospitalization or death at 90 days or 1 year with high reliability and
validity.16 The CAN score therefore stratifies patients who are at greatest
risk for major adverse outcomes, enabling enhanced care management
services to be directed to those veterans.
High-Risk Patient Management
As popularized by Atul Gawande’s New Yorker article,17 “The Hot Spotters,” another Triple Aim home run could be addressing the needs of
the sickest and most vulnerable patients. Nationally, just 10% of the
population is estimated to account for about 64% of health care expenditures, often because of overutilization of the hospital, emergency
Redesigning an Ambulatory Care Regulatory Framework
787
room, and other acute-care resources.18 Addressing care coordination,
targeting intensive interventions, and ensuring greater access would
enable this segment of the population to benefit from better health and
would reduce costs. Many primary care practices are now testing highrisk patient management, in either an “ambulatory intensive care unit”
or another designation. Preliminary evidence from programs for highrisk elderly patients shows modest reductions in hospital and emergency
department utilization, although how generalizable these findings are
to a broader (nonelderly) high-risk population is not clear.19
Rapid but Judicious Access to Specialty Expertise
The market for specialty services is different from different vantage
points. For private providers who take care of affluent, generally commercially insured patients, the problem may be the supply-driven overuse
of expensive specialty resources. Meanwhile, the supply and demand for
specialty services are greatly mismatched for patients and providers in
safety-net systems, leading to long wait times and delays in care. Innovations in accessing specialty expertise may help both sides of the issue
by improving the value of specialty care while distributing its reach.
For instance, in San Francisco, a program known as eReferral—piloted
in a safety-net system—uses simple technology to allow for expeditious,
iterative communication between primary care providers and specialists,
which sometimes eliminates the need for in-person consultation.20 Similarly, a national program known as Project ECHO has shown that with
the right staffing and technology infrastructure, primary care providers
and specialists can comanage patients with complex, chronic diseases
like hepatitis C.21
Integrated Behavioral Health
Individuals with serious physical health problems often have concomitant mental health issues, and nearly half of those with any mental
disorder meet the criteria for 2 or more disorders.22 New York has been
a leader in incorporating behavioral health services into primary care,
particularly through Medicaid Health Homes. More broadly, however,
most primary care doctors are ill-equipped, lack the time, or are not reimbursed in a manner that allows them to fully address the psychosocial
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D.A. Chokshi, J. Rugge, and N.R. Shah
issues underlying many patients’ visits. In some cases, patients do not
have access to dedicated behavioral health professionals, and rarely are
physical health and behavioral health providers colocated to enable
“warm handoffs” between them, although models for integrated or collaborative behavioral health and primary care are emerging.23 In one
example, the Southcentral Foundation’s Nuka System of Care in Alaska,
behavioral health has become a routine component of medical care, with
integrated charts, care teams, and clinic design facilitating collaboration,
from informal consultation to joint visits to more formal referrals.24
Together, these components of high-performing primary care provide
a foundation for delivering on the Triple Aim and enshrining continuity
of care as a central goal of the larger ambulatory care enterprise.
Innovations in Convenient
Ambulatory Care
Across the United States, patients visit health care providers about
50 million times annually for low-acuity conditions such as sinusitis and
urinary tract infections.25 Some of these visits take place in emergency
departments, though it is sometimes difficult to distinguish between
low-acuity and urgent conditions a priori, and such visits can also reflect
poor access to primary care rather than patients’ poor judgment.26,27
Indeed, there might have been many more than 50 million annual visits
if primary care appointments had shorter wait times, and the expansion
of the Affordable Care Act’s coverage may make wait times even longer
rather than shorter. Partly in response to these demands, new ambulatory
options, such as retail clinics (eg, CVS Caremark’s MinuteClinic) and
urgent care centers, have expanded rapidly in recent years. For example,
between 2007 and 2009, the number of visits to retail clinics increased
nationally fourfold and by 2012 were estimated to account for almost
6 million annual visits.28 In rural areas, concerns about insufficient emergency care capacity have led to the promulgation of upgraded diagnostic
and treatment centers (with limited emergency care capabilities) and the
establishment of freestanding emergency departments.
The benefits of these convenient ambulatory care options remain conjectural, although the greater access and low-overhead cost structure
intuitively seem to be an improvement. The risks of these options include less continuity of care and more fragmentation. While the care
provided may be less expensive for each visit, better access may lead to
Redesigning an Ambulatory Care Regulatory Framework
789
more patients seeking care, thereby increasing overall utilization and
spending. Access also may be heavily weighted toward more affluent patients depending on payment sources accepted. For example, only about
60% of retail clinics in the United States accept Medicaid, and usually
only in a limited form.29 Finally, the reallocation of private revenue to
convenient care options could threaten the viability of much needed
primary care practices and hospital-based emergency departments.30
Innovations in Specialty Ambulatory
Care Services
New models of ambulatory care delivering specialty services over the
past 2 decades have complicated the relationships between hospitals
and physicians. Enhanced physician practices (so-called physician megagroups), nonhospital surgery (including ambulatory surgery centers and
office-based surgery), advanced diagnostic imaging centers, and radiation therapy all fall into this category. The number of these facilities has
steadily risen in New York and around the country as physicians, taking advantage of new forms of technology and available capital, pursue
new ventures separate from hospital centers.31 Proponents argue that
such novel arrangements create “centers of excellence” for specialty care
and, in the case of enhanced physician practices, promote communitybased population health. But detractors contend that despite providing
complex and costly services, the enhanced arrangements operate with
insufficient oversight of safety and quality and cherry-pick the lowerrisk, more affluent patients while delivering more lucrative services.
The amalgamation of “specialty ambulatory care services” has made
each category of service even more complex. Although enhanced physician practices are in some ways the most natural accountable care organizations, they can also destabilize existing safety-net providers by
luring away commercially insured patients. Nonhospital surgery spans
care sites with drastically different cost structures and regulatory responsibilities, and there is little help to patients to find appropriate sites of
care. As a result, the same procedure may be performed in office-based
surgery, ambulatory surgery centers, and hospitals. Advanced diagnostic
imaging is almost certainly overused, although the underlying reasons
are more complicated than financial inducements, as defensive medicine,
patient preference, and time constraints all likely play a role.32 Meanwhile, radiation therapy might be appropriately utilized as a whole, even
790
D.A. Chokshi, J. Rugge, and N.R. Shah
though the predilection toward costlier modalities of radiation therapy
may warrant scrutiny.
Regulatory Tools
In New York State, medicine may be practiced in one of two modes: professional or institutional. The state’s statutes and regulations for practicing medicine in both the professional and the institutional modes contain
and use many regulatory tools to shape the delivery, monitor the quality,
and define the cost of care, including formal licensing, registration with
periodic re-registration, establishment through the CON process, close
definition of allowed scope of services, use of third-party agencies for
purposes of accreditation, posting requirements, naming conventions
and restrictions, routine surveillance, investigation of complaints with
imposition of sanctions as appropriate, requirements to accept certain
insurance, and requirements to connect to information exchanges.
The aim of New York’s regulatory approach is to value the pluralism
of the state’s health care delivery system and recognize in this diversity
the numerous benefits, including greater choice for consumers, practice
options for providers, ability to tailor service programs to the needs of
different communities and populations, and, perhaps most beneficial of
all, an opportunity for experimentation and innovation in order to create
better models of caregiving.
A Vision for Ambulatory Care
Developing N
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Ethics and Regulations in Healthcare
Course number:
PHC 216
CRN:
13967
Assignment #1 :
Saudi ministry of health announced November 2019 a large
awareness campaign about patient consent. In 500 words feedback
answer the following questions:
•Why informed consent is important in medical ethics and MOH
give all that consideration? (5marks) CLO2
•Define the term capacity in terms of medical ethics, how can you
evaluate a patient’s capacity, describe with an example. (5 marks)
CLO1
Student Name:
Student ID:
Submission Date:
Instructor name:
Dr. Ibrahim Alqasmi
Grade:
…. Out of 10
College of Health Sciences
Department of Public Health
Assignment’s guideline:
· Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted
· Do not write the answer as points
· Font should be 12 Time New Roman
· Color should be black
· Line spacing should be 2
· Don’t bold or Italic or underline your paragraph
· Start write your answer in the third page
· AVOID PLAGIARISM
A community member on your hospital’s advisory body has asked you to provide an overview of the relationship between informatics, technology in healthcare, and the status of healthcare delivery today. Provide an answer addressing four key points you would make and the rationale for each.Using the following resourcesHebda, T., Hunter, K. M., & Czar, P. (2019). In Handbook of Informatics for Nurses and Health Care Professionals (6th) chapter 1-4 and the attached articles Pearson. Chapter 1-4
Choose an economic issue in health care that is driving change in the industry. For example, pandemic responses, staffing shortages, drug prices, the emergence of pharmacy-provided health care, the aging population, chronic disease, et cetera. Choose an issue of interest to you. An upcoming assignment will require you to delve deeper into the subject.Provide a one-page description of the economic issue and how or why it is driving change in health care.
Reproductive (female) Case Study Assignment
Connie is a 38 y.o. female presenting to your office today stating she has pain in the left breast
and two weeks ago a milky discharge occurred. The right breast does not hurt and no discharge
has been seen from the right. The outside of the left breast is painful and even brushing her arm
on the side of the breast is felt. See the following information below:
Ht.: 5’4”
Wt. 200 lbs.
BMI: 33
BP: 128/72
HR: 72
Never smoked
H/O migraines
Connie tells you for the last few weeks the outside of her left breast has been sore, but the last
few days it is painful to touch. There is not redness or swelling she can see, but there is a lump
felt in the upper, outer side.
Develop this case study identifying at least 3 differential diagnoses and one definitive diagnosis
and a follow-up/further investigation plan. Use 7th edition APA format and limit this paper to no
more than 6 pages. This is a formal paper and will include a title and reference page. Resources
used should include your assigned textbook.
Please include the following information in this assignment:
What additional questions would you want to ask the patient regarding her signs and symptoms
prior to your diagnosis?
What do you suspect this patient’s diagnosis is? List at least three differential diagnoses and one
definitive diagnosis. Discuss how you derived these diagnoses.
What are the associated risk factors for this disease? Specifically, what risk factors does this
patient exhibit?
What is the underlying pathophysiology of this disease process (your definitive diagnosis)?
Discuss potential complications of this disease and why it is so important to treat.
What can you teach the patient about lifestyle changes (discuss at least five) that could help
reduce the frequency of her symptoms? Elaborate on why each of your lifestyle
recommendations could be helpful.
List and discuss 3 over the counter (OTC) medications patients may use to alleviate this patient’s
type of symptoms. If OTC medication will not help, explain why it would not help.
Discussion Paper #1: Explaining the Prescription Drug Provisions in the Inflation Reduction Acthttps://www.kff.org/medicare/issue-brief/explainin…Write a 1 to 2 page paper (Double-spaced, 12 Times Roman Font) addressing the following prompts. Each prompt does not need to be answered separately, just as long as they are addressed within the body of your paper.Briefly explain what prevented Medicare from negotiating drug prices with drug manufacturers prior to passage of the IRA?Briefly explain the criteria by which Part D drugs and Part B drugs will be selected for price negotiations under the IRA? How are the drugs to be selected by Medicare?One of the IRA provisions is “Drugs that are less than 9 years (for small-molecule drugs) or 13 years (for biological products) from their FDA-approval or licensure date” will be excluded from the negotiation process. How does it protect and/or limit drug manufacturer revenues? How might it incentivize drug manufacturers to develop biologocal products over small-molecule drugs?Aside from negotiated lower prices on certain drugs with Medicare, how else might the IRA change the way drug manufacturers conduct their business? What are the potential ramifications?
Psychiatric notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Focused SOAP notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.
For this Assignment, you will document information about a patient that you examined during the last 4 weeks, using the Focused SOAP Note Template provided. You will then use this note to develop and record a case presentation for this patient.
Review the Kaltura button from the Classroom Support Center (accessed via the Help button) for help creating your self-recorded Kaltura video.
Select an adult patient that you examined during the last 4 weeks who presented with a disorder other than the disorder present in your Week 3 Case Presentation.
Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations.
Please Note:
All SOAP notes must be signed, by your Preceptor.
Note: Electronic signatures are not accepted.
When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of the completed assignment signed by your Preceptor.
You must submit your SOAP note using Turnitin.
Note: If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy.
Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record.
Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning.
Ensure that you have the appropriate lighting and equipment to record the presentation.
The purpose of this assignment is to develop a professional presentation that will review and reflect on your practicum project. You will add your voice to a PowerPoint presentation that covers all major areas of your project in a 10-12-minute video using Zoom, YouTube, Prezi, or another video presentation website. Prior to recording your video, make sure you practice your presentation skills.
You will submit only a Word Document with the link to your video.
Be sure to address:
Site/organization
Needs assessment results (or how you knew of the need for your project)
Project topic
Project goals
Project outcome (or anticipated outcome if not implemented)
How was your project received by stakeholders?
If you implemented your project, how will it be sustained? If it is not sustainable, how will the one-time implementation make a difference?
If you did not implement your project, how did you perform a hand-off for the next steps?
What were the professional goals you set for yourself and the AONL competencies you hoped to achieve?
Ultimately, what did you learn from this project?
Include an additional slide for References at the end.
Note: If you are using Zoom, refer to the Class Resources for guidance.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines.
Unformatted Attachment Preview
Business Proposal: Integration of Dialysis Unit within the Cardiovascular Institute (CVI)
Executive Summary
Project Title: Integration of Dialysis Unit within CVI
Prepared By:
Date: September 20, 2023
Objective:
This proposal outlines the strategic integration of a dialysis unit within the Cardiovascular
Institute (CVI) at Glenbrook Hospital. The decision to initiate this project stems from the
anticipation of an influx of dialysis patients due to the expansion of cardiac care services, which
raises questions regarding the capacity to meet their needs.
Key Findings:
•
Analysis of patient population data from Glenbrook Hospital, Evanston Hospital, and
Highland Park Hospital reveals a significant number of dialysis patients exist.
•
A substantial portion of these dialysis patients also have cardiac-related diagnoses.
•
Glenbrook Hospital treated 426 dialysis patients, with 105 having cardiac diagnoses.
•
On average, each patient undergoes 2 dialysis treatments during a 4-day hospital stay.
Introduction
Background
By early 2024, NorthShore will complete its Cardiovascular Institute that will make it a regional
destination for the most advanced heart care on the North Shore. This means that as the hospital
progresses it will handle more complex cases.
Rationale
As NorthShore University Health System transitions heart care from Evanston Hospital to
Glenbrook, concerns arise about the capacity to accommodate these patients due to the potential
influx of dialysis patients from Evanston as a result of the expansion of cardiac services.
Integration Plan
Capacity Assessment
•
Currently at Glenbrook, dialysis treatments are being done in patient’s room, three times
a week (Monday, Wednesday, and Friday, or Tuesday, Thursday, or Saturday per
patient).
•
After evaluating data provided by DaVita for the months of April, May, and June,
Glenbrook Hospital was able to accommodate 426 patients, with 105 having cardiacrelated diagnoses. During this time, Evanston Hospital treated 515 dialysis patients, with
110 having cardiac-related diagnoses. Additionally, Highland Park was able to
accommodate 474 patients, with 90 having cardiac related diagnosis.
•
On average, patients receive 2 dialysis treatments during a four-day hospital stay (with an
average stay of four days). This indicates that Glenbrook should be able to accommodate
an increase in dialysis patients.
Proposed Dialysis Unit:
•
To increase the efficiency of patient dialysis, the hospital should plan to create two
dedicated ICU monitoring rooms where nurses can monitor two patients simultaneously.
With minor remodeling, the hospital should be able to install a sliding door connecting
the two rooms, allowing nurses to monitor patient status more effectively.
•
Dialysis treatments typically take 3 hours, and by allocating an hour for clean-up, a nurse
should be able to perform six treatments per day, equating to 144 treatments per month in
total.
Transfer Arrangements:
•
As a contingency plan, the hospital should be prepared to transfer patients to Evanston
Hospital in case of a surge in dialysis patient volume. Additionally, as part of this study,
it was identified that there was a high volume of dialysis patients with non-cardiac
diagnoses. With this in mind, the hospital is considering transferring this population to
Evanston in order to accommodate the CVI cases that will be coming to Glenbrook.
•
Currently, Evanston has an 8-bay unit for dialysis, which provides room to dialyze the
non-cardiac population due to the CVI cases leaving Evanston.
Budget
•
•
By implementing a more efficient dialysis model where one nurse can dialyze two
patients simultaneously, the hospital stands to achieve substantial cost savings. The
current cost per patient treatment is $477.41 when one nurse is assigned to each patient.
However, with the proposed model one nurse serving two patients, the cost per patient
treatment reduces significantly to $386.36.
The cost savings per patient treatment, by utilizing one nurse for two patients instead of
one, is approximately $91.05 per treatments. This means that in the months of April,
May, and June, the hospital spent $203,376.66 on dialysis. With the new model, it can be
reduced to $164,589.36.
Description
Current Cost
Proposed
Model (1 nurse
for 2 patients)
Cost Per
Treatment
$477.41
386.36
Monthly-Cost
(April-June)
$203,376.66
$164,589.36
Total Savings
(April-June)
Annual savings
$38,787.3
$155,149.2
Convert 2 ICU rooms
Convery 4 ICU rooms
•
$86,000.00
$152,000.00
These cost savings directly impact the budget of the integration of the project. By
adopting the efficient dialysis model, the hospital can reallocate the saved funds to other
critical areas of the project or use them to enhance patient care and services within the
Cardiovascular Institute (CVI).
Risks and Mitigation:
•
A sudden surge in critical patients may require converting the dialysis rooms into regular
ICU rooms. In such cases, the hospital should have the ability to convert these rooms and
safely store the dialysis equipment.
•
Another risk pertains to quality, which should be verified through an assessment by the
Infectious Disease (ID) department and DaVita.
Conclusion
•
To successfully implement a smooth transition of cardiac care to Glenbrook Hospital,
proactive measures are necessary to handle the potential influx of dialysis patients.
•
This initiative aligns with Glenbrook Hospital’s expansion plan and its commitment to
patient care.
Recommendation
•
Based on my study, for more efficient patient dialysis, it is recommended that the hospital
create four dedicated ICU monitoring rooms with a sliding door connecting them,
allowing nurses to simultaneously monitor two patients.
•
Transfer non-cardiac patients to Evanston in order to accommodate the CVI cases that
will be coming to Glenbrook. Currently, Evanston has an 8-bay unit for dialysis, which
provides room to dialyze the non-cardiac population due to the relocation of CVI cases
from Evanston.
Integration of
Dialysis Unit
within the
Cardiovascular
Institute (CVI)
Prepared By: Mehul Abraham
Date: October 12, 2023
Northshore University
Health System:
Glenbrook Hospital
•
•
•
•
Located at the heart of Glenview,
Illinois
Affiliation: Part of the
Northshore University Health
System.
Services:
– Advanced surgical Procedures
– State-of-the-art technologies
– Comprehensive clinical care
Commitment to patient-first
approach, dedicated professional
team, and Enhancing community
health & well-being.
Background
•
By early 2024, NorthShore
will complete its
Cardiovascular Institute that
will make it a regional
destination for the most
advanced heart care on the
North Shore. This means
that as the hospital
progresses it will handle
more complex cases
Needs Assessment
Project topic
• Creation of dedicated ICU monitoring rooms.
• Advantages: Efficiency and cost savings.
Project goals
• Contingency plans for patient transfers to
Evanston Hospital.
• Rationale: High volume of non-cardiac dialysis
patients.
Project Outcome
• Current vs. proposed cost per patient
treatment.
• Potential savings with the new model.
stakeholders
References
• [Any sources or references you’ve used during
your project.]
Integration of
Dialysis Unit
within the
Cardiovascular
Institute (CVI)
Prepared By:
Date: October 12, 2023
Northshore University
Health System:
Glenbrook Hospital
•
•
•
•
Located at the heart of Glenview,
Illinois
Affiliation: Part of the
Northshore University Health
System.
Services:
– Advanced surgical Procedures
– State-of-the-art technologies
– Comprehensive clinical care
Commitment to patient-first
approach, dedicated professional
team, and Enhancing community
health & well-being.
Background
•
By early 2024, NorthShore
will complete its
Cardiovascular Institute that
will make it a regional
destination for the most
advanced heart care on the
North Shore. This means
that as the hospital
progresses it will handle
more complex cases
Needs Assessment
Project topic
• Creation of dedicated ICU monitoring rooms.
• Advantages: Efficiency and cost savings.
Project goals
• Contingency plans for patient transfers to
Evanston Hospital.
• Rationale: High volume of non-cardiac dialysis
patients.
Project Outcome
• Current vs. proposed cost per patient
treatment.
• Potential savings with the new model.
stakeholders
References
• [Any sources or references you’ve used during
your project.]
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
Background facts about the Ergonomic challenge including incidence and prevalence
The impact of the Ergonomic challenge on the Healthcare worker
The impact of the Ergonomic challenge on the patient
Your recommendations to improve this Ergonomic challenge based on evidence from the literature
Your paper should meet the following structural requirements:
Four pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external.
Explain, with concrete examples, the differences among leadership, management, and followership. Then, discuss the following:
At times, do the examples overlap with a nurse acting in all three capacities at the same time?
Are two of the three capacities more likely to overlap? If yes, which two capacities?
Pick a current local, state, or national political leader and differentiate the leadership and management qualities of the leader. Who are these leaders and followers?
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.
EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
BY DAY 7 OF WEEK 7
Submit Part 3A and 3B of your Evidence-Based Project.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as MD4Assgn+last name+first initial.
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6052_Module04_Week07_Assignment_Rubric
NURS_6052_Module04_Week07_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomePart 3A: Critical Appraisal of ResearchCritical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include: · An Evaluation Table
45 to >40.0 pts
Excellent
The critical appraisal accurately and clearly provides a detailed evaluation table. …The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected.
40 to >35.0 pts
Good
The critical appraisal accurately provides an evaluation table. …The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity.
35 to >31.0 pts
Fair
The critical appraisal provides an evaluation table that is inaccurate or vague. …The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected.
31 to >0 pts
Poor
The critical appraisal provides an evaluation table that is inaccurate and vague or is missing.
45 pts
This criterion is linked to a Learning OutcomePart 3B: Evidence-Based Best PracticesEvidence-Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with the selected resources.
35 to >31.0 pts
Excellent
The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. …The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. …The responses provide a complete, detailed, and specific synthesis of the four peer reviewed articles.
31 to >27.0 pts
Good
The responses accurately suggest a best practice that is adequately aligned to the research reviewed. …The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. …The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained.
27 to >24.0 pts
Fair
The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed. …The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. …The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained.
24 to >0 pts
Poor
The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing. …The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field or are missing. …A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing.
35 pts
This criterion is linked to a Learning OutcomeResource Synthesis
5 to >4.0 pts
Excellent
The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.
4 to >3.0 pts
Good
The response integrates at least one outside resource and two or three course-specific resources that may support the responses provided.
3 to >2.0 pts
Fair
The response minimally integrates resources that may support the responses provided.
2 to >0 pts
Poor
The response fails to integrate any resources to support the responses provided.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.
4 to >3.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.
3 to >2.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.
2 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. …No purpose statement, introduction, or conclusion is provided.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains a few (one or two) grammar, spelling, and punctuation errors.
3 to >2.0 pts
Fair
Contains several (three or four) grammar, spelling, and punctuation errors.
2 to >0 pts
Poor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors.
4 to >3.0 pts
Good
Contains a few (one or two) APA format errors.
3 to >2.0 pts
Fair
Contains several (three or four) APA format errors.
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number. Case study is:55-year-old Asian female living in a high-density poverty housing complex.Pre-school aged white female living in a rural communities ANSWER QUESTIONS BELOWWhat are the barriers to interpersonal communication?What are the procedures and examination techniques that will be used during the physical exam of your patient?Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit. Provide an overview of the article you selected.What population (individual, group, or family) is under consideration?What was the specific intervention that was used? Is this a new intervention or one that was already studied?What were the author’s claims?Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides. Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.
Discussion 1
Describe the fundamental principles of servant leadership. Present two qualities of servant
leadership and explain how they support interprofessional communication in providing patient
care.
Reply to three classmates.
Discussion 2
Describe the characteristics of performance-driven team. Describe the difference between
intrinsic and extrinsic motivation and explain why it is important in understanding the types of
motivation when it comes to team performance.
Respond to three classmates.
EXECUTIVE SUMMARY
In this assignment, you will propose a quality improvement initiative from your place of
employment that could easily be implemented if approved. Assume you are presenting this
program to the board for approval of funding. Write an executive summary (750-1,000 words) to
present to the board, from which the board will make its decision to fund your program or project.
Include the following:
1.
2.
3.
4.
5.
6.
The purpose of the quality improvement initiative.
The target population or audience.
The benefits of the quality improvement initiative.
The interprofessional collaboration that would be required to implement the quality improvement
initiative.
The cost or budget justification.
The basis upon which the quality improvement initiative will be evaluated.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment.
Sources must be published within the last 5 years, 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.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to
become familiar with the expectations for successful completion.
Executive Summary Feedback Form
Student Name:__________________
Date of Interview:________________
Section & Faculty Name:_________________________________
Provider Information
Employee Name :
Last
Credentials:
First
M.I.
Title:
(I.e. MS, RN, etc.)
Organization:
Phone Number:
E-mail Address:
Feedback Section
The RN to BSN program at Grand Canyon University meets the requirements for clinical
competencies as defined by CCNE and AACN using non-traditional experiences for practicing
nurses. These experiences come in the form of direct and indirect care experiences in which
licensed nursing students engage in learning within the context of their hospital organization,
their specific care discipline and their local communities.
This activity is intended to foster demonstration of skills related to leadership and management.
Share your written proposal with your manager, supervisor or other colleague in a formal
leadership position within a health care organization. Request their feedback using the following
questions as prompts:
1.
2.
Do you believe the proposal would be approved if formally proposed?
What are some strengths and weaknesses of the proposal?
_______________________________
_________________
Signature of Individual Providing Feedback
Date Signed
NOTE:
Acknowledgement form is to be returned to the student for electronic submission to the faculty member
via the learning management system (LoudCloud).
Background: Assessment and evaluation in motor behavior are key components or systematic processes of
gathering and interpreting information about a student. Motor development tests evaluate progression of typical
motor functioning on a continuum. The use of developmental norms assumes that comparing the performance of
a student with disabilities against norms for typical development is appropriate, and deviations from the norm are
indicative of a delay or problem in development or are associated with a physical or cognitive disability. It is
important that teachers, health professions, and physical therapists quickly determine which students qualify for
special service/treatment, what is the development stages, or risks of developmental delays by using various
assessment and evaluation procedure. You can use The Affordances in the Home Environment for Motor Development-Infant Scale, ASQ-3, TGMD-3, Bruininks- Oseretsky Motor Proficiency Assessment 2, The Movement Assessment Battery for Children (MABC) for this case study.
Instruction: You may know some families/parents with children with/wo disabilities who are seeking an informal
assessment toward the daily motor functioning/development stage and looking for potential recommendations and
suggestions for the treatment/intervention. In this assignment, you will think about a sample case (individual child
aged between 3–16-year-old) and conduct an informal assessment using one age-appropriate instrument/scale
regarding the development stage/problems/delays in the area of obesity, physical activity, motor skill, and/or
social-emotional skill (1-2 areas can be covered); and write a summary report with potential recommendations
and suggestions to the family/parents.
Case Study Assessment Report Includes:
Introduction (1-2 pages):
1) You will define the problems/diseases that are apparent in your child of choice in detail.
2) You will build the rationale for why an assessment needs to be conducted for this child.
3) Describe the characteristics (demographic, behavioral, problems, medical history) of this child or any
previous diagnoses. It is suggested to have some physical measures such as height/weight, BMI as the
fundamental patient information to be included in the report. You may take pictures in the process of your
assessment which may be used in the final poster presentation. You also can include the picture in the
case study assessment report if needed.
Description of the Scale you choose to use for assessment (2-3 pages):
1) Introduce the scale/instrument you choose for this child’s assessment.
2) Describe the assessment protocols (procedures, equipment, instructions, scaling, scoring, other
relevant information).
3) Report the results of your child through a screen shot of the scoring sheet or in a graph/table.
Summary and Discussion (2-3 pages):
1) Summarize the overall results or problems that have been identified based on your assessment
a. Go into discussion here talking about the implications of each finding in the subset of your
assessments (depending on which one you chose).
2) Identify the solution or recommendations for improvement or potential intervention to make
improvements (if any) for your case. Please provide the references/citation if your
recommendation/suggestion are based on reliable outside resources.
Note: This report is to be done in APA format, Times New Roman 12 font or Arial 11 font. You can refer to this
website for APA guidelines:
Feel free to make everything up, I have nothing to go off off. I have more information on each assessment so whichever one you choose I can upload the powerpoint I have for it.
Hello,i want you to use this link to analysis each day of these diet form separately and do these 2 for each one of them please. and make sure to send me a screenshot of each one that you entered on the link.1. Assess average daily kilocalories:2. Discuss inadequacies and excesses:Then do the carbohydrates analysis for all three days at one at this formula. Remember you need to cahnge the dates, information, and the numbers. This is the example i put her for you
Research a peer-reviewed article in the SEU library regarding workflow analysis in healthcare. Discuss the following aspects:StrengthsWeaknessesOpportunitiesThreatsRisks that are identified in the workflow described. What changes are recommended and provide additional recommendations you would make to improve the efficiency and effectiveness of this process. Your paper should meet the following structural requirements:Four pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition and Saudi Electronic University writing standardsProvide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external.
the topic is Iron Deficiency Anemia in the Kingdom of Saudi Arabia
Unformatted Attachment Preview
PHC 241-Group presentation
This assignment is a group effort. Students will work in groups of three to five and will choose
one of these topics on nutrition and public health:
1. Protein Energy Malnutrition and Early Child Development
2. Iron Deficiency Anemia in the Kingdom of Saudi Arabia
3. Maternal Nutrition and Low Birth Weight
4. Nutrition in School-Age Children and Cognitive Development.
5. Fast Food Consumption and Obesity among University Students
6. The Nutritional Transition and Its Implications for the Developing World
7. The Covid-19 Pandemic and Food Consumption Patterns
8. Food Insecurity and Malnutrition in Developing Countries
9. Food Security in a Global Pandemic
10. Elderly Health: Nutritional Issues of Older Adults
Presentations should include the following:
An adequate description of the nutritional issue, including a general or specific case.
Discussion of preventive or treatment strategies, and any related local or national
policies.
Practical recommendations for reducing malnutrition.
Questions for class discussion.
Important guidelines for students:
Presentation should consist of no more than 15 PowerPoint slides (including one page of
class discussion questions).
The cover slide should include the following: university logo; presentation title, group
members names and students ID numbers.
Presentation time should be 10–12 minutes, followed by five minutes of class discussion.
Each group should have a maximum of five students.
Support your presentation with at least three references (APA style).
The group will be graded as per the “Presentation Marking Rubric”
Poor
0.25 pts
Fair
0.50 pts
Good
0.75 pts
Excellent
1 pts
Organization Audience cannot
understand
presentation because
there is no sequence
of information.
Audience has
difficulty
following
presentation
because
student jumps
around.
Subject
Knowledge
Student does not
have grasp of
information; student
cannot answer
questions about
subject.
Student is
uncomfortable
with
information
and is able to
answer only
rudimentary
questions.
Student
presents
information
in logical
sequence
which
audience can
follow.
Student is at
ease with
expected
answers to all
questions, but
fails to
elaborate.
Graphics
Student uses
superfluous graphics
or no graphics
Mechanics
Student’s
presentation has four
or more spelling
errors and/or
grammatical errors.
Student
occasionally
uses graphics
that rarely
support text
and
presentation.
Presentation
has three
misspellings
and/or
grammatical
errors.
Student
presents
information in
logical,
interesting
sequence which
audience can
follow.
Student
demonstrates
full knowledge
(more than
required) by
answering all
class questions
with
explanations
and elaboration.
Student’s
graphics
explain and
reinforce screen
text and
presentation.
Group
Dynamics
Multiple group
members not
participating.
Evident lack of
preparation/rehearsal.
Dependence on
slides.
Significant
controlling by
some members
with one
minimally
contributing.
Primarily
prepared but
with some
dependence on
just reading off
slides.
Student’s
graphics
relate to text
and
presentation.
Presentation
has no more
than two
misspellings
and/or
grammatical
errors.
Slight
domination of
one presenter.
Members
helped each
other.
Very well
prepared.
Presentation has
no misspellings
or grammatical
errors.
All presenters
knew the
information,
participated
equally, and
helped each
other as needed.
Total (5)
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project.
Discuss the following
System approach
Resource allocation you identify as important
Identify the executive sponsor
Identify the stakeholders and steering committee members
Environment for local team leaders to collaborate, and 6) governance of the metrics.
The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
Four pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Identify what specialty courts are in existence.
If you could create a specialty court (has to be a population not already covered) what would it be and why?
Why would this specialty court be important to start?
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
You were asked to create the initial steps of an Evidence-Based Practice (EBP) project using your chosen topic from Week 3 and the articles your instructor approved in Week 4. After gathering your approved articles, you completed appraisals on a quantitative or qualitative review and systematic review in Week 6.
This week, you will be using your two approved sources to complete your EBP project poster.
Your poster should include:
Explanation of the nursing issue significance with three statements
Description of your position on the issue and three statements on how a nurse can impact this issue
Include only the two approved journal sources used in your Week 6 appraisals to support your position.
After you submit your poster, you will be automatically assigned one peer review. You will review one of your classmate’s posters using the grading rubric. Please fill out the rubric and provide substantive feedback on your classmate’s poster.
View the Getting Started With Peer Reviews page for details on how the peer review process works.
Exemplar Poster 1Download Exemplar Poster 1
Exemplar Poster 2Download Exemplar Poster 2
You can use Word, PowerPoint, Canva, or any other software platform to create your poster.
View the Week 9 Resources page for additional information.
See rubric for specific grading criteria.
Rubric
Week 9: Poster Assignment Rubric
Week 9: Poster Assignment Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomePoster Overall Appearance
5 pts
Meets or Exceeds
Shows creativity. Contains 1 slide. Poster has organized and purposeful arrangement
4 pts
Mostly Meets Expectations
Moderately arranged. 1 slide included
3 pts
Below Expectations
Some organizational issues noted. Minimal creativity.
2 pts
Does Not Meet Expectations
Information is scattered and disorganized. Lacks creativity. Contains more than 1 slide
5 pts
This criterion is linked to a Learning OutcomePoster Title and Author
5 pts
Meets or Exceeds Expectations
Short title-to the point that clearly indicates the direction of the project. Students name is beneath the title
4 pts
Mostly Meets Expectations
Moderately to the point. Students name is missing
3 pts
Below Expectations
Lengthy or not indicative of the project. Name is missing or out of place
2 pts
Does Not Meet Expectations
Missing title and name
5 pts
This criterion is linked to a Learning OutcomeContent
80 pts
Meets or Exceeds Expectations
Explanation of the Nursing Issue & significance w/3 statements. Description of your position on the issue and how a nurse can impact this issue. No HIPAA violations
69.33 pts
Mostly Meets Expectations
Minimal explanation of the nursing issue w/3 statements. Minimal discussion on your position and how a nurse can impact this issue. No HIPPA violations.
55.47 pts
Below Expectations
Explanation lacks clear association. Minimal to no discussion of how a nurse can impact this issue. HIPPA violations noted
48 pts
Does Not Meet Expectations
Missing explanation or description of position and how a nurse can impact this issue
80 pts
This criterion is linked to a Learning OutcomeText Content StructureGrammar, spelling punctuation, vocabulary and sentence structure
5 pts
Meets or Exceeds Expectations
No spelling or grammar errors
4 pts
Mostly Meets Expectations
Minor spelling or grammar errors
3 pts
Below Expectations
Several spelling and or grammar errors
2 pts
Does Not Meet Expectations
Major spelling and grammar errors
5 pts
This criterion is linked to a Learning OutcomeAPA FormatAPA format for 3 citations included (week 4 articles)
5 pts
Meets or Exceeds Expectations
APA style is adhered to for citations and references. All images cited in APA style.
4 pts
Mostly Meets Expectations
Minimal problems with APA style. Most images include citations in APA style.
3 pts
Below Expectations
Moderate problems with APA style. Some images include APA citations.
2 pts
Does Not Meet Expectations
Major problems with APA style. Images do not include citations.
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.
Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.
In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
To Prepare:
Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
Select a healthcare program within your practice and consider the design and implementation of this program.
Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–4 pages)
In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
What examples of conflict theory do you see in society today?
Be specific in describing conflicts that occur and how that impacts social work clients.
What is the role of social work in relation to conflict theory and intervention?
How comfortable are you when dealing with conflict?
How will you manage conflict as a social worker?
OR
Select a case from the reading and apply strength based and solution focused framework.
How would you work with the clients to reframe their experience?
Discuss the limitations of these approaches
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
You will select one of your assignments for this course and write about which essential(s) it most closely aligns with. You may select any of the assignments…your choice. This will be 2-3 pages not including the cover sheet. Please remember to reference appropriately throughout the paper. APA 7th Professional. I am attaching the assignment to this email.
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1
An Analysis of a Recent Article on the Impact of Nurse Practitioners in Society
Shana Spratt
Elms College
2023 Fall DNP Immersion I (NUR-7100-DNPD1)
Professor Sharon Brown, DNP, FNP-BC
September 12, 2023
2
An Analysis of a Recent Article on the Impact of Nurse Practitioners in Society
Article Selected
Many articles have been written in the recent past detailing nurse practitioners in practice
and their impact on society. A notable health issue that the role of nurse practitioners is deemed
essential in addressing is the opioid epidemic. Regarding this aspect, Jenna Elizabeth posted an
article titled “The Evolving Role of Nurses Amidst the Opioid Epidemic” on the Nursa blog site
(Elizabeth, 2023). The article is among many other articles that offer varied perceptions about
the role of nurse practitioners in the wake of the opioid epidemic.
Overview of the Article
Jenna Elizabeth explores several factors concerning nurse practitioners’ role evolution
amidst the opioid epidemic. The article details how nurse practitioners are at the forefront of
combating the opioid epidemic by monitoring patient’s pain and offering pharmacological
interventions for pain alleviation (Elizabeth, 2023). The article further offers precise information
on what opioids are, the various types of opioids, and a detailed description of valium (a
commonly abused opioid). With regards to the evolved nursing practitioners’ role amidst the
epidemic, the article expounds on how nurses are currently completing opioid prescribing pieces
of training to be able to fight opioids effectively. Additionally, the article details the role of nurse
practitioners in overdose recovery among affected patients, pointing out that nurse practitioners
have the role of recommending and administering such substances as naloxone for emergency
treatment of the health issue and aiding in addiction recovery.
3
An Analysis of a Recent Article on the Impact of Nurse Practitioners in Society
Nurse Practitioner’s Impact on Society
The article admits that the opioid epidemic has a devastating impact on society and that
nurse practitioners, among other healthcare practitioners, have a significant role in the fight
against the epidemic (Elizabeth, 2023). A notable impact of nurse practitioners on society in the
fight against the opioid epidemic, as detailed in the article, is that they are at the forefront of
monitoring patients affected by the epidemic and using pharmacological interventions to address
the pain attributable to the woes of the opioid epidemic. Another societal impact of nurse
practitioners in the war against the opioid epidemic is the earlier screening of opioid misuse
disorder and prescribing pharmacological and non-pharmacological interventions. Earlier
screening of opioid use disorder is critical in forming strategies to address the societal issue and
bar its progression. Another impact of nurse practitioners in the fight against the health crisis is
formulating and executing strategies to aid addiction recovery. Notably, many US citizens have
opioid use disorder and addiction problems; thus, the advanced nursing practice plays a critical
role in recovering from addiction among addicts. Other impacts include guiding, counseling, and
forming society-based educational programs.
Personal Reflection
Jenna Elizabeth’s “The Evolving Role of Nurses Amidst the Opioid Epidemic” article
profoundly opened my eyes to the evolving role of nurse practitioners in combating healthcare
problems of societal and community significance. The article has shown me how impactful the
practice can be in targeted communities and societies when dealing with healthcare issues. Nurse
practitioners’ role expansion to include prescription, as detailed in the opioid prescribing pieces
4
An Analysis of a Recent Article on the Impact of Nurse Practitioners in Society
of training undertaken by nurses, shows how the dynamic healthcare environment and changing
patients’ needs may call for an evolution of roles to fit societal needs. As a nurse practitioner, I
will apply feasible and effective strategies and interventions to impact society concerning
healthcare issues that have surmountable impacts on the community. This is something that is
near and dear to my heart because I have been a Substance Abuse, detox nurse for three years.
Every single year the more we try to get better the worse the epidemic gets. It’s very refreshing
to me that nurse practitioners are taking a vital role in trying to stop people from dying. I hope to
become one of them in this fight.
5
An Analysis of a Recent Article on the Impact of Nurse Practitioners in Society
Reference
Elizabeth, J. (2023, August 9). The opioid epidemic: What is the role of nurses? The Opioid
Epidemic: What Is the Role of Nurses? https://nursa.com/blog/the-evolving-role-ofnurses-amidst-the-opioid-epidemic
Feelings and Compromising: Pick a situation in which you are having a conflict with another person who is important in your life. Try to acknowledge the other person’s underlying feelings. Ask them to do the same for you. Brainstorm solutions that will be acceptable to both of you. Then try to agree on a final compromise. Write down the problem in 1-2 pages, the other person’s feelings, and the agreed upon solution. Then evaluate how it has worked out.
The field of nursing has changed over time. In a 750‐1,000-word paper, discuss
nursing practice today by addressing the following:
1. Explain how nursing practice has changed over time and how this evolution
has changed the scope of practice and the approach to treating the
individual.
2. Compare the differentiated practice competencies between an associate
(ADN) and baccalaureate (BSN) education in nursing. Explain how scope of
practice changes between an associate and baccalaureate nurse.
3. Identify a specific client care situation and describe how nursing care, or
approaches to decision making, differ between the BSN‐prepared nurse
and the ADN nurse.
4. Discuss the significance of applying evidence‐based practice to nursing care
and explain how the academic preparation of the RN‐BSN nurse supports
its application.
5. Discuss how nurses today communicate and collaborate with
interdisciplinary teams and how this supports safer and more effective
client outcomes.
PART B
1. Choose at least 5 of the characteristics of an effective counselor and explain why you chose those 5 supporting it with at least 1 scholarly reference.
2 List and explain some of the ethical issues related to counseling from a multicultural perspective, technology perspective, and the assessment process perspective (chapter 3 of the Theory & practice of counseling and psychotherapy Corey book)
I want 100/100 correct answers I want you to write the question and then the correct answer
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What do we call emotions and feelings that derive from a personal, group, or
community past experiences?
Universal values
Community values
Personal values
Group values
Q2:
Which of the following describes multisectoral partnerships?
Partnerships between academic universities only
Partnerships between the private sector only
Partnerships between governments, nonprofit, private and public organizations,
academia, and others
Partnerships between governments only
Q3:
Which of the following approaches applies to community mobilization?
Bottom-up approach
Authority-driven approach
Top-down approach
Vertical approach
Q4:
Which one of the following emphasizes listening to deepen understanding?
Dispute
Debate
Dialogue
Marketing
Q5:
What is the definition of “Attention” in Social Cognitive Theory?
People’s ability to remember the action being modeled and observed
People’s awareness of the action being modeled and observed
People’s internal impulse and intention to perform the action
People’s ability to reproduce the action being modeled and observed
Q6:
What is the best practice that a communication intervention would do when it
impossible is to target the entire target population, because of the large population
size?
Project cancelation
Population replacement
Objective modification
Audience segmentation
Q7:
Which of the following is the period when the person is seriously considering the
beginning of the protective behavioral change, according to the Transtheoretical
Model?
Contemplation
Action
Precontemplation
Preparation
Q8:
Which of the following refers to “the path selected to reach the intended audience
with health messages and materials”?
Communication message
Communication objective
Research activities
Communication channel
Q9:
Which of the following refers to voluntary acts, such as using verbal expressions?
Signs
Sample
Symptoms
Symbol
Q10:
Which of the following refers to “ diseases or health conditions that discrim- inate and
tend to be more common and more severe among vulnerable and underserved
populations” ?
Health disparities
Health equity
Health lottery
Communication success
Q11:
Which choice is accurate in the following blank: multifaceted approaches are usually
_________than single/sporadic approaches?
Cost less
Less effective
More effective
Less engaging
Q12:
Which of the following is defined as” a type of new media that uses communities of
interest to connect to others”?
Health communication
Social Networking
Individual relations
Private relations
Q13:
Which of the following is defined as “the art and science of establishing and
promoting a favorable relationship with the public”?
New media
Public relations
Old media
Private relations
Q14:
Which of the following is a personal selling example of health communication?
Radio announcement of a new invention
Posting about the benefits of COVID-19 vaccination on a blog
Door-to-door immunization as a core strategy of the worldwide polio eradication
campaign
Press release about a new disease
Q15:
What do we call emotions and feelings that people may share across different groups
within the same culture or in some cases across cultures?
Universal values
Gender
Personal values
Culture
Q16:
What do we achieve by providing every person with the same opportunity to stay
healthy or to effectively cope with disease and crisis, regardless of race, gender, age,
economic conditions, social status, environment, and other socially determined
factors?
Health disparities
Health equity
Health communication
Health information
Q17:
Which of the following refers to the ability to achieve desired outcomes with minimal
time and cost?
Efficiency
Effectiveness
Culture
Behavior
Q18:
The art and technique of informing, influencing, and motivating individual,
institutional,
and public audiences about important health issues
Exchange of information
Message
Health Communication
Access
————
There are different formats of policy briefs, but the essential elements to be included
are eight. List the 4 essential elements of policy briefs.
Provide two examples of old media?
As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.
In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.
RESOURCES
Edit
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
Reflect on which type of dissemination strategy you might use to communicate EBP.
BY DAY 3 OF WEEK 9
Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.
I want 100/100 correct answers I want you to write the question and then the correct answer
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Which one of the following bones are generally thin, afford considerable protection,
and provide extensive surfaces for muscle attachment?
Irregular bones
Flat bones
Short bones
Long bones
Sweat glands, which produce perspiration to lower the body temperature are the
example of which type of gland ?
Pineal gland
Endocrine gland
Pituitary gland
Exocrine gland
Which of the following term means away from the head or lower part of a structure?
Superior
Posterior
Inferior
Anterior
Which of the following process is the alteration of a protein shape when it encounters
the hostile environment in such a way that it will no longer be able to carry out its
cellular function?
Form hydrogen bonds
Becomes an electrolyte
Release energy
Denaturation
In which of the following process large solid particles such as whole bacteria or
viruses or aged or dead cells are taken in by the cell?
Leukocytosis
Phagocytosis
Pinocytosis
Exocytosis
Which of the following plays a key role in communication among and between cells
and their external environment?
Plasma membrane
Nucleus
Lysosomes
Cytoplasm
Q7:
Which of the following bond are formed when outer shell electrons are
transferred from one atom to another?
Digestive
Reproductive
Lymphatic
Polar covalent bond
Q8:
What are the two divisions of the autonomic nervous system?
Dura and epidural
Sympathetic and parasympathetic
Thalamus and hypothalamus
Cerebrum and Cerebellum
Q9:
What is the function of olfactory nerve?
Vision
Smell
Hearing
Chewing
Q10:
Which part of human body is composed from group of cells that function together to
carry out specialized activities?
Brain
Bone
Heart
Tissues
Q11:
Which one is the longest, heaviest, and strongest bone in the body?
Fibula
Tibia
Femur
Radius
Q12:
Which cells are specialized to store triglycerides?
Fibroblasts
Mast cells
Adipocytes
Plasma cells
Q13:
Which epidermal layer includes stem cells that continually undergo cell division?
Stratum granulosam
Stratum corneum
Stratum spinosum
Stratum basale
Q14:
Which of the following cavity contains one pericardial and two pleural cavities?
Pelvic cavity
Abdominal cavity
Thoracic cavity
Cranial cavity
Q15:
Which level of organization is made when different types of tissues join together to
form body structures?
System level
Chemical level
Cellular level
Organ level
Q16:
Which of the following refers to the process in which mRNA associates with
ribosomes and directs synthesis of a protein by converting the sequence of
nucleotides in mRNA into a specific sequence of amino acids?
Translation
Diffusion
Transcription
Crenation
Q17:
Which part of the brain lies posterior to the brain stem?
Cerebrum
Cerebellum
Thalamus
Medulla Oblangata
Q18:
Which of the following is the inability of a muscle to contract forcefully after prolonged
activity?
Twitch contraction
Muscle fatigue
Muscle tone
Proprioception
——————————-Why mitochondria are known as “powerhouses” of a cell?
Write down the names of any four hormones of anterior pituitary.
Strategic planning can be done with the use of a variety of planning tools. The tools that you use in the planning process will depend on what is being planned and the end product desired.
Chapter 4 in Essentials of Strategic Planning in Healthcare (2nd ed.) identifies two tools in the strategic planning process—SWOT analysis and Gap analysis.
In a 3- to 4-page paper, complete the following:
Part 1
Explain in detail the use of SWOT and Gap analysis.
Conduct additional research; identify and explain at least 2 additional strategic tools that can be used in health care strategic planning.
Part 2
Choose a health care organization that you are familiar with and complete a SWOT analysis answering the following questions:
Identify the organization.
Strengths:
What does the organization do well?
Is the organization strong in its market? (Do research and support with evidence.)
Does the organization have a strong mission and vision supported by its culture?
Weaknesses:
What does the organization do poorly?
What problems could be avoided?
What potential difficulties does the organization might face?
Opportunities:
What industry trends can the organization adopt? (Do research, support with evidence, provide sources.)
Are there any new technologies the organization could employ?
Threats:
Who are the organization’s competitors? (Use specific examples from your organization’s marketplace.)
What are the competitors doing well?
What obstacles might the organization face?
Note: Answers to the questions should not be simply yes or no. Detailed answers are required.
In your scholarly paper, you should include an introduction and conclusion paragraph.
SLP Assignment Expectations
Conduct additional research to gather sufficient information to justify/support your analysis.
Limit your response to a maximum of 4 pages, not including the title or reference pages.
Support your paper with peer-reviewed articles, with at least 3 references. Use the following link for additional information on how to recognize peer-reviewed journals:
Harris, J. M. (Ed.). (2018). Section 3: The strategic planning process. In Healthcare strategic planning (4th ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Harrison, J. P. (2016). Chapter 1: Leadership, mission, vision, and culture: The foundation for strategic planning. In Essentials of strategic planning in healthcare (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Harrison, J. P. (2016). Chapter 3: Fundamentals of strategic planning. In Essentials of strategic planning in healthcare (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Harrison, J. P. (2016). Chapter 4: Strategic planning and SWOT analysis. In Essentials of strategic planning in healthcare (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Optional Reading
Speziale, G. (2015). Strategic management of a healthcare organization: Engagement, behavioral indicators, and clinical performance. European Heart Journal Supplements, 17( suppl_A), A3–A7. doi: 10.1093/eurheartj/suv003. Retrieved from https://academic.oup.com/eurheartjsupp/article/17/…
The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.
For this assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 4. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.
rite a brief overview of the selected health care problem or issue. In your overview:
Summarize the health care problem or issue.
Describe the professional relevance of this topic.
Describe any professional experience you have with this topic.
Identify peer-reviewed articles relevant to this health care issue or problem.
Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic
Use keywords related to the health care problem or issue you are researching to select relevant articles.
Assess the credibility and explain relevance of the information sources you find.
Determine if the source is from an academic peer-reviewed journal.
Determine if the publication is current.
Determine if information in the academic peer-reviewed journal article is still relevant.
Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide a rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:
Identify the purpose of the article.
Summarize the information.
Provide rationale for inclusion of each article.
Include the conclusions and findings of the article.
Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.
List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliograph
the subject name is Clinical Decision-Making in nursing, so i need to create case study in word file about patient have Intracerebral Hemorrhage take from this book page 276 https://www.pdfdrive.com/decision-making-in-emerge…, , after explain the case information and data and investigation i need how to apply decision making about the case in deep. i will attach case i made it before you can take a hint from it . if there is other websites or books regarding this you can use them also
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CASE STUDY
ON INTRACRANIAL HEMORRHAGE
Student’s Name: Talahi Sulaiman AlRsheedi
ID: 2231008236
Instructor’s Name: Dr. Najwa Ghonim
Advanced Critical Care Nursing
NCC 632
HISTORY
Personal History
Complaints
Present History
Past History
VITAL
SIGNS
Family History
Vital Signs
1.Name: Mrs M. A
2. Age: 23 years’ old
3. Sex: Female
4. Marital state: Married
5. Occupation: hair dresser
6. Residence: in urban areas
Patient came to ER via an ambulance after a
head trauma. Patient was brought in
unconscious, having a head swelling and
bleeding
Patient was relatively well in the morning, but
encountered a road traffic accident while
returning from work. This happened on a fast
lane, where her car ran into another bus. The
patient collided with her head to the front of
the car, resulting in swelling and hemorrhage.
This resulted from the head trauma, MRI and
head CT revealed an intracranial bleed
Left sided weakness 10 years ago, treated with
aspirin 325mg to full recovery; s/p
She is a known hypertensive not consistent
with her medication
She is diabetic, and currently on medication
(Metformin)
This could not be gotten as patient was
unconscious
Blood pressure: 190/89mmHg
Pulse rate: 132bpm
Temperature: 37.6°C
Respiratory rate: 32bpm
SPO2: 95%
Weight: 60kg
Patient was unconscious, had a swelling on the
head, no clubbing or pallor. Had severe
bleeding and was dehydrated
Upper limb: no finger clubbing, there is
Musculoskeletal scaring and pigmentation
Lower extremities: no oedema
System
Head: there is a wound on the scalp and
swelling
No abnormal heart sound, tachycardia
Inspection: no abnormal pulsation,
Cardiovascular
Percussion: Apex beat was noticed at 5th
system
intercostal space, no thrills
Auscultation: S1 and S2 were normal, no S3
and S4.
Chest Examination There is decreased air entry bilaterally,
presence of rhonchi heard on expiration
Inspection: no scarification or dilated vein seen
Gastrointestinal Percussion: L°S°K°, no fluid thrills
Auscultation: no bruit and bowel sounds were
heard and normal
Level of responsiveness: obtunded, arousal
only with repeated and painful stimuli
Verbal output cannot be comprehended
Some purposeful movement to stimuli
Pupillary Response: RRR
Corneal Reflex intact
B.1.1. Examination of mental functions:
1) State of consciousness: GCS 5/15 (
Neurological
E2V1M3) , patient is unconscious .
Examination
2) Orientation for time and place: No
orientation in time, place and person
a. Anterograde amnesia: presence of loss of
memory
b. Retrograde amnesia: presence of loss of
memory for remote events
B.1.2. Cranial nerve examination.
development of ocular motor CN disturbance.
All other than that has been noted normally .
EXAMINATION
General
examination
Investigations
MEDICATION
Investigations
Laboratory
Investigations
Medications
B.1.3. Examination of the motor system:
1) Inspection:
muscles Size : normal – Left side was affected ,
unilateral with Pseudo-hypertrophy .
2) Examination of muscle tone:
Decreased in muscle tone in the 4
Reflexes: Hyporreflexia in all 4 limbs
3)Examination of muscle strength:
For upper and lower right scoring 1, but for
upper left scoring 1 and lower left scoring 2.
4) Examination of muscle power:
Functional muscle testing: is scoring 1 for left
side, 1 for right side.
6) Meningeal irritation: no irritation
Chest x-ray: Pulmonary embolism noticed
ECG: normal sinus rhythm
CT scan: small infarction or artifact at the
right-sided pons and a skull fracture, with
intracranial bleeding
MRI: this showed severe bleeding into the
brain meninges
Laboratories:
• Blood Sugar: 8.5mol/dl
Full blood count is normal
Platelet count is normal
IV Fentanyl
Midazolam
Lisinopril
Nifedipine
Cefriaxone 5.2 gms IV OD
IV Line and Fluids
NURSING INTERVENTION AND NURSING CARE
Nursing Care Plan
Nursing Intervention
Patient should be given bed rest
Inability to move body parts
Ensure that patient is turned every 2 hrs
Assessment of patients power on all limbs
Patient in unconscious should be tilted sideways
Airway Maintenance
Sanctioning of patient when drooling
Use of oropharyngeal tube if there is obstruction
Lines are set on both arm
This helps for the giving of fluid and drugs in both
Ensure breathing and circulations
arms
SPO2 should be checked
Assessment for cyanosis
IV Fentanyl
Midazolam
Medication
Lisinopril
Nifedipine
Cefriaxone 5.2 gms IV OD
IV Line and Fluids
Quarterly monitoring of vital signs
General assessment
This include;
Blood pressure
Pulse rate
Temperature
Respiratory rate
SPO2
Weight
Fluid intake and output should be monitored
Patient should be placed on Electronic monitoring
device
This involves draining the blood in the brain. The
Surgical management
procedures are an open craniotomy
Insertion of external ventricular drain
Decompressive craniotomy
Locate your assigned case study and answer the questions which correspond to the FIRST letter of your LAST name. Then you will respond to the main postings of two other learners; at least one response should be to a peer who has answered questions different from yours.
A 70-year-old woman has scheduled an initial evaluation with you. Her medical diagnoses include hypertension, hyperglycemia, mild obesity, and hyperlipidemia. Her psychiatric diagnoses include anxiety and depression. Her current medications are atorvastatin 20 mg daily for seven years, Ozempic 1 mg injection weekly for three years, lisinopril 10 mg daily for 10 years, and Abilify 5 mg daily for six years.
Labs: Fasting Blood Glucose – 115, HbgA1C – 6.9, Total Cholesterol – 200, LDL – 100, HDL – 37. Her height is 5’2” and her weight is 176 pounds. Her blood pressure was 146/83 upon arrival at the office.
During your interview, she explains she became depressed following the death of her husband seven years ago. She became anxious about performing everyday tasks without him present. After starting Abilify, she gained 25 pounds and required an increased dose of atorvastatin and Ozempic. She has been unable to lose the weight she gained and tries to closely monitor her dietary intake due to her persistently elevated glucose but reports still craving carbohydrates. Her depression has improved slightly but she is still anxious to go out alone, so she no longer goes for daily walks to exercise.
Questions:
What advice or modifications to his treatment regimen would you recommend for your new patient? (Discuss a minimum of two). Please support your answer with research-based evidence.
If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?
Please include the subjective and objective information in this post.
If your LAST name begins with the letters A through N please address the following:
A 70-year-old woman has scheduled an initial evaluation with you.
Her medical diagnoses include hypertension, hyperglycemia, mild obesity, and hyperlipidemia.
If your LAST name begins with the letters O through Z please address the following:
Your patient is a 36-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of fluoxetine and olanzapine for two years. She is morbidly obese at 340 pounds at 5’5” in height, has type II diabetes, hypertension, and hyperlipidemia. She has concerns about her weight and has tried numerous ‘fad diets’ to no avail. She explains she has lost, at most, 15 pounds and has been able to keep it off for three months.
She has three children, one of which is severely disabled, and a husband who has a terminal diagnosis. She expresses worry that her weight will impact her ability to care for her disabled child when her husband dies. She reports she eats out frequently due to her children’s busy schedules. She is a stay-at-home mother but gets little exercise and performs no regular physical activity.
She reports feelings of shame that she can no longer orgasm on the rare occasions her husband has the energy and desire to be intimate.
Questions:
What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.
What would be our approach to the sexual side effects she is experiencing?
If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?
Please include the subjective and objective information in this post.
All responses must by supported by correct APA 7th edition formatted citations and references.
Go to the literature available through the Xavier library databases (i.e., CINAHL, MEDLINE EBSCO, Nursing, and Allied Health Database, etc.) and research two peer-reviewed articles that address healthcare informatics. The selected articles should have been published within the last five years. Use the information and knowledge gained from your article readings, and respond to the questions below in no less than 500 -750words total. You may also use your textbook in addition to the articles as a resource to supplement answering the questions. Cite your articles and or text at the end of your assignment. Use APA format when writing your assignment.What is one (1) current topic in the area of healthcare informatics that the professional nurse should be conversant about?What are the current beliefs about the future of healthcare informatics and information technologies as it relates to the quality, cost, and effectiveness of healthcare delivery?What should the role of nursing be in achieving the future goals related to the use of information systems and technology?Textbook: Handbook of Informatics for Nurses and Healthcare Professionals 6th edition by Toni Hebda.
Instructions:Answer the following questions:Which antipsychotics are considered first-generation and why are they used less often than second generation antipsychotics? Are second-generation antipsychotics more effective?Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Describe how the overuse of the word “trauma” impacts persons diagnosed with PTSD.
What is the cockroach brain in the context of trauma?
Using the biopsychosocial approach learned in HBSE I, explain the differences between stress and trauma and its impacts on persons who experience symptoms of this disorder.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Students you are responsible for reading the article and providing a critique on your personal thoughts and opinions based on the article itself. You will need to utilize APA format and provide the citation at the top of the assignment. You do not need to include name, title page, etc. just start with the citation and go from there. Assignment is to be submitted on a word document and as said in accordance to the APA guidelines.
Paper should consist of:
Minimumum 500 words.
Double spaced.
NO PLAGIARIZING!
Citation at the top.
Well organized and grammatically correct.
Describe the main ideas and what the author wants to express and your personal critique of the article.
Analyze each important and interesting point and develop an explanation of the article.
Interpret the author’s intention.
Summarize and evaluate the value of an article, stating whether you agree or disagree with the author, with supporting evidence.
Middle School
Guidelines for Sports Concussion Management,
Neurocognitive Testing& Return to Play Protocol
____________________________
Athletic Trainer, Lake Travis ISD
____________________________
Registered Nurse, Lake Travis ISD
____________________________
Dr. Michael Shane Reardon
Child Neurology Consultants of Austin
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
INTRODUCTION
A concussion is a type of traumatic brain injury (TBI) that can occur to any person or any age group.1
Youth athletes are more susceptible to getting a concussion due to their brains still developing as they age.2 It
can be caused by a bump to the head, blow, or jolt that can alter the way your brain normally works.1,3 Signs
and symptoms can occur in a rapid onset or be delayed anywhere from several minutes to a couple hours after
an injury.3 Concussions and/or head injuries can also occur when the body takes a hit that causes the head to
move rapidly back and forth.1 Concussions can occur in any sport or recreational activity.4 All coaches, parents,
and student-athletes need to be aware of concussion signs and symptoms and what to do if a concussion and/or
head injury occur. There is an estimated 1.6-3.8 million concussion that occur every year in sports and
recreational activities.5 Athletes that have sustained at least one concussion in their life are 4-6 times more
likely to sustain another concussion.5 If an athlete is suspected of having a concussion and/or head injury, they
need to be seen by a medical provider.1 In order for the athlete to return to sport or their respected activity, the
student-athlete must undergo a return to play protocol with the LTISD middle school nurse and coaching staff.
Additionally, the LTISD Athletic Trainers and Coaching Staff have the right to pull an athlete from
practice/games and initiate the concussion protocol, based on an athlete’s presentation and observation during
concussion sideline assessment or performing the SCAT5.6,7 To have a standard method of managing
concussions to LTISD athletes, the following guidelines are intended to serve as a written protocol for
concussion management.
WHAT IS A CONCUSSION?
A sports-related concussion (SRC) can be defined as the representation of acute and sudden symptoms
that are comparative with a TBI.3 A SRC can be the result of biomechanical forces that cause the brain to move
rapidly within the skull.3 Due to the impact of the forces placed on the body, it can cause brain function to
change which results in an altered mental state (either temporary or prolonged).3 Student-athletes can have
symptoms that are somatic, cognitive and/or emotional.3 Some of those symptoms include, but are not limited
to: a brief loss of consciousness, headache, amnesia, nausea, dizziness, confusion, blurred vision, ringing in the
ears, loss of balance, moodiness, poor concentration or mentally slow, lethargy, photosensitivity, sensitivity to
noise, and a change in sleeping patterns.3 There is also a concern for the risk of repeated concussions and
second impact syndrome (SIS) to young athletes.6 SIS can occur when an athlete returns to play before they
have fully recovered from a concussion and/or head injury.2,8 These two problems can have long lasting, and
even fatal effects, on the individual.3,8
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
HISTORY
The following events played a significant role leading up to the development and implementation of the LTISD
concussion management and return to play protocol:
1) October 2016: the 5th International Conference on Concussion in Sport convened in Berlin, Germany
and published its Consensus Statement on Concussion in Sport
2) January 2015: the NCAA Executive Committee updated its policy statement regarding concussions.
3) April 2019: the National Federation of State High School Associations published Suggested Guidelines
for the Management of Concussion in Sports.
4) June 2011: The Texas’ Legislature’s House Bill 2038, also known as Natasha’s Law, was passed, and
signed into law. This is a law relating to prevention, treatment, and oversight of concussions affecting
public school students’ participation in interscholastic athletics.
5) Summer 2011: Texas Education Code updated Chapter 38, Sub Chapter D regarding concussion
management of student-athletes participating in interscholastic sports in Texas.
6) Summer 2011: The University Interscholastic League updated its requirements for concussion
management in student-athletes participating in activities under the jurisdiction of the UIL, and
published Implementation Guide NFHS Suggested Guidelines for Concussions and Chapter 38, Sub
Chapter D of the Texas Education Code
PURPOSE
Lake Travis Independent School District will continue to keep the health, safety, and welfare of its
student-athletes foremost. In addition, this Protocol complies with HB 2038, the UIL’s concussion management
protocol and TEC Section 38.153.
This Concussion Management (CM) and Return to Play Protocol (RTP) is designed to help the LTISD
Athletic Department treat its student-athletes who are suspected of having sustained a concussion and/or head
injury in a safe, efficient, and objective manner. By following this protocol, LTISD will be able to provide an
efficient treatment plan to keep the student-athlete’s health and well-being a top priority. In addition, this
Protocol complies with the UIL’s Implementation Guide for NFHS Suggested Guidelines for Concussions and
Chapter 38, Sub Chapter D of the Texas Education Code and HB 2038.
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
DESCRIPTION
According to this CM & RTP protocol:
A) LTISD Athletic Department will create and implement a Concussion Oversight Team.
“The governing body of each school district and open-enrollment charter school
with students enrolled who participate in an interscholastic athletic activity shall
appoint or approve a concussion oversight team. Each concussion oversight
team shall establish a return-to-play protocol, based on peer reviewed scientific
evidence, for a student’s return to interscholastic athletics practice or
competition following the force or impact believed to have caused a
concussion.” (UIL Concussion Management Protocol Implementation Guide)
The members of the Concussion Oversight Team are made up of the LTISD
Athletic Training staff, Registered Nurse’s, and Dr. Michael Shane Reardon.
B) LTISD Athletic Training staff, middle school nurses and coaching staff will:
1) Complete all UIL-required training regarding concussion management.
2) Educate student-athletes about concussions.
3) Educate the coaching staff about the LTISD CM and RTP protocol and the coaches’ role within
the protocol.
4) Maintain documentation of the incident, evaluation, continued management and clearance of
student-athletes who have suffered a concussion and/or head injury.
5) Maintain documentation of the completed UIL Concussion Management Protocol Return to Play
Form. This form must be completed and signed by the appropriate people prior to a studentathlete’s return to play following a concussion and/or head injury.
6) Communicate with LTISD coaches as to the medical clearance of student-athletes who have
suffered concussions and/or head injury.
C) The coaching staff of LTISD will:
1) Complete all UIL-required training regarding concussions.
2) Educate student-athletes about concussions.
3) Remove a student-athlete from a practice or competition if they show any signs, symptoms, or
behaviors consistent with a concussion and/or head injury, and refer them for evaluation by an
appropriate, licensed health care professional (Medical Doctor, Athletic Trainer, Nurse
Practitioner, etc.).
4) Follow all participation restrictions that are placed on a student-athlete by an appropriate,
licensed healthcare professional that has evaluated the student-athlete.
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
D) A student-athlete must be removed from a practice or competition immediately if struck with an object
above the neck region during the practice or competition.
E) A student-athlete must be removed from a practice or competition immediately if one of the following
persons believes the student might have sustained a concussion and/or head injury during practice or
competition:
● Coach
● Athletic Trainer
● Medical Doctor
● Licensed Health Care Professional
● Parent, guardian, or another person with legal authority to make medical decisions for the
student.
F) If a student-athlete shows any signs, symptoms, or behaviors consistent with a concussion and/or head
injury:
1) The student-athlete shall be immediately removed from game/practice.
2) The student-athlete shall be evaluated by an appropriate, licensed health care professional as
soon as it is practical to do so (Medical Doctor, Athletic Trainer, Nurse Practitioner, etc.).
3) Inform the student-athlete’s parent or guardian about the possible concussion and/or head injury
and provide them:
● Educational material on concussions and/or head injuries, including instructions for
monitoring the student-athlete.
● Return to Play Guidelines
4) The student-athlete shall not be allowed to return to participation that day regardless of how
quickly the signs or symptoms of the concussion and/or head injury resolve and shall be kept
from activity until a Medical Doctor indicates they are symptom-free and gives clearance to
return to activity as described below with the LTISD middle school nurse and coaching staff.
5) A coach of an interscholastic athletics team may not authorize a student’s return to play.
EVOLUTION & FUTURE CONSIDERATIONS
This protocol as well as the issue of sports concussion management should be continually updated following
established guidelines and new standards of care as they become available.
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
Parental Information
What is a concussion?
A sports-related concussion (SRC) can be defined as the representation of acute and sudden symptoms
that are comparative with a TBI.3 A SRC can be the result of biomechanical forces that cause the brain to move
rapidly within the skull.3 Due to the impact of the forces placed on the body, it can cause brain function to
change which results in an altered mental state (either temporary or prolonged).3 Student-athletes can have
symptoms that are somatic, cognitive and/or emotional.3 Some of those symptoms include, but are not limited
to: a brief loss of consciousness, headache, amnesia, nausea, dizziness, confusion, blurred vision, ringing in the
ears, loss of balance, moodiness, poor concentration or mentally slow, lethargy, photosensitivity, sensitivity to
noise, and a change in sleeping patterns.3
What are the symptoms of a concussion?
Due to the impact of the forces placed on the body, it can cause brain function to change which results in
an altered mental state (either temporary or prolonged).3 Student-athletes can have symptoms that are somatic,
cognitive and/or emotional.3 Some of those symptoms include, but are not limited to: a brief loss of
consciousness, headache, amnesia, nausea, dizziness, confusion, blurred vision, ringing in the ears, loss of
balance, moodiness, poor concentration or mentally slow, lethargy, photosensitivity, sensitivity to noise, and a
change in sleeping patterns.3 Signs and symptoms can last anywhere between 7-10 days or be prolonged up to
several weeks or months.2,3,8
What should be done if a concussion is suspected?
1. Immediately remove student from practice or game
2. Seek medical attention right away.
3. Do not allow the student to return to play until proper medical clearance and return to play guidelines
have been followed. The permission for return to play will come from the appropriate health care
professional or professionals.
If you have any questions concerning concussions or the return to play policy, you may contact the LTISD
athletic trainers.
What are risks of returning to activity too soon from or currently with a concussion and/or head injury?
Student-athletes cannot participate in practice/games with a concussion and/or head injury. Rest is key
after a concussion and/or head injury. There is also a concern for the risk of repeated concussions and second
impact syndrome (SIS) to young athletes. SIS can occur when an athlete returns to play before they have fully
recovered from a concussion and/or head injury.2 This condition presents when the brain has not recovered from
the initial concussion—usually within a short time (hours, days, and weeks) and can slow recovery or increase
the chances for long-term problems and be fatal.3 Student-athletes are not allowed to return to play the day of
injury unless cleared by a licensed health care professional. Sometimes athletes, parents, and other school or
league officials wrongfully believe that it shows strength and courage to play while injured. Discourage others
from pressuring injured athletes to play. Don’t let your athlete convince you that they’re “just fine.” Parents
should encourage their student-athlete to be honest when reporting signs and symptoms to the appropriate
health care provider. As a result, education of administrators, coaches, parents, and students is the key for
student-athlete’s safety.
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
Liability Provisions
The student and the student’s parent or guardian or another person with legal authority to make medical
decisions for the student understands this policy does not:
1. Waive any immunity from liability of a school district or open-enrollment charter school or of district of
charter school officers or employees.
2. Create any liability for a cause of action against a school district or open-enrollment charter school or
against district or charter school officers or employees.
3. Waive any immunity from liability under Section 74.151, Civil Practice and Remedies Code.
4. Create any liability for a member of a concussion oversight team arising from the injury or death of a
student participating in an interscholastic athletics practice of competition, based only on service on the
concussion oversight team.
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
Name: ____________________________________
Sport: ____________________________________
Grade/ Team: _______________________________
Date of Injury: ______________
Date: ______________________
Time: _____________________
How do you feel? You should score yourself on the following symptoms, based on how you feel now.
1. Headache
2. “Pressure in head”
3. Neck Pain
4. Nausea or vomiting
5. Dizziness
6. Blurred vision
7. Balance problems
8. Sensitivity to light
9. Sensitivity to noise
10. Feeling slowed down
11. Feeling like “in a fog”
12. “Don’t feel right”
13. Difficulty concentrating
14. Difficulty remembering
15. Fatigue or low energy
16. Confusion
17. Drowsiness
18. Trouble falling asleep
19. More emotional
20. Irritable
21. Sadness
22. Nervous or Anxious
None
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Mild
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
Moderate
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
3
4
Do symptoms get worse with physical activity?
Yes / No
Do symptoms get worse with mental activity?
Yes / No
Total Number of Symptoms: ______________
Severe
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
5
6
Symptom Severity Score: _________________
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
Athlete Name: ______________________________ Date/Time of injury: ____________ Sport: __________
Examiner: ___________ Age: ___ Gender: M / F Current Grade:
Dominant hand: Right / Left
How many concussions have you had in the past?
Most recent concussion: ___________________
How long was your recovery from the most recent concussion? _____________________________________
Have you ever been hospitalized for a head injury?
Yes / No
Have you ever been diagnosed with headaches or migraines? Yes / No
– Have you ever been prescribed medication for
headaches/migraines? Yes / No
– Do you normally take medication for headaches/migraines?
Yes / No
– Have you taken that medication today? Yes / No
Have you been diagnosed by ad doctors with a
learning disability, dyslexia, ADD / ADHD? Yes / No
– Have you been prescribed ADD/ADHD medication?
Yes / No
– Do you normally take your ADD/ADHD medication?
Yes / No
– Have you taken that medication today? Yes / No
Have you been diagnosed with depression, anxiety, or any other
psychiatric disorder? Yes / No
– Have you been prescribed with psychiatric medication?
Yes / No
– Do you normally take medication for a psychiatric disorder?
Yes / No
– Have you taken that medication today? Yes / No
Have you been to the eye doctor in the last year?
Yes / No
– Have you been prescribed glasses or contacts? Yes / No
– Which do you wear while participating in sports?
Contacts / Glasses / None
– Which one are you wearing today?
Contacts / Glasses / None
Are you color-blind?
Yes / No
– What color are you color-blind to? Red / Green/ Unsure
Please list all other medications:
How many hours ago did you last work-out? _____________
What work-out/activity did you perform?
– What was the intensity? Low Moderate Vigorous
How many hours did you sleep last night? _______________
How many hours do you normally sleep? ________
Are you feeling 100% normal today? Yes / No What percent? ___________
Why if not, why?
_____________________________________________________
Cognitive Assessment
What month is it?
What is the date today?
What is the day of the week?
What year is it?
What time is it right now? (w/i hour)
Orientation score
0
1
0
1
0
1
0
1
0
1
___ of 5
NOTES: MOI/ UE&LE Findings/ ROM/ Tenderness
Delayed Recall
Eat Dog Run
Y/N
Concentration months in reverse order Y / N
Dec – Nov – Oct – Sept – Aug – Jul – Jun – May – Apr –
Mar – Feb – Jan
Balance Examination
Footwear: Shoes / Barefoot / Braces Which foot was tested?
Double Leg Stance
Single Leg Stance
Tandem Stance
Errors
Errors
Errors
L /R
Coordination Examination
Upper limb coordination: Which arm was tested: L / R Both
Coordination score: ___of 1
List A
4-9-3
6-2-9
3-8-1-4
3-2-7-9
6-2-9-7-1
1-5-2-8-9
7-1-8-4-6-2
5-3-9-1-4-8
Digits Backwards
List B
List C
5-2-6
1-4-2
Y N
4-1-5
6-5-8
Y N
1-7-9-5
6-8-3-1
Y N
4-9-6-8
3-4-8-1
Y N
4-8-5-2-7
4-9-1-5-3
Y N
6-1-8-4-3
6-8-2-5-1
Y N
8-3-1-9-6-4
3-7-6-5-1-9
Y N
7-2-4-8-5-6
9-2-6-5-1-4
Y N
Digits Score:
Immediate Memory: 5 Word
List
Finger Penny Blanket Lemon
Insect
Candle Paper Sugar Sandwich
Wagon
Baby Monkey Perfume Sunset
Iron
Elbow Apple Carpet Saddle
Bubble
Dollar Honey Mirror Saddle
Anchor
Jacket Arrow Pepper
Cotton Movie
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Trial 1
Total:
0
0
0
0
0
0
0
0
/4
Trial 2 Trial 3
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
Athlete Name: ____________________________
Date of Injury: ____________________
Sport /Team: _____________________________
Time of Injury: ____________________
Lake Travis ISD has developed a protocol for managing concussions and/or head injuries. This policy includes a
multidiscipline approach involving Athletic Trainer clearance, Medical Doctor referral and clearance, the middle school
nurse and successful completion of activity progressions related to their sport. The following is an outline of this
procedure; the injured athlete must complete and successfully pass all phases (with 0 symptoms) of the protocol to return
to sport activity after having a concussion and/or head injury.
I.
II.
III.
IV.
V.
All athletes who sustain head injuries are required to be evaluated by a Medical Doctor and will complete
the Return to Play Protocol. This includes athletes who were initially referred to an emergency department.
The student will be monitored daily at school by the middle school nurse and coaching staff. His/her teachers will
be notified of their injury and what to expect. Accommodations may need to be given according to Medical
Doctor recommendations and observations.
The student must be asymptomatic at rest and exertion to move on to the next phase. Additionally, the student
must be asymptomatic for 3 calendar days before starting the Return to Play Protocol.
Once cleared to begin activity, the student will start a progressive step-by-step procedure outlined in the Prague
statement. The progressions will advance at the rate of one step per day (24 hours in between phases). Each phase
of the protocol MUST be completed with the middle school nurse and coaching staff.
Upon completion of the return to play protocol, he/she may return to their sport with no restrictions, with a
DOCTORS CLEARANCE.
Name/Number of Parent Called: _________________________________________________________________
Evaluating Athletic Trainer/ Supervising Coach: _________________Date: _____________
Last date with symptoms: _______________Concussion Checklist Completion Date: _______________
Name of Physician ______________________________ Date of Visit: ________________
Cleared to return to activities: Yes:
No:
Reason: ______________________________________________
Restrictions if needed: __________________________________________________________________________
Phase 0 – Asymptomatic for 3 days – Date: _________
Phase 1 – Stationary Bike (15min) – Date: _________
Phase 2 – Jog on track or field (20min) – Date: _________
Phase 3 – Practice w/ No Contact & Weights (30+ min) – Date: ________
FB – Helmet, Shoulder Pads, Shorts, Girdle
Phase 4 – Full Athletic Practice – Date: _________
Phase 5 – Return to Play
Parent Signature ____________________________ Doctors Signature_______________________________
By signing this form, I (parent/guardian/ person with legal authority) grant permission and understand the risks and dangers related
with returning to play too soon after a concussion. Furthermore, if my son/daughter is diagnosed with a concussion and/or head
injury, I give my consent for my son/daughter to participate in and comply with the Lake Travis ISD return to play protocol.
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
Lake Travis ISD
Guidelines for Middle School Sports Concussion and/or Head Injury
Management, Neurocognitive Testing& Return to Play Protocol
REFERENCES
1.
2.
3.
4.
5.
6.
7.
8.
Mild tbi and concussion. https://www.cdc.gov/traumaticbraininjury/concussion/index.html#print.
Updated Novemeber 14, 2022. Accessed2023.
Halstead ME, Walter KD. Clincial report-sports- related concussion in children and adolescents. A Aca
Pediatr. 2010;126(6):597-611 doi:10.1542/peds.2010-2005
McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sports- the 5th
international confrence on concussion in sport held in berlin, october 2016. Br J Sports Med.
2018;51:838-847 doi:10.1136/brjsports-2017-097699
Gessel KM, Fields SK, Collins CL, Dick RW, Comstock RD. Concusssions amoung united states high
school and collegiate athletes. J Ath Train. 2007;42(4):495-503.
Brain injury research institute. https://www.protectthebrain.org/. Accessed 2023.
May T, Foris LA, Donnally III CJ. Second impact syndrome. Treasure Island (FL): StatPearls; 2022.
SCAT 5. Br J Sports Med Web site. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports2017-097506SCAT5.full.pdf. Accessed2023.
Echemendia RJ, Meeuwisse W, McCrory P, et al. The sports concsussion assessment tool 5th edition
(SCAT5): background and rationale. Br J Sports Med. 2017;51:848-850 doi:10.1136/bjsm-2017-097506
Lake Travis ISD. ⚫ 3324 RR 620 South ⚫ Austin, TX 78738
FOCUSED REVIEW/REMEDIATION AND REQUIRED REMEDIATION DOCUMENT MUST MEET THE FOLLOWING CRITERIA:
If not done in the classroom, first attempt must be completed with a closed book and without additional resources.
Use the Three Critical Concepts Remediation Document
Focused review Post-Study quiz must be completed if assigned, and upload screenshot.
Focused review topics that are assigned must be included in the 3 critical concepts remediation document to correlate with the ATI Individual Performance Profile report.
The 3 critical concepts must be typed with complete and thoughtful answers.
Must be original work for each assignment. Assignments are not to be re-used.
In one submission, attach both documents – (1) the ATI Individual Performance Profile report and (2) the Completed 3 Critical Concepts Remediation Document.
You may submit your work PRIOR to the due date but not ahead of week 5 or 6.
THREE CRITICAL CONCEPTS REMEDIATION EXAMPLES
Example 1
Example 2
Unformatted Attachment Preview
Individual Performance Profile
RN Fundamentals 2023
Individual Name: VAHE GEVORGYAN
Adjusted Individual Total Score:
65.0%
Student Number: 21GV82698
ATI Proficiency Level:
National Mean:
Program Mean:
National Percentile Rank:
Program Percentile Rank:
Level 2
64.6%
64.2%
52
53
Institution:
West Coast U LA BSN
Program Type:
BSN
Test Date:
10/10/2023
Individual Performance in the Major Content Areas
#
Individual
Points
Score
National
Program
Type
National
Program
Type
Management of Care
9
66.7%
66.1%
64.9%
46
49
Safety and Infection
Control
14
78.6%
60.8%
59.8%
83
85
Health Promotion and
Maintenance
6
66.7%
67.6%
69.2%
61
57
Psychosocial Integrity
4
75.0%
N/A
N/A
N/A
N/A
Basic Care and Comfort
8
75.0%
60.3%
59.8%
74
75
Pharmacological and
Parenteral Therapies
7
100.0%
66.6%
66.3%
99
99
Reduction of Risk
Potential
9
66.7%
66.4%
65.9%
42
43
Sub-Scale
Mean
Percentile Rank
Physiological Adaptation
3
0.0%
N/A
N/A
N/A
N/A
Clinical Judgment
27
63.0%
N/A
N/A
N/A
N/A
Individual Score (% Correct)
NOTE: N/A indicates where means and percentile ranks are not presented for sub-scales with fewer than five items.
Topics To Review
Management of Care (3 items)
Advocacy (1 item)
Therapeutic Communication: Responding to a Client Who Has a Terminal Illness and Wants to Continue Care (Active
Learning Template – Basic Concept)
Informed Consent (1 item)
Legal Responsibilities: Obtaining Informed Consent for a Client Who Is Unconscious (Active Learning Template – Basic
Concept)
Legal Rights and Responsibilities (1 item)
Legal Responsibilities: Identifying Negligence (Active Learning Template – Basic Concept)
Safety and Infection Control (2 items)
Standard Precautions/Transmission-Based Precautions/Surgical Asepsis (1 item)
Infection Control: Isolation Precautions While Caring for a Client Who Has Influenza (Active Learning Template – Basic
Concept)
Use of Restraints/Safety Devices (1 item)
Please see page 8 for an explanation of the Scores and Topics to Review sections
Report Created on: 10/17/2023 03:53 AM EDT
Page 1 of 8
REP_COMP_3_0_IndividualProctored_3_0_V3
Topics To Review
Client Safety: Planning Care for a Client Who Has a Prescription for Restraints (Active Learning Template – Nursing Skill)
Health Promotion and Maintenance (2 items)
Health Screening (1 item)
Nutrition Assessment/Data Collection: Obtaining Anthropometric Measurements (Active Learning Template – Nursing Skill)
Health Promotion/Disease Prevention (1 item)
Middle Adults (35 to 65 Years): Identifying Risk Factors for Cardiovascular Disease (Active Learning Template – Growth
and Development)
Psychosocial Integrity (1 item)
Crisis Intervention (1 item)
Therapeutic Communication: Responding to a Client Who Has Depression (Active Learning Template – Basic Concept)
Basic Care and Comfort (2 items)
Assistive Devices (1 item)
Mobility and Immobility: Identifying Appropriate Crutch Gait for a Client (Active Learning Template – Basic Concept)
Mobility/Immobility (1 item)
Mobility and Immobility: Planning Care for a Client Who Is Immobile (Active Learning Template – Nursing Skill)
Reduction of Risk Potential (3 items)
Changes/Abnormalities in Vital Signs (1 item)
Vital Signs: Nursing Actions for Elevated Blood Pressure (Active Learning Template – Nursing Skill)
Potential for Alterations in Body Systems (1 item)
Safe Medication Administration and Error Reduction: Administering Medications to a Client Who Has Dysphagia (Active
Learning Template – Nursing Skill)
Potential for Complications of Diagnostic Tests/Treatments/Procedures (1 item)
Intravenous Therapy: Actions To Take for Fluid Overload (Active Learning Template – Therapeutic Procedure)
Physiological Adaptation (3 items)
Alterations in Body Systems (2 items)
Airway Management: Positioning for Postural Drainage (Active Learning Template – Therapeutic Procedure)
Client Safety: Priority Action When Caring for a Client Who Is Experiencing a Seizure (Active Learning Template Nursing Skill)
Pathophysiology (1 item)
Adverse Effects, Interactions, and Contraindications: Identifying Manifestations of an Anaphylactic Reaction (Active
Learning Template – Basic Concept)
Clinical Judgment (6 items)
Prioritize Hypotheses (1 item)
Nasogastric Intubation and Enteral Feedings: Recognizing Postoperative Complications (Active Learning Template Therapeutic Procedure)
Analyze Cues (4 items)
Adverse Effects, Interactions, and Contraindications: Caring for a Client Who Is Receiving Antibiotics (Active Learning
Template – Medication)
Health Promotion and Disease Prevention: Identifying Risks for Heart Disease (Active Learning Template – Basic
Concept)
Middle Adults (35 to 65 Years): Identifying a Client’s Risk for Osteoporosis (Active Learning Template – Basic Concept)
Pressure Injury, Wounds, and Wound Management: Identifying Risks for Delayed Wound Healing (Active Learning
Template – Basic Concept)
Take Actions (1 item)
Home Safety: Providing Discharge Teaching for a Client Who Is Recovering From Pneumonia (Active Learning Template
– Therapeutic Procedure)
Please see page 8 for an explanation of the Scores and Topics to Review sections
Report Created on: 10/17/2023 03:53 AM EDT
Page 2 of 8
REP_COMP_3_0_IndividualProctored_3_0_V3
Outcomes
No of
Points
Individual
Score
RN Assessment
5
20.0%
The assessment step of the nursing process involves application of
nursing knowledge to the collection, organization, validation and
documentation of data about a client’s health status. The nurse
focuses on the client’s response to a specific health problem
including the client’s health beliefs and practices. The nurse thinks
critically to perform a comprehensive assessment of subjective and
objective information. Nurses must have excellent communication
and assessment skills in order to plan client care.
RN Analysis/Diagnosis
26
65.4%
The analysis step of the nursing process involves the nurse’s ability
to analyze assessment data to identify health problems/risks and a
client’s needs for health intervention. The nurse identifies patterns
or trends, compares the data with expected standards or reference
ranges and draws conclusions to direct nursing care. The nurse
then frames nursing diagnoses in order to direct client care.
RN Planning
14
64.3%
The planning step of the nursing process involves the nurse’s ability
to make decisions and problem solve. The nurse uses a client’s
assessment data and nursing diagnoses to develop measureable
client goals/outcomes and identify nursing interventions. The nurse
uses evidenced based practice to set client goals, establish
priorities of care, and identify nursing interventions to assist the
client to achieve his goals.
RN Implementation/Therapeutic
Nursing Intervention
35
74.3%
The implementation step of the nursing process involves the nurse’s
ability to apply nursing knowledge to implement interventions to
assist a client to promote, maintain, or restore his health. The nurse
uses problem-solving skills, clinical judgment, and critical thinking
when using interpersonal and technical skills to provide client care.
During this step the nurse will also delegate and supervise care and
document the care and the client’s response.
RN Evaluation
7
100.0%
The evaluation step of the nursing process involves the nurse’s
ability to evaluate a client’s response to nursing interventions and to
reach a nursing judgment regarding the extent to which the client
has met the goals and outcomes. During this step the nurse will
also assess client/staff understanding of instruction, the
effectiveness of interventions, and identify the need for further
intervention or the need to alter the plan.
No of
Points
Individual
Score
5
80.0%
Thinking Skills
No of
Points
Individual
Score
Foundational Thinking
11
72.7%
The ability to comprehend information and concepts. Incorporates
Blooms Taxonomy categories of Remembering and Understanding.
Clinical Application
49
71.4%
The ability to apply nursing knowledge to a clinical situation.
Incorporates Blooms Taxonomy category of Applying.
Clinical Judgment
27
63.0%
The ability to analyze and interpret elements of a clinical situation to
make a decision and respond appropriately. Incorporates Blooms
Taxonomy categories of Analyzing and Evaluating.
Nursing Process
Priority Setting
Please see page 8 for an explanation of the Scores and Topics to Review sections
Report Created on: 10/17/2023 03:53 AM EDT
Description
Description
Ability to demonstrate nursing judgment in making decisions about
priority responses to a client problem. Also includes establishing
priorities regarding the sequence of care to be provided to multiple
clients.
Description
Page 3 of 8
REP_COMP_3_0_IndividualProctored_3_0_V3
No of
Points
Individual
Score
RN Management of Care
9
66.7%
The nurse coordinates, supervises and/or collaborates with
members of the health care to provide an environment that is costeffective and safe for clients.
RN Safety and Infection Control
14
78.6%
The nurse uses preventive safety measures to promote the health
and well-being of clients, significant others, and members of the
health care team.
RN Health Promotion and
Maintenance
6
66.7%
The nurse directs nursing care to promote prevention and detection
of illness and support optimal health.
RN Psychosocial Integrity
4
75.0%
The nurse directs nursing care to promote and support the
emotional, mental and social well-being of clients and significant
others.
RN Basic Care and Comfort
8
75.0%
The nurse provides nursing care to promote comfort and assist
client to perform activities of daily living.
RN Pharmacological and Parenteral
Therapies
7
100.0%
The nurse administers, monitors and evaluates pharmacological
and parenteral therapy.
RN Reduction of Risk Potential
9
66.7%
The nurse directs nursing care to decrease clients’ risk of
developing complications from existing health disorders, treatments
or procedures.
RN Physiological Adaptation
3
0.0%
The nurse manages and provides nursing care for clients with an
acute, chronic or life threatening illness.
QSEN
No of
Points
Individual
Score
Safety
36
77.8%
The minimization of risk factors that could cause injury or harm
while promoting quality care and maintaining a secure environment
for clients, self, and others.
Patient-Centered Care
14
71.4%
The provision of caring and compassionate, culturally sensitive care
that is based on a patient’s physiological, psychological,
sociological, spiritual, and cultural needs, preferences, and values.
Evidence Based Practice
33
57.6%
The use of current knowledge from research and other credible
sources to make clinical judgments and provide client-centered
care.
Quality Improvement
1
0.0%
Care-related and organizational processes that involve the
development and implementation of a plan to improve health care
services and better meet the needs of clients.
Teamwork and Collaboration
3
100.0%
The delivery of client care in partnership with multidisciplinary
members of the health care team, to achieve continuity of care and
positive client outcomes.
NCLEX®
Please see page 8 for an explanation of the Scores and Topics to Review sections
Report Created on: 10/17/2023 03:53 AM EDT
Description
Description
Page 4 of 8
REP_COMP_3_0_IndividualProctored_3_0_V3
No of
Points
Individual
Score
Human Flourishing
9
77.8%
Human flourishing is reflected in patient care that demonstrates
respect for diversity, approaches patients in a holistic and patientcentered manner, and uses advocacy to enhance their health and
well-being.
Nursing Judgment
63
71.4%
Nursing judgment involves the use of critical thinking and decision
making skills when making clinical judgments that promote safe,
quality patient care.
Professional Identity
4
50.0%
Professional identity reflects the professional development of the
nurse as a member and leader of the health care team who
promotes relationship-centered care, and whose practice reflects
integrity and caring while following ethical and legal guidelines.
Spirit of Inquiry
11
54.5%
A spirit of inquiry is exhibited by nurses who provide evidence based
clinical nursing practice and use evidence to promote change and
excellence.
No of
Points
Individual
Score
Liberal Education for Baccalaureate
Generalist Nursing Practice
9
66.7%
The need for an education that exposes nurses to multiple fields of
study providing the foundation for a global perspective of society as
well as high level thinking and acquisition of skills that can be
applied to complex patient and system-based problems.
Basic Organization and Systems
Leadership for Quality Care and
Patient Safety
20
70.0%
The need for nurses to be able to understand power relationships
and use decision-making and leadership skills to promote safe
practice and quality improvement within health care systems.
Scholarship for Evidence-Based
Practice
27
63.0%
The need for nurses to be able to understand the research process
and base practice and clinical judgments upon fact-based evidence
to enhance patient outcomes.
Interprofessional Communication and
Collaboration
3
100.0%
The need for nurses to be able to function as a member of the
healthcare team while promoting an environment that supports
interprofessional communication and collaboration with the goal of
providing patient-centered care.
Clinical Prevention and Population
Health
16
75.0%
The need for nurses to be able to identify health related risk factors
and facilitate behaviors that support health promotion, and disease
and injury prevention, while providing population-focused care that
is based on principles of epidemiology and promotes social justice.
Baccalaureate Generalist Nursing
Practice
12
66.7%
The need for nurses to be able to practice as a generalist using
clinical reasoning to provide care to patients across the lifespan and
healthcare continuum and to individuals, families, groups,
communities, and populations.
NLN Competency
BSN Essentials
Please see page 8 for an explanation of the Scores and Topics to Review sections
Report Created on: 10/17/2023 03:53 AM EDT
Description
Description
Page 5 of 8
REP_COMP_3_0_IndividualProctored_3_0_V3
No of
Points
Individual
Score
Analyze Cues
19
63.2%
Link recognized cues to a client’s clinical presentation and
establishing probable client needs, concerns, or problems.
Compare client findings to evidence-based resources and standards
of care.
Analyze expected and unexpected findings in health data.
Anticipate illness/injury and wellness progression.
Identify client problems and related health alterations.
Analyze client needs.
Identify potential complications.
Identify how pathophysiology relates to clinical presentation.
Identify data that is of immediate concern.
Prioritize Hypotheses
4
50.0%
Establish priorities of care based on the client’s health problems (i.e.
environmental factors, risk assessment, urgency, signs/ symptoms,
diagnostic test, lab values, etc.).
Organize client assessment information according to changes,
patterns and trends.
Use standards of care and empirical frameworks for priority setting.
Establish and prioritize client problems/needs based on the analysis
of information and factors.
Take Actions
4
75.0%
Implement appropriate interventions based on nursing knowledge,
priorities of care, and planned outcomes to promote, maintain, or
restore a client’s health.
Promptly and accurately perform nursing actions based on
prioritized client problems.
Implement a plan of care in collaboration with members of the
interprofessional health care team.
Implement a plan of care in collaboration with the client and care
partners.
Accurately document client care data and information.
Incorporate client preferences and needs when performing nursing
actions.
Provide education to the client and/or care partner(s) regarding their
health condition and care management.
Participate in coordination of care with the client and healthcare
team.
Monitor the client’s response to interventions.
Clinical Judgment
Please see page 8 for an explanation of the Scores and Topics to Review sections
Report Created on: 10/17/2023 03:53 AM EDT
Description
Page 6 of 8
REP_COMP_3_0_IndividualProctored_3_0_V3
No of
Points
Individual
Score
Knowledge for Nursing Practice
23
56.5%
Integration, translation, and application of established and evolving
disciplinary nursing knowledge and ways of knowing, as well as
knowledge from other disciplines, including a foundation in liberal
arts and natural and social sciences. This distinguishes the practice
of professional nursing and forms the basis for clinical judgment and
innovation in nursing practice.
Person-Centered Care
19
78.9%
Person-centered care focuses on the individual within multiple
complicated contexts, including family and/or important others.
Person-centered care is holistic, individualized, just, respectful,
compassionate, coordinated, evidence-based, and developmentally
appropriate. Person-centered care builds on a scientific body of
knowledge that guides nursing practice regardless of specialty or
functional area.
Population Health
5
60.0%
Population health spans the healthcare delivery continuum from
public health prevention to disease management of populations and
describes collaborative activities with both traditional and nontraditional partnerships from affected communities, public health,
industry, academia, health care, local government entities, and
others for the improvement of equitable population health outcomes.
Scholarship for the Nursing Discipline
9
55.6%
The generation, synthesis, translation, application, and
dissemination of nursing knowledge to improve health and transform
health care.
Quality and Safety
25
80.0%
Employment of established and emerging principles of safety and
improvement science. Quality and safety, as core values of nursing
practice, enhance quality and minimize risk of harm to patients and
providers through both system effectiveness and individual
performance.
Interprofessional Partnerships
2
100.0%
Intentional collaboration across professions and with care team
members, patients, families, communities, and other stakeholders to
optimize care, enhance the healthcare experience, and strengthen
outcomes.
Professionalism
4
50.0%
Formation and cultivation of a sustainable professional identity,
including accountability, perspective, collaborative disposition, and
comportment, that reflects nursing’s characteristics and values.
AACN Essentials
Please see page 8 for an explanation of the Scores and Topics to Review sections
Report Created on: 10/17/2023 03:53 AM EDT
Description
Page 7 of 8
REP_COMP_3_0_IndividualProctored_3_0_V3
Score Explanation and Interpretation
Individual Performance Profile
ATI PROFICIENCY LEVELS
Proficiency Level
Proficiency Level Definition
Score Range*
Below Level 1
Scores below the Proficiency Level 1 standard can be considered below
minimum expectations and can be indicative of significant risk in this
content area. ATI strongly advises these students to develop and complete
an intensive plan for focused review and remediation, including the use of
ATI materials, textbooks, class notes, reference materials, and assistance
from nurse educators.
0.0% to 49.9%
Level 1
Scores meeting the Proficiency Level 1 standard can be considered to meet
the absolute minimum expectations for performance in this content area.
Scores at this level were judged by the content expert panel to indicate a
student as likely to just meet NCLEX-RN® standards in this content area. ATI
advises these students to develop and complete a rigorous plan of focused
review in order to achieve a firmer grasp of this content.
50.0% to 64.9%
Level 2
Scores meeting the Proficiency Level 2 standard can be considered to
exceed minimum expectations for performance in this content area. Scores
at this level were judged by the content expert panel to indicate a student
as fairly certain to meet NCLEX-RN standards in this content area. ATI
advises these students to engage in continuous focused review in order to
improve their knowledge of this content.
65.0% to 81.6%
Level 3
Scores meeting the Proficiency Level 3 standard can be considered to
exceed most expectations for performance in this content area. Scores at
this level were judged by the content expert panel to indicate a student as
likely to exceed NCLEX-RN standards in this content area. ATI advises these
students to engage in continuous focused review to maintain and improve
their knowledge of this content.
81.7% to 100.0%
*There are no scoring gaps between the ranges of each level to include all possible scores of the NGN assessment.
ADJUSTED INDIVIDUAL TOTAL SCORE
PRETEST ITEMS
To adjust for possible differences in difficulty among the forms
of this assessment, the raw score (the total number of points
received) is converted to an adjusted raw score through a
standard process known as equating. The adjusted individual
total score is a function of the adjusted raw score divided by the
total number of points possible on the assessment.
There are 10 unscored and 60 scored questions throughout
the assessment. The unscored questions are used for
research purposes.
Adjusted raw score
Total number of points possible
PROGRAM MEAN
× 100
The adjusted individual total score is on a scale of 0% to 100%
and is incremented in units of 0.1%. For example, if a student
received 76 points (raw score) and an adjusted raw score of
75.5810 on a test that has 99 total points possible, then the
adjusted individual total score is equal to 76.3%:
75.5810 × 100 = 76.3%
99
ITEM SCORING
ATI follows NCSBN guidance for item scoring. Accordingly,
each item is worth one or more points. Depending on the itemspecific scoring method, a student’s response may earn full,
partial, or no points.
TOTAL NUMBER OF POINTS POSSIBLE
The total number of points possible is the sum of the number of
points possible of all scored items and is greater than the total
number of scored items on the assessment. The total number
of points possible may vary across assessment versions.
NATIONAL MEAN
This is the average score of all examinees.
This is the average score of all examinees within your specified
program type.
NATIONAL PERCENTILE RANK
This is the percentage of examinees who scored at or below
your score.
PROGRAM PERCENTILE RANK
This is the percentage of examinees within your program type
who scored at or below your score.
TOPICS TO REVIEW
Based on the questions missed on this assessment, a listing
of content areas and topics to review is provided. A variety
of learning resources can be used in the review process,
including content, images, animations and videos in ATI’s
Content Mastery Series® Review Modules, online practice
assessments, and a focused review that is individualized to the
questions missed.
Copyright 2023 Assessment Technologies Institute, L.L.C. All rights reserved. This resource is copyright protected material of ATI and is provided
for use solely under license by ATI. Copying, distributing, or posting this material on the internet or social media is strictly prohibited. Posting on
institution LMS requires ATI’s prior written permission.
Write an essay about medical condition ( colon cancer), disease or medication that interests you, runs in your family or that you would like to know more about.Instructions:1. 10 pages, double spaced, typed ( no typos)2. if the information is taken from the internet it has to be put into your own words, otherwise it would be plagiarism.3. You can put pictures in it4. At the back of the essay there has to be a bibliography, if information taken from the internet, give the address.
dentify a person you know who has an immune system disorder or cancer. Review content in your text for potential types of disorders.
Interview the affected person and write a 3-5 page paper identifying your findings including:
Identify the pathophysiology of the immune system disorder
Discuss the treatment for the immune system disorder
Summarize the findings of the interview.
Use at least one scholarly source to support your findings or identify therapies that may be new or different from what the affected person may be using. Examples of scholarly sources include academic journals, textbooks, reference texts.
Cite your sources in-text and on a References page using APA format. Have questions about APA? Visit the online APA guide:
Questions you may want to use to guide your interview:
How would you describe your immune system disorder?
How long have you had this disorder?
How has this disorder changed your life (home and work)?
Are you able to carry out daily activities independently?
What treatments are you using to manage this disorder?
What side effects have you experienced with the treatments?
How has this disorder changed your body?
How has this disorder impacted you emotionally?
Have alternative therapies, such as Eastern medicine (acupuncture, herbal treatment, yoga) been tried or recommended?
Unformatted Attachment Preview
Rasmussen University – NUR2063: Essentials of Pathophysiology
Title of Assignment:
Module 02 Written Assignment – Immune System Disorders
Purpose of Assignment:
Apply knowledge and understanding of the pathophysiology of immune system disorders. Autoimmune
disorders are generally considered the host attacking itself, which manifests in different types of
disorders.
Course Competency(s):
•
Determine the cellular functions required to regulate homeostasis.
Instructions:
Content:
Identify a person you know who has an immune system disorder or cancer. Review content in your text
for potential types of disorders.
Interview the affected person and write a 3–5-page summary of the interview, including:
•
Identify the pathophysiology of the immune system disorder
•
Discuss the treatment for the immune system disorder
•
•
Summarize the findings of the interview
Use at least one scholarly source to support your findings or identify therapies that may be new
or different from what the affected person may be using. Examples of scholarly sources include
academic journals, textbooks, reference texts, and CINAHL nursing guides. You can find useful
reference materials for this assignment in the School of Nursing guide:
•
Cite your sources in-text and on a References page using APA format. Have questions about
APA?
Questions you may want to use to guide your interview:
1. How would you describe your immune system disorder?
2. How long have you had this disorder?
3. How has this disorder changed your life (home and work)?
4. Are you able to carry out daily activities independently?
5. What treatments are you using to manage this disorder?
6. What side effects have you experienced with the treatments?
7. How has this disorder changed your body?
8. How has this disorder impacted you emotionally?
9. Have alternative therapies, such as Eastern medicine (acupuncture, herbal treatment, yoga)
been tried or recommended?
09/10/2021
Submit a Problem-Focused SOAP note here for grading. You must use an actual patient from your clinical practicum. Review the rubric for more information on how your assignment will be graded. Be sure to use the SOAP note template for your program and view the rubric associated with your program for details on how your assignment will be graded.Patient: 85 y.o. FEMALEName: D.S.Came in for burning and painful urination.THE REST CAN BE MADE UP.PLEASE FOLLOW THE RUBRIC AS MAX
Unformatted Attachment Preview
FNP/AGPC-NP/AGAC-NP SOAP Note Rubric
Criteria
S
(Subjective)
Ratings
Points
10
points
10 points
Accomplished
Symptom analysis is
well organized, with
C/C, OLD CART,
pertinent negatives,
and pertinent
positives. All data
needed to support
the diagnosis &
differential are
present. Is complete,
concise, and relevant
with no extraneous
data.
5 points
Satisfactory
Symptom analysis
well organized with
C/C, OLD CART,
pertinent negatives,
and pertinent
positives. Some
extraneous data is
present and/or one
minor data point
missing.
2.5 points
Needs Improvement
Symptom analysis is
not well organized.
Data is missing. There
is too much
extraneous data
and/or 2-3 minor
data points missing
0 points
Unsatisfactory
Symptom analysis
is inadequate, is not
organized.
Objective or other
data is mixed into
the subjective data.
Important data is
missing.
O
(Objective)
10 points
Accomplished
Complete, concise,
well organized, well
written, and includes
pertinent positive
and pertinent
negative physical
findings. Organized
by body system in
list format. No
extraneous data.
5 points
Satisfactory
All relevant exams
were done
thoroughly but
extraneous exams
were also done. It is
somewhat organized
in list format.
2.5 points
Needs Improvement
Symptom analysis is
not well organized.
Data is missing. There
is too much
extraneous data
and/or 2-3 minor
data points missing.
0 points
Unsatisfactory
Omitted important
relevant exams
and/or subjective
data are included.
Lacking
organization.
10
points
A
(Assessment)
10 points
Accomplished
Diagnosis and
differential dx are
correct, include ICD
code, and are
supported by
subjective and
objective data.
2.5 points
Needs Improvement
Diagnosis is correct
but either does not
include ICD code or is
missing two or more
important differential
diagnoses according
to the subjective and
objective data
provided.
0 points
Unsatisfactory
Diagnosis is not
correct, is not
provided or is not
reflective of the
subjective and
objective data
provided.
10
points
P
(Plan)
10 points
Accomplished
Plan is organized,
complete and
supported with 2
evidence-based
references.
Addresses each
diagnosis and is
individualized to the
specific patient and
includes medication
teaching and all 5
components: (Dx
plan, Tx plan, patient
education,
referral/follow-up,
health maintenance).
5 points
Satisfactory
Diagnosis is correct
with ICD codes and
is supported by
subjective and
objective data.
Differential
diagnosis was
inaccurate based on
subjective and
objective data.
5 points
Satisfactory
Plan is organized,
complete and
evidence-based
according to
National Standards
of Care. Addresses
each diagnosis and is
individualized to the
specific patient and
includes medication
teaching but may be
missing 1-2 minor
points.
2.5 points
Needs Improvement
Plan is less organized
and not based on
evidence according to
the National
Standards of Care.
Does not address
each diagnosis or may
not be individualized
to the specific
patient. Missing
medication teaching
or one of the 5
components.
0 points
Unsatisfactory
No Plan provided
or is not organized.
Does not address
all diagnoses
identified and/or
does not include all
5 components of
plan, including
medication
teaching.
10
points
Total
40
points
FNP SOAP Note Template
Use this template for Comprehensive Notes (H&Ps) and Problem-Focused Notes
(Episodic/progress notes). For the Problem-Focused Notes, only include pertinent
problem-focused information related to the chief concern (CC).
Demographic Data
o
o
Patient age and gender identity
MUST BE HIPAA compliant
Subjective
Chief Complaint (CC)
O
O
Place the complaint in Quotes
Brief description -only a few words and in the patient’s words … “My chest
hurts,” “I cannot breath,” or “I passed out,” etc.
History of Present Illness (HPI) – the reason for the appointment today
Use the OLD CARTS acronym to document the eight elements of a chief
concern (CC): Onset, Location/radiation, Duration, Character, Aggravating
factors, Relieving factors, Timing, and Severity)
O Briefly describe the general state of health prior to the problem.
O Are Activities of Daily Living (ADL) impacted by the current problem?
O
PAST MEDICAL HISTORY:
O List current and past medical diagnoses
PAST SURGICAL HISTORY:
O List all past surgeries
FAMILY HISTORY:
O Include medical/psychiatric problems to include 3 generations (parents,
grandparents, siblings, or direct relatives.
CURRENT MEDICATIONS:
O Include current prescription(s), over-the-counter medications, herbal/alternative
medications as well as vitamin/supplement use.
ALLERGIES: Include medications, foods, and chemicals such as latex.
IMMUNIZATIONS HISTORY: list current immunization status and address deficiency
PREVENTATIVE HEALTH HISTORY: (See Table below – Appendix A)
SOCIAL HISTORY:
Include nutrition, exercise, substance use (details of use: caffeine, EtOH, illicit
drug use), sexual history/preference, financial problems, legal issues, kids, and
history of abuse, including sexual, emotional, or physical.
O Employment/Education: occupation (type), exposure to harmful agents,
highest school achievement
O
REVIEW OF SYSTEMS:
O A ROS is a question-seeking inventory by body systems to identify signs
and/or symptoms that the patient may be experiencing or has experienced
that may or may not correlate with the CC.
*If a + finding is found not related to the cc this may represent an additional
problem that will need to be detailed in the HPI.
O Must include any physical complaint(s) by the body system that is relevant to
the treatment and management of the current concern(s). List only the
pertinent body systems specific to the CC.
O Remember to include pertinent positive and negative findings when detailing
the ROS related to a chief concern (cc).
O Do not repeat the information provided in HPI
O Use the format below when detailing the ROS
ROS:
General:
Eyes:
Ears, nose, mouth & throat:
Cardiovascular:
Respiratory:
Gastrointestinal:
Skin & Breasts:
Musculoskeletal:
Allergic:
Immunologic:
Endocrine:
Hematopoietic/Lymphatic:
Genitourinary:
Neurological:
Psychiatric/Mental Status:
Objective
PHYSICAL EXAMINATION:
VITAL SIGNS: Blood pressure. Heart rate (regular or irregular). Respirations. SaO2 (on
room air or O2). Temperature. Weight. Height.
*Document the presence of any internal/external devices (IV, Central lines, NGTs, G-tubes,
Ostomies, urinary catheters) and dates of placement.
General:
Eyes:
Ears, nose, mouth & throat:
Cardiovascular:
Respiratory:
Gastrointestinal:
Skin & Breasts:
Musculoskeletal:
Allergic:
Immunologic:
Endocrine:
Hematopoietic/Lymphatic:
Genitourinary:
Neurological:
Psychiatric/Mental Status:
Pertinent Diagnostic Test Results:
Assessment (Diagnosis)
Differential Diagnosis (DDx)
O
Include two (2) differential diagnoses you considered but did not select as the
final diagnosis. Why were these 2 diagnoses not selected? Support with
pertinent positive and negative findings for each differential with an evidencebased guideline(s) (required).
Working or Final Diagnosis:
O Final or working diagnosis (1) (including ICD-10 code)
O Provide a rational explanation supported by evidenced-based guidelines
(required). List the pertinent positive and negative symptoms/signs that
support your final diagnosis.
Plan
Treatment (Tx) Plan: pharmacologic and/or nonpharmacologic
Pharmacologic -include full prescribing information for each medication(s)
ordered
O Refill Provided: Include full prescribing information for each medication(s)
refilled and the correlating diagnosis related to the refill.
O
Patient Education:
O Include specific education related to each medication prescribed.
O Was risk versus benefit of current treatment plan addressed for medication(s)
and interventions? Was the patient included in the medical decision making
and in agreement with the final plan
O NPs should not be prescribing non-FDA approved medications or medications
related to off-label use. If a physician prescribed a non-FDA-approved
medication for working diagnosis or recommended off-label use was
education provided and was the risk to benefit of the medication(s) addressed
in the patient’s education?
Prognosis Good, Fair, or Poor?
O Indicate the patient’s prognosis: Good, Fair, Poor
O Provide support for your selected prognosis
Referral/Follow-up
O Did you recommend follow-up with PCP, or other healthcare professionals?
O When is the subsequent follow-up?
Disposition:
O Indicate the disposition of the patient.
O
O
Was the patient sent home, Emergency room via EMS, etc.
Include rationale for the follow-up recommendation or referral
Reference(s)
o Include APA formatted references for written assignments.
o Minimum 2 references are required from evidence-based resources.
o Oral assignments should include verbally articulated evidence-based
guideline(s) used to prepare the oral presentation.
APPENDIX A
PREVENTATIVE CARE SCHEDULE (Example – not all-inclusive)
Preventive
Care
Pap
Mammogram
A1C
Eye Exam
Monofilament
Test
Urine
Microalbumin
Diet/Lifestyle
Modifications
Digital Rectal
Exam (DRE)
PSA
Colonoscopy
or FOBT
Dexa Scan
CXR
BNP
ECG
Echo
Stress
Test
Vaccines
Date
Result
Referrals Made
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Select three from the six survival skills learned in this unit that help stop crisis and assist the client recover in the aftermath of the crisis.
Share an example of a crisis experience and explain how the three skills that you selected could be used in your social work practice to address the crisis you described.
Identify key points learned from the guest presenter.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Write a discussion post about How can barriers to implementing a topic within your chosen article be overcome?And reply to one classmate post (I will sent the post as soon as you finish writing the discussion )Attached 2 articles choose one article and answer the question Discussion Rules:There is a 2-sentence minimum for the discussion post and a 1-sentence minimum for a response to a post.p.Please reference at least one specific example/portion of your chosen article in your post and feel free to incorporate examples from rotations and/or dental clinic experience.Please vary your responses; try not to repeat your classmates’ responses.Please keep posts/responses professional and constructive while remembering that these posts are public to the class and used to enhance everyone’s leaning
I want 100/100 correct answers I want you to write the question and then the correct answer
Unformatted Attachment Preview
Which of the microscope is necessary for viewing tiny things such as viruses?
Confocal microscope
Electron microscope
Compound microscope
Simple microscope
Which of the following is a condition of “illness” in general?
Pathology
Mortality
Morbidity
Autopsy
Which of the following refers to leukocyte?
Plasma
Platelets
White blood cells
Red blood cells
What occurs when anatomy or physiology is not normal?
Disease
Anatomy
Health
Physiology
Q5:
Which of the following is a process of cell eating?
Lysis
Lymphatic
Phagocytosis
Lymphocyte
Q6:
Which of the following is the process of quieting down?
Narcosis
Operative
Anesthesia
Sedation
Q7:
What does Mesopotamia mean ?
Stone.
Between the rivers.
Black stone.
Mountain.
Q8:
Which of the following anesthesia is injected into a specific area on a patient’s body?
Topical anesthesia
Local anesthesia
General anesthesia
Physical anesthesia
Q9:
Which of the following is specializes in anesthesia?
Anatomist
Physiologist
Anesthetist
Anesthesiologist
Q10:
Which of the following is the inflammation of the joints?
Arthritis
Fracture
Bursitis
Osteoporosis
Q11:
Which of the following tiny organ of human cell contains 46 chromosomes?
Lysosomes
Ribosomes
Nucleus
Nucleolus
Q12:
Which of the following are the tiny organ like structures that carry out specific
functions within a cell?
Sub atomic particles
Organ
Organelles
Atom
Q13:
Which of the following systems has organs mainly bone and joints?
Integumentary system
Exocrine system
Endocrine system
Skeletal system
Q14:
Which of the following bones name means breastplate?
Cranial bones
Sternum
Vertebral column
Shoulder girdle
Q15:
Which of the following is one of the first records of medical regulations and
language?
Hippocratic Oath
Claudius Galen Theory
Ancient Greek medicine
The Code of Hammurabi
Q16:
Which of the following therapy involves the use of the sun and its rays for healing
purposes?
Heliotherapy
Cryotherapy
Diathermy
Radiotherapy
Q17:
Which of the following is considered as the first or most primitive types of “animals”?
Fungus
Virus
Bacteria
Protozoa
Q18:
Which of the following refers to pathology?
Study of infection
Study of disease and suffering
Study of physical wound
Study of natural treatment
مقآإلي
Define the term microscopic and macroscopic Organisms.
List the two broad categories of therapy.
This assignment aims to assess your ability to examine the political, historical, and research literature regarding a topic in health care policy and economics and current active State or current pending Federal legislation that may impact the outcome. You must demonstrate an understanding of the political process’s workings and the pertinent political history related to the topic.
You will select a political or economic health care issue, which is of personal or professional interest and is presently being addressed with current active State legislation or current pending Federal legislation. A thoroughly in-depth literature review will be conducted, which provides a perspective on the extent of this issue. All viewpoints should be explored. You will critically analyze the literature and present a synthesis of the views and analysis.
Instructions
Your paper should include:
An introduction with the purpose for selecting the health care policy/economic issue (statistics, demographic considerations, and other relevant evidence-based data).
History of the issue with the past bills/legislations/laws.
Evidence-based, Ethical, and Value-Based Frameworks applicable to the selected healthcare issue (aspects related to SJEDI, Social Determinants of Health, Sustainable Development Goals related to the selected healthcare policy/economic issue, principles of healthcare economics, finance, payment methods, and the relationships between policy and health economics related to the health care issue and selected legislation/bill/law).
The current state of the issue and the selected bill/legislation/law, including different viewpoints (support/oppose) and your viewpoints. Strengths and weaknesses of the selected bill/legislation/law.
Explain why the selected bill/legislation/law is a fiscally-sound policy (Cost-Benefit, Cost-effectiveness, Cost-utility, and other related finance and healthcare economics considerations).
Proposal of next steps/recommendations that Advanced Practice Registered Nurses can take to prevent/solve the health care issue to continue.
Implications for Advanced Practice Nursing (e.g., the future of the nursing profession’s ability to influence health regarding healthcare policy, social policy, teamwork and collaboration in the selected healthcare policy/economic issue, and advocacy mechanisms).
Conclusion
Word Count: At least 1,000 words are required. Include the number of words in your paper before the reference list
Reference List: At least five references in APA style. References should be not older than five years
Unformatted Attachment Preview
Rubric for Papers
Course: NSG606 Health Policy & Finance
Criteria
Required
formatting/subheading
s for each section
Contents
Referencing
Outstandin
Commendable
Marginal
Marginal
Failing
1 point
0.8 points
0.7 points
0.6 points
0 points
Paper clearly contains the
subheadings/subtitles/se
ctions required in this
paper
Paper partially contains
the
subheadings/subtitles/se
ctions
It is unclear whether or
not the
subheadings/subtitles/se
ctions are included
Paper is missing two or
more
subheadings/subtitles/se
ctions
Paper is missing all
subheadings/subtitles
ctions
6 points
4.8 points
4.2 points
3.6 points
0 points
Clearly includes a
response for all the items
required in this section
Responses to each item
are comprehensive and
evidence-based
Includes a response for
most of the items
Includes a response for
some of the items
Includes a response for a
few of the items required
required in this section –
required in this section –
in this section – Three
One of the items
may be missingResponses to each
item are
comprehensive and
evidence-based
Two of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
or more of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
Missing all the respon
for the required items
Responses to each ite
are not comprehensiv
evidence-based
1 point
0.8 points
0.7 points
0.6 points
0 points
Citations and references
are in proper APA
format. Required number
of sources are cited. All
claims are supported
with a professional
reference.
Citations and references
are in proper APA
format. Most claims are
supported with a
professional reference.
Some citations and
references are in proper
APA format. Some claims
are supported with a
professional reference.
Citations and referenc
are limited, missing or
incorrect. Few claims
supported with a
professional reference
Paper has one less of the
required number of
references in APA style.
Paper has two less of the
required number of
references in APA style.
Most citations and
references are limited,
missing or incorrect.
Some claims are
supported with a
professional reference.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding reference.
1.6 points
1.4 points
The number of minimum
required references in
APA style are included in
the paper.
Writing organization
and style Timeliness
Required number of
words
2 points
Assignment was
submitted on time.
Complies with the
required minimum
number of words.
Includes the total
number of words
before the
reference list.
The paper is well
organized both
Assignment was
submitted within
one day after the
deadline.
Complies with the
required minimum
number of words
but it does not
include the total
number of words
before the
Assignment was
submitted within
two days after the
deadline.
Assignment has
less than the
required number
of words and/or it
does not include
the total number
of words before
Paper has 3 references
less of the required
number and
Paper includes less th
3 references in APA
style.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding referen
or paper is not in
compliance with
copyright guidelines.
1.2 points
0 points
in APA style.
Assignment was
submitted within
three days after
the deadline.
Assignment has
30% or less than
the required words
and/or it does not
include the total
number of words
before the
Assignment wa
submitted afte
four days beyo
the deadline.
Assignment ha
50% or less tha
the required
number of wor
and/or it does
include the tot
number of wor
overall and at the
paragraph and
sentence structure
level. Sentences
are smooth and
carefully crafted.
There are virtually
no errors in
punctuation,
spelling, grammar,
or usage.
reference list.
The paper is well
organized, but the
paragraphs and
sentence structure
may sometimes be
disjointed. The
paper may have a
few incorrect
passages and a
few errors in
punctuation,
spelling, grammar,
the reference list.
The paper is
basically well
organized, though
individual
paragraphs and
sentence
structures may be
disjointed or
misplaced. The
writing is
competent, but
often wordy,
overly general,
and usage.
Presentation has
between 15-19 pp
reference list.
The paper is
poorly organized.
Most sentences
are confusing and
their meaning
does not clearly
emerge. Words
may be imprecise,
incorrect, trite, or
vague.
imprecise, or trite.
before the
reference list.
The paper lack
clarity. The
language or
sentence struc
is incorrect and
unclear in seve
parts of the pa
Errors in
punctuation,
spelling, gramm
and usage are
constantly
present.
slides
Total
Overall Score
Outstanding
Commendable
Marginal
Unsatisfactory
10 points minimum
8 points minimum
7 points minimum
6 points minimum
?What is the name of the supporting structure of the tooth
Crown
Gingivae
Periodontium
Enamel
:Q2
?Which of the following best describes a biofilm
A type of algae
A type of virus
A group of fungi
A thin layer of bacteria that sticks to a surface
:Q3
?How many baby teeth are in primary dentition
26
20
30
32
:Q4
?Which of the following can cause intrinsic staining
Tetracycline taken as an antibiotic during early childhood or passed to the fetus when the
.mother is pregnant
.Tannin in tea and coffee
.Betel nut chewing
.Tobacco
:Q5
?Which one of the following terms refers to excessive dryness of the mouth
Neuro-linguistic programming
Non-verbal types of communication
Phonics and visual communication
Paralinguistic communication
:Q6
?What is tooth morphology
The study of how teeth grow
The arrangement of teeth in the mouth
The number of teeth in the mouth
The shape of teeth in relation to their function
:Q7
?What is a fissure sealant
A clear aligner for orthodontic treatment
A plastic resin material used to prevent or arrest caries
A dental filling material to replace decay
A toothpaste for sensitive teeth
:Q8
How are intrinsic sugars different from extrinsic sugars according to the Committee on
?Medical Aspects of Food and Nutrition Policy (COMA)
Intrinsic sugars are healthier than extrinsic sugars
Intrinsic sugars are found in processed foods, while extrinsic sugars are found in natural
foods
Intrinsic sugars are added to foods, while extrinsic sugars are natural sugars
Intrinsic sugars are natural sugars found within the cell structure of food, while extrinsic
sugars are released from the cell structure
:Q9
Which of the following is the largest salivary gland and produces 25% of the total volume of
?saliva
Thyroid gland
Parotid gland
Submandibular gland
Sublingual gland
:Q10
?What is the message that the OHE should promote
Healthy gums should be swollen
Healthy gums should be painful
Healthy gums should not bleed
Healthy gums should be red
:Q11
?What are the three main types of caries
Smooth surface, pit and fissure, and root caries
Acute, chronic, and aggressive caries
Root, enamel, and dentin caries
Early childhood, adult, and elderly caries
:Q12
?What is the primary benefit of sugar-free chewing gum
.It increases saliva flow to wash away debris
.It is a substitute for a meal
It is a replacement for brushing teeth
.It neutralizes the acid in the mouth
:Q13
?What is the primary cause of chronic gingivitis
Alcohol consumption
Smoking
Poor oral hygiene
Poor diet
:Q14
?What are the two main types of calculus
Smooth and rough
Organic and inorganic
Soft and hard
Supragingival and subgingival
:Q15
?Which part of the teeth are the most common sites for plaque to form
Occlusal pits and fissures
Incisal edges
Between teeth
In the roots
:Q16
?Which type of teeth are sharp and pointed for gripping and tearing food
Incisors
Molars
Premolars
Canines
:Q17
?Which of the following is the definition of caries
The strengthening of teeth by fluoride treatment
The growth of new teeth
The repair of enamel and dentine
The destruction of enamel, dentine, and cementum due to microbial activity
:Q18
?What is abrasion
The loss of dental hard tissue when bacterial action is not a factor
The loss of dental hard tissue caused by tooth-to-tooth contact
The loss of dental hard tissue from bacterial action
The progressive loss of hard tissue due to mechanical factors other than tooth-to-tooth
contact
مقآإلي
?What are two benefits of fluorinated water
.What is xerostomia? Mention any two causes of xerostomia
Which of the following agencies is widely known and responsible for publishing the
?list of known or suspected occupational carcinogens
.International Labour Organization (ILO)
.Health and Safety Executives (HSE)
.International Agency for Research on Cancer (IARC)
.World Health Organization (WHO)
Which of the following health effects is a consequence of exposure to hexavalent
?,chromium compounds
.Alzheimer’s disease
.Cardiac arrhythmias
.Pulmonary carcinogen
.Glucose metabolism
Which of the following is produced by the incomplete combustion of carbonaceous
?compounds
.CO
.CH4
.O3
.SO4
?Which of the following is one index of acute toxicity in animal studies
.LOAEL
.SCE
.WELs
.LD50
?Which of the following diseases is an occupational Food and water-borne infection
.Escherichia coli
.Hepatitis C virus
.AIDS
Psittacosis
:Q6
?What is the primary role of occupational health in the workplace
.Education
.Practices
.Prevention
.Skills
:Q7
Which of the following diseases is a tick-borne disease that affects deer and rodents
?and can be transmitted to humans
.Malaria
.Psittacosis
.Orf
.Lyme disease
:Q8
Which of the following occupational lung disorders is caused by the accumulation of
?dust in the lungs and tissues reaction to its presence
.Extrinsic allergic alveolitis
.Pneumonia
.Acute inflammation
.Pneumoconiosis
:Q9
Which of the following terms is defined as a multifaceted and multidisciplinary
?activity concerned with the prevention of ill health in employed populations
.Occupational health
.Occupational toxicology
.Occupational therapy
.Occupational epidemiology
:Q10
Which of the following particles is generated by the machining and processing of
?timber and affects mucosal surfaces and the upper respiratory tract
.Synthetic mineral fibers
.Wood dust
.Asbestos
.Coal dust
:Q11
Which of the following diseases is the most common coinfection among those who
?have AIDS due to their compromised immune system
.Tuberculosis
.Hepatitis A
.Avian Flu
.Norovirus
:Q12
Which of the following agents affects the reproductive system that causes
?prematurity and birth defects
.Ionizing radiation
.Anesthetic gases
.Cytotoxic drugs
Calcium carbonate
:Q13
Which of the following occupational groups are at high risk of contracting
?Meningococcal meningitis
.Farmers
.Agricultural advisers
.Ambulance crew
Forestry workers
:Q14
Which of the following terms is defined as the study of substances that can have
?adverse health effects, especially in relatively small doses
.Occupational toxicology
.Occupational epidemiology
.Occupational health
.Occupational therapy
:Q15
Which of the following agencies is the main governmental agency for enforcing
?occupational health and safety legislation in the United States (USA)
.National Health Service (NHS)
.American Conference of Governmental Industrial Hygienists (ACGIH)
.Health and Safety Commission (HSC)
.Occupational Health and Safety Administration (OSHA)
:Q16
Which of the following gases is the product of anaerobic decay of organic matter and
?found in sewers and wherever biodegradable organic matter is stored or dumped
.Methane
.Carbon Dioxide
Nitrogen
.Ammonia
:Q17
Which one of the following countries has a legal requirement for the provision of
?occupational health services
.Developed countries
.Non-industrialized countries
.Developing countries
Rapidly industrialized countries
:Q18
?Which of the following health effects is caused by stochastic ionizing radiation
.Cataracts
.Genetic damage
.Dermatitis
.Acute radiation syndrome
نقال
There are many Health promotions and activities aimed at strengthening the health
status of workers. List any 4 of these Health promotion activities
What are the 4 determinants of the toxicity of substances that can make them
?capable of causing harm
1. Construct an overview to introduce your identified population health issue and its relationship to the health of the American public.
Include a problem statement and an introduction to the issue.
Describe the incidence and prevalence of the problem in epidemiologic terms, if appropriate, citing your sources.
Discuss the rationale for selecting the issue. What is its significance or importance in relation to population health, social justice or other ethical principles?
2. Perform a comprehensive review the literature and include an annotated reference list from a variety of fields other than nursing to answer the questions below.
Include the following parameters, if appropriate: identification of the at-risk populations; identification of risk factors, causes, known prevention measures; any efficacious, evidenced-based diagnosis and treatment that may be available/not available for the at-risk population and this specific health problem.
Do inequities exist? If yes, please describe and document your sources.
What situations/barriers exist that prevent elimination or decrease in this health problem or might amplify the problem?
What situations/supports exist in the community that facilitate prevention, elimination or decrease in this health problem?
3. This paper should analyze the public health issue in terms of the justice, legal, regulatory, data and advanced practice issues. Be sure to identify how your discussion relates to the objectives of Healthy People 2020.
What strategies or policies have been used to address the issue? Are they working? Why or why not? What strategies do you propose to improve the situation? Is legislative change needed?
4. What are the implications of this issue for advanced practice nursing and/or public health? Provide a summation of your findings and how this public health policy analysis can be used in multiple communities across the US – and how you might be able to apply and utilize this data in your capstone project.
1. Go to the CDC Behavioral Risk Factor Surveillance System at https://www.cdc.gov/brfss/brfssprevalence/index.html 2. Select a state of interest and a topic of interest and survey at least three years of data. 3. Look for patterns or trends in the data (differences by gender, race, etc.) 4. Select 2-3 patterns or state trends and compare against the national data. 5. Search for additional peer reviewed articles on the identifiable trends. 6. Produce a short PowerPoint presentation on the observed trends and how they compare to national estimates. Provide a potential explanation or argument for the observed trends, incorporating the reviewed literature to support your argument. Include recommendations for future research. Be sure to reference the literature within the PowerPoint slides using APA formatting. Include a list of references using APA formatting on the last slide. Click on assignment to see grading rubric.
review the attachments from chapter 8 create an informative PowerPoint on Integration of professional social work with classroom and practicum be mindful my practicum is working with kids from the urban area at the boys and girls club I will attach knowledge you need to put from the book but do the PowerPoint in Laymans term so others can understand also use nice pictures examples and comparisons
1) Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Practices of Culturally Sensitive Care and Ensuring the Integrity of Human Dignity in the Care of all Patients
While APA style is not required for the body of this assignment, solid academic writing is expected.
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2) Assess the culture of the organization for potential challenges in incorporating the nursing practice intervention. Use this assessment when creating the strategic plan. Discuss with your preceptor the culture of your organizations and what are the potential problems.
Write a strategic plan (150-250 words) defining how the nursing practice intervention will be implemented in the capstone project change proposal.
In this module, you have learned about searching for evidence, mainly primary sources through bibliographic databases. You have reviewed how to use keywords and Boolean operators to narrow your search. Now let us critique a component of a journal article. Within a journal article, there is a section called either “Literature Review” or “Summary of Literature”. This section is the compilation of the evidence that has been analyzed and synthesized and written so the reader can draw conclusions about this body of evidence and the gaps noted. Here the reader should also note whether this section supports the research question and purpose for the study.For this discussion please complete the following:Review the article by Apel, S., Brucker, N., Bond, J., Weitzel, T., Chamberlain, J. (2021). Peripheral IV site change when clinically indicated vs. customary practice of every 96 hours. Medsurg Nursing, 30(2), p.10Then, choose one study from the literature review to discuss, provide details.After you have provided information from the study explain if the literature review study that you chose supports the Apel et al. research question.Reflect on the overall purpose of the literature review section of the article and discuss one strategy you found helpful in creating a strong literature review. Support to help guide you in answering this question can be found in chapter six of your research text.View article here : https://link.gale.com/apps/doc/A659262262/AONE?u=e…Researcg question: In adult, acute care patients, does leaving an intravenous (IV) line intact until removal is clinically indicated (end of therapy, redness, occlusion, or leakage) versus the customary practice of changing the IV after 96 hours of dwell time impact rates of phlebitis?
Hello, please create a reply for the discussion of the following student.Minimun 150 words 2 references. Thank you!
Other student Discussion:
Antipsychotic medication
Psychotic disorders are mental illnesses that cause a person to lose touch with reality characterized by a loss of contact with reality. Common symptoms of psychotic disorders include delusions, hallucinations, disorganized speech, and disorganized behavior. Antipsychotic medications are often used to treat these disorders. One particular type of antipsychotic medication is Clozapine. This paper explores the use of Clozapine in treating psychotic disorders, its potential side effects, dosing, mechanism of action, and the receptors it affects in the brain. It also compares and contrasts four movement disorders associated with antipsychotic medication use: Tardive Dyskinesia, Acute Dystonia, and Athetosis.
Clozapine
Clozapine is a second-generation antipsychotic that acts on the brain’s serotonin, dopamine, and noradrenaline receptors. It blocks multiple receptors in the brain, including dopamine, serotonin, and histamine receptors, which reduces psychotic symptoms. This action helps reduce the intensity of the symptoms experienced by the patient. Drugscom (2019) states the recommended dose is between 200-600mg daily. The dose may need to be adjusted depending on the patient’s response. Clozapine is associated with weight gain, sedation, and agranulocytosis. Agranulocytosis is a rare but potentially life-threatening side effect in about 1% of patients taking Clozapine (Rattay & Benndorf, 2021). Therefore, patients taking Clozapine require regular monitoring of their white blood cell count
Tardive Dyskinesia is the most common movement disorder associated with antipsychotic medication use and can be irreversible. The risk of developing Tardive Dyskinesia increases with the duration of antipsychotic medication use, especially with typical antipsychotics. Acute Dystonia is a less common movement disorder that typically occurs within the first few days of starting antipsychotic medication (Factor et al., 2019). It is characterized by sudden, painful muscle spasms that can affect the neck, back, and eyes. Athetosis is a rare movement disorder characterized by slow, twisting fingers, hands, and feet movements. Tics are sudden, repetitive movements or vocalizations that can be either simple or complex.
In conclusion, Clozapine is a highly effective antipsychotic medication for treating psychotic disorders, although it may be associated with potential side effects such as agranulocytosis and weight gain. Its unique mechanism of action involves blocking multiple receptors in the brain, including dopamine, serotonin, and histamine receptors, which reduces psychotic symptoms. Tardive Dyskinesia is the most common and potentially irreversible movement disorder associated with antipsychotic medication use. Acute Dystonia and Athetosis are less common movement disorders that can occur with antipsychotic medication use. Patients taking antipsychotic medications should be closely monitored for potential side effects.
Factor, S. A., Burkhard, P. R., Caroff, S., Friedman, J. H., Marras, C., Tinazzi, M., & Comella, C. L. (2019). Recent developments in drug-induced movement disorders: a mixed picture. The Lancet Neurology, 18(9), 880–890. https://doi.org/10.1016/s1474-4422(19)30152-8
Rattay, B., & Benndorf, R. A. (2021). Drug-Induced Idiosyncratic Agranulocytosis – Infrequent but Dangerous. Frontiers in Pharmacology, 12, 727717. https://doi.org/10.3389/fphar.2021.727717
Google Sites is recommended for this assessment; the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account (I will give my gmail account if needed).
Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.
It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.
Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on a specific patient safety issue. Each resource listing should include the following:
An APA-formatted citation of the resource with a working link.
A description of the information, skills, or tools provided by the resource.
A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to a specific patient safety issue.
A description of how nurses can use this resource and when its use may be appropriate.
Remember that you must make your site “public” so that your faculty can access it. Check out the Google Sites resources for more information.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to a specific patient safety issue.
Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on a specific patient safety issue.
Analyze the value of resources to reduce patient safety risk related to a specific patient safety issue.
Present reasons and relevant situations for use of resource tool kit by its target audience.
Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.
To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.
You want to propose a new way to solve a problem at your workplace. To describe your implementation for this change, use the following information to submit a business plan detailing the need for this change to the head of your department.For this assignment, complete the “Business Plan” template. Write a 500-750 word summary detailing how implementing the business plan would be beneficial for the organization. Explain how the plan would be a good return on investment for the organization.Provide two to four scholarly resources, in addition to information from your textbook.
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
These are the articles that were used for the last assignment that are required for this assignment:
Article 1: Dierkes, A. M., Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Riman, K. A., & McHugh, M. D. (2022). Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis. BMJ open, 12(3), e056802. https://doi.org/10.1136/bmjopen-2021-056802
The level of evidence is level 2
Article 2: Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Anusiewicz, C. V., Martin, B., Reneau, K., Alexander, M., & McHugh, M. D. (2021). Is Hospital Nurse Staffing Legislation in the Public’s Interest?: An Observational Study in New York State. Medical care, 59(5), 444–450. https://doi.org/10.1097/MLR.0000000000001519
The article is level 2 evidence level.
Article 3:Twigg, D. E., Whitehead, L., Doleman, G., & El-Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review. Journal of advanced nursing, 77(12), 4599–4611. https://doi.org/10.1111/jan.14909
The third article is level 1 of evidence
Article 4:Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study. BMJ open, 11(12), e052899. https://doi.org/10.1136/bmjopen-2021-052899
Modules tab
Scroll down to: The Neville C.W. Smith M.D. Memorial Library
Click on: Student Research Project
Click on: Student Research Log Sheet
Log sheet will download as a Word Doc.
Click on: enable editing
Fill document out
Save as PDF
File Save Format:
Name: Last name, First name
Title of Presentation
Research Log or Presentation
Current Module
Format (PDF, PPT, PPTX)
Student Submission and Format Requirements
Citations: APA format
Research Log: PDF format
PowerPoint Presentation: PDF & PPT/PPTX formats
Rubric
MXAN201 GSRP
MXAN201 GSRP
Criteria Ratings Pts
This criterion is linked to a Learning Outcome25% Preparation Methodology
0.5 pts
Meets Expectations
Content: Accuracy and depth of information: Does the presentation demonstrate a thorough understanding of the topic? Relevance and organization: Is the content well-structured and organized? Does it address the main points effectively? Use of supporting evidence: Are relevant facts, examples, and research included to support key points? Visual Design: Slide layout and design: Are the slides visually appealing and well-designed? Is the layout consistent and easy to read? Effective use of visuals: Are appropriate images, graphs, charts, or diagrams used to enhance understanding and engagement? Integration of multimedia: Are multimedia elements effectively incorporated to support the content? Grammar, Spelling, and Formatting (10%) Grammar and spelling: Is the research free from grammatical errors, typos, and spelling mistakes? Formatting consistency: Does the research follow consistent formatting, such as font size, line spacing, headings, and citations?
0 pts
Does Not Meet Expectations
Preparation was not properly done.
0.5 pts
This criterion is linked to a Learning Outcome25% Presentation Skills
0.5 pts
Meets Expectations
Delivery Skills: Verbal communication: Is the presenter articulate, clear, and confident in delivering the presentation? Nonverbal communication: Does the presenter maintain eye contact, use gestures, and display positive body language? Engagement with the audience: Does the presenter actively engage the audience through questions, interaction, or discussions? Time Management: Adherence to time limit: Does the presenter stay within the designated time frame? Pace and flow: Is the presentation well-paced, allowing the audience to follow along without feeling rushed or bored?
0 pts
Does Not Meet Expectations
Presentation was not professional, was unclear with lack of confidence by presenter.
0.5 pts
This criterion is linked to a Learning Outcome25% Submission to CANVAS (LMS) assignment section
0.5 pts
Meets Expectations
GSRP (Group Study and Research Presentation: Does the research paper adhere to the required format guidelines specified by the institution or program including ppt for Presentation and pdf for GSRP Log? Student Information: Is the student’s personal and contact information included and accurately provided in the designated file format, e.g.: First and last Name Topic Name Quarter Code.ppt First and last Name Topic Name Quarter Code.pdf
0 pts
Does Not Meet Expectations
Submission did not happen or did not include student’s name, ID, topic name, quarter, file format (ppt or pdf) was not followed
0.5 pts
This criterion is linked to a Learning Outcome25% Participation for entire presentations
0.5 pts
Meets Expectations
Active Engagement: Attention and Focus: Does the student demonstrate active listening and attentiveness throughout the presentations? Nonverbal cues: Does the student maintain eye contact with the presenter? Are they nodding, taking notes, or displaying other signs of engagement? Avoiding distractions: Is the student refraining from engaging in distracting behaviors, such as using electronic devices or engaging in side conversations? Respectful Behavior: Respectful attitude: Does the student show respect for the presenter and their efforts by refraining from disruptive or disrespectful behavior? Supportive feedback: Does the student provide positive feedback, such as applause or encouraging gestures, when appropriate? Avoiding distractions: Is the student mindful of their own actions and behavior, ensuring they do not distract or disrupt the presenter or other audience members? Participation: Asking questions: Does the student actively participate by asking relevant and thoughtful questions during the Q&A or discussion sessions? Contributions to discussion: Does the student contribute to the discussion by sharing insights, providing constructive feedback, or offering additional perspectives? Engaging with the material: Does the student demonstrate an active interest in the topic by participating in discussions and showing a willingness to learn? Attendance and Punctuality: Regular attendance: Has the student consistently attended all presentations without unexcused absences? Punctuality: Has the student arrived on time for each presentation and remained present throughout the entire session?
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
Background facts about the Ergonomic challenge including incidence and prevalence
The impact of the Ergonomic challenge on the Healthcare worker
The impact of the Ergonomic challenge on the patient
Your recommendations to improve this Ergonomic challenge based on evidence from the literature
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
Clustered in order of priority
Related to nursing diagnosis
Documented source
25 points
Nursing Diagnosis:
Prioritizing (using the NANDA format)
Based on the data collected
One actual and one at risk diagnoses selected
8 points
Expected Outcome:
(Attainable through nursing interventions)
Two short-term outcomes per nursing diagnosis (16 points)
Must be measurable with a realistic timeframe (4 points)
20 points
Interventions & rationale:
Three nursing specific interventions for each short-term goal (not to include monitoring a patient)
Congruent with the nursing diagnosis
Demonstrate theoretical/scientific principles and integrate research
Documented with supportive literature
40 points
Evaluation (rationale):
(Outcome criteria met, partially met, or not met)
2 points
Formatting:
Grammar, spelling and terminology must be correct
Minimal use of standard abbreviations
References cited in APA format
5 points
Total Score
Nursing Plan of Care
Student name: Patient initials: Room No.: Date of Care:
All material submitted must be typed in the space provided!
Patient’s Admitting Diagnosis:
List patient’s past medical history related to admission:
PATHOPHYSIOLOGY
Provide brief/key aspects of pathophysiology related to your patient’s admitting diagnosis in the space provided below.
Instructions for assessment:
In the space below enter the subjective and objective data gathered during your patient assessment based on systems, including laboratory and diagnostic assessments.
A
S
S
E
S
S
M
E
N
T
Subjective Data Entry
Objective Data Entry
TIME OUT!
To be sure your patient diagnostic statement written below is accurate, you need to review the assessment data and determine if it is appropriate and relevant for the diagnostic statement below.Do you have an accurate match or is additional data required or does another nursing diagnosis need to be investigated? Have you appropriately categorized the subjective and objective data? Have you prioritized and clustered your assessment data to formulate the nursing diagnosis? List at least one (1) actual and one (1) at risk nursing diagnosis for your patient.
Nursing Diagnostic Statement:
Nursing Diagnostic Label:
Related to:
As Evidenced By:
Nursing Diagnostic Statement:
Nursing Diagnostic Label:
Related to:
As Evidenced By:
TIME OUT!
The diagnostic label must be NANDA approved and describes the patient’s response to health conditions. Is there a possibility that the diagnostic label can be misunderstood as a medical diagnosis? Are the related factors displaying the reason why the patient is exhibiting the diagnostic label? Are the defining characteristics (“as evidenced by”) show the evidence of the problem? List two (2) short term goals (STG) for each nursing diagnosis.
Expected Goals/Outcomes:
Diagnosis A:
STG #1:
STG #2:
Diagnosis B:
STG #1:
STG #2:
TIME OUT!
The desired outcome must meet criteria to be accurate. The outcome must be specific, realistic, measurable, and include a time frame for completion. Does the action verb describe the patient’s behavior to be evaluated? Can the outcome be used in the evaluation step of the nursing process to measure the patient’s response to the nursing interventions listed below? List at maximum of three (3) interventions for each goal.
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N
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E
R
V
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N
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I
O
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Interventions
A1
A2
B1
B2
Rationale for Selected Intervention Using Evidence-Based Practice (EBP) references
A1
A2
B1
B2
TIME OUT!
Do your interventions assist in achieving the desired outcome? Do your interventions address further monitoring of the patient’s response to your interventions and to the achievement of the desired outcome?Are qualifiers: when, how, amount, time, and frequency used? Is the focus of the actions of the nurse and not on the patient? Do your rationales provide sufficient reason, directions, and best evidence-based practice?
E
V
A
L
U
A
T
I
O
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Was the desired outcome achieved? Include data and if not, or partially met, what revisions to either the desired outcome, goals, or interventions would you make?
Yes No Partially met
Complete this care plan using a minimum of four scholarly resources including your textbook and your ATI resources. These resources must be easily available if requested. Attach a reference list using APA format on a separate sheet of paper to this document. All resources must be current within the last 3-5 years.
Use this link to find your answers. https://www.labcorp.com/test-menu/search
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Phlebotomy Health Nursing HLTH242
Tube of the Week
Using the LabCorp Test Menu Answer the following questions
LabCorp Test Menu
List all common tests related to this ETS tube.
(At least 5-10 tests)
What is the additive in this tube?
How does the additive work?
Does this tube produce a serum or plasma
sample, and why?
What are the special handling requirements for
this tube?
Choose four tests you have listed above and
identify what conditions/illnesses/or diseases
would warrant the test being ordered. (Why
would the healthcare provider order the test?)
Where does this tube go in the order of draw?
(What comes before and after it)?
What department does this tube go to?
Other important information.
(Storage, handling requirements, how long the
sample is stable, etc.)
Tim Smith has a cousin who is having surgery and he would like to donate blood for his cousin in case they need a transfusion during surgery. Tim knows that his blood type is O but he does not know his cousin’s blood type.
Can you explain to Tim some details about donating blood? Be sure to include details about the process.
How old do you have to be to donate blood?
Where in this area would you recommend Tim go to donate blood?
What are the four blood types?
What are the different types of blood products?
What are some reasons why people need blood products?
Is all blood compatible with all plasma? Why or why not?
Which blood type is considered the universal donor?
Which blood type is considered the universal recipient?
Do you think Tim’s blood could be given to his cousin? Why or Why not?
Pick one (1) of the following topics. Then, address the corresponding questions/prompts for your selected topic. Use at least one (1) documented example of the corresponding primary source in your writing.
Option 1: McCarthyism and Anti-Communist Campaigns
The Cold War brought about an irrational fear of communism and communist activities in the United States. As we are learning this week, one of the most vocal instigators of this paranoia was Senator Joseph McCarthy. McCarthy delivered a speech about the imminent threat of communism on February 9, 1950. Perform a search on the internet and locate and read Joseph McCarthy’s speech given in Wheeling, West Virginia on February 9, 1950. Copy and paste the following keywords into your Google search bar: “Joseph McCarthy, Wheeling, West Virginia.” The speech is also referred to as “Enemies from Within.”
Construct the case study by responding to the following prompts:
Explain how Senator Joseph McCarthy defined communist nations within the speech. What specific threats did these nations pose?
Assess if Senator Joseph McCarthy charges were accurate.
Analyze anti-communist sentiments during the Cold War era, were these sentiments valid. If so, how? If not, why not?
Explain if there are other examples of events similar to the Red Scare that have occurred throughout history and modern day.
Examine what happened to people who invoked the Fifth Amendment, refused to appear or were found in violation of the law as defined by the Congressional Committee.
Option 2: The Civil Rights Movement
Using the Internet, locate and read Martin Luther King Jr’s “I Have a Dream” speech given in Washington D.C., August 1963. Copy and paste the following keywords into your Google search bar: “I Have a Dream by Martin Luther King, Jr.” Feel free also to locate and incorporate additional scholarly sources to respond to this case study, including information on the Civil Rights Movement.
Construct the case study by responding to the following prompts:
Explain if the Civil Rights Movement of the 1960s effectively changed the nation.
What effect would the Civil Rights Acts have across the continent on minority groups?
Do you think that the tactics and strategies that civil rights activists used in the 1960s would apply to today’s racial and ethnic conflicts? Why or why not?
Do the ideas of the 1960s still have relevance today? If so how? If not, why not?
Analyze how the Civil Rights Movement would impact diversity in America today.
Option 3: American Domestic and Foreign Policies (1953-1991)
Complete a search either in the Chamberlain Library or internet for domestic and foreign polices of four (4) of the following Presidents. Please incorporate at least one primary source of either a policy or act that you have chosen to write about.
Eisenhower
Kennedy
Johnson
Nixon
Ford
Carter
Reagan
Then, compare domestic and foreign polices of your four (4) presidents by answering the following prompts:
Explain how your selected presidents worked to improve the United States economically and socially. Give at least one example of each president.
Assess if the policies of your choice of presidents strengthen or weaken the United States.
Explain how you see your choice of presidents served the public interest and further the cause of democracy.
Determine if it is constitutional for the United States to fight preemptive wars.
Determine if human rights and morality should be the cornerstones of United State foreign policy.
REQUIREMENTS
Length: 4-5 pages (not including title page and references page)
1-inch margins
Double spaced
12-point Times New Roman font
Title page
References page
In-text citations that correspond with your end reference
This assignment consists of a reflection (3-4 pages) on an interaction between you and a an experience within your field practicum.
Items to be included:
Brief description of the interaction
Reflection on personal thoughts, feelings, etc. that occurred as a result of the interaction, and
A connection to a topic from the course (lecture, readings, etc.).
This should not be retelling of events, this paper should demonstrate your critical thinking and understanding of individual self-awareness.
Competency #1 is measured within this assignment. (Competency 1: Demonstrate Ethical and Professional Behavior)
You can make up a description or interaction. I’ll give you brief description as to what I do for my practicum . I am an acting social work intern at the Harland boys and girls club in Atlanta GA. The Harland boys and girls club is literally one mile away from Clark Atlanta university and is one of the nicest boys and girls club in the county. It focus on arts so it is equipped with all the equipment to perform arts a full visual arts studio, graphic design center, studio booth equipment and much more. The children that come here are very urban usually a little ghetto some struggle with poverty and not being able to read or write or struggle in school. Create a scenario and resolution that may seem realistic for this stage use key examples and be sure to incorporate the competency 1
Write a literature review for these 3 articles. Each article should have a paragraph. Make sure to have citations for each article. https://www.pewresearch.org/internet/2014/04/03/older-adults-and-technology-use/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074950/https://www.aarp.org/about-aarp/info-2021/oats-senior-planet.html
I took a Nurse practitioner board predictor test and need to submit remediation for missed questions.
2-3 small paragraphs per missed question
Instructions
Remediation Overview:
Remediation is available for students who score less than 70% on the exam. If needed, the remediation plan should be started immediately and be submitted no later than Sunday of Week 7 of the course.
Students who score less than 70% on the Pre-Predictor Exam will have an opportunity to earn up to 400 points by thoroughly completing the remediation assignment. Students may not be awarded more than 400 total points in the grade book for the Pre-Predictor Exam.
Remediation Point Scale:
≥ 70 = encouraged to remediate weak areas – maximum points earned
65 – 69 = with remediation can earn up to 100 points
60 – 64 = with remediation can earn up to 200 points
0 – 59 = with remediation can earn up to 300 points
Remediation Instructions:
To review the Pre-Predictor Exam Summary Report: APEA OTC.
Expand all categories by clicking “Expand All” to see all categories under the topic areas.
Create a Word Document with headings that correlate with the missed Knowledge Area, Question Topic, and Domain on the Pre-Predictor Exam Summary Report. (See Diagram 1 below).
Use resources such as your textbook, or a reputable standard of care website, such as the American College of Cardiology, etc. to remediate. Summarize the missed content topic in 2-3 paragraphs and include a hyperlink to the reference.
All missed questions must be addressed to earn all points.
Remediation should begin as soon as possible.
Submit in Week 7: Pre-Predictor Exam Remediation
Homepage – Fa23 ECED 1240-22 Planning & Implementing Curriculum (minnstate.edu) week 10 mod 14 to 15
username – te0077ed, password January1
ASSIGNMENT: Relationships & Expectations – Poster
Hide Assignment Information
Instructions
Assignment #1: Create the following page to submit:
Make a poster listing and describing at least 7 ways teachers can build relationships with students to create a nurturing, safe, connected environment. Think of yourself as the lead teacher and what you would want as expectations for each adult in the room in building positive relationships with the students. (Use course videos and Relationship-Building Articles in your course content, but put them in your own words.) Add at least one picture, and use a large font.
Always view course content videos & readings before completing assignments – knowledge of course content is expected to be demonstrated.
Grading: [7 points] 1 point each answer
Does not contradict course content
Follows instructions
Each answer is listed and described
Please double-check that you have submitted the correct, completed document, as I can not accept assignments after the close date. I recommend saving your document with the word “DONE” at the end so you choose the correct one for sure!
You have now submitted and received feedback on all milestones, which are parts of the final project. Review all the feedback you have received from your instructor so far. Write a journal assignment that describes your approach to implementing the feedback you have received.In the assignment, be sure to address the following:Provide a general introduction describing the areas where you showed proficiency and the areas where you need improvement.Identify specific issues your instructor noted that you agree with, and describe how you will address them. For example, if your instructor noted a place where more information was needed, what additional information will you include, and how will it help clarify your analysis?Identify specific issues your instructor noted that you disagree with, and explain why you disagree. For example, if your instructor noted a place where your conclusions were incomplete, express why they were not.Describe the steps you will take to make improvements in your final draft.below are milestones attached
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Milestone 2
Dania Atieh
Southern New Hamphsire University
Milestone Two HCM
1
Cottage Senior Living specializes in long-term care, among other things. The
administrative center of the business is located in Huntsville, Alabama. Cottage Senior Living
runs three different senior living residences. The Assisted Living, Memory Care, and Active
Adult homes offer long-term care services. As a result, significant changes have been made to
the company’s customer service philosophy and strategy. The current study incorporates
market characteristics to define the three strategic approaches contributing to the firm’s
growth and performance. This case study analysis evaluates the applicability of strategic
analysis to identify the problems the company has and potential remedies.
The Organization’s Approach
Senior Cottage Living is a well-structured organization that aims to help the elderly.
Cliff White, the company’s president, underlined the need to pay particular attention to the
interests of the elderly clients in his speech. Their mission statement states that they want to
ensure that elderly individuals are treated with dignity and compassion. This indicates how
the business bases its strategic decision-making on its target market’s wants and needs (Ginter
et al., 2018). The business has a clear plan for the future, which includes assessing where it is
now in terms of growth and contrasting it with where it needs to be.
The president has divided their expansion into three phases by asking only three
questions regarding the organization’s future development: what, why, and how regarding
location and capacity for growth. The focus on “service offerings” in the vision demonstrates
that Cottage Senior Living is considering a range of services in addition to housing to support
members’ preferred way of life. This all-encompassing approach can be a component of their
master plan to differentiate themselves from the competitors (Harrington et al., 2016).
Providing residents with amenities and services that encourage ongoing physical and social
engagement is certainly one of their long-term goals. The company’s president also discussed
2
how serving non-subsidized, private-pay clients in tertiary markets sets it apart from rivals
(“Cottage Senior Living, n.d.).
The Major Issue Identified From the Case Study
The case study has brought to light a significant need for methods of growth and
expansion. The president of the company presented information showing the company’s aim
to expand into nearby towns, which might be a huge growth engine but is only as good and
effective as the management of the organization (“Cottage Senior Living, n.d.). It is vital to
assess the situation first before moving forward. In each location, franchisees also own the
land on which their businesses are built, which might make it difficult to hire and keep a large
enough pool of qualified workers. However, all business-related tasks, such as hiring staff
and running advertisements, fall within the purview of the Cottage Senior Living corporate
office. As a result, the firm must create an expansion plan that complies with all relevant
regulations. An assessment of present patterns and changes can be used to make predictions
about how it will operate in the future. It will be crucial to assess critical directions for
improving a framework for flexible change in the future (Harrington et al., 2016). The rising
proportion of patients with Medicaid insurance—which is already over 60%—is one of the
current trends. Cottage Senior Living does not currently accept Medicaid patients.
Strategic Planning Concerns
The leadership of the company has pledged its efforts to organize the development
resources of the company to enable it to realize its vision statement. The organization’s goal
is to offer people housing and services that encourage an active, sociable, and involved way
of life. This suggests that creating a distinctive way of life for its residents has been a
significant priority of their strategic planning (Ginter et al., 2018).
The Role of Healthcare Manager
3
Senior Cottage Living is a corporate entity that focuses on assisting the senior
population. Within this organization, a healthcare manager assumes a significant
responsibility in ensuring the provision of high-quality healthcare services to align with the
company’s goal and vision (Ginter et al., 2018). The cottages are categorized according to the
specific requirements of the clientele, namely Assisted Living, Memory Care, and Active
Adult (“Cottage Senior Living, n.d.). Hence, a healthcare manager plays a crucial role in
evaluating the suitability of potential locations for establishing healthcare entities and
providing recommendations by the regulatory framework governing the industry’s corporate
operations.
Stakeholders
Customers stand to gain the most from the company’s agenda, as their patronage is
crucial to the success of the enterprise. The growth of the organization is dependent on the
participation of seniors, regardless of their demands. The growth of the business has been
segmented into three areas so that all of its resources can be devoted to serving the needs of
the elderly. As a result, customer satisfaction has become a focal point in the company’s
efforts to serve the community and realize its goals in that regard (Harrington et al., 2016).
Conclusion
Based on the case study, the organization has established its advantages and barriers
related to growth and development, which is its major agenda. From a personal standpoint,
strategic planning is based on a company’s ability to identify its limitations and address them
as growth opportunities. Since Senior Cottage Housing has recognized “empty nesters” as a
key demographic within the senior housing industry, the company has devised a plan to
expand into neighboring communities to meet their needs. By using this segmentation
strategy, they may now cater their products and services to this specific demographic
4
References
(n.d.). Cottage Senior Living.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The Strategic Management of Health
Care Organizations. John Wiley & Sons.
https://books.google.com/books?hl=en&lr=&id=3qVFDwAAQBAJ&oi=fnd&pg=PR
7&dq=Ginter,+P.+M.,+Duncan,+W.+J.,+%26+Swayne,+L.+E.+(2018).+Strategic+M
anagement+of+Health+Care+Organizations.+Hoboken,+New+Jersey:+Wiley&ots=4
UJvqqsYFD&sig=JvfRfoN77k8b3X_K7unVdUTO-og#v=onepage&q&f=false
Harrington, C., Schnelle, J. F., McGregor, M., & Simmons, S. F. (2016). Article
Commentary: The Need for Higher Minimum Staffing Standards in US Nursing
Homes. Health Services Insights, 9, HSI-S38994. https://doi.org/10.4137/HSI.S38994
Milestone Three HCM
Dania Atieh
Southern New Hamphsire University
Milestone Three HCM
1
Companies seek new ways to stand out in competitive marketplaces in today’s fastchanging business environment. Cottage Senior Living (CSL), a tertiary senior home
provider that targets non-subsidized, private-pay users, is one such company that has
established itself effectively. Cottage Senior Living (CSL) seeks expansion while addressing
regulatory issues in tertiary areas to provide specialized elder care.
Brief Summary of the Case Study
The focus of the case study is Cottage Senior Living (CSL), a provider of senior
housing with its main office in Huntsville, Alabama. CSL’s 1980s founding by Peg
Thompson and Wade White introduced a groundbreaking assisted living service framework
(“Cottage Senior Living,” n.d.). The company targets non-subsidized, private-pay consumers
in tertiary markets. CSL’s extensive elder care portfolio includes independent living (IL),
assisted living (AL), memory care (MC), and skilled nursing facility (SNF) choices. The
franchise-like CSL structure allows each facility to operate as a legal company. They pay
CSL a management fee to unify operations and branding throughout the firm (“Cottage
Senior Living,” n.d.). CSL aims to exclude Medicaid beneficiaries to focus on private-pay
consumers.
Policies Addressing the Issue
Cottage Senior Living (CSL) deliberately addresses the challenge of supplying nonsubsidized, private-pay consumers in tertiary markets. Medicaid exclusion is a crucial policy
that fits CSL’s overall plan (“Cottage Senior Living,” n.d.). CSL controls its consumer base
by avoiding Medicaid and focusing on private-pay clients, ensuring its services meet its target
market. CSL’s franchise-like structure, with each facility as a legal company, pays CSL a
management fee. This structure requires organization-wide branding uniformity, operational
standards, and management fee agreements. In addition, the extensive array of senior care
services offered by CSL, including independent living, assisted living, memory care, and
2
skilled nursing, strongly supports standards to guarantee quality and compliance for each
service category.
Alignment with Mission and Vision
Cottage Senior Living (CSL) aligns its strategic planning with its mission and vision
to serve non-subsidized, private-pay consumers in tertiary markets. Several factors support
this alignment. First, CSL’s objective is to provide specialized elder care, and its ambition is
to provide high-quality care in tertiary markets (“Cottage Senior Living,” n.d.). By targeting
private-pay consumers, CSL’s strategic strategy carefully follows its objective and vision.
Medicaid enrollees are excluded to ensure CSL’s services target its target market. As stated in
its mission and vision, CSL provides specialized treatment to private-pay customers, ensuring
service quality. CSL may fulfill its mission by entering less crowded areas and offering
specialized treatment. Furthermore, the franchise-like structure in the case standardizes
operations and branding among CSL sites (Crawford-Spencer & Cantatore, 2016).
Standardization fits the organization’s objective of providing specialized services consistently
and a vision of high-quality care across its operations.
SWOT Analysis
Strengths
Specialization in Private-Pay Market: Cottage Senior Living (CSL) excels in serving nonsubsidized, private-pay consumers. CSL differentiates itself in the elder living sector by
servicing private-pay consumers and setting pricing structures that reflect its dedication to
high-quality, specialized care.
Comprehensive Senior Care Portfolio: CSL excels in independent living, assisted living,
memory care, and skilled nursing. This complete solution enables CSL to meet older
population demands, improving its market presence and agility.
3
Standardized Operations: In CSL’s franchise-like organization, maintaining service quality
and brand awareness requires standardization. For instance, all CSL facilities provide
consistent care, amenities, and experiences, building confidence and loyalty.
Weaknesses
Limited Market Reach: CSL’s strategy concentration on tertiary markets may restrict its
market reach and development prospects. Serving sparsely inhabited regions may reduce
earnings due to a limited number of private-pay consumers.
Revenue Source Limits: CSL may encounter revenue source limits by rejecting Medicaid
clients. In recessions or when prospective inhabitants are low-income, relying only on
private-pay consumers is dangerous.
Opportunities
Growth in Tertiary Markets: CSL can benefit from the tertiary markets’ potential for
development. Seniors may require specialized care in tertiary areas, allowing CSL to grow its
client base.
Expansion into New Regions: CSL may reach more private-pay clients by expanding into
new locations. To succeed in new areas, however, extensive market analysis and
demographic adaptation are essential.
Service Diversification: CSL may get a competitive edge by diversifying its services to fulfill
consumer demands. Innovative elder care services, wellness initiatives, and technologydriven solutions may expand the consumer base and income. CSL’s specialized treatment
makes it ideal for these chances.
Threats
Competition from Larger Players: CSL confronts significant competition from more
extensive elder living facilities. Established companies may have more significant resources,
marketing strength, and brand awareness.
4
Economic Fluctuations: Economic downturns threaten CSL’s sole reliance on private-pay
consumers. Seniors may need help to afford private-pay elder care during downturns.
Environmental Factors and Impact on Care Delivery
The environmental elements discovered via the SWOT analysis are crucial in
determining how CSL delivers care and significantly impact its daily operations. CSL’s
capacity to serve private-pay consumers may be affected by healthcare regulatory changes,
particularly Medicaid and Medicare laws. To comply with changing legislation, CSL must be
flexible and explore changing its business strategy, such as partnering with government
programs or diversifying income streams. CSL’s target clientele—private-pay seniors may be
affected by economic downturns. CSL should prepare to help prospective residents overcome
financial difficulties during economic downturns to boost occupancy rates. The senior living
market, where CSL competes, is very competitive and dominated by more prominent firms.
In this context, CSL must spend on marketing, branding, and service quality to stand apart.
Additionally, technology allows CSL to improve care and efficiency. Telemedicine, EHRs,
and smart home technology may enhance treatment and resident experiences.
In conclusion, Cottage Senior Living’s mission, vision, and strategic planning fit a
changing healthcare sector well. Depending on regulations, the company’s concentration on
private-pay consumers in tertiary markets may be a strength or weakness. CSL’s strategic
planning focuses on specialized, high-quality elder care, matching its purpose and vision.
Demographic changes and wellness trends provide development potential, while regulatory
uncertainty and economic swings represent dangers. CSL must be flexible and imaginative to
provide excellent care while tackling new problems and capitalizing on elder living sector
expansion.
5
References
(n.d.). Cottage Senior Living.
Crawford-Spencer, E., & Cantatore, F. (2016). Models of Franchising for Social
Enterprise. Journal of Marketing Channels, 23(1–2), 47–59.
https://doi.org/10.1080/1046669x.2016.1147891
Milestone Four HCM
Dania Atieh
Southern New Hamphsire University
Milestone Four HCM
Milestone Four HCM
1
Cottage Senior Living (CSL) has clear rules for its elder care and assisted living
services. Regulatory compliance, resident well-being, and fiscal responsibility depend on
these personnel, healthcare, facility, and financial management rules. As the elder care
business changes, CSL must adjust its internal rules to accommodate new difficulties and
possibilities.
Summary of Current Policies
CSL provides elder care and assisted living. CSL has policies covering its operations
and services. Organizational policies include personnel, healthcare, facilities requirements,
and financial management. CSL’s staffing standards mandate LPNs and RNs and specific
staffing ratios to guarantee that residents get proper care (Cottage Senior Living,” n.d.). These
rules comply with state assisted living and memory care standards, showing CSL’s regulatory
compliance. Healthcare policies may ensure that residents get proper medicine delivery,
evaluations, and care plan adherence (Bombard et al., 2018). These policies promote resident
well-being and excellent healthcare. CSL also has safety, construction, and food service rules
(“Cottage Senior Living,” n.d.). These standards guarantee that CSL’s facilities satisfy
regulations and are safe and pleasant for inhabitants.
Current Organizational Policies
CSL policies address specific environmental or external issues. These policies
emphasize regulatory compliance and resident well-being, notably in personnel, healthcare,
and facility requirements. CSL’s employment practices maintain state compliance, which is
vital in an industry where regulatory changes may drastically affect operations (“Cottage
Senior Living,” n.d.). In addition, healthcare service policies include medicine delivery and
evaluation methods to protect residents’ health. Facility standards and regulations follow
regulatory rules to ensure resident safety and comfort. However, CSL should frequently
2
evaluate and amend these rules in order to adequately respond to the evolving eldercare
sector.
Internal Policy Changes
I believe that CSL needs particular internal policy modifications and new policies to
meet its issues and potential better. First, CSL should create market growth rules that define
how to penetrate new locations, especially college towns. These strategies should handle state
regulatory differences and establish market research and feasibility evaluations. Second, CSL
should establish technology and innovation strategies that promote ongoing improvement and
technological integration. These policies should describe how to find and adopt new
technologies that improve resident care, operational efficiency, and data-driven decisionmaking. Third, to manage growth and financial sustainability, the company should use
financial flexibility policies (Fischer et al., 2019). Finally, CSL should emphasize outreach to
residents, their families, and local communities in its community participation and feedback
policy. Regular surveys, feedback, and resident participation in decision-making should be
encouraged by these rules.
Role of Healthcare Manager
Healthcare managers are crucial leaders who connect strategy objectives to policy
execution. In an organization like CSL, a healthcare manager’s involvement in directing
strategic planning processes around policy revision or development is crucial. Healthcare
managers should lead policy modification and development strategy planning. This job is
crucial owing to their healthcare policy, regulatory, and industry trends knowledge.
Healthcare managers should be policy specialists, keeping up with changes in legislation and
rules to ensure policies meet industry standards (Huebner & Flessa, 2022). They must also
actively engage in strategic planning to align policies with CSL’s goal and vision. Healthcare
administrators should openly communicate with stakeholders to seek input and resolve policy
3
change concerns. They should monitor policy implementation, liaising with appropriate
departments to guarantee compliance and resolve issues. Healthcare managers can also
promote continuous improvement by assessing policy efficacy and pushing for changes to
adapt to changing external conditions.
Influence of Key Stakeholders
The strategic planning process of policy change or development within an
organization like CSL is significantly influenced by key stakeholders. These stakeholders
include residents, their relatives, employees, regulators, and the community. Residents and
their families are critical partners in policy change and planning. Their tastes, experiences,
and comments influence policy. Since resident happiness and well-being are paramount, CSL
must consider their needs and expectations while creating or amending policies. Staff,
healthcare professionals, and administrators also have significant effects. They understand
how policies affect everyday operations. Staff involvement in planning provides knowledge
and encourages ownership and commitment to policy execution. The elder care business
relies on government and regulatory authorities (Mosadeghrad, 2014). Compliance with these
standards is mandatory, and regulatory changes typically require policy modifications. To
avoid fines, CSL must continuously monitor and respond to changing regulatory demands.
Local authorities and neighbors might impact strategic planning. Support or disagreement
from the local community might affect CSL’s capacity to develop or adopt new policies.
In conclusion, Cottage Senior Living must adjust to elder care sector changes. CSL
should revise its internal policies to meet its strategic goals and provide high-quality care to
residents. Leading this process and ensuring that policies stay applicable and efficient in a
changing healthcare environment are crucial duties played by the healthcare manager and
other important stakeholders.
4
References
(n.d.). Cottage Senior Living.
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., Onate, K.,
Denis, J.-L., & Pomey, M.-P. (2018). Engaging Patients to Improve Quality of Care:
A Systematic Review. Implementation Science: IS, 13(1).
https://doi.org/10.1186/s13012-018-0784-z
Fischer, R. J., Halibozek, E. P., & Walters, D. C. (2019). Contingency planning emergency
response and safety. In Introduction to Security (pp. 249–268). Elsevier.
Huebner, C., & Flessa, S. (2022). Strategic Management in Healthcare: A Call for LongTerm and Systems-Thinking in an Uncertain System. International Journal of
Environmental Research and Public Health, 19(14), 8617.
https://doi.org/10.3390/ijerph19148617
Mosadeghrad, A. M. (2014). Factors Influencing Healthcare Service Quality. International
Journal of Health Policy and Management, 3(2), 77–89.
https://doi.org/10.15171/ijhpm.2014.65
After reading chapters 15,17 answer the next question.Which level of measurement would you prefer to utilize for quantitative research? Defend your answer.
After reading the article, summarize the article and write your thoughts about the article. Specifically, the summary must be at least two pages (or more), and the critique must also be at least two pages (or more).In summary, you just summarize what the article talks about (do not include your personal thoughts here!). In critique, please write the strengths & weaknesses of the article, and applications/suggestionsYou must also follow this instruction as well: no cover and reference pages are required. *Just write your name and the name of the article. The Publication Manual of the American Psychological Association (6th ed.) must be followed with 1-inch margins, double-spaced, 12-point Time New Romans, and no spaces in between lines.High-quality writing is expected and also grading (especially about plagiarism) will be strict. You must use your own words for both summary and critique parts. Do not copy and directly paste any sources from the article.https://learn-us-east-1-prod-fleet02-xythos.conten…
Goals: Meets MAERB Standards V.C.18 (Discuss examples of diversity)
Examine the concepts of culturally respectful care
Examine the concepts of whole health from the individual within a cultural context
Examine the concepts of whole health care as it relates to Medical Assisting
Instructions:
Read Purnell Model of Cultural Competence.pdf article. (Hyperlink is provided and article is also in “Resource Central.”)
Respond to three of the following prompts in essay format.
Identify and describe the top three areas that impacted you the most from this reading and why? Be specific and detailed in your response.
Compare & contrast the types of culture that Purnell’s addresses. Describe your thoughts as to why Dr. Purnell represented culture as he did.
Describe Purnell’s concepts of culture as a process. Secondly, apply these concepts to Medical Assisting Education.
Compare and contrast stereotyping and generalizations as it applies to a person’s cultural views. Be comprehensive and detailed.
Compare and contrast the circles within the Purnell Model. Provide sufficient details.
Describe the various components of secondary characteristics of culture.
This article was originally published 2005. Compare and contrast its applicability to today’s healthcare arena.
Work must include:
A minimum of three to five in-text citations (properly formatted to APA or MLA standards) for each of the three prompts selected.
Spelling, grammar, and punctuation must be at acceptable sophomoric college level work.
Proper use of paragraphs within body of work.
Double spaced formatting.
Ethics are essential to the integrity of the nursing profession as it helps ensure better patient care. Nursing is a fast-paced job with new challenges arising daily, but nothing has been more challenging than the COVID-19 pandemic. The COVID-19 pandemic has changed the image of our world with its circular impact on health, living tradition, economy, and politics. In particular, the tradition of the health industry has changed dramatically because of the unpredictable nature of the pandemic. Since the breakout of COVID-19, health care providers have faced multidimensional challenges in performing their professional duties and responsibilities. Health professionals are challenged by a lack of pandemic preparedness, scarcity of clinical supplies, and in the implementation of COVID related protocols such as social distancing. Many of these situations are rooted in protecting patients’ rights, adequate staffing, advanced decision-making, and quality patient care. Amid the pandemic, health professionals were challenged to apply the four main principles of biomedical ethics in taking care of the clients, i.e. autonomy, justice, beneficence, and non-maleficence. For instance, health workers who were assigned on duty without personal protective equipment were at high risk of infection not only to themselves but also to their families and other clients. Thus, it violates “no harm to others” or “non-maleficence” ethical principle. If nurses do not adequately deal with ethical issues, the result could be a decline in patient care, tense clinical relationships, and moral distress. Please review the ANA Code of Ethic for Nurses with Interpretive Statements. Using 3 Provisions to substantiate your view, explain the changes in health care during the pandemic and the ethical implications to your future nursing practice.
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Assignment : NRSG261- Nursing Ethics Amid Covid 19
Level of Achievement
Total points possible:
Criteria
Exemplary – exceeds expectations Proficient – meets expectations
100
percent of
score
Content
30%
Writing and Critical Thinking Skills
30%
Timeliness and Format
20%
Referencing
20%
100%
90-100%
Responded to assignment
questions with knowledge from
literature, logic and insight using
ethical theories and/or principles
as well as the ANA Code of Ethics
and Provisions. Applied to
personal nursing practice.
77.6 -89%
Falls short of expectations needs improvement
77.5% or below
Score:
Questions were partially
Paper unfocused or incomplete,
answered; Paper was
diverging from assignment
somewhat logical, briefly
questions, failed to
mentioning ethical theories or
include ethical theories or
principles, citing the ANA
principles or the Code of Ethics.
Code of Ethics. Process plan is not Process plan is mentioned but not
clear as to how it fits in the
clearly developed.
nursing practice.
Paper follows logical sequence of Logical sequence of ideas loosely Conclusion does not follow from
ideas leading to justifiable
linked to conclusion. Paragraphs concepts in the narrative.
conclusion. Paragraphs are well
developed but not connected with Paragraphs lack cohesion or
developed with transition
transition sentences.
transitions.Standards, leadership
sentences.
concept or institutional impact
lack the supporting information
Paper submitted at the assigned
Paper submitted at the assigned Paper submitted at assigned due
due date; No errors of
due date; Minimal errors of
date. Multiple punctuation,
punctuation, spelling or grammar. punctuation, spelling or grammar. spelling and grammar errors.
Complete within 3 pages with
Paper mostly completed on 3
Paper exceeds 3 page limit,
bibliography on 4th page.
pages.
rambles or is minimal at 2 pages
or less. Justification for selection
of the implementation process is
unclear.
Bibliography includes more than 2 Bibliography includes 2
current references in APA format references in APA format using
using appropriate citations within citations within the narrative.
the narrative. No plagiarism used. Plagiarism not detected.
Bibliography has less than 2
references, APA format not
followed. Plagiarism may be
detected.
0
Now that you have completed an in-depth analysis of the case study, it is time to provide recommendations. You will recommend a course of action regarding strategic planning in light of the issue the healthcare organization is facing. Be sure to address the following:Provide a brief summary of the issue facing the healthcare organization and the aspects you have previously reviewed that relate to the issue.What course of action would you recommend the healthcare manager take in terms of strategic planning around this issue? Be sure to justify your recommendation with evidence.What recommendations would you make to ensure that identified key stakeholders in the organization are involved in driving the strategic planning process? Be sure to substantiate your claims.How might the organization better align its strategic planning and policy processes with its overall mission and vision, particularly with regard to this issue? Be sure to provide evidence to justify your response.below i attached milestones 1-4 for refrence
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Case Study One: Cottage Senior Living
Dania Atieh
Southern New Hamphsire University
Milestone One
1
Introduction
Serving the requirements of elderly and disabled people who need daily support, Cottage
Senior Living operates in the dynamic long-term care and assisted living market. Several urgent
issues, such as decreased resident satisfaction, increased employee turnover rates, and heightened
competition, are facing this sector. Given the industry’s predicted growth, fueled by an aging
Baby Boomer generation and longer life expectancies among older people, these challenges are
of the utmost importance. This paper summarizes the challenges, interpretation of the mission,
vision, and values, and their impacts on the challenges faced.
Summary Of the Circumstances and The Problems
Cottage Senior Living is a part of the more significant long-term care and assisted living
sector, which includes a variety of healthcare and residential service providers for elderly and
disabled people in need of help with daily life. The organization faces falling resident
satisfaction, increased staff turnover, and increased competition in the assisted care market.
These concerns are critical given the industry’s anticipated growth, predominantly fueled by the
aging Baby Boomer demographic and rising life expectancy among older people. In addition,
Cottage Senior Living operates in a competitive market where private payers account for a
sizeable portion of revenue and the four top industry providers hold a meager 13 percent of the
market. It is essential to comprehend the demographics of senior living communities, the variety
of care services provided, and the advent of cutting-edge models like continuing care residential
communities (CCRCs) and memory care institutions to address these issues. Despite Medicaid’s
significance to the sector, the organization made the strategic decision not to advertise to or
accept Medicaid recipients, which gives its situation a unique twist (“Cottage Senior Living,
n.d.).
2
Interpretation of the Mission, Vision, and Values of Cottage Senior Living
In the context of the long-term care and assisted living industries, Cottage Senior Living’s
mission, vision, and values come together to provide a guiding framework that determines the
organization’s identity and purpose. The mission statement highlights the organization’s
commitment to improving the quality of life for senior citizens by putting their safety, care, and
comfort first. It reflects a dedication to offering all-encompassing support, considering a person’s
physical, emotional, and social needs. The organization’s daily operations are guided by this
objective, which places a premium on resident pleasure and general welfare. The vision
statement outlines Cottage Senior aspirational aim of becoming the top option for senior living.
It focuses on the pursuit of excellent care and conveys a dedication to going above and beyond
what is expected in the field. The organization’s commitment to adapting to changing healthcare
trends and resident expectations is shown by including “innovation” in the mission statement
(“Cottage Senior Living, n.d.).
These values of compassion, integrity, respect, and quality provide Cottage Senior
Living’s ethical and practical compass. “Compassion” highlights the organization’s commitment
to empathic and sincere care for residents, fostering a supportive and trusting environment.
Reiterating the value of moral behavior and openness, “integrity” ensures all stakeholders can
believe in the organization’s decisions. Regarding inhabitants’ requirements and preferences,
“respect” directs how they are treated decently. “Excellence” establishes a benchmark for
continual progress and motivates the business to offer the best possible care and services. When
taken as a whole, these values foster an organizational culture that aligns with the organization’s
mission and vision, fostering a setting where residents receive exceptional care and staff
members are committed to their jobs (“Cottage Senior Living, n.d.).
3
Impact Of the Mission, Vision, And Values on Organizational Circumstances
How Cottage Senior Living interprets its goal, vision, and values is crucial to how it
responds to its difficulties. The mission establishes high standards for well-being and guides care
on residents’ needs to overcome diminishing satisfaction. The organization is inspired to stand
out and effectively engage with the community since the vision’s emphasis on outstanding
service and innovation aligns with the competitive landscape. The organization’s principles also
foster a supportive workplace culture, which addresses staff turnover issues by encouraging
employee engagement and happiness. According to Fuertes et al. (2020), these guiding principles
give Cottage Senior Living a framework for making strategic decisions that will improve
resident satisfaction, keep it competitive, and increase staff retention while adhering to its
mission to offer great care in a loving and secure environment (“Cottage Senior Living, n.d.).
Conclusion
In the constantly changing environment of the long-term care and assisted living
industries, Cottage Senior Living faces some complex problems. These difficulties include
dwindling resident satisfaction, rising staff turnover, and intensified competition. However, the
organization’s apparent interpretation of its goal, vision, and values provides a strong foundation
for tackling these difficulties. Cottage Senior Living can seek to improve the quality of life for its
residents, excel in the delivery of care, and establish a welcoming workplace that benefits
residents and staff by aligning its actions with these guiding principles. Although the path ahead
may be difficult, the company’s dedication to its goal, vision, and values guide it through these
difficulties, ultimately securing its long-term success and reputation as a top choice for senior
living.
4
References
(n.d.). Cottage Senior Living.
Fuertes, G., Alfaro, M., Vargas, M., Gutierrez, S., Ternero, R., & Sabattin, J. (2020). Conceptual
Framework for the Strategic Management: A Literature Review—Descriptive. Journal of
Engineering, 2020, 1-21. https://doi.org/10.1155/2020/6253013
Milestone 2
Dania Atieh
Southern New Hamphsire University
Milestone Two HCM
1
Cottage Senior Living specializes in long-term care, among other things. The
administrative center of the business is located in Huntsville, Alabama. Cottage Senior Living
runs three different senior living residences. The Assisted Living, Memory Care, and Active
Adult homes offer long-term care services. As a result, significant changes have been made to
the company’s customer service philosophy and strategy. The current study incorporates
market characteristics to define the three strategic approaches contributing to the firm’s
growth and performance. This case study analysis evaluates the applicability of strategic
analysis to identify the problems the company has and potential remedies.
The Organization’s Approach
Senior Cottage Living is a well-structured organization that aims to help the elderly.
Cliff White, the company’s president, underlined the need to pay particular attention to the
interests of the elderly clients in his speech. Their mission statement states that they want to
ensure that elderly individuals are treated with dignity and compassion. This indicates how
the business bases its strategic decision-making on its target market’s wants and needs (Ginter
et al., 2018). The business has a clear plan for the future, which includes assessing where it is
now in terms of growth and contrasting it with where it needs to be.
The president has divided their expansion into three phases by asking only three
questions regarding the organization’s future development: what, why, and how regarding
location and capacity for growth. The focus on “service offerings” in the vision demonstrates
that Cottage Senior Living is considering a range of services in addition to housing to support
members’ preferred way of life. This all-encompassing approach can be a component of their
master plan to differentiate themselves from the competitors (Harrington et al., 2016).
Providing residents with amenities and services that encourage ongoing physical and social
engagement is certainly one of their long-term goals. The company’s president also discussed
2
how serving non-subsidized, private-pay clients in tertiary markets sets it apart from rivals
(“Cottage Senior Living, n.d.).
The Major Issue Identified From the Case Study
The case study has brought to light a significant need for methods of growth and
expansion. The president of the company presented information showing the company’s aim
to expand into nearby towns, which might be a huge growth engine but is only as good and
effective as the management of the organization (“Cottage Senior Living, n.d.). It is vital to
assess the situation first before moving forward. In each location, franchisees also own the
land on which their businesses are built, which might make it difficult to hire and keep a large
enough pool of qualified workers. However, all business-related tasks, such as hiring staff
and running advertisements, fall within the purview of the Cottage Senior Living corporate
office. As a result, the firm must create an expansion plan that complies with all relevant
regulations. An assessment of present patterns and changes can be used to make predictions
about how it will operate in the future. It will be crucial to assess critical directions for
improving a framework for flexible change in the future (Harrington et al., 2016). The rising
proportion of patients with Medicaid insurance—which is already over 60%—is one of the
current trends. Cottage Senior Living does not currently accept Medicaid patients.
Strategic Planning Concerns
The leadership of the company has pledged its efforts to organize the development
resources of the company to enable it to realize its vision statement. The organization’s goal
is to offer people housing and services that encourage an active, sociable, and involved way
of life. This suggests that creating a distinctive way of life for its residents has been a
significant priority of their strategic planning (Ginter et al., 2018).
The Role of Healthcare Manager
3
Senior Cottage Living is a corporate entity that focuses on assisting the senior
population. Within this organization, a healthcare manager assumes a significant
responsibility in ensuring the provision of high-quality healthcare services to align with the
company’s goal and vision (Ginter et al., 2018). The cottages are categorized according to the
specific requirements of the clientele, namely Assisted Living, Memory Care, and Active
Adult (“Cottage Senior Living, n.d.). Hence, a healthcare manager plays a crucial role in
evaluating the suitability of potential locations for establishing healthcare entities and
providing recommendations by the regulatory framework governing the industry’s corporate
operations.
Stakeholders
Customers stand to gain the most from the company’s agenda, as their patronage is
crucial to the success of the enterprise. The growth of the organization is dependent on the
participation of seniors, regardless of their demands. The growth of the business has been
segmented into three areas so that all of its resources can be devoted to serving the needs of
the elderly. As a result, customer satisfaction has become a focal point in the company’s
efforts to serve the community and realize its goals in that regard (Harrington et al., 2016).
Conclusion
Based on the case study, the organization has established its advantages and barriers
related to growth and development, which is its major agenda. From a personal standpoint,
strategic planning is based on a company’s ability to identify its limitations and address them
as growth opportunities. Since Senior Cottage Housing has recognized “empty nesters” as a
key demographic within the senior housing industry, the company has devised a plan to
expand into neighboring communities to meet their needs. By using this segmentation
strategy, they may now cater their products and services to this specific demographic
4
References
(n.d.). Cottage Senior Living.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The Strategic Management of Health
Care Organizations. John Wiley & Sons.
https://books.google.com/books?hl=en&lr=&id=3qVFDwAAQBAJ&oi=fnd&pg=PR
7&dq=Ginter,+P.+M.,+Duncan,+W.+J.,+%26+Swayne,+L.+E.+(2018).+Strategic+M
anagement+of+Health+Care+Organizations.+Hoboken,+New+Jersey:+Wiley&ots=4
UJvqqsYFD&sig=JvfRfoN77k8b3X_K7unVdUTO-og#v=onepage&q&f=false
Harrington, C., Schnelle, J. F., McGregor, M., & Simmons, S. F. (2016). Article
Commentary: The Need for Higher Minimum Staffing Standards in US Nursing
Homes. Health Services Insights, 9, HSI-S38994. https://doi.org/10.4137/HSI.S38994
Milestone Three HCM
Dania Atieh
Southern New Hamphsire University
Milestone Three HCM
1
Companies seek new ways to stand out in competitive marketplaces in today’s fastchanging business environment. Cottage Senior Living (CSL), a tertiary senior home
provider that targets non-subsidized, private-pay users, is one such company that has
established itself effectively. Cottage Senior Living (CSL) seeks expansion while addressing
regulatory issues in tertiary areas to provide specialized elder care.
Brief Summary of the Case Study
The focus of the case study is Cottage Senior Living (CSL), a provider of senior
housing with its main office in Huntsville, Alabama. CSL’s 1980s founding by Peg
Thompson and Wade White introduced a groundbreaking assisted living service framework
(“Cottage Senior Living,” n.d.). The company targets non-subsidized, private-pay consumers
in tertiary markets. CSL’s extensive elder care portfolio includes independent living (IL),
assisted living (AL), memory care (MC), and skilled nursing facility (SNF) choices. The
franchise-like CSL structure allows each facility to operate as a legal company. They pay
CSL a management fee to unify operations and branding throughout the firm (“Cottage
Senior Living,” n.d.). CSL aims to exclude Medicaid beneficiaries to focus on private-pay
consumers.
Policies Addressing the Issue
Cottage Senior Living (CSL) deliberately addresses the challenge of supplying nonsubsidized, private-pay consumers in tertiary markets. Medicaid exclusion is a crucial policy
that fits CSL’s overall plan (“Cottage Senior Living,” n.d.). CSL controls its consumer base
by avoiding Medicaid and focusing on private-pay clients, ensuring its services meet its target
market. CSL’s franchise-like structure, with each facility as a legal company, pays CSL a
management fee. This structure requires organization-wide branding uniformity, operational
standards, and management fee agreements. In addition, the extensive array of senior care
services offered by CSL, including independent living, assisted living, memory care, and
2
skilled nursing, strongly supports standards to guarantee quality and compliance for each
service category.
Alignment with Mission and Vision
Cottage Senior Living (CSL) aligns its strategic planning with its mission and vision
to serve non-subsidized, private-pay consumers in tertiary markets. Several factors support
this alignment. First, CSL’s objective is to provide specialized elder care, and its ambition is
to provide high-quality care in tertiary markets (“Cottage Senior Living,” n.d.). By targeting
private-pay consumers, CSL’s strategic strategy carefully follows its objective and vision.
Medicaid enrollees are excluded to ensure CSL’s services target its target market. As stated in
its mission and vision, CSL provides specialized treatment to private-pay customers, ensuring
service quality. CSL may fulfill its mission by entering less crowded areas and offering
specialized treatment. Furthermore, the franchise-like structure in the case standardizes
operations and branding among CSL sites (Crawford-Spencer & Cantatore, 2016).
Standardization fits the organization’s objective of providing specialized services consistently
and a vision of high-quality care across its operations.
SWOT Analysis
Strengths
Specialization in Private-Pay Market: Cottage Senior Living (CSL) excels in serving nonsubsidized, private-pay consumers. CSL differentiates itself in the elder living sector by
servicing private-pay consumers and setting pricing structures that reflect its dedication to
high-quality, specialized care.
Comprehensive Senior Care Portfolio: CSL excels in independent living, assisted living,
memory care, and skilled nursing. This complete solution enables CSL to meet older
population demands, improving its market presence and agility.
3
Standardized Operations: In CSL’s franchise-like organization, maintaining service quality
and brand awareness requires standardization. For instance, all CSL facilities provide
consistent care, amenities, and experiences, building confidence and loyalty.
Weaknesses
Limited Market Reach: CSL’s strategy concentration on tertiary markets may restrict its
market reach and development prospects. Serving sparsely inhabited regions may reduce
earnings due to a limited number of private-pay consumers.
Revenue Source Limits: CSL may encounter revenue source limits by rejecting Medicaid
clients. In recessions or when prospective inhabitants are low-income, relying only on
private-pay consumers is dangerous.
Opportunities
Growth in Tertiary Markets: CSL can benefit from the tertiary markets’ potential for
development. Seniors may require specialized care in tertiary areas, allowing CSL to grow its
client base.
Expansion into New Regions: CSL may reach more private-pay clients by expanding into
new locations. To succeed in new areas, however, extensive market analysis and
demographic adaptation are essential.
Service Diversification: CSL may get a competitive edge by diversifying its services to fulfill
consumer demands. Innovative elder care services, wellness initiatives, and technologydriven solutions may expand the consumer base and income. CSL’s specialized treatment
makes it ideal for these chances.
Threats
Competition from Larger Players: CSL confronts significant competition from more
extensive elder living facilities. Established companies may have more significant resources,
marketing strength, and brand awareness.
4
Economic Fluctuations: Economic downturns threaten CSL’s sole reliance on private-pay
consumers. Seniors may need help to afford private-pay elder care during downturns.
Environmental Factors and Impact on Care Delivery
The environmental elements discovered via the SWOT analysis are crucial in
determining how CSL delivers care and significantly impact its daily operations. CSL’s
capacity to serve private-pay consumers may be affected by healthcare regulatory changes,
particularly Medicaid and Medicare laws. To comply with changing legislation, CSL must be
flexible and explore changing its business strategy, such as partnering with government
programs or diversifying income streams. CSL’s target clientele—private-pay seniors may be
affected by economic downturns. CSL should prepare to help prospective residents overcome
financial difficulties during economic downturns to boost occupancy rates. The senior living
market, where CSL competes, is very competitive and dominated by more prominent firms.
In this context, CSL must spend on marketing, branding, and service quality to stand apart.
Additionally, technology allows CSL to improve care and efficiency. Telemedicine, EHRs,
and smart home technology may enhance treatment and resident experiences.
In conclusion, Cottage Senior Living’s mission, vision, and strategic planning fit a
changing healthcare sector well. Depending on regulations, the company’s concentration on
private-pay consumers in tertiary markets may be a strength or weakness. CSL’s strategic
planning focuses on specialized, high-quality elder care, matching its purpose and vision.
Demographic changes and wellness trends provide development potential, while regulatory
uncertainty and economic swings represent dangers. CSL must be flexible and imaginative to
provide excellent care while tackling new problems and capitalizing on elder living sector
expansion.
5
References
(n.d.). Cottage Senior Living.
Crawford-Spencer, E., & Cantatore, F. (2016). Models of Franchising for Social
Enterprise. Journal of Marketing Channels, 23(1–2), 47–59.
https://doi.org/10.1080/1046669x.2016.1147891
The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare:
By Day 1 of this week, you will be assigned to one of the following specific case studies for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.
Review the following case studies:
InstructionsYou are a member of the board of directors for Selfless Health, an integrated delivery system that includes an academic medical center, three community hospitals, a long term care facility, and a home health agency. Selfless Health struggles to operate in the black, in fact any years where the system does not lose money is considered an achievement. The board has been approached by MMC (Massive Mega-Capital, a venture capital firm) with an offer to acquire the health system.The board chair has asked you to provide a summary analysis comparing not-for-profit and for-profit health systems. What are the benefits and risks of each model? Is there evidence of the superiority of either system? Does your home state allow for-profit ownership of hospitals? Conclude your summary with a recommendation for Selfless Health. Should it accept the takeover? Why or why not? Your analysis should be 8-10 pages. The cover page, references, and any figures are not included in the page count). At least five resources, three of which are scholarly, should be utilized in the paper and included in references. APA 7 format should be followed. please include refernces
Examine the importance of professional associations in nursing. Choose a professional nursing organization that relates to a specialty area of interest. In a 750‐1,000-word paper, provide a detailed overview of the organization and its advantages for members. Include the following:
Describe the organization and its significance to nurses in the specialty area. Include its purpose, mission, and vision. Describe the overall benefits, or “perks,” of being a member.
Explain why networking is important for a nurse in this specialty field. Discuss how this organization creates networking opportunities for members.
Discuss how the organization keeps its members informed of health care changes and changes to practice that affect the specialty area.
Discuss opportunities the organization provides for continuing education and professional development.
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.
Prepare this assignment according to the guidelines 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.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.750‐1,000-word paper750‐1,000-word paper750‐1,000-word paper
Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.
Generalized Anxiety Disorder is a psychological condition that affects 6.1 million Americans, or 3.1% of the US Population. Despite several treatment options, only 43.2% of those suffering from GAD receive treatment. This week you will review several different classes of medication used in the treatment of Generalized Anxiety Disorder. You will examine potential impacts of pharmacotherapeutics used in the treatment of GAD. Please focus your assignment on FDA approved indications when referring to different medication classes used in the treatment of GAD.
To Prepare:
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history with GAD.
Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD. In addition, suggest different treatment options you would suggest to treat a patient with the topic of discussion.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply! NOTE: Your initial response must be with intext-citations and at least 3 or more references.Responses must be with intext-citation and at least 2 or more references
Please see the discussion board for the study guide and find your name by your assigned topic. Using your Pediatric Textbook, please create a study guide outline for your assigned topic including, patho, s/s, nursing interventions and other key points that are important to the topic. At the end of your outline, please create 2 practice study questions (Multiple choice or Select all). Please then list the answer with a rationale and page number from your textbook or ATI
Based on Module 1: Lecture Materials & Resources and experience, please answer the following questions.Describe the roles and responsibilities of the APRN when prescribing medication.Describe the method used to determine what drug therapy to prescribe?Discuss responsibilities for patient education and teaching based on the prescribed therapy. Discuss Schedule drugs and prescribing restrictions for each scheduled drug. Submission Instructions:Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.Each question must be answered individually as in bullet points. Not in an essay format. Example: Question 1, followed by the answer to question 1; Question 2, followed by the answer to question 2; and so forth.
Please follow the instructions from the attached document and do everything without missing any point in the excel sheet which is given to you
Unformatted Attachment Preview
INFO6063: Assignment 2: Financial
Information
Create a Report: Focus on Financial Information
Total Marks: 50
Weighted Mark: 15% of final grade
Due: Friday 23:59 pm, end of Week 8, November 1, 2019
Academic Integrity:
Here are the links to: Academic Integrity and Fanshawe College Policy Information for Students
It is your responsibility to know and understand the content of these policies. Any suspicious
behaviour such as
•
•
•
copying ANY part of another person’s work, which also includes the work of friends and
roommates is considered cheating
sharing ANY part of your documentation with another student is considered cheating
using and not citing another person’s material is considered cheating
Cheating is taken very seriously, and penalties range from receiving 0 on an assignment through
to failing the course and being expelled from Fanshawe.
Assignment Purpose:
The purpose of this assignment is for students to prepare a spreadsheet report regarding financial
information. Within healthcare, reporting occurs at all levels of the organization. Reporting needs to be
professional and well written. The reports need to demonstrate an understanding of information and
the ability to display the information in a meaningful manner for colleagues and management.
This is the second of three assignment reports required for HSY INFO6063. The focus is to analyse
information using advanced Excel formulas, find and access data from an outside source and to display
the data in a professional manner.
Instructions:
The Manager of your department has requested that you prepare a report regarding healthcare
spending in Ontario.
In your own words, using correct sentence structure, grammar and spelling, create a document using
the following directions.
The data file being used for this document is: A2-Financial_Information.xlsx
Instructions:
Instructions
Details
Mark
Value
Part A
Report Contents
Accessing, Analysing, Displaying Data
In pairs or individually:
You/your team will need to decide on the format, alignment, font
colour, the position of the information to ensure that this is an easy
to read, easy to understand, professional report.
Information
Analysis
Using the data document supplied, please do the following:
• Sum each row
•
•
12
Sum each column
Average each column
•
•
Bar Graph
Average each row
Calculate a % of the yearly total for each column and each
row for each expense
• Enter a grand total for all 5 years for the expenses.
Prepare a bar graph that demonstrates each of the expenses, the
year of the expense and compares all of the values.
10
•
Source, access
and display data
Check the graph title and ensure that it describes the content
of the graph.
• Check the graph axis titles and ensure that they describe the
content of the axis information.
• Ensure that the graph is clear and easy to read, including any
values being displayed
Navigate to the CIHI website
https://yourhealthsystem.cihi.ca/hsp/?lang=en
•
•
•
•
Select in Depth
Select Ontario
Select Indicator Results
Select Efficiency
•
Enter the values on the 2nd worksheet in the Excel document
A3-Financial_Information.
•
Format the values for currency and/or percentages as is
appropriate to the data displayed.
•
Ensure that the worksheet document is appropriately titled,
and the content appropriately formatted.
6
•
•
Drill down into the Ontario Cost of a Standard Hospital Stay
Navigate to the Results for All Regions Within the
Province/Territory
Locate the Cost of a Standard Hospital Stay for each LHIN.
Transfer the information to the Excel Spreadsheet and
perform the following actions:
o Sort the values from highest to lowest.
o Calculate and display the percentage of the Costs of a
Standard Hospital Stay in Ontario for each LHIN
compared to the cost for Ontario and for Canada
10
Insert a visual that displays each LHIN with its value.
• Ensure all information is clearly legible.
• Enter labels and titles to clearly identify
• Totals, averages, currency
• Prepare a meaningful report title for the top of the document
Submit the Excel document to the Assignment 2 Dropbox before the
deadline.
5
•
•
Before
submission
check all of
these items
2
Please name the Assignment:
firstname_last3digitsofyourstudentnumber_A2_6063F17 or
Twofirstnames_3 digitsofeachstudentnumber_A2_6063F17
Deductions
Late Assignments: 20% per day, will be deducted for late
assignments.
• Sentence structure, grammar, spelling:
deductions at .5 per item to a maximum of 5 marks
5
Before Submitting your report, please verify that that all items below have been addressed:
Prepare a meaningful report title for each worksheet
Ensure all information is legible
Enter labels and titles to clearly identify the information in the report,
the information in each area and the type of information being displayed
Check all spelling and grammar
Have you compared the completed assignment sections, content, requirements to the rubric?
Yes
No
values are millions of dollars
Expense
Administration
Capital
Drugs
Hospitals
Other Health Spending
Other Institutions
Other Professionals
Physicians
Public Health –
2016
2015
2014
2013
2012
$2,227.20 $2,185.50 $2,162.90 $2,213.00 $2,029.50
$3,579.70 $3,755.00 $3,146.00 $3,268.60 $3,578.00
$14,629.40 $14,250.50 $13,881.10 $13,498.40 $13,209.70
$23,700.30 $23,155.60 $22,787.00 $22,685.00 $3,578.00
$5,108.80 $5,010.10 $4,858.30 $4,612.00 $22,336.10
$8,810.50 $8,620.80 $8,378.40 $8,047.20 $4,576.60
$8,545.80 $8,333.40 $8,151.00 $7,726.10 $7,693.30
$13,638.70 $13,398.50 $13,280.10 $12,882.40 $7,722.20
$5,323.50 $5,145.30 $4,898.50 $4,549.90 $12,755.10
2015-2016
Overview
Administrative Expenses:
Cost of a Standard Hospital Stay:
Ontario
Canada
References:
Canadian Institute for Health Information. (2017, 02 07). Publice and Private Sector Health Expenditures by Use of Funds. ON
es by Use of Funds. ON and AB, Canada.
This week you will be covering Psychological Disorder management. During this week, there are several media cases for you to review for your discussion assignment. Per the requirements, you will select an interactive media piece to practice decision making when treating patients with psychological disorders.
For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
This week, you will evaluate patients for the treatment of neurologic and musculoskeletal disorders by focusing on specific patient case studies through a decision tree exercise. You will analyze the decisions you will make in the decision tree exercise and reflect on your experiences in proposing the recommended actions to address the health needs in the patient case study.
Assignment:
In your course resources under week 6 you will find the decision tree under required media.
Choose the case ” Complex Regional Pain Disorder”, It should be the second on the list
To 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.
https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/…
Complex Regional Pain Disorder
White Male With Hip Pain
BACKGROUND
This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”
SUBJECTIVE
The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”
The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”
He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.”
During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation, and is future oriented.
Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter
Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day
Neurontin 300 mg po BEDTIME with weekly increases of 300 mg per day to a max of 2400 mg if needed
Use all you have learned about health care and public health structures and current structural bias, racism, and social inequities to describe what you see in the future for a particular public health topic. The paper should be at least 1500 words on a topic of your choosing (see below); the total paper grade is 200 points. Outline of your paper:Select one issue in public health you anticipate will change in the future as a consequence of globalization, climate change, and human/animal interactions (e.g., we will have permanent water rationing; our coastline cities will be flooded; we will be challenged by new emerging infectious diseases). Describe the situation and why the change is likely to occur, emphasizing the role of globalization, climate change, and/or human/animal interactions as causal contributors. Discuss why you think this issue is important and cite research evidence to the extent possible.Discuss if this change will increase or decrease issues of health equity. In particular, discuss the group(s) most affected by this change and why you think this, including addressing the contexts of structural bias, social inequities, and racism. Discuss the both the societal and community-level challenges that public health leaders will face in trying to address the public health issue and ensure health equity. Cite research evidence to the extent possible.If the future event is negative, how might we intervene to either keep it from happening or to lessen its impact? If the future event is positive, how might we help bring it about?Overall, whose responsibility is it to either to prevent a negative event or promote a positive event?Please use APA style for references.Below is 2 examples of the paper
Unformatted Attachment Preview
Climate Change
“SUMMERS: So, what has the heat been like in Austin this year for you?”
“BUCHELE: It’s been relentless. You know, it started in the spring, and we started getting triple digits in
May with very little rain. And it’s just basically stayed that way. Here in central Texas, we’re now at
around 45 days of triple-digit heat this year. It stays warm through the night, you know, so you wake up
and it’s hot out first thing in the morning. This is a level of heat that the state’s grid operator said it did
not expect going into this summer. But summers are getting hotter here with climate change, so it’s also
kind of becoming more of the norm” (Buchele, 2022.)
It isn’t just in the U.S, across the world heat related incidents are becoming more common
“Summer heatwaves in France, Germany, Spain, and Britain led to more than 20,000 “excess” deaths, a
report compiling official figures said on Thursday. Temperatures hit nearly 40 degrees Celsius or above
from Paris to London in 2022 and climate scientists from the World Weather Attribution group found
that such high temperatures would have been “virtually impossible” without climate change” (Portala,
2022).
Climate change takes many forms, but in the summer of 2022, throughout Texas, the rest of the
United States and every other part of the world, temperatures continued to break record highs.
“Extreme heat events have long threatened public health in the United States. Many cities, including St.
Louis, Philadelphia, Chicago, and Cincinnati, have suffered dramatic increases in death rates during heat
waves. (CDC, 2022). As climate change continues to change temperatures with milder winters and
longer, hotter summers the public’s health is at risk. Not just from acute heat related accidents but also
from other factors that such as cardiovascular, respiratory, and cerebrovascular disease (CDC, 2022).
“Heat waves are also associated with increased hospital admissions for cardiovascular, kidney, and
respiratory disorders. Extreme summer heat is increasing in the United States, and climate projections
indicate that extreme heat events will be more frequent and intense in coming decades” (CDC, 2022). As
the population of the United States continues to flee the middle of the country for the Southwest and
Southeast this issue will need to be put on the forefront of public health research to mitigate deaths and
disease as much as possible. As the climate continues to change and the world continues to warm it will
cause specific places in the Middle East to become uninhabitable leading to a potential migration crisis
across the world. Educating and informing people on this topic before heatwaves strike will allow them
to be prepared for these potentially life threating situations as they continue to become more frequent.
Climate Change and Health Equity
The threat continues as heatwaves threaten the power grid and force homes to reduce energy
usage during peak times. “The Electric Reliability Council of Texas (ERCOT), which operates the grid that
serves more than 26 million customers, initiated a rarely used emergency program that is triggered
when supplies fall below a critical safety margin. Earlier, ERCOT had urged residents to cut power use
during the hottest hours of the day and warned of a risk for rolling blackouts. Residents were asked to
turn up thermostats, defer the use of high-power appliances and turn off swimming pool pumps”
(Varghese, 2022).
As power grids are stressed and power companies continue to increase prices people with lower
incomes will be affected by heat related death and disease disproportionally. Those who can afford the
higher energy costs will be able to use air conditioning in their homes. Impoverished people, if they even
have access to air conditioning in the first place, will be forced to use it less as costs rise. As we know,
people in poverty are less likely to have access to resources that could help them as temperatures rise.
On top of a lack of air conditioning, it will be much harder for them to relocate to a safer living situation
and often, they don’t have motor vehicles which makes it even harder for them to leave their living
situation. This will disproportionally affect people of color in the United States. These people will be less
likely to be able to afford preventative measures before a heat wave takes out the grid like a generator
or stocking up on supplies. These people are often living paycheck to paycheck and that will hurt their
ability to prepare and deal with the catastrophic situations when they start.
Proposed Interventions and Whose Responsible
It will be up to public health officials to bridge these disparities as the warming climate
continues to bring on acute illness and chronic conditions. From a community level standpoint,
preparation is key. As we have seen in the past the federal response to disasters in the United States has
been lackluster. At the community level it is important to know what kind of threat exist and what they
community should be prepared for given the worst-case scenario. Often this will include stocking certain
supplies and having a community center ready to take in people who are suffering from the extreme
weather conditions. This center should be well air-conditioned, be able to hold a large amount of people
for an indefinite amount of time, including sleeping quarters, food, and water. With the lackluster
response to large scale disasters such as hurricane Katrina and the 2003 power outage it will come down
to local communities to be ready for heat related disasters. On top of a community center for the people
who are hit the hardest, other will need assistance as well and having plenty of supplies on hand for the
rest of the community will be important as well. Hospitals and other important health related places,
like senior homes and urgent cares should have backup power and have a surge plan in place for heat
related illnesses. While the community should have these plans, the funding needs to come from the
federal level realistically.
Society and the federal government need to be ready for heat related power outages, illnesses,
and a potential mass migration from the Middle East and Pacific islands as well as the costs, especially
the gulf coast of the United States. “Cities that stretch across the “sun belt” of the southern and southwestern US have in recent years enjoyed population booms, with people lured by the promise of cheap
yet expansive properties, warm winters, and plentiful jobs, with several large corporations shifting their
bases to states with low taxes and cheaper cost of living. But this growth is now clashing with the reality
of the climate emergency, with parts of the sun belt enduring the worst drought in more than 1,000
years, record wildfires and punishing heat that is triggering a range of medical conditions, as well as
excess deaths” (Milman 2022). To address these problems with the greatest health equity we need to
“responsibly manage the problems facing our environment by taking sensible steps toward protecting
human health and safety. Whether measures are meant to reduce future climate change impacts or
address the health impacts of climate change that are happening already, early action provides the
greatest health benefits. It makes sense to invest in creating the strongest climate-health adaptation
and preparedness programs we can (CDC, 2022).
Heat related public health problems stem directly from climate change, so as a society we need
to prioritized mitigating the effects of climate change. On an individual level we can contribute to this by
“Reducing the release of heat-trapping gases like CO2 can help protect our health and wellbeing by
decreasing impacts on our climate system. Activities that reduce the amount of heat-trapping CO2 in the
atmosphere are many of the same things we already know prevent health problems. Active modes of
transport like biking or walking can help reduce traffic-related air pollution and encourage physical
activity, which has public health benefits including reduced rates of obesity, heart disease, and diabetes”
(CDC 2022). But it is important to note that reversing climate change does not fall on the individual
rather large global corporations are the biggest contributors to the warming environment we live in.
“The results showed that nearly two-thirds of the major industrial greenhouse gas emissions (from fossil
fuel use, methane leaks, and cement manufacture) originated in just 90 companies around the world,
which either emitted the carbon themselves or supplied carbon ultimately released by consumers and
industry” (Starr, 2016).
As climate change continues to warm the earth it is important to remember that heat related
illnesses and chronic conditions stemming from them are only part of a much bigger picture. While
these problems will continue to become more prevalent, climate change doesn’t simply warm the globe
as was first thought. Weather patterns across the world are changing and this will also contribute to
future global public health issues. Extreme heat and cold, changing severe weather patterns, and
droughts will change how individuals are able to live their lives. Ultimately, if we are to solve or attempt
to prevent some of these issues it will have to come from global cooperation to reduce greenhouse gas
emissions and change how we consume fossil fuels. The World Health Organization is already
responding to climate change and warming global temperatures but so far, has not made the impact
needed to reduce negative climate change outcomes. Climate change, along with most scientific opinion
today, continues to be challenged by powerful people and corporations that have the money to stop
effective legislation from pushing the U.S. and other countries in the right direction of energy
consumption. The only hope is that we can continue making green energy more affordable and
appealing for consumers and producers. If we can make the right changes, we can avoid global
catastrophe. If we cannot make the right changes, it will be a tough road ahead for public health officials
in the wake of climate change and warming temperatures.
References
Buchele, M. (2022, July 26). It’s Texas’ hottest summer ever. can the electric grid handle people
turning up AC? NPR. https://www.npr.org/2022/07/26/1113816003/its-texas-hottestsummer-ever-can-the-electric-grid-handle-people-turning-up-ac
Centers for Disease Control and Prevention (n.d.). Extreme heat can impact our health in many
ways. https://www.cdc.gov/climateandhealth/pubs/extreme-heat-final_508.pdf
Milman, O. (2022, July 20). Alarm as fastest growing US cities risk becoming unlivable from
climate crisis. The Guardian. https://www.theguardian.com/us-news/2022/jul/20/usfastest-growing-cities-risk-becoming-unlivable-climate-crisis
Portala, J. (2022, November 24). Europe’s heatwave may have caused more than 20,000 ‘excess’
deaths. Reuters. https://www.reuters.com/business/cop/europes-heatwave-may-havecaused-more-than-20000-excess-deaths-2022-1124/#:~:text=Europe’s%20heatwave%20may%20have%20caused%20more%20than%2020
%2C000%20’excess’%20deaths,By%20Juliette%20Portala&text=Nov%2024%20(Reuters)%20%2D%20Summer,official%
20figures%20said%20on%20Thursday.
Starr, D. (n.d.). Just 90 companies are to blame for most climate change, this ‘carbon …
https://www.science.org/content/article/just-90-companies-are-blame-most-climatechange-carbon-accountant-says
Varghese, A. (2022, July 13). Texas grid takes emergency actions to avoid blackouts amid
heatwave. Reuters. https://www.reuters.com/world/us/texas-power-use-breaks-record-heatwave-again-with-no-blackouts-2022-07-13/
601 Assignment 2
There is agreement amongst the scientific community that human activity is causing global
warming and this increase in oceanic and atmospheric temperatures is giving rise to global
humanitarian and health crises (Ghazali et al., 2018, p.1). Namely, in this century climate
change has brought about natural disasters (such as tornadoes, tsunamis, hurricanes and
tropical storms), escalation of extreme weather (such as extreme heat, wildfires, flooding), and
rising sea levels with consequences for air, water, and food access and quality as well as the
spread of vector-borne disease (Sorensen et al., 2020, p.168). These phenomena will cause
negative health repercussion for populations which will drive more citizens to seek care through
emergency medicine, and hospitals’ emergency rooms will bear the brunt of this load (Sorensen
et al., 2020, p.168).
As climate change continues to progress, the risks to the health care system are profound,
especially those serving vulnerable populations and those already at social risk. Emergency
medicine is already at the forefront of acute care, when compared with other providers of
healthcare, this branch of the system is serving a larger population of those at risk. For
example, emergency departments (EDs) percent of population served includes 34.8 percent
from low socioeconomic status and 48.3 percent with comorbidities (Sorensen et al., 2020,
p.172). EDs can anticipate the increase in frequency of these climate change risks–whether
natural disasters, infectious disease, or extreme weather–will result in increased injury,
sickness, population displacement, exacerbation of disease, and mental health crisis (Sorensen
et al., 2020, p.171). In order to protect these more vulnerable populations and ensure that
emergency medicine is able to be the primary point of access for these affected populations,
advanced planning of disaster response situations must include health care system access and
readiness, clinical quality of care, and protective public health measures.
It’s important to note that in general EDs serve more vulnerable populations, but all hospitals
and the populations they serve are not equal in the provision of care to those at social risk.
Embedded in our society are the structural biases that create different hubs or areas that are
intrinsically more affected by the impact of climate change and therefore there will be greater
pressure on the specific EDs serving those populations. Take for example inner-city Baltimore
versus suburban Potomac hospitals, Baltimore has a higher likelihood of having urban heat
islands, highly polluted environments, and areas that are prone to flood or have poorly
maintained infrastructure (Sorensen et al., 2020, p.172). They will likely experience a larger
percentage of those with chronic medical conditions, those more likely to face homelessness
post climate crisis, and are at higher risk of needing emergency care when exposed to climate
stressors (Sorensen et al., 2020, p.172).
These types of hospitals, public hospitals serving populations at greater social risk, are true
safety-nets as they do things no one else will: they treat—not just stabilize—patients regardless
of their ability to pay. They provide access to healthcare to low-income, underinsured patients,
the majority of whom are from racial and ethnic minority groups. Unlike other hospitals serving
more affluent, predominantly white neighborhoods, many people rely on these essential
hospitals for high-risk care that otherwise would be unavailable to them (Kacick, 2021).
In this current era, we are unpacking the issue of systemic racism that essentially has created a
segregated hospital system. Research indicates that most private hospitals serve a patient
population earning $29K above the national average, whereas safety-net hospitals serve those
earning $27K below the national average (Kacick, 2021). Most commercial hospitals seek
paying customers with private insurance, prioritizing revenue over social impact. Safety-net
hospitals count on Medicaid and Medicare reimbursement at below-market value rates and
assume the social risk inherent with the population they serve.
Safety-net hospitals are in the trenches, dealing with the fall-out of the public health crisis of
racism. These hospitals need more support, and to do so we need to understand the factors
that cause racial disparities. The U.S. Department of Health and Human Services (HHS) report
from May 2021 describes social risk as a key contributing factor to worse health outcomes.
Social risk is a bit of a curveball, as it’s a newer distinction separate but related to social
determinants of health and social needs. Specifically, it encompasses social standing; race,
ethnicity and culture; gender; and community context (Zuckerman et al., 2021). When we are
looking at safety-net hospitals and the populations they serve, we are talking about communities
whose health is exacerbated by social risk. Being within a vulnerable population with higher
social risk may be correlated to physiologic, cultural, and socioeconomic factors all which are
exacerbated by disproportionate exposures to climate stressors as well as limited access to
health care and coverage (Sorensen et al., 2020, p.172).
Within our current federal healthcare funding system, there is really no financial reward for these
safety-net hospitals serving populations at greater social risk, they are not acknowledged or
awarded for the bulk of work they do to serve patients regardless of their financial means or
socioeconomic status (Zuckerman et al., 2021). Even if plans for Medicare to develop equity
measures and attempt to fiscally incentivize them were enacted, unfortunately, a
disproportionate share of hospital payments are completely discretionary by state and leave
many regions of the U.S. underfunded. For instance, Maine gives 97% of its Medicaid money to
its public hospitals, while Tennessee gives 0.7%, although on average states give 14% of
Medicaid allotments to safety-nets (“Medicaid: States’ Use and Distribution of Supplemental
Payments to Hospitals,” 2019). As government bodies slowly churn toward change, it would
make sense to offer additional support and funding based on the percentage of patients served
with elevated social risk, and redistribute that funding from hospitals that do not have high social
risk patients, especially as rapid climate change escalates risk for these institutions.
In the same vein, climate change brings about added risk for adverse health outcomes for
populations as well, and certainly within those more vulnerable and marginalized populations
who are disproportionately affected by climate stressors. Some of these adverse health
outcomes are heat-related disease, respiratory disease, cardiovascular and cerebrovascular
disease, waterborne gastrointestinal disease, vector-borne and zoonotic disease, accidental
and non accidental trauma, and mental health emergencies (Sorensen et al., 2020, p.171). In
addition to these demands on ED resources in the short and long term, natural disasters and
extreme weather disasters will take a toll on not only population health but also hospital
infrastructure. To prepare for these eventualities, safety-net hospitals need funding, preparation
and planning so that they can handle increased volume, mitigate longer wait times, increase
medical and mental health staffing and supply needs, and prepare for potential infrastructure
damages (Sorensen et al., 2020, p.172).
Recently we have seen a massive shift in policy and programming to add racial and social
equity as a priority for health systems. The pandemic was central to such a shift, as we
collectively woke up to embedded structural racism and its results—a significantly higher
COVID-19 mortality rate for people of color. There is a concerted effort to rectify the mistakes of
the past and retool the system such that Medicare embeds solutions to the equity divide within
its programming. These efforts are still in the concept phase. The Centers for Medicare and
Medicaid Services (CMS), which regulate financial incentives and deterrents, is beginning to
reevaluate how safety-net hospitals serve communities with higher social risk and is formulating
ways to financially reward those working to reduce racial disparities in health outcomes in
comparison to those hospitals that serve in primarily more affluent, white areas (Tepper, 2021).
In 2021, along with other government healthcare stakeholders, HHS conducted a report that
outlines the next steps to identify and incorporate equity measures to reduce disparities, still
tying in quality measures but adding a next layer measuring improved care and health outcomes
for those with greater social risk (Zuckerman et al., 2021). The comprehensive in-depth report
investigates eleven equity measurement approaches. The report defined health equity
measurement—evaluating the extent to which the quality of healthcare provided by an
organization improves the care and health of those with greater social risk—and emphasized
the importance of monitoring performance to determine if disparities are indeed improving
(Zuckerman et al., 2021). These nascent plans and programs need to take hold such that
funding streams for safety-net hospitals see reform. Programs like Medicare need to allocate
funds based on the volume of work hospitals do to heal social risk by directly serving large
percentages of vulnerable populations, and states must allocate funding not arbitrarily but
proportionate to social risk served.
In addition to proper funding for safety-net hospitals, there are clinical interventions as well as
system wide approaches that are important to implement at the local level within these
safety-net hospitals, those include health care system access and readiness, quality of care,
protective public health measures (Sorensen et al., 2020, p.171). The US Department of Health
and Human Services created the Sustainable and Climate Resilient Health Care Facilities
Toolkit, to assist hospitals in developing a resilience plan in the face of disasters to decrease
infrastructure damage and continue to provide care (Sorensen et al., 2020, p.173). Clinically,
EDs management can implement climate-sensitive protocol that will affect clinical decisions and
behavioral interventions, as well as take into account time-sensitive education about exposures
that can reduce morbidity and mortality (Sorensen et al., 2020, p.173). Additionally, increased
surveillance activities will help identify and address regional climate hot spots, such as New
York Cities system that tracks heat-related EMS dispatches and ED triage logs to help prepare
for heat related health crises and proactively protect those most vulnerable (Sorensen et al.,
2020, p.174). Another strategy, disaster preparedness, requires stress testing to determine if
the system can cope with patient surges due to unparalleled climate events, teams designed to
handle disaster management would create and update surge protocols frequently (Sorensen et
al., 2020, p.173). Again, all of these climate preparedness strategies are dependent upon
proper funding and resources being allocated to these safety-net hospitals. Vulnerable
populations stand to be disproportionately negatively affected by extreme climate events,
therefore the management and staff in hospitals serving these populations need to be prepared
and federal funding needs to support these hospitals for the work they do bearing the brunt of
these disasters.
References
Ghazali, D.A., Guericolas, M., Thys, F., Sarasin, F., Arcos González, P., Casalino, E. (2018,
May 5). Climate Change Impacts on Disaster and Emergency Medicine Focusing on
Mitigation Disruptive Effects: an International Perspective. Int. J. Environ. Res. Public
Health. https://doi.org/10.3390/ijerph15071379
Kacick, A. (2021, May 25). Urban hospitals tend to cater to white patients, analysis finds.
Modern Healthcare.
https://www.modernhealthcare.com/patient-care/urban-hospitals-tend-cater-white-pati
ents-analysis-finds
Medicaid: States’ Use and Distribution of Supplemental Payments to Hospitals. (2019,
July). U.S. Government Accountability Office (U.S. GAO).
https://www.gao.gov/assets/gao-19-603.pdf
Sorensen, C. J., Salas, R. N., Rublee, C., Hill, K., Bartlett, E. S., Charlton, P., Dyamond, C.,
Fockele, C., Harper, R., Barot, S., Calvello-Hynes, E., Hess, J., & Lemery, J. (2020).
Clinical implications of climate change on US emergency medicine: Challenges and
opportunities. Annals of Emergency Medicine, 76(2), 168-178.
https://doi.org/10.1016/j.annemergmed.2020.03.010
Tepper, N. (2021, November 16). How to pay for equitable outcomes. Modern Healthcare.
https://www.modernhealthcare.com/politics-policy/how-pay-equitable-outcomes
Zuckerman, R., Samson, L., Tarazi, W., Aysola, V., & Adetinji, O. (2021, May). Developing
Health Equity Measures. ASPE | Office of the Assistant Secretary for Planning and
Evaluation.
https://aspe.hhs.gov/sites/default/files/migrated_legacy_files//200651/developing-heal
th-equity-measures.pdf
You were asked to create the initial steps of an Evidence-Based Practice (EBP) project using your chosen topic from Week 3 and the articles your instructor approved in Week 4. After gathering your approved articles, you completed appraisals on a quantitative or qualitative review and systematic review in Week 6.
This week, you will be using your two approved sources to complete your EBP project poster.
Your poster should include:
Explanation of the nursing issue significance with three statements
Description of your position on the issue and three statements on how a nurse can impact this issue
Include only the two approved journal sources used in your Week 6 appraisals to support your position.
After you submit your poster, you will be automatically assigned one peer review. You will review one of your classmate’s posters using the grading rubric. Please fill out the rubric and provide substantive feedback on your classmate’s poster.
View the Getting Started With Peer Reviews page for details on how the peer review process works.
NURS 350
TITLE
Name
How Nurses Can Impact this Issue
You can add some clip
art here – remember not to take images
from anywhere, but clip art (make it
professional) is okay
SIGNIFICANCE
OF THE ISSUE
• Make three bullet points here
from the information you learned
from the articles you used in Week 4
• Be sure to cite the source for
each intervention
• Make it scholarly – what does
the evidence say?
In this section, you will discuss the
issue. This is a good place to get
information from your initial Week 2
paper where you described the
background and the importance to
nursing (APA citation). Make 1-2
sentences about the background and
then the significance in bullet points
POSITION STATEMENT
Significance to Nursing
•
•
•
Most newly graduated nurses
will join the workforce through
a Nurse Residency Program
(APA citation)
Nurse Residency Programs
focus on evidence-based
practice (APA Citation)
Newly graduated nurses will
need to present evidencebased practice in poster
format (APA citation)
DON’T USE “I”
STATEMENTS, JUST
GIVE A SCHOLARLY
EXPLANATION:
NEWLY GRADUATED
NURSES NEED TO BE
ABLE TO USE AND
PRESENT EVIDENCEBASED PRACTICE TO
CARE FOR PATIENTS IN
THE CURRENT
HEALTHCARE
ENVIRONMENT
References
PUT YOUR REFERENCES
HERE – ALL THREE
ARTICLES IN APA
FORMAT – the three you
used in Week 4
NURS 350
Title
DESCRIPTION OF THE
ISSUE
NAME
In this section, you will discuss the issue.
This is a good place to get information
from your initial Week 2 paper where you
described the background and the
importance to nursing (APA citation).
Make 1-2 sentences about the background
and then the significance in bullet points
SIGNIFICANCE TO NURSING
•
•
•
Most newly graduated nurses will
join the workforce through a Nurse
Residency Program (APA citation)
Nurse Residency Programs focus
on evidence-based practice (APA
Citation)
Newly graduated nurses will need to
present evidence-based practice in
poster format (APA citation)
POSITION STATEMENT
DON’T USE “I” STATEMENTS, JUST
GIVE A SCHOLARLY EXPLANATION:
NEWLY GRADUATED NURSES
NEED TO BE ABLE TO USE AND
PRESENT EVIDENCE-BASED
PRACTICE TO CARE FOR PATIENTS
IN THE CURRENT HEALTHCARE
ENVIRONMENT
YOU CAN ADD A DESIGN OR CLIPART
BELOW. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
YOU CAN ADD A DESIGN OR CLIPART
HERE. REMEMBER THAT YOU NEVER
TAKE IMAGES FROM A SOURCE WITHOUT
PERMISSION– ONLY APPROPRIATE
CLIPART
How Nurses Can
Impact this Issue
• Make three bullet points
here from the
information you learned
from the articles you
used in Week 4
• Be sure to cite the
source for each
intervention
• Make it scholarly – what
does the evidence say?
References
PUT YOUR REFERENCES HERE – ALL
THREE ARTICLES IN APA FORMAT
NOTE: You will be writing a paper that I will present. Just make it easy and clear for me to be able to present in 5-10 minutes.
NOTE: I will be submitting a narrative of all my video content to this assessment
For this assessment, you are a presenter! You will create a 5–10-minute video using Kaltura or similar software. In the video:
Propose an evidence-based care plan that you believe will improve the safety and outcomes of the patient in the case study presented in the
Add your thoughts on what more could be done for the patient and what more information may have been needed.
Discuss the ways in which an EBP model and relevant evidence helped you to develop and make decisions about the plan you proposed
Wrap up your video by identifying the benefits of the remote collaboration in the scenario, as well as discuss strategies you found in the literature or best practices that could help mitigate or overcome one or more of the collaboration challenges you observed in the scenario.
Be sure you mention any articles, authors, and other relevant sources of evidence that helped inform your video. Discuss why these sources of evidence are credible and relevant. Important: You are required to submit an APA-formatted reference list of the sources you cited specifically in your video or used to inform your presentation. You are required to submit a narrative of all your video content to this assessment and to SafeAssign.
Make sure that your video addresses the following grading criteria:
Propose your own evidence-based care plan to improve the safety and outcomes for a patient in the provided case study.
Explain the ways in which you used an EBP model to help develop your plan of care for the client.
Reflect on which evidence you found in your search that was most relevant and useful when making decisions regarding your care plan.
Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.
Communicate in a professional manner that is easily audible and uses proper grammar, including a reference list formatted in current APA style.
Your assessment should meet the following requirements:
References: Cite at least three professional or scholarly sources of evidence to support the assertions you make in your video. Include additional properly cited references as necessary to support your statements.
APA reference page: Submit a correctly formatted APA reference page that shows all the sources you used to create and deliver your video. Be sure to format the reference page according to current APA style. Submit a narrative of all of your video content
Unformatted Attachment Preview
Assessment 04 –
Remote Collaboration and Evidence-Based Care
Create a 5-10 minute video of yourself, as a presenter, in which you will propose an
evidence-based plan to improve the outcomes the patient in the provided case study
below, and examine how remote collaboration provided benefits or challenges to
designing and delivering the care.
Before you complete the instructions detailed in the courseroom, first review the case
study below.
INTRODUCTION
Congestive heart failure (CHF) is a serious condition in which the heart doesn’t pump
blood as efficiently as it should. Providing evidence-based care for CHF can be
challenging, especially when care is being provided remotely. In this case study, we will
observe how healthcare professionals collaborate remotely and virtually to provide care
for a patient with CHF.
PATIENT INFORMATION
The patient is a 65-year-old male diagnosed with congestive heart failure. He lives in a
rural area and has limited access to specialized cardiac care. The patient has a history
of hypertension and has been experiencing symptoms such as shortness of breath,
fatigue, and in the legs.
COLLABORATION PROCESS
The patient’s primary care physician, Dr. Johnson, collaborates remotely with a team of
healthcare professionals, including a cardiologist, a nurse, and a pharmacist, to provide
evidence-based care for CHF.
• Dr. Johnson: “Good morning, everyone. Thank you for joining this virtual meeting to
discuss the care of our patient with congestive heart failure. Based on the patient’s
symptoms and medical history, I believe he would benefit from a comprehensive
treatment plan. I would like to hear your input and recommendations.”
• Cardiologist: “Thank you, Dr. Johnson. I have reviewed the patient’s medical records
and echocardiogram results. I agree that the patient has congestive heart failure and
requires a comprehensive treatment plan. I recommend initiating medication therapy,
including ACE inhibitors and diuretics, to manage his symptoms and improve cardiac
function.”
• Nurse: “I have been monitoring the patient’s vital signs remotely and have noticed
fluctuations in blood pressure and weight. I suggest implementing a telemonitoring
system to closely monitor the patient’s condition and provide timely interventions when
necessary. This will help us detect any worsening of symptoms and prevent
hospitalizations.”
• Pharmacist: “I have reviewed the patient’s medication list and potential drug
interactions. It is crucial to ensure that the patient understands the importance of
medication adherence and any potential side effects. I recommend providing education
and counseling to the patient and his family on the proper use of medications and
lifestyle modifications.”
• Dr. Johnson: “Thank you all for your valuable input. I will incorporate your
recommendations into the patient’s treatment plan. Let’s schedule regular virtual followup visits to monitor his progress and make any necessary adjustments to his care.”
Consider additional consultations that might be necessary as you develop your plan of
care for
this patient.
Note: For question 2, you need to add formula and for question 3, you need to draw a diagramsee reading resources attached. And the assignment.
Unformatted Attachment Preview
CLINICAL APPLICATIONS
MEDICALJOSEPH
10.1177/0272989X05275156
BROPHY,
CLINICAL
CHOOSING
MAR–APR
DECISION
APPLICATIONS
A PLATELET
MAKING/MARCH–APRIL
GLYCOPROTEIN IIBIIIA
2005
INHIBITOR
Medical Decision Making with Incomplete
Evidence—Choosing a Platelet
Glycoprotein IIbIIIa Receptor Inhibitor for
Percutaneous Coronary Interventions
James M. Brophy, MD, PhD, FRCP(c), FACC, Lawrence Joseph, PhD
Background. Medical decision making must often be performed despite incomplete evidence. An example is the
choice of a glycoprotein IIb/IIIa (GP2b3a) inhibitor, a class of
potent antiplatelet medications, as adjunctive therapy during percutaneous coronary interventions (PCIs). GP2b3a inhibitor efficacy in reducing adverse outcomes has been well
documented with multiple placebo-controlled randomized
trials, but there is a paucity of comparative data about their
individual equivalency. Substantial cost differentials are also
present between the drugs. Methods. A systematic review of
the literature was performed to identify all randomized
placebo-controlled trials of GP2b3a inhibitors as adjunctive
therapy for PCI. Three complimentary methods were used to
assist in decision making regarding drug equivalency. First,
the data from the single direct comparative trial are analyzed
from a Bayesian perspective. Next, prior information from
other GP2b3a inhibitor trials in similar but not identical patient populations is incorporated. In the 3rd method, indirect
comparisons of GP2b3a inhibitors are carried out using a hierarchical meta-analytic model of the placebo-controlled trials identified by the systematic review. Results. A total of 12
randomized trials were identified involving 3 agents (abcixi-
T
he prevailing paradigm for clinical decision making revolves around evidence-based medicine,
with randomized clinical trials representing the zenith
of experimental comparative designs. When a sufficient number of trials for the treatment of interest have
been run in the target population, this may be appropriate. But what if there are only a few trials, or even just a
single trial? Or what if the trials do not contain head-tohead comparisons of 2 competing treatments, or are
conducted in populations different from that of current
interest? In general, how should we proceed in the absence of unequivocal evidence from sufficient num222 • MEDICAL DECISION MAKING/MAR–APR 2005
mab, eptifibatide, tirofiban), but only 1 involved a direct comparison of 2 drugs (abciximab v. tirofiban). In contradiction to
the original publication, the authors’ Bayesian analysis both
without (method 1) and with (method 2) the inclusion of
some prior information suggests a reasonable probability of
equivalency. The indirect comparisons from all randomized
placebo-controlled trials (method 3) also failed to provide
support for superiority of any agent over the others. Conclusion. Decision making with incomplete evidence is a difficult
but frequently occurring medical dilemma. The authors propose 3 methods that may elucidate the process and illustrate
them in the context of the choice of GP2b3a inhibitor for adjunctive therapy during PCI. Further data may or may not
eventually lead to a different conclusion, but based on the evidence available to date, the authors’ 3 methods suggest clinical equivalency between GP2b3a inhibitors, in contrast to the
initial conclusions from the single comparative randomized
trial. Key words: percutaneous coronary interventions;
platelet glycoprotein IIbIIIa receptor inhibitor; decision making; Bayesian analysis. (Med Decis Making 2005;25:222–228)
bers of concordant clinical trials in the population of
interest? Decisions must still be made. In this article,
we illustrate several techniques that may be useful to
Received 23 April 2004 from the Division of Cardiology, Department of
Medicine, and Department of Epidemiology and Biostatistics, McGill
University, Montréal, Québec. Revision accepted for publication 27
September 2004.
Address correspondence to James M. Brophy, Division of Cardiology,
Royal Victoria Hospital, 687 Pine Avenue West Room R4.12, Montréal,
Québec H2L 4M1, Canada; james.brophy@mcgill.ca.
DOI: 10.1177/0272989X05275156
CHOOSING A PLATELET GLYCOPROTEIN IIBIIIA INHIBITOR
reach reasonable, although possibly tentative, decisions in the face of less than ideal evidence.
Ischemic heart disease remains the leading cause of
patient mortality and morbidity in Western countries.
Percutaneous coronary interventions (PCIs) have become a widely accepted therapy for the symptoms of
ischemic heart disease, with more than 600,000 angioplasties performed annually in the United States.1 PCI
is a generally safe technique with low rates of mortality
and morbidity, but uncontrolled plaque rupture may
expose underlying plaque debris, stimulating platelet
glycoprotein IIb/IIIa receptor (GP2b3a) activation and
resulting in platelet aggregation and thrombosis. This
may mediate the complications associated with interventional procedures, including death and myocardial
infarction (MI). Three GP2b3a inhibitors (abciximab,
eptifibatide, and tirofiban) are commercially available,
and although approved indications as well as individual properties are slightly different, all will suppress
platelet aggregation by at least 80% at therapeutic levels. The majority of PCI procedures are now done under protection of these medications,2 but there has been
only 1 direct comparative randomized trial.3 A narrow
interpretation of “evidence-based medicine” might
base the choice of agent on these results, but existing
practice guidelines have not made specific recommendations as to the choice of drug, perhaps implicitly recognizing the paucity of data. Nevertheless, clinicians
and health care managers must make decisions as to
whether meaningful health benefits exist between the
agents, thereby possibly justifying differences in acquisition costs.
As an illustrative example of decision making with
incomplete evidence and as an extension of previous
work using indirect comparisons to circumvent a lack
of direct comparative trials,4,5 we present several different methods to assess the equivalency of GP2b3a inhibitors as adjunctive therapy for PCI.
of death and MI. After identification of all pertinent information and summarization using a hierarchical
model, we applied the following 3 techniques to assist
in data interpretation and decision making.
METHODS
In method 2, we further develop our Bayesian approach by including information from past trials in the
form of a prior distribution. In particular, we use indirect evidence from placebo-controlled trials of GP2b3a
inhibitor in acute coronary syndrome patients, a similar, but not identical, patient population to the PCI trials. This furnishes separate prior beliefs for the effectiveness of each of the treatments used in these trials
compared to placebo. Taking the difference of the 2
treatment effects (i.e., tirofiban compared to placebo
and abciximab compared to placebo) provides an indirect estimate of the tirofiban to abciximab difference
that is of main interest. A normal distribution is then fit
Literature Review
Following the “Users’ Guides to the Medical Literature,”6 our 1st step, after framing the question, was to
find all available evidence. We performed a systematic
electronic search for all randomized controlled trials of
GP2b3a inhibitors as adjunctive therapy for PCI. Using
PUBMED and the key words randomized controlled
trial, angioplasty, glycoprotein, and inhibition, we
identified 160 articles published up to 31 March 2004.
Trials had to report the meaningful clinical end points
CLINICAL APPLICATIONS
Method 1—Objective Bayesian Analysis
In method 1, an objective Bayesian analysis, the data
from the only comparative trial are examined from a
Bayesian perspective, but without incorporating any of
the information available outside of this single trial.
Standard statistical analyses of randomized clinical trials, including the original analysis reported for this
trial,3 fail to provide a direct estimate of the probability
of treatment superiority, the probability that a clinically meaningful difference exists, or the probability of
clinical equivalence, for any given clinical cutpoint. A
Bayesian analysis, whether or not formally incorporating prior beliefs based on previous trials or other evidence, permits the calculation of these important and
highly clinically relevant probabilities, allowing for
more lucid decision making. In this 1st analysis, we assumed a noninformative prior so that the final probabilities are determined almost exclusively from the observed data of the comparative trial. We used a simple
beta-binomial model. As the sample size in the trial
was large, a Haldane or beta(0,0) prior distribution was
used for the 2 probabilities of interest, that is, the probability of a clinical event (death or nonfatal MI at 30 d)
with either drug, and a binomial likelihood represented the information contained in the observed comparative data. Probability differences were derived by
forming the difference between the 2 beta posterior
densities, and probabilities of clinical interest were
calculated as areas under the curve of this density.7
Method 2—Bayesian Analysis
Incorporating Prior Information
223
BROPHY, JOSEPH
to this estimate, which forms our prior distribution.
These prior beliefs are then updated by the direct comparative data from the direct comparative (TARGET)
trial3 via normal distribution updating, approximating
the binomial likelihood function with a normal density. Because the sample sizes for all of these trials are
quite large, normal approximations fit very well. With
smaller trials, exact methods can be used.7 Because the
prior information is derived from indirect evidence
and on a population not identical to that in the target
trial, one can argue that the prior evidence should be
discounted. At 1 extreme, one would completely discount all previous studies, leading to an analysis identical to the objective Bayesian approach (method 1) described above. At the other extreme, there would be no
discounting. We performed a sensitivity analysis
whereby the degree of discounting of the prior information from the indirect studies is varied, leading to a
range of posterior distributions from which probabilities could be calculated.
Method 3—Indirect Comparisons via
Hierarchical Bayesian Meta-Analysis
In the 3rd method, we again perform an indirect
comparison in which GP2b3a inhibitors are compared
from the systematic review of the placebo-controlled
trials using a Bayesian hierarchical meta-analytic
model.8 At the 1st level, each subject in each arm of
each trial is assumed to follow a binomial distribution,
with separate probabilities of events for each arm of
each trial. At the 2nd level, logarithms of the odds ratios among each study are assumed to follow a normal
distribution. Separate meta-analytic models are run for
all trials of abciximab versus placebo, and for the trials
of eptifibatide or tirofiban versus placebo, so that the
end result of the meta-analyses is 3 posterior distributions, each summarizing the effect of drug versus placebo in all available trials. Taking the ratio of these posterior distributions then produces a ratio of these odds
ratios. Values larger than 1 indicate superiority of
abciximab compared to eptifibatide or tirofiban.
RESULTS
Available Evidence
The systematic literature search found 11 randomized placebo-controlled trials of GP2b3a inhibitors as
adjunctive therapy to PCI, 8 with abciximab,9–16 2 with
eptifibatide,17,18 and 1 with tirofiban.19 Despite the
high-risk populations studied in these 11 trials, death
224 • MEDICAL DECISION MAKING/MAR–APR 2005
rates have been remarkably low for both those receiving GP2b3a drugs (93 deaths in 10,421 patients, 0.9%)
and placebo (103 deaths in 8124 patients, 1.3%). Comparing death rates in GP2b3a drugs to placebo results in
a wide confidence interval for the odds ratio (OR 0.761,
95% CI [0.546, 1.07]), indicating an inconclusive result. Although not including any head-to-head comparisons of the 3 drugs under consideration here, these
trials are of high quality with little evidence of selection, performance, or attribution biases. Therefore, indirect comparisons can be formed,20 as described in
method 3 above.
The systematic literature search identified only 1
head-to-head double-blinded randomized trial comparing 2 GP2b3a inhibitors in the setting of modern PCI
with coronary stenting.3 This TARGET trial was designed to demonstrate the noninferiority of tirofiban as
compared with abciximab. The end point (composite
of death or nonfatal MI at 30 d) occurred more frequently among the 2398 patients in the tirofiban group
than among the 2411 patients in the abciximab group
(7.2% v. 5.7%; hazard ratio [HR] 1.26; 1-sided 95% CI
1.51) and consequently failed to meet the prespecified
limit for noninferiority of tirofiban. The equivalency
requirement was an upper bound of the 95% CI of the
hazard ratio for the comparison of tirofiban with
abciximab 1. By Bayes’s
law,
P(a) P(b | a) / P(b) = P(a | b) ;
so,
P(a) = P(b) P(b | a)/ P(b | a) = .5 * .7 / .3 =
.35 / .3).
Needless to say, in a system with a lot of
such numbers, making sure they are consistent
can be a problem, and one system (PROSPECTOR)
had to implement special-purpose techniques
to handle such inconsistencies (Duda, Hart,
and Nilsson 1976). Therefore, it is a nice
property of the Bayesian networks that if you
specify the required numbers (the probability
of every node given all possible combinations
of its parents), then (1) the numbers will be
consistent and (2) the network will uniquely
define a distribution. Furthermore, it is not
too hard to see that this claim is true. To see
it, we must first introduce the notion of joint
distribution.
A joint distribution of a set of random variables v1 … vn is defined as P(v1 … vn ) for all
values of v 1 … v n . That is, for the set of
Boolean variables (a,b), we need the probabilities P(a b), P(¬ a b), P(a ¬ b), and P(¬ a ¬ b). A
joint distribution for a set of random variables gives all the information there is about
the distribution. For example, suppose we
had the just-mentioned joint distribution for
(a,b), and we wanted to compute, say, P(a | b):
P(a | b) = P(a b) / P(b) = P(a b) / (P(a b) +
P(¬ a b) .
family-out
light-on
3
1
bowel-problem
dog-out
4
hear-bark
5
2
Figure 5. A Topological Ordering.
In this case, I made it a simple top-down numbering.
Note that for n Boolean variables, the joint
distribution contains 2n values. However, the
sum of all the joint probabilities must be 1
because the probability of all possible outcomes must be 1. Thus, to specify the joint
distribution, one needs to specify 2n -1 numbers, thus the 2n -1 in the last section.
I now show that the joint distribution for a
Bayesian network is uniquely defined by the
product of the individual distributions for
each random variable. That is, for the network in figure 2 and for any combination of
values fo, bp, lo, hb (for example, t, f, f, t, t),
the joint probability is
P(fo bp lo do hb) = P(fo)P(bp)P(lo | fo)P(do | fo
bp)P(hb | do) .
Consider a network N consisting of variables v1 … vn. Now, an easily proven law of
probability is that
P(v1 … vn) = P(v1)P(v2 | v1) … P(vn | v1 … vn-1).
This equation is true for any set of random
variables. We use the equation to factor our
joint distribution into the component parts
specified on the right-hand side of the equation. Exactly how a particular joint distribution
is factored according to this equation depends
on how we order the random variables, that
is, which variable we make v1, v2, and so on.
For the proof, I use what is called a topological
sort on the random variables. This sort is an
ordering of the variables such that every variable comes before all its descendants in the
graph. Let us assume that v1 … vn is such an
ordering. In figure 5, I show one such ordering for figure 1.
Let us consider one of the terms in this
product, P(vj | vj – 1). An illustration of what
nodes v 1 … v j might look like is given in
figure 6. In this graph, I show the nodes
immediately above vj and otherwise ignore
everything except vc, which we are concenWINTER 1991
55
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…the most
important
constraint…is
…that…this
computation
is NP-hard…
a
vc
vj – 2
vj – 1
e
vj
vm
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c
b
d
Figure 6. Node vj in a Network.
Figure 7. Nodes in a Singly Connected Network.
I show that when conditioning vj only on its successors,
its value is dependent only on its immediate successors,
vj – 1 and vj – 2.
Because of the singly connected property, any two nodes
connected to node e have only one path between them—
the path that goes through e.
trating on and which connects with vj in two
different ways that we call the left and right
paths, respectively. We can see from figure 6
that none of the conditioning nodes (the nodes
being conditioned on in the conditional
probability) in P(vj | v1 … vj – 1) is below vj (in
particular, v m is not a conditioning node).
This condition holds because of the way in
which we did the numbering.
Next, we want to show that all and only
the parents of vj need be in the conditioning
portion of this term in the factorization. To
see that this is true, suppose vc is not immediately above vj but comes before vj in the numbering. Then any path between vc and vj must
either be blocked by the nodes just above vj
(as is the right path from vc in figure 6) or go
through a node lower than vj (as is the left
path in figure 6). In this latter case, the path
is not d-connecting because it goes through a
converging node vm where neither it nor any
of its descendants is part of the conditioning
nodes (because of the way we numbered).
Thus, no path from vc to vj can be d-connecting, and we can eliminate vc from the conditioning section because by the independence
assumptions in Bayesian networks, vj is independent of vc given the other conditioning
nodes. In this fashion, we can remove all the
nodes from the conditioning case for P(vj | v1
… vj – 1) except those immediately above vj .
In figure 6, this reduction would leave us
with P(vj | vj – 1 vj – 2). We can do this for all
the nodes in the product. Thus, for figure 2,
we get
P(fo bp lo do hb) = P(fo)P(bp)P(lo | fo)P(do | fo
bp)P(hb | do) .
We have shown that the numbers specified
by the Bayesian network formalism in fact
define a single joint distribution, thus
uniqueness. Furthermore, if the numbers for
each local distribution are consistent, then
the global distribution is consistent. (Local
consistency is just a matter of having the
right numbers sum to 1.)
Evaluating Networks
As I already noted, the basic computation on
belief networks is the computation of every
node’s belief (its conditional probability)
given the evidence that has been observed so
far. Probably the most important constraint
on the use of Bayesian networks is the fact
that in general, this computation is NP-hard
(Cooper 1987). Furthermore, the exponential
time limitation can and does show up on
realistic networks that people actually want
solved. Depending on the particulars of the
network, the algorithm used, and the care
taken in the implementation, networks as
small as tens of nodes can take too long, or
networks in the thousands of nodes can be
done in acceptable time.
The first issue is whether one wants an
Articles
Bayesian networks have been extended to handle
decision theory.
exact solution (which is NP-hard) or if one
can make do with an approximate answer
(that is, the answer one gets is not exact but
with high probability is within some small
distance of the correct answer). I start with
algorithms for finding exact solutions.
Exact Solutions
Although evaluating Bayesian networks is, in
general, NP-hard, there is a restricted class of
networks that can efficiently be solved in
time linear in the number of nodes. The class
is that of singly connected networks. A singly
connected network (also called a polytree) is one
in which the underlying undirected graph has
no more than one path between any two
nodes. (The underlying undirected graph is
the graph one gets if one simply ignores the
directions on the edges.) Thus, for example,
the Bayesian network in figure 5 is singly connected, but the network in figure 6 is not.
Note that the direction of the arrows does not
matter. The left path from vc to vj requires one
to go against the direction of the arrow from
vm to vj. Nevertheless, it counts as a path from
vm to vj.
The algorithm for solving singly connected
Bayesian networks is complicated, so I do not
give it here. However, it is not hard to see
why the singly connected case is so much
easier. Suppose we have the case sketchily
illustrated in figure 7 in which we want to
know the probability of e given particular
values for a, b, c, and d. We specify that a and
b are above e in the sense that the last step in
going from them to e takes us along an arrow
pointing down into e. Similarly, we assume c
and d are below e in the same sense. Nothing
in what we say depends on exactly how a and
b are above e or how d and c are below. A
little examination of what follows shows that
we could have any two sets of evidence (possibly empty) being above and below e rather
than the sets {a b} and {c d}. We have just
been particular to save a bit on notation.
What does matter is that there is only one
way to get from any of these nodes to e and
that the only way to get from any of the
nodes a, b, c, d to any of the others (for exam-
ple, from b to d) is through e. This claim follows from the fact that the network is singly
connected. Given the singly connected condition, we show that it is possible to break up
the problem of determining P(e | a b c d) into
two simpler problems involving the network
from e up and the network from e down.
First, from Bayes’s rule,
P(e | a b c d) = P(e) P(a b c d | e) / P(a b c d) .
Taking the second term in the numerator, we
can break it up using conditioning:
P(e | a b c d) = P(e) P(a b | e) P(c d | a b e) /
P(a b c d) .
Next, note that P(c d | a b e) = P(c d | e )
because e separates a and b from c and d (by
the singly connected condition). Substituting
this term for the last term in the numerator
and conditioning the denominator on a, b,
we get
P(e | a b c d) = P(e) P(a b | e) P(c d | e) / P(a b)
P(c d | a b) .
Next, we rearrange the terms to get
P(e | a b c d) = (P(e) P(a b | e) / P(a b)) (P(c d |
e) (P(c d | a b)) .
Apply Bayes’s rule in reverse to the first collection of terms, and we get
P(e | a b c d) = (P(e | a b ) P(c d | e)) (1 / P(c d |
a b)) .
We have now done what we set out to do.
The first term only involves the material from
e up and the second from e down. The last
term involves both, but it need not be calculated. Rather, we solve this equation for all
values of e (just true and false if e is Boolean).
The last term remains the same, so we can
calculate it by making sure that the probabilities for all the values of E sum to 1. Naturally,
to make this sketch into a real algorithm for
finding conditional probabilities for polytree
Bayesian networks, we need to show how to
calculate P(e | a b) and P(c d | e), but the ease
with which we divided the problem into two
distinct parts should serve to indicate that
these calculations can efficiently be done. For
a complete description of the algorithm, see
Pearl (1988) or Neapolitan (1990).
Now, at several points in the previous discussion, we made use of the fact that the network was singly connected, so the same
argument does not work for the general case.
WINTER 1991
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a
a
c
b
b c
d
d
Figure 8. A Multiply Connected Network.
Figure 9. A Clustered, Multiply
Connected Network.
There are two paths between node a and node d.
By clustering nodes b and c, we turned the graph of
figure 8 into a singly connected network.
However, exactly what is it that makes multiply connected networks hard? At first glance,
it might seem that any belief network ought
to be easy to evaluate. We get some evidence.
Assume it is the value of a particular node. (If
it is the values of several nodes, we just take
one at a time, reevaluating the network as we
consider each extra fact in turn.) It seems that
we located at every node all the information
we need to decide on its probability. That is,
once we know the probability of its neighbors, we can determine its probability. (In
fact, all we really need is the probability of its
parents.)
These claims are correct but misleading. In
singly connected networks, a change in one
neighbor of e cannot change another neighbor of e except by going through e itself. This
is because of the single-connection condition.
Once we allow multiple connections between
nodes, calculations are not as easy. Consider
figure 8. Suppose we learn that node d has
the value true, and we want to know the conditional probabilities at node c. In this network, the change at d will affect c in more
than one way. Not only does c have to
account for the direct change in d but also
the change in a that will be caused by d
through b. Unlike before, these changes do
not separate cleanly.
To evaluate multiply connected networks
exactly, one has to turn the network into an
equivalent singly connected one. There are a
few ways to perform this task. The most
common ways are variations on a technique
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called clustering. In clustering, one combines
nodes until the resulting graph is singly connected. Thus, to turn figure 8 into a singly
connected network, one can combine nodes
b and c. The resulting graph is shown in
figure 9. Note now that the node {b c} has as
its values the cross-product of the values of b
and c singly. There are well-understood techniques for producing the necessary local
probabilities for the clustered network. Then
one evaluates the network using the singly
connected algorithm. The values for the variables from the original network can then be
read off those of the clustered network. (For
example, the values of b and c can easily be
calculated from the values for {b c}.) At the
moment, a variant of this technique proposed by Lauritzen and Spiegelhalter (1988)
and improved by Jensen (1989) is the fastest
exact algorithm for most applications. The
problem, of course, is that the nodes one
creates might have large numbers of values.
A node that was the combination of 10
Boolean-valued nodes would have 1024
values. For dense networks, this explosion
of values and worse can happen. Thus, one
often considers settling for approximations
of the exact value. We turn to this area next.
Approximate Solutions
There are a lot of ways to find approximations of the conditional probabilities in a
Bayesian network. Which way is the best
depends on the exact nature of the network.
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However, many of the algorithms have a lot
in common. Essentially, they randomly posit
values for some of the nodes and then use
them to pick values for the other nodes. One
then keeps statistics on the values that the
nodes take, and these statistics give the
answer. To take a particularly clear case, the
technique called logic sampling (Henrion
1988) guesses the values of the root nodes in
accordance with their prior probabilities.
Thus, if v is a root node, and P(v) = .2, one
randomly chooses a value for this node but in
such a way that it is true about 20 percent of
the time. One then works one’s way down the
network, guessing the value of the next lower
node on the basis of the values of the higher
nodes. Thus, if, say, the nodes a and b, which
are above c, have been assigned true and
false, respectively, and P(c | ¬ b) = .8, then we
pick a random number between 0 and 1, and
if it is less than .8, we assign c to true, otherwise, false. We do this procedure all the way
down and track how often each of our nodes
is assigned to each of its values. Note that, as
described, this procedure does not take evidence nodes into account. This problem can
be fixed, and there are variations that improve
it for such cases (Shacter and Peot 1989; Shwe
and Cooper 1990). There are also different
approximation techniques (see Horvitz, Suermondt, and Cooper [1989]). At the moment,
however, there does not seem to be a single
technique, either approximate or exact, that
works well for all kinds of networks. (It is
interesting that for the exact algorithms, the
feature of the network that determines performance is the topology, but for the approximation algorithms, it is the quantities.) Given
the NP-hard result, it is unlikely that we will
ever get an exact algorithm that works well
for all kinds of Bayesian networks. It might be
possible to find an approximation scheme
that works well for everything, but it might
be that in the end, we will simply have a
library of algorithms, and researchers will
have to choose the one that best suits their
problem.
Finally, I should mention that for those
who have Bayesian networks to evaluate but
do not care to implement the algorithms
themselves, at least two software packages are
around that implement some of the algorithms I mentioned: IDEAL (Srinivas and Breese
1989, 1990) and HUGIN (Andersen 1989).
Applications
As I stated in the introduction, Bayesian networks are now being used in a variety of
applications. As one would expect, the most
?
Figure 10. Map Learning.
Finding the north-south corridor makes it more likely that there is an intersection
north of the robot’s current location.
common is diagnosis problems, particularly,
medical diagnosis. A current example of
the use of Bayesian networks in this area is
PATHFINDER (Heckerman 1990), a program to
diagnose diseases of the lymph node. A
patient suspected of having a lymph node
disease has a lymph node removed and examined by a pathologist. The pathologist examines it under a microscope, and the information
gained thereby, possibly together with other
tests on the node, leads to a diagnosis.
PATHFINDER allows a physician to enter the
information and get the conditional probabilities of the diseases given the evidence so far.
PATHFINDER also uses decision theory. Decision theory is a close cousin of probability
theory in which one also specifies the desirability of various outcomes (their utility) and
the costs of various actions that might be performed to affect the outcomes. The idea is to
find the action (or plan) that maximizes the
expected utility minus costs. Bayesian networks have been extended to handle decision
theory. A Bayesian network that incorporates
decision nodes (nodes indicating actions that
can be performed) and value nodes (nodes
indicating the values of various outcomes) is
WINTER 1991
59
Articles
eat out
straw-drinking
order
milk-shake
“order”
“milk-shake”
drink-straw
animal-straw
“straw”
Figure 11. Bayesian Network for a Simple Story.
Connecting “straw” to the earlier context makes the drink-straw reading more likely.
called an influence diagram, a concept invented by Howard (Howard and Matheson 1981).
In PATHFINDER , decision theory is used to
choose the next test to be performed when the
current tests are not sufficient to make a diagnosis. PATHFINDER has the ability to make treatment decisions as well but is not used for this
purpose because the decisions seem to be sensitive to details of the utilities. (For example,
how much treatment pain would you tolerate
to decrease the risk of death by a certain
percentage?)
PATHFINDER’s model of lymph node diseases
includes 60 diseases and over 130 features
that can be observed to make the diagnosis.
Many of the features have more than 2 possible outcomes (that is, they are not binary
valued). (Nonbinary values are common for
laboratory tests with real-number results. One
could conceivably have the possible values of
the random variable be the real numbers, but
typically to keep the number of values finite,
one breaks the values into significant regions.
I gave an example of this early on with earthquake, where we divided the Richter scale for
earthquake intensities into 5 regions.) Various
versions of the program have been implemented (the current one is PATHFINDER-4), and the
use of Bayesian networks and decision theory
has proven better than (1) MYCIN-style certainty
factors (Shortliffe 1976), (2) Dempster-Shafer
theory of belief (Shafer 1976), and (3) simpler
Bayesian models (ones with less realistic independence assumptions). Indeed, the program
has achieved expert-level performance and
has been implemented commercially.
60
AI MAGAZINE
Bayesian networks are being used in less
obvious applications as well. At Brown University, there are two such applications: map
learning (the work of Ken Basye and Tom
Dean) and story unders
Week 3 Assignment – Health Care Law and Violation Analysis
Due: Mon Oct 23, 2023 9:00amDue: Mon Oct 23, 2023 9:00amUngraded, 105 Possible Points105 Possible Points
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Details
Overview
The field of health law is experiencing significant change. This change presents administrators with numerous legal challenges related to electronic health records (EHRs), outcome-based payments, mergers, fraud, insurance disbursements, antitrust laws, as well as the ethical and privacy implications of disruptive medical innovations in biotechnology and treatment research.
To be a proficient health care administrator, it is crucial to possess a thorough understanding of key health care laws, including:
Stark LawLinks to an external site..
HIPAA for ProfessionalsLinks to an external site..
HITECH Act Enforcement Interim Final RuleLinks to an external site..
Emergency Medical Treatment & Labor Act (EMTALA)Links to an external site..
A Roadmap for New Physicians: Fraud & Abuse Laws; Anti-Kickback StatuteLinks to an external site..
The Genetic Information Nondiscrimination Act of 2008Links to an external site..
The primary objective of this assignment is to provide a clear and comprehensive analysis of a health care law and a court case while offering practical recommendations to organizational leadership.
Scenario
In this assignment, you will take on the role of an administrator in a hospital or health care organization who is being considered for a promotion. To improve your chances for promotion, you are encouraged to prepare a report for senior leadership that demonstrates your knowledge and interpretation of one of the health care laws mentioned above and to examine a violation of that law.
Preparation
Choose one of the health care laws listed above and research a court case where a violation of that law occurred.
Instructions
Prepare a 5-page report in which you:
Analyze the chosen health care law using the SESC formula (State, Explain, Support, and Conclude), considering its effects on the health care system, stakeholders, and delivery of services. In your analysis, evaluate the practical, legal, ethical, financial, and operational implications resulting from the law’s implementation.
Analyze the selected court case where the health care law was violated using the SESC formula.
Examine the steps that organizational leadership in the chosen court case could take to proactively prevent future violations of the health care law.
Cite at least 3 peer-reviewed articles less than 5 years old to support your analysis, including in-text citations. Use proper SWS formatting.
Meet clarity, writing mechanics, and SWS formatting requirements.
Formatting Requirements
Subheadings: Use bold subheadings to divide the report into sections that correspond to the areas listed in the instructions.
Length: Ensure that your report consists of a minimum of 5 pages, plus a title page and sources page, making the total length of the report approximately 7-8 pages.
Citations: This course requires the use of Strayer Writing Standards (SWS). The library is your home for SWS assistance, including citations and formatting. Please refer to the Library site for all support. Check with your professor for any additional instructions.
The specific course learning outcome associated with this assignment is:
Assess legal situations involving patients, providers, and health care personnel, using case or statutory law to guide leaders’ decision-making.
View Rubric
Week 3 Assignment – Health Care Law and Violation Analysis
Week 3 Assignment – Health Care Law and Violation Analysis
Criteria Ratings Pts
Analyze the chosen health care law using the SESC formula (State, Explain, Support, and Conclude), considering its effects on the health care system, stakeholders, and delivery of services.
view longer description
31.5 to >28.35 pts
Exemplary
Analyzed the chosen health care law using the SESC formula, considering its effects on the health care system, stakeholders, and delivery of services.
28.35 to >25.2 pts
Competent
Analyzed the chosen health care law using the SESC formula, considering its effects on one or two of the following – the health care system, stakeholders, or delivery of services.
25.2 to >22.05 pts
Needs Improvement
Analyzed the chosen health care law, but did not use the SESC formula.
22.05 to >0 pts
Unacceptable
Did not analyze the chosen health care law.
/ 31.5 pts
Analyze the selected court case where the health care law was violated using the SESC formula.
view longer description
31.5 to >28.35 pts
Exemplary
Analyzed the selected court case where the health care law was violated using the SESC formula.
28.35 to >25.2 pts
Competent
Analyzed the selected court case where the health care law was violated but did not use the SESC formula.
25.2 to >22.05 pts
Needs Improvement
Described but did not analyze the selected court case where the health care law was violated.
22.05 to >0 pts
Unacceptable
Did not describe the selected court case.
/ 31.5 pts
Examine the steps that organizational leadership in the chosen court case could take to proactively prevent future violations of the health care law.
view longer description
26.25 to >23.62 pts
Exemplary
Examined the steps that organizational leadership in the chosen court case could take to proactively prevent future violations of the health care law.
23.62 to >21 pts
Competent
Examined steps that organizational leadership in the chosen court case could take to prevent future violations of the health care law, but did not emphasize proactive measures.
21 to >18.37 pts
Needs Improvement
Described but did not examine steps the organizational leadership in the chosen court case could take to prevent future violations of the health care law.
18.37 to >0 pts
Unacceptable
Did not describe steps the organizational leadership in the chosen court case could take to prevent future violations of the health care law.
/ 26.25 pts
Cite at least three peer-reviewed articles less than five years old to support your analysis, including in-text citations.
view longer description
10.5 to >9.45 pts
Exemplary
Cited at least three peer-reviewed articles less than five years old to support the analysis, including in-text citations.
9.45 to >8.4 pts
Competent
Cited at least three peer-reviewed articles to support the analysis, including in-text citations.
8.4 to >7.35 pts
Needs Improvement
Cited at least three articles to support the analysis.
7.35 to >0 pts
Unacceptable
Did not cite at least three articles.
/ 10.5 pts
Meet clarity, writing mechanics, and SWS formatting requirements.
view longer description
5.25 to >4.72 pts
Exemplary
Met clarity, writing mechanics, and SWS formatting requirements.
4.72 to >4.2 pts
Competent
Met writing mechanics and SWS formatting requirements, but the content is unclear or disorganized.
4.2 to >3.67 pts
Needs Improvement
Met writing mechanics requirements, but the content is unclear or disorganized and does not follow SWS formatting.
3.67 to >0 pts
Unacceptable
Did not meet clarity, writing mechanics, nor SWS formatting requirements.
/ 5.25 pts
Total Points: 0
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This assignment will provide the opportunity for students to explore and identify issues to anticipate during the transition from nursing
student to a nurse in today’s complex healthcare environment.
Assignment Criteria:
Develop a scholarly paper that addresses the following criteria:
1. Describe the various roles of a new graduate nurse in today’s complex healthcare environment.
2. Identify the skills, knowledge and attitudes nursing leaders desire in new nurses.
3. Describe a personal communication with a nurse leader regarding what skills, knowledge and/or attitudes new nurses are
lacking based upon the leader’s experience with new nurses.
4. Explain the issues and challenges faced by new nurses upon entering the workforce.
5. Discuss methods / strategies to assist new nurses in transitioning into the nursing profession.
6. Provide examples from scholarly sources to support the above criteria.
7. The scholarly paper should be in narrative format, 3 to 5 pages excluding the title and reference page.
8. Include an introductory paragraph, purpose statement, and a conclusion.
9. Include level 1 and 2 headings to organize the paper.
10. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: I, we,
you, me, our may not be used. In addition, describing yourself as the researcher or the author should not be used
11. Include a minimum of 3 professional peer-reviewed scholarly journal references to support the paper (review in Ulrich
Periodical Directory) and be less than five (5) years old.
12. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations).
13. Submit the assignment to Turnitin prior to the final submission, review the originality report, and make any needed changes
14. Submit by the posted due date
Try to remember a situation in your own life that involved unnecessary change. Why do you think that the change was unnecessary? What types of turmoil did it cause? Were there things a change agent could have done that would have increased unfreezing in this situation? Make sure to repost the question you selected at the top of your posting. A brief introductory paragraph introduces the topic of the discussion. One or more succinct paragraphs are needed to answer each of the discussion board questions. Use current literature (5 years old or less) to support your views. Be sparing in your use of quotes. Learn to paraphrase the information you are sharing from a source. A paragraph at the end gives a brief summary of the discussion. The initial posting for each topic should be a minimum of 500 words in length (not including the references).Use APA formatting, 12-point type font, double spacing, indenting of each paragraph, and proper spelling and grammar. You do not need a title page or a separate “References” sheet, but a “References” section should be included at the end of your posting if you cite sources..
1 – start to Write a paragraphs content of 300 words about Important of networking with reference in APA style . 2- Identify at least two academic and at least two professional individuals or teams to collaborate with to be successful in the MSN program and as a practicing nurse 3- Explain why these individuals and/or teams were selected and how they will support success in the MSN program and as a practicing nurse. 4- Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in- text citations, and reference lists. see upload file for rubric
Intrinsic v Extrinsic Motivation and Sport Enjoyment in College Sports
Amazing Students,
For this discussion, I want you all to do the following:
1. Watch this Ted Talk video on Diana Nyad and her experience swimming from Cuba to Key West
2. If we were to survey college-level athletes on campus, what percentage would you say are intrinsically motivated versus extrinsically motivated?
3. In the same survey, if we were to ask how many students ENJOY competing in their sport, what percentage do you think would say Yes? No? Somewhere in between?
4. How do you think understanding motivation and fufillment in a sport impacts YOUR ability to train/re-train skills for your clients in your chosen profession?
I will not assign a word count for this (don’t make me regret that decision please) but I do ask that you use your critical thinking skills for these questions and respond to at least two of your classmates posts. Feel free to share articles, videos and/or personal experiences to support your responses to the questions.
I need my post and also 2 replies from my classmates, I’m gonna put the 2 to posts down below.
Blog 1 by Ethan Cook-Williams
1. If we were to do a study on college-level athletes i would say that most are extrinsically motivated because of the pressures that they face and they are basically pushed to do the best so that they continue playing, even though this aspect is a little unfair you do have to be motivated regardless if sports is something you want to take seiously like that.
2. I think if were to ask these players if they enjoy playing the spport we would get a 50/50 or somewhere in between. This is because alot of the love gets lost for the sport once you realize tyou have to do everything their way or it becomes alot more serious to people(coaches) and they take out the fun of the sport all together.
3. I think motivation plays the biggest role in training/ re-training skills, because if you arent motivated to doing it why are you doing it in the first place? you should at least have some sort of positive feelings about what you are doing in your life and should never feel as if you are just doing it to do it. This goes with every aspect in life.
Blog 2 by Taylor Jones
1. The TED talk on Diana Nyad was very motivational and a prime example of intrinsic motivation. She strives to achieve this goal to prove to herself that no matter what she puts her mind to she is going to get it. She also did this without getting anything in return which proves she is intrinsically motivated.
2. If I were to survey college-level athletes on campus, I would say most of the population is intrinsically motivated. There would be a very high percentage of athletes who are intrinsically motivated over those who are extrinsically motivated athletes. If I had to give an estimated percentage, I would say about 80% of college-level athletes are intrinsically motivated. I say this because it is very challenging to make it to the college level, so you really have to have a desire and want to get there. Those who go to play sports in college just to get their school paid for are examples of extrinsically motivated people. Many individuals may have the talent and feel the need to play college-level sports because they were told to do so. However, for the most part, I believe that most college-level athletes are intrinsically motivated. I also believe this because of my own personal experience.
3. I would say there is also a higher percentage of individuals who enjoy their sport over the ones who do not. As I said in the question above, it is very difficult to make it to the college level. You have to have a want and desire to get there and for the most part, I believe most athletes have that. Athletes may get tired of doing the same thing all the time, but at the end of the day, they enjoy what they do.
4. Understanding motivation and fulfillment in sports will help you pass it on to your clients. When clients see your motivation and desire it gives them that same drive to better themselves as well.
NO NEW CONTENT for WEEK 9! final project.
Homepage – Fa23 ECED 1240-22 Planning & Implementing Curriculum (minnstate.edu)
username- te0077ed, password- January.
Hide Assignment Information
Instructions
Assignment 2: Submit the Interactions & Expectations PPE Worksheet by answering the questions according to the course content videos with 3 ideas/points listed for each. Where it says “describe,” use complete sentences. Where it says “list” sentences are not needed.
Grading: [13 points] details on worksheet.
Please double-check that you have submitted the correct, completed document, as I can not accept assignments after the close date. I recommend saving your document with the word “DONE” at the end so you choose the correct one for sure!
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Assignment 2: Submit the Interactions & Expectations PPE Worksheet by answering the questions according to the course content videos with 3 ideas/points listed for each. Where it says “describe,” use complete sentences. Where it says “list” sentences are not needed.
Grading: [13 points] details on worksheet.
Please double-check that you have submitted the correct, completed document, as I can not accept assignments after the close date. I recommend saving your document with the word “DONE” at the end so you choose the correct one for sure!
Unformatted Attachment Preview
Interactions & Expectations Module PPE Worksheet, ECED 1240 SCTCC, Kerry Youso
Dysregulation Emotions Behavior Regulation
Fight Flight Shut Down Helpful Unhelpful
Your answers must come from the content videos. Grading: 13 points (1/2 pt. each answer)
1. Describe: What is emotional dysregulation? [1 pts]
2. List 3 toddler/preschooler behaviors you might see with a “fight” response? [1.5 pts]
3. List 3 toddler/preschooler behaviors you might see with a “flight” response. [1.5 pts]
Interactions & Expectations Module PPE Worksheet, ECED 1240 SCTCC, Kerry Youso
4. List 3 toddler/preschooler behaviors you might see in a “shut down” response. [1.5 pts]
5. List 3 examples of what could happen in the body when dysregulated. [1.5 pts]
6. Describe 3 things a teacher might DO to help emotional regulation. [1.5 pts]
Interactions & Expectations Module PPE Worksheet, ECED 1240 SCTCC, Kerry Youso
7. Describe 3 things a teacher might SAY to help emotional regulation. [1.5 pts]
8. Describe 3 objects a teacher might USE to help emotional regulation. [1.5 pts]
9. List 3 things teachers should AVOID & not helpful to a dysregulated child. [1.5 pts]
Reflect on the work you have accomplished throughout the course on your final project. This would be a good time to review the Final Project Guidelines and Rubric PDF one more time, paying particularly close attention to the “Exemplary” column of the rubric. Answer the following questions in your journal reflection:
Reconsider the audience you identified in Module Two. Remember that this audience should have the ability to help effect necessary change in regard to your topic. Do you believe that your identified audience needs to be adjusted? Explain the rationale for this audience.
Review and discuss the feedback you have received throughout the course. Do you have questions regarding the feedback? Do you feel comfortable incorporating the feedback into your final paper?
Discuss your research. Are there any gaps? Do you need to do additional research to round out and finalize your paper? If so, explain what you still need.
Review the Final Project Guidelines and Rubric document. Have you addressed all critical elements of Sections I and II? Does your paper meet the details described in the rubric? Briefly explain your rationale.
A GLIMPSE BELOW OF ONE OF THE MILESTONES
Health Issue Analysis
Best Practices
The obesity prevention strategies are twofold: interdisciplinary and interprofessional approach and family-centered intervention. The interdisciplinary and interprofessional approach requires collaboration among the health care provider with the community on aspects related to nutrition and healthy lifestyle intervention. In this approach, care providers are also required to take a proactive role in the dissemination of nutritious knowledge within the community (Zhao et al., 2013). Meanwhile, the family-centered approach is based on its efficacy in reducing and preventing excess weight gain in adolescents and children (Smith et al., 2018). This intervention is also based on the premise that the family environment has significant effects on adolescent behaviors and thus can be leveraged to promote and reinforce healthy eating behaviors.
Prevention Option for Adolescents and Individuals like Michelle
The prevention options for adolescents and people like Michelle include physical exercise and access to a nutritious diet. In the adolescent population, physical activity has immense benefits that positively impact mental, physical, and social outcomes. Specifically, Scotto et al. (2023) opined that physical activity also influences other outcomes, such as life satisfaction and self-esteem. Thus, engaging in physical activities helps in increasing energy expenditure and thus helps in slowing the development of abdominal obesity. Even though Michele engages in some form of exercise at the school gym, that lack of structure and frequency contributes to the limited efficacy in preventing the development of obesity. The second option includes the intake of healthy diets. For instance, the Mediterranean diet has been shown to have a positive effect on weight loss when compared to low fat and low carbohydrate diet; the diet is equally varied, tasty, and with many flavors, which promote adherence (Dominguez et al., 2023). Thus, for individuals like Michele, an individualized Mediterranean diet and a physical activity program would help mitigate morbid obesity. Further, education programs focusing on the benefits of the Mediterranean would also increase Michelle’s awareness about the importance of a healthy diet rather than focusing on cereals and missing breakfast.
Influence of Age on Prevention Method
The age factor influenced the selection of the intervention. In part, for the physical activities, individuals within the age groups of 10-19 years are more likely to benefit from such intervention both physically and mentally. Besides, adolescent girls prefer to engage in low to moderate physical activities when compared to boys. Thus, Michelle’s age is at a phase where the impacts of physical activities are more likely to yield positive outcomes and mitigate the health risks associated with obesity in the long run. Meanwhile, the adolescent age group is often characterized by the daily intake of high-energy foods from sources that are sweet. Further, sweet foods have been cited as the main calorie contributor in the daytime (Bawajeeh et al., 2022). This food taste also affects the food choices and intake in later stages of life. Hence, Michele, as with all other adolescents, is more likely to be influenced in making a dietary choice that is not healthy. These risk factors can be mitigated through education and awareness of the role of the Mediterranean diet as a healthy alternative. Thus, the selection of the physical and the nutritional intervention were all influenced by the age factor and the possibility of influencing the development of positive behaviors and attitudes that will have long-term impacts.
References
Bawajeeh, A., Zulyniak, M. A., Evans, C. E. L., & Cade, J. E. (2022). Characterizing Adolescents’ Dietary Intake by Taste: Results From the UK National Diet and Nutrition Survey. Frontiers in Nutrition, 9. https://doi.org/10.3389/fnut.2022.893643
Dominguez, L. J., Veronese, N., Di Bella, G., Cusumano, C., Parisi, A., Tagliaferri, F., Ciriminna, S., & Barbagallo, M. (2023). Mediterranean diet in the management and prevention of obesity. Experimental Gerontology, 174, 112121. https://doi.org/10.1016/j.exger.2023.112121
Scotto, S., Guillaume Martinent, Popa-Roch, M., Ballereau, M., Soufyane Chahdi, Escudero, L., & Guillet-Descas, E. (2023). Obesity in Childhood and Adolescence: The Role of Motivation for Physical Activity, Self-Esteem, Implicit and Explicit Attitudes toward Obesity and Physical Activity. Children (Basel), 10(7), 1177–1177. https://doi.org/10.3390/children10071177
Smith, J. D., Berkel, C., Jordan, N., Atkins, D. C., Narayanan, S. S., Gallo, C., Grimm, K. J., Dishion, T. J., Mauricio, A. M., Rudo-Stern, J., Meachum, M. K., Winslow, E., & Bruening, M. M. (2018). An individually tailored family-centered intervention for pediatric obesity in primary care: study protocol of a randomized type II hybrid effectiveness–implementation trial (Raising Healthy Children study). Implementation Science, 13(1). https://doi.org/10.1186/s13012-017-0697-2
Zhao, S. R., Cao, S., Lin, P. S., Yenor, J., Lam, R., Chang, E., Liu, R., & Liu, J. (2013). Interprofessional and Interdisciplinary Approach from Undergraduate Health and Pre-Medical Students in Children’s Health Educational Initiative. Journal of Community Medicine & Health Education, 4. https://doi.org/10.4172/2161-0711.1000266
Write a 3-4 page paper on the use of clinical reasoning in developing and applying advanced health history and physical assessment skills at the graduate level. Consider contemporary nursing literature on the development of clinical reasoning and decision-making. How does the use of the nursing process enhance critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level? Please use the submission parameters and rubric below to guide you when completing this assignment.
SUBMISSION PARAMETERS
For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is 3-4 pages, which does not include the cover page and reference page(s).
I. Introduction of topic in one paragraph with a purpose statement
II. Clinical Reasoning
Describe & define how clinical reasoning is used in developing and applying advanced health history and physical assessment skills at the graduate level.
Differentiate clinical reasoning, critical thinking, clinical judgement & clinical decision-making.
III. Nursing Process
Describe how the use of the nursing process enhances critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level.
IV. Clinical Example
Discuss an example from your practice or the literature demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning with the well-adult.
Also discuss how nursing care is provided when each of these concepts are evidenced in care of the patient within one of the following patient populations: older adult, adolescent, or another special population of your choice.
V. Conclusion
VI. References (consider contemporary nursing research studies or reliable electronic sources)
Please use the following as a guide to follow APA formatting:
Include a title page.
Include transitions in your paper (i.e. headings or subheadings).
Use in-text citations throughout the paper.
Use double space, 12-point Times New Roman font.
Apply appropriate spelling, grammar, and organization.
Include a reference list in APA formatting.
Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP).
Packed red blood cells
Leukocyte-reduced red blood cells
Washed red blood cells
Fresh frozen plasma
Cryoprecipitate
Albumin
Transfusion reactions
Transfusion administration process
Crystalloids and colloids to treat hemorrhagic and hypovolemic shock;
compensatory response to blood loss
Decision to transfuse
FP24
Multiple electrolytes solution
Non-blood product coagulopathy reversal agent
reference one : https://www.pdfdrive.com/lehnes-pharmacology-for-n…
and use anothe refrences from books and researches as yo can
Unformatted Attachment Preview
Project rubrics
Value 20%
Word limit 1500 (excluding references)
Evaluation Items
Introduction
Body
Conclusion
Flow of essay
Grammar
Spelling
Work limit
References
Poor
(1)
The aim of the essay is
clearly stated
Defines the project
States the components
Outlines the arguments
to be presented
idea are presented,
explored, and
discussed
Use of literature to
support arguments
Balance of arguments
Statement on the
future of nursing
informatics
Clearly Summarises the
essay
Ease of read
Unsound
(marks lost)
10% outside word limit
(marks lost)
Number
20
References are
consistently formatted
Fair
(2)
Good
(3)
Excellent
(4)
The purpose of this assignment is to demonstrate your understanding of the responsibility of a health care organization in establishing a risk management program that addresses liability and malpractice.
Assume your organization will begin offering synchronous telemedicine services and you have been asked to present information about incorporating an enterprise risk management program that mitigates risks and provides strategies for operational (credentialing, standard of care, and documentation) clinical/patient safety, financial, and legal/regulatory (HIPAA, HITECH, CMS), state-specific regulations, and technology.
Write a 750-1,000-word report to the administrative team that:
Describes how the risk management program will address areas of concern over operational, clinical/patient safety, financial, legal/regulatory, and state-specific regulations, as well as technology.
Explains the risk for potential liability and malpractice upon the provider or organization if policies and procedures do not address identified risk concerns.
In addition to your textbook, you are required to support your analysis with at least three credible health-related resources.
Prepare this assignment according to the guidelines 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.
Unformatted Attachment Preview
Collapse All
Telemedicine and Risk Management – Rubric
Risk Management Program and Areas of Concern
35 points
Criteria Description
Description of how the risk management program will address areas of concern over
operational, clinical/patient safety, financial, legal/regulatory, and state-specific
regulations, as well as technology.
5. Target
35 points
Description of how the risk management program will address areas of concern
over operational, clinical/patient safety, financial, legal/regulatory, and state-specific
regulations, as well as technology, is comprehensive. The submission encompasses
essential details and provides convincing support.
4. Acceptable
29.75 points
Description of how the risk management program will address areas of concern
over operational, clinical/patient safety, financial, legal/regulatory, and state-specific
regulations, as well as technology, is incorporated in full. The submission
encompasses basic details and provides appropriate support.
3. Approaching
26.25 points
Description of how the risk management program will address areas of concern
over operational, clinical/patient safety, financial, legal/regulatory, and state-specific
regulations, as well as technology, is incorporated, but minimal detail or support is
provided for one or more components.
2. Insufficient
22.75 points
Description of how the risk management program will address areas of concern
over operational, clinical/patient safety, financial, legal/regulatory, and state-specific
regulations, as well as technology, is partially incorporated, but the information
provided is incomplete, inaccurate, or otherwise deficient.
Risk for Potential Liability and Malpractice
35 points
Criteria Description
Explanation of the risk for potential liability and malpractice upon the provider or
organization if policies and procedures do not address identified risk concerns.
5. Target
35 points
Explanation of the risk for potential liability and malpractice upon the provider or
organization if policies and procedures do not address identified risk concerns is
comprehensive. The submission encompasses essential details and provides
convincing support.
4. Acceptable
29.75 points
Explanation of the risk for potential liability and malpractice upon the provider or
organization if policies and procedures do not address identified risk concerns is
incorporated in full. The submission encompasses basic details and provides
appropriate support.
3. Approaching
26.25 points
Explanation of the risk for potential liability and malpractice upon the provider or
organization if policies and procedures do not address identified risk concerns is
incorporated, but minimal detail or support is provided for one or more
components.
2. Insufficient
22.75 points
Explanation of the risk for potential liability and malpractice upon the provider or
organization if policies and procedures do not address identified risk concerns is
partially incorporated, but the information provided is incomplete, inaccurate, or
otherwise deficient.
Thesis, Position, or Purpose
7 points
Criteria Description
Communicates reason for writing and demonstrates awareness of audience.
5. Target
7 points
The thesis, position, or purpose is clearly communicated throughout and clearly
directed to a specific audience.
4. Acceptable
5.95 points
The thesis, position, or purpose is adequately presented. An awareness of the
appropriate audience is demonstrated.
3. Approaching
5.25 points
The thesis, position, or purpose is discernable in most aspects but is occasionally
weak or unclear. There is limited awareness of the appropriate audience.
2. Insufficient
4.55 points
The thesis, position, or purpose is unfocused or confused. There is very little
awareness of the intended audience.
Development, Structure, and Conclusion
7 points
Criteria Description
Advances position or purpose throughout writing; conclusion aligns to and evolves
from development.
5. Target
7 points
The thesis, position, or purpose is logically advanced throughout. The progression
of ideas is coherent and unified. A clear and logical conclusion aligns to the
development of the purpose.
4. Acceptable
5.95 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on
each other. Conclusion aligns to the development of the purpose.
3. Approaching
5.25 points
Limited advancement of thesis, position, or purpose is discernable. There are
inconsistencies in organization or the relationship of ideas. Conclusion is simplistic
and not fully aligned to the development of the purpose.
2. Insufficient
4.55 points
Writing lacks logical progression of the thesis, position, or purpose. Some
organization is attempted, but ideas are disconnected. Conclusion is unclear and
not supported by the overall development of the purpose.
1. Unsatisfactory
0 points
Evidence
6 points
Criteria Description
Selects and integrates evidence to support and advance position/purpose; considers
other perspectives.
5. Target
6 points
Specific and appropriate evidence is included. Relevant perspectives of others are
clearly considered.
4. Acceptable
5.1 points
Relevant evidence that includes other perspectives is used.
3. Approaching
4.5 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or
integration of other perspectives is present.
2. Insufficient
3.9 points
Evidence is limited or irrelevant. The interpretation of other perspectives is
superficial or incorrect.
1. Unsatisfactory
0 points
Mechanics of Writing
6 points
Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence
structure, etc.
5. Target
6 points
No mechanical errors are present. Appropriate language choice and sentence
structure are used throughout.
4. Acceptable
5.1 points
Few mechanical errors are present. Suitable language choice and sentence
structure are used.
3. Approaching
4.5 points
Occasional mechanical errors are present. Language choice is generally
appropriate. Varied sentence structure is attempted.
2. Insufficient
3.9 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language
choice or sentence structure are recurrent.
Format/Documentation
Criteria Description
4 points
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level;
documents sources using citations, footnotes, references, bibliography, etc.,
appropriate to assignment and discipline.
5. Target
4 points
No errors in formatting or documentation are present.
4. Acceptable
3.4 points
Appropriate format and documentation are used with only minor errors.
3. Approaching
3 points
Appropriate format and documentation are used, although there are some obvious
errors.
2. Insufficient
2.6 points
Appropriate format is attempted, but some elements are missing. Frequent errors
in documentation of sources are evident.
Total 100 points
https://es.eskill.com/es/quiz/?testId=631001b3671d7bb7I’m trying to get this job for at home but I’m too busy working to even complete the next step. Could someone please help. Here’s the directions I’ve also attached what you need to add to this link above to access it.The next step in your application process is to complete our pre-hire assessment which tests your English grammar and medical terminology knowledge, both necessary skills to be successful as a medical scribe. This assessment is divided into two parts, the first covering grammar/syntax in a medical setting (20 questions), and the second covering common medical terms and abbreviations as well as anatomical knowledge (50 questions). Altogether, it should take approximately 30 to 45 minutes to complete the assessment.Along with the assessment link below, we are providing a Medical Packet for you to review and study before attempting our required assessments. This packet contains a list of medical terms that you will need to know to be successful in AQuity’s training program as well as details about the requirements and responsibilities of working as a Virtual Medical Scribe. While not required, we highly encourage you to take as much time as you need to study the material in preparation for the assessments. ONLY ONE (1) ATTEMPT is allowed for both sections, and a passing score of 80% is required.
Purpose: The purpose of this assignment is to learn how to analyze a 3-day diet and compare the intakes to the Dietary Reference Intakes (DRIs). Your paper should follow the following format: double spaces, 10- or 12-point standard type font (examples: Arial or Times New Roman), and 2 to 3 pages in length (excluding table).
Instructions: Choose ONE 3-day diet to analyze (Diet A 10-year-old male.pdf, Download Diet A 10-year-old male.pdf,Diet B 30-year-old female.pdf, Download Diet B 30-year-old female.pdf,Diet C 65-year-old male.pdf) Download Diet C 65-year-old male.pdf).
Enter the example person’s 3-day food intake into MindTap’s Diet & Wellness Plus+ (a diet analysis program–green apple icon on the right vertical toolbar in MindTap). Be sure to carefully enter each item and its serving size. Choose items that most closely match the items listed.
View the “Intake vs. Goals” report for each day AND the “3-Day Average” report. Use the information to complete this table: Diet Analysis Table.docx Download Diet Analysis Table.docxDiet Analysis Table.pdf Download Diet Analysis Table.pdfBe sure to select the correct corresponding date ranges. Analyze the person’s 3-day intake by comparing their intake to their DRIs. Any percentage below 80 % is considered a nutrient deficiency; any percentage above 120 % is considered a nutrient excess. (Note: You may have to adjust your margins to a “narrow” setting of 0.5” on all sides to make the table fit.)
Discuss each nutrient deficiency and excess and identify specific foods (not dietary supplements) to improve intake. It is optional to discuss caffeine and/or alcohol–see textbook regarding recommendations. (You may find it helpful to use the “MyPlate Analysis” report in Diet & Wellness+).
Address whether or not their physical activity should increase, decrease, or remain the same (explain why). Provide at least 1 practical suggestion for improving or maintaining their physical activity.
This assignment must be submitted as a Word or pdf document in Canvas.
To summarize, the following steps should be completed:
Choose a diet to analyze (Diet A .pdf, Download Diet A .pdf,Diet B.pdf, Download Diet B.pdf,Diet C.pdf Download Diet C.pdf).
Analyze the diet using Diet & Wellness Plus+ (in MindTap).
Fill in the attached table Diet Analysis Table.docx Download Diet Analysis Table.docxDiet Analysis Table.pdf Download Diet Analysis Table.pdfwith the results and compare the results to the DRIs for your example person.
Discuss all nutrient excesses (greater than 120 % DRI) and deficiencies (less than 80 % DRI).
Create a plan for the individual to improve their intakes, helping them to better meet the DRIs. Include specific foods they may consume/reduce to improve nutrient deficiencies/excesses.
Address whether or not their physical activity should increase, decrease, or remain the same (explain why). Provide at least 1 practical suggestion for improvement or maintenance.
Please review the grading rubric below before completing this assignment.
Click here to see an example of this assignment. (This example is simply a guide. DO NOT copy or paraphrase this example assignment):
Diet Analysis Example Paper.pdf
Prepare a PowerPoint or Prezi for new coaches or physical educators, introducing them to the key concepts from and prudent practices to follow in order to avoid a malpractice lawsuit. Incorporate in an introduction, personal reflection and specific application to your area of professional life (My area of professional life is a COACH).
WIthin each slide (or multiple slides), include a thorough discussion about all of the following key concepts. Include appropriate reference citations where needed.
Each key concept should have its own slide or slides, depending on the amount of content needed to give an appropriate overview of the topic. Including your title slide, and reference slide, you should have a minimum of 20-slides in total.
*Please refer to the attached example for reference.
Negligence
Defenses Against Negligence
Waiver and Releases
Premises Liability
Products Liability
Emergency Care
Supervision
Transportation
Assault and Battery
Criminal Law and Sport
Risk Management Process
Audits in Risk Management
Crisis Management
Due Process
Search and Seizure
Drug Testing
Participants with Disabilities
Gender Equity and Title IX.
This assignment will be graded using the attached rubric. Please review this rubric before you complete your assignment.
Unformatted Attachment Preview
A Cheerleading Coach’s Guide to
Avoiding a Malpractice Lawsuit
Protect Your
Team, Protect
Yourself
Created by: ___________
What is a Cheerleader?
A cheerleader is defined as a
member of a group (typically
a group of young women)
who shout out special songs
or chants to encourage the
team and entertain the
crowd during a sporting
game such as football or
basketball.
TRUE…
But it’s so much
Cheerleading is:
Dancing
Stunting
Tumbling
Jumping
Tossing
Flipping
Catching
Flying
Twisting
All while keeping a smile on your face!
We, as cheer coaches, understand
that our job is to properly and
efficiently train athletes in
one of the most physically
demanding, aggressive and
dangerous sports imaginable.
In order to help protect
ourselves from a
cheerleading coaching
lawsuit, we should be:
Knowledgeable and Experienced in the Sport
Nationally Trained and Certified
Educated in the AACCA Safety Rules and Guidelines
Familiar with the Legal Expectations of a Cheer Coach
THE Goal
“The Legal Aspect”
This presentation will
assist in developing a
more comprehensive
understanding of the
legal issues that might
arise as a result of
coaching not only
cheerleading, but any
NEGLIGENCE
An unintentional tort…
NEGLIGENCE:
– – – – –
NEGLIGENCE (cont.):
– – – – –
Defenses Against Negligence:
There are many defenses
against negligence, all of which
come from one of three
sources:
1) 2) 3) –
Defenses Against Negligence (cont.):
Some examples of common defenses:
–
–
Waivers and Releases
A contract in which…
Waivers and Releases:
Requirements for a valid waiver:
–
–
Waivers and Releases (cont.):
A note about waivers
and minors:
The general rule…
Premises Liability
The body of law which makes…
Premises Liability:
Legal Obligations of
a Coach
– – – – – – –
Products Liability
Relates primarily to…
Products Liability:
–
–
–
3 Types of Product
Defects:
Products Liability (cont.):
How does this relate
to coaching?
It’s important…
Emergency Care
The provision of…
Emergency Care:
The responsibility to…
Coaches that have a duty to provide adequate
emergency care must consider 4 elements:
1.
2.
3.
4.
–
Emergency Care (cont.):
Helpful Hints:
– – – –
– –
Supervision
Responsibility for…
Supervision:
3 Types of
Supervision:
–
–
Supervision (cont.):
1. 2. 3. 4. 5. 6. 7. –
Duties of a
Supervisor
Transportation
If an organization…
Transportation:
–
3 Types of
Transportation Options:
Criminal Law
The body of law…
Criminal Law and Sport…
Assault and Battery
Generally involve…
Assault: Any …
Battery: Intentional…
Assault and Battery:
Elements of Assault:
Elements of Battery:
– –
– –
– –
– –
– –
– –
Audits in Risk Management
3 Risk Management Tools for Coac
Each of these…
Risk Management Process
Most Recent Definition of Risk Management (2009):
A course…
The Process:
Developing the Plan:
1) 2) 3) –
1) 2) 3) –
Risk Management Plan
More Than a Safety Checklist!
4 Methods of Treating Risks:
1.2.3.4.-
Crisis Management
A process intended…
Having a Crisis Management Plan in place is critical…
Due Process
Found in the Fifth Amendment of…
There are 2 types of Due Process:
–
Search and Seizure
The Fourth Amendment…
Once …
Search and Seizure:
The Fourth Amendment … must consider 3
basic issues:
–
Drug Testing
Performance-enhancing drug…
Participants With Disabilities
One of the stated intents …
Participants With Disabilities:
How does an individual pursue
a claim?
He or she must establish 4 elements:
1. 2. 3. 4. –
Participants With Disabilities (cont.):
Support …:
–
Gender Equity and Title IX
– –
–
–
Gender Equity and Title IX:
Title IX Enforcement:
–
–
References
–
–
–
Article Critique Grading Rubric
(88 points)
Student Name:
Criteria
Title Slide
Proficient/Outstanding
Quality
4
A thoughtful and vibrant title
page was created. The slide
includes a unique and descriptive
title of the overall presentation.
(4 points)
Introduction
Negligence
Defenses Against
Negligence
Substantial/Satisfactory
Quality
3
A title page was created. The
slide includes a unique and
descriptive title of the overall
presentation.
(3 – 3.99 points)
The value of knowing the key
The value of knowing the key
concepts of sport law is clearly
concepts of sport law is
articulated. In-depth, personal
articulated. Personal reflection
reflection and how this
and how this information is
information is relevant to
relevant to professional life is
professional life is clearly defined. defined.
Emerging/Marginal Quality
2
A title page was created but is
lacking in detail.
(2 – 2.99 points)
The value of knowing the key
concepts of sport law is
articulated. Personal reflection
and how this information is
relevant to professional life is
defined but is lacking detail.
Limited/Inadequate
Quality
1
A title page was not created.
Instructor
Score/ 0-4
4
(0 – 1.99 points)
The value of knowing the key
concepts of sport law and
personal reflection is not
presented or is minimally
addesssed.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
4
4
4
Defenses Against
Negligence
4
(4 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
Waiver and Releases and sport. Significant themes
within the topic have also been
identified.
Premises Liability
Products Liability
Emergency Care
Supervision
(3 – 3.99 points)
(2 – 2.99 points)
The slide(s) explains the key
The slide(s) explains the key
concept and its relationship to
concept and its relationship to
physical education,
physical education,
administration, exercise science
administration, exercise science
and sport and/or themes within
and sport. Themes within the
the topic have also been
topic have also been identified.
identified but are lacking detail.
(0 – 1.99 points)
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
The slide(s) explains the key
concept and its relationship to
concept and its relationship to
physical education,
physical education,
administration, exercise science
administration, exercise science
and sport and/or themes within
and sport. Themes within the
the topic have also been
topic have also been identified.
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
4
4
4
4
Transportation
Assault and Battery
Criminal Law and
Sport
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
(4 points)
Risk Management
Process
The slide(s) explains the key
The slide(s) explains the key
concept and its relationship to
concept and its relationship to
physical education,
physical education,
administration, exercise science
administration, exercise science
and sport and/or themes within
and sport. Themes within the
the topic have also been
topic have also been identified.
identified but are lacking detail.
(3 – 3.99 points)
The slide(s) clearly explain the key
concept and its relationship to
The presentation explains the
physical education,
implications of the study and its
administration, exercise science relationship to physical
and sport. Significant themes
education, administration,
within the topic have also been
exercise science, and sport.
identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
4
4
(0 – 1.99 points)
The presentation explains the
The presentation does not
implications of the study and its explain or minimally explains the
relationship to physical
implications of the study and its
education, administration,
relationship to physical
exercise science, and sport but is education, administration,
lacking detail.
exercise science, and sport.
(2 – 2.99 points)
4
(0 – 1.99 points)
4
Audits in Risk
Management
The slide(s) clearly explain the key
concept and its relationship to
The presentation explains the
physical education,
implications of the study and its
administration, exercise science relationship to physical
and sport. Significant themes
education, administration,
within the topic have also been
exercise science, and sport.
identified.
(4 points)
Crisis Management
Supervision
Due Process
Search and Seizure
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
(3 – 3.99 points)
The presentation explains the
The presentation does not
implications of the study and its explain or minimally explains the
relationship to physical
implications of the study and its
education, administration,
relationship to physical
exercise science, and sport but is education, administration,
lacking detail.
exercise science, and sport.
(2 – 2.99 points)
The slide(s) explains the key
The slide(s) explains the key
concept and its relationship to
concept and its relationship to
physical education,
physical education,
administration, exercise science
administration, exercise science
and sport and/or themes within
and sport. Themes within the
the topic have also been
topic have also been identified.
identified but are lacking detail.
4
(0 – 1.99 points)
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
4
4
4
Drug Testing
Participants with
Disabilities
Gender Equity and
Title IX
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport. Themes within the
topic have also been identified.
The slide(s) explains the key
concept and its relationship to
physical education,
administration, exercise science
and sport and/or themes within
the topic have also been
identified but are lacking detail.
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
The slide(s) clearly explains the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Significant themes
within the topic have also been
identified.
(4 points)
The slides are very attractive and
the text is easy to read. Graphics
and effects are used
Visual
Presentation/Graphics appropriately throughout to
enhance the presentation.
(4 points)
The slide(s) explains the key
The slide(s) explains the key
concept and its relationship to
concept and its relationship to
physical education,
physical education,
administration, exercise science
administration, exercise science
and sport and/or themes within
and sport. Themes within the
the topic have also been
topic have also been identified.
identified but are lacking detail.
(3 – 3.99 points)
(2 – 2.99 points)
The slide(s) do not explain the
key concept and its relationship
to physical education,
administration, exercise science
and sport. Themes within the
topic have not been identified.
(2 – 2.99 points)
4
4
(0 – 1.99 points)
The slides are not attractive
The slides are attractive and the The slides are minimal and/or the
and/or the text is not easy to
text is easy to read. Graphics and text is easy to read. Graphics and
read. Graphics and effects are
effects are used appropriately
effects are somewhat used
not used appropriately
throughout to enhance the
appropriately throughout the
throughout the presentation or
presentation.
presentation.
are not present at all.
(3 – 3.99 points)
4
(0 – 1.99 points)
4
APA guidelines
The presentation is written in
The presentation is written in
The presentation is written in
The presentation is written in APA
APA format; Margins are 1 inch; APA format; Margins are 1 inch; APA format; Margins are 1 inch;
format; Margins are 1 inch; 12
12 point font Times New Roman; 12 point font Times New Roman; 12 point font Times New Roman;
point font Times New Roman;
Double spaced text throughout Double spaced text throughout Double spaced text throughout
Double spaced text throughout
entire document; parenthetical entire document; parenthetical entire document; parenthetical
entire document; parenthetical
citations throughout document; citations throughout document; citations throughout document;
citations throughout document;
minimal use of quotations but
minimal use of quotations but
minimal use of quotations but
minimal use of quotations.
has 2-3 errors.
has 4-5 errors.
has more than 5 errors.
(4 points)
Writing
(3 – 3.99 points)
Style of writing is in 3rd person;
Style of writing is in 3rd person;
scholarly not colloquial; solid
scholarly not colloquial; solid
sentence structure;
sentence structure; grammatically
grammatically correct; no
correct; no spelling errors;
spelling errors; presentation is
presentation is logically organized
logically organized and
and structured.
structured but has 2-3 errors.
(4 points)
(3 – 3.99 points)
(2 – 2.99 points)
(0 – 1.99 points)
Style of writing is in 3rd person;
scholarly not colloquial; solid
sentence structure;
grammatically correct; no
spelling errors; presentation is
logically organized and
structured but has 4-5 errors.
Style of writing is in 3rd person;
scholarly not colloquial; solid
sentence structure;
grammatically correct; no
spelling errors; presentation is
logically organized and
structured but has more than 5
errors.
(2 – 2.99 points)
(0 – 1.99 points)
4
4
88.00
Total Score
100.00%
PASS
FAIL
94% and above
A
90%
93.99%
A-
87%
89.99%
B+
84%
86.99%
B
80%
77%
83.99%
79.99%
BC+
73%
70%
66%
60%
59.99%
76.99%
72.99%
69.99%
65.99%
59.98% or below
C
CD+
D
F
A grade below 73% in any graduate course will need to be repeated.
A
A grade below 73% in any graduate course will need to be repeated.
0.00%
F
88.36
9
60%
D
66%
D+
70%
C-
73%
C
77%
C+
80%
B-
84%
B
87%
B+
90%
94%
AA
84.6
81.78
78.96
75.2
72.38
68.62
65.8
62.04
56.4
8
7.3
7.2
10.8
9.6
8.76
8.75
Comments
Instructors: This is a self calculating Rubric.
1) Enter students name in cell B2.
2) Enter the student scores for each criteria in column F. The associated rubric
column will be highlighted.
3) Enter comments in cells G5-13 (if desired).
4) Enter overall comments in cell G15 (if desired).
Totals will automatically be calculated for the total scrore, the percentage and
the letter grade.These cells will also be highlighted appropriately with green for
a passing grade and red for a failing grade. (remove this note before sending to
students.)
Create a 3-5 page submission in which you develop a PICO(T) question for the diagnosis you worked with in the first two assessments and evaluate the evidence you locate, which could help to answer the question.
NOTE: we are using the same diagnosis as the 2 others papers.
After reviewing the materials you created to research a specific diagnosis in the first two assessments, apply the PICO(T) process to develop a research question and research it.
Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your chosen diagnosis, and explain how the evidence would help you plan and make decisions related to your question.
In your submission, make sure you address the following grading criteria:
Define a practice issue to be explored via a PICO(T) approach. Create a PICO(T)-formatted research question
Identify sources of evidence that could be potentially effective in answering a PICO(T) question (databases, journals, websites, etc.).
Explain the findings from articles or other sources of evidence as it relates to the identified health care issue.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.
Your assessment should meet the following requirements:
Length of submission: Create a 3-5 page submission focused on defining a research question and interpreting evidence relevant to answering it.
Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to the current APA style.
This week, the rough draft of the paper on organizational change through leadership is due. This paper is meant as a final demonstration and culmination of perspectives gained from this course and will assist you in the research of corporate issues and the methods used to bring change to an area of challenge.
Starting with an actual organizational problem, you will detail the interventions that the organization has engaged in over the past 5–10 years to address the problem. In addition, you will detail the adaptive change that you think is required to resolve and move past this problem.
Tasks
Below are the key tasks you need to complete in this assignment:
Identify an organization (preferably the organization that you currently work in) that has been facing an organizational-level problem for the past several years (5–10) and has engaged in various interventions to address the problem, albeit unsuccessfully. This organization must be a healthcare organization/facility.
Investigate the problem and collect evidence to support the fact that the problem exists.
Review all interventions utilized till date to resolve the challenge the organization is experiencing. Collect evidence to support the interventions implemented by the organization.
Suggest a proposal to correct the issue and build the case for why your solution may work to correct the issue the organization is facing.
Based on your analysis, prepare a 10- to 12-page paper, providing the following:
A detailed and in-depth description of the problem. Your description should include actual evidence supporting that the issue exists.
A detailed description of all interventions utilized till date to resolve the challenge the organization is experiencing. Your description should include actual evidence supporting that the interventions mentioned have been implemented by the organization.
A proposal to correct the issue. Your proposal should be based on evidence from current literature that support your idea. Include a minimum of ten credible citations from current literature.
A reference list citing all sources in APA format.
Motor Development and Skill Learning (PET 3056) Midterm Assignment Description and RubricDescription: The purpose of this assignment is for student’s to apply their knowledge of skill classification, motivation/arousal, learning styles and the behavioral theories of motor control. The midterm will consist of three parts: (1) Presentation introducing and classifying your chosen skill, (2) Demonstration of teaching your skill and (3) Providing feedback to your classmates. The midterm assignment is worth 150 points and will be an individual assignment. Students will be graded on the following:
Presentation (70 points): Students will create a presentation (this can be a video lecture, PowerPoint, Tri-Fold board, etc.) in which they describe the skill they have chosen, explain why the chose the skill, classify the skill (see slides 11-16 of the first lecture), provide ways to increase arousal during training, provide a learning style that would be most successful for your skill and determine the behavioral learning theory of motor control that would drive your action plan. Presentations should be no longer than 10 mins in length and should contain a minimum of 10 slides (including the title slide and references). Mrs. Reece will provide an example presentation for you to use as a template.
Demonstration (50 points): Students will teach an assigned classmate the skill chosen for their presentation. This will include all of the components of the skill and provide recommendations for limiting distractions and accommodating for individual differences and needs. Demonstrations will be included in the student’s assigned presentation time and should be no longer than 10 mins. Mrs. Reece will provide an example of a skill learning demonstration in class.
Peer Feedback (30 points): Students will complete a Google Form survey provided by Mrs. Reece to evaluate the classmates’ presentations and demonstrations.
Midterm Presentations will take place Monday, October 17th and Wednesday, October 19th. Mrs. Reece will provide a presentation template and skills learning demo on Wednesday 10/12/22.I want to talk about the reaction time in tennis.
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1 Case 2 Case 3
76-year-old Black/African-American male with disabilities living in an urban setting.
Adolescent Hispanic/Latino boy living in a middle-class suburb
55-year-old Asian female living in a high-density poverty housing complex.
Pre-school aged white female living in a rural community.
16-year-old white pregnant teenager living in an inner-city neighborhood.
35-year-old transgender white male living in a homeless shelter.
Answer the following questions. Please be specific and relate your questions to your specific case (s). Assignments per case study are below.
What are the barriers to interpersonal communication?
What are the procedures and examination techniques that you will use during the physical exam of your patient?
Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.
Submission Instructions:
You have been assigned your case number (See Announcement), and you will post about the case number you have been assigned.
You will reply to your peers who have posted on the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
These are your Case Study Number assignments. Please keep in mind, that you are assigned the same case study number throughout the course, meaning you will always prepare your discussions using the same Case Study Number. Place your Case Study Number at the beginning of your discussion as your heading title.
The final deliverable for this assessment will be a PowerPoint presentation with detailed presenter’s notes representing the material you would deliver at an in-service session to raise awareness of your chosen safety improvement initiative focusing on a specific patient safety issue and to explain the need for such an initiative. Additionally, you must educate the audience as to their role and importance to the success of the initiative. This includes providing examples and practice opportunities to test out new ideas or practices related to the safety improvement initiative.
Be sure that your presentation addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Describe the purpose and goals of an in-service session focusing on a specific patient safety issue.
Explain the need for and process to improve safety outcomes related to a specific patient safety issue.
Explain to the audience their role and importance of making the improvement plan successful.
Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative.
Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.
There are various ways to structure an in-service session; below is just one example:
Part 1: Agenda and Outcomes.
Explain to your audience what they are going to learn or do, and what they are expected to take away.
Part 2: Safety Improvement Plan.
Give an overview of the current problem focusing on a specific patient safety issue, the proposed plan, and what the improvement plan is trying to address.
Explain why it is important for the organization to address the current situation.
Part 3: Audience’s Role and Importance.
Discuss how the staff audience will be expected to help implement and drive the improvement plan.
Explain why they are critical to the success of the improvement plan focusing on a specific patient safety issue.
Describe how their work could benefit from embracing their role in the plan.
Part 4: New Process and Skills Practice.
Explain new processes or skills.
Develop an activity that allows the staff audience to practice and ask questions about these new processes and skills.
In the notes section of your PowerPoint, brainstorm potential responses to likely questions or concerns.
Part 5: Soliciting Feedback.
Describe how you would solicit feedback from the audience on the improvement plan and the in-service.
Explain how you might integrate this feedback for future improvements.
Remember to account for activity and discussion time.
……………………………………………………………………………………………………………………………….
Presentation length: There is no required length; use just enough slides to address all the necessary elements. Remember to use short, concise bullet points on the slides and expand on your points in the presenter’s notes. If you use 2 or 3 slides to address each of the parts in the above example, your presentation would be at least 10 slides and no more than 15 slides (not including the title, conclusion, or references slides).
Speaker notes: Speaker notes (located under each slide) should reflect what you would actually say if you were delivering the presentation to an audience. This presentation does NOT require audio or a transcript. Another presenter would be able to use the presentation by following the speaker’s notes.
APA format: Use APA formatting for in-text citations. Include an APA-formatted reference slide at the end of your presentation.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence to support your assertions. Resources should be no more than 5 years old.
Scenario
You are assigned to six patients on the medical surgical unit working with a LPN/LVN and
share a CNA with another RN. You are receiving report for your patients and need to
identify what activities you will be assigning, delegating, supervising, and prioritizing for
the shift.
Instructions
• Client number 1: 50-year old male who had a heart attack and stent placed with
normal vital signs
• Client number 2: 46-year-old female with full-thickness burns to the leg who needs
to have dressings changed
• Client number 3: 33-year-old male firefighter who has fallen and broken his right
femur after surgery with pain in his leg
• Client number 4: 18-year-old male with wheezing and labored respirations
unrelieved by an inhaler
• Client number 5: 74-year-old female with new onset dementia awaiting lab results
• Client number 6: 52-year-old female who has been recently diagnoses with diabetes
type 2 and is getting discharged
1.
2.
3.
4.
5.
Describe the patients you will be assigning to the LPN
Describe the care that you will be delegating to the LPN and CNA
List the interventions that you would want to supervise for the LPN and CNA
List the clients and care from the highest to lowest priority
Provides stated ideas with professional language and attribution for credible
sources with correct APA citation, spelling, and grammar.
In the realm of marketing, a successful branding strategy is one of the most important contributors to organizational success. A solid branding strategy can help add visibility and credibility to a company’s products.
Similarly, nurse-scholars can build a personal brand to add visibility and credibility to their work. You can begin building your brand by developing and maintaining an academic portfolio. Such an activity can help share the results of your efforts and contribute to your success. This Module’s Discussion asks you to consider and share strategies for building your portfolio.
To Prepare:
Reflect on strategies that you can pursue in developing portfolios or portfolio elements that focus on academic achievements.
Review one or more samples from your own research of resources focused on portfolio development
Post an explanation of at least two strategies for including academic activities and accomplishments into your professional development goals. Then, explain how those goals may align with the University’s emphasis on social change. Be specific and provide examples
**********************PLEASE MAKE SURE TO PROVIDE AT LEAST TWO REFERANCES, INCLUDE IN TEXT CITATIONS AND HAVE IT IN APA STYLE************
The purpose of this assignment is to gain real-world insight into how risk management programs operate within health care organizations.
Select a local health care organization where you can conduct an interview with an employee who is involved in risk management processes. This organization can be your current employer or a different health care facility in your community. Acute care, urgent care, large multi‐provider private medical clinics, assisted living facilities, and community/public health clinical facilities are all ideal options to complete the requirements of this assignment. Select an individual who can provide sufficient information regarding how their organization manages risk within its facility to answer the questions below.
In your interview, address the following:
Risk management strategies used in the organization’s risk control program, along with specific examples.
How the facility’s educational risk management program addresses key professional, legal, and ethical issues, such as prevention of negligence, malpractice litigation, and vicarious liability.
Policies the facility has implemented that address how to manage emergency triage in high‐risk areas of health care service delivery (e.g., narcotics inventories, declared pregnancy policies, blood-borne disease vector, etc.), and identify how these align with Occupational Safety and Health Administration (OSHA) standards.
Challenges the organization faces in managing and controlling high-risk health care (e.g., infectious diseases, nuclear medicine, abortion, class 4 narcotics/opioids, etc.), and include how cultural and religious beliefs affect the provision of patient care.
Strategies the facility utilizes to monitor, evaluate, and maintain compliance within its risk management program.
After conducting the interview, compose a 750‐1,000-word summary analysis of the interview that includes the prompts above, in conjunction with the interviewee’s responses. In addition, include the following elements in your response:
An assessment of the organization’s risk management program, including how it attends to high-risk health care and legal concerns.
Action steps you would take to improve one area of the organization’s risk management program, along with your rationale for doing so.
Cite appropriate references as needed to support your statements and rationale.
Prepare this assignment according to the guidelines 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.
Unformatted Attachment Preview
Collapse All
Organizational Risk Management Interview – Rubric
Risk Management Strategies
10 points
Criteria Description
Summary analysis of risk management strategies used in the organization’s risk control
program, along with specific examples.
5. Target
10 points
Summary analysis of risk management strategies used in the organization’s risk
control program, along with specific examples is comprehensive. The submission
encompasses essential details and provides convincing support.
4. Acceptable
8.5 points
Summary analysis of risk management strategies used in the organization’s risk
control program, along with specific examples is incorporated in full. The
submission encompasses basic details and provides appropriate support.
3. Approaching
7.5 points
Summary analysis of risk management strategies used in the organization’s risk
control program, along with specific examples, is incorporated, but minimal detail
or support is provided for one or more components.
2. Insufficient
6.5 points
Summary analysis of risk management strategies used in the organization’s risk
control program, along with specific examples, is partially incorporated, but the
information provided is incomplete, inaccurate, or otherwise deficient.
Professional, Legal, and Ethical Issues
10 points
Criteria Description
Summary analysis of how the facility’s educational risk management program
addresses key professional, legal, and ethical issues, such as prevention of negligence,
malpractice litigation, and vicarious liability.
5. Target
10 points
Summary analysis of how the facility’s educational risk management program
addresses key professional, legal, and ethical issues, such as prevention of
negligence, malpractice litigation, and vicarious liability, is comprehensive. The
submission encompasses essential details and provides convincing support.
4. Acceptable
8.5 points
Summary analysis of how the facility’s educational risk management program
addresses key professional, legal, and ethical issues, such as prevention of
negligence, malpractice litigation, and vicarious liability, is incorporated in full. The
submission encompasses basic details and provides appropriate support.
3. Approaching
7.5 points
Summary analysis of how the facility’s educational risk management program
addresses key professional, legal, and ethical issues, such as prevention of
negligence, malpractice litigation, and vicarious liability is incorporated, but minimal
detail or support, is provided for one or more components.
2. Insufficient
6.5 points
Summary analysis of how the facility’s educational risk management program
addresses key professional, legal, and ethical issues, such as prevention of
negligence malpractice litigation and vicarious liability is partially incorporated
Facility Policies
10 points
Criteria Description
Summary analysis of policies the facility has implemented that address how to manage
emergency triage in high-risk areas of health care service delivery (e.g., narcotics
inventories, declared pregnancy policies, blood-borne disease vector, etc.), and
identification of how these align with Occupational Safety and Health Administration
(OSHA) standards.
5. Target
10 points
Summary analysis of policies the facility has implemented that address how to
manage emergency triage in high-risk areas of health care service delivery and how
these align with OSHA standards is comprehensive. The submission encompasses
essential details and provides convincing support.
4. Acceptable
8.5 points
Summary analysis of policies the facility has implemented that address how to
manage emergency triage in high-risk areas of health care service delivery and how
these align with OSHA standards is incorporated in full. The submission
encompasses basic details and provides appropriate support.
3. Approaching
7.5 points
Summary analysis of policies the facility has implemented that address how to
manage emergency triage in high-risk areas of health care service delivery and how
these align with OSHA standards is incorporated, but minimal detail or support is
provided for one or more components.
2. Insufficient
6.5 points
Summary analysis of policies the facility has implemented that address how to
manage emergency triage in high-risk areas of health care service delivery and how
these align with OSHA standards is partially incorporated, but the information
provided is incomplete, inaccurate, or otherwise deficient.
Managing and Controlling High-Risk Health Care
10 points
Criteria Description
Summary analysis of challenges the organization faces in managing and controlling
high-risk health care (e.g., infectious diseases, nuclear medicine, abortion, class 4
narcotics/opioids, etc.), and inclusion of how cultural and religious beliefs affect the
provision of patient care.
5. Target
10 points
Summary analysis of challenges the organization faces in managing and controlling
high-risk health care and how cultural and religious beliefs affect the provision of
patient care is comprehensive. The submission encompasses essential details and
provides convincing support.
4. Acceptable
8.5 points
Summary analysis of challenges the organization faces in managing and controlling
high-risk health care and how cultural and religious beliefs affect the provision of
patient care is incorporated in full. The submission encompasses basic details and
provides appropriate support.
3. Approaching
7.5 points
Summary analysis of challenges the organization faces in managing and controlling
high-risk health care and how cultural and religious beliefs affect the provision of
patient care is incorporated, but minimal detail or support is provided for one or
more components.
2. Insufficient
6.5 points
Summary analysis of challenges the organization faces in managing and controlling
high-risk health care and how cultural and religious beliefs affect the provision of
patient care is partially incorporated, but the information provided is incomplete,
inaccurate, or otherwise deficient.
Monitor and Maintain Risk Management Program
10 points
Criteria Description
Summary analysis of strategies the facility utilizes to monitor, evaluate, and maintain
compliance within its risk management program.
5. Target
10 points
Summary analysis of strategies the facility utilizes to monitor, evaluate, and
maintain compliance within its risk management program is comprehensive. The
submission encompasses essential details and provides convincing support.
4. Acceptable
8.5 points
Summary analysis of strategies the facility utilizes to monitor, evaluate, and
maintain compliance within its risk management program is incorporated in full.
The submission encompasses basic details and provides appropriate support.
3. Approaching
7.5 points
Summary analysis of strategies the facility utilizes to monitor, evaluate, and
maintain compliance within its risk management program is incorporated, but
minimal detail or support is provided for one or more components.
2. Insufficient
6.5 points
Summary analysis of strategies the facility utilizes to monitor, evaluate, and
maintain compliance within its risk management program is partially incorporated,
but the information provided is incomplete, inaccurate, or otherwise deficient.
1. Unsatisfactory
0 points
Health and Legal Concerns
10 points
Criteria Description
Assessment of the organization’s risk management program, including how it attends
to high-risk health care and legal concerns.
5. Target
10 points
Assessment of the organization’s risk management program, including how it
attends to high-risk health care and legal concerns, is comprehensive. The
submission encompasses essential details and provides convincing support.
4. Acceptable
8.5 points
Assessment of the organization’s risk management program, including how it
attends to high-risk health care and legal concerns, is incorporated in full. The
submission encompasses basic details and provides appropriate support.
3. Approaching
7.5 points
Assessment of the organization’s risk management program, including how it
attends to high-risk health care and legal concerns, is incorporated, but minimal
detail or support is provided for one or more components.
2. Insufficient
6.5 points
Assessment of the organization’s risk management program, including how it
attends to high-risk health care and legal concerns, is partially incorporated, but the
information provided is incomplete, inaccurate, or otherwise deficient.
Action Steps to Improve
10 points
Criteria Description
Action steps to improve one area of the organization’s risk management program,
along with rationale for doing so.
5. Target
10 points
Action steps to improve one area of the organization’s risk management program,
along with rationale for doing so, are comprehensive. The submission encompasses
essential details and provides convincing support.
4. Acceptable
8.5 points
Action steps to improve one area of the organization’s risk management program,
along with rationale for doing so, are incorporated in full. The submission
encompasses basic details and provides appropriate support.
3. Approaching
7.5 points
Action steps to improve one area of the organization’s risk management program,
along with rationale for doing so, are incorporated, but minimal detail or support is
provided for one or more components.
2. Insufficient
6.5 points
Action steps to improve one area of the organization’s risk management program,
along with rationale for doing so, are partially incorporated, but the information
provided is incomplete, inaccurate, or otherwise deficient.
Thesis, Position, or Purpose
7 points
Criteria Description
Communicates reason for writing and demonstrates awareness of audience.
5. Target
7 points
The thesis, position, or purpose is clearly communicated throughout and clearly
directed to a specific audience.
4. Acceptable
5.95 points
The thesis, position, or purpose is adequately presented. An awareness of the
appropriate audience is demonstrated.
3. Approaching
5.25 points
The thesis, position, or purpose is discernable in most aspects but is occasionally
weak or unclear. There is limited awareness of the appropriate audience.
2. Insufficient
4.55 points
The thesis, position, or purpose is unfocused or confused. There is very little
awareness of the intended audience.
1. Unsatisfactory
0 points
Development, Structure, and Conclusion
7 points
Criteria Description
Advances position or purpose throughout writing; conclusion aligns to and evolves
from development.
5. Target
7 points
The thesis, position, or purpose is logically advanced throughout. The progression
of ideas is coherent and unified. A clear and logical conclusion aligns to the
development of the purpose.
4. Acceptable
5.95 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on
each other. Conclusion aligns to the development of the purpose.
3. Approaching
5.25 points
Limited advancement of thesis, position, or purpose is discernable. There are
inconsistencies in organization or the relationship of ideas. Conclusion is simplistic
and not fully aligned to the development of the purpose.
2. Insufficient
4.55 points
Writing lacks logical progression of the thesis, position, or purpose. Some
organization is attempted, but ideas are disconnected. Conclusion is unclear and
not supported by the overall development of the purpose.
Evidence
6 points
Criteria Description
Selects and integrates evidence to support and advance position/purpose; considers
other perspectives.
5. Target
6 points
Specific and appropriate evidence is included. Relevant perspectives of others are
clearly considered.
4. Acceptable
5.1 points
Relevant evidence that includes other perspectives is used.
3. Approaching
4.5 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or
integration of other perspectives is present.
2. Insufficient
3.9 points
Evidence is limited or irrelevant. The interpretation of other perspectives is
superficial or incorrect.
1. Unsatisfactory
0 points
Mechanics of Writing
6 points
Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence
structure, etc.
5. Target
6 points
No mechanical errors are present. Appropriate language choice and sentence
structure are used throughout.
4. Acceptable
5.1 points
Few mechanical errors are present. Suitable language choice and sentence
structure are used.
3. Approaching
4.5 points
Occasional mechanical errors are present. Language choice is generally
appropriate. Varied sentence structure is attempted.
2. Insufficient
3.9 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language
choice or sentence structure are recurrent.
Format/Documentation
4 points
Criteria Description
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level;
documents sources using citations, footnotes, references, bibliography, etc.,
appropriate to assignment and discipline.
5. Target
4 points
No errors in formatting or documentation are present.
4. Acceptable
3.4 points
Appropriate format and documentation are used with only minor errors.
3. Approaching
3 points
Appropriate format and documentation are used, although there are some obvious
errors.
2. Insufficient
2.6 points
Appropriate format is attempted, but some elements are missing. Frequent errors
in documentation of sources are evident.
1. Unsatisfactory
0 points
Total 100 points
Read the case study below and copy and paste the case study and questions into a Word document of no longer than three double-spaced pages. Type your responses below each question. Please refrain from yes or no answers. Be sure to reference the material you have read in this module and at least one outside source to support your answers and remember to use APA for any citations. Since there wont be any references from module, 2 outside sources would be great. Case Study: Refusal of HIV TreatmentCase: Thandi, a 19- year-old woman who is unmarried but has a partner, visits a government antenatal clinic, where it is confirmed that she is pregnant. Three out of every ten women who attend public antenatal clinics in the region are HIV-positive. Due to the high prevalence of HIV amongst pregnant women, all women who attend such clinics are routinely tested for HIV, and Thandi was tested for the same without her knowledge. On her next visit to the clinic for her follow-up appointment, the attending doctor, Dr. Zaku, counseled her before disclosing her HIV status to her. Dr. Zaku explains to her that she needs to be treated with Anti-Retroviral (ARV) drugs for her own sake and to prevent the risk of her transmitting the infection to her unborn child during natural childbirth. Thandi refuses treatment because, in her society, HIV-positive women are ostracized. She requests that her HIV status be kept confidential.Should Dr. Zaku ethically respect Thandi’s wishes not to be treated?Can Dr. Zaku ethically require that Thandi receive prevention of mother-to-child transmission (PMTCT) treatment against her wishes?Can Dr. Zaku ethically give priority to the interests of the fetus/child to be born over those of Thandi?Can Dr. Zaku ethically suggest to Thandi that she should terminate the pregnancy? Should Dr. Zaku ethically heed Thandi’s request for confidentiality?
All Experiments are attached below. Please answer each one in its file and send them back, DO NOT MIX THEM, BECAUSE EACH EXPERIMENT HAS A DIFFERENT DROPBOX TO SUBMIT.Please, if there are any questions, let me know. Do not hesitate yourself by asking me. I hope everything is clear for you in the attached files.
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PRE-LAB QUESTIONS
1. List the functions of the skeletal system.
2. What material contributes the most to the compressive strength of bone?
3. Briefly describe the process of bone remodeling.
4. Research Wolff’s Law. How does the formation of torus mandibularis relate to this theory?
5. Given your understanding of Wolff’s Law, what mechanical consideration would be important
when designing a bioreactor for osteocyte growth ex vivo?
Post-Lab Questions
1. Why is it important to classify bones?
1. Aside from length, what are some other common characteristics of a long bone? Are long bones
typically associated with the axial or appendicular skeleton?
2. Compare and contrast flat bones and long bones.
EXPERIMENT 2: DIGITAL SLIDE IMAGE EXAMINATION – BONE
Post-Lab Questions
1. Identify the indicated components in the slide image.
A_________________
B_________________
C_________________
D_________________
1. Identify the indicated components in the slide image.
A_________________
B_________________
2. Compare and contrast the structures of cortical bone and trabecular bone.
3. What is the purpose of cortical bone and trabecular bone?
4. What are trabeculae? What is their function?
5. What are Haversian systems? What is their function?
LAB 6: EFFECTS OF ACID ON BONE
Data Tables
Table 9: Effect on Pellet Bones
Beaker
Water
Vinegar
Observations
Develop a 2-4 page scholarly paper in which you describe the diagnosis you researched for the previous assessment, and then identify and analyze credible evidence that could be used as the basis for applying EBP to the issue.
Diagnoses:
Congestive Heart Failure (CHF): A chronic condition in which the heart doesn’t pumpblood as well as it should:
o Interventions: Diuretics, ACE inhibitors, beta-blockers, fluid restriction, daily weight monitoring, and patient education on symptom management.
The purpose of this analysis is to better understand what constitutes credibility of journal articles as well as websites. The role of the baccalaureate-prepared nurse in incorporating evidence-based research continues to growth in clinical practice. As quality improvement (QI) measures to reduce safety risks continue to be emphasized, the need for evidence-based models and evidence-based templates is growing. This type of systematic approach to incorporating evidence-based findings allows nurses to make clinical and operational decisions based upon the best available evidence. When the most up-to-date evidence-based findings are utilized, patient-centered care improves outcomes and enhances the patient experience.
Below is a quick review table of several well-known Evidence-Based Practice Models used to guide exploration:
Evidence-Based Practice Models
Iowa Model of Evidence-Based Practice
Stetler Model
Ottawa Model
PARiHS (Promoting Action on Research Implementation in Health Services) Model
ACE (Academic Center for Evidence-Based Practice) Star Model
ARCC (Advancing Research and Clinical Practice Through Close Collaboration) Mode
John Hopkins Model
KTA (Knowledge-to-Action) Model
For this assessment:
Explain the criteria that should be used when determining the credibility of journal articles as well as websites.
Support your explanations with references to the literature or research articles that describe criteria that should be used to determine credibility.
Your identification and determination of credibility should be done within the context of your chosen diagnosis for this assessment. Your initial identification of resources should be of resources that will best help address the presented diagnosis you selected. Since you are locating resources to help provide evidence-based care for the diagnosis/health care issue you identified in the first assessment, you may want to begin your literature and evidence search from the databases that were identified.
Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.
Describe a chosen diagnosis that could benefit from an evidence-based approach.
Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
Analyze the credibility and relevance of evidence and resources within the context of a chosen diagnosis.
This is where you are selecting the specific resources to help address the diagnosis you selected for the first assessment.
Identify the Evidence-Based Practice model and explain the importance of incorporating credible evidence into the EBP model used to address a chosen diagnosis. Review the literature below and choose the appropriate model for your diagnosis.
……………………………………………………………………………………….
Your assessment should meet the following requirements:
Length of submission: 2-4-page scholarly paper, this does not include the APA-formatted title page and reference list.
Number of references: Cite 3-5 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than five years old.
APA formatting: References and citations are formatted according to current APA style
The use of spirituality in nursing practice is not new. However, it is more studied and utilized in a more structured format in nursing. Identify and discuss tools used to evaluate spirituality.The discussions require 400 words, with 2 scholarly references, and policies require plagiarism to be lower than 21%. I need the discussion to 10/18/2023
Imagine that two focus groups have been conducted in an Asian American and immigrant community in a large urban city. The rationale for conducting the qualitative study was a previous research finding that Asian Americans and immigrants are reluctant to seek mental health services. To further understand this issue, service providers including social workers, counselors, doctors, and nurses were recruited to discuss the barriers in implementing mental health services targeted to Asian Americans and immigrants. After the focus groups were transcribed, two research assistants completed a content analysis of the transcripts.
In this Assignment, you assume the role of the social worker reviewing the content analysis. You have been tasked with working with an advisory board in the community to formulate social work practice recommendations. You must also consider how culture may influence interpretation of qualitative data.
RESOURCES
TO PREPARE
Review the Content Analysis of Focus Groups document in the Learning Resources.
BY DAY 7
Submit a 3- to 4-page paper in which you:
List the main themes found in the Content Analysis of Focus Groups. Based on the data, provide a thorough analysis of the current barriers to services (found in each theme).
Select one barrier to service and create two social work recommendations to address that specific barrier. Use literature to support your recommendations.
Discuss how you would collaborate with other service providers and key community members to ensure that they understand the need for a culturally appropriate intervention.
Critically reflect on your own culture and explain how your cultural values and beliefs may have influenced how you interpreted the focus group data. What specific strategies would you undertake to become more culturally competent to practice or conduct research with this group?
Use the Learning Resources and peer-reviewed scholarly journal articles to support your paper. Make sure to include appropriate APA citations and a reference list.
An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.
Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.
An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.
The Assignment (1- to 2-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following:
Both the neurological and musculoskeletal pathophysiologic processes would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.
A 64-year-old male presents to the clinic with complaints of gradual onset of weakness to the left hand. He is left hand dominant. He has had ongoing numbness and tingling that feels as though it starts at his elbow. However, over the past 2-3 days he had been dropping items due to the weakness. He denies any recent injuries but state that he sustained a crushing injury to the left thumb 4 years ago. He is employed as a mechanic. Several years ago, he tripped over a tire and fell backwards striking his head on the fender of a car. He didn’t seek medical attention because he only had a small scrape on his elbow. A CT of the head is within normal limits and all labs are normal with the exception of a slightly elevated, non-fasting blood sugar (135). He has no history of diabetes. An x-ray of the neck reveals mild-to-moderate degenerative disc disease at C6-C7 with neuroforaminal narrowing and slight impingement of the exiting nerve root.
Submit your Case Study Analysis Assignment by Day 7 of Week 8.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates All papers submitted must use this formatting.
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area
NURS_6501_Module5_Case Study_Assignment_Rubric
NURS_6501_Module5_Case Study_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDevelop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:Explain both the neurological and musculoskeletal pathophysiologic processes of why the patient presents these symptoms.
30 to >27.0 pts
Excellent
The response accurately and thoroughly describes the patient symptoms. … The response includes accurate, clear, and detailed explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation.
27 to >24.0 pts
Good
The response describes the patient symptoms. … The response includes accurate, explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation.
24 to >22.0 pts
Fair
The response describes the patient symptoms in a manner that is vague or inaccurate. … The response includes explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by explanations that are vague or based on inappropriate evidence/research.
22 to >0 pts
Poor
The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. … The response does not include explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms, or the explanations are vague or based on inappropriate evidence/research.
30 pts
This criterion is linked to a Learning OutcomeExplain how the highlighted processes interact to affect the patient.
30 to >27.0 pts
Excellent
The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.
27 to >24.0 pts
Good
The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.
24 to >22.0 pts
Fair
The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/research.
22 to >0 pts
Poor
The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/research.
30 pts
This criterion is linked to a Learning OutcomeExplain any racial/ethnic variables that may impact physiological functioning.
25 to >22.0 pts
Excellent
The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.
22 to >19.0 pts
Good
The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.
19 to >17.0 pts
Fair
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations that are based on inappropriate evidence/research.
17 to >0 pts
Poor
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research.
25 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …The purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.
3.5 to >3.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. … The purpose, introduction, and conclusion of the assignment are vague or off topic.
3 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. ... No purpose statement, introduction, or conclusion were provided.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting - English Writing Standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.5 pts
Good
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
3.5 to >3.0 pts
Fair
Contains several (3 or 4) grammar, spelling, and punctuation errors.
3 to >0 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors.
4 to >3.0 pts
Good
Contains a few (1 or 2) APA format errors.
3 pts
Fair
Contains several (3 or 4) APA format errors.
3 to >0 pts
Poor
Contains many (≥ 5) APA format errors.
5 pts
Total Points: 100
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1
Title of the Paper in Full Goes Here
Student Name Here
Program Name or Degree Name, Walden University
Course Number, Section, and Title
(Example: NURS 0000 Section 01, Title of Course)
Instructor Name
Month, Day, Year
(enter the date submitted to instructor)
2
Title of the Paper
This is your introductory paragraph designed to inform the reader of what you will cover
in the paper. (BSN Students – Carefully follow your course-specific Grading Rubric concerning
the content that is required for your assignment and the Academic Writing Expectations [AWE]
level of your course.) This template’s formatting—Times New Roman 12-point font (other
options include Calibri 11, Arial 11, Lucida Sans Unicode 10, and Georgia 11), double spacing,
1” margins, 1/2” indentations beginning of each paragraph, page numbers, and page breaks—is
set for you, and you do not need to change it. Do not add any extra spaces between the heading
and the text (you may want to check Spacing under Paragraph, and make sure settings are all set
to “0”). The ideas in this paper should be in your own words and supported by credible outside
evidence. Cite the author, year of publication, and page number, if necessary, per APA. The
introductory paragraph should receive no specific heading because the first section functions as
your paper’s introduction. Build this paragraph with the following elements:
1. Briefly detail what has been said or done regarding the topic.
2. Explain the problem with what has been said or done.
3. Create a purpose statement (also commonly referred to as a thesis statement) as the last
sentence of this paragraph: “The purpose of this paper is to describe…”.
Level 1 Heading (Name According to the Grading Rubric Required Content)
This text will be the beginning of the body of the paper. Even though this section has a
new heading, make sure to connect this section to the previous one so the reader can follow
along with the ideas and research presented. The first sentence, or topic sentence, in each
paragraph should transition from the previous paragraph and summarize the main point in the
paragraph. Make sure each paragraph addresses only one topic. When you see yourself drifting
3
to another idea, make sure you break into a new paragraph. Avoid long paragraphs that are more
than three-fourths of a page. Per our program recommendations, each paragraph should be at
least 3-4 sentences in length and contain a topic sentence, evidence, analysis, and a conclusion or
lead out sentence. See the MEAL plan (Main idea, Evidence, Analysis, and Lead out) in the
Writing Center. In your paragraphs, synthesize your resources/readings into your own words and
avoid using direct quotations. In the rare instances you do use a direct quotation of a historical
nature from a source, the page or paragraph numbers are also included in the citation. For
example, Leplante and Nolin (2014) described burnout as “a negative affective response
occurring as result of chronic work stress” (p. 2). When you transition to a new idea, you should
begin a new paragraph.
Another Level 1 Heading (Name According to the Grading Rubric Required Content)
Here is another Level 1 heading. Again, the topic sentence of this section should explain
how this paragraph is related to or a result of what you discussed in the previous section.
Consider using transitions between sentences to help readers see the connections between ideas.
Be sure to credit your source(s) in your paper using APA style. The APA Manual 7th
edition and the Walden Writing Center are your best citation resources. Writing Center resources
are available at https://academicguides.waldenu.edu/writingcenter/apa/citations. You must
appropriately and correctly cite all works used in your document.
The following paragraph provides examples of in-text citation examples. According to
Leplante (2019), employers cause burnout when employees are stressed by too much work. Or
you might write and cite in this manner: Employers cause burnout when employees are stressed
by too much work (Leplante, 2019). When paraphrasing, the author name and year of publication
in citations is required by APA to direct the reader to a specific source in the reference list.
4
Personal communications are not listed in the reference page but are noted in text as (S. Wall,
personal communication, May 24, 2019). This should immediately follow the content of the
interview. Also, go to
Another Level 1 Heading (Name According to the Grading Rubric Required Content)
APA can seem difficult to master, but following the general rules becomes easier with
use. The Writing Center also offers numerous APA resources on its website and can answer your
questions via email. Prior to submitting your paper for grading, submit your draft to SafeAssign
Drafts found in the left column of your course.
And so forth until the conclusion….
Conclusion
The conclusion section should recap the major points of your paper. Do not introduce
new ideas in this paragraph; the conclusion should interpret what you have written and what it
means in the bigger picture.
5
References
Please note that the following references are intended as examples only. List your own
references in alphabetical order. Also, these illustrate different types of references; you are
responsible for any citations not included in this list. In your paper, be sure every reference entry
matches a citation, and every citation refers to an item in the reference list.
Journal Article; Two Authors; DOI
Leplante, J. P. & Nolin, C. (2014). Consultas and socially responsible investing in Guatemala: A
case study examining Maya perspectives on the Indigenous right to free, prior, and
informed consent. Society & Natural Resources, 27(4), 231–248.
https://doi.org/10.1080/08941920.2013.861554
Journal Article, Two Authors; URL
Eaton, T. V., & Akers, M. D. (20007). Whistleblowing and good governance. CPA Journal,
77(6), 66–71. http://archives.cpajournal.com/2007/607/essentials/p58.htm
Journal Article, More Than Twenty Authors; DOI
Wiskunde, B., Arslan, M., Fischer, P., Nowak, L., Van den Berg, O., Coetzee, L., Juárez, U.,
Riyaziyyat, E., Wang, C., Zhang, I., Li, P., Yang, R., Kumar, B., Xu, A., Martinez, R.,
McIntosh, V., Ibáñez, L. M., Mäkinen, G., Virtanen, E., . . . Kovács, A. (2019). Indie pop
rocks mathematics: Twenty One Pilots, Nicolas Bourbaki, and the empty set. Journal of
Improbable Mathematics, 27(1), 1935–1968. https://doi.org/xxx/xxxxxx
Book; One Author
Weinstein, J. A. (2019). Social change (3rd ed.). Rowman & Littlefield.
6
Book; Chapter in an Edited Book
Christensen, L. (2020). For my people: Celebrating community through poetry. In B. Bigelow,
B. Harvey, S. Karp, & L. Miller (Eds.), Rethinking our classrooms: Teaching for equity
and justice (Vol. 2; pp. 16–17). Rethinking Schools.
Professional Organization Web page
Centers for Disease Control and Prevention. (2018). Back to school.
https://www.cdc.gov/features/teens-back-to-school/index.html
Professional Organization Book
American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.).
Two or more works by same author in the same year
Wall, S. (2018a). Effects of friendship on children’s behavior. Journal of Social Psychology,
4(1), 101–105.
Wall, S. (2018b). Trials of parenting adolescents with deviant behaviors. Journal of Child
Psychology, 4(12), 161–167.
Government Article
National Institute of Mental Health. (1990). Clinical training in serious mental illness (DHHS
Publication No. ADM 90-1679). U.S. Government Printing Office.
Lecture Notes
Health effects of exposure to forest fires [Lecture notes]. (2019). Walden University Blackboard.
https://class.waldenu.edu
Personal Communication (Only Goes in Body of Paper and not in References)
7
Video
Walden University. (2009). Title of video here [Video]. Walden University Blackboard.
https://class.waldenu.edu
Television (Audio)
Important, I. M. (Producer). (1990, November 1). The nightly news hour [TV series episode].
Central Broadcasting Service.
APA Resources
You have other several options to assist you in the formulation of your reference page.
•
Your American Psychological Association (APA) Manual is your best reference
resource. Use the current edition with a copyright date of 2020.
•
The Walden Writing Center also a great place for referencing advice at
https://academicguides.waldenu.edu/writingcenter/apa/references.
•
Citation and reference examples are provided in the ‘BSN TOP Ten References and
Citations” handout found in the Writing Resources tab of the course. This document
covers the 10 most commonly used reference and citation formats. You are responsible
for looking up any that are not included on this list.
For this assignment, you’ll identify and analyze the various stakeholders that have influence over the issue you are addressing in your organization. Then, you will analyze how your organization will engage the stakeholders.
Once you’ve completed this activity, write an analysis explaining how you will address each of the four quadrants — how do you plan to monitor, share with, partner with and engage your stakeholders? Include this analysis in your strategic plan.
This is the idea of Homes for the Homeless. Homesfitforhomeless.org
Name of Organization: Homes Fit for Homeless
Location: Los Angeles
Type of Organization: Non-Profit (Federally/State/Privately Funded)
Reason: Reduce the number of homeless people out on the streets, provide a foundation necessary for homeless people to better themselves and provide them with tools needed to apply for jobs, and fix old and/or broken homes (city renewal).
Mission:
We exist to be a community fit for the homeless and give hope, keeping families together, providing compassionate care, and guiding and facilitating those we serve on a path to life change.
Vision:
Our Vision is to end homelessness by building homes fit for homeless communities that will empower families to become resilient and independent.
Values:
Our goal is to bring about transformation in the lives of those who are hurting through the provision of housing solutions and support services; and to serve as a guiding partner in transforming, educating, creating stability and bringing the better and bright futures into relationships in these communities that we help.
Strategic Plan: Goals & Objectives
PM 564: Diana Marcos Emily Chea Humberto Liriano
Goals:
Address the critical issues facing the organization
Reduce the number of homeless people out on the streets by providing them with permanent housing as a foundation to better their lives.
Focus on the needs of stakeholders
Find and organize the funding to renew the housing. Network and solidify the agreements with federal government agencies, local government agencies, and/or agencies in the private sector.
Objectives: (S.M.A.R.T)
Goal #1
Measurable: See if the number of homeless people lowers overtime with the addition of housing. Can measure (count) how many homeless people in a location (sample size) and compare it to a future count.
Specific: This goal is aimed towards a specific group of people, homeless people. This goal also has a specific plan of rebuilding and fixing homes that are in bad condition and specifically placing the homeless people into these homes.
Time-dated: In the city of Los Angeles there are about 75% of homeless that lack permanent shelter, the goal is to decrease by 10% the first year and by 50% by year 5.
Goal #2
1.Specific: We will seek funding from many private and public companies to support our organization in the amount of $15 million dollars to rebuild 100 homes at the cost of $150,000 for each home.
2. Attainable: Funding and support for example from government agencies like the US Department of Housing and Urban Development that can provide housing and community development assistance.
3.Measurable: To obtain $15 million dollars to rebuild 100 homes in order to decrease homeless people in Los Angeles by 400 averaging about $150,000 per home spent on renovaation
SWOT ANALYSIS: Strategic Plan
Strength
Objective and Perspective: Homes Fit for Homeless has a solid and engaging goal and vision centered on eradicating homelessness and delivering a brighter future for homeless individuals and families, which can excite contributors and supporters.
Non-profit Status: Getting classified as a non-profit organization provides opportunities to obtain grants, tax exemptions, and other advantages that can assist in achieving the organization’s goals
Assistance from the community: The organization is expected to garner the endorsement of the local community in Los Angeles, owing to its objective of mitigating homelessness and enhancing living standards.
Sources of Funding: Public and Private: Homes Fit for Homeless aims to obtain money from various sources, such as private entities and government agencies, to broaden its financial resources.
Weaknesses
Economic reliance: Being a non-profit organization, Homes Fit for Homeless may significantly depend on external funding, which can be uncertain and vulnerable to economic swings.
Funding Competition: The substantial rivalry for financing among non-profit organizations that focus on treating homelessness poses difficulty in obtaining the required resources Operational intricacy: Undertaking rebuilding and repairing homes while providing extensive support services can be operationally intricate, necessitating excellent administration and coordination.
Opportunities
Collaborations: The organization may consider forging alliances with local government agencies, real estate developers, and other non-profit organizations to broaden its scope and accomplish its goals.
Increasing awareness: The rising recognition of homelessness as a pivotal societal concern has the potential to generate heightened public and private backing for groups such as Homes Fit for Homeless.
State assistance: Government agencies, such as the US Department of Housing and Urban Development, offer financial assistance and backing for housing and community development initiatives through grants and subsidies.
Volunteer Participation: Community members can contribute as volunteers, dedicating their time, skills, and resources to further the organization’s success.
Threats
Economic Obstacles: The organization may need help achieving its goals due to economic downturns, leading to decreased financial availability and increased service demand.
Concerns related to regulations and standards: Non-profit organizations have regulatory and compliance obstacles, which can require significant time and resources if not handled efficiently.
Perception by the general public: Unfavorable public opinion or misunderstandings regarding homelessness and the organization’s activities might impede fundraising endeavors and community backing.
Limitations on available resources: The objective of achieving a 50% reduction in homelessness within five years may be ambitious and might potentially exert significant pressure on the organization’s resources and skills.
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Group Project Instructions: Develop a Strategic
Plan for a New Health Organization
Goal:
As health is delivered locally, it is imperative to understand not just the larger national view, but
also the local community (marketplace) view. This exercise is designed to provide students with
knowledge of the components of the health system as they function at the marketplace level.
This practice will also provide the skills necessary to analyze the system(s) in any community or
marketplace and potential organizational opportunities and challenges.
Instructions:
Select a marketplace that your group is interested in analyzing from the perspective of the
community’s health needs, the existing health system(s) that serve those needs, and
opportunities for development. Your group should identify an opportunity for new organizational
development via the creation of a new public health or healthcare organization in this
community.
Components:
Complete a strategic organizational plan including the following elements:
1. Name and type of organization (government, NGO, for-profit, etc.)
2. Organization mission statement
3. Target clients/community
● Present a composite picture of the community and its health status. Present
and discuss trends in demographic data, socio-economic indicators, and
other pertinent indicators of health status.
4. Community/Marketplace Analysis
● What are the facilities in the community where individuals obtain care? Are
these out-patient or in-patient facilities? What payment mechanisms exist for
this care? Do these facilities attract patients from outside the community/
marketplace, etc.?
● Is there a suitable match between the health services needs of the community
and the supply of services? What are the trends (national, regional, local)
impacting the health status and health system of this community? How is the
community/marketplace responding to these trends/forces? What do you
anticipate in the future?
5. SWOT Analysis
6. Goals of the new organization (5 year goals and 1 year goals)
PM 564 |Final Group Project Instructions Page 1
7. List of key stakeholders relevant to the new organization
● Identify diverse stakeholders
● Consider stakeholders with regard to their contribution, legitimacy, potential
conflict of interest, willingness to engage, influence, and necessity of
involvement
● Strategize how to monitor, share with, partner with, and engage stakeholders
8. Key Performance Indicators/Evaluation of the new organization
● What do you expect to be the impacts of the new organization?
● What are some key indicators you will use to measure the impacts o f your
organization?
● What methods might you employ to gather evidence a nd determine the
effects of your organization?
● Imagine an unintended or negative consequence of the new organization.
Describe it and how you would a dapt and re-design your new organization to
avoid this effect.
9. Marketing plan of the new organization
● How would you market your new organization?
● What are some of the key strategies and tactics you would use?
10. Human Resources (Team) of the new organization
• What combination of professionals would you need to develop this new
organization?
• Provide an organization chart
11. Operational Plan
● Identify and describe the key services or programs your organization will offer
in line with its mission and goals. Then map out each of these, ideally in a
Gantt chart, so you know when each service/program will start (between a 1 5 year period) and who will lead them. Describe why you chose this specific
order to launch each service/program.
12. Financial Projections (or budget) of the new organization
• Develop the financial projections for your organization for its first 5-year
period.
• Identify the key expenses that will be required to launch your organization and
its services/programs (including staff, rent, utilities, equipment, supplies,
marketing, etc.).
• In addition, identify the revenues you anticipate earning from the key services/
programs you provide during this period.
• If your services o r programs are not revenue-generating, identify the amount
and possible sources of funding you plan to obtain to cover your expenses
(grant funding from specific institutions, foundations, etc.).
Final Products
When all components have been completed, you will finalize them into the following
product:
PM 564 |Final Group Project Instructions Page 2
Elevator Pitch
Each student completes a 3-5 minute “elevator pitch” designed to outline the organization’s
mission and inspire the viewer to invest in your organization. Consider how to market your
organization in a way that’s short and catchy and will grab the audience’s interest.
Note that this is as much a professional development exercise as a course assignment
and the pitch should reflect this level of professionalism (understanding that you will have
varying levels of video-editing capabilities and skills).
Grading
Elevator Pitch
Grade
General Quality
Persuasiveness
Presentation Style
A
(9-10 points)
Excellent work. Project
demonstrates original
thought, analysis and
innovation.
Information goes
beyond what was
discussed in
class/readings. Ideas
are clearly presented.
Very good work.
Project indicates
understanding of
concepts and
applications. Some
analysis and
innovation are present
but overall project is
descriptive rather than
analytical.
Only meets minimum
requirements.
Concepts are
Mission is clearly
highlighted and pitch is
designed to inspire the
viewer to invest in the
organization. Pitch takes
into account marketing
strategies learned in
course.
Presentation is high quality
and reflects presenters’
professionalism. A clear
effort was made to develop
a strong, professional
recording.
Mission is highlighted;
pitch is somewhat
persuasive and may use
some marketing strategies
learned in course.
Presentation is clear and
articulate but not of high
quality. Some effort was
made to develop a strong,
professional recording.
Mission is unclear and/or
pitch does not persuade
Pitch presentation is of poor
quality. Does not reflect
professionalism and/or
B
(7-8 points)
C or lower
(6 or fewer
points)
PM 564 |Final Group Project Instructions Page 3
incorrectly applied or
ideas are largely
undeveloped.
the viewer to care about
the organization.
quality of
recording/presentation is
poor..
PM 564 |Final Group Project Instructions Page 4
An important consideration when working with patients is their cultural background. Understanding an individual’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future. Culture helps to establish a sense of identity, as well as to set values, behaviors, and purpose for individuals within a society. Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms. What one culture may deem as appropriate another culture may find inappropriate. As a result, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to substance-related disorders. At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations.
For this Assignment, you will practice assessing and diagnosing a patient in a case study who is experiencing a substance-related or addictive disorder. With this and all cases, remember to consider the patient’s cultural background.
Review this week’s Learning Resources and consider the insights they provide.
Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
BY DAY 7 OF WEEK 8
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Training Title 114Name: Ally Chen
Gender: female
Age: 44 years old
Background: Only child, raised by parents in Philadelphia, PA. Has PhD in biology and master’s
degree in high school education (8–12). Her supervisor has asked the school EAP counselor to
intervene with concerns regarding potential substance use in effort to facilitate getting her help
and be able to retain her. She is divorced, has a 4-year-old son who lives with his father. Appetite
healthy, sleeping 9 hours/24 hrs., wakes 2-3 times during the night. Denied drug use. had DUI
when she was age 21.
Symptom Media. (Producer). (2018). Training title 114-2 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-114-2
Addressing Immigration Policy Reform: Social, Ethical, and Economic Dimensions
Addressing immigration policy reform is a complex and multifaceted social, ethical, and economic issue. In this discussion, we will explore some of the key reasons and rationales for addressing immigration policy reform in each of these domains, supported by recent scholarly references:
Social Reasons:
Cultural Diversity and Enrichment
One of the primary social reasons for immigration policy reform is the enrichment of cultural diversity. Immigration brings people from different backgrounds, languages, and traditions, contributing to a more culturally vibrant society. This cultural diversity can foster cross-cultural understanding and tolerance, enhancing social cohesion.
Rationale: Embracing cultural diversity promotes inclusivity and reduces social tensions, leading to a more harmonious and tolerant society (Schmid et al., 2019).
Family Reunification
Immigration policies often affect families, causing separation and hardship. Reform efforts seek to address family reunification, recognizing the importance of keeping families together.
Rationale: Promoting family unity is a fundamental ethical principle that supports social well-being (Hainmueller et al., 2017).
Ethical Reasons:
Human Rights and Dignity
Ethical considerations are at the core of immigration policy reform. Treating immigrants with dignity and respecting their human rights is a fundamental principle. Reform seeks to ensure humane treatment and fair processes for migrants.
Rationale: Upholding human rights and dignity is a moral obligation and reflects a just and compassionate society (Gibney & Jensen, 2017).
Refugee Protection
Providing refuge to those fleeing persecution and violence is an ethical imperative. Reform efforts aim to improve the asylum process and support refugees in rebuilding their lives.
Rationale: Protecting refugees upholds international humanitarian norms and demonstrates a commitment to global justice (Hathaway, 2017).
Economic Reasons:
Labor Market Needs
Many countries face demographic challenges, including an aging population and a shrinking workforce. Immigration can help address labor shortages and drive economic growth.
Rationale: A well-managed immigration policy can provide economic vitality, filling critical labor gaps and contributing to national prosperity (Borjas, 2017).
Innovation and Entrepreneurship
Immigrants often contribute significantly to innovation and entrepreneurship. Reforming policies to attract skilled immigrants can boost a nation’s technological advancement and economic competitiveness.
Rationale: Encouraging immigrant entrepreneurs and innovators can stimulate economic growth and job creation (Kerr & Kerr, 2018).
Conclusion
Addressing immigration policy reform is imperative due to social, ethical, and economic factors. These reforms aim to create a more inclusive, prosperous society while upholding human rights, dignity, and cultural diversity. Recognizing and addressing these multifaceted dimensions is crucial for shaping effective and equitable immigration policies.
References
Borjas, G. J. (2017). The Earnings of Undocumented Immigrants. ILR Review, 70(5), 1077-1110.
Gibney, M. J., & Jensen, E. (2017). Immigration and Asylum: From 1900 to the Present. ABC-CLIO.
Hainmueller, J., Hangartner, D., & Lawrence, D. (2017). When lives are put on hold: Lengthy asylum processes decrease employment among refugees. Science, 356(6337), 1436-1440.
Hathaway, J. C. (2017). The Rights of Refugees under International Law. Cambridge University Press.
Kerr, S. P., & Kerr, W. R. (2018). Immigrant entrepreneurship in America: Evidence from the Survey of Business Owners 2007 & 2012. Research Policy, 47(5), 795- 814.
Schmid, K., Dovidio, J. F., Saguy, T., & Gaertner, S. L. (2019). Implicit and explicit intergroup bias against immigrants: The moderating role of immigrant national identification. Cultural Diversity and Ethnic Minority Psychology, 25(4), 560-570.
by Daniela Carolina Villasmil Vera –
Number of replies: 0
Immigration policy reform is a complex and contentious issue in many countries, including the United States. To effectively address the challenges posed by immigration, it is crucial to consider the social, ethical, and economic factors at play. This essay highlights some of the key reasons for addressing immigration policy reform within these dimensions, citing recent scholarly references to support the arguments.
Social Reasons
Integration and Social Cohesion: Immigration, when not properly regulated, can lead to social fragmentation and marginalization. Scholars like Kogan (2019) emphasize the importance of immigration policies that promote integration, as this contributes to social cohesion. Reform can help immigrants become active, contributing members of society, reducing tensions and enhancing social harmony.
Humanitarian Concerns: Human rights and humanitarian principles are vital drivers for immigration policy reform. Refugees and asylum seekers, fleeing violence or persecution, require protection. Han et al. (2019) discuss how a more humane approach to immigration policy is essential to uphold international human rights standards and values, providing a compelling argument for reform efforts.
Ethical Reasons
Moral Responsibility: Ethical considerations are intrinsic to immigration policy reform. Sassen (2020) argues that advanced economies have a moral responsibility to address the challenges faced by less fortunate nations, including refugees and economic migrants. Reforming immigration policies in an ethical manner acknowledges the shared humanity and interconnectedness of the world.
Justice and Fairness: Addressing economic and social inequalities is an ethical imperative. Discriminatory immigration policies can perpetuate injustice. Recent scholarship, like the work of Dancygier and Laitin (2019), underlines the ethical importance of creating policies that are fair and equitable, ensuring opportunities for all, irrespective of nationality or origin.
Economic Reasons
Labor Force Dynamics: Immigration policy reform can have substantial economic implications. A study by Chassamboulli and Peri (2019) demonstrates that immigrants often fill gaps in the labor market, contributing to economic growth. Reform can optimize the labor force by addressing skills shortages and increasing productivity.
Economic Growth: Economists like Peri (2019) argue that well-designed immigration policies can boost economic growth, particularly through increased innovation and entrepreneurship. Reforms that attract and retain skilled immigrants can lead to economic prosperity and help address demographic challenges.
In conclusion, immigration policy reform is an essential and multifaceted issue, requiring a balanced approach that considers social, ethical, and economic dimensions. Recent scholarly research supports the imperative of addressing these aspects. By focusing on integration, humanitarian concerns, moral responsibility, justice, labor force dynamics, and economic growth, policymakers can develop more effective and compassionate immigration policies that benefit both receiving and immigrant populations, fostering a more inclusive, just, and prosperous society.
References
Chassamboulli, A., & Peri, G. (2019). The labor market effects of reducing the number of illegal immigrants. Journal of Political Economy, 127(1), 211-252.
Dancygier, R. M., & Laitin, D. D. (2019). Immigration into Europe: Economic discrimination, violence, and public opinion. Annual Review of Political Science, 22, 325-344.
Han, E., Sutherland, K., & Vink, M. P. (2019). Asylum recognition rates in EU countries: Revisiting the determinants of refugee status. International Migration Review, 53(3), 812-841.
Kogan, I. (2019). Immigrant integration policies and perceived group threat: A multilevel study of 27 Western and Southern European countries. International Migration Review, 53(1), 245-280.
Sassen, S. (2020). Immigration in the Global Age: An Ethnography of a Western European Policy. Annual Review of Sociology, 46, 305-323.
DirectionsThroughout the first half of the semester, you have learned about our US health system and what makes it unique. In your opinion, what are the biggest pros and cons of our healthcare system? Provide at least 3 pros and 3 cons of our health system and explain your reasoning behind selecting each of them. Make sure to clearly highlight your pros and cons so I know that you properly covered at least 3 pros and cons per the directions. Your post should be at least 250 words.When formatting your response, be sure to include in-text citations and a reference page if you use online sources to help strengthen your response. Reminder, if they aren’t your own words, citations need to be included.
An important first step toward cultural competence is an awareness of one’s own culturally-informed beliefs, values, attitudes, and potential biases. Recognizing the potential limitations in one’s cultural knowledge and being open to new ideas, contradictory information and advice illustrates an important concept referred to as “cultural humility.” When you understand how culture shapes your own beliefs, you become more open to understanding that someone of another culture may have a different perspective on a specific health issue and different strategies for achieving health. As a core competency of effective public health nursing, this Discussion assists in exploring your own cultural perceptions.
To Prepare:
Complete the Diversity Eye-Opener Self-Assessment. (ATTACHED TO FILE)
Post an explanation of the traits you believe you possess that enable you to effectively facilitate cross-cultural communication. Then, explain what traits you possess that might make it challenging for you to be effective in cross-cultural encounters with diverse others. Lastly, summarize at least two strategies for effective, culturally competent health care practice.
USW1_NURS_6710_Week08_Discussion_Rubric
USW1_NURS_6710_Week08_Discussion_Rubric
Criteria Ratings Pts
Main Posting
50 to >44.0 pts
Excellent
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
44 to >39.0 pts
Good
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
39 to >34.0 pts
Fair
Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.
34 to >0 pts
Poor
Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Record a 5-10 minute video reflection on your work and experiences in this course. (TRANSCRIPT ONLY– STUDENT WILL MAKE VIDEO).
Health care professionals have many opportunities to reflect on their contributions to their field and organization. After completing any portion of a project, it is important to evaluate how well it met its objectives. Such evaluation enables practitioners and leaders to explore and reflect on their experiences and identify opportunities for future improvement. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).
This assessment provides an opportunity for you to reflect on your achievements, challenges, and improvement opportunities related to your work on your project and at your project site during this course. By reflecting on these areas, you can deepen your critical-thinking and problem-solving skills, as well as locate your position on your project journey as you progress to NHS-FPX9902.
DEMONSTRATION OF PROFICIENCY
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 4: Reflect on your growth and learning during the IRB process and project planning phase.
Reflect on process, outcomes, success, and opportunities for improvement related to the development of a QI/PI framework.
Reflect on process, outcomes, success, and opportunities for improvement related to the development of a project implementation plan and logic model.
Reflect on process, outcomes, success, and opportunities for improvement related to collaboration and other relevant work at a project site.
Communicate orally in a clear, confident, and professional manner.
Competency 6: Address assessment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences.
Integrate support from scholarly and authoritative sources to strengthen claims and substantiate decision making.
Reference
Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. Sciedu International Journal of Higher Education, 7(4).
Important Note: You do not need to submit the transcript of your video. However, make sure you submit an APA-formatted reference list for the authors or sources of evidence used to support your assertions or inform your reflection approach in your video.
One way you could organize your reflection is to take a simplified gap-analysis approach for each of the four main topics for the reflection:
What happened?
What did you do and what were the results of your work?
Remember to mention the relevant evidence you used to guide your approach to your work.
What went well?
What did not go well?
How did actual events differ from your predictions?
If relevant, mention the evidence that helped you formulate your prediction about what should have happened.
How are your experiences changing your thinking, analysis, and communication patterns?
How can you use this information to improve?
If relevant, look to the literature to support your potential changes.
While you may use any appropriate approach to organize your reflection, be sure that you address the following scoring guide criteria:
Reflect on process, outcomes, success, and opportunities for improvement related to the development of your QI/PI framework.
Reflect on process, outcomes, success, and opportunities for improvement related to the development of your project implementation plan and logic model.
Reflect on process, outcomes, success, and opportunities for improvement related to collaboration and other relevant work at the project site.
Integrate support from scholarly and authoritative sources to strengthen claims and substantiate decision making.
Communicate orally in a clear, confident, and professional manner.
Unformatted Attachment Preview
Reflection Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Reflect on process,
outcomes, success, and
improvement opportunities
related to the development
of a QI/PI framework.
Does not describe the
process, outcomes,
success, or improvement
opportunities related to the
development of a QI/PI
framework.
Describes the process,
outcomes, success, and
improvement opportunities
related to the development
of a QI/PI framework.
Reflects on process,
outcomes, success, and
improvement opportunities
related to the development
of a QI/PI framework.
Reflects on process, outcomes,
success, and improvement
opportunities related to the
development of a QI/PI framework.
Considers the context and
significance of one’s work and the
application of lessons learned.
Reflect on process,
outcomes, success, and
improvement opportunities
related to the development
of a project implementation
plan and logic model.
Does not describe the
process, outcomes,
success, or improvement
opportunities related to the
development of a project
implementation plan and
logic model.
Describes the process,
outcomes, success, and
improvement opportunities
related to the development
of a project implementation
plan and logic model.
Reflects on process,
outcomes, success, and
improvement opportunities
related to the development
of a project implementation
plan and logic model.
Reflects on process, outcomes,
success, and improvement
opportunities related to the
development of a project
implementation plan and logic model.
Considers the context and
significance of one’s work and the
application of lessons learned.
Reflect on process,
outcomes, success, and
improvement opportunities
related to collaboration and
other relevant work at a
project site.
Does not describe the
process, outcomes,
success, or improvement
opportunities related to
collaboration and other
relevant work at a project
site.
Describes the process,
outcomes, success, and
improvement opportunities
related to collaboration and
other relevant work at a
project site.
Reflects on process,
outcomes, success, and
improvement opportunities
related to collaboration and
other relevant work at a
project site.
Reflects on process, outcomes,
success, and improvement
opportunities related to collaboration
and other relevant work at a project
site. Acknowledges the influence of
own preconceptions, assumptions, or
biases on attitude and approach to
the work.
Integrate support from
scholarly and authoritative
sources to strengthen
claims and substantiate
decision making.
Does not identify scholarly
or authoritative sources to
strengthen claims or
substantiate decision
making.
Identifies scholarly and
authoritative sources to
strengthen claims and
substantiate decision
making but does not
integrate sources into the
reflection.
Integrates support from
scholarly and authoritative
sources to strengthen
claims and substantiate
decision making.
Integrates support from scholarly and
authoritative sources to strengthen
claims and substantiate decision
making. Notes the relevance of
sources to the claims and decisions
that they support.
Communicate orally in a
clear, confident, and
professional manner.
Does not communicate
orally.
Communicates orally
without clarity, confidence,
and/or professionalism,
inhibited by digressions or
limited vocabulary.
Communicates orally in a
clear, confident, and
professional manner.
Communicates orally in a clear,
confident, and professional manner.
Communication is articulate and
engaging in expression of ideas.
The Critical Reflective Journal assignment serves as a platform for you to engage deeply with course materials, discussions, activities, and readings. Through reflective writing, you will explore your thoughts, emotions, and learning experiences, fostering self-awareness, understanding, and personal growth.
Instructions
1. Each journal entry should span between 3 to 5 pages.
2. Engage with class materials, activities, discussions, and required readings to guide your reflection.
3. Reflect on your experiences, opinions, insights, and challenges related to the course content.
4. Address questions, uncertainties, connections, and alternative perspectives that have arisen.
5. Utilize a subjective writing style to express your thoughts, emotions, and critical analysis.
Guidelines:
1. Your reflective writing should go beyond description and involve analysis, exploration, and introspection.
2. Balance personal expression with academic engagement, minimizing colloquial language.
3. Employ personal pronouns (‘I,’ ‘my,’ ‘we’) as appropriate.
4. Address various aspects such as your perceptions of the course, insights, experiences, and connections to prior knowledge.
5. Aim for a thoughtful blend of logic, experience, and personal voice in your writing.
Unformatted Attachment Preview
Critical Reflective Journal Assignment 2
Purpose
The Critical Reflective Journal assignment serves as a platform for you to engage deeply with course
materials, discussions, activities, and readings. Through reflective writing, you will explore your thoughts,
emotions, and learning experiences, fostering self-awareness, understanding, and personal growth.
Instructions
1. Each journal entry should span between 3 to 5 pages.
2. Engage with class materials, activities, discussions, and required readings to guide your reflection.
3. Reflect on your experiences, opinions, insights, and challenges related to the course content.
4. Address questions, uncertainties, connections, and alternative perspectives that have arisen.
5. Utilize a subjective writing style to express your thoughts, emotions, and critical analysis.
Guidelines:
1. Your reflective writing should go beyond description and involve analysis, exploration, and
introspection.
2. Balance personal expression with academic engagement, minimizing colloquial language.
3. Employ personal pronouns (‘I,’ ‘my,’ ‘we’) as appropriate.
4. Address various aspects such as your perceptions of the course, insights, experiences, and connections
to prior knowledge.
5. Aim for a thoughtful blend of logic, experience, and personal voice in your writing.
Guidelines
APA Format
Page Length: 3-5pgs
Sources:
Format Font and margins according to APA format. MS Word.
Grading
For grading criteria, refer to the rubric in the assignments tab on Moodle.
Due
Submit on selected week on your syllabus.
•
•
Reference material
View Human Rights Campaign: Mental Health in the Queer & Trans BIPOC Communities –
Indian Child Welfare Act – Educational Resource Video
Re-visioning family therapy through a culture lens – Monica McGoldrick -uploaded the article.
Incorporating Intersectionality Into Psychology: An Opportunity to Promote Social Justice and Equity
Lisa Rosenthal Pace University- uploaded the article
Intersectionality as a Useful Tool: Anti-Oppressive Social Work and Critical Reflection Tina Mattsson1 –
uploaded the article.
Criteria
Depth of
Reflection
25pts
Excellent
Demonstrates
exceptional depth of
reflection, delving into
profound insights and
personal growth related
to the course content.
Analysis and
Critical
Thinking
25pts
Shows exceptional
analysis and critical
thinking, presenting
well-developed
connections between
personal experiences,
course materials, and
broader implications.
Integrates a wide range
of course materials,
incorporating diverse
sources to support
reflections and insights
effectively.
Expresses ideas and
reflections with
exceptional clarity,
precision, and
eloquence.
Integration of
Course
Materials
20pts
Clarity of
Expression
15pt
Proficient
Exhibits a solid level of
reflection, showcasing
meaningful insights
and personal
development in
connection to the
course content.
Demonstrates
proficient analysis and
critical thinking,
establishing clear links
between personal
experiences, course
materials, and
broader implications.
Integrates relevant
course materials
effectively, using
various sources to
support reflections
and insights.
Communicates ideas
and reflections clearly
and effectively, with
minimal instances of
ambiguity.
Basic
Displays basic
reflection, capturing
some insights and
personal growth
related to the course
content.
Limited
Shows minimal
reflection with
limited insights or
personal growth in
connection to the
course content.
Displays basic
analysis and critical
thinking, outlining
some connections
between personal
experiences, course
materials, and
broader implications.
Integrates some
course materials to
support reflections
and insights, but may
lack diversity or
depth.
Presents ideas and
reflections with basic
clarity, occasional
instances of
ambiguity may arise.
Presents limited
analysis and critical
thinking, with weak
connections
between personal
experiences, course
materials, and
broader implications.
Integrates minimal
course materials,
with limited use of
sources to support
reflections and
insights.
Communicates ideas
and reflections with
limited clarity,
making it challenging
Article
Intersectionality as a Useful Tool:
Anti-Oppressive Social Work
and Critical Reflection
Affilia: Journal of Women and Social
Work
2014, 29(1) 8-17
ª The Author(s) 2013
Reprints and permission:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/0886109913510659
aff.sagepub.com
Tina Mattsson1
Abstract
This article introduces intersectionality as a usable tool for critical reflection, which as a part of the
critical social work tradition aims to challenge oppression and inequality. It is argued that in critical
reflection, oppression and injustice are often understood in general terms and that oppression and
inequalities related to gender, sexuality, class, and race therefore risk being neutralized and
undetected. The suggestion is made that by using an intersectional approach, which focuses the
interplay and complexity between gender, sexuality, class, and race, critical reflection gets the
capacity to keep central power relations in urgent focus.
Keywords
anti-oppressive social work, critical social work, critical reflection, intersectionality, oppression
Introduction: Oppression and Critical Social Work
Critical and radical social work has been occupied with oppression and the ways through which
social structures shape social work practice since the 1960s. It criticizes traditional social work for
maintaining and reinforcing oppression and inequality, as social problems are usually understood as
an effect of the individual’s lack of ability to cope with everyday life. By the view of critical social
workers and researchers, social work should be a practice with an ambition to challenge inequality,
marginalization, and oppression at a structural level by using structural understandings of social
problems (Adams, Dominelli, & Payne, 2002; Bailey & Brake, 1975; Dominelli, 2002; Pease &
Fook, 1999; Sakamoto & Pitner, 2005).
The interest in critical and anti-oppressive social work has increased during the last decades, and
several critical social work theorists have stressed the need for critical perspectives in a world
affected by and dependent on globalization and market economy (Dominelli, 2002; Fook, 2002;
Lewis, 2001; Morley, 2004; Stepney, 2005). Globalization creates economical standardization and
increasing economical dependency between states. At the same time, it increases Western, industrialized countries’ monopolies of technological, financial, communications, and weaponry resources.
1
School of social work, Lund University, Lund, Sweden
Corresponding Author:
Tina Mattsson, School of social work, Lund University, Box 23, SE-221 00 Lund, Sweden.
Email: tina.mattsson@soch.lu.se
Mattsson
9
Within this context, governmental power is eroding and democratic control over policy is decreased
as transnational corporations and international banks are becoming stronger (Dominelli, 2002; Fink,
Lewis, & Clarke, 2001; Fook, 2002; Lewis, 2001; Morley, 2004; Stepney, 2005). Neoliberal principles have become dominant and affect the conditions of social work practice as the welfare states’
services are minimalized. For example, in Sweden, the public monopoly of welfare services has been
replaced by freer forms and has been exposed to competition between social services producers. The
social security system is confined and excludes a growing number of people. These changes are
hardly unproblematic, as they result in increasing social exclusion, poverty, and marginalization
(Höjer & Forkby, 2011; Schierup & Ålund, 2011). For critical social work practice, which aims
to challenge oppression and injustice, these changes implicate growing demands on usable tools for
critical practice and for the critical social worker in Sweden, as well in other Western societies.
Critical reflection has been developed as part of this need and aims to bring knowledge of how
social structures affect social work practice (Brookfield, 2009; Dominelli, 2002; Fook, 2002).
Critical theorists have introduced reflection as a way for the social worker to develop awareness
of how she and social work practice uphold oppression as part of an unreflective, everyday practice.
By understanding oppression as a result of ordinary people’s unconscious thoughts and feelings, it is
possible to emphasize how oppression and injustice are upheld not first and foremost by outspoken
racism, homophobia, or sexism, but by actions, thoughts, and feelings in everyday life (Essed, 1996;
Young, 1990). For example, as Young (1990) explains, oppression might be understood as:
. . . the vast and deep injustices some groups suffer as a consequence of often unconscious assumptions
and reactions of well meaning people in ordinary interactions, media, and cultural stereotypes, and structural features of bureaucratic hierarchies and market mechanisms—in short, the normal processes of
everyday life. (Young, 1990, p. 21)
For social work practice, this implies that a social worker might uphold and reproduce social
structures and oppression even though they might just be doing their job with good intentions.
Critical reflection deals with this challenge and focuses on the social worker and her unconscious
assumptions and actions as part of reinforcing and maintaining oppression. By critical reflection, the
social worker is getting knowledge and insights of how social structures work in everyday life, and
therefore becomes capable of working against oppression and injustice (Brookfield, 2009; Dominelli, 2002; Fook, 2002; Fook & Gardner, 2007; Mattsson, 2010; Morley, 2004; Pitner & Sakamoto,
2005). In this article, I will argue that critical reflection is an important but challenging approach to
social work. In the tradition of critical reflection, oppression and inequality are understood and
explained in general terms, and gender, sexuality, class, and race are not emphasized as central categories of oppression and injustice. They therefore risk being unrecognized and neutralized when
critical reflection is used in practice, especially since it is often particularly challenging to visualize
oppression and inequality that relates to the social worker herself, her professional role and her
private life, and not just to the client’s vulnerability and exclusion. As a critical and antioppressive practice, social work needs a usable tool to be able to stay focused on gender, sexuality,
class, and race to be able to visualize and understand oppression and injustice. Combing critical
reflection and intersectionality might be a useful premise for this purpose.
Intersectionality: Oppression as Complexity
Intersectionality might be explained as an analytical ambition to explore gender, sexuality, class, and
race as complex, intertwined, and mutual reinforcing categories of oppression and social structures
(Davis, 2008; de los Reyes & Mulinari, 2005). The background of intersectionality is found in feminist theory, which started to work with this complex understanding of gender to capture women’s
10
Affilia: Journal of Women and Social Work 29(1)
different experiences of oppression during the 1990s. A main point for feminists was the ability to
capture inequality and oppression within groups of women, and not only among women and men
(Collins, 1989, 1990; Crenshaw 1991; hooks, 1989; Lorde, 1984; Rich, 1993).
Intersectionality has become a central way for feminist research to understand how women are
positioned in patriarchy as well as within other systems of oppression, for example, those of class
and race (Davis, 2008). Although the perspective is quite well used, it is also conceptualized and
used inconsistently. For example, intersectionality has been described as a theory, a method, a perspective, a concept, and a framework (Carbin & Edenheim, 2013; Davis, 2008; Mehrotra, 2010).
Different understandings and uses of intersectionality argue that the perspective might be used as
a way to understand individuals’ multiple identities, interlocking systemic inequalities at the level
of social structures or multiplicity of social, historical, and cultural discourses (Chang & Culp,
2002; Davis, 2008; de los Reyes & Mulinari, 2005; Lykke, 2010; McCall, 2005; Yuval-Davis,
1997).
In social work, intersectionality has been used as an analytical approach during recent years and it
has been a way to understand both complex identities and how social structures affect people’s living
conditions (Eliassi, 2010; Fahlgren, 2013; Fahlgren & Sawyer, 2005; Grönvik & Söder, 2008;
Mattsson, 2005, 2010; Mehrotra, 2010; Murphy, Hunt, Zajicek, Norris, & Hamilton, 2009; Pease,
2010; Sawyer, 2012). Mehrotra (2010) argues that intersectionality is usable in social work and that
different intersectional approaches in analysis strengthen the field. Drawing on McCall’s (2005)
typology, she describes different approaches in intersectional analysis usable for social work: an
intercategorical approach that aims to understand how different social groupings are affected by
structural inequalities and how identity is determined and shaped by social structures. Intracategorical approaches focus on diversity within social groups and illuminate lived experiences, multiple
identities, and standpoints of people who are situated in the intersections of numerous oppressions.
The third approach, the anticategorical, are generally aligned with a poststructuralist feminism that
challenges the idea of social categories such as gender, sexuality, class, and race, and problematizes
categories as real, fixed, homogenous, and bound by social structures (McCall, 2005; Mehrotra,
2010).
Using intersectionality, critical reflection might be understood as a mix of the different
approaches (cf. Sandberg, 2013). A central aim for the reflection should be to understand the complexity of categories and power relations. At the same time, it must be stressed that the aim is to
disclose and challenge social structures and oppression, which is why the anticategorical approach
should be combined with an intercategorical approach which stress structural inequalities between
different groups and how identity is shaped by social structures.
Critical Social Work and Critical Reflection
A dilemma for the critical tradition in social work during the 1960s and 1970s was the difficulties in
using the structural understandings of social problems in clinical social work on an individual level.
A structural understanding of social problems tends to be far away from the client’s everyday life.
Social workers works and adapts in relation to organizations and bureaucratic rules, managers
demands, and sometimes also to community cultures. In this context, it’s easy to feel powerless and
without personal responsibility and it is sometimes hard to hold on to ideological and political ideals
focusing structural change (Brookfield, 2009; Fook, 1993, 2002; Fook & Gardner, 2007; Mclaughlin, 2005; Morley, 2004; Stepney, 2005). Critical social work aims to challenge these problems and
in recent years important works has been done by Jan Fook, who has also been working together with
Fiona Gardner (Fook, 2002; Fook & Gardner, 2007). Fook (2002) might be understood as developing critical social work by changing the focus from how social structures affect people’s living
conditions, to focusing on how social structures affect social work practice, and the social workers’
Mattsson
11
ideas, emotions, and reactions. Fook argues that critical social work needs to be a critical reflection
which helps the social worker to develop her professional role in relation to an understanding of
social structures and the globalization context. She argues that critical reflection is a way to bring
practice and theory together in a way that develops awareness of the ability to contribute to social
change (Fook, 2002; Fook & Gardner, 2007; cf. Brookfield, 2009; Dominelli, 2002; Mattsson, 2010;
Morley, 2004; Pease, 2006; Pitner & Sakamoto, 2005; Sakamoto & Pitner, 2005).1
The critical reflection that Fook introduces aims to deconstruct our experiences and knowledge in
a way that gradually illustrates how we are part of and sustain social structures and oppression
(Fook, 2002; Fook & Gardner, 2007). To reflect critically means to focus on a chosen event or situation and to analyze the feelings, thoughts, and actions it involves in a way that opens up alternative
ways of understanding. By the new ways of comprehending, it is possible for the social worker to
become more aware of how social structures affect her, the client, and social work practice. The
reflection gives alternative and more dynamic ways to comprehend, and therefore develops more
complex understandings of social problems, the client, the social workers’ positions, and the interaction with the client. By using a complex way of thinking, the social worker not only can develop an
understanding of her own assumptions and conceptions, she might also in time change her way of
thinking and acting as a result of her increasing knowledge (Brookfield, 2009; Fook & Gardner,
2007; Pitner & Sakamoto, 2005; Sakamoto & Pitner, 2005). By this process, a possibility to challenge social structures and oppression is created, as the social worker develops an ability to work
in ways that might challenge social structures and stereotypical images of clients. The critical
reflection, therefore, is seen as a potential for social work to be a profession which actually changes
society, since the social worker is able to change her actions when she understands how social
structures affect social work practice.
In Fook’s critical reflection, gender, sexuality, class, and race are implicit, but not in focus. She
opens up the space for working on power and oppression related to, for example, gender and race;
yet, she does not put them in the foreground, as she uses general understandings of power and
oppression (also see Fook & Gardner, 2007; Morley, 2004). I would like to argue for taking one
more step by using critical reflection with the specific ambition of analyzing and changing gender,
sexuality, class, and race oppression. My argument is that critical reflection with the ambition to
explore and disclose social structures and oppression needs to stay focused on gender, sexuality,
class, and race, since these are elementary power relations with respect to marginalization, oppression, and injustice. It is also important to stress how these power relations tend to be habitual and
taken for granted, which makes them particularly hard to make visible and keep in analytical focus;
this is why it is especially important to work with a clear ambition to recognize them in critical social
work practice.
An intersectional analysis aims to explore oppression and inequality focusing the interplay
between different categories of oppression. The approach is based on a key understanding that gender, sexuality, class, and race are intertwined and reinforced ‘‘in and through relation to each other’’
(McClintock, 1995, s. 5, emphasis in original). No structure or category is homogenous, and the
intersection between gender, sexuality, class, and race creates oppression and inequality both within
and among groups (Davis, 2008; de los Reyes & Mulinari, 2005; Lykke, 2010). Intersectionality is a
usable approach for critical social work since it highlights gender, sexuality, class, and race and
makes it possible to understand and problematize the unequal relation between the social worker and
the client in a complex way.
Theoretical Points of Departure
The critical tradition in social work has traditionally found its theoretical framework in structural
theories. When developing the theoretical base for critical reflection, Fook finds her theoretical
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Affilia: Journal of Women and Social Work 29(1)
framework in postmodern and poststructural theories. She argues for the possibility of using these
approaches, as they manage to dispute and deconstruct the presupposed in a way that opens up for
variations, subordinated narratives, contradictions, and complexities. The poststructural approach
brings an understanding of reality to be a reflection of both external and internal structures of thinking. This places power relations situated in both external and internal structures—an understanding
which opens up for the individual as a bearer and reproducer of social structures. Postmodernism
calls the production of knowledge into question and understands knowledge as socially constructed.
It recognizes the importance of context and highlights how knowledge is mediated by cultural,
political, and social assumptions. The scientific idea of external, objective reality is problematized,
as knowledge is understood as intimately connected with subjective values and judgments. Facts
become facts as they are constructed as parts of historical, social, and political interests. For postmodernism, the aim is to open up for different experiences and to give them place and legitimacy
in a way that gives room to question dominating truths and knowledge (Fook, 2002, s. 11ff; Fook
& Gardner, 2007, s. 33; Morley, 2004). This approach is useful and important for critical reflection
since it provides space for reflection which manages to question dominating ways of understanding
social problems, clients, and the social work profession.
Fook (2002) starts with the postmodern understanding of knowledge and then she develops a
splendid theoretical framework for critical reflection. She uses poststructural understandings of language, power, and discourse in a way that brings understanding of how social structures affect social
workers at an individual level. Without a doubt, when her theoretical approach is used in critical
refection, the reflection surely becomes a way to bring theory and practice together in a way that
can make oppression and power relations visible. Even though, there are two problems with Fook’s
theoretical framework worth discussing. One is the incapacity of postmodernism to handle power
relations. The postmodern aim to open up and investigate alternative knowledge and experiences
in a way that is not interested in what is true or more accurate, also opens up for relativism where
all knowledge and experiences are equally truthful. Postmodernism is focused on the deconstruction
of the truth rather than to actually investigate and illustrate power relations and social structures. If
critical reflection aims to explore and change social structures, postmodernism is not unproblematic
since it bears the risk of falling into relativism. Fook’s solution of this problem is to combine her
postmodern approach with Foucault’s theory on power (Fook, 2002; Fook & Gardner, 2007). Even
though I really do like this solution, I see a problem in that Fook stays with an understanding of
power which does not emphasize the specific aspects of social structures related to gender, sexuality,
class, and race. This is the second problem in her theoretical framework; that is, gender, sexuality,
class, and race are not highlighted as central social structures and forms of oppression.
Using intersectionality as a basis for the reflection would take the critical reflection one step further. Understanding intersectionality as a way to explore how power relations are created and reinforced by the interplay between gender, sexuality, class, and race, it is possible to keep them in
urgent focus. In theoretical practice, this means to combine postmodern thinking and poststructural
theories on gender, sexuality, class, and race. As intersectionality is not a theory in itself, there is a
need for developing a theoretical framework. It is possible to use the same general understandings of
how structures, power, and identities work and affect our lives as Fook recommends, but with the
difference that specific theories which explain aspects of gender, sexuality, class, and race
structures, are necessary. Intersectionality gives a specific ambition to hold on to and understand
interaction between gender, sexuality, class, and race as a basis for—and upholding of oppression
and inequality (cf. Davis, 2008, p. 73). By using an intersectional approach and, for example, poststructural feminist and postcolonial theory, the reflection would be based in a tradition of understanding how social structures affect people’s living conditions which also emphases gender,
sexuality, class, and race (cf. Carbin & Edenheim, 2013). This would solve both the problem with
the postmodern relativism and the problem with the risk of neutralizing or making aspects of gender,
Mattsson
13
sexuality, class, and race invisible when not emphasizing them in the theoretical framework. Gender,
sexuality, class, and race are crucial categories for understanding oppression and injustice. At the
same time, they tend to be normalized and invisible, which makes them challenging to recognize,
explore, and transform (Dominelli, 2002). Critical reflection needs a powerful understanding of the
relation between oppression and the intersection of gender, sexuality, class, and race. A reflection
carried out without that kind of understanding risks reinforcing oppression and injustice.
Intersectionality in Social Work Practice
Following is a structure in three steps for how to critically reflect on a specific incident: (inspired by
Fook, 2002, p. 43, 89ff; Fook & Gardner, 2007; Mattsson, 2010; Morley, 2004).
Step 1: Start with identifying a critical incident and describe it with as much specific details as
possible. It could be any practice experience that made you stop and think, and react on what
have happened. Write down your description, as writing is a good way to think the incident
through, and to actually remember it and its different parts. It is natural that your description
develops as you are writing it.
Step 2: Make a critical reflection on your description. Start with identifying power relations
operating in the incident. By using intersectionality as a base for the reflection, it is possible
to stay focused on gender, sexuality, class, and race as central categories of oppression and how
they actually work in and affect social work practice. When understanding how power relations
might affect the social worker, the client, and the social work organization, it is possible to
investigate alternative understandings and actions.
Step 3: Reconstruct and redevelop new and emancipating strategies for theory and practice which
are possible, as the social worker identifies and understands the means of social change and
recognizes her agency and her own construction of power.
The three steps give structure for critically working through an incident or situation. By making
reflections, it is possible to explore new ways of thinking and feeling about the chosen incident. It is
possible to find other ways to understand what has happened and the role the social worker plays in
the situation. The structure is important in doing the reflection, as its various steps are what keeps
focus on analysis and evolves new insights and understandings.
Step 2 is a crucial analytical part of the reflection, and using intersectionality as a tool especially
affects this step. It is in this step that intersectionality as an approach is practiced, and where analysis
and theory are in focus. Theory is important in critical reflection; without theory it is hard for the
reflection to actually bring new understandings of the incident, understandings that reveal the effects
of power in the situation. Power relations related to gender, sexuality, class, and race are difficult to
actually see, recognize, and acknowledge. For example, in Sweden, a gendered-balanced workforce
is often stressed as important in social work practice. Gender balance is understood as necessary both
according to gender equality policies and to an understanding of women and men as completing each
other in corresponding to what is perceived as males and females different needs in treatment.
Indirectly, male and female social workers come to represent femininities and masculinities that are
supposed to be heterosexual, middle class, and ‘‘Swedish.’’ As a result, they tend to uphold and
reproduce stereotype gender and class hierarchies, heterosexual norms, and white Swedish
supremacy (Fahlgren, 2013; Mattsson, 2005; Sawyer, 2012; cf. Lewis, 2001). By using feminist and
postcolonial theory which both use a critical approach to shed light on social orders that are usually
taken for granted and therefore reinforce and uphold oppression and injustice at the same time, the
critical reflection enables understanding power beyond the common sense that usually makes us
blind to it and its effects. The critical reflection with its focus on gender, sexuality, class, and race
14
Affilia: Journal of Women and Social Work 29(1)
brings awareness and knowledge on how power relations work and affect the social worker, and how
the social worker herself functions as a bearer of these structures. By using an intersectional
approach in critical reflection, the reflection will show how conceptions of social workers,
‘‘clients,’’ and social problems are constructed and upheld. It will do this by asking deconstructing
questions about used understandings and concepts: What is included and incorporated in the social
workers understandings of herself and of the ‘‘client?’’ What is excluded? What is visualized? What
remains unnoticed and invisible? How does this contribute to the positions of the social worker as
normal and the ‘‘client’’ as deviant? And most importantly, how does these constructs uphold conceptions and power relations related to gender, sexuality, class, and sexuality?
By these kinds of questions, raised with poststructural feminist and postcolonial understandings
which are used when reflecting on the answers, critical reflection will give urgent answers on how
these constructions reinforces oppression and injustice in case of gender, sexuality, class, and race,
and it will make a more complex understanding of the social worker, the ‘‘client,’’ and of social
problems possible. The reflection becomes a usable tool to make the ‘‘unconscious assumptions and
reactions of well meaning people’’ (Young, 1990, p. 41) conscious and visible.
Step 3 in the critical reflection reminds us of the importance of the reflection being antioppressive and challenging of power relations. It is at this point that the social worker can explore
alternative ways of handling different power relations. When understanding the effects of power
relations and how gender, sexuality, class, and race intersect and reinforce each other, the social
worker can develop an alternative thinking and alternative actions. By understanding, she can start
working in a way that challenges, rather than reinforces oppression and injustice. This work,
however, demands continuous reflection; there is no finishing or end point in doing critical social
work or in being a critical social worker. The critical social worker never knows it all.
Critical Reflection and Intersectionality Challenges
Intersectionality practiced in critical reflection is probably best described as a combination of the
anticategorical and the inter-categorical approach (McCall, 2005; Mehrotra, 2010). The reflection
aims to understand and challenge the complexity of different categories which are intertwined and
reinforce each other. This also means that the reflection might end up in dissolution of gender, sexuality, class, and race where it is actually hard to see or understand structural inequalities, as they
appear too complex and dynamic. I would like to stress the importance of understanding that using
intersectionality in critical reflection means to understand and analyze the intersection of gender,
sexuality, class, and race at maybe the most complex level. Observing the effects of social structures
is generally easier on a structural level than in a micro context or at an individual level where structural patterns easily become invisible in the complexity that tends to dominate. This is why it might
be fruitful to understand the use of intersectionality in critical reflection as a combination of the
anticategorical and the intercategorical approach, where the latter one stresses and focuses on structural inequalities between different groups and the effects of social structures on identity (cf. Sandberg, 2013). Otherwise, the reflection bears the risk of ending up unable to reflect on structures at all
(Pease, 2010). Once again, this also stresses the importance
The Week 6 Assignment: Reading Research Literature (RRL) Worksheet is a learning activity that requires you to read an assigned article for the session you are taking the course, then answer questions on the required Reading Research Literature (RRL) Worksheet. Both the required article and worksheet may change from session to session.
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Read the required research article assigned, then answer each question in your own words on the required Reading Research Literature (RRL) worksheet about the study.
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Unformatted Attachment Preview
RESEARCH
“I WAS HERE FIRST, WHY DID THEY GO BEFORE
ME”: EXAMINING PATIENTS’PERCEPTIONS OF
PRIORITY IN A PSYCHOMETRIC STUDY OF
EMERGENCY DEPARTMENT TRIAGE
Authors: Joshua Ray Tanzer, PhD, Marlene Dufault, PhD, RN, Linda Roderick Rioux, BS, RN, Jason Machan, PhD,
Kathy Bergeron, MS, GCNS, RN, and Anthony Napoli, MD, MHL, Providence, Kingston, and Newport, RI
Contribution to Emergency Nursing Practice
What is already known on patient satisfaction is that
there is a significant interplay between patient expectations and perceptions, with patients generally expecting
faster service than is realistic within the emergency
department.
The main finding of this paper is that the Patient Perception of Priority to Be Seen Survey can reliably measure
patient subjective experience, and a verbal explanation
of common triage procedures could standardize patient
expectations.
Recommendations for translation of the findings of this
paper into emergency clinical practice include using the
Patient Perception of Priority to Be Seen Survey in
research, quality improvement projects, and interventions to improve patient-nurse communication in the
emergency department.
Abstract
Introduction: Unrealistic patient expectations for wait times
can lead to poor satisfaction. This study’s dual purpose was: (1)
to address disparities between patients’ perceived priority level
and the Emergency Severity Index (ESI) assigned by emergency
room triage nurses; and (2) to evaluate validity and reliability of
using the Patient Perception of Priority to be Seen Survey
(PPPSS) to investigate patient expectations for emergency
department urgency.
Methods: A two-group pretest-posttest quasi-experimental
approach compared patient urgency opinions to nurse urgency
ratings with and without a scripted educational intervention.
This tested how closely patient perceptions were related to
triage nurse ratings.
Results: Reliability for the PPPSS was acceptable (reliability
¼ 0.75). Patients who were rated lower urgency on the ESI
by triage nurses tended to self-report higher urgency (rho ¼
0.44, P < .01). Attitudes were more consistent in the posttest
patient group who were exposed to the scripted verbal description of emergency department procedures (x2 (1, N ¼ 352) ¼
8.09, P < .01). Patients who disagreed with emergency nurse
scores tended to be younger on average (eg, < 40 years old;
rho ¼ 0.69, P < .01). Male identified patients tended to be rated
both by nurses and themselves as higher urgency (beta ¼ 0.18,
P ¼ .02).
Discussion: We recommend the PPPSS for nurses and re-
searchers to quickly assess patient expectations. Additionally,
promoting patient understanding through a scripted educational
Joshua Ray Tanzer is a Biostatistician, Lifespan Biostatistics, Epidemiology,
Research Design, Informatics Core, Providence, RI.
Department of Emergency Medicine, Newport Hospital Emergency
Department, Newport, RI.
Marlene Dufault is Professor and Nursing Consultant, University of Rhode
Island, Department of Nursing, Kingston, RI.
For correspondence, write: Joshua Ray Tanzer, PhD, Lifespan Biostatistics,
Epidemiology, Research Design, Informatics Core, 130 Plain Street,
Providence, RI 02903; E-mail: jtanzer@lifespan.org
Linda Roderick Rioux is Staff Nurse Newport Hospital Emergency Department,
Department of Emergency Medicine, Newport, RI.
Jason Machan is Director of the Lifespan ClinTECH Center and Lifespan
Biostatistics, Epidemiology, and Research Design Core, Providence, RI.
Kathy Bergeron is Clinical Nurse Educator, Newport Hospital and Adjunct
Faculty, Department of Nursing, Salve Regina University, Newport, RI.
Anthony Napoli is Professor of Emergency Medicine, Department of Emergency
Medicine, Warren Alpert School of Medicine at Brown University and Chair,
294
JOURNAL OF EMERGENCY NURSING
J Emerg Nurs 2023;49:294-304.
Available online 24 December 2022
0099-1767
Copyright Ó 2022 Emergency Nurses Association. Published by Elsevier Inc. All
rights reserved.
https://doi.org/10.1016/j.jen.2022.09.017
VOLUME 49 ISSUE 2
March 2023
Tanzer et al/RESEARCH
strategy about the ESI system may also result in improvements
in communication between patients and nurses.
Key words: Emergency department; Triage; Patient perception;
Psychometrics; Educational intervention
Introduction
patient-reported subjective urgency scores with the ESI
scores rated by the triage nurse. In addition, we used a
quasi-experimental approach to see whether or not informing patients of ED triage procedures through a scripted
educational intervention improves patient-reported expectations for wait times. Finally, we use expert knowledge from
more than 35 years’ nursing experience to verify that the patients whom we thought would have unrealistic expectations
for wait times did demonstrate such discrepancies empirically. This provided a multifaceted validation of the Patient
Priority to be Seen Survey and an estimation of reliability.
Discussion is provided of how to interpret individual scores,
possible clinical applications, and how this could be used in
research on patient satisfaction.
PROBLEM DESCRIPTION
Current best practice policies for triaging patients seeking
care in hospital emergency departments are aimed to assure
that emergency nurses, in collaboration with medical staff,
provide triage assessments with a high level of accuracy for
those seeking rapid, emergent treatment.1 The goal of triaging in the emergency department is to assess each patient in
an expedient manner and to prioritize their care. The emergency severity index (ESI) based on joint Emergency Nurses
Association/American College of Emergency Physicians
standards is often used as a tool for facilitating efficient
triage.2 The 5-level emergency triage algorithm provides
clinically relevant prioritization of patients into 5 groups
from 1 (requires immediate intervention) to 5 (least urgent).
Triage nurses are responsible for this assessment using a
rapid, systematic collection of data relevant to the patient’s
chief complaint, age, allergies, and vital signs to obtain sufficient information to determine the ESI level and to be seen
by the emergency provider.3
Although ESI triage procedure provides an efficient algorithm for designating patient urgency, it may not always
be apparent to patients in the waiting room, which risks patient confusion and dissatisfaction. To inform patient provider communication, in 2013, Toloo et al4 developed the
Patient Perception of Priority to Be Seen Survey (PPPSS),
although it has received very little use in research or clinical
settings. The full scale includes 11 questions about patient
health and demographics, including one question directly
asking about how quickly a patient expects to be seen by a
provider. This item seems an intuitive way to calibrate
how realistic patient expectations are for ED efficiency;
however, its lack of use raises concern about its reliability
and validity. The original project that developed the scale
emphasized the face validity of questions. They also did
find positive correlations with pain and seriousness reported
by ambulatory patients, supporting validity of the Patient
Priority to be Seen Survey as a measure of urgency during
a crisis.4 Reliability was not estimated.
In this report, we review some of the challenges in patient communication and psychometric theory and provide
an evaluation of the Patient Priority to be Seen Survey for
use in the emergency department to facilitate nurse-patient
communication. We accomplished this by comparing
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AVAILABLE KNOWLEDGE
Emergent patients often perceive their throughput time
more favorably than those with less emergent needs.5 Previous research has found that shorter wait times are positively
associated with patient satisfaction.6-9 Beyond subjective
quality of care, prolonged wait times in the emergency
department also have been associated with increased
morbidity and mortality, especially among critical care
patients.10 Ensuring an efficient emergency department is
important for quality patient care. An evidence summary table of the studies we reviewed is provided in Online
Supplement 1.
Educational interventions have demonstrated some efficacy in raising triage nurses’ understanding regarding priorities to be seen;11 however, less well-studied is the great
misunderstanding in patient’s perception about standard
triage procedures and how this can be ameliorated. Previous
research has shown a discrepancy between patient and practitioner perceptions of priority of need to be seen.12 In addition, triage communication of expected wait time has
demonstrated an association with overall ED satisfaction.8
At this project location, a recent quality improvement survey indicated only 9% agreement between triage nurses’ ratings of urgency and patients’ self-reported perceptions of
priority to be seen.
The balance between patient expectations and what is
realistic was emphasized by Maister13 who conceptualized
what constitutes patient satisfaction. Maister focused on
the discrepancy between patient perceptions and expectations. He goes so far as to suggest that improving the
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experience while waiting for care may decrease the perceptions of wait times and increase satisfaction without an
actual change in the wait time. This is important, because
target ED wait times are often not met, likely because of
contextual factors that are not easy to change.14 If better
patient-nurse communication can improve patient
perceived wait times, this provides a much simpler avenue
to improve patient satisfaction.
RATIONALE
We propose the PPPSS to help to facilitate better research
and quality improvement projects on subjective patient experiences and nurse-patient communication. In addition, if
reliable and valid, this instrument could be used as part of an
intervention during the patient triage process to produce
higher quality, safe, and expedient care that promotes satisfaction both for patients and nurses.
In particular, we used concurrent validity testing
against the validating criterion of urgency scored by trained
triage nurses using the ESI. Thus, the PPPSS was compared
as the extent to which its scores were similar to the “gold
standard” ESI criterion. Previous research has indicated
the ESI provides valid estimates of patient urgency and
has strong inter-rated reliability when used by triage nurses
(reliability estimates ranged from 0.83-0.94),15-17 although
some concerns have been raised that measurement is less
reliable in less developed countries.18 If triage nurse ratings
demonstrate concordance with patient-reported urgency,
this would support the use of the PPPSS as a measure of subjective patient urgency.
In addition, we examine construct validity through the
use of a quasi-experimental design. For the first half of data
collection, a pretest group of patients were simply asked to
report their opinions on the PPPSS in a nonstandardized
way. During the second half of data collection, posttest patients were provided with a brief scripted standardized verbal description of the ESI triage protocol before
completing the questionnaire. If the PPPSS validly measures
patient expectations for when they will be seen, then directly
informing their expectations should result in more standard
scoring.
SPECIFIC AIMS
We aim to better understand patient experiences in the
emergency department, to validate the PPPSS as a tool for
evaluating patient subjective urgency. We hypothesized
that patients who perceived their needs as urgent on the
PPPSS would tend toward lower urgency scores assigned
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JOURNAL OF EMERGENCY NURSING
by triage nurses using the ESI, as has been suggested
previously.4,13 We estimated reliability and validity contextualized by nurse ratings, demographic variables, general
health status, and health care usage behavior. To inform
how to interpret PPPSS scores in research and clinical settings, we estimated the relationships among observed triage
scores, patient health traits, and individual uniqueness.
Finally, we hypothesized that there would be greater agreement between nurse and patient urgency and need to be
seen when patients were provided a verbal description of
ED procedures by the triage nurse.
Methods
SETTING
Data were collected at an emergent care unit situated in a
community magnet-designated hospital in New England.
At capacity, the hospital can care for 40,000 patients annually, although most years there are closer to 33,000. The ED
staff consisted of 43 registered nurses. Of these, 29
(67.44%) were credentialed to perform triage nursing functions using the ESI. This site has used the ESI since 2005
and all triage nurses received updated training following
ESI revisions in 2012. All nurses were required to have at
least a Bachelor of Science in Nursing, and only those nurses
with a year or 2 of emergency nursing experience are trained
to be triage nurses. Training to use the ESI includes a 2-hour
structured didactic course and on-the-job training. In addition, nurses are encouraged to pursue continuing education
opportunities on nursing in general at discounted rates in
collaboration with universities in the area, to maintain familiarity with best practices in nursing.
DATA COLLECTION
DESIGN
AND
QUASI-EXPERIMENTAL
To test the validity of using the PPPSS as a measure of subjective patient urgency, we compared scores with the ESI as
a test of concurrent validity. In addition, we used a quasiexperimental design, with data collected before and after
providing posttest patients with the standardized scripted
verbal description of what to expect. If discrepancies between patient and nurse triage ratings are because patients
have improper expectations for ED procedures, then simply
informing patients of what to expect should standardize
scoring. This tests construct validity, using a script written
by the principal investigator read to patients. If the PPPSS
is a valid measure of patient subjective urgency,
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Tanzer et al/RESEARCH
discrepancies between patient- and nurse-reported urgency
will be larger in the pretest nonstandardized group of patients.
The principal investigator was responsible for data
collection using paper and pencil scoring. Patients were oriented to the study when they entered the emergency department after their initial triage assessment. The purpose of the
study was explained and patients verbally consented and
were asked to complete a short survey, the 11-question
PPPSS (Supplementary Appendix A), read to them by the
triage nurse investigator. Patients were not informed as to
the triage nurse assessments. Nurses had pre-existing
ongoing nurse-initiated protocols, which were added to
the list. For the verbal description condition, after more urgent needs were addressed, nurses explained the triage standard of care to patients, script provided in Supplementary
Appendix B. All responses were kept confidential and measures were taken to ensure anonymity of the patients by not
linking patient demographic variables to patient names or
ID numbers. Two independent samples were collected in
the same emergency department. This directly evaluated patient expectations for triage procedures, to compare expectations with ESI triaged urgency, with and without the
scripted verbal description provided.
PARTICIPANTS
Patients were recruited on a walk-in basis over the course of
4 months broken into 2 groups: 2 months of nonstandardized observation (76 patients recruited) and 2 months
with the scripted verbal intervention (100 patients recruited;
total sample 176 patients). Samples were independent of
each other except for the chance possibility that a patient
entered the emergency department twice, with and without
the verbal description. Although patients were allowed to
participate regardless of the time they entered the emergency
department, most patients were enrolled in the morning and
afternoon, when most people visit the emergency department. All patients were English-speaking conscious adults,
at the age of 18 years and older. Exclusion criteria for this
sample were patients with dementia, children, or those unable to answer the short survey. After hearing the study
goals, we asked patients in the emergency department to
participate with no direct benefit to individual patients
provided.
MEASURES
Developed in an earlier study by Toloo et al,4 the PPPSS full
survey includes 11 questions regarding factors that could
explain patients’ perceived urgency such as demographics
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(age, sex, ethnicity, socioeconomic status), health beliefs
and preferences (perceived health status, urgency, previous
ED visits), and perceived acuteness including reasons for
seeking care in the emergency department (Supplementary
Appendix A). We focused on the question asking about patient expectations for wait time. Patients were asked by the
triage nurse to rate the urgency of their needs in time they
thought they could wait on a scale from 1 (representing
“within 2 hours”) to 5 (representing “immediately”). We
sought to validate this question on the PPPSS for the purpose of assessing patient expectations for ED procedures
and subjective urgency.
Patient ethnic identity was measured only as Hispanic
and not Hispanic self-reported by patients owing to this
emergency department’s patients being primarily white
and a lack of ethnic diversity within the community. We
had thought Hispanic ethnic identity might be a more
cogent single social group than the inclusion of many underrepresented racial categories. No other race or ethnicity
questions were asked. Although a sample of more diverse respondents would be preferred, this measurement scheme is
consistent with recommendations on how to conceptualize
ethnicity.19
PSYCHOMETRIC THEORY
More detailed discussion of psychometric theory and statistical estimation are included in Online Supplement 2. We
estimated reliability for the PPPSS as internal consistency
from intraclass correlation coefficient for individual patient
traits within a generalizability theory framework and mixed
effects modeling estimation.20-22 Reliability greater than
0.70 is considered acceptable, although values greater than
0.80 are preferred. Reliability at this level would indicate
that repeated use of the PPPSS would tend to produce
similar scores for similar patients at least 70% of the time
depending on the level of reliability.
Previous work has used the PPPSS measure in research
settings; however, its psychometric properties were not the
emphasis of the project.4 This will document the applicability and extend interpretability of this measurement tool
to a clinical setting. By performing a validity analysis, the results can inform how to interpret individual PPPSS scores,
so far as they relate to nurse-rated urgency and other personal health and demographic information. We focus on
concurrent validity relative to the ESI and construct validity
contextualized by the quasi-experimental design and patient
demographic information.
Finally, we incorporated expert opinion into the analysis to ensure face validity, described in detail in Online
Supplement 2. Face validity is the extent to which an
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instrument appears to be an adequate measure, and typically
not considered critical, we believed it could be important if
patients’ resistance to being measured reflects their view that
the scale is of no significance to their problem. Led by the
principal investigator, the research team categorized patients
by how likely they were to agree with the triage nurse and by
how subjectively stressful their symptoms were. This
allowed for consideration within the analysis of those patients for whom there was concern that they may not have
appropriate expectations or patients who may have reasons
to feel that their needs are urgent. If the PPPSS is valid
for understanding subjective patient needs, then patients expected to disagree with the triage nurse or patients with subjectively unpleasant conditions should demonstrate the
largest improvements in concordance between nurse- and
patient-reported ratings when the verbal description is provided.20-22 We tested this empirically.
ANALYSIS PLAN
We determined significance as P < .05. The sample
included 176 individuals (76 nonstandardized pretest and
100 with the scripted verbal description of ED protocol).
For each patient, there were 2 scores, 1 ESI rating and 1
PPPSS patient-reported urgency rating, resulting in a total
sample of 352 observations. First, we examined the correlation matrix and performed discriminant function analysis.23
This helps to understand the characteristics of the expertdetermined patients who may have unrealistic expectations
of ED efficiency, testing concurrent validity.20,21 Observed
discrepancies between patient and nurse triage ratings being
categorized by the expert as likely to disagree with the nurse
would support the validity of the PPPSS. In addition, subjective discomfort of admitting condition is an intuitive
reason patients might disagree with the triage nurse. Finally,
based on the observation while collecting data that younger
patients seemed more likely to disagree, age also was
included in the analysis.
Next we compared PPPSS scores with and without the
verbal description of ED procedures, a direct test of
construct validity. Out of concern that some patients may
have a better intuition for standard triage procedures than
others, a specific comparison was made between participants
categorized as likely agreeing with nurse ratings and those
who would likely disagree. This amounted to a 2 3 2 3
2 repeated measures analysis of variance design with interactions comparing quasi-experimental condition (unstructured pretest or posttest with verbal description of ED
procedures provided), rater of urgency (nurse or patient),
and patient type (agree or disagree with nurse). If the PPPSS
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is valid for the purpose of understanding patient experiences, then the interaction between scripted intervention
condition and rater would be significant, indicating that patient ratings were more standard with the verbal description
but not nurse ratings, which should be consistent regardless.
To further assess concurrent validity, the analysis
included a number of covariates, specifically age, gender,
ethnicity, enrollment with a primary care physician, reported knowledge of the ED triage system, use of the emergency department in the past 6 months, patient-reported
health ratings, and categorized rating of how subjectively
stressful the patient’s condition may be. Finally, several
random effects accounted for the known structure to the
data and model sources of variation (eg, heterogeneous variances and correlation between nurse ESI and patient PPPSS
ratings), as is consistent with generalizability theory
methods.21 Estimating power indicated that this analytic
framework could likely detect at least a moderate effect
size demonstrated by the manipulation (see Online
Supplement 2).24-26
ETHICAL CONSIDERATIONS
The hospital’s Human Subjects Safety Committee deemed
the study, which followed a quality improvement project, to
be exempt from review. As stated earlier, responses were
kept confidential and measures were taken to ensure anonymity of the patients by not linking patient demographic
variables to patient names or ID numbers.
Results
Respondents spanned the age range, most between 18 and
60 years old (see Table). All respondents were patients;
none were caregivers. There were similar proportions of
male- (48.86%) and female- (51.14%) identifying respondents. The majority did not identify as Hispanic
(90.91%). Most respondents indicated that they did have
a primary care provider (60.80%) but did not know about
the ED triage system (73.30%) and had not been to the
emergency department recently (68.18%). Rated from 1
(“poor”) to 5 (“excellent”), most respondents indicated
good or very good health, with a mean of 3.88 (SD ¼ 0.73).
There were a wide variety of reasons respondents came
to the emergency department, from allergic reactions to
abnormal laboratory test results. Most patient needs were
rated as moderately stressful (M ¼ 2.07 rated from 1
[“low stress”] to 3 [“high stress”], SD ¼ 0.64). Most respondents thought they should be seen within about 20 minutes,
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Tanzer et al/RESEARCH
TABLE
Respondent characteristics (N [ 176)
Variable
Demographic variables
Age
Sex
Ethnicity
Health variables
Do you have a primary care provider?
Do you know about the ED triage system?
Have you used the ED in the last 6 mo?
How is your general health?
Emergency circumstance stress expert
rating
Patient ratings: I should be seen
Nurse triage rating
Predicted agreement with triage nurse
Level
N
%
18-29 y
30-49 y
50þ y
Female
Male
Not Hispanic
Hispanic
73
52
51
90
86
160
16
41.48
29.55
28.98
51.14
48.86
90.91
9.09
No
Yes
No
Yes
No
Yes
Poor
Fair
Good
Very good
Excellent
Low stress
69
107
129
47
120
56
0
3
49
90
34
30
39.20
60.80
73.30
26.70
68.18
31.82
0.00
1.70
27.84
51.14
19.32
17.05
Moderate stress
High stress
Within 2 h
Within 60 min
Within 30 min
Within 10 min
Immediately
Nonurgent
Semiurgent
Urgent
Emergent
Highest priority
Agree
Disagree
104
42
6
26
35
65
44
0
0
0
148
28
81
95
59.09
23.86
3.41
14.77
19.89
36.93
25.00
0.00
0.00
0.00
84.09
15.91
46.02
53.98
ED, emergency department.
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FIGURE
Differences in triage urgency ratings. Note: Nurse ESI scores were reversed so a higher number represents higher urgency, as is the scoring on the PPPSS. ESI, Emergency Severity
Index; PPPSS, Patient Perception of Priority to Be Seen Survey.
at most an hour (M ¼ 22.61 minutes, SD ¼ 26.97 minutes). Patients were consistently rated as high urgency by
nurses (M ¼ 4.16, SD ¼ 0.35; reverse scored so a larger
value indicates higher urgency).
The discriminant function analysis indicated observed
agreements between nurse and patient urgency ratings
tended to be independently classified as likely agreement
by the expert (lambda ¼ 0.83), supporting concurrent validity of the measurements (Wilks’ lambda ¼ 0.52, F(5,
170) ¼ 32.01, P < .01). Older patients also tended to agree
with the nurse, corroborating the anecdotal observation
(lambda ¼ 1.37). Contrary to expectations, subjective
discomfort operationalizing patient subjective stress had
minimal relationship to agreement or disagreement
(lambda ¼ 0.10).
Figure plots the scoring tendencies with and without
verbal description of ED procedures, comparing between
patients expected to agree with the nurse and patients expected to disagree with the nurse. During the unstructured
pretest, ratings were close between nurses and patients for
the patients expected to agree with the triage nurse (nurse,
M ¼ 4.19, 95% confidence interval [CI] 3.92-4.46; patient,
M ¼ 3.87, 95% CI 3.01-4.74). For patients expected to
disagree with the triage nurse, there was a discrepancy during the unstructured pretest period (nurse, M ¼ 4.06, 95%
CI 3.81-4.31; patient, M ¼ 3.33, 95% CI 2.54-4.11; x2 (1,
N ¼ 352) ¼ 14.61, P < .01).
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However, during the scripted intervention posttest after
rounding, ratings by nurses were identical for agree and
disagree classified patients (nurse, M ¼ 4.16, 95% CI
3.88-4.45), and patient-reported ratings also were very close
(agree, M ¼ 3.62, 95% CI 2.80-4.43; disagree, M ¼ 3.66,
95% CI 2.83-4.48). This is evidence that ratings were more
standard with scripted verbal description of ED procedures,
supporting construct validity of the PPPSS as a measure of
patient expectations (x2 (1, N ¼ 352) ¼ 8.09, P < .01).
Estimating internal consistency reliability, the ratio of
individual variance to total variance for each rater, across
nurse ESI ratings (reliability ¼ 0.73) and patient PPPSS ratings (reliability ¼ 0.75), both demonstrated acceptable reliability (reliability > 0.70). Examining the correlations
between observed ratings and model implied true patient urgency, both rating systems indicated large and nearly identical correlations (nurses, rho ¼ 0.54; patients, rho ¼ 0.55).
That said, the correlation between these 2 rating systems
was moderate to large and negative (rho ¼ 0.38). This
supports the reliability and concurrent validity of the
PPPSS, which demonstrated consistent measurements of
patient urgency. That said, when patients rated themselves
as more urgent, it was likely a nurse would rate them as
less urgent.
Finally, contrary to expectations, only one additional
measure of concurrent validity demonstrated significant association at alpha ¼ 0.05. Patients identified as female
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Tanzer et al/RESEARCH
tended to be rated as lower urgency (t(163) ¼ 2.23, P ¼
.02), a small magnitude of difference (beta ¼ 0.18).
Discussion
SUMMARY AND INTERPRETATION
We estimated reliability and considered ways to make valid
interpretations of the PPPSS as a tool for understanding patient subjective experience.13 Using a modern analytic
framework drawing from generalizability theory, reliability
for the measure was acceptable. The quasi-experimental
design targeting patient understandings of triage procedures
supported validity. When patients were explicitly informed
of ED triage procedures, PPPSS scores across patient groups
were nearly identical. This suggests that by directly informing patients of what to expect, this may have standardized
rating systems. By being aware of standard ESI procedures,
all patients received and reported similar ratings of urgency.
This supports the validity of the PPPSS and also demonstrates why clear communications of expectations may
improve ED efficiency.
The concordance between all of patient ratings, triage
nurse ratings, and independent expert ratings supported
convergent concurrent validity. When patients and nurses
gave similar urgency ratings, the expert also tended to indicate that they would likely have agreed. We originally
thought that subjective discomfort may be a primary aspect
of why patients disagree with the triage nurse; however,
there was little evidence of this. Instead, age grouped patients the most. Younger patients tended toward worse expectations for standard ED procedures.
Another finding that was counter to expectations was
that nurses tended to rate patients as higher urgency on
average, which is inconsistent from findings by Toloo
et al.4 This highlights the reasons for performing validity
analysis: to inform how to interpret a measurement for an
intended purpose. There was an inverse relationship between nurse scores and patients scores. As such, no matter
how urgent patients are rated in an absolute sense, to understand patient subjective experiences, PPPSS scores should
only be interpreted relative to standard urgency within a
specific emergency department. For the purpose of triaging
patients, ESI scores are determined based on their ordered
scaling, but the average may differ between emergency departments or by time of day. An example of this scaling
problem is the coronavirus disease 2019 pandemic, wherein
intensive care units were overwhelmed with high urgency
patients.
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The issue of scaling complexity is particularly relevant
in the case of the PPPSS, for which discrepancies among patient needs are a likely cause of improper expectations.
Scores should be considered relative to the urgency of
most other patients at the same emergency department
based on what is a typical patient urgency. A low urgency
patient could easily feel like somebody cut in line if they
are not familiar with ESI standards and see other patients
triaged sooner. The severity of this problem may depend
on the unique urgency of the emergency department at a
given moment. Seeking to communicate with these patients
about their likely wait time may improve satisfaction. We
recommend the PPPSS for implementing an intervention
with this target or as a tool for research and quality improvement projects trying to improve ED communications.
Finally, an important consideration for patient satisfaction is successful social communication, improvements in
which may have been facilitated by informing patients
regarding what to expect.13 As previously mentioned,
when patients were expected to disagree with the triage
nurse, they were much more likely to be young. There
may have been a social or generational disconnect between
younger patients and triage nurses that prohibited clear
communication about ED procedures. In addition, gender
identity stood out, with maleprese
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Now that you have completed your paper, build and deliver a video presentation that details your solution to the healthcare issue that serves as your topic.
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Exhibit comprehensive research and understanding by referencing important points and insights from the perspectives of inquiry papers.
Present your issue and your argument for your solution
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Remain within the time requirement.
Demonstrate planning, preparation, and practice.
Employ effective visual elements (multimedia).
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1
Signature Assignment Paper: Culminating Argument on Surgical Abortion
2
Abstract
In the contemporary world, surgical abortion continues to elicit different emotions and
discussion. This paper’s primary concern is evaluating this ongoing debate’s ethical dilemma.
This practice maintains a vital position within the ever-changing healthcare environment,
informed by medical technology advances and the complexity of ethical issues. To understand
the scope of the subject matter, it is necessary to adopt a historical point of view and follow its
development through legal conflicts, altering society’s views, and medical developments. The
researches address concerns about accessibility, within the delicate balance that must be
maintained between these factors, which may result in dangerous treatments. The value of
medical care lies in the fact that it sheds light on the ethical dilemmas that underlie people’s
understanding of reproductive rights and moral principles.
Surgical abortion continues to attract global debate, particularly concerning the ethical,
societal, and medical factors it entails. Because the subject is critical in health practice,
evaluating this issue using peer-reviewed articles is essential. This research investigates issues
surrounding medical surgery, namely pain management procedures, financial implications, and
quality of care. The articles evaluate various concepts and components surrounding surgical
abortion, which include socioeconomic and ethical dimensions. It provides insightful findings
to healthcare stakeholders, including patients, policymakers, and practitioners. The analysis’s
primary objective is to contribute to existing knowledge to improve the practice and
knowledge and improve patient services and outcomes. Also, the study aims at eliminating the
misconceptions surrounding the topic. Because the topic is controversial, this paper concludes
with information on how its findings can play a critical role in improving healthcare.
3
Surgical Abortion
Introduction
In today’s society, the question of surgical abortion remains essential for debate and
conversation. Abortions performed surgically affect various domains, including law, ethics,
and public discourse (Czekajewska et al., 2022). Because of this, several medical implications
and consequences linked to abortion have been questioned, including autonomy, fetal rights,
and the broader social responsibility involved with reproductive decision-making. This
practice is pivotal in the larger context of the interaction between women’s rights, ethical
concerns, and the ever-changing panorama of medical operations. Because of this complex
problem, medical professionals must conduct further research into its complexities. This
situation arises and not only has the potential to affect the progression of reproductive
healthcare but also our understanding of ethics, autonomy, and societal conventions.
The ongoing discussions in this topic are one of the most critical aspects that pertains
to abortion via surgical methods. This sensitive subject matter has provoked many
conversations and discussions among people. It is important to understand the historical
evolution of this topic regarding legal fights, shifting societal standards, and advancements in
medical technology. Doing so will allow one to nurture an intellectually strong and fruitful
dialogue that recognizes and appreciates the diversity of perspectives surrounding this issue.
However, this research focuses primarily on the ethical dilemma at the core, which is a
complicated connection between a woman’s natural entitlement to reproductive autonomy and
the moral concerns and rights connected to the fetus.
4
Relevance of Surgical Abortion in Today’s Landscape
In the contemporary healthcare landscape, the topic of surgical abortion stands as a
crucial and timely subject of inquiry. It reflects medical advancements while navigating
complex discussions on autonomy, fetus rights, and societal responsibilities. Shaping
healthcare and broader narratives prompts reflection on the evolving intersection of women’s
rights, ethics, and medicine (Czekajewska et al., 2022). In medicine, the relevance of surgical
abortion is intertwined with medical technology and practice advancements.
Although the word “surgery” is commonly employed, it is essential to note that the
majority of abortions are characterized by minimum invasiveness and do not necessitate the
use of general anesthesia. A surgical abortion is a medical intervention to terminate a
pregnancy (Tufa et al., 2021). Surgical procedures are a viable alternative for individuals
seeking to undergo abortion procedures inside the controlled environment of a clinical or
medical facility.
Medical abortions, a viable alternative for most individuals, are predominantly
conducted in the comfort of one’s residence.
The majority of surgical abortions are performed using a delicate suctioning method
referred to as vacuum aspiration. When visiting a clinic it may span many hours, the actual
surgery is usually completed within a timeframe of 5 to 10 minutes. This operation can be
quick and efficient, if no health issues occur during the procedure. This quick operation is one
of the things that makes it more appealing to people.
Surgical abortion is an alternative for terminating a pregnancy at later stages compared
to medical abortion, also known as “the abortion pill.” Obtaining an abortion throughout the
5
later stages of pregnancy is contingent upon the legal framework established within one’s state
and guidelines.
Due to recent law modifications to abortion regulations in the United States, the
availability of surgical abortion procedures has been limited in certain states. However,
individuals still have alternatives, such as the possibility of receiving abortion drugs through
postal delivery and more.
Unsafe and Safe Abortion
The risk and issue of unsafe abortion continues to put a significant challenge to many
health factors. According to the WHO, an abortion is deemed safe when administered using a
method that adheres to the safety guidelines and is performed by a qualified individual who has
received appropriate training (Agula et al., 2021). The meaning of a safe procedure or a
qualified individual has undergone many changes over time, particularly about the involvement
of non-physician healthcare practitioners. These significant changes has been characterized by
the availability of medical abortion. The legislation and development holds the potential to
facilitate self-administration, particularly in regions where access to abortion services is
severely limited or prohibited by law. The nature of the healthcare and legal landscape
necessitates a understanding of abortions, precluding a simplistic categorization into binary
classifications of safety and being unsafe. The World Health Organization now has a
classification system consisting of three categories: safe, least safe abortions, and less safe.
These categories are designed to reflect varying levels of risk associated with factors such as the
abortion technique, the provider involved, and the stage of pregnancy.
6
Epidemiology
The magnitude of complications associated with abortion are contingent upon the
gestational age during which the abortion is performed and the specific procedure used at the
time of the termination. According to available medical reports, the estimated rates of abortion
complications are approximately 2% for pharmaceutical abortions and 1.5% for those
conducted in the second trimester or beyond (Gebremariam et al., 2023). The mortality rate
associated with induced abortion in the United States was reported to be 0.6 deaths for every
100,000 abortions (Gebremariam et al., 2023). The regulations of abortions in the US led to a
significant decrease in mortality rates associated with septic abortion. The likelihood of
mortality resulting from bacterial abortion escalates as gestation advances.
Etiology
Complications are a common occurrence when it comes to abortion. Infection may occur
due to a lack of adherence to universal precautions before the procedure, including inadequate
hand hygiene, failure to use surgical gloves, improper sterilization and use of non-sterile
instruments, and underlying conditions in the patient, such as endometritis. Incorrect removal
may cause accumulation of blood in the uterus, leading to excessive stretching and loss of
muscle tone, ultimately resulting in hemorrhaging, It may also result in infection and potentially
sepsis. The occurrence of injury resulting from the surgical process is contingent upon the
specific method employed, encompassing cervical or vaginal lacerations and potential harm to
the uterus.
7
Unveiling Complexity: Controversy and Ethical Dilemmas
Internationally, a broad spectrum of legal classifications exists about abortion. Certain
nations grant women the right to request an abortion without justification. Conversely, other
countries impose specific criteria for abortion eligibility, while some have ambiguous laws that
prohibit illegal abortions without explicitly stating lawful grounds. Additionally, many
countries prohibit abortion, regardless of circumstances (Williams et al., 2023). Throughout
history, there has been ongoing debate and modification of laws, driven by many underlying
causes that dictate their intended scope of regulation. In jurisdictions with comparatively
permissive abortion legislation, such as the United States and South Africa, several women
may have difficulty accessing abortion services (Tadele et al., 2019). Access obstacles to
abortion services can arise due to several factors, including the distance individuals must travel
to reach healthcare facilities, the stringent rules governing these institutions, concerns
regarding privacy at clinics, the financial implications associated with the procedure, and the
limited number of health workers who are ready to provide abortion services. The significance
of the latter aspect lies in the observation made by the WHO regarding the substantial
hindrance to women’s accessibility to safe abortion caused by the insufficient presence of
healthcare professionals offering abortion services. Obtaining the services of healthcare
professionals willing to offer abortion care can pose challenges, particularly in environments
characterized by stringent abortion legislation and a cultural climate that stigmatizes the
profession. Consequently, abortion service providers often encounter social stigma and
prejudice.
8
Abortion, especially involving surgical methods, remains contentious and evokes solid
opinions and discussions. Comprehending this topic’s complexities is imperative for fostering
well-informed and productive dialogues that respect diverse perspectives. The historical
trajectory of surgical abortion is marked by legal battles, shifting societal values, and
advancements in medical technology. What particularly interests me is the ethical dilemma
inherent in this topic. This dilemma encompasses a woman’s right to reproductive autonomy
juxtaposed with the ethical considerations and rights attributed to the fetus.
Ethical and Religious Justifications
Ethical problems involve conflicting ethical principles or values, leading to
disagreements on balancing these principles effectively and arriving at a conclusion. Moral
dilemmas frequently emerge when healthcare practitioners are compelled to employ broad
conceptions of the law due to the intersection of professional ethics and personal beliefs
(Broussard et al., 2019). The activation of fundamental beliefs and values was observed among
the study participants concerning the availability of abortion services. Some individuals
perceive abortion as malicious, while others perceive it as assisting vulnerable women,
aligning with the concept of doing good or beneficence (Thornborg, 2023). The last point was
frequently prioritized, with most healthcare professionals expressing willingness to support
women seeking abortion, particularly when women did not meet the strictest legal criteria
(Broussard et al., 2019). These judgments arise as instances of situations where individuals
desire to act in a morally positive manner. In their endeavor to uphold the ethical ideals of
beneficence and nonmaleficence, healthcare providers navigated morally ambiguous
situations, leading them to accept what they perceived as falsehoods and consequently engage
9
in legal flexibility. The obligation of health practitioners to accept a woman’s testimony,
irrespective of their perspectives, placed significant demands on them.
Instead of framing abortion solely within the context of women’s autonomy and bodily
agency, the narratives of healthcare professionals highlight its significance as a public health
concern. These accounts underscore the role of abortion in mitigating the considerable health
risks associated with unsafe procedures, preventing childbirth among young and economically
disadvantaged unmarried women, and enabling young women to pursue their education
without interruption.
Balancing Autonomy and Societal Norms
A critical perspective that has caught my consideration is the multifaceted harmony
expected between an individual’s independence in pursuing personal decisions and the cultural
standards and values that can impact these choices. It raises a central issue: Is it morally
satisfactory for a lady to wield full command over her body, even when it means discontinuing
a potential life? Conversely, how do society’s moral principles and responsibilities intermingle
with an individual’s autonomy, mainly when a potential conflict exists between personal
choices and broader values? Adding another layer to this complex issue is the accessibility of
surgical abortion. This element is concerning because it may lead to women seeking risky
operations, threatening their health and the fetus’s development.
Accessibility and Health Concerns
Adding another layer to this complexity is the issue of accessibility to surgical
abortion. The accessibility aspect is concerning due to its potential to drive women towards
unsafe procedures, jeopardizing their health and the development of the fetus. This assertion
10
emphasizes the need for comprehensive reproductive healthcare that ensures safe and ethical
options for women while respecting their autonomy. By exploring this problem, I aim to foster
a nuanced understanding of the ethical landscape surrounding surgical abortion and contribute
to developing balanced solutions that respect women’s autonomy while addressing broader
societal and moral considerations.
Despite being considered safe, both therapeutic abortions and spontaneous
miscarriages can result in a range of problems. Approximately one million abortions are
conducted annually in the United States exclusively (Guendelman et al., 2020). Most problems
are minor, encompassing discomfort, infection, bleeding, and post-anesthesia difficulties.
Several other complications might arise, including uterine atony and subsequent hemorrhage,
uterine perforation, damage to nearby organs such as the bowels or bladder, and septic
abortion. The estimated overall rate of complications connected to abortion, encompassing
various sources of care such as emergency rooms and the initial abortion clinic, is
approximately 2% (Williams et al., 2023). The user’s text is already academic and does not
require any rewriting. Approximately 40% of individuals who undergo an abortion experience
needing emergency medical care within six weeks following the first surgery (Williams et al.,
2023). These rates are alarming. Few people can access safe abortion.
Investigating further into this topic, my problem statement could be;
“How can we navigate the intricate ethical landscape surrounding surgical abortion to
ensure comprehensive reproductive healthcare, all while considering the concerns of
autonomy, fetal rights, and accessibility?”
11
I invite you to share your unique perspectives on these concepts. I am particularly
interested in whether a woman’s autonomy should be the primary consideration or other ethical
and moral factors should hold a more significant influence. I am also keen to explore how we
can find a harmonious middle ground that respects women’s reproductive rights while
addressing the ethical complexities and dilemmas that this topic poses.
The overarching goal of this Assignment is to lay the groundwork for our final papers.
As we embark on this journey, our objective is to identify a specific area of focus and develop
a topic that centers on a pressing issue or challenge within that domain. Let us always
remember that our endeavors aim to propose and present practical solutions to the healthcare
issue we choose to address. Women seeking reproductive choices and comprehensive
healthcare would benefit from a solution to the ethical complexities surrounding surgical
abortion.
Literature Review
Article 1: Pain Control in Surgical Abortion
Cansino et al. (2021) explore pain management options during surgical abortion. Their
article focuses on moderate sedation, profound sedation, and general anesthesia. It offers
clinicalrecommendations and protocols for anesthesia, considering patient factors and safety
measures. It is an integral area that requires significant comprehension for increased efficiency
among the practitioners to provide quality care to their clients. The source is credible, as it is a
peer-reviewed article published in the journal “Contraception.” It is a reputable scientific
journal. The authors of the material are also experts in family planning and healthcare—a
component providing further credibility to the article. The article is a recent publication, which
12
implies it contains relevant data and information by borrowing from past accounts to make
informed decisions. This document will be invaluable for understanding the scientific aspects
of anesthesiain surgical abortions—a factor that directly contributes to considerations about
comprehensive reproductive healthcare and improving patient experience.
Article 2: Quality of Care and Abortion
According to Darney et al. (2018), quality of care is substantial in all areas. In their
article, they stress the prominence of quality of care in abortion services. Abortion is a
potentially sensitive area that requires increased efficiency to increase outcomes. The authors
argue for a broader focus beyond safety, outlining the need for effective, efficient, patientcentered care. This research module is published in the peer-reviewed journal “BMJ Sexual &
Reproductive Health.” The authors are also reproductive health and healthcare policy experts,
making the source credible. Technically, this is a scientific article and directly correlates with
theissue discussed at hand. It offers a look into the quality of abortion services, which will be
critical in addressing the ethical and practical complexities surrounding the provision of
surgicalabortion services.
Article 3: The Mesoeconomics of Abortion
Lattof et al. (2020) provide a scoping review of the economic aspects of abortion. The
focus on the economic consequences of abortion on health systems and communities is an area
that takes up most of the article. It appears in “PLOS ONE,” a peer-reviewed journal. The
multi-disciplinary team of authors lends further credibility to the research. It is also a recent
documentpublished in 2020, making it valid for this research topic. Comprehending the
economic effects of abortion is crucial for policymakers and healthcare providers. The study
13
material will help address the issue of abortion from an economic perspective. It is a factor that
will influence discussions on accessibility and affordability.
Improving Healthcare Outcomes
Although the majority of abortions are uncomplicated, there exists a subset of cases that
are accompanied by difficulties, posing a potential risk to the individual’s life. The
recommendation is to assemble an interdisciplinary team consisting of health and nursing
practitioners due to the elevated mortality associated with complications arising from abortion
procedures.
A considerable proportion of individuals experiencing post-abortion problems seek
medical attention at the emergency department, where the screening nurse initially assesses
them. The triage nurse must possess knowledge of potential difficulties that may arise following
an abortion procedure, enabling them to admit the patient and notify the interprofessional
healthcare team promptly. Also, to severe hemorrhage, post-abortion consequences encompass
septic shock, perforation of the bladder or colon, and potential ectopic pregnancy. Failure to
promptly diagnose these diseases can result in significant fatality rates. While coordinating the
imaging investigations, the nursing staff must verify the presence of two large-bore intravenous
catheters, administer oxygen, and guarantee that a typical blood work routine, particularly a
cross-match, has been dispatched for the patient. Continuous monitoring by a devoted nurse,
who promptly reports any irregularities to the clinician, is crucial for managing
hemodynamically unstable patients.
It is imperative to promptly conduct a comprehensive physical examination
encompassing the pelvic region to ascertain the absence of any overlooked injuries. If the
14
patient needs expeditious surgical intervention, it is imperative to promptly inform the
anesthetic team and the surgical facility nursing staff. Close monitoring is necessary for stable
individuals due to the potential presence of internal bleeding that may not be readily apparent.
During monitoring period, it is considered proper care when the nurse promptly communicates
with the team of specialists in the event of any alterations in vital signs or abdominal pain.
With the growing number of self-induced procedures, there is expected to be a decrease
in abortion-related deaths. The significance of understanding women’s care requirements
persists, and the utilization of morbidity as a health outcome metric will continue to be pivotal.
To enhance the rigor and comparability of future facility-based research studies, it is
recommended that standardized definitions, such as the WHO near-miss criteria, be consistently
employed. Additionally, it is advisable for researchers to explicitly outline the clinical criteria
utilized in their studies, preferably data collection in a prospective manner.
Conclusion
In summary, examining surgical abortion through a meticulous evaluation of scholarly
literature has shed light on the complex interplay of medical, sociological, and ethical factors
that include this essential healthcare topic. This research study examined three peer-reviewed
studies that focused on important aspects of surgical abortion, specifically pain management,
the provision of high-quality treatment, and the economic considerations related to abortion.
Throughout this academic exploration, it becomes clear that surgical abortion extends beyond
simple medical treatment. It involves profoundly examining patient welfare, ethical
ramifications, and economic outcomes.
15
The significance of an exhaustive review of these peer-reviewed papers cannot be
emphasized. These resources provide significant perspectives on improving the
implementation of surgical abortion procedures, considering various patient considerations,
and ensuring the delivery of high-quality healthcare. Moreover, these findings add to a broader
and deeper understanding of the moral and sociological aspects that shape the discussion
surrounding this particular medical methodology. The insights derived from scholarly
publications are of great value to healthcare providers, policymakers, and researchers as they
strive to explore the complex surgical abortion practice. These technologies facilitate informed
dialogues, strengthen healthcare practices, and eventually contribute to improved patient
experiences. Surgical abortion continues to be the subject of significant debate and careful
consideration. However, by actively interacting with the academic literature, healthcare
stakeholders can progress toward understanding its complexity and approaching it with
enhanced awareness. These essential components evaluated in the study serve as a foundation
upon which healthcare stakeholders can construct knowledgeable dialogues, enhance
healthcare procedures, and strive to enhance the comprehensive welfare of those seeking
medical care. However, active involvement with scholarly sources can advance stakeholders’
understanding and approach to this issue by enhancing peace effectiveness, knowledge, and
empathy in tackling its complexities.
The significance of an exhaustive review of these peer-reviewed papers cannot be
emphasized. These resources provide significant perspectives on improving the
implementation of surgical abortion procedures, considering various patient considerations,
and ensuring the delivery of high-quality healthcare. Moreover, these findings add to a broader
16
and deeper understanding of the moral and sociological aspects that shape the discussion
surrounding this particular medical methodology. The insights derived from scholarly
publications are of great value to healthcare providers, policymakers, and researchers as they
strive to explore the complex surgical abortion practice. These technologies facilitate informed
dialogues, strengthen healthcare practices, and eventually contribute to improved patient
experiences. Surgical abortion continues to be the subject of significant debate and careful
consideration. However, by actively interacting with the academic literature, healthcare
stakeholders can progress toward understanding its complexity and approaching it with
enhanced awareness. These essential components evaluated in the study serve as a foundation
upon which healthcare stakeholders can construct knowledgeable dialogues, enhance
healthcare procedures, and strive to enhance the comprehensive welfare of those seeking
medical care. However, active involvement with scholarly sources can advance stakeholders’
understanding and approach to this issue by enhancing peace effectiveness, knowledge, and
empathy in tackling its complexities.
17
References
Agula, C., Henry, E. G., Asuming, P. O., Agyei-Asabere, C., Kushitor, M., Canning, D., … &
Bawah, A. A. (2021). Methods women use for induced abortion and sources of services:
insights from poor urban settlements of Accra, Ghana. BMC Women’s Health, 21(1), 1–12.
Andersen, M., Bryan, S., & Slusky, D. (2020). Covid-19 surgical abortion restriction did not
reduce visits to abortion clinics.
Broussard, G., Rubenstein, L. S., Robinson, C., Maziak, W., Gilbert, S. Z., & DeCamp, M.
(2019). Challenges to ethical obligations and humanitarian principles in conflict settings: a
systematic review. Journal of International Humanitarian Action, 4(1), 1-13.
Cansino, C., Denny, C., Carlisle, A. S., & Stubblefield, P. (2021). Society of Family Planning
clinical recommendations: pain control in surgical abortion part 2–moderate sedation, profound
sedation, and general anesthesia.
Czekajewska, J., Walkowiak, D., & Domaradzki, J. (2022). Attitudes of Polish physicians,
nurses, and pharmacists towards the ethical and legal aspects of the conscience clause. BMC
Medical Ethics, 23(1), 107. https://link.springer.com/article/10.1186/s12910-022-00846-0
Darney, B. G., Powell, B., Andersen, K., Baum, S. E., Blanchard, K., Gerdts, C., & Kapp, N.
(2018). Quality of care and abortion: beyond safety. BMJ sexual & reproductive health, 44(3),
159-160.
Gebremariam, F. A., Habtewold, E. M., Degife, D. T., Geneti, H. B., & Gebrekiros, D. H.
(2023). Health facilities readiness to provide comprehensive abortion care and factors
associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling
approach. Reproductive Health, 20(1), 1-18. https://reproductive-health-
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journal.biomedcentral.com/articles/10.1186/s12978-023-01610-2
Guendelman, S., Yon, E., Pleasants, E., Hubbard, A., & Prata, N. (2020). Shining the light on
abortion: Drivers of online abortion searches across the United States in 2018. Plos one, 15(5),
e0231672.
Lattof, S. R., Coast, E., Rodgers, Y. V. D. M., Moore, B., & Poss, C. (2020). The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortionon
health systems. PloS one, 15(11), e0237227.
Roe, A. H., & Bartz, D. (2019). Society of Family Planning clinical recommendations:
contraception after surgical abortion. Contraception, 99(1), 2-9.
Tadele, G., Haukanes, H., Blystad, A., & Moland, K. M. (2019). ‘An uneasy compromise’:
strategies and dilemmas in realizing a permissive abortion law in Ethiopia. International
Journal for Equity in Health, 18, 1-13.
Thornburg, E. L. (2023). The Public Health Crisis of Media Misinformation, Disinformation,
and Conspiracy Theories: A Case for Bioethical Intervention (Doctoral dissertation, Temple
University).
Tufa, T. H., Prager, S., Wondafrash, M., Mohammed, S., Byl, N., & Bell, J. (2021). Comparison
of surgical versus medical termination of pregnancy between 13-20 weeks of gestation in
Ethiopia: A quasi-experimental study. Plos one, 16(4), e0249529. https://doi.org/10.1371/
journal.pone.0249529
Williams, C. R., Valeria Bahamondes, M., Gómez Ponce de León, R., da Costa Machado, H.,
Bahamondes, L., Caffe, S., & Serruya, S. J. (2023). Analyzing the context and characteristics
of legal abortion and comprehensive post-abortion care among adolescents aged 10–14 in a
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network of sentinel centers in Latin America: a retrospective cross-sectional study, 2016–
2020. Sexual and Reproductive Health Matters, 31(1), 2175442.
Discuss the safety and effectiveness of alternative and complementary medicine for the treatment of specificillnesses such as cancer, diabetes, and hypertension. Share your opinions about holistic and allopathic care.Would you have any conflicts or concerns supporting a patient who chooses holistic or allopathic medicine?Instructions: Word limit 500 words. Please make sure to provide citations and references (in APA, 7th ed. format) for your work.
https://es.eskill.com/es/quiz/?testId=631001b3671d7bb7I’m trying to get this job for at home but I’m too busy working to even complete the next step. Could someone please help. Here’s the directions I’ve also attached what you need to add to this link above to access it. The next step in your application process is to complete our pre-hire assessment which tests your English grammar and medical terminology knowledge, both necessary skills to be successful as a medical scribe. This assessment is divided into two parts, the first covering grammar/syntax in a medical setting (20 questions), and the second covering common medical terms and abbreviations as well as anatomical knowledge (50 questions). Altogether, it should take approximately 30 to 45 minutes to complete the assessment.Along with the assessment link below, we are providing a Medical Packet for you to review and study before attempting our required assessments. This packet contains a list of medical terms that you will need to know to be successful in AQuity’s training program as well as details about the requirements and responsibilities of working as a Virtual Medical Scribe. While not required, we highly encourage you to take as much time as you need to study the material in preparation for the assessments. ONLY ONE (1) ATTEMPT is allowed for both sections, and a passing score of 80% is required.
In this assignment, you will write a critical appraisal that demonstrates comprehension of two qualitative research studies.
For this assignment, use the nursing practice problem and two qualitative peer-reviewed research articles you identified in Topic 1 (or two new articles based on instructor feedback in Topic 1). In a 1,000-1,250-word essay, summarize two qualitative studies.
Use the “Research Critique Guidelines – Part I” document to organize your essay.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
use the specific safety concern identified in your previous assessment as the subject of a root-cause analysis and safety improvement plan.
You will create a plan to improve the safety of patients related to the case study based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Analyze the root cause of a specific patient safety issue in an organization.
Apply evidence-based and best-practice strategies to address the safety issue.
Create a feasible, evidence-based safety improvement plan to address a specific patient safety issue.
Identify organizational resources that could be leveraged to improve your plan.
Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style
…………………………………………………………………………………………………………………….
Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4–6 page root cause analysis and safety improvement plan pertaining to a specific patient safety issue.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to current APA style.
Unformatted Attachment Preview
1
Root-Cause Analysis and Safety Improvement Plan
Your Name
School of Nursing and Health Sciences, Capella University
NURS4020: Improving Quality of Care and Patient Safety
Instructor Name
Month, Year
2
Root-Cause Analysis and Safety Improvement Plan
Introduce a general summary of the issue or sentinel event that the root-cause analysis
(RCA) will be exploring. Provide a brief context for the setting in which the event took place.
Keep this short and general. Explain to the reader what will be discussed in the paper and this
should mimic the scoring guide/the headings.
Analysis of the Root Cause
Describe the issue or sentinel event for which the RCA is being conducted. Provide a
clear and concise description of the problem that instigated the RCA. Your description should
include information such as:
•
What happened?
•
Who detected the problem/event?
•
Who did the problem/event affect?
•
How did it affect them?
Provide an analysis of the event and relevant findings. Look to the media simulation, case
study, professional experience, or another source of context that you used for the event you
described. As you are conducting your analysis and focusing on one or more root causes for your
issue or sentinel event, it may be useful to ask questions such as:
•
What was supposed to occur?
o Were there any steps that were not taken or did not happen as intended?
•
What environmental factors (controllable and uncontrollable) had an influence?
•
What equipment or resource factors had an influence?
•
What human errors or factors may have contributed?
•
Which communication factors may have contributed?
3
These questions are just intended as a starting point. After analyzing the event, make sure you
explicitly state one or more root causes that led to the issue or sentinel event.
Application of Evidence-Based Strategies
Identity best practices strategies to address the safety issue or sentinel event.
•
Describe what the literature states about the factors that lead to the safety issue.
o For example, interruptions during medication administration increase the risk of
medication errors by specifically stated data.
o Explain how the strategies could be addressed in safety issues or sentinel events.
Improvement Plan with Evidence-Based and Best-Practice Strategies
Provide a description of a safety improvement plan that could realistically be
implemented within the health care setting in which your chosen issue or sentinel event took
place. This plan should contain:
•
Actions, new processes or policies, and/or professional development that will be
undertaken to address one or more of the root causes.
o Support these recommendations with references from the literature or professional
best practices.
•
A description of the goals or desired outcomes of these actions.
•
A rough timeline of development and implementation for the plan.
Existing Organizational Resources
Identify existing organizational personnel and/or resources that would help improve the
implementation or outcomes of the plan.
o A brief note on resources that may need to be obtained for the success of the plan.
4
o Consider what existing resources may be leveraged to enhance the improvement
plan?
Conclusion
5
References
Reference page should be double spaced throughout without extra spaces between entries.
Each reference page entry should be formatted according to APA 7 guidelines with a hanging
indent as is seen here.
The use of spirituality in nursing practice is not new. However, it is more studied and utilized in a more structured format in nursing. Identify and discuss tools used to evaluate spirituality.APA style, 500 words, no less than 2 references. No plagiarism.
Follow the instructions (under module 2 file) use the article and use the article as resource. Please use your own words, my school is so strict about plagiarism. At least 3 se per question.
Unformatted Attachment Preview
NURS 321
Nursing Research & Evidence-Based Practice
Module 2 Individual Case Study Discussion Questions
Chapter 5
Evan and Marlyce have a 4-year-old son (Micah) who has cerebral palsy. Their life is very
challenging because they both have to work and recently lost their home to foreclosure. Micah is
being discharged to home this afternoon, and Marlyce is obviously anxious. Marlyce states, “I
just feel like we are always out of touch when we go home. I have other children to care for, and
we are always on the go.“ This case study is based on a longitudinal qualitative study from
Canada (Woodgae, Edwards, & Ripat, 2012).
1. Propose a qualitative research study purpose that would help the nurse provide better care for
Micah’s family.
2. As the researchers set up a qualitative study for families of patients such as Micah, they used
purposive sampling. What does this mean, including some ideas for inclusion and exclusion
factors?
3. Now that inclusion and exclusion criteria are set for the study, how can the participants be
recruited? How many participants would be necessary?
Chapter 6
Simon is undergoing cardiac catheterization after a heart attack. Throughout his hospital stay,
the case manager asks about resources at home. Much to everyone’s amazement, it is discovered
that Simon is homeless. Simon is supposed to undergo extensive follow-up and cardiac
rehabilitation. Because of the location of this facility, the case manager knows that there are
other situations similar to Simon’s in this community.
1. If the case manager wanted to research Simon’s experience (managing cardiac disease while
being homeless), how might the researcher maintain rigor?
2. Describe a grounded theory study and an ethnographic study structure for Simon’s case.
3. The case manager is using an ethnographic research methodology for patients who are
homeless and have heart disease. Describe the data gathering process.
Chapter 7
Two teenaged girls visit the school nurse and are concerned about acne. Both have tried “things
and food” that their friends told them about, but nothing is working. They are asking for more
information and something that will help with “these totally annoying zits.”
1. Propose using social media to better understand how acne affects teenaged girls.
2. For a researcher collecting data through social media, how might their interaction affect the
results and how could this be avoided?
3. Discuss how the researcher could verify the findings from the qualitative research.
Chapter 8
The nurse recognizes that there has been an increase in the number of urinary tract infections
(UTIs) on one unit of the rehabilitation facility. He heard about a new type of peri-care bath
wipes. The nurse would like to try them as a way of seeing if they help decrease the incidence of
cystitis.
1. What are the independent and dependent variables in this study?
2. List some extraneous variables in this study.
3. How might the nurse ensure randomization of the participants to the experimental or control
groups?
Chapter 9
Mirlande is an 18-year-old woman in the clinic with asthma. She has been in the United States
for 6 months and has gone through three albuterol inhalers and two salmeterol inhalers. The
nurse practitioner is considering treatment strategies for the client.
1. As the nurse practitioner considers research studies about the best treatment option, she is
frustrated that she cannot find purely experimental studies. Is there value in reviewing a
study that used quasi-experimental methodology? Provide rationale for your answer.
2. If the nurse practitioner was unable to find research specifically about the young adult or
older adolescent, what may be an acceptable alternative? Provide rationale for your answer.
3. Propose a study for clients with asthma that would compare using a long-acting inhaler (antiinflammatory) with an oral medication (anti-inflammatory). Describe the methodology if a
Solomon four-group design was used.
Chapter 18
A woman brings in her 8-year-old child, who has a serious history of asthma. The nurse notes
that the mother is tired looking, and the child is very “clingy.” As the nurse asks questions of the
mother, the mother takes a deep breath and looks away. The nurse senses that there is something
concerning the parent. After the nurse says, “You seem pretty tired,” the mother states that she is
worn out from “chasing around all the kids.”
1. On the basis of an appraisal of the article by Cerdan et al (2012), can the nurse assume that
the client’s mother is likely to become divorced? Support your answer.
2. The nurse would like to compare the current research (Cerdan et al, 2012) to a known
evidence-base. What would you recommend?
3. As the nurse reviews the Cerdan et al article, she notes that in previous research, there was no
correlation between the number of emergency department visits and parental quality of life
scores. Conversely, in the Cerdan et al study data, there was a significant correlation. How
should the nurse use this information?
pharmacy
Article
Exploration of Nurses’ Knowledge, Attitudes,
and Perceived Barriers towards Medication
Error Reporting in a Tertiary Health Care
Facility: A Qualitative Approach
Eman Ali Dyab 1 , Ramadan Mohamed Elkalmi 2 , Siti Halimah Bux 3 and
Shazia Qasim Jamshed 3, *
1
2
3
*
Department of Pharmaceutics, Faculty of Pharmacy, Tripoli University,
Tripoli 42300, Libya; eman_diab2008@yahoo.com
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi Mara,
Puncak Alam 42300, Malaysia; edriph@gmail.com
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia,
Kuantan 25200, Malaysia; sitihalimah@iium.edu.my
Correspondence: shazia_jamshed@iium.edu.my; Tel.: +601-7470-3692
Received: 15 September 2018; Accepted: 2 November 2018; Published: 5 November 2018
Abstract: Medication error reporting (MER) is an effective way used to identify the causes of
Medication Errors (MEs) and to prevent repeating them in future. The underreporting of MEs
is a challenge generally in all MER systems. The current research aimed to explore nurses’ knowledge
on MER by determining their attitudes towards reporting and studying the implicated barriers
and facilitators. A total of 23 nurses were interviewed using a semi-structured interview guide.
The saturation point was attained after 21 interviews. All the interviews were tape-recorded and
transcribed verbatim, and analysed using inductive thematic analysis. Four major themes and
17 sub-themes were identified. Almost all the interviewees were aware about the existence of the
MER system. They showed a positive attitude towards MER. The main barriers for MER were the
impacts of time and workload, fear of investigation, impacts on the job, and negative reactions
from the person in charge. The nurses were knowledgeable about MER but there was uncertainty
towards reporting harmless MEs, thus indicating the need for an educational program to highlight
the benefits of near-miss reporting. To improve participation strategies, a blameless reporting culture,
reporting anonymously, and a simplified MER process should be considered.
Keywords: medication error reporting; nurses’ attitudes; qualitative study; barriers; medication error
1. Introduction
The main principle of giving medication to the patient is to serve them in order to restore his/her
health without any harm [1]. Adverse events and medical errors are the main issues threatening
the patient’s safety, and are awkward predicaments in nearly all healthcare systems [2]. The World
Health Organization (WHO estimated that millions of people suffer injuries directly attributed to
medical care, and many are preventable [3], although prevalence in developing countries is reported
to be higher than developed nations [4]. In Southeast Asian countries, the reported administration
error rates ranged from 15.2% to 88.6% [5]. In Taiwan, a study mentioned that the overall rate of the
medical incidents ranged from 30% to 47.6%, and most of them were related to MEs [6]. In a Malaysian
study, Johari et al. reported 2572 reported cases of ME in 2009 [7]. The prevalence of ME among
geriatric patients was 25.17% [8] whereas in paediatrics this figure was 11.7% [9]. A recently published
Pharmacy 2018, 6, 120; doi:10.3390/pharmacy6040120
www.mdpi.com/journal/pharmacy
Pharmacy 2018, 6, 120
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four-year retrospective study reported that the total number of paper-based ME reports submitted
to the National Medication Error Reporting system (NMER) was 17,357, but only 0.3% of MEs were
in the administration stage [10]. The percentage in the administration stage is very low, representing
paper-based reports only (excluding online submitted MEs reports) collected by the NMER system,
as well as the effect of underreporting. The annual estimated cost of MEs in Malaysia was estimated to
be 111,924 Malaysian Ringgit (MYR) [10]. Clinically, MEs can have small to severe consequences for
patients. It was reported that the total number of MEs in the administering stage was 166, where 1%
had fatal consequences, 20% were serious, 32% were significant, and 46% were nonsignificant [11].
The identification of trends and patterns of MEs were the main reasons for establishing a ME
reporting system [12]. The effectiveness of all these systems depend on their ability to document
the occurred MEs. Establishing guidelines for medical error reporting (MER) is not enough, as the
healthcare practitioners (reporters) play a vital role in the MER process. The healthcare practitioners’
knowledge about MER, their attitudes toward reporting MEs, and perceived barriers toward MER are
important factors which determined the success of MER systems. Health care professionals in general
and nurses in particular are responsible for MER. It has been reported that the MEs are underreported
in all countries. Nurses’ knowledge and attitudes as well as barriers and facilitators toward MER
among nurses in Malaysia are little-studied issues and warrant investigation.
This study is intended to attain deeper insight into the knowledge and attitudes held by Malaysian
nurse practitioners towards the ME concept and MER process, as well as to investigate the barriers
which prevent nurses from reporting their MEs.
1.
2.
3.
4.
What do nurses know about the ME and MER system?
What are the nurses’ attitudes toward MER?
What are the barriers which could hinder nurses from reporting their MEs?
What are the factors which could facilitate MER among nurses?
2. Methods
2.1. Study Design and Setting
The study was conducted after getting approval from both the Medical Research Ethics
Committee Ministry of Health Malaysia (NMRR-15-2485-24709) and the International Islamic
University of Malaysia Research Ethics Committee (IREC 446). Use of a qualitative method (in-depth
interviews) provides flexibility and efficiency in collecting data related to personal feelings, attitudes,
and experiences [13] and hence, these methods are used for the exploration of the participants’
experiences towards medication error reporting. The individual interview method was chosen over
focus group discussions because of privacy, suitability, and comfort zone issues for shy and hesitant
participants [14]. This gives liberty to the participants to elaborate his/her answers without distractions
from others [14]. The current research was executed in a tertiary healthcare facility of Kuantan city,
Pahang, Malaysia.
2.2. Participants
The target study population was nurses practicing in different units of the hospital. No specific
inclusion and exclusion criteria were applied, and thus all nurses were eligible to participate in
the current research. The participants were recruited by using convenience and snowball sampling
technique. The snowball method helps to recruit hidden subjects which cannot be easily found [15].
The first participant was a nurse from the medical unit and was given information on the details of
the research along with an assurance of confidentiality and anonymity. After her acceptance she was
asked to fill in demographics form and sign the consent form. The interviews were recorded by using
Audio Recording Titanium Software® version 8.5.5 (AATSystems, Kent, UK), and notes were taken
during the interviews. After finishing the first interview, the interviewee was asked to nominate the
Pharmacy 2018, 6, 120
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next participant. Thus, she made a referral to the next nurse, with the same pattern for the subsequent
interviews. Thus, a chain referral technique followed throughout the research study. The number
of participants was determined once the saturation point was achieved. The saturation point occurs
when no new concepts and themes emerge [14,16,17]. Two extra interviews were conducted to confirm
the saturation point. The field supervisor also helped in recruitment process. Participation was
simply on a voluntary basis, and they were informed that anytime during the course of research they
could withdraw. Moreover, they were assured that their confidentiality and anonymity would be
maintained. Only the research team had access to records. The purpose of the study was explained
to each participant before the interviews commenced and therefore, all the participants were asked
to sign an “informed consent form” followed by the addition of their demographic characteristics.
A total of 23 nurses were interviewed.
2.3. Procedure and Interview Process
In-depth interview sessions were conducted using a semi-structured interview guide in June 2015.
This guide was developed on the basis of prior published studies related to MER among health care
professionals [18–20]. The purpose of using this guide was to make sure that all important issues
about the topic were covered in the interviews [13,21]. The medium of communication during the
interview was primarily English, followed by a couple of interviews being conducted in Bahasa
Malayu i.e., the native language of participants. The field supervisor agreed to work as a research
assistant and a translator and assisted the nurses who could not understand the English language. As a
result, participants who expressed their thoughts in the Bahasa Malayu language were also included.
Each interview lasted for about 30–45 min. Venue was chosen as per proximity to nurses’ working units,
their preference of level of comfort/privacy, and the level of noisiness. Places such as the library private
room, the seminar room, and nurses’ rooms were selected as the venue for interviews. The discussion
was focused on several major issues; the nurses’ knowledge, experiences, and perceptions about ME
and MER, exploring their attitudes towards MER, comprehending the factors which might prevent
the nurses from reporting their MEs, and those factors which would promote MER among nurses.
Probing questions were asked to provoke more details from interviewees [13,21].
2.4. Data Analysis
The data analysis was performed using the inductive thematic analysis approach. The participants’
approved transcripts (transcribed verbatim) were coded as (N1, N2, . . . , N23). The process is illustrated
in Figure 1. The analysis followed a cyclic pattern, where it started by familiarization stage, generation
of initial codes stage and revision stage to refine the emerged codes [22,23]. The transcripts were
analysed again by another researcher to validate the resulted themes [22], and a third person’s opinion
was sought to resolve any disagreement between the previous analyses [24,25].
The current research followed an established criterion for maintaining quality in qualitative
research and thus follow the standards of Guba and Lincoln [26] for generating credibility,
transferability, dependability, and confirmability. For strengthening the credibility of the research there
was a continuous interaction with the participants, with checking of interpretations against interview
transcripts. A review with the participants was undertaken. Contrary to quantitative research, the aim
of qualitative is not generalizability but to observe and execute transferability. Therefore, a detailed
description of the participants’ experiences helped the researchers identify the patterns of social
relationships in reporting MEs and as well as the cultural backgrounds of the participants who reported
hesitancy in reporting. For dependability purposes, external audit criteria were put in place, and a
researcher not involved directly in research helped in the evaluation of interpretation and conclusions
with respect to the data collected. For establishing confirmability, not only a conformability audit (as
mentioned above) but also triangulation and reflexivity were maintained. In terms of establishing
triangulation, both methodological triangulation (i.e., the research followed the quantitative design
after qualitative inquiry) and analyst triangulation (i.e., using different analysts to review the findings)
Pharmacy 2018, 6, 120
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were maintained,
whereas
forREVIEW
reflexivity, a reflexive note-sheet was used to record the methodological
Pharmacy 2018,
6, x FOR PEER
4 of 14
parameters and logistics involved. Interviewees were female (n = 22); of Malay race (n = 22); holding a
note-sheet was used to record the methodological parameters and logistics involved. Interviewees
diploma (n = 21). The nursing diploma is a 3-year course in Malaysia and on its successful completion
were female (n = 22); of Malay race (n = 22); holding a diploma (n = 21). The nursing diploma is a 3one can register
with
Board
Malaysia
work asone
a staff
nurse. with
All participants
year course
in Nursing
Malaysia and
on its
successfuland
completion
can register
Nursing Boardwere full
time employees.
Half
of
the
participants
(n
=
12)
have
working
experience
of
than 11 years.
Malaysia and work as a staff nurse. All participants were full time employees. Half of themore
participants
(n
=
12)
have
working
experience
of
more
than
11
years.
Slightly
more
than
three-quarters
the the prior
Slightly more than three-quarters of the participants (n = 18) had not reported any MEs of
over
participants (n =18) had not reported any MEs over the prior 12 months. The interviewees were
12 months. The interviewees were attached to different units in the hospital such as intensive care units
attached to different units in the hospital such as intensive care units (ICUs), medical units, critical
(ICUs), medical
units, critical cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic
cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic units, neonatal intensive
units, neonatal
intensive
care
units
(NICUs),
units.
The demographic
characteristics
of
care units
(NICUs),
and
paediatric
units.and
Thepaediatric
demographic
characteristics
of participants
are
presented
in Table 1. in Table 1.
participants
are presented
1. The study
process
flowchart.(I)
(I)transcription
transcription step,
(II) (II)
datadata
analysis
step, (III)
analysts’
Figure 1.Figure
The study
process
flowchart.
step,
analysis
step,
(III) analysts’
triangulation
(two researchers
performed
analysis
and person
third person
resolved
any
triangulation
method method
(two researchers
performed
analysis
and third
resolved
any disagreement),
disagreement), and (IV) final result.
and (IV) final result.
3. Results
Table 1. Interviewees socio-demographic characteristics (n = 23).
Four major themes and 17 sub-themes were emerged: knowledge about MER, attitudes toward
Characteristic
Number (n = 23)
Percentage (%)
MER, barriers toward MER, and facilitators to improve MER process. Figure 2 represents the
Female
22
95.7
emerged themes
Genderand categories.
Male
Race
Characteristic
Age
1
Malay
Table 1. Interviewees socio-demographic
characteristics (n22= 23).
Chines
1
Gender
Race
≤30
30–40
Female
41–50Male
51≥
Malay
Education level
Diploma
Chines
Bachelor
Experience in years
Age
≤5
6–1030–40
≥11 41–50
≤30
Practice site
51≥
Medical unit
a
ICUDiploma
b
CCU
Bachelor
A&Ec
Orthopaedic unit
NICU d
Paediatric unit
Number of reports in the last 12 months
Never report
≥1
Education level
Number (n
6 = 23)
2214
12
1
22
21
1
2
6
5
14 6
2 12
14
21 9
22
3
2
1
2
18
5
4.3
95.7
4.3
Percentage
(%)
26.1
95.7 60.9
4.3 8.7
4.3
95.7
91.3
4.3
8.7
26.1
21.7
60.9 26.1
8.7 52.2
4.3 17.4
91.3 39.1
8.7 8.7
13
8.7
4.3
8.7
78.3
21.7
(a ) Intensive care unit. (b ) Critical cardiac unit. (c ) Accident and emergency unit. (d ) Neonatal intensive care unit.
Medical unit
4
17.4
ICU a
9
39.1
b
2
8.7
CCU
Practice site
A&Ec
3
13
Orthopaedic unit
2
8.7 5 of 14
Pharmacy 2018, 6, 120
NICU d
1
4.3
Paediatric unit
2
8.7
3. Results
Never report
18
78.3
Number of reports in the last 12 months
≥1
5
21.7 toward
Four major themes and 17 sub-themes were emerged:
knowledge about
MER, attitudes
Intensive
care unit.
(b) Critical
cardiac unit.
(c) Accident
andprocess.
emergency
unit. 2(d)represents
Neonatal intensive
MER,(a)barriers
toward
MER,
and facilitators
to improve
MER
Figure
the emerged
careand
unit.categories.
themes
Emergent themes and sub-themes. MER:
MER: medical error reporting.
Figure 2. Emergent
3.1. Knowledge about MER
3.1.1. Concept of ME
The nurses were asked about their understanding of the ME concept. Almost all of them correctly
understood the concept of ME. Moreover, they linked its meaning to five/seven rights, while others
just gave simple and general answers like “giving incorrect medication to the patient”.
“Medication error is an error when giving medication including dosage and also the type of medication,
make sure to follow the 7Rs practice in the hospital.” (N1)
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“Medication error is when something unwanted occurs such as wrong medication is given to the
patient.” (N7)
“Medication error means giving wrong medication to the patient, which includes wrong dose,
wrong route, and wrong documentation.” (N13)
3.1.2. The Existence of a System for MER and the Importance of MER
All the interviewees were aware about the existence of MER system and the importance of MER.
They stated that data collected by MER can be used as an indication of the quality of health service
provided to the patient. It can be used to improve this service by carrying out root-cause analysis
for the MEs reports, and the reported data can be utilized for learning purposes. In other words,
ME reports can be used as good resources to help nurses in avoiding repeating the same errors again
in future.
“Yes, we have a system for medication error reporting [ . . . ] And, it is very important because it
involves the quality of service which is being given to the patient and it is very important to monitor
ME.” (N1)
“It is important because we want to improve the way of delivering care and serving the patient.
To learn from reports, where and which thing can be done. So we have more information about what
has been done and their consequences.” (N3)
“It is important because we want to detect what is ME and to prevent it from happening again.” (N7)
“Normally, we do root-cause analysis to find out when and how this happened. Sometimes it comes
from the wrong prescription like wrong dose or wrong route or wrong frequency and then we find out
how that happen and try to tackle.” (N5)
“It is to guide our practice [ . . . ] Not add more error to this collection [ . . . ] To avoid ME in future
[ . . . ] It is considered as a good resource.” (N4)
3.1.3. The Availability and Confidentiality of the Reporting Form
The majority of interviewed nurses claimed that during their practice, they did not report MEs,
since until the time of interviews they did not commit any error. As a result, most of them did not see
the reporting form and some of them had seen it but they did not remember its content.
“The reporting form is available in the pharmacy department.” (N5)
“I have not seen the reporting form before. Because, so far, I did not make any error.” (N8)
The nurses were asked about their opinions on the reporting form.
“I have seen it; it is easy to fill, it does not need modification or re-designation.” (N1)
“The report is not too detailed like describing everything, but it underlines or highlights when the
medication was given to the patient.” (N3)
3.2. Attitude of Nurses toward ME Reporting
The nurses were asked about their attitudes toward ME reporting. The majority of the participants
had a positive attitude toward reporting of MEs, whether these MEs caused a serious side effect to the
patient or not. The other group had uncertain attitudes and they tended to report the MEs which led
to harm to the patient only.
Pharmacy 2018, 6, 120
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3.2.1. Positive Attitude
The majority of nurses claimed that they report all encountered MEs immediately. They reported
them irrespective to their seriousness or the level of patient’s harm due to the error.
“Nothing affects my decision to report, once the error occurs it should be reported.” (N4)
“It is not a matter of choice.” (N7)
“Once I detect an error, I cannot just ignore it, and I straightforward report it […] We must make a
report also because this is ME, and we must report whether it is serious or not.” (N2)
“Here in A and E department, it does not matter if the error is big, mild, or small, it must be reported.” (N8)
3.2.2. Uncertain Attitude toward ME Reporting
During the discussion with the participants about their attitude toward MER, some participants
showed uncertain attitudes towards MER. They would report MEs only based on another factor such
as the severity of the ME or route of administration, or when they received a direct request form the
person in-charge.
“If the error caused big and serious complication I have to report.” (N17)
“Based on the patient, I will see the effect on the patient first. My first concern is the patient, I will
not report unless something happens to the patient. In this case, the doctor gives antidote and then
there is an investigation and eventually, they will revert to me.” (N9)
One nurse related the medication error reporting to the dosage form of administered medicine.
He believes that errors are serious when the medication given by the intravenous route, and this
type of error should be reported, while those resulting from oral or topical administration should not
be reported.
“Based on the route of administration IV it should be reported.” (N18)
One nurse insisted that she reports only if the person in charge requests her to fill the
reporting form.
“I just inform the sister and the doctor, and let them choose to fill the form or not but as for investigation,
I will come and join them” (N13)
Before reporting, the nurses think of the problems that will be faced after reporting their errors.
This has a high effect on their decision to report or not.
“Some nurses, at first, they think about what happen and the problems associated with reporting,
so they do not report.” (N12)
3.2.3. Reporting of Others’ Errors
Some of the interviewees stated that they do not have any problems in reporting MEs committed
by other staff. They believe that the reporting of MEs is better for both the nurses and also for the
patient, whether the MEs have been committed by themselves or by other health care professionals.
While the other group insisted that everyone is responsible for reporting his/her own initiated MEs.
“I will report if other staff nurse made a mistake.” (N1)
“I will report errors committed by others because this is in the best interest of the patient, and also it
would help things go smooth in the future, for example, patient allergy . . . ” (N3)
“If I made a mistake I would inform, also if others from my colleagues made a mistake, I would still
inform.” (N6)
“No, I report only my errors. If my colleagues made mistakes, I would just advise her to report, but I
will not report her error.” (N8)
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3.3. Barriers towards Medication Error Reporting
There are many barriers towards MER which were mentioned by the interviewees. These barriers
are heavy workload, lack of time, tiredness, embarrassment due to reactions of peers and family,
and fear of disciplinary action.
3.3.1. Lack of Time
The main barrier for MER mentioned by the interviewees was time. They considered that the ME
reporting is a time consuming process. As described by the participants, the problem is not the time
needed to fill the MER form. The problem appears after filling the MER form when the investigation
takes place in order to discuss the causes which led to the ME.
“We will be exposed to so many questions [ . . . ] long time [ . . . ] time to discuss the ME that was
reported [ . . . ] investigations take time. No other problems, just that it takes time to report and then
questions from pharmacist or doctors. We do not have time for reporting. It is a long story and takes
much time.” (N4)
“Sometimes, I decide not to report. Because, if there is an investigation we have to be presented, as you
know it will take a long time and we will be all inconvenient.” (N9)
3.3.2. Tiredness
The nurses are responsible for inpatient care, this responsibility requires them to accomplish
many physical activities. Performing these activities make nurses tired, when they are exhausted,
a low number of ME reports will be received from them.
“Sometimes, we are tired. Once we are tired we decide not to report.” (N4)
3.3.3. Embarrassment
The post-embarrassment feeling has been pinpointed by interviewees as another barrier toward
MER. As a result, they tend to hide their MEs and never report them.
“Facing the embarrassment from my family and friends is tough. They will blame us.” (N4)
“They (family and friends) understand because these are not things that a person does on purpose.
But facing them still difficult.” (N9)
3.3.4. Fear
Fear from the legal problems has been addressed by the interviewees as a barrier towards MER.
“I fear from legal problems and disciplinary actions from the hospital.” (N8)
“Sometimes, I do not want to get into issues, I do not want people to come to ask me for investigation
later.” (N2)
The effect of reporting on the personal job record is another factor which might prevent nurses
from reporting.
“If I report this will affect my record because everything will be recorded in my personal record.” (N9)
“Fearing others, especially the investigation, because in Malaysia all errors must be reported to your
job record and they do disciplinary action.” (N4)
Pharmacy 2018, 6, 120
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3.3.5. Negative Reaction from Sister In-Charge
The response of managers toward nurses who report their MEs were important factors which
prevented nurses from reporting their MEs. It has been noticed that most of the interviewees insisted
that receiving a negative reaction from senior nurses is a normal response when the MEs occur. As they
always tend to blame and scold the nurses if they commit MEs. They believe that guidance is the main
role of senior nurses during their practices, not blaming the nurses.
“The sister will monitor me more.” (N8)
“Negative reaction from sister and matron [ . . . ] they must not punish the staff, they must guide the
staff and follow the staff and ensure that the stuff follows the standards.” (N4)
3.3.6. The Confidentiality of the Reporting Form
The reporting form which is used to report ME is a strict confidential form. Filling this type of the
reporting requires the reporter’s details such as name, signature and contact details. Some nurses did
not report their MEs because of this issue and they wish if they can report by using an anonymous
reporting form. Consequently, the number of reports will increase by use of anonymous MER forms.
“I prefer to fill anonymous form [ . . . ] Because I feel shy and would not work further. Also, I would
feel sorry for the patient. So, I prefer to fill the form without names.” (N2)
“I prefer to fill the anonymous form as it is good for us. If mistakes have been done, the news of
medication errors should be displayed without names being mentioned. In the future, if the people
know that this person made a mistake, people would decide not to deal with this person again. This will
damage the confidence of the nurse. In the future, they will not report and there will be no chance to
learn from the mistakes.” (N6)
“Off course, if no names mentioned the number of reports will increase.” (N8)
3.3.7. Absence of Effective Feedback
The lack of feedback from the hospital managers:
“No one goes through all the errors and give me a feedback.” (N7)
“I did not receive any feedback for my ME report.” (19)
3.4. Facilitators to Improve ME Reporting
The nurses were asked about the factors which could encourage them towards MER. Their main
concern revolv
Post your PowerPoint presentation summarizing your Public Health Analysis Paper along with your initial post. In 1-2 paragraphs, describe why you chose your selected topic and some interesting things you have learned about this over the duration of this course. What was one challenge that you faced in compiling this project? Has this motivated anyone to become more involved in health policy? If so, how? APA format with references
Unformatted Attachment Preview
1
Comprehensive Review of the Literature: Enhancing Vaccination Rates through
Advanced Practice Nursing Interventions
Sabina Thomas, MSN, APRN, FNP-C
South University
NSG 7005
Dr. Alejandro
9/4/2023
2
Comprehensive Review of the Literature: Enhancing Vaccination Rates through
Advanced Practice Nursing Interventions
In order to develop a robust evidence-based Public Health Analysis Paper on
enhancing vaccination rates through advanced practice nursing (APN) interventions, it is
essential to conduct a comprehensive review of the existing literature. This literature review
will serve as the foundation for understanding the current state of vaccination rates, the role
of APNs, and the effectiveness of APN interventions in addressing this critical public health
issue.
Current State of Vaccination Rates
It is imperative to understand the current state of vaccination rates in the United
States. The literature suggests that despite the availability of safe and effective vaccines,
vaccination rates for certain diseases have fallen below the desired thresholds, leading to
outbreaks and public health concerns (Orestein & Ahmed, 2017). Studies and reports from
organizations like the Centers for Disease Control and Prevention (CDC) provide valuable
statistics and trends related to vaccination coverage across various age groups and vaccines
(CDC, 2020).
The Role of Advanced Practice Nurses in Vaccination
Advanced practice nurses play a crucial role in healthcare delivery and preventive
care. They are often at the forefront of primary care and are well-positioned to address
vaccination-related issues (American Association of Nurse Practitioners, 2022). Several
studies highlight the importance of APNs in vaccination advocacy, education, and
administration. These professionals are not only skilled in providing vaccinations but also in
counseling patients and families about vaccine safety and efficacy (Limaye et al., 2021).
Research indicates that patients are more likely to accept vaccines when recommended by
3
their APN, underscoring the influential role APNs can play in improving vaccination rates
(Siddiqui et al., 2022).
Effectiveness of APN Interventions
The effectiveness of APN interventions in enhancing vaccination rates is a critical
aspect of this literature review. Research studies evaluating the impact of APN-led initiatives
on vaccination rates provide valuable insights. These interventions may include communitybased immunization clinics, educational campaigns, and collaborations with schools and local
health departments. It is crucial to explore the strategies employed by APNs to address
vaccine hesitancy and improve vaccine acceptance among diverse populations. Tailoring
interventions to specific communities, taking into account cultural and socioeconomic
factors, has been shown to be effective in increasing vaccination rates (Rodrigues & Plotkin,
2020). Examining successful case studies and evidence-based practices can provide valuable
guidance for APNs seeking to implement interventions in their practice settings (Ismail et al.,
2022; NICE, 2022).
Alignment with Healthy People 2020 Objectives
An integral part of this literature review involves assessing how the proposed APN
interventions align with the objectives of Healthy People 2020, specifically those related to
immunization and infectious diseases (Office of Disease Prevention and Health Promotion,
2021). Healthy People 2020 aims to increase vaccination rates, reduce vaccine-preventable
diseases, and eliminate health disparities in immunization coverage (CDC, 2020). The
literature should be scrutinized to identify examples where APN-led interventions have
contributed to achieving these objectives. Research demonstrating the impact of such
interventions on improving vaccination rates at the population level can underscore their
significance in public health efforts.
Relating Data to the Capstone Project
4
The integration of findings from the literature review into the capstone project, which
focuses on community health promotion, is a critical step in ensuring that evidence-based
strategies are applied effectively. The literature review will identify specific best practices
and interventions that can directly inform the design and implementation of the capstone
project. For example, if the review highlights that community-based vaccination clinics led
by advanced practice nurses (APNs) have significantly increased vaccination rates, these
clinics can be used as a model for the capstone project. The capstone project could involve
establishing similar clinics within the targeted community to provide convenient access to
vaccinations. Furthermore, the literature review will guide the selection of vaccines to
prioritize based on the unique needs of the community. For instance, if the review reveals that
a specific vaccine-preventable disease is more prevalent in the community, the capstone
project can focus on increasing vaccination coverage for that particular disease.
Conclusion
This comprehensive review of the literature is essential for building a strong
evidence-based foundation for the Public Health Analysis Paper. It will provide a thorough
understanding of the current state of vaccination rates, the role of APNs, the effectiveness of
APN interventions, alignment with Healthy People 2020 objectives, and practical insights for
application in the capstone project. By synthesizing and critically analyzing existing research,
this literature review will contribute to the development of a well-informed and impactful
analysis of the public health issue at hand.
5
References
American Association of Nurse Practitioners. (2022, October). State Practice Environment.
Retrieved from American Association of Nurse Practitioners:
https://www.aanp.org/advocacy/state/state-practice-environment
CDC. (2020, December 14). Healthy People 2020. Retrieved from Centers for Disease
Control and Prevention: https://www.cdc.gov/nchs/healthy_people/hp2020.htm
Ismail, S. A., Lam, S. T., Bell, S., Fouad, F. M., Blanchet, K., & Borghi, J. (2022).
Strengthening vaccination delivery system resilience in the context of protracted
humanitarian crisis: a realist-informed systematic review. BMC Health Services
Research.
Limaye, R. J., Opel, D. J., Dempsey, A., Ellingson, M., Spina, C., Omer, S. B., . . . O’Leary,
S. T. (2021). Communicating With Vaccine-Hesitant Parents: A Narrative Review.
Academic Pediatrics, 21(4), S24-S29.
NICE. (2022). Evidence review for interventions to increase the uptake of routine vaccines by
improving access: Vaccie Uptake in the General Population. National Institute for
Health and Care Excellence (NICE).
Office of Disease Prevention and Health Promotion. (2021, October 27). Immunization and
Infectious Diseases. Retrieved from Office of Disease Prevention and Health
Promotion: HealthyPeople 2020: https://wayback.archiveit.org/5774/20211119191447/https://www.healthypeople.gov/2020/topicsobjectives/topic/Immunization-and-Infectious-Diseases/objectives
Orestein, W. A., & Ahmed, R. (2017). Simply put: Vaccination saves lives. Proceedings of
the National Academy of Sciences of the United States of America, 114(16), 40314033.
6
Rodrigues, C. M., & Plotkin, S. A. (2020). Impact of Vaccines; Health, Economic and Social
Perspectives. Frontiers in Microbiology, 11.
Siddiqui, F. A., Padhani, Z. A., Salam, R. A., Aliani, R., Lassi, Z. S., Das, J. K., & Bhutta, Z.
A. (2022). Interventions to Improve Immunization Coverage Among Children and
Adolescents: A Meta-analysis. Pediatrics, 149(6).
Create a 2-4 page resource that will describe databases that are relevant to EBP around a diagnosis you choose and could be used to help a new hire nurse better engage in EBP.
For this assessment:
Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to the diagnosis in this scenario and describe to which of these you would direct a nurse colleague to search for evidence.
Describe where you might go in the work place to complete this research and how you would access the desired, relevant research within research databases or other online sources.
Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.
Describe communication strategies to encourage nurses to research the diagnosis/practice issue, as well as strategies to collaborate with the nurses to access resources.
Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis/health care issue within the context of a specific health care setting.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis/practice issue.
Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis/health care issue.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Scenario:
You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.
Diagnosis:
Congestive Heart Failure (CHF): A chronic condition in which the heart doesn’t pumpblood as well as it should
o Interventions: Diuretics, ACE inhibitors, beta-blockers, fluid restriction, daily weight monitoring, and patient education on symptom management.
Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis/practice issue, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.
Translating knowledge into practice establishes evidence-based practice (EBP) within the nursing profession. Nurse practitioners participate in the dissemination of research evidence to support the creation of practice interventions. The purpose of this assignment is to prepare students to disseminate evidence to support practice. Students will synthesize the information they have gathered during the course to formulate a presentation advocating for a practice change in relation to an area of interest to NP practice.
REQUIREMENTS
In Week 7, students will create a PowerPoint slide show with notes pages discussing their PICOT question, literature review, and recommendations for change. In Week 8, students will create a Kaltura recording of the presentation for the Peer Discussion thread.
CRITERIA FOR CONTENT
Students will synthesize the information they have gathered during the course to formulate a presentation advocating for a practice change in relation to an area of interest to NP practice.
Creating a Professional PowerPoint Presentation
In a PowerPoint Presentation, address the following.
Title Slide
Introduction (1 slide): Slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered.
Practice Issue (1-3 slides): Describe the area of interest and practice issue/problem related to NP practice selected in week 2. Explain why the issue/concern is important to nurse practitioner practice and its impact on health outcomes. Provide speaker notes. Provide scholarly references to support your ideas.
PICOT Question (1 slide): Provide the PICOT question developed in week 2. Describe each element of your PICOT question in one or two sentences, being sure to address all the following:
P-Population and problem – What is the nursing practice concern or problem and whom does it affect?
I–Intervention – What evidence-based solution for the problem would you like to apply?
C–Comparison – What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.
O–Outcome – Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome.
T–Time frame – What is the Timeframe involved for the EBP initiative or the target date of completion?
Literature review (2-4 slides):Summarize the literature review completed in week 5. Discuss themes and special concerns. Discuss any unique insight or perspective offered from the literature. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented.
Recommendations (3 slides):
Slide 1: Identify the evidence-based recommendation for the identified practice change. Speaker’s notes should fully explain the recommended change and rationale for the change. Provide support from scholarly references to support the recommendation.
Slide 2: Identify the key stakeholders impacted by the recommended change. Speaker’s notes add detail.
Slide 3: Analyze the recommendation in terms of fit, feasibility, and appropriateness as discussed by Dang and Dearholt (2018), Ch. 8. Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
Conclusion: (1 slide)Slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.
References: Reference elements provided in APA format, may use bullets. Hanging indents not required.
PREPARING THE PRESENTATION
Submission Requirements
Application: Use Microsoft Power Point to create the presentation. Submit as a .ppt or .pptx file.
Length: The PowerPoint presentation should be between 9-13 total slides (excluding title and reference slides).
Speaker notes should be used and include in-text citations when applicable. Use the Notes Page view feature in PowerPoint to include speaker notes.
Submission: Submit the PowerPoint file to the Week 7 Dropbox.
Best Practices in Preparing the Presentation
The following are best practices in preparing this presentation:
Review directions thoroughly.
Follow submission requirements.
Make sure all elements on the grading rubric are included.
Follow rules of grammar, spelling, word usage, and punctuation consistent with formal, scientific writing.
Review the Creating a Professional Presentation located in Course Resources.
Correctly cite and reference ideas and information that come from scholarly literature.
Abide by Chamberlain University academic integrity policy.
ASSIGNMENT CONTENT
Category
Points
%
Description
Introduction
(1 slide)
10
5%
Introduction includes concepts to be addressed. Identify sections of the PowerPoint presentation. Speaker notes include details of what will be covered in the presentation.
Nursing Practice Issue/Problem
20
10%
Describes one specific issue or concern within the selected area of advanced practice nursing. Explanation of the impact of this issue or concern on health outcomes. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern.
*The nursing practice issue/problem description may be reused from the Week 2 worksheet
PICOT question
20
10%
Includes the PICOT question in the standard PICOT question format with each letter separately, such as:
P =
I =
C =
O =
T =
PICOT question =
Speaker notes accurately and clearly describe each of the PICOT elements.
*The PICOT question and explanation may be reused from the Week 2 worksheet
Literature Review
50
25%
Summarize the literature review completed in week 5. Discuss themes and special concerns. Discuss any unique insight or perspective offered from the literature. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented.
Recommendations Slide 1: Identify EBP change
20
10%
Slide 1: Identify the evidence-based recommendation for the identified practice change. Speaker’s notes should fully explain the recommended change and rationale for the change. Provide support from scholarly references to support the recommendation.
Slide 2: Identify the key stakeholders impacted by the recommended change. Speaker’s notes add detail.
Recommendations Slide 3: Analyze fit, feasibility, and appropriateness
20
10%
Slide 3: Analyze the recommendation in terms of fit, feasibility, and appropriateness as discussed by Dang and Dearholt (2018), ch. 8. Speaker’s notes add detail.
*Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
Conclusion
(1 slide)
10
5%
Summarize key information presented in PowerPoint presentation. Provide speaker notes.
170
85%
Total CONTENT Points= 170 pts
ASSIGNMENT FORMAT
Category
Points
%
Description
APA Format
10
5%
Ideas and information that come from scholarly sources must be cited and referenced correctly. In-text and parenthetical citations must be used and may be provided on the slide or within the speaker notes. Slides, speaker notes, and reference elements are consistent with current APA format. May use bullets on the reference slide. Hanging indents not required.
Presentation of Slides
10
5%
PowerPoint presentation includes title slide, 9-13 content slides, and reference slide(s). Presentation of slides is professional in appearance and tone. Balance among space, words and graphics, and color is effective.
Writing Mechanics
10
5%
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal written work as found in the current APA manual.
30
15%
Total FORMAT Points = 30 pts
ASSIGNMENT TOTAL = 200 points
Rubric
NR505NP Week 7 EBP Presentation Rubric
NR505NP Week 7 EBP Presentation Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction
10 pts
Excellent
Presentation of information is concise and includes the following elements: • Identification of sections of the presentation • Speaker notes used to add depth to introduction
9 pts
Very Good
Presentation of information is adequate and includes the following elements: • Identification of sections of the presentation • Speaker notes used to add depth to introduction
8 pts
Satisfactory
Presentation of information includes ONE of the following elements: • Identification of sections of the presentation • Speaker notes used to add depth to introduction
5 pts
Needs Improvement
Presentation of information is unclear or disorganized and includes one of or both the following elements: • Identification of sections of the presentation • Speaker notes used to add depth to introduction
0 pts
Unsatisfactory
No introduction slide
10 pts
This criterion is linked to a Learning OutcomeNursing Practice Issue/Problem
20 pts
Excellent
Presentation of information is comprehensive and concise and includes all of the following elements: • Describes one specific issue or concern within the selected area of advanced practice nursing • Provides speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern
18 pts
Very Good
Presentation of information is superficial in places and includes all of the following elements: • Describes one specific issue or concern within the selected area of advanced practice nursing • Provides speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern
17 pts
Satisfactory
Presentation of information is minimally demonstrated and includes all of the following elements: • Describes one specific issue or concern within the selected area of advanced practice nursing • Provides speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern
10 pts
Needs Improvement
Presentation of information in one of the following elements fails to meet expectations or is missing the following: • Describes one specific issue or concern within the selected area of advanced practice nursing • Provides speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern
0 pts
Unsatisfactory
Presentation of information in two or more following elements fail to meet expectations or are missing the following: • Describes one specific issue or concern within the selected area of advanced practice nursing • Provides speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern
20 pts
This criterion is linked to a Learning OutcomePICOT Question
20 pts
Excellent
Presentation of information is comprehensive and concise and includes all of the following elements: • Includes the PICOT question in the standard PICOT question format with each letter separately, such as: o P = o I = o C = o O = o T = o PICOT question = • Speaker notes accurately and clearly describe each of the PICOT elements *The PICOT question and explanation may be reused from the Week 2 worksheet
18 pts
Very Good
Presentation of information is superficial in places and includes all of the following elements: • Includes the PICOT question in the standard PICOT question format with each letter separately, such as: o P = o I = o C = o O = o T = o PICOT question = • Speaker notes accurately and clearly describe each of the PICOT elements *The PICOT question and explanation may be reused from the Week 2 worksheet
17 pts
Satisfactory
Presentation of information is minimally demonstrated and includes all of the following elements: • Includes the PICOT question in the standard PICOT question format with each letter separately, such as: o P = o I = o C = o O = o T = o PICOT question = • Speaker notes accurately and clearly describe each of the PICOT elements *The PICOT question and explanation may be reused from the Week 2 worksheet
10 pts
Needs Improvement
Presentation of information in one of the following elements fails to meet expectations or is missing the following: • Includes the PICOT question in the standard PICOT question format with each letter separately, such as: o P = o I = o C = o O = o T = o PICOT question = • Speaker notes accurately and clearly describe each of the PICOT elements *The PICOT question and explanation may be reused from the Week 2 worksheet
0 pts
Unsatisfactory
Presentation of information in two or more of the following elements fail to meet expectations or are missing the following: • Includes the PICOT question in the standard PICOT question format with each letter separately, such as: o P = o I = o C = o O = o T = o PICOT question = • Speaker notes accurately and clearly describe each of the PICOT elements. *The PICOT question and explanation may be reused from the Week 2 worksheet
20 pts
This criterion is linked to a Learning OutcomeLiterature Review
50 pts
Excellent
Presentation of information is comprehensive and concise and includes all of the following elements: • Summarize the literature review completed in week 5 • Discuss themes and special concerns. • Discuss any unique insight or perspective offered from the literature • Provide speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented
46 pts
Very Good
Presentation of information is superficial in places and includes all of the following elements: • Summarize the literature review completed in week 5 • Discuss themes and special concerns. • Discuss any unique insight or perspective offered from the literature. • Provide speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented
42 pts
Satisfactory
Presentation of information is minimally demonstrated and includes all of the following elements: • Summarize the literature review completed in week 5 • Discuss themes and special concerns. • Discuss any unique insight or perspective offered from the literature • Provide speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented
25 pts
Needs Improvement
Presentation of information in one of the following elements fails to meet expectations or is missing the following: • Summarize the literature review completed in week 5 • Discuss themes and special concerns • Discuss any unique insight or perspective offered from the literature • Provide speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented
0 pts
Unsatisfactory
Presentation of information in two or more of the following elements fail to meet expectations or are missing the following: • Summarize the literature review completed in week . • Discuss themes and special concerns • Discuss any unique insight or perspective offered from the literature • Provide speaker notes • Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented
50 pts
This criterion is linked to a Learning OutcomeRecommendations: Identify EBP Change
20 pts
Excellent
Presentation of information is comprehensive and concise and includes all of the following elements: • Identify the evidence-based recommendation for the identified practice change. • Speaker’s notes should fully explain the recommended change and rationale for the change. • Provide support from scholarly references to support the recommendation.
18 pts
Very Good
Presentation of information is superficial in places and includes all of the following elements: • Identify the evidence-based recommendation for the identified practice change. • Speaker’s notes should fully explain the recommended change and rationale for the change. • Provide support from scholarly references to support the recommendation.
17 pts
Satisfactory
Presentation of information is minimally demonstrated and includes all of the following elements: • Identify the evidence-based recommendation for the identified practice change. • Speaker’s notes should fully explain the recommended change and rationale for the change. • Provide support from scholarly references to support the recommendation.
10 pts
Needs Improvement
Presentation of information in one of the following elements fails to meet expectations or is missing the following: • Identify the evidence-based recommendation for the identified practice change. • Speaker’s notes should fully explain the recommended change and rationale for the change. • Provide support from scholarly references to support the recommendation.
0 pts
Unsatisfactory
Presentation of information in two or more of the following elements fail to meet expectations or are missing the following: • Identify the evidence-based recommendation for the identified practice change. • Speaker’s notes should fully explain the recommended change and rationale for the change. • Provide support from scholarly references to support the recommendation.
20 pts
This criterion is linked to a Learning OutcomeRecommendations: Key Stakeholders
20 pts
Excellent
Presentation of information is comprehensive and concise and includes all of the following elements: • Identify the key stakeholders impacted by the recommended change. • Speaker’s notes add detail
18 pts
Very Good
Presentation of information is superficial in places and includes all of the following elements: • Identify the key stakeholders impacted by the recommended change. • Speaker’s notes add detail.
17 pts
Satisfactory
Presentation of information is minimally demonstrated and includes all of the following elements: • Identify the key stakeholders impacted by the recommended change. • Speaker’s notes add detail.
10 pts
Needs Improvement
Presentation of information in one of the following elements fails to meet expectations or is missing the following: • Identify the key stakeholders impacted by the recommended change. • Speaker’s notes add detail.
0 pts
Unsatisfactory
Presentation of information in two or more of the following elements fail to meet expectations or are missing the following: • Identify the key stakeholders impacted by the recommended change. • Speaker’s notes add detail.
20 pts
This criterion is linked to a Learning OutcomeRecommendations: Fit, Feasibility, Appropriateness
20 pts
Excellent
Presentation of information is comprehensive and concise and includes all of the following elements: Using Dang and Dearholt (2018, chapter 8): • Analyze the recommendation in terms of fit • Analyze the recommendation in terms of feasibility • Analyze the recommendation in terms of appropriateness • Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
18 pts
Very Good
Presentation of information is superficial in places and includes all of the following elements: Using Dang and Dearholt (2018, chapter 8): • Analyze the recommendation in terms of fit • Analyze the recommendation in terms of feasibility • Analyze the recommendation in terms of appropriateness • Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
17 pts
Satisfactory
Presentation of information is minimally demonstrated and includes all of the following elements: Using Dang and Dearholt (2018, chapter 8): • Analyze the recommendation in terms of fit • Analyze the recommendation in terms of feasibility • Analyze the recommendation in terms of appropriateness • Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
10 pts
Needs Improvement
Presentation of information in one of the following elements fails to meet expectations or is missing the following: Using Dang and Dearholt (2018, chapter 8): • Analyze the recommendation in terms of fit • Analyze the recommendation in terms of feasibility • Analyze the recommendation in terms of appropriateness • Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
0 pts
Unsatisfactory
Presentation of information in two or more of the following elements fail to meet expectations or are missing the following: Using Dang and Dearholt (2018, chapter 8): • Analyze the recommendation in terms of fit • Analyze the recommendation in terms of feasibility • Analyze the recommendation in terms of appropriateness • Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
20 pts
This criterion is linked to a Learning OutcomeConclusion
10 pts
Excellent
Presentation of information is comprehensive and concise and includes the following element: • Summarizes key information presented in PowerPoint presentation • Provides speaker notes
9 pts
Very Good
Presentation of information is adequate and includes the following element: • Summarizes key information presented in PowerPoint presentation • Provides speaker notes
8 pts
Satisfactory
Presentation of information is minimally demonstrated in the following element: • Summarizes key information presented in PowerPoint presentation • Provides speaker notes
5 pts
Needs Improvement
Presentation of information in the following element is missing: • Summarizes key information presented in PowerPoint presentation Provides speaker notes
0 pts
Unsatisfactory
Conclusion is not provided
10 pts
This criterion is linked to a Learning OutcomeAPA Format
10 pts
Excellent
APA guidelines, as per the current edition of the manual, are demonstrated for the following: • In-text citations are used and provided on the slide or within the speaker notes. • Slides, speaker notes, and reference elements are consistent with current APA format. May use bullets on the reference slide. Hanging indents not required. One deduction for each type of APA format error. 0 to 1 APA error is present
9 pts
Very Good
APA guidelines, as per the current edition of the manual, are demonstrated for the following: • In-text citations are used and provided on the slide or within the speaker notes. • Slides, speaker notes, and reference elements are consistent with current APA format. May use bullets on the reference slide. Hanging indents not required. One deduction for each type of APA format error. 2–3 APA errors are present
8 pts
Satisfactory
APA guidelines, as per the current edition of the manual, are demonstrated for the following: • In-text citations are used and provided on the slide or within the speaker notes. • Slides, speaker notes, and reference elements are consistent with current APA format. May use bullets on the reference slide. Hanging indents not required. One deduction for each type of APA format error. 4–5 APA errors are present
5 pts
Needs Improvement
APA guidelines, as per the current edition of the manual, are demonstrated for the following: • In-text citations are used and provided on the slide or within the speaker notes. • Slides, speaker notes, and reference elements are consistent with current APA format. May use bullets on the reference slide. Hanging indents not required. One deduction for each type of APA format error. 6–7 APA errors are present
0 pts
Unsatisfactory
APA guidelines, as per the current edition of the manual, are demonstrated for the following: • In-text citations are used and provided on the slide or within the speaker notes. • Slides, speaker notes, and reference elements are consistent with current APA format. May use bullets on the reference slide. Hanging indents not required. One deduction for each type of APA format error. 8 or greater APA errors are present
10 pts
This criterion is linked to a Learning OutcomePresentation of Slides
10 pts
Excellent
PowerPoint presentation addresses all of the following elements: • Title slide • Reference slide(s) • Slides are professional in appearance and tone • Slides are balanced spatially, including words and graphics • Color is effective • Presentation is 9-13 total slides
9 pts
Very Good
PowerPoint presentation does not address one of the following elements: • Title slide • Reference slide(s) • Slides are professional in appearance and tone • Slides are balanced spatially, including words and graphics • Color is effective • Presentation is 9-13 total slides
8 pts
Satisfactory
PowerPoint presentation does not address two of the following elements: • Title slide • Reference slide(s) • Slides are professional in appearance and tone • Slides are balanced spatially, including words and graphics • Color is effective • Presentation is 9-13 total slides
5 pts
Needs Improvement
PowerPoint does not address three or more of the following elements: • Title slide • Reference slide(s) • Slides are professional in appearance and tone • Slides are balanced spatially, including words and graphics • Color is effective • Presentation is 9-13 total slides
0 pts
Unsatisfactory
PowerPoint is unprofessional and does not include any elements
10 pts
This criterion is linked to a Learning OutcomeWriting Mechanics
10 pts
Excellent
1–2 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual
9 pts
Very Good
3–4 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual
8 pts
Satisfactory
5–6 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual
5 pts
Needs Improvement
7–8 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual
0 pts
Unsatisfactory
9 or greater errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual
10 pts
This criterion is linked to a Learning OutcomeLate Penalty Deductions
0 pts
0 Points Deducted
0 pts
20 Points Deducted
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
I want you to write me a proposal about Implementation of Medication therapy management clinic in primary health care centers and ill attach my work but only for an example and you can get what you want from it. Also, Keep in my mind that all this is is free for patient and we don not ask for any billing information in my country. The things that must be included are
background , Aim , Objective, Work flow, Needs ( which
includes staff equipment), Requirement, Equipment(medical and non medical), Referral,
Appointments, Time need for each, Electronic order entry system (we have
Best Care), Referral forms, and Assessment and follow up forms.
I want you to include all references you used in this proposal.
Let me know if you have any question or need any help.
ASSESSING MUSCULOSKELETAL PAIN Case Study: Ankle PainA 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses (DDx) for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing? Instructions: Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.Bear in mind – any musculoskeletal complaint should reflect a mechanism of injury. Specifically indicate how the injury occurred. Additionally, the justification of DDx is not the clinical definition or diagnostic criteria. What are the findings in the note to support the differential diagnosis?Please use a minimum of 3 current resources, including both the school material and outside peer-reviewed resources.
1. Module 3 assignment: You are the nurse caring for a 66-year-old female client with complaints of lower abdominal pain, nausea, vomiting, and a low-grade fever over the past two days who is admitted to the medical-surgical unit with the diagnosis of urinary tract infection (UTI). The client’s family reported the client was confused and incontinent with urine that had a “strong odor.” The client is on a clear liquid diet and has an intravenous infusion of lactated Ringer’s solution at 50 ml/hour.2. module 5 assignment: You are the nurse caring for a 64-year-old male client who is postoperative day four on the medical-surgical unit after having an emergency right colectomy due to cancer. The client is NPO with a nasogastric (NG) tube to low intermittent suction. The client has a history of smoking and no other health problems. Vital signs: Temperature: 99.2° F Heart rate: 91 beats/min Respirations: 20 breaths/minute O2 saturation: 93% on 2L oxygen via nasal cannula Blood pressure: 110/68 mm Hg Pain: “6/10” Focused assessment findings: Alert and oriented to person, place, and time Moves all four extremities, refuses to ambulate Apical pulse is regular at 91 beats/minuteLungs clear to auscultation, diminished bilaterally Bowel sounds hypoactive, abdomen soft, tender in all four quadrantsMidline abdominal incision well approximated with staples intact, no erythema, Penrose drain intact with scant serous drainageRight lower quadrant Jackson-Pratt drain with sutures intact, no erythema, 30 mL of serosanguineous drainage 3.CONCEPT ANALYSIS: Crash Cart
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NUR2349 Professional Nursing I
Module 03 Written Assignment – Care Plan
Student Name: __________________________
Date: ______________________
Client Gender: ____________
Client Age: ________
Client Diagnosis: __________________________________________________________________________________________________
Assessment data for
Nursing Diagnosis
Nursing Diagnosis (3)
Expected Outcomes
with Indicators
(1 per Nursing
Diagnosis)
Nursing Interventions
(2 per Expected
Outcome)
Respond to this critical thinking question:
Describe how altered urinary elimination can affect the integumentary system?
Support your response with evidence from credible sources.
Evidence-based
Rationale for each
Nursing Intervention
(Cited/referenced)
Evaluation
(How do you know it
worked?)
NUR2349 Professional Nursing I
Module 05 Written Assignment – Care Plan
Student Name: __________________________
Date: ______________________
Client Gender: ____________
Client Age: ________
Client Diagnosis: __________________________________________________________________________________________________
Assessment data for
Nursing Diagnosis
Nursing Diagnosis (3)
Expected Outcomes
with Indicators
(1 per Nursing
Diagnosis)
Nursing Interventions
(2 per Expected
Outcome)
Evidence-based
Rationale for each
Nursing Intervention
(Cited/referenced)
Respond to this critical thinking question:
Describe evidence-based precautions to prevent this client from obtaining a nosocomial infection. Provide supporting rationales.
Support your response with evidence from credible sources.
Evaluation
(How do you know it
worked?)
ACTIVE LEARNING TEMPLATE:
Concept Analysis
STUDENT NAME______________________________________
CONCEPT ANALYSIS_____________________________________________________________________
Defining Characteristics
Antecedents
Negative Consequences
(WHAT MUST OCCUR/BE IN PLACE FOR
CONCEPT TO EXIST/FUNCTION PROPERLY)
(RESULTS FROM IMPAIRED ANTECEDENT —
COMPLETE WITH FACULTY ASSISTANCE)
Related Concepts
Exemplars
(REVIEW LIST OF CONCEPTS AND IDENTIFY, WHICH
CAN BE AFFECTED BY THE STATUS OF THIS CONCEPT
— COMPLETE WITH FACULTY ASSISTANCE)
ACTIVE LEARNING TEMPLATES
Concept Analysis
A15
Write a 2-page summary paper that addresses the following: Briefly summarize the patient case study, including each of the three decisions you chose for the patient presented. Support your decisions with evidence-based literature. Be specific and provide examples. What were you hoping to achieve with the decisions you recommended for the patient case study? 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. Use and cite at least 4 sources for the assignment. Please discuss each medication option listed in Decision Points 1-3. Why did you not choose the alternative options? What is the mechanism of action for each medication? What are first line FDA approved medications for the disease state? Link to Case Study: http://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html
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NURS_6521_Week8_Assignment_Rubric
NURS_6521_Week8_Assignment_Rubric
Criteria
Ratings
This criterion is linked to a
Learning OutcomeBriefly
summarize the patient case
study you were assigned,
including each of the three
decisions you took for the
patient presented. Be
specific.
20 to >17.8 pts
17.8 to >15.8 pts
15.8 to >13.8 pts
13.8 to >0 pts
Excellent
Good
Fair
Poor
The response accurately and
thoroughly summarizes in detail
the patient case study assigned,
including specific and complete
details on each of the three
decisions made for the patient
presented.
The response accurately
summarizes the patient
case study assigned,
including details on each
of the three decisions
made for the patient
presented.
The response inaccurately
or vaguely summarizes the
patient case study assigned,
including details on each of
the three decisions made
for the patient presented.
The response inaccurately and
vaguely summarizes the
patient case study assigned,
including details on each of
the three decisions made for
the patient presented, or is
missing.
NURS_6521_Week8_Assignment_Rubric
Criteria
This criterion is linked to a
Learning OutcomeBased on
the decisions you
recommended for the
patient case study, explain
whether you believe the
decisions provided were
supported by the evidencebased literature. Be specific
and provide examples. Be
sure to support your
response with evidence
and references from
outside resources.
Ratings
25 to >22.25 pts
22.25 to >19.75 pts
19.75 to >17.25 pts
17.25 to >0 pts
Excellent
Good
Fair
Poor
The response accurately and
thoroughly explains in detail
how the decisions
recommended for the
patient case study are
supported by the evidencebased literature. … The
response includes specific
and relevant outside
reference examples that
fully support the
explanation provided.
The response accurately
explains how the decisions
recommended for the
patient case study are
supported by the evidencebased literature. … The
response includes relevant
outside reference examples
that lend support for the
explanation provided that
are accurate.
The response inaccurately or
vaguely explains how the
decisions recommended for
the patient case study are
supported by the evidencebased literature. … The
response includes inaccurate
or vague outside reference
examples that may or may not
lend support for the
explanation provided or are
misaligned to the explanation
provided.
The response inaccurately
and vaguely explains how the
decisions recommended for
the patient case study are
supported by the evidencebased literature, or is missing.
… The response includes
inaccurate and vague outside
reference examples that do
not lend support for the
explanation provided, or is
missing.
NURS_6521_Week8_Assignment_Rubric
Criteria
This criterion is linked to a
Learning OutcomeWhat
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.
Ratings
20 to >17.8 pts
17.8 to >15.8 pts
15.8 to >13.8 pts
13.8 to >0 pts
Excellent
Good
Fair
Poor
The response accurately
and thorough explains in
detail what they were
hoping to achieve with the
decisions recommend for
the patient case study
assigned. … The response
includes specific and
relevant outside reference
examples that fully
support the explanation
provided.
The response accurately
explains what they were
hoping to achieve with the
decisions recommended for
the patient case study
assigned. … The response
includes relevant outside
reference examples that
lend support for the
explanation provided that
are accurate.
The response inaccurately or
vaguely explains what they
were hoping to achieve with the
decisions recommended for the
patient case study assigned. …
The response includes
inaccurate or vague outside
reference examples that may or
may not lend support for the
explanation provided or are
misaligned to the explanation
provided.
The response inaccurately and
vaguely explains what they
were hoping to achieve with
the decisions recommended
for the patient case study
assigned, or is missing. … The
response includes inaccurate
and vague outside reference
examples that do not lend
support for the explanation
provided, or is missing.
NURS_6521_Week8_Assignment_Rubric
Criteria
This criterion is linked to a
Learning OutcomeExplain
any difference between
what you expected to
achieve with each of the
decisions and the results of
the decisions in the
exercise. Describe whether
they were different. Be
specific and provide
examples.
Ratings
20 to >17.8 pts
17.8 to >15.8 pts
15.8 to >13.8 pts
13.8 to >0 pts
Excellent
Good
Fair
Poor
The response accurately and
clearly explains in detail any
differences between what
they expected to achieve
with each of the decisions
and the results of the
decisions in the exercise. …
The response provides
specific, accurate, and
relevant examples that fully
support whether there were
differences between the
decisions made and the
decisions available in the
exercise.
The response accurately
explains any differences
between what they
expected to achieve with
each of the decisions and
the results of the decisions
in the exercise. … The
response provides accurate
examples that support
whether there were
differences between the
decisions made and the
decisions available in the
exercise.
The response inaccurately or
vaguely explains any
differences between what
they expected to achieve with
each of the decisions and the
results of the decisions in the
exercise. … The response
provides inaccurate or vague
examples that may or may not
support whether there were
differences between the
decisions made and the
decisions available in the
exercise.
vaguely explains in detail any
differences between what
they expected to achieve
with each of the decisions
and the results of the
decisions in the exercise, or is
missing. … The response
provides inaccurate and
vague examples that do not
support whether there were
differences between the
decisions made and the
decisions available in the
exercise, or is missing.
NURS_6521_Week8_Assignment_Rubric
Criteria
This criterion is linked to a
Learning OutcomeWritten
Expression and Formatting
– Paragraph Development
and Organization:
Paragraphs make clear
points that support well
developed ideas, flow
logically, and demonstrate
continuity of ideas.
Sentences are carefully
focused–neither long and
rambling nor short and
lacking substance.
This criterion is linked to a
Learning OutcomeWritten
Expression and Formatting
– English writing standards:
Correct grammar,
mechanics, and proper
punctuation
Ratings
5 to >4.45 pts
4.45 to >3.95 pts
3.95 to >3.45 pts
3.45 to >0 pts
Excellent
Good
Fair
Poor
Paragraphs and sentences
follow writing standards
for flow, continuity, and
clarity.
Paragraphs and sentences
follow writing standards for
flow, continuity, and clarity
80% of the time.
Paragraphs and sentences
follow writing standards for
flow, continuity, and clarity
60%–79% of the time.
Paragraphs and sentences
follow writing standards for
flow, continuity, and clarity less
than 60% of the time.
5 to >4.45 pts
4.45 to >3.95 pts
3.95 to >3.45 pts
3.45 to >0 pts
Excellent
Good
Fair
Poor
Uses correct grammar,
spelling, and punctuation
with no errors
Contains a few (1–2)
grammar, spelling, and
punctuation errors
Contains several (3–4)
grammar, spelling, and
punctuation errors
Contains many (≥ 5) grammar, spelling,
and punctuation errors that interfere
with the reader’s understanding
NURS_6521_Week8_Assignment_Rubric
Criteria
This criterion is linked to a
Learning OutcomeWritten
Expression and Formatting
– The paper follows correct
APA format for title page,
headings, font,
spacing, margins,
indentations, page
numbers, running head,
parenthetical/in-text
citations, and reference list.
Total Points: 100
Ratings
5 to >4.45 pts
4.45 to >3.95 pts
3.95 to >3.45 pts
3.45 to >0 pts
Excellent
Good
Fair
Poor
Uses correct APA format with
no errors
Contains a few (1–2) APA
format errors
Contains several (3–4) APA
format errors
Contains many (≥ 5) APA
format errors
Describe the health care problem or issue you selected for use in Assessment 2 and provide details about it.
Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
Identify possible causes for the problem or issue.
Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
You may find the applicable Undergraduate Library Research Guide helpful in your search.
Review the Think Critically About Source Quality to help you complete the following:
Assess the credibility of the information sources.
Assess the relevance of the information sources.
Analyze the health care problem or issue.
Describe the setting or context for the problem or issue.
Describe why the problem or issue is important to you.
Identify groups of people affected by the problem or issue.
Provide examples that support your analysis of the problem or issue.
Discuss potential solutions for the health care problem or issue.
Describe what would be required to implement a solution.
Describe potential consequences of ignoring the problem or issue.
Provide the pros and cons for one of the solutions you are proposing.
Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
Describe what would be necessary to implement the proposed solution.
Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
Provide examples from the literature to support the points you are making
The following resources provide information about evidence-based practice:
Macias, C. G., Loveless, J. N., Jackson, A. N., & Srinivasan, S. (2017). Delivering value through evidence-based practice. Clinical Pediatric Emergency Medicine, 18(2), 89–97.
Thomas, S. J. (2016). Does evidence-based health care have room for the self? Journal of Evaluation in Clinical Practice, 22(4), 502–508.
Agency for Healthcare Research and Quality. (n.d.). EPC evidence-based reports. http://www.ahrq.gov/research/findings/evidence-bas…
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Analyzing a Current Health Care Problem or Issue
Page |1
Analyzing a Current Health Care Problem or Issue
Makeiah Karmea Bynum
Capella University
NHS-FPX4000: Developing a Healthcare Perspective
Instructor: Dr. Joan Vermillion
April 10, 2023
Analyzing a Current Health Care Problem or Issue
Page |2
Applying Ethical Principles
It is impossible to overestimate the significance of pharmaceutical errors in healthcare,
which I have already mentioned. In this investigation, concerns about patient safety that
unintentionally occur when getting medications will be explored upon. Healthcare providers
should take all reasonable precautions to ensure patient safety. Patient safety should be promoted
in all facets of healthcare. If nurses were able to implement a culture where drug errors were a top
priority, it would be a significant step in preventing those errors from frequently occurring.
Everyone involved in the healthcare system should discuss how to make it better. Improved
infrastructure would also be a big help in resolving this issue. Pharmaceutical errors do not only
happen in hospitals. Medication mistakes may accompany the patient back to their home or
nursing home (Fatima, Douglas & Richard, 2020).
Elements of the Problem/Issue
Studies show that patients receiving care from hospital medical professionals are
susceptible to drug mistakes and potential harm. Patient safety issues are typically caused by
medication errors, which are preventable adverse outcomes (Albara, Suzanne, Joanne, & Val,
2020). Medication errors can be caused by three main sources: not understanding the directions,
fulfilling the order too swiftly, and communicating with other healthcare professionals.
When a nurse disregards her incapacity to grasp the instructions and nonetheless provides
the authorized dose, the wrong medication or the erroneous dosage may be given. A patient may
experience terrible side effects if they receive an excessive amount of one drug. For instance,
sliding-scale insulin has parameters that determine how much to provide dependent on the
Analyzing a Current Health Care Problem or Issue
Page |3
patient’s blood sugar level. If you don’t understand the parameters, you might administer too much
insulin and cause hypoglycemia in the patient (Albara, Suzanne, Joanne, & Val, 2020).
Rushing through an order to finish it can cause you to miss a mistake that the doctor might
have made. Without taking the time to read the order carefully and determine whether what was
ordered for the patient makes sense, the patient could suffer severe harm. A person who is
prescribed Lasix because their lower extremities retain fluid is an example of this. In addition to
causing them to lose vital electrolytes, which can cause a host of other problems, failing to review
the most current lab findings could force all the fluid to come off them. Therefore, the key to
avoiding a medicine blunder is to carefully read the order.
The outcomes of poor doctor-nurse communication can be disastrous. Negative outcomes
for a patient could result from failing to inform a doctor that a particular order might cause more
damage than good to a patient. A doctor prescribing MiraLAX to a patient is an illustration of
this. Because it is ordered, new nurses will provide it, even when the patient is experiencing
bowel movements. Dehydration could result from this, which can cause a diverse range of
problems. The nurse could hold the order or inform the doctor that they are using the restroom
and stop the order to prevent fluid imbalances.
Analysis
Since becoming a registered nurse, I made it a critical part of my practice to make sure I
completely understand the medication that I am administering to my patients prior to them being
given. I am the last resort in the line of defense before they can receive the medication that has
been prescribed by a medical professional. Making a mistake when administering medication or
failing to spot a mistake made within the medication order can result in serious harm to the
patient. When I am unsure about any orders or prescriptions given, I make sure to question and
Analyzing a Current Health Care Problem or Issue
Page |4
receive other people’s opinions, preferably seasoned nurses, or the provider themselves, to make
sure that I avoid making a mistake. Anyone can make a mistake. If a mistake were made, it is best
to inform the manager about the error because it can help improve strategies to prevent the error
from happening again, therefore, reducing medication error frequency.
The Context for Patient Medication Errors
Another contributing factor to patient medication errors is the constant evolution of
healthcare. It is changing constantly with daily research being done to progress medicine. As an
employee in medicine, we must make sure we are up to date on these advances in healthcare. It is
highly exhausting to learn the newest and best information that is other it. It is also a challenge to
always provide top-notch healthcare to our patients when there are staffing shortages, unsafe
assignments, and unavailable equipment that is needed to perform our duties. Any arrangement of
these factors can result in unsatisfactory healthcare and increase the likelihood of medication
errors.
Populations Affected by Patient Safety Issues
Medication errors do not have a stereotype. Any demographic group can become a victim
of a medication error. As healthcare providers, we try to notice any mistake that is made including
medication errors, but because we are human, that is not always possible. We can strive to make
as few mistakes as possible, but even then, some adverse effects can be unknown. Every shift, I
notice where an error could have been made had I not been more vigilant and paying attention to
my orders. The best way to become excellent at identifying errors and preventing harm is
knowing the medication you are attempting to give and asking questions at any point where there
Analyzing a Current Health Care Problem or Issue
Page |5
is uncertainty. Due to this, I eliminate any mistakes that might occur which prevents my patients
from suffering an avoidable injury.
Considering Options
To reduce medication errors, healthcare professionals could implement some of these
strategies. Education on carefully reviewing orders and querying the physician if an order doesn’t
seem correct is a step in preventing errors from happening. As a new grad nurse, I was always
unsure when to question a physician about an order. Now after two years, I have found that
sometimes orders get put in on the wrong patient and it was a good step that I questioned the
orders that didn’t seem to relate to my patient’s primary complaint. Another is assigning fewer
patients so that the nurse can focus on a smaller ratio. Anyone working in healthcare currently
knows that depends on staffing. Reviewing the orders that have been placed in detail is the easiest
and most obvious course of action. Taking your time and avoiding rushing through the task is a
key step in minimizing prescription error rates. The opportunity of sitting down and carefully
reading directions would lessen the likelihood of medication errors. Prescription errors would be
less likely if it was possible to sit down and attentively study orders.
Questioning a doctor when they issue an order that appears to be erroneous is one of the
hardest things to undertake. The ability to discuss it with the doctor is a key method where drug
errors could be prevented. Although incredibly intelligent, doctors are nonetheless human and fall
short just like everyone else. Because of this, it’s crucial for nurses to contact them if an
instruction seems strange. The patient could avoid injury thanks to this very little interaction. The
interaction between healthcare professionals is one element that I believe is neglected. I believe it
is crucial to note the time you administered painkillers in your report. A medication error can be
avoided by having open communication.
Analyzing a Current Health Care Problem or Issue
Page |6
Solution
It is impossible to find only one solution for the treatment of medical errors because there
is a variety of contributing factors that lead to the error occurring, which means there needs to be
a solution for every possible factor out there. Improving communication between physicians and
nurses, querying orders when clarification is needed, lowering patient ratios, and having adequate
time to carefully review orders in full detail could improve the prevention of medication errors.
As healthcare professionals, all we can do is continue in our efforts to reduce the occurrence of
drug errors.
Implementation
Every healthcare worker signed an oath before beginning their employment. One of the
most important aspects of that oath is nonmaleficence, or the duty to do no harm. The best care is
given to each patient as part of our effort to show this. Medication mistakes can be considerably
reduced by putting these changes into practice. A number of these adjustments must be made and
implemented by the person. Management is unable to use them precisely. The greatest way to
lessen prescription errors, in my opinion, is to employ these strategies.
Conclusion
Eliminating drug mistakes won’t ever be successful 100%. It is impossible to totally
eradicate drug errors because mistakes will always be made by people. On the other hand, the
implementation of some strategies discussed along with increasing healthcare professional
awareness could significantly help minimize the frequency of medication errors which in turn
would provide the patients with the best care possible. It is crucial that nurses comprehend that
Analyzing a Current Health Care Problem or Issue
Page |7
implementing these measures is not intended to make their jobs harder, but rather to safeguard
both the patient and their professional license.
Analyzing a Current Health Care Problem or Issue
Page |8
References
Alomari, A., Sheppard‐Law, S., Lewis, J., & Wilson, V. (2020, July 6). Effectiveness of Clinical
Nurses’ interventions in reducing medication errors in a paediatric ward. Journal of
Clinical Nursing, 29(17–18), 3403–3413. https://doi.org/10.1111/jocn.15374
Alqenae, F. A., Steinke, D., & Keers, R. N. (2020, March 3). Prevalence and Nature of
Medication Errors and Medication-Related Harm Following Discharge from Hospital to
Community Settings: A Systematic Review. Drug Safety, 43(6), 517–537.
https://doi.org/10.1007/s40264-020-00918-3
Athanasakis, E. (2019, June 6). A meta‐synthesis of how registered nurses make sense of their
lived experiences of medication errors. Journal of Clinical Nursing, 28(17–18), 3077–
3095. https://doi.org/10.1111/jocn.14917
Secginli, S., Nahcivan, N. O., Bahar, Z., Fernandez, R., & Lapkin, S. (2021, October 8). Nursing
Students’ Intention to Report Medication Errors. Nurse Educator, Publish Ahead of Print.
https://doi.org/10.1097/nne.0000000000001105
You have been the evening charge nurse in the emergency department at Memorial Hospital for the last 2 years. You have two licensed vocational nurses (LVNs) and four registered nurses (RNs) working in your department with you. Your normal staffing is to have two RNs and one LVN on duty Monday to Thursday and one LVN and three RNs on duty during the weekend.
It has become apparent that one of the LVNs, Maggie, resents the recently imposed limitations of LVN duties because she has had 10 years of experience in nursing, including a tour of duty as a medic in the first Gulf War. The emergency department physicians admire her and are always asking her to assist them with any minor wound repair. Occasionally, she has exceeded her job description as an LVN in the hospital, although she has done nothing illegal of which you are aware. You have given her satisfactory performance evaluations in the past, even though everyone is aware that she sometimes pretends to be a “junior physician.” You also suspect that the physicians sometimes allow her to perform duties outside her licensure, but you have not investigated this or seen it yourself.
Tonight, you come back from supper and find Maggie suturing a deep laceration while the physician looks on. They both realize that you are upset, and the physician takes over the suturing. Later, the doctor comes to you and says, “Don’t worry! She does a great job, and I’ll take the responsibility for her actions.” You are not sure what you should do. Maggie is a good employee and taking any action will result in unit conflict.
ASSIGNMENT:
What are the legal ramifications of this case? Discuss what you should do, if anything. What responsibility and liability exist for the physician, Maggie, and you? Use appropriate rationale to support your decision.
Instruction
you are solving at the start of your analysis and provide a brief summary of the case. Be sure to apply an appropriate problem-solving/decision-making model (Traditional Problem-Solving Process, Managerial Decision-Making Model, The Nursing Process, or the Integrated Ethical Problem-Solving Model) in determining what you should do. Justify your decision with supporting evidence.
Writing Expectations—3 to 4 pages, double-spaced, in length, not counting title page and references. APA format required (title page, citations in body of paper, and reference list). The steps of the problem-solving or decision-making model chosen should be used as subheadings for the paper. Each analysis should include a brief introduction and conclusion.
Library assignment: Title: “The Benefits and Challenges of Breastfeeding: Exploring Breastfeeding Resources for Empowered Mothers and Healthy Infants” Guidelines: APA Format MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.Research paper must be 650-1000 words. 3 or more scholarly sources must be utilizedSources must be within the last 5 years Must have a minimum of 3 Sources All article sources must be cited by including them in reference sheet (separate).
n this final discussion, look back on your experiences in the course and thoughtfully reflect on what you have learned.
Each discussion is meant to be a collaborative space for conversation in which to process the concepts within the course. To ensure an interesting and respectful discussion, you are encouraged to think creatively about your initial posts and build upon the points made by your peers. Discussing challenges that face our world often means investigating opinions and ideas different from your own. Remember to remain thoughtful and respectful towards your peers and instructor in your discussion post and replies.
Create one initial post and follow up with at least two response posts.
In your initial post, address the following:
How has your understanding of wellness been enhanced as a result of analyzing it through the four lenses?
What are the potential implications of current discussions about wellness for the future? You may consider any future you like, such as the future of your community or the future of humankind.
How do you believe the critical analysis skills learned in this course will support you going forward personally, academically, and/or professionally?
For your response posts, address the following:
Consider your vision of the future compared to your peers’. How do their insights about their changing awareness of wellness expand your vision of the future?
Remember, this assignment is graded on the quality of your initial post and at least two response posts to your classmates. You are not required to do research for this discussion. If you do refer to resources, be sure to include an attribution to the resource.
To complete this assignment, review the Discussion Rubric.
Criteria Exemplary
Proficient
Needs Improvement
Not Evident
Criterion Score
Comprehension
40 points
Develops an initial post with an organized, clear point of view or idea using rich and significant detail
34 points
Develops an initial post with a point of view or idea using adequate organization and detail
22 points
Develops an initial post with a point of view or idea but with some gaps in organization and detail
0 points
Does not develop an initial post with an organized point of view or idea
Score of Comprehension,
/ 40
Timeliness
10 points
N/A
This level is not applicable for grading of this criterion.
10 points
Submits initial post on time
5.5 points
Submits initial post one day late
0 points
Submits initial post two or more days late
Score of Timeliness,
/ 10
Engagement
30 points
Provides relevant and meaningful response posts with clarifying explanation and detail
25.5 points
Provides relevant response posts with some explanation and detail
16.5 points
Provides somewhat relevant response posts with some explanation and detail
0 points
Provides response posts that are generic with little explanation or detail
Score of Engagement,
/ 30
Writing (Mechanics)
20 points
Writes posts that are easily understood, clear, and concise using proper citation methods where applicable with no errors in citations
17 points
Writes posts that are easily understood using proper citation methods where applicable with few errors in citations
11 points
Writes posts that are understandable using proper citation methods where applicable with a number of errors in citations
0 points
Writes posts that others are not able to understand and does not use proper citation methods where applicable
Instructions for submission: The assignment must be submitted with a properly filled cover sheet (Name, ID, CRN, Submission date) in a word document, Pdf is not accepted.The length of the write-up should be 1 pages’ maximum of 1000 words.Text size 12-Times New Roman with 1.5-line spacing. Heading should be BoldThe text color should be Black Do proper paraphrasing to avoid plagiarism with proper references/sources. References must be in APA
Unformatted Attachment Preview
ASSIGNMENT COVER SHEET
Course name:
Road traffic Injuries & Disability Prevention
Course number:
PHC313
CRN:
Write a short essay to discuss risk factors
associated with road crashes and injury severity in
the Kingdom of Saudi Arabia
Assignment title or task:
(You can write a question)
➢ What is the magnitude of road accidents in
KSA?
➢ What are the main causes and contributory
factors of road crashes in KSA?
➢ What are the interventions applied to reduce
these risk factors?
Student name:
Student ID:
Submission date:
To be filled in by the instructor only
Instructor’s name:
Dr. Ahmed Hazazi
Grade:
…..out of 10
Instructions for submission:
•
•
•
•
•
•
•
•
The assignment must be submitted with a properly filled cover sheet (Name, ID,
CRN, Submission date) in a word document, Pdf is not accepted.
The length of the write-up should be 1 pages’ maximum of 1000 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Due date 14/10/2023
Obesity and Its Impact on Health: Investigate the health consequences of obesity, including the increased risk of chronic diseases like diabetes, heart disease, and certain cancers. Guidelines: APA Format MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.Research paper must be 500 – 650 words. 3 or more scholarly sources must be utilizedSources must be within the last 5 years Must have a minimum of 3 Sources All article sources must be cited by including them in reference sheet (separate).
Occupational Health
Course name:
Course number:
PHC 261
CRN
12069
Assignment title or task:
(You can write a question
)
Name
1.
Student’s name and ID
2.
3.
4.
5.
Submission date:
Instructor name
Grade
Dr. Mohammed Osman Ali
… out of 10
ID
Instructions for the presentation
contents
There must be an introduction
The presentation length is preferred to be between 10-15 slides
It is advised to include some pictures, figures or tables
There must be reference list at the end using APA style
References
–
–
Analyze the history, structure, and process of health-care-policy and politics in nursing and the health care delivery systems in the United States.
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Y
Grading Rubric
Your assignment will be graded according to the grading rubric.
Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts
Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.
Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.
Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.
Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.
5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines
Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.
3 points
Response to Posts of Peers
Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.
Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.
Poor – 0 points
Student provided no response to a peer’s post.
This week you will submit the final draft of your term paper. Your term paper should:
Discuss the technical aspects of your topic in general terms.
Discuss the public policy debates relevant to the topic you choose. This section should cover arguments that favor and oppose the use of the techniques or products.
Express your personal opinion regarding the topic’s importance and the validity of the pro and con arguments. Within the personal opinion/conclusion, frame your position with an ethical theory from the six workable theories covered in this course.
Your submission must include:
A title page
The body of the paper, which includes 4–6 content pages, not including title or reference pages
At least three references from textbooks, websites, and articles that provide adequate justification and support your claim
Subheadings (technical aspects, public policy, and personal opinion/conclusion)
Appropriate in-text citations throughout the paper
A reference list with only the sources used in the body of the paper (All sources should be less than five years old unless recent research is not available, and at least one reference must be a peer-reviewed article from a professional journal. Do not use Wikipedia or an encyclopedia as they are not considered reliable academic sources and will not be accepted.)
APA style formatting throughout your paper, using only one of these fonts: 11-point Calibri,11-point Arial,12-point Times New Roman, or 11-point Georgia.
Start Assignment
Due Sunday by 11:59pm
Points 60
Submitting a text entry box or a file upload
Unit 6
Diagnostic Tools Paper
Instructions
Write a 4-5 page paper describing the use of a specific screening tool. Discuss what diagnosis
you are using the tool for, how to score the tool, and support use of the tool with evidence and
rationale. Next, develop a treatment plan for the patient based on your findings in the
diagnostic test and interpretation.
Sections should include:
Introduction to the diagnostic tool
Discussion of Tool: why it is used, how, and for what diagnosis
Discussion of Interpretation of Scoring for the Tool
Treatment Plan for patient with positive results from the tool, include non-pharmacological
and pharmacological approaches, patient education, additional testing required, and followup as needed.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 6 hours
NU673 Unit 6 Assignment – Diagnostic Tools Paper
Criteria
Content of
Paper
Analysis and
Synthesis of
Paper
Content and
Meaning
Ratings
Pts
12 pts
10 pts
5 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Demonstrates a wellarticulated
Demonstrates an
understanding of the
Demonstrates a
moderate
Does
not
understanding of the
subject matter in a
clear, complex, and
subject matter.
Explains and applies
knowledge of
understanding of the
subject matter.
Summarizes content
meet
the
Section
informative manner.
Develops content and
evidence-based
practice, ethics, theory,
with minimal
application to
theories are well. Links
content to the paper
requirements and
and/or role. Uses a
variety of scholarly
resources from the
evidence-based
practice, theory, or
role-development.
practical experience.
Includes relevant
material that fulfills all
course material and
some that were not
provided in the course
Presents content but
is missing depth and
or development. Uses
objectives of the paper.
Uses scholarly
materials. Includes
relevant material that
only scholarly
resources that were
resources that were not
provided in the course
materials. Completes
fulfills all objectives of
the paper. Completes
all instruction
provided in the course
materials Completes
most instruction
all instruction
requirements.
requirements.
requirements.
12 pts
12 pts
8 pts
5 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Provides critical analysis
in an accurate, clear,
Provides evidence of
further synthesis of
Lacks clarification or
new information.
Does
not
concise, and complete
presentation of the
required content.
course content via
scholarly resources.
Synthesizes
Supports content with
scholarly reference
without adding any
meet
the
Section
Synthesizes information
from scholarly
information to help
fulfill paper
new information or
insight. Provides
resources. Provides new
requirements.
content that may be
12 pts
Criteria
Ratings
Pts
information or insight
related to the context of
the assignment with
Supports content
with at least one
viewpoint.
confusing or unclear,
and the summary may
be incomplete.
both supportive and
alternative information
or viewpoints.
Completes all
instruction
requirements.
Completes most
instruction
requirements.
Completes all instruction
requirements.
Application
of
Knowledge
12 pts
8 pts
5 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Offers a multidisciplinary
Presents a
Lacks objective
Does
approach via scholarly
resources. Applies
practice that is accurate
summary of the
paper’s content,
findings, and
Section. Applies
superficial bridge
between the
not
meet
the
and plausible. Supports
practice with additional
knowledge gained.
Indicates how the
assignment and the
broader course
Section
scholarly resources.
Answers all questions
posed within the
information will be
used within their
professional
content. Indicates
how they will apply
this new knowledge
assignment in a welldeveloped manner with
practice. Completes
all instruction
to their clinical
practice in a vague
citations for validation.
Completes all instruction
requirements.
requirements.
manner. Completes
most instruction
requirements.
12 pts
Criteria
Organization
College-level
academic
writing
Ratings
Pts
12 pts
8 pts
5 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Provides wellorganized content
Provides organized
content with an
Provides poor
organization, and flow of
Does
not
with a clear and
complex purpose
statement and
informative purpose
statement and
supportive content
ideas distract from
content. Provides a
purpose statement.
meet the
Section
content argument.
Provides concise
and summary
statement. Provides
Provides narrative that is
difficult to follow and
writing with a
logical flow of
ideas.
argument content with
minimal issues in
content flow.
frequently causes reader
to reread work.
12 pts
8 pts
4 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Includes no more
than three
Includes no more than
four grammatical,
Includes five or more
grammatical, spelling,
Does
not
grammatical,
spelling, or
punctuation errors
spelling, or punctuation
errors that do not
interfere with the
and punctuation errors
makes understanding
parts of assignment
meet
the
Section
that do not interfere
with the readability.
readability. Meets the
length requirements.
difficult, but does not
interfere with
Meets the
assignment length
requirements.
readability. Meets the
length requirements.
12 pts
12 pts
Total Points: 60
Using the Dalrymple, KA, Garrido, L, & Duchaine, B (2014) Dissociation between face perception and face memory in adults, but not children, with developmental prosopagnosia. Developmental Cognitive Neuroscience (10), complete an annotated bibliography using APA 6th edition format (https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_style_introduction.html).
MPH Practicum on the topic:How can Belmont Hospice help connect with historically underserved/ marginalized populations in our community when it pertains to end-of-life/ Hospice care?
Unformatted Attachment Preview
DocuSign Envelope ID: 8535B86F-6352-4FB7-ADC9-294D182EA390
Department of Public Health
Applied Practice Experience (APE)
Learning Agreement
Please complete this document in consultation with your Site Preceptor and your
Practicum Faculty Advisor.
When completing this document please review the directions in Canvas.
Do not type or sign in the signature section. Once this is approved by the Practicum
Faculty Advisor it will be sent via Docusign to both the student and the Site Preceptor
for their electronic signatures.
This document must be typed. Handwritten versions will not be accepted.
Student Name: Courtney Jefferson
Site Preceptor Name: Victor Gonzales
Site Preceptor Email Address: vicedsw@gmail.com
Site/Organization Name: Belmont Hospice
Clinical Preceptor Name (only for PUBH7850 students):
Overview of Project
I. Mission of the Site/Organization
What does your site/organization do? Who do they serve?
Belmont is committed to maintaining the highest level of dignity and comfort for all our
patients and their loved ones by being dedicated and compassionate healthcare
professionals.
II. Description of Project and Student’s Role
Briefly describe the nature of the project you are helping with, along with the specific
role or activities you will perform.
DocuSign Envelope ID: 8535B86F-6352-4FB7-ADC9-294D182EA390
My project will focus on helping Belmont Hospice connect with historically
underserved/marginalized populations in our community when it pertains to end-of-life/
hospice care. I will be working with their organization as a Community Liaison. I will be
responsible for facilitating communication between the organization and members of the
community. I will be focused on promoting a new outreach program in hopes it will bring
in more non-white patients. To do this, I will design an outreach program to engage with
the community to increase awareness and engage any misinformation or cultural
concerns. This project recognizes that certain populations are suspicious about the
motives and intentions of the healthcare system and have had a lot of negative
experiences that can negatively impact their trust in health care systems. The goal of the
outreach will be to inform and empower these populations and to educate and increase
trust that hospice is not about taking away their choices and withholding care.
Deliverables and Competencies
For your practice experience you must create a minimum of two high quality deliverables
that are useful to the host organization. The deliverables should derive from the work
you are doing for the organization and should be for the organization, not primarily for
ATSU. Together, the deliverables must demonstrate attainment (exercise of) of at least
five competencies in total (at least three must be foundational).
In the table below, please list the deliverables you will create during your APE and the
competencies that will be demonstrated by each product. The competencies are listed
below the table.
A deliverable should be listed as a thing (not an activity) that you will submit into
Canvas at the end. For example, you might list a PowerPoint presentation or an
educational curriculum rather than saying you will provide education.
If you are involved in activities (for example, helping organize an event), think of
what deliverables are part of developing or helping with that activity that could
demonstrate the work you will be doing.
When identifying/listing competencies, think of them as a specific type of activity
or skill that you will perform and which your deliverables must demonstrate. Did
DocuSign Envelope ID: 8535B86F-6352-4FB7-ADC9-294D182EA390
you use that competency to create that deliverable? Be realistic about whether
your product actually demonstrates that skill/competency.
For more info about how to understand deliverables, competencies and this
form, please view the APE Learning Agreement section in Canvas and watch the
Informational Video in the course.
Deliverable That Will Be Created for Site
and Submitted to Canvas
List a thing (and include a brief description
if that would be helpful)
Competencies Demonstrated by the
Deliverable
Please list the actual #s and competencies
(see the list below)
Deliverable #1:
Public Health & Health Care Systems
Short White Paper
6. Discuss the means by which structural
bias, social inequities and racism
undermine health and create challenges
to achieving health equity at
organizational, community and societal
levels.
Deliverable #2:
Planning & Management to Promote
Health
Develop an outreach plan/packet that will
include the following:
1. Targeted stakeholders: Ex; Faith
leaders, Hospital administrators,
and Community health workers
8. Apply awareness of cultural values
and practices to the design or
implementation of public health
policies or programs.
9. Design a population-based policy,
program, project, or intervention.
2. Develop a strategy: this is where I
make my presence known within
the community. Ex; canvassing,
organizing, or participating in
events.
27. Evaluate organizational structures,
culture, and political factors, to initiate
and sustain organizational change.
DocuSign Envelope ID: 8535B86F-6352-4FB7-ADC9-294D182EA390
3. Communication: How I will get my
message across? Ex; Flyers, social
media, phone calls and emails.
Policy in Public Health (Foundational)
13. Propose strategies to identify
stakeholders and build coalitions and
partnerships for influencing public
health outcomes.
** Please add rows to this chart if you intend to submit more than 4 deliverables.
Signatures
Do not type or write in this section. Once this is approved by the ATSU Faculty
Advisor it will be sent via Docusign to both the student and the Preceptor(s) for their
electronic signatures. It will be approved in Canvas after all individuals sign.
7/24/2023
Student: __________________________________
Date:___________
Preceptor: _________________________________
Date:___________
Preceptor: _________________________________
Date:___________
7/26/2023
DocuSign Envelope ID: 8535B86F-6352-4FB7-ADC9-294D182EA390
MPH Competencies
Evidence-based Approaches to Public Health (Foundational)
1. Apply epidemiological methods to the breadth of settings and situations in public
health practice.
2. Select quantitative and qualitative data collection methods appropriate for a given
public health context.
3. Analyze quantitative and qualitative data using biostatistics, informatics,
computer-based programming and software, as appropriate.
4. Interpret results of data analysis for public health research, policy or practice.
Public Health & Health Care Systems (Foundational)
5. Compare the organization, structure and function of health care, public health
and regulatory systems across national and international settings.
6. Discuss the means by which structural bias, social inequities and racism
undermine health and create challenges to achieving health equity at
organizational, community and societal levels.
Planning & Management to Promote Health (Foundational)
7. Assess population needs, assets and capacities that affect communities’ health.
8. Apply awareness of cultural values and practices to the design or implementation
of public health policies or programs.
9. Design a population-based policy, program, project, or intervention.
10. Explain basic principles and tools of budget and resource management.1
11. Select methods to evaluate public health programs.
Policy in Public Health (Foundational)
12. Discuss the policy-making process, including the roles of ethics and evidence.2
13. Propose strategies to identify stakeholders and build coalitions and partnerships
for influencing public health outcomes.
14. Advocate for political, social, or economic policies and programs that will improve
“Resource management” refers to stewardship (planning, monitoring, etc.) of resources
throughout a project, not simply preparing a budget statement that projects what resources will be
required.
2 This competency refers to technical aspects of how public policies are created and adopted,
including legislative and/or regulatory roles and processes, ethics in public policy making, and the
role of evidence in creating policy.
1
DocuSign Envelope ID: 8535B86F-6352-4FB7-ADC9-294D182EA390
health in diverse populations.3
15. Evaluate policies for their impact on public health and health equity.
Leadership (Foundational)
16. Apply leadership and/or management principles to address a relevant issue.4
17. Apply negotiation and mediation skills to address organizational or community
challenges.5
Communication (Foundational)
18. Select communication strategies for different audiences and sectors.
19. Communicate audience-appropriate (i.e., non-academic, non-peer audience)
public health content, both in writing and through oral presentation.
20. Describe the importance of cultural competence in communicating public health
content.
Interprofessional Practice (Foundational)
21. Integrate perspectives from other sectors and/or professions to promote and
advance population health.6
Systems Thinking (Foundational)
22. Apply systems thinking tool to visually represent a public health issue in a format
other than standard narrative.7
General MPH Concentration Competencies (not Foundational)
* These can only be used by students not in the dental track.
23. Analyze the significance of public health journal articles.
3 This competency refers to the ability to influence policy and/or decision making, such as through
stakeholder mobilization, educating policy makers, etc. Ability to argue in support of (or in
opposition to) a position, as in a standard debate, is not sufficient. Deliverables that demonstrate
this competency should be part of an advocacy campaign or effort (e.g., legislative testimony, fact
sheets, advocacy strategy outline, etc.).
4 Such principles may include creating a vision, empowering others, fostering collaboration, and
guiding decision making.
5 “Negotiation and mediation,” in this competency, refers to the set of skills needed when a
common solution is required among parties with conflicting interests and/or different desired
outcomes. Such skills extend beyond the level of negotiation required in a successful intra-group
process; effective communication within a work group or team is more closely related to
competency 16.
6 This competency requires direct engagement (in-person or online) between the student and an
individual or individuals in a profession or sector other than public health to complete a task, solve
a problem, etc.
7 Systems thinking tools depict or map complex relationships, demonstrating, for example, how
component parts of a system interact with and influence one another. Examples include causal
loop diagrams, systems archetypes, network analyses, and concept maps. Logic models and
evidence tables are not sufficient to address this competency.
DocuSign Envelope ID: 8535B86F-6352-4FB7-ADC9-294D182EA390
24. Use theory, principles and perspectives to analyze the ethical dimensions of
public health problems.
25. Apply health behavior models to address needs in a priority population.
26. Demonstrate approaches to assess, prevent, and control environmental and/or
occupational health hazards.
27. Evaluate organizational structures, culture, and political factors, to initiate and
sustain organizational change.
Dental Concentration Competencies (Not Foundational)
* These can only be used by students in the dental track.
28. Integrate the social determinants of health into dental public health practice.
29. Demonstrate ethical decision-making in the practice of dental public health.
30. Apply and evaluate evidence to address oral health issues for individuals and
populations.
31. Lead collaborations on oral and public health issues.
32. Evaluate systems of care that impact oral health.
Application of Theory: PowerPoint Presentation
Review literature regarding issues or concerns within your selected area of advanced practice
nursing. (Please Note: My selected area of practice is Nursing Informatics)
Select a nursing theory or model which is relevant to your selected area of advanced practice
nursing and would offer a meaningful context for evidence-based practice surrounding the issue
or concern which you identified.
In a PowerPoint Presentation, address the following.
•
Introduction to the presentation
•
Identify and describe a theory or model, and explain its relevance to the selected area of
advanced practice
•
Describe an issue or concern regarding the selected area of advanced practice, and
explain its impact on health care outcomes
•
Explain how the nursing theory or model can be used as a framework to guide evidencebased practice to address the issue or concern and discuss the unique insight or
perspective offered through the application of this theory or model.
•
Conclusion to the presentation. Connect your nursing philosophy to the application of
theory related to the situation being addressed.
•
References in APA current edition format
Preparing the Presentation
•
Application: Use Microsoft PowerPoint to create the PowerPoint presentation.
•
Length: The PowerPoint presentation should be 7 total slides (excluding title and
reference slides).
•
Speaker notes are used and include in-text citations when applicable.
•
A minimum of three (3) scholarly literature sources must be used.
•
Name must appear on the title slide
Theoretical Framework to Support Evidence-based Practice
Your name
Class
Sessions
Introduction Slide
•
General information on what will be presented in your PowerPoint.
•
Identify the theory you have chosen
•
Identify the sections of the PowerPoint presentation
Remember, references from scholarly literature should be included. And you can use the primary
source for the theory only on this slide and the theory or model slides
Theory or Model Slide
•
Identify your theory or model that you’ve chosen to present in this PowerPoint.
•
Provide an overview of that theory or model,
•
Provide discussion in your speaker notes
Remember to use in-text and parenthetical citations for slide and speaker notes, scholarly support
is required. And again, for this section of your PowerPoint, you can use the primary source for
the theory.
Relevance to Advanced Practice Nursing
•
Explain why it is relevant to your selected area of advanced nursing practice. Why is this
theory or model relevant?
•
Remember to provide your discussion in the speaker notes and
•
Use in-text citations for scholarly support used to support this slide.
Issue or Concern
•
Describe one specific issue or concern within your specific area of Advanced Practice
Nursing
•
Explain the impact of this issue or concern on health outcomes
•
Validate the importance of the issue or concern with scholarly support.
•
Provide that discussion in your speaker notes and use bullet points on your slide.
•
Use in-text citations for scholarly support used to support this slide
Theory as Framework For EBP
•
Explain how the theory or model can be used to guide evidence-based practice to address
the issue or concern
Application of Theory or Model
•
Discuss your unique insights or perspective through applying the theory or model. You
want to provide the information comprehensively and concisely because we are using
PowerPoint slides for this presentation.
•
Use bullet points on your slide and then put your longer information and details in the
speaker notes
•
Use in text citation for scholarly support used to support
Conclusion
•
Summary of key information from the PowerPoint
•
Provide speaker notes
References
•
APA 6th ed format
•
One or two in length depending on how many references you have.
•
Use proper formatting, punctuation, hanging indents, etc per APA 6th ed guidelines.
•
Minimum of 3 scholarly literature sources published in the last 5 years.
•
Use one of the primary sources for the theory only in addition to 3 current sources.
•
Examples:
Author last name, first initial. (year). Title of article. Title of Journal, vol.(issue),
page numbers. doi:
Professional Capstone and Practicum Reflective Journal – Topic 6 Assessment Description Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week’s entry, students should reflect on the personal knowledge and skills gained. Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing. Topic Focus: Population Health Concerns and Health Disparities Prepare this assignment according to the guidelines found in the APA Style Guideplagiarism report (less than 10%) Note: For this assignment I need to talk about how Population Health Concerns and Health Disparities (the topic focus) relates to this week’s assignments. Please, let me know if you have any questions.I will send you shortly this week’s assignments so you know what to write about on this assignment.
I need to summaries this article on PowerPoint using the same articles world
Unformatted Attachment Preview
Complete dentures
DiRcult
denture
birds
Alex Koper,
B.S., D.D.S.*
Inglewood,
Calif.
D
enture patients are “special”
people because they have the problem of adapting
to a prosthesis which affects one of the most sensitive and emotionally
charged regions of the body. This must take place in full view of their friends, who, like baseball fans, are often opinionated
and voluble “experts,”
The problem is compounded
by the fact that in our North American
culture, with its emphasis on youth, virility
or femininity,
and apparent
immortality,
the individual
who lacks a normal and
attractive
dentition
is disadvantaged.
Therefore,
it takes an uncommonly
secure
individual
to accept dentures with equanimity.
During
the time their dentures are being made, and later while they are learning to use them, our patients are dependent,
frightened,
“less than whole”
people.
and in many instances, regress to infantile behavior. There are individuals
who have
so much difficulty with their dentures that they never make an acceptable
adjustment to them. Some wander from dentist to dentist in search of a solution to their
dental needs, while others isolate themselves from society. These people are called
problem
denture patients or dificult
denture patients.
Because American
standards
of function
and appearance
are so high, people
whose physical or emotional
limitations
prevent adequate
achievement
with dentures suffer much and seek help from dentists. In other parts of the world where
teeth are not looked upon as such a necessary and positive asset, these individuals
might suffer little as a result of this deficiency.
The difficult
denture
patient
is,
therefore,
a more common problem to American
dentistry, and is a product of ours
higher living conditions.
IDENTIFICATION
OF TtlE PROBLEM
DENTWtE
PATIENT
Difficult
denture patients have been described by Schultz’
present abnormal
and uncommon
denture problems.
Because
Read
before
the American
This article is being published
and the Journal
of the Southern
tween the editors.
*Co-director
of The Odontic
532
Prosthodontic
Society
in Chicago,
Feb.
as “Individuals
of the extreme
who
com-
3, 1967.
simultaneously
in the JOURNAL OF PROSTHETIC DENTISTRY
California
Dental
Association
by special arrangements
beSeminar,
Los
Angeles.
Difficult
denture birds
533
plexities of their symptoms and their physical and emotional handicaps, these are
difficult denture patients.”
It is conceded that what may be an abnormal and uncommon denture problem
for one dentist may be fairly routine to a more experienced practitioner.
Also, the
evaluation of the physical and emotional limitations
a patient presents varies with
the perception, observation, and experience of the dentist who treats him. It is also
true that there are individuals
who present severe challenges to all dentists who
a:te npt to treat them. This poses the questions: “What makes a problem denture
patient? Are there any criteria by which one may measure an edentulous patient
in order to determine whether or not he is or will be ‘difficult’?”
SOME CHARACTERISTICS
OF PROBLEM
DENTURE
PATIENTS
1. They complain.
2. They have pain.
3. They are hostile.
4. They exhibit regressive behavior.
5. They are tense, anxious, and appear unhappy.
6. They often have systemic illnesses.
7. They are inordinately
preoccupied
and conscious of their mouth and their
dental problem.
8. They have an unrealistic fantasy regarding dentures.
9. They are often devious, deceptive, and disarming.
10. They are indefatigable
and persevering in their efforts to obtain satisfaction.
While it may be true that some of these signs appear in patients needing types
of treatment other than dentures, difficult denture patients exhibit all or most of
these limitations, and often have additional handicaps which aggravate and intensify
their symptoms.
Many edentulous patients become problem patients because they lack the physical apparatus to wear dentures successfully. Some are frustrated in their attempts to
adapt themselves to a mechanical appliance which requires a rather high degree of
neuromuscular
skill and coordination.
This most often comes at a time in their lives
when they yearn for the comfort of familiar things and do not have the energy for
this difficult task.
FROM WHISTLER’S
MOTHER
TO THE KARATE
HAWK
Prosthodontic
literature is replete with many analyses of these problems. There
are certain individuals
who cannot wear dentures successfully. Most writers on this
subject attribute the causes for this lack of success to personality or emotional problems, physical problems, or failure of the dentist to provide the proper treatment for
his patient. Whatever the cause of their lack of success with dentures, these people
do not become problem denture patients unless they have had considerable experience as recipients of various kinds of dental therapy, and have thereby developed a
particularly
colorful and effective modus operandi which continuously
and successfully thwarts efforts to construct workable oral prosthetic devices for them.
Only occasionally does one come upon discussions of denture failures in the
literature.2
Brewer3 writes that he has no failures, just varying degrees of success.
It might be erroneously
surmised that the problem denture patient, the D~Ju~u~u
Calamitous
Amrricanus,
likr the dodo bird and the silver dollar. is brcornit~~!
extinct. Nothing could be farther from the truth. As vet. no statistics on the rlrm~t)~XI
and varieties of these birds are available.
but informed
observers rstimatc. thrir
number to be as hiah as 5 per cent of the denture-wearimg
population.
Ijentists wlrc;
have encountered
them are happy to disengage themselves from the clutchry (Ii
these predatory creatures, and forget their experiences as quickly as possible.
Problem denture patients do not wear wrist bands that would identify them.
and even well-trained
veteran observers often fail to spot them. There simply is no
ty$cal problem denture patient. They come younp and old, male and female. rich
and poor. They may be as gentle and kind as Whistler‘s mother. or as aggrrssi,t: a<
. . .
.
.
a pohtlclan a week before pollmg time. Generally. the female of the specit~ is man‘
colorful than the male.
Just as there is no stereotype of the problem denture patient, neither is the1.c.
a uniform pattern to his behavior. Some of them will become unhappy and un,manageable at the first appointment;
for others, the difficulties begin at the try-in
appointment;
while the majority wait until the dentures are completed before the
begin their perverse maneuvers. Most of them need this time to measure their prrs
and plan their tactics.
I have been in a particula,rly
strategic position to observe many exotic species
of these denture birds. My experiences with grievance committees of the Los Angrles
County Dental Society for the past fifteen years, plus a practice which is yuitt’
heavily populated
with many varieties of these creatures, has made an avid and
wary denture bird watcher of me. Although
I have never seen such rare specitnenh
as the l’awkorchoo
Gobblrr
(Fig. 1) who uses two separate lower dentures-- -on
Purchase answer to see full
attachment
Impasse is a point at which parties to a conflict believe they can currently take no further action. They are, in essence, gridlocked. Although the word impasse itself may connote impossibility, impasse does not mean that action is impossible, only that no movement toward resolution is wanted or possible at the time. Sometimes, in fact, disputants may use impasse purposefully to exert power, look for alternatives, or stall the process. Refusing to engage further in negotiation can have very high stakes in some types of conflict, particularly international conflict, because often the escalation of such conflicts after impasse has been reached leads to economic sanctions or military action, both of which have the potential to be disastrous for citizens.
A famous example of international impasse is the Bay of Pigs Invasion (or Invasión de Playa Girón, as it is known in Cuba) instigated by the United States against Cuba, and the subsequent nuclear missile standoff between the two countries (with Soviet Union support for Cuba). After a miscalculated secret attempt to destroy Cuban military aircraft and train Cuban immigrants in the United States to lead a coup to overthrow then leader Fidel Castro, relations with Cuba became openly hostile. The United States was exposed for having lied to the United Nations about these efforts as well. Cuba responded by allowing the Soviet Union to build ballistic nuclear weapons on its island, thus providing an insurance policy against further U.S. attacks. Many of U.S. President Kennedy’s advisors recommended the missiles be destroyed before they were operational. Kennedy preferred to implement a naval quarantine to block Soviet vessels from reaching Cuba. The world waited, white knuckled, in apprehension of a nuclear war as the leaders of the two countries faced an impasse with catastrophic potential consequences for the planet. Kennedy remained committed to diplomatic solutions and privately agreed to disable U.S. nuclear weapons in Turkey. He also pledged that the United States would not attack Cuba, to which Soviet Premier Khrushchev responded by agreeing to dismantle the arms program in Cuba. Never in history before or since has an impasse had such grave potential consequences.
For this Assignment, you analyze an international conflict that has stalled or reached impasse to determine why the impasse exists, why the parties were unable to reach Pareto optimality, and strategies or steps they might take to move beyond the impasse.
To Prepare:
Review Chapter 9 in your course text, The Dynamics of Conflict: A Guide to Engagement and Intervention.
Select one international conflict that you feel has reached impasse or otherwise stalled in the resolution process.
The Assignment (6–8 pages):
In two pages or less, briefly describe the relevant facts of the conflict you selected, such as sources, stakeholders, interests of each party, and interventions attempted.
In at least three pages, answer each of the following questions:
Prior to the conflict stalling, how did the parties deal with the integrative and distributive aspects of the negotiation?
Why were the parties unable to reach Pareto optimality?
Has true impasse been reached? How do you know?
Finally, in at least two pages, explain what steps can be taken for the parties to effectively work through impasse. (Refer to Chapter 9 of The Dynamics of Conflict: A Guide to Engagement and Intervention, and keep in mind that working through impasse sometimes means finding the next best step; do not force an agreement or push the parties out of impasse if that is their best option.)
The entire paper should be 6–8 pages and include a minimum of three outside peer-reviewed sources in addition to references to the Learning Resources from the course.
For this project, you will complete a clinical case study analysis, research review, and PowerPoint video presentation about the pathophysiology of a topic of your choice.
Your presentation should follow a case study SBAR format (situation, background, assessment, and recommendations).
You must include three (3) different medical-based evidence and/or research recommendations.
You must include at least three (3) scholarly sources in your overall presentation.
Your PowerPoint presentation should include the following slides:
Introduction to the case or situation
Background detail
Clinical assessment
Recommendations
Application to future practice
Reference slide: At least three (3) scholarly references supporting your ideas.
Your presentation should be 3-5 minutes in length. Upload your completed video presentation here for grading.
You will also post it to the Discussion Board for your Week 9 Discussion. Look ahead to the Week 9 Discussion Board for details.
This is part 4 of your evidence-based practice project (EBP).
In this assignment, you will refer back to assignment you completed in previous weeks, as this assignment will build upon it. You’ll be providing a solution to a clinical problem using the EBP process.
For this assignment, you will create a 13-16 slide PowerPoint, excluding the title and reference slides, covering the items below. This should be a high-level overview of what you’ve already discussed in your papers. Be sure to summarize your information (do not simply copy and paste).
Describe the select EBP problem
List the created PICOT question
“In pregnant women (Population), does the use of medication prior to labor (Intervention), compared with those without medications (Control), reduce the risk of postpartum hemorrhage (Outcome) within the first 12 weeks after childbirth (Time-frame)”
Provide a high-level overview of the articles you found, organizing them by design (i.e.; qualitative, quantitative, mixed methods)
Summarize the search strategy you used to locate the articles.
Search Strategy Correspondingly, addressing the PICOT question featured exploring research findings on the use medications as intervention for reducing the risk of postpartum hemorrhage in expecting mothers prior to labor. Specifically, The search strategy involved using key terms such as ‘Medication’, ‘Postpartum Hemorrhage’, ‘Labor’, and ‘Prevention’ to search for relevant articles in authoritative online research databases on nursing and healthcare, including CINAHL Plus with Full Text in EBSCO and Nursing and Allied Health Database in ProQuest. Initially, a broad search was conducted incorporating all the relevant keywords. Since the initial search yielded a substantial number of articles, the search was refined by carefully evaluating and screening the abstracts and text of the retrieved articles that led to the selection of three study articles.
Discuss what changes could be made as a result of these findings
Describe strategies and resources you would use to implement a change based on these findings
Describe areas of opportunity for future research and EBP related to your topic
Provide a conclusion and discussion of next steps
This should be a high-level overview of what you’ve already discussed in your papers. Be sure to summarize your information (do not simply copy and paste from previous papers). Your PowerPoint slides should be bullet points and/or images and not paragraphs of text. Descriptions and explanations will be written in the “speaker notes” section of the PowerPoint slides. In other words, use the “notes” section to write out what you would say if you were presenting the slides to a live audience.
You will be graded on presentation and layout. Be sure to not overcrowd your slides (follow the 7×7 Rule- No more than 7 bullet points per slide and no more than 7 words per bullet point). Finally, your background should be consistent throughout, and ensure your slides are readable. Do not use too many graphics either.
In addition, you must follow APA guidelines, providing a title slide, reference slide, and in-text citations.
Please review the rubric to ensure that your assignment meets criteria.
Assignment Resources
Gray, J. R., Grove, S. K. & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier Saunders. ISBN 978-0-323-37758-4
Chapters 1,2, 3
National Council of State Boards of Nursing, Inc. (2020).NCSBN regulatory guidelines and evidence-based quality indicators for nursing education programsLinks to an external site.. https://www.ncsbn.org/NCSBN-Regulatory-Guidelines-…
Please view NCSBN document on Evidence-Based Nursing education. Consider the integration of clinical evidence and best practices in nursing education. Review topics of interest regarding best practices in areas of nursing education.
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Follow the guidelines attached when completing this assignment.
Please be sure to only read, use, and cite the selected required article which has been attached. Here is the citation for it:
Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ Adherence to Patient Safety Principles: A Systematic Review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028
Requirements: Minimum 1 Full Page Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages | .doc file
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to carefully follow the instructions.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each body paragraph written.
Abstract: Background: Quality-of-care improvement and prevention of practice errors is dependent
on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic
review of the international literature, to synthesise knowledge and explore factors that influence
nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian,
and Finnish languages were searched, using appropriate keywords to retrieve empirical articles
published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing
risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare
provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were
found that focused on adherence to patient-safety principles during clinical nursing interventions.
They focused on the management of peripheral venous catheters, surgical hand rubbing instructions,
double-checking policies of medicines management, nursing handover between wards, cardiac
monitoring and surveillance, and care-associated infection precautions. Patients’ participation,
healthcare providers’ knowledge and attitudes, collaboration by nurses, appropriate equipment and
electronic systems, education and regular feedback, and standardization of the care process influenced
nurses’ adherence to patient-safety principles. Conclusions: The revelation of individual and systemic
factors has implications for nursing care practice, as both influence adherence to patient-safety
principles. More studies using qualitative and quantitative methods are required to enhance our
knowledge of measures needed to improve nurse’ adherence to patient-safety principles and their
effects on patient-safety outcomes.
Keywords: adherence; quality of care; patient-safety principles; nursing intervention; practice errors;
safe care
1. Introduction
The World Health Organization defines patient safety as the absence of preventable harm to
patients and prevention of unnecessary harm by healthcare professionals [1]. It has been reported
that unsafe care is responsible for the loss of 64 million disability-adjusted life years each year
across the globe. Patient harm during the provision of healthcare is recognized as one of the top 10
causes of disability and death in the world [2]. Regarding the financial consequence of patient harm,
a retrospective analysis of inpatient harm based on data collected from 24 hospitals in the USA showed
Int. J. Environ. Res. Public Health 2020, 17, 2028; doi:10.3390/ijerph17062028
www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2020, 17, 2028
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that harm-reduction strategies could reduce total healthcare costs by $108 million U.S. and generate a
saving of 60,000 inpatient care days [3]. Additionally, the loss of income and productivity due to other
associated costs of patient harm are estimated to be trillions of dollars annually [4]. The burden of
practice errors on patients, their family members, and the healthcare system can be reduced through
implementing patient-safety principles based on preventive and quality-improvement strategies [5].
Patient-safety principles are scientific methods for achieving a reliable healthcare system that minimizes
the incidence rate and impact of adverse events and maximizes recovery from such incidents [6].
These principles can be categorized as risk management, infection control, medicines management,
safe environment and equipment [7], patient education and participation in own care, prevention of
pressure ulcers, nutrition improvement [8], leadership, teamwork, knowledge development through
research [9], feeling of responsibility and accountability, and reporting practice errors [10].
The nurses’ role is to preserve patient safety and prevent harm during the provision of care in
both short-term and long-term care settings [11,12]. Nurses are expected to adhere to organizational
strategies for identifying harms and risks through assessing the patient, planning for care, monitoring
and surveillance activities, double-checking, offering assistance, and communicating with other
healthcare providers [13,14]. In addition to clear policies, leadership, research driven safety initiatives,
training of healthcare staff, and patient participation [1,15], nurses’ adherence to the principles of
patient safety [16,17] is required for the success of interventions aimed at the prevention of practice
errors and to achieve sustainable and safer healthcare systems.
Background
Adherence to and compliance with guidelines and recommendations are influenced by personal
willingness, culture, economic and social conditions, and levels of knowledge [18,19]. On the other
hand, lack of adherence and compliance contravenes professional beliefs, norms, and expectations of
the healthcare professional’s role [20].
Institutional systemic factors influencing nurses’ adherence to and compliance with patient-safety
principles are as follows: the organizational patient-safety climate [21], workload, time pressure,
encouragement by leaders and colleagues [22–24], level of ward performance [25], provision of
education for the improvement of knowledge and skills [11,18], institutional procedures or protocols,
and also communication between healthcare staff and patients [11]. In addition, personal motivation,
resistance to change, feelings of autonomy, attitude toward innovation, and empowerment are personal
factors that impact on the nurses’ adherence to patient-safety principles [26].
A theoretical framework for analysing risk and safety in healthcare practice has been devised by
Vincent et al. (1998) [27] based on the Reason’s model of organizational accidents [28]. It combines
‘person-centred’ approaches, where the focus is on individual responsibility for the preservation of
patients’ safety and prevention of their harm, and the ‘system-centred’ approach, which considers
organizational factors as precursors for endangering patient safety [29]. According to this theoretical
framework, initiatives aimed at the improvement of patient safety require systematic assessments
and integrative interventions to target different elements in the hierarchy of the healthcare system,
including patient, healthcare provider, task, work environment, and organization and management.
This framework, and similar models for risk and safety management, can help with the analysis of
patient harm, to identify probable pitfalls, as well as explore how to prevent future similar incidents [30].
Adherence to the principles of patient safety and the prevention and reduction of practice errors
have been facilitated by technological solutions in recent years [31,32]; however, suboptimal quality
and safety of care remain evident, indicating the need for improved understandings of the various
factors and conditions that increase adherence in daily nursing practice [33]. Consequently, this review
aimed to retrieve, explore, and synthesise factors evident in the international literature that influenced
nurses’ adherence to patient-safety principles. Vincent’s framework was used for the classification of
findings, in order to systematically present the findings and inform clinical practice.
Int. J. Environ. Res. Public Health 2020, 17, 2028
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2. Materials and Methods
2.1. Design
A systematic review was conducted. It is an explicit and clear method of data collection, systematic
description, and synthesis of findings, to reach the study goal [34–36]. The review findings are presented
narratively since heterogeneities in the methods, objectives, and results of studies that met the inclusion
criteria did not lend themselves to meta-analysis. The Preferred Reporting Items Systematic Reviews
and Meta-analysis (PRISMA) Statement (2009) was applied to inform this systematic review [36].
2.2. Search Methods
Search keywords were determined after team discussions, performing a pilot search in general
and specialized databases, and consultation with a librarian. Key search terms relating to adherence to
patient-safety principles by nurses were used to conduct a Boolean search. For operationalising the
study concept, the definition of adherence as a behaviour carried out actively by people according to
orders or advice was used [37]. The word adherence is used interchangeably with, and sometimes
at the same time as, the word compliance, since both can indicate the outcome of care interactions
between the healthcare provider and the caregiver [38–42]. However, adherence indicates responsibility
and empowerment on the healthcare professional’s part to actively perform the expected behaviour
compared to compliance that shows responsibility on the patient’s part to follow up the therapeutic
regimen [43,44].
The search was limited to the time period of January 2010 to August 2019, in English scientific
journals available through the following online databases: PubMed (including Medline), CINAHL,
Scopus, Web of Science, PsycINFO, ProQuest, and EBSCO. In addition, the authors performed searches
in Nordic and Finnish databases to improve the search coverage. To find relevant studies for inclusion
in the data analysis and synthesis, inclusion criteria for selection were articles with a focus on adherence
to patient-safety principles in clinical nursing interventions published in online peer-reviewed scientific
journals. Articles on patients and other healthcare providers, or on non-clinical initiatives, or that had
no exact relevance to adherence to patient-safety principles were excluded.
2.3. Search Outcome and Data Extraction
The authors (M.V., S.T., J.K., and F.V.M.) independently performed each step of the systematic
review, holding frequent online discussions and making collective agreements on how to proceed
through the review steps. Gray literature, such as unpublished dissertations and policy documents
and cross-referencing from bibliographies, were assessed, to improve the search coverage. Guidance
and support with the search process were obtained from the librarian, when needed. All authors
independently screened the titles, abstracts, and full texts of the studies retrieved during the search
process. In the cases where disagreements about the inclusion of selected studies occurred, discussions
were held until a consensus was reached.
A data extraction table was used to collect data on the characteristics of studies. The table included
the lead author’s name, publication year, country, design, sample size and setting, and information
relating to adherence to patient-safety principles. Prior to the full data extraction, this table was
pilot-tested with a few selected studies, to ensure that data relevant to the review aim and analysis
would be appropriately gathered.
2.4. Quality Appraisal
The selected articles were appraised based on the appropriateness of the research structure using
the evaluation tools provided by the Enhancing the QUAlity and Transparency of health Research
(EQUATOR) website [45] and criteria outlined by Hawker et al. (2002) [46], addressing the study aim,
research structure, theoretical/conceptual research framework, conclusion, and references. The appraisal
tool appropriate to cross-sectional, observational and cohort studies such as the Strengthening the
Int. J. Environ. Res. Public Health 2020, 17, 2028
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Reporting of Observational Studies in Epidemiology (STROBE) was used to evaluate the suitability of
selected studies for inclusion in the final data synthesis and analysis. The researchers believed that the
quality appraisal items for determining the inclusion of a study in the final dataset did not align to a
scoring system; therefore, they used a yes/no system to answer the appraisal-tool items during the
quality appraisal and held frequent discussions on the importance and quality of each article before
making the final decision on the selection of studies for data analysis and synthesis.
2.5. Data Abstraction and Synthesis
The Vincent’s framework for analysing risk and safety in clinical practice [27,47] was used
to organize and connect the review findings to the wider theoretical perspective of patient safety.
This framework was developed based on the Reason’s organisational accident model [28]. Accordingly,
issues in patient safety originate in various systemic features at different categories of patient, healthcare
provider, task, work environment, and organisation and management [27,47]. The use of this framework
helped with the description and categorisation of data retrieved and accommodated heterogeneities in
the studies retrieved, with respect to method, samples, settings, and findings, facilitating the integrative
presentation of the review findings. The authors (M.V., S.T., P.A.L., J.K., and F.V.M.) reviewed the
included studies, to allocate the studies’ findings to each category, and used frequent discussions to
reach a consensus.
3. Results
3.1. Search Results and Study Selections
The thorough literature search using the key terms led to the retrieval of 10,855 articles.
After deleting irrelevant and duplicate titles, 382 entered the abstract-reading phase. Each abstract
was assessed by using the inclusion criteria, resulting in 84 possibly relevant articles. The full texts
were obtained from Finnish and Norwegian libraries and were carefully read to select only those
articles that had a precise focus on adherence to patient-safety principles during clinical nursing
interventions by nurses. This resulted in the final six articles chosen for data analysis. Excluded studies
were on adherence by other healthcare providers, rather than nurses, or had no exact relevance to
patient-safety principles. The methodological quality of the selected articles was assessed during the
full-text appraisal, and no article was excluded. In general, they had acceptable qualities with respect
to study research structure, theoretical and conceptual research frameworks, and relevant findings to
the review aim. Grey literature and the manual search in the reference lists of the selected studies led
to no more articles being discovered for inclusion. Appendix A presents the search results, giving the
number of articles located in each database. The Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) flowchart is shown in Figure 1.
3.2. General Characteristics of the Selected Studies
The general characteristics of the selected studies (n = 6) are presented in Table 1. The studies
were published from 2014 to 2019 and were conducted in Australia [48], Finland [49], Norway [50],
South Korea [51], Sweden [52], and the UK [53].
Three studies used a survey design [50–52]; one study used an observational method [53];
one applied an observational intervention design [49]; and another one was a three-stage pre-post
time-series study [48]. Except for one study [49] that was published in the Finnish language, all other
articles were written in English.
Diverse foci were evident in the studies: adherence to patient-safety principles on the management
of peripheral venous catheters [52], surgical hand rubbing instructions [49], double-checking policies
of medicines’ preparation and administration [53], handover from the intensive care unit (ICU) to the
cardiac ward [48], cardiac monitoring and surveillance standards [50], and care-associated infection
precautions [51].
ron. Res. Public Health 2020, 17, x
Int. J. Environ. Res. Public Health 2020, 17, 2028
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Figure 1. The study flow diagram according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA).
ure 1. The study flow diagram according to the Preferred Reporting Items for Systematic Revie
Meta-Analyses (PRISMA).
eral Characteristics of the Selected Studies
e general characteristics of the selected studies (n = 6) are presented in Table 1. The
ublished from 2014 to 2019 and were conducted in Australia [48], Finland [49], Norw
orea [51], Sweden [52], and the UK [53].
ree studies used a survey design [50–52]; one study used an observational method [5
an observational intervention design [49]; and another one was a three-stage pre-po
udy [48]. Except for one study [49] that was published in the Finnish language, a
were written in English.
verse foci were evident in the studies: adherence to patient-safety principles
Int. J. Environ. Res. Public Health 2020, 17, 2028
6 of 15
Table 1. Characteristics of selected studies for data analysis and synthesis.
Authors, Year, Country
Aim
Förberg et al., 2014, Sweden [52]
To investigate nurses’ adherence to
the clinical practice guidelines
regarding peripheral venous
catheters and investigate their
understandings of work context
influencing it.
Rintala et al., 2014, Finland [49]
To evaluate adherence to surgical
hand rubbing directives among
operating room personnel, in public
hospitals in Southwest Finland.
Alsulami et al., 2014, UK [53]
To explore the follow-up of
double-checking policies by nurses
and assess the identity of
medication-administration errors
despite double-checking.
Method
Sample and Setting
Main Finding
Conclusion
Survey
A children’s hospital with 245 beds,
373 nurses from 23 medical and
surgical inpatient, intensive care, the
operating, anaesthetic, advanced
homecare, and outpatient wards.
The importance of the
workplace condition in
terms of information
sharing and feedback.
The need for various
strategies for improving
adherence among nurses.
Observational before-after
intervention
11 surgical settings of four hospitals,
190 and 73 nurses in the first and
second observation rounds,
respectively.
The relative impact of the
feedback intervention on
adherence by nurses.
Necessity of effective
educational methods and
role models.
Prospective observational
Medical and surgical wards, the
PICU and NICU, observation of
preparation and administration of
2000 drug doses to 876 children.
Deviations from the
policies of medication
administration.
Encouragement of
double-checking steps
during medication
administration, and
prevention of
interruptions.
Graan et al., 2016, Australia [48]
To investigate the adoption of
standardised nursing handover
guidelines from the ICU to the
cardiac ward in regard to
understanding risks to patient
safety before and after the
implementation.
Three-stage, pre–post time
series, and focus group
interviews pre-and/or
post-implementation.
A metropolitan private hospital with
a 15-bed ICU and a 46-bed cardiac
surgical ward; 20 consecutive
episodes of ICU-to-ward handover
and a further 20 post-implementation
episodes; A purposive sample of 19
senior nurse managers and clinicians.
Unsafe practice of
handover interventions
and information gap.
The need for the adoption
of standardised handover
tools for reducing
handover variabilities.
Fålun et al., 2019, Norway [50]
To study cardiovascular nurses’
knowledge of, and adherence to,
practice standards for cardiac
surveillance and their knowledge
improvements over time, in years
2011 and 2017.
Survey
363 nurses from 44 hospitals in 2011
and 38 hospitals in 2017.
Failure to fully adhere to
cardiac telemetry
monitoring standards.
Developing educational
programmes regarding
the safe practice of cardiac
monitoring.
Lim et al., 2019, South Korea [51]
To investigate nurses’ adherence to
standard precautions and its
association with their perceptions
of safe care.
Cross-sectional
329 nurses working in a teaching
hospital.
Intermediate adherence to
standard precautions.
Devising integrative
curricula to improve
nurses’ transition to
professional practice.
PICU: paediatric intensive care unit; NICU: neonatal intensive care unit; ICU: intensive care unit.
Int. J. Environ. Res. Public Health 2020, 17, 2028
Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW
7 of 15
7 of 15
3.3. Findings of Studies with Connection to the Vincent’s Framework
3.3. Findings of Studies with Connection to the Vincent’s Framework
The findings were classified based on the theoretical framework for analysing risk and safety in
The
findings
were classified
based
on the
theoretical
framework
forfactors
analysing
riskto
and
in
clinical
practice
developed
by Vincent
(1998,
2010)
[27,47] and
grouped by
related
thesafety
patient,
clinical practice
developed
by Vincent
(1998,and
2010)
[27,47] andand
grouped
by factors
related in
to the
the
healthcare
provider,
task, work
environment,
organisation
management.
Variations
patient,
healthcare
provider,
task,
work
environment,
and
organisation
and
management.
Variations
findings within the selected studies related to the type of patient-safety principles or different clinical
in the findings
within
selected and
studies
relatedoftofindings
the typeunder
of patient-safety
principles or
different
settings
facilitated
the the
description
synthesis
the above-mentioned
categories
clinical
settings
facilitated
the
description
and
synthesis
of
findings
under
the
above-mentioned
(Figure 2).
categories (Figure 2).
Figure 2.
model
of nurses’
adherence
to patient-safety
principles
based onbased
the Vincent’s
Figure
2. Schematic
Schematic
model
of nurses’
adherence
to patient-safety
principles
on the
framework.
Vincent’s
framework.
3.3.1.
3.3.1. Patient
Patient
This
This category
category was
was about
about the
the role
role of
of patients
patients and
and how
how they
they could
could impact
impact nurses’
nurses’ adherence
adherence to
to
patient-safety
For For
instance,
errors made
administration,
patient-safetyprinciples.
principles.
instance,
errorsduring
mademedicines’
during preparation
medicines’ and
preparation
and
and
a deviation from
bysafety
nursesprinciples
were reported.
The deviation
with a high
administration,
and medication
a deviationsafety
from principles
medication
by nurses
were reported.
The
possibility
of
endangering
patient
safety
happened
where
the
parents
of
patients
or
their
companions
deviation with a high possibility of endangering patient safety happened where the parents of
were
left unobserved
and unsupervised
nurses to administer
medicinesby
to patients.
patients
or their companions
were leftbyunobserved
and unsupervised
nurses toUnobserved
administer
or
unsupervised
administration
contravenes
the
medicines
management
principle,
which
a
medicines to patients. Unobserved or unsupervised administration contravenes the requires
medicines
nurse’s
direct
supervision;
a
crucial
consideration
for
the
prevention
of
abuse
and
patient
avoidance
of
management principle, which requires a nurse’s direct supervision; a crucial consideration for the
taking
medicines
as and
prescribed
Moreover,
in spite
of the emphasis
on patient
participation
in
prevention
of abuse
patient[53].
avoidance
of taking
medicines
as prescribed
[53]. Moreover,
in spite
patient-safety
activities,
nursing
handovers
were
delivered
mainly
outside
the
patient’s
room
[48],
or
no
of the emphasis on patient participation in patient-safety activities, nursing handovers were
information
was provided
patients
regarding
the purpose
and process of
cardiac
monitoring
[50].
delivered mainly
outside to
the
patient’s
room [48],
or no information
was
provided
to patients
These
deviations
could
hinder
patients’
active
involvement
in
their
own
safe
care.
Additionally,
the
only
regarding the purpose and process of cardiac monitoring [50]. These deviations could hinder
communication
between patients
and nurses
wasAdditionally,
the call bell, and
nurses
rarely questioned
patients’ active line
involvement
in their own
safe care.
the only
communication
line
patients
their
pain
or comfort.
identified
issues
represent
missed
opportunities
forpain
the
betweenabout
patients
and
nurses
was the These
call bell,
and nurses
rarely
questioned
patients
about their
nurses’
continuous
observation
role
for
early
detection
and
prevention
of
harm
during
handovers
from
or comfort. These identified issues represent missed opportunities for the nurses’ continuous
the
ICU to the
cardiac
warddetection
[48].
observation
role
for early
and prevention of harm during handovers from the ICU to the
cardiac ward [48].
3.3.2. Healthcare Provider
3.3.2.This
Healthcare
categoryProvider
described how nurses’ knowledge and attitudes were associated with their adherence
to patient-safety principles. Variations in nurses’ adherence to patient-safety principles could be
This category described how nurses’ knowledge and attitudes were associated with their
attr
read the instructions and answer the question below
Unformatted Attachment Preview
LECOM School of Pharmacy
Pharmaceutics III DE 2022/2023
Drug Stability Assignment
Dr. Miroshnyk
Your name_____________________________
Consider the accelerated stability testing data for a new drug product and perform the
following:
1. Compute the missing parameters and fill out the table.
2. Use Excel to generate an Arrhenius plot (log k vs 1/T)
3. Solve the Arrhenius Eq for kapp at 25 0C (= 298 K).
4. Calculate t90 assuming that the initial drug concentration was 50 mg/tablet.
5. Assign the expiration date of this new drug product, assuming that it will be
manufactured on September 1st, 2022.
Accelerated Stability Data
Temperature
(0C)
70
80
90
Temperature (K)
Rate Constant
(k) (min-1)
1.73E-05
3.38E-05
6.45E-05
1/K
Log k
Week 8 Assignment: Family Disaster Plan – Tornado Scenario
Picture yourself living in Los Angeles and you are somewhat prepared for a natural disaster. You have enough supplies for yourself for a day:
For this paper you must cite and reference at least two (2) scholarly resources. The paper should be 2–3 pages and
written using the current 7th ed. APA student format (must have a title page and reference page). List word count as
the last line of your Reflection/Conclusion. (word count # ).
Your paper should address the following:
Title Page
Introduction – Family Disaster Plan Scenario
A. You must include research on the dangers and explain the recommended safety measures in a tornado
emergency.
How would you prepare for the following situation?
(Scenario) At this moment, you are sitting at home working on your homework. Suddenly, the National
Weather Bureau sends an alert across your cell phone—a tornado is headed your way. You have 15
minutes before touchdown in your neighborhood.
A. What is your plan? This is a ‘shelter in place’ scenario, you cannot outrun the tornado. Identify a safe place in
your home (residence) to take shelter.
B. Provide realistic examples and explain how you would apply the safety and survival measures you learned in
your research of a tornado emergency to your specific living arrangements.
Example: “I will turn off my utilities before I shelter in place to mitigate damage to my residence.”
Example: “I will take by “go-bags” with me to my shelter in place.
How prepared are you in the event of a disaster?
A. Describe your level of disaster preparedness using specific examples.
Example: “I am more prepared for a water-related disaster than a fire-related disaster even though I live in a
highly secluded, forested area. I have a boat as transportation in the event of flooding, but I do not have rain
barrels or fire barrier supplies on hand.”
Example: “There were many missing items on my preparedness checklist. I realized that I do not own a
flashlight. If I had to use my phone as a light it would drain the battery very quickly.
Reflection/Conclusion
A. Reflect on how prepared you were before this class and compare it with how prepared you are now.
Have you acquired any new emergency items?
Do you plan to take any additional training or certification courses?
Have you shared your knowledge with friends and family?
B. How does what you have learned in this course impact you as a future nurse?
Reference Page
A. Cite and reference at least two (2) scholarly resources using 7th ed APA format.
In a 2-3 page paper,PMHNPs use rating scales for reasons such as screening, collection of information, standardization of data, tracking changes, measuring severity, and formal evaluation of performance. Select a standardized measurement scales for psychiatric practice and briefly summarizes the scale, including the purpose, reliability, internal consistency, and validity. Use evidence-based research to support your data.
The use of spirituality in nursing practice is not new. However, it is more studied and utilized in a more structured format in nursing. Identify and discuss tools used to evaluate spirituality. Please include 500 words in your initial post with three scholarly articles.
Medical Errors – Policy and Procedures (100 points)
Reporting errors in healthcare is an essential component of patient safety.
For this assignment, you will assume that you are a healthcare administrator at a healthcare facility (Hospital, long term care facility, clinic, etc.).
You are tasked with creating a process for reporting errors and reducing adverse events at your facility. Your submission will demonstrate your knowledge of healthcare error reporting to create your process. Be sure to include at least one QI tool and discuss the process involved.
Describe how your process aligns with current practices in KSA. Include current data of medical errors in healthcare settings within KSA and describe what the current gaps are. Your process should address these gaps that are published in the literature.
Your process should include the following:
An identification of the most prevalent and common medical errors in your facility
Risks associated with those medical errors
All individuals (staff, groups, agencies) who will be involved in the reporting process
Design a reporting template and be sure to include any workflow processes or tools can be used in the process
Provide a brief evaluation of departments responsible for following up on the errors and events.
Your report should meet the following structural requirements:
Be five to six pages in length, not including the title or reference pages.
Be formatted according to APA 7th edition Saudi Electronic University writing guidelines.
Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
Utilize headings to organize the content of your work.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
Unformatted Attachment Preview
Medication Errors – Policy and Procedures
Saudi Electronic University
Master of Health Administration
HCM-520: Quality and Performance Imprve
Critical Thinking Assignment, Module: 07
Dr. Bryan Bermeier
G200318352
Sultan Alshehri
March 11, 2022
Introduction
Every day, medication errors occur nationwide. These errors can happen at a hospital,
long-term care facility, rehabilitation facility, or even in home health. Every year, between 7,000
and 9,000 people die from drug errors, affecting over 7 million people, costing over $40 billion
to cure (Tariq et al., 2018).
The most common medication accidents are unreported. By definition, a pharmaceutical
error is “any preventable incidence that results in drug errors that cause patient harm.” While
medications offer many benefits, misuse can bring harm.(Alshammari et al., 2021) They produce
protracted hospital stays, poor outcomes, and poor quality of life. To prevent pharmaceutical
errors, the public must be made aware of their occurrence and consequences. There are several
ways to make medication errors in hospitals.(Alshammari et al., 2021)
A medication error reporting system is essential to safeguard patients by reducing
medication errors. Using CPOE helps eliminate these errors. Intentional drug errors may increase
mortality. Thus, a safe medical environment helps reduce medication errors. To improve patient
safety and treatment quality, Saudi Arabian HCPs must know that everyone must report
medication errors. Understanding existing knowledge and practice is also required to build
specific strategies and plans to enhance them. The Saudi Central Board for Accreditation of
Healthcare Institutions (CBAHI) standards should be utilized to prevent prescription
errors.(Reporting Medical Errors, n.d.) The CBAHI is the official accrediting body for all Saudi
public and private hospitals. The CBAHI sets quality and patient safety standards for all health
care establishments. To analyze healthcare personnel’s comprehension of medication mistakes,
reporting protocols, and predictors of reporting medication errors throughout Saudi Arabian
hospitals.
Common Medical Errors
Medication errors are a big issue in hospitals worldwide. MEs arise in hospitals for
several reasons. Pharmaceutical formulary restrictions need patient substitutions. Hospital
medical mistakes arise for many reasons. A lack of communication can lead to medical mistakes,
such as misdiagnosis . They may arise between a doctor, nurse, public health worker or
patient.(Alshammari et al., 2022) The same occurs for medical errors caused by technology
flaws. Technical failures include implants and medical equipment. Insufficient staffing may also
result in poor staffing patterns, increasing the risk of medical mistakes. Information overload
may also lead to medical errors. Patients are shifted from one hospital or department to another
without sufficient information flow. Not knowing essential facts that might impact prescription
selections can cause complications.(Alshammari et al., 2021)
Every day, doctors mess up. However, this isn’t always the case. Medication mistakes can
be fatal. The most common medication errors are dosage errors; patients must take the dosages
their bodies require. Too much or too little might make you sick. Incorrect dose can occur both
while prescribing and hospitalizing.(Alqenae et al., 2020) Errors in prescriptions arise when
doctors give the wrong medication or fail to address allergies or drug interactions. Wrong Drug
is regularly prescribed or administered. This is a disastrous mistake that affects everyone in
medicine, from doctors to pharmacists. The drug’s method of entrance into your body.(Alqenae
et al., 2020)
Overdosing on prescription medication is another common mistake. The doctor,
pharmacist, or patient may make this mistake. Taking medication at the inappropriate time is
common among the elderly. Patients may be given the wrong medicine or be misled. This leads
to people taking someone else’s prescription, which can be dangerous.(Tariq et al., 2018) Every
day, doctors must deal with a great number of patients, yet everyone must be treated as an
individual, lest the wrong prescription be prescribed.
Risks Associated with Medical Errors
It’s critical to comprehend medical blunders and their causes. The main reason is because
medical mistakes can injure both patients and caregivers, and in the worst instance, cause death.
Incorrect diagnosis might lead to unnecessary or harmful therapy (Tingle, 2017). A misdiagnosis
also means that the patient’s genuine disease would be handled slowly, if at all. Delay in
diagnosis can be as damaging as misdiagnosis. A delayed diagnosis may prevent timely therapy.
The patient’s health may also be threatened if the doctor prescribes the wrong dose or ignores
medication interactions. Doctors and caregivers should extensively evaluate a patient’s clinical
history for allergies and possible medication interactions.(Alharbi et al., 2019)
Adverse Drug Events (ADE) risk factors vary by patient, medication, and provider.
Polypharmacy, or taking more drugs than required, is perhaps the biggest risk factor. Elderly
individuals take more prescriptions and are more susceptible to certain pharmaceutical side
effects than younger patients.(Alsulami et al., 2019) Pediatric patients are particularly
vulnerable, as many drugs for children must be dosed according to weight. Lack of health
literacy and numeracy are also well-documented patient risk factors (the ability to use arithmetic
operations for daily tasks). Patient-level risk factors are probably an under-recognized cause of
ADEs in ambulatory care. Studies reveal that both caregivers (even parents of ill children) and
patients make medication mistakes often.(Alsulami et al., 2019)
The Institute for Safe Medication Practices keeps track of high-risk drugs that might
cause serious patient damage if misused. Drugs with serious side effects are included, as are
medications with identical names and outward appearance but radically distinct pharmacological
qualities. The Beers criteria have typically been used to assess pharmaceutical safety.
Conversely, the STOPP criteria (Screening Tool of Older Person’s Inappropriate Prescriptions)
have been demonstrated to better predict ADEs than the Beers criterion.(Rasool et al., 2020)
Process for submitting a report
When a medication error is identified, the following measures should be followed by
medical professionals: A paper-based reporting form must be filled out and sent within 24 hours
to a pharmaceutical safety office. Then, an inquiry into the incident and its underlying cause
must be conducted. In the website of the Ministry of Health’s General Department of
Pharmaceutical Care, a drug safety officer has documented the inaccuracy.(Alharbi et al., 2019).
One of its main goals is to collect all the information necessary to identify and correct
medication errors, along with the gender and age of patients, prescribed medications (such as the
name, drug category, and route of administration), error details (e.g., date, description, and
contributing factors), and the job level of staff who report and cause them. The reporting of
errors is completely up to the individual members of the medical team. Medical professionals,
patients, and consumers might all be at risk for medication errors, which are defined as any
avoidable incident that could lead to improper drug use and/or injury to patients. Prescriptions
and orders, product labels and nomenclature, packaging and distribution, compounding and
administration are only a few examples of events that may be connected to professional practice
and healthcare items, processes and systems.(Alshammari et al., 2022)
Reporting form
Six Sigma in Minimizing Medical Errors
The hospital can use the six-sigma problem-solving approach to improve the reporting
process and reduce the likelihood of a medical mistake. Six Sigma is a quality improvement
method in healthcare that helps enhance patient care, reduce waste, and eliminate faults like
medical blunders (Trakulsunti & Antony, 2018). Even though Six Sigma is a difficult concept to
grasp, the advantages far outweigh the negatives. Six Sigma teaches healthcare executives how
to manage operations while cutting costs and increasing efficiency. This quality improvement
strategy helps reduce variability in healthcare operations and identify best practices. Six Sigma
also helps manage change and enhance healthcare operations.
Six Sigma can reduce medical mistakes to zero by applying it in the institution. Six
Sigma supports sustainable and quick healthcare delivery (Miglani, 2015). This quality
improvement technique minimizes mortality. It also ensures patient safety, prompt service, and
improved care organization. The Six Sigma approach also decreases work completion time for
diagnostic laboratories and other departments. It also speeds up compensation claim
reimbursement. Six Sigma is crucial in healthcare to provide patient access to information. It also
ensures that patients’ views are considered while making healthcare choices. Ignoring this vital
voice may reduce demand for medical services. This might cost you a lot of money. Six Sigma
technologies are used in hospitals to help improve quality and solve issues(Miglani, 2015). The
DMAIC method is a well-known systematic problem-solving strategy.
DMAIC is a Six Sigma process improvement approach. DMAIC can be used to reduce
medical mistakes in a hospital. First, establish the medical mistake and the reporting process’s
goals. Following the facility’s specialists’ assessment, their performance must be measured.
Patient outcomes and clinical excellence can quantify adjustments or improvements. The
measurement data should be clear and straightforward, reflecting the medical mistake stated.
Then complex techniques are used to analyze the medical mistake. During the Improve stage, the
patient safety plan may need to be tweaked. To measure progress, this step involves a complete
evaluation of the improvements. The control step builds on previous progress. It may require
new policies, procedures, and other methods to ensure care meets DMAIC standards.(Trakulsunti
& Antony, 2018)
Departments Responsible for Following up on Errors
Various departments within a healthcare institution should be involved in tracking
medical mistakes, and each department should have a specific role. The hospital administration,
in particular, should play a crucial role in ensuring that every responsible department is carrying
out its responsibilities on time. The medical department, which is mostly comprised of
physicians, should be the first department to participate in the following-up process. Because
physicians are the ones who order and dispense pharmaceuticals, their department should be
involved in the investigation and follow-up of any medical mistakes that occur (Royce et al.,
2019). Additionally, the pharmacy department, which plays a critical role in the production and
dispensing of medicine, should be included in the follow-up of medication since they have a role
to play if a medical error arises. In addition, Additionally, the nursing department is the other
accountable unit that should be involved in the investigation of mistakes and their resolution.
Due to the fact that nurse practitioners are engaged in both the delivery and monitoring of
medicine, their participation in the follow-up process is essential. The pathology department that
is accountable for the medical error might also be included in the investigation and follow-up.
Because the pathology department is relatively vast, it is necessary to include a specific unit that
is associated with a certain medical mistake in the follow-up procedure.(Alsulami et al., 2019)
Conclusion
Patients’ experiences should be improved while the chance of damage is reduced,
according to practitioners. Despite the best efforts of healthcare professionals, the rate of medical
errors continues to remain high, resulting in significant disability and even death. Medical
mistakes, regardless of how they’re classified, are almost always the consequence of a series of
unfortunate circumstances (Alqenae et al., 2020). Medical mistakes that might have been
prevented have a major influence on healthcare spending, particularly in terms of higher perperson health coverage costs. Only by collaboration between healthcare professionals can the
cost and damage associated with medical mistakes be decreased. As a result, reporting medical
errors in our health-care institutions is an important step in the prevention of medical errors.
Identifying and reporting errors helps to reduce the risks associated with medical errors, which
are always harmful. For practitioners, failure to disclose mistakes may result in administrative
implications as well as an increased risk of legal consequences as a result of the failure to report.
Refrences
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 5
Course name:
HCM
Course number:
101
CRN
•
•
Assignment title or task:
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
College of Health Sciences
Department of Public Health
Guidelines:
•
•
•
•
•
•
•
Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
Technology on Patient Surveys.Please write the opposing Arguments (needs to be 3) Portion of the Paper and why technology may not be best suitable for patient surveys – especially in the healthcare industry.Please have it typed out like a paper-report.
Please break your paper into 3 paragraphs with headings addressing the 3 parts of the rubric. I understand it was difficult if you were in child development centers, but you still need to explain how you demonstrated leadership, interprofessionalism, and basically how it helped you grow as a nurse. Your simulation also offers quite a bit of opportunities for you to think like an RN and prioritize and delegate. If you cannot match the rubric topics to your experience than say that and describe. (Reminder that a paragraph should be no more than 3/4 a page). This paper should be about 1 page in length. (ok if longer)Basically talk about what you learn in the clinical? does it support to your lecture? Communication, nurse to patient, nurse to nurse, around 2-4 page, follow the rubric. I also attached 2 samples she provided. the subject was pediatric nursing and I had nightshift clinical for this term.
Unformatted Attachment Preview
Running head: NURSING EVOLUTION
1
Stephanie Martinez
Nursing Evolution
NURS 307
West Coast University
Professor Dyer
July 30, 2018
Nursing Evolution
2
Reflection on Current Theory and Clinical Class:
Theory and clinical courses supported each other as I was able to visualize and take part
of a health care team collaborating care for my 2-month old patient with epilepsy at Children’s
Hospital, Los Angeles. Theory instruction taught me how to prepare and implement nursing
actions for a lumbar puncture procedure in the hospital; such as maintaining a prone position for
my client post procedure to prevent a headache and implementing seizure precautions. In
addition to supporting my knowledge base for optimum and safe care the Program Learning
Outcomes allowed me to provide health care education for the family of my patient, plan
preventative interventions that were effective and efficient, as well as develop effective
communication to decrease procedure related anxiety, and comply with professional standards of
moral, ethical, and legal conduct in practice for my patient. This gave me a new perspective on
the human experience and how families deal with a child who is ill and the psychological effect
it has on the whole family. As nurses it is important to inquire and analyze many aspects of our
care to ensure the patient is comfortable and safe within our scope of practice. Social and cultural
aspects of this course enabled me to learn how this affects parents and how their different views
influence the way children’s care is delivered. For example, Spanish speaking families may have
difficulty understanding the course of disease and the care that is being coordinated.
Communication Style:
I developed effective communication for interacting with my patients and their families,
as well as the health care team of RN’s, doctors, RT’s, and patient care associates by providing
holistic, patient centered nursing care to children from ages 2 months to 20 years of age. I
communicated with the healthcare team in a professional manner by making direct eye contact
Nursing Evolution
3
and correctly documenting findings and observations. I was in constant communication with my
charge nurse to ensure I communicated changes in condition and vital signs that were out of the
patients baseline. The population I served consisted of caucasian and hispanic origin and I was
sensitive to their needs by answering questions, directing them to the proper personnel, and
inquiring how they felt about the care being provided. During rounds I communicated the
importance of medications, procedures, as well as psychosocial understanding. I made sure to
listen to their needs by making eye contact when appropriate, leaning slightly forward, in a
relaxed position without making them feel rushed.
Leadership:
I demonstrated leadership by providing safe, quality nursing care under my instructors directions
and enabling coordination within a health care team. I was confident and made sure to complete
my tasks of patient rounds, documentation, and effective communication was completed prior to
moving on to the next task. I took accountability for every action I took and the effect it had on
the care delivered under my responsibility. I was able to make independent decisions such as
post care for lumbar procedure using evidence based practices that were taught in class which led
to high quality nursing care. I implemented seizure precautions without the need for constant
direction and reported vital signs that were out of the norm for a 2-month old client to the RN.
Rounds were made taking into consideration the patients views and and cultural practices. I was
also able to collaborate with my fellow clinical nursing classmates and assisted them in showing
them how to document and find sources on the electronic medical administration record to lead
to better care delivery.
Nursing Evolution
4
Running head: NURSING EVOLUTION
Nursing Evolution
Nicollete Juarez
NURS 307 – Developing Family and Community
West Coast University
1
NURSING EVOLUTION
2
Nursing Evolution
The theory class helped me understand the foundation of nursing pediatric care by
learning the basic information that served as my basic foundation knowledge I significantly
needed to become successful in my clinical experience during this term. Learning how children
transition through different stages of development, acquiring knowledge about major health
promotion and disease prevention concepts, application of nursing process to pediatric patient
population suffering from different types of acute and chronic diseases, nutritional requirements
for pediatric requirements and current issues regarding health care in theory class allowed me to
apply the concept of nursing process and critical thinking during patient care and support and
performed the therapeutic nursing interventions specific for the patients and families assigned to
me during clinical rotations.
During my clinical rotation this term, I have provided holistic patient centered care by
utilizing therapeutic communication not only with my patient but also to their family members. I
was able to prioritize their needs and provided it with the highest quality of care that meets the
standard protocol of my clinical site. I was able to participate in a collaborative care for the
patient assigned to me. I was assigned to an eight-year-old male patient who was admitted to the
pediatric intensive care unit of the hospital. The charge nurse asked me to take the patient’s
temperature and assisted her in providing personal care to the patient such as removing the soiled
diaper and changed it to a new one, provided oral care, and repositioned the patient. During the
care, the patient had an episode of seizure which lasted about three minutes. The charge nurse
who was with me at that time, instructed me to watch the clock to remember when the seizure
started and asked me to time the duration of the seizure. She also yelled out for the rest of the
staff to inform them that the patient was having a seizure. She asked me to help her turn the
NURSING EVOLUTION
3
patient to the left side while she gave instructions to the LVN and another RN nurse in the room.
The charge nurse also gave instructions to the Respiratory therapist as the patient’s oxygen
dropped to 72 %. I have never witnessed a child had a seizure prior to that day and it was really
intense. After the seizure stopped, the nurses and Respiratory therapist worked on the patient to
stabilized him. I assisted by attending to their every request such as getting them new towels,
diaper, wipes, etc.
I have seen a lot of situations where the application of leadership concepts and skills and
decision making were done to ensure that high quality nursing care, healthcare team coordination
and collaborative care happens. In addition to the seizure episode event that I already described
above, I wanted to share that the same team I mentioned above had shown excellent care to the
same patient while I was there throughout the day. They were able to assess the patient and
quickly identify that his health status was declining really fast. They were able to render and
implemented therapeutic nursing interventions by constantly and effectively communicating with
the primary doctor, the pharmacy, the laboratory and diagnostic department, and family. The
patient had three more episodes of seizure lasting about three to four minutes and the last
episode, the patient became unstable and unresponsive. The team followed protocol on what to
do during a seizure on every seizure episode the patient had. After the last seizure, they were
quick to determined that the patient’s status became unstable and the doctor decided that he
needed to intubate the patient. As soon as the doctor told them the plan, everyone worked into
action. The charge nurse called the pharmacy to order the medications needed for intubation, the
respiratory therapist gathered her equipment for ventilation support, the LVN and other RN
started another IV line on the patient and the primary doctor provided oversight and made sure
that everyone is up to the task. I witnessed how quickly everyone moved to gather all the
NURSING EVOLUTION
4
necessary tools, equipment and medications needed and completed the intubation procedure. The
situation was intense, emotional and chaotic but I would say that it was an organized chaos. I
could tell from everyone’s faces who collaborated in that patient’s care that they were under a lot
of pressure and stress, but they worked cautiously, effectively and safely trying to save the
patient’s life. The doctor took charged of the situation by respectfully telling his team on what
they needed to do. The team which included of two RNs, one LVN and one Respiratory
therapist, effectively communicated with one another, did the tasks assigned to them by the
doctor and most importantly, they showed support to one another during the entire ordeal and
setting their differences and emotions on the side.
Lecture Notes Module 8: Revenue Cycle Management_ATI.pdfArticle: What Is Healthcare Revenue Cycle Management?Video: Medical Billing – The Revenue Cycle, Co-Pays, Claims, Deductibles and More!2. You have just been hired in your first job as a medical practice administrator.Your top priority, according to the doctors, is to “fix the billing department” What are four indicators/benchmarks you will identify to determine what needs to be “fixed”
Lupton, D. (2015) The pedagogy of disgust: the ethical, moral, and political implications of using disgust in public health campaigns. Critical Public Health, 25(1): 4-14.
Controversy has swirled over the past three decades about the ethics of fear-based public health campaigns. The evidence has increasingly suggested that fear-based campaigns work and emotionally-charged public health messages have, as a consequence, become more commonplace.
The HIV/AIDS epidemic provided a context in which advocacy groups were almost uniformly hostile to any use of fear, arguing that it was inherently stigmatizing and always backfired. Although this argument was often accepted within public health circles, surprisingly, some bioethicists felt that fear could actually increase autonomy because such campaigns may help populations understand health risk “in their guts.”
Find a link to a PSA that is fear-based and post it to this board.
Then, discuss your views on fear-based public health campaigns in general.
Are they ethical?
What are the limits of such campaigns—how far can they go?
Do you believe that they are stigmatizing?
Topic: The prevalence and impact of substance abuse among nurses (impaired nursing
You must use the PowerPoint presentation template provided at the top of this assignment.
You are to create bullet points for each slide, not including the title and reference slides. Every slide must have a speaker note with a minimum of 4-5 sentences addressing the bulleted items on the slide.
Include a minimum of 4-5 peer-reviewed research articles as references in the presentation. All research articles need to have been published within 5 years from today’s date. No blog, chat, other university or Wikipedia information allowed in presentation. The PowerPoint presentation must follow current APA style.
Your presentation should only include the following slides:
Title slide
Why the topic was chosen
How your topic impacts nursing practice
Current relevance of the topic
Clinical Practice Integration
Plan for lobbying: Describe your plan on what and how you would lobby your legislators or local government for funding and support for your chosen issue/trend.
Conclusion
Reference slide
High Turnitin scores will be evaluated on an individual basis and may result in points deducted and/or a grade of “zero” for the assignment. Use the Turnitin Plagiarism Check to upload your assignment and verify your plagiarism score before submitting your assignment.
You will need to follow these steps below for saving your PowerPoint so that your speaker notes are visible:
Open your PPT and go to “file” in top left corner.
Click “print” option. Make sure “print all slides” and “print slides with notes” is selected.
Go to “Save As” on the left hand side and be sure you save as a PDF.
Under your save as selection, click “more options”. Select the “Options” button and click the “Publish What” pull-down and then select “Notes Pages.” (If you click slides it will not show the speaker notes)
Click “OK.”
Complete your selection process by checking “Open file after publishing” and selecting the “Optimize for: ‘Standard’ and ‘Minimum Size’” choices.
Click on “Save” next to the “Tools” button at the bottom of the box.
Windows: https://support.microsoft.com/en-us/office/print-your-powerpoint-slides-handouts-or-notes-194d4320-aa03-478b-9300-df25f0d15dc4#OfficeVersion=WindowsLinks to an external site.
Mac: https://support.microsoft.com/en-us/office/print-your-powerpoint-slides-handouts-or-notes-194d4320-aa03-478b-9300-df25f0d15dc4#OfficeVersion=macOSLinks to an external site.
Rubric
Week 8 PowerPoint Presentation
Week 8 PowerPoint Presentation
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIdentification, definition, and description of topic, background & why topic was chosen
24 pts
Meets or Exceeds Expectations
Provides an exemplary and insightful analysis of the identification, definition, description and background of the topic & why it was chosen
18 pts
Mostly Meets Expectations
Provides accurate identification, definition, description and background of the topic & why it was chosen
12 pts
Approaches Expectations
Provides partial identification, definition, description and background of the topic & why it was chosen
6 pts
Below Expectations
Provides limited identification, definition and description and background of the topic & why it was chosen
0 pts
Does Not Meet Expectations
Missing identification, definition and description and background of the topic & why it was chosen
24 pts
This criterion is linked to a Learning OutcomeHow the topic impacts nursing
24 pts
Meets or Exceeds Expectations
Presents an exemplary and insightful analysis of the current issue and trend and how the topic impacts nursing
18 pts
Mostly Meets Expectations
Presents an accurate analysis of the current issue and trend and how the topic impacts nursing
12 pts
Approaches Expectations
Presents a partial analysis of the current issue and trend and how the topic impacts nursing
6 pts
Below Expectations
Provides limited explanations of the current issue and trend and how the topic impacts nursing
0 pts
Does Not Meet Expectations
Lacks understanding for the current issue and trend and how the topic impacts nursing
24 pts
This criterion is linked to a Learning OutcomeCurrent Relevance
24 pts
Meets or Exceeds Expectations
Presents an exemplary and insightful analysis of the current relevance of the issue and trend in nursing
18 pts
Mostly Meets Expectations
Presents an accurate analysis of the current relevance of the issue and trend in nursing
12 pts
Approaches Expectations
Presents a partial analysis of the current relevance of the issue and trend in nursing
6 pts
Below Expectations
Provides limited explanations of the current relevance of the issue and trend in nursing
0 pts
Does Not Meet Expectations
Lacks understanding of the current relevance of the issue and trend in nursing
24 pts
This criterion is linked to a Learning OutcomeClinical Practice Integration
24 pts
Meets or Exceeds Expectations
Presents an exemplary and insightful analysis of how the current issue and trend is integrated into clinical nursing practice
18 pts
Mostly Meets Expectations
Presents an accurate analysis of how the current issue and trend is integrated into clinical nursing practice
12 pts
Approaches Expectations
Presents a partial analysis of how the current issue and trend is integrated into clinical nursing practice
6 pts
Below Expectations
Provides minimal analysis of how the current issue and trend is integrated into clinical nursing practice
0 pts
Does Not Meet Expectations
Lacks understanding of how the current issue and trend is integrated into clinical nursing practice
24 pts
This criterion is linked to a Learning OutcomePlan for lobbying
24 pts
Meets or Exceeds Expectations
Presents an exemplary and insightful analysis of the importance of lobbying legislators or local government for support funding. Offers detailed and specific examples of current legislation regarding the effect on current clinical practice settings
18 pts
Mostly Meets Expectations
Makes accurate connections to the importance of lobbying legislators or local government for support funding. Offers some detailed examples of current legislation regarding the effect on current clinical practice settings
12 pts
Approaches Expectations
Makes partial connections to the importance of lobbying legislators or local government for support funding. Offers few detailed examples regarding effect on current clinical practice settings
6 pts
Below Expectations
Provides insufficient connections to the importance of lobbying legislators or local government for support funding. Offers no details and/or examples regarding effect on current clinical practice settings
0 pts
Does Not Meet Expectations
Information is missing. Response indicates no understanding of the importance to lobby for any support funding
24 pts
This criterion is linked to a Learning OutcomeCreativity and Professionalism
10 pts
Meets or Exceeds Expectations
Includes an exemplary visual presentation (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains no spelling, grammatical, and/or mechanical errors. References and citations contain no APA errors. Sources include peer-reviewed, research-based articles, within last 5 years
7.5 pts
Mostly Meets Expectations
Includes an adequate visual presentation (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains 1-3 spelling, grammatical, and/or mechanical errors. References and citations contain 1-3 APA errors. Most sources include peer-reviewed, research-based articles, within last 5 years
5 pts
Approaches Expectations
Include partial (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains 4-6 spelling, grammatical, and/or mechanical errors. References and citations contain 4-6 APA errors. Few sources include peer-reviewed, research-based articles. Sources are >5 years old
2.5 pts
Below Expectations
Include few (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains >7 spelling, grammatical, and/or mechanical errors. References and citations contain greater than 6 APA errors. Sources are included, but are not current, not peer-reviewed, and/or are not research-based articles
0 pts
Does Not Meet Expectations
Template was not used. No visuals were included. Writing contains many spelling, grammatical, and/or mechanical errors. No reference or citations were included.
This assignment aims to deepen your understanding of mental health conditions, therapeutic interventions, and ethical considerations in mental health nursing. You will be provided with a case study featuring a patient with a mental health condition. Your task is to analyze the case and answer the corresponding question.
Case Scenario:
A woman is admitted to the adult inpatient behavioral health unit after experiencing flashbacks to her rape that occurred when she was a 12-year-old girl while at her babysitter’s. She was raped by the babysitter’s 15-year-old son and three of his friends. Upon admission, the client is quiet, curled on her side in the fetal position on the bed, and rejecting of others who enter her room, shrinking to the far side of the bed whenever any person opens her door. Her sister, who accompanied her to the hospital, tells you that the client has been like this since a news story appeared last week about a young girl being abducted from a mall and beaten and raped by several teenage boys. The client has not eaten, slept, or gone to work since hearing the news account. (Learning Objective: 2, 3, 4, 5)
a. What trauma/stress-related disorder is this client experiencing? What risk factors does she exhibit?
b. List at least two treatment interventions that are viable options to assist the client at this time.
Instructions
Read Thoroughly: Familiarize yourself with the case, noting key elements like symptoms, medical history, and social factors affecting the patient.
Research: Conduct scholarly research to better understand the condition presented in the case study. Use at least five peer-reviewed articles to support your analysis.
Ethical Considerations: Examine any ethical considerations associated with the case. For example, consider patient consent, confidentiality, and duty of care.
Reflection: Write a 300-word reflection on what you have learned from this assignment and how it will impact your future practice
Create one Word documents containing all parts of the assignment.
Format your document with one-inch margins and 12-point Times New Roman font.
One page, double-spaced for each part.
Instructions: Part 1
1. -Read Capko, Chapter 1: ” Managing Revenue to Maximize Profit” Provide a summary of the three key points (one paragraph each) that you have learn from the chapter.
-In your opinion, what is the one biggest challenge for successful revenue cycle managment ?
Instructions: Part 2
Provide a one page summary of the article “What is healthcare revenue cycle management.” https://revcycleintelligence.com/features/what-is-healthcare-revenue-cycle-management
Student Name West Coast University Amber McCall 10/22/2023 Week 7 Case Video PresentationA. You will produce a 4–7 minute audio-video presentation: Topic Define and describe the pathophysiology of diverticular disease of the colon. In your presentation, include the following: Include at least one type of visual aid in your presentation, such as PowerPoint slides, diagrams, whiteboard use, etc. You are expected to explain the processes or concepts in your own words using references to support your explanations. Include a reference list at the end and cite references verbally or with on-screen citations. Use appropriate master’s level terminology. Include all necessary physiology and/or pathophysiology in your explanation. Use detailed explanations to teach or explain. Your audience is your classmates and professional colleagues. Reference at least two sources; you may cite your e-text as a source. Use APA format to style your visual aids and cite your sources. Include a reference page in your video. Your presentation must include both audio and visual components and be professional in nature. B. Presentation Reflection and Analysis Consider what you’ve learned about the topic you presented an answer the following questions: How does this topic relate to something you might see in clinical practice?Which ideas make the most sense and why? How does this topic to current events?What might make this problem more treatable? Use at least one scholarly source besides your textbook to connect your response to national guidelines and evidence-based research to support your ideas.
I need a Power Point that can help me elaborate this education presentation video.
For your signature assignment, you will create a short 3 to 5-minute patient education video. The video is intended to be a teaching tool that you could use for a patient and family who is newly diagnosed with a psychiatric illness.
Select one of the following diagnoses covered this term: Major Depressive Disorder, Generalized Anxiety Disorder, Bipolar Disorder, Schizophrenia, Attention Deficit/ Hyperactivity Disorder, Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, and Eating disorder.
Create a patient education video using an innovative platform such as Biteable, Animaker, Canva, or other video creation tool. The video should include:
A description of the diagnosis and common symptoms using lay terms
A holistic treatment plan that includes: One medication, one specific therapy, and one evidenced-based non-pharmacologic treatment that is used for this diagnosis. Briefly explain how each will help the patient.
Appropriate resources for patients to get further information and/ or support
The last slide should include your references
Week 6
Practice Problem Analysis and Presentation
ASSIGNMENT
PURPOSE
The purpose of this assignment is to critically evaluate a practice problem idea you identified. This assignment builds on the Week 4 assignment. Information used in the Week 4 assignment may be used as a basis for this assignment. The goal is to develop a deeper understanding of the identified practice problem idea, using two continuous quality improvement tools, specifically, a Failure Mode and Effects Analysis (FMEA) and an Ishikawa (fishbone) cause and effect diagram to analyze, improve, and mitigate related risks. This assignment will allow you to apply competencies through sequential development of workflow steps in relation to an identified practice problem idea and promotion of presentation skills. Assignment content supports professional formation, communication, and dissemination skills relevant to the DNP-prepared nurse.
INSTRUCTIONS
This assignment has four components:
Identified practice problem idea in PICOT format
Failure Mode and Effects Analysis
Ishikawa (Fishbone) cause and effect diagram
Professional PowerPoint with speaker notes at the bottom of each slide to disseminate information
Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.
Consider the identified practice problem idea used in the Week 4 translation science project including PICOT, background, and significance. Incorporate course faculty feedback from the Week 4 assignment.
Review the examples of the failure mode and effects analysis and fishbone diagram in the Week 4 Explore section of the course called Evidence-Based Practice: Improving Outcomes.
Download the required documents inserted in the guidelines:
Link (PPT): PowerPoint TemplateLinks to an external site.
Link (Word doc): Failure Mode and Effects Analysis TemplateLinks to an external site.
Link (Word doc): Ishikawa Fishbone Template ALinks to an external site. (Word 2016 or higher)
Link (Word doc): Ishikawa Fishbone Template BLinks to an external site. (older version of Word)
Complete the failure mode and effects analysis and then the Ishikawa fishbone diagram. The Ishikawa fishbone diagram requires Word 2016 to download. If you do not have the Word 2016 version, you may update your current version of Word (click on the following link for instructions: Office 365Links to an external site.) or use the alternative version provided or create your own fishbone diagram as long as you are addressing the five areas:
People
Environment
Materials
Methods
Equipment
Create the PowerPoint Presentation.
The assignment should include the following components. Use the templates provided for the assignment.
Introduction (1 slide)
Title of Practice Problem Analysis Presentation
Student Name
Assignment Title
Course Faculty Name
Practice Problem Identification (1-3 slides)
State identified practice problem as a PICOT question in question format.
Identify all PICOT components.
Describe the background and significance of the identified practice problem idea (cited).
Develop inclusion criteria for the population of interest.
Develop exclusion criteria for the population of interest.
Failure Mode and Effects Analysis (1-2 slides)
Identify three steps in the identified practice problem idea process with potential breakdown or process gaps.
Identify at least one potential error (failure mode) for each of the three process steps.
Identify at least one possible cause of failure (failure cause) for each of the three process steps.
Identify at least one adverse consequence (failure effect) for each of the three process steps.
Using a scale 1-10, rate likelihood of occurrence of failure for each process step.
Using a scale 1-10, rate likelihood of detection of failure for each process step.
Using a scale 1-10, rate likelihood of severity of harm if failure occurs for each process step.
Calculate the Risk Profile Number (Multiply likelihood of occurrence X likelihood of detection X likelihood of severity or harm).
Summarize FMEA analysis.
Note: The following article has scoring guidelines for FMEA ratings which may be helpful.
Warnick, R. E., Lusk, A. R., Thaman, J. J., Levick, E. H., & Seitz, A. D. (2020). Failure mode and effects analysis (FMEA) to enhance safety and efficiency of Gamma Knife Radiosurgery.Links to an external site. Journal of Radiosurgery and SBRT, 7, 115-125.
Ishikawa (Fishbone) Cause and Effect Diagram (1-2 slides)
Identify people involved in the identified practice problem idea.
Identify the environment in which the identified practice problem idea occurs.
Identify the materials used.
Identify the methods used.
Identify the equipment used.
Summarize cause and effect analysis.
Evidence-Based Intervention (1 -2 slides)
Identify the evidence-based intervention for your identified practice problem idea (listed in PICOT).
Identify barriers to overcome based upon what you learned from the FMEA and Fishbone Analyses.
Discuss feasibility of the evidence-based intervention.
Conclusion (1 slide)
Summarize the purpose and findings of the analysis.
Provide and justify the main conclusions.
Draw inferences from the quality improvement analysis.
References (1 slide)
Include in-text citations used in the presentation.
Provide complete matching references in correct APA format.
Include minimum of four scholarly sources.
WRITING REQUIREMENTS
Length: Maximum of 14 slides
Standard English usage and mechanics
APA format guidelines for in-text citation and references
Clear, succinct, and readable slides
Elaboration on the slide questions
Speaker notes section with legible comprehensive notes for each slide
GRADUATE RE-PURPOSE POLICY
The late assignment policy and the reuse repurpose policy (located in the student handbook) apply to this assignment.
PROGRAM COMPETENCIES
This assignment enables the student to meet the following program competencies:
Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
COURSE OUTCOMES
This discussion enables the student to meet the following course outcomes:
Assess the impact of informatics and information technology on organizational systems, change, and improvement. (PCs 2, 4; PO 6)
Design programs that monitor and evaluate outcomes of care, care systems, and quality improvement. (PC 4; PO 7)
Appraise consumer health information sources for accuracy, timeliness, and appropriateness. (PC 4; PO 7)
Resolve ethical and legal issues related to the use of information, communication networks, and information and patient care technology. (PCs 2, 4; PO 6)
Write a paper in APA Style that discusses each of the AACN Essentials and describe how you met each essential. Incorporate evidence from your previous Nursing Evolution assignments, as well as detailed examples from your didactic, skills lab, and clinical rotations.
For each essential include the following:
A brief summary explanation of the essential that is cited with at least one scholarly source
At least one example of how you met the essential during your nursing program
Review the rubric for more information on how your assignment will be graded.
AACN Essentials Paper
Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice
First Paragraph for each Essential: The student provides an accurate and concise summary paragraph for each Essential. All summary descriptions expertly identify key aspects of each essential. Every essential is supported with at least one scholarly source. You need to cite your source(s) like the ACCN Essentials pdf that was provided.
Second Paragraph for each Essential: At least one detailed and explicit example of how the student met each essential during the nursing program is provided for all nine Essentials. The student expertly synthesizes and incorporates significant feedback, concepts, and ideas from the week’s discussion into the assignment. It is evident that the student has thoroughly reflected upon and met the nine essentials.
Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety
Essential III: Scholarship for Evidence Based Practice
Essential IV: Information Management and Application of Patient Care Technology
Essential V: Healthcare Policy, Finance, and Regulatory Environments
Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes
Essential VII: Clinical Prevention and Population health
Essential VIII: Professionalism and Professional Values
Unformatted Attachment Preview
Faculty Tool Kit
NURSE FACULTY TOOL KIT FOR THE
IMPLEMENTATION OF THE BACCALAUREATE ESSENTIALS
February 19, 2009
Table of Contents
Page
Overview
2
Integrative Learning Strategies
Essential I
Essential II
Essential III
Essential IV
Essential V
Essential VI
Essential VII
Essential VIII
Essential IX
3
4
4
5
6
6
7
8
8
10
Opportunities for Program Enhancement
11
Helpful Web links, including Stakeholders
19
AACN Presentations
22
References/Bibliography
23
1
OVERVIEW
The purpose of the Baccalaureate Essentials Tool Kit is to provide resources and
exemplars to assist faculty with the implementation of the Essentials of
Baccalaureate Education for Professional Nursing Practice (2008). The tool kit
provides integrative learning strategies, opportunities for program enhancement, and
resources that will assist faculty with the integration of the Baccalaureate Essentials
throughout the nursing curriculum. This tool kit includes a review of the nine
Baccalaureate Essentials followed by Integrative Learning Strategies, Opportunities
for Program Enhancement, Web Links, AACN Presentations, and References.
Baccalaureate Essentials
Essentials I through IX delineate the outcomes expected of graduates of baccalaureate
nursing programs. Achievement of these outcomes will enable graduates to practice
within complex healthcare systems and assume the roles: provider of care;
designer/manager/coordinator of care; and member of a profession.
The nine Essentials are:
• Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice
o A solid base in liberal education provides the cornerstone for the practice and
education of nurses.
• Essential II: Basic Organizational and Systems Leadership for Quality Care and
Patient Safety
o Knowledge and skills in leadership, quality improvement, and patient safety
are necessary to provide high quality health care.
• Essential III: Scholarship for Evidence Based Practice
o Professional nursing practice is grounded in the translation of current
evidence into practice.
• Essential IV: Information Management and Application of Patient Care
Technology
o Knowledge and skills in information management and patient care technology
are critical in the delivery of quality patient care.
• Essential V: Healthcare Policy, Finance, and Regulatory Environments
o Healthcare policies, including financial and regulatory, directly and indirectly
influence the nature and functioning of the healthcare system and thereby are
important considerations in professional nursing practice.
• Essential VI: Interprofessional Communication and Collaboration for
Improving Patient Health Outcomes
o Communication and collaboration among healthcare professionals are critical
to delivering high quality and safe patient care.
• Essential VII: Clinical Prevention and Population Health
o Health promotion and disease prevention at the individual and population
level are necessary to improve population health and are important
components of baccalaureate generalist nursing practice.
2
•
•
Essential VIII: Professionalism and Professional Values
o Professionalism and the inherent values of altruism, autonomy, human
dignity, integrity, and social justice are fundamental to nursing.
Essential IX: Baccalaureate Generalist Nursing Practice
o The baccalaureate-graduate nurse is prepared to practice with patients,
including individuals, families, groups, communities, and populations
across the lifespan and across the continuum of healthcare environments.
o The baccalaureate graduate understands and respects the variations of
care, the increased complexity, and the increased use of healthcare
resources inherent in caring for patients (AACN, 2008).
INTEGRATIVE LEARNING STRATEGIES
Achievement of outcomes delineated in the Essentials of Baccalaureate Education for
Professional Nursing Practice (2008) is enhanced through the intentional use of active,
collaborative, and integrative learning strategies. The American Association of Colleges
& Universities (AAC&U 2004) defines Integrative Learning Strategies as powerful,
active, and collaborative instructional methods that thread general education concepts
throughout the major. Integrative learning strategies, as used in this document, expand on
this definition and includes the integration of:
• liberal education throughout the nursing curriculum
• practice with theory
• practice knowledge and theory across essentials
• active learning strategies throughout the curriculum
• interprofessional learning opportunities; and
• learning activities across academic disciplines
The purpose of this document is to provide nursing programs with examples of
educational approaches that actively engage the learner and integrate liberal education,
nursing science, clinical reasoning, and ethical considerations into both classroom and
clinical learning. These examples are provided as a starting point to develop learning
activities for the preparation of entry-level professional nurses and may be relevant to
more than one essential. The learning strategies include a variety of methods, such as
unfolding case studies, simulation, and reflective practice exercises to assist with
implementation of a well-integrated curriculum based on the AACN’s Baccalaureate
Essentials. By their nature, integrative learning strategies listed in this document may
address more than one of the Baccalaureate Essentials.
The following integrative learning strategies were developed by the American
Association of Colleges of Nursing (AACN) Task Force on the Revision of the Essentials
of Baccalaureate Education for Professional Nursing Practice with input from
participants at regional meetings held across the Unites States in 2007-2008. These
strategies are consistent with the work of the AAC&U (2007) and the Carnegie
Foundation’s (In press) ongoing work on education in the professions.
3
Examples of Integrative Learning Strategies
Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice
•
•
•
•
•
•
•
•
•
•
•
Provide local, national, and international experiences, framed by reflective
questions, in a variety of cultures, organizations, and communities.
Promote activities and projects with students from the arts, humanities, and
sciences to address community issues or problems.
Use collaborative learning projects to build communication and leadership
skills.
Engage in community-based activities to promote ethical reasoning, advocacy,
collaboration, and social justice.
Provide opportunities to reflect on one’s own actions and values to promote
ongoing self-assessment and commitment to excellence in practice.
Provide guided exploration of diverse philosophies, ways of knowing, and
intellectual approaches to problem solving.
Use simulation exercises and case-based scenarios with students from other
academic disciplines such as history, religion, business, and engineering.
Provide direct experiences integrating artistic ways of knowing such as the
arts, cinema, poetry, literature, and music to enhance the practice of nursing.
Provide opportunities to observe and participate in various cultures through
study abroad.
Participate in interprofessional service learning activities such as health
promotion and disease prevention projects for diverse populations.
Use writing intensive assignments to promote reflection, insight, and
integration of ideas across disciplines and courses.
Essential II: Basic Organizational and Systems Leadership for Patient Safety and
Quality Care
•
•
Provide leadership experiences in a variety of organizations and communities.
Provide opportunities for students to:
o Engage in practice settings to build communication and leadership
skills.
o Communicate with recognized leaders to solve healthcare practice
problems.
o Develop a leadership or quality improvement project that spans several
courses (e.g., review literature about a practice problem in one course,
propose a practice change based on an evidence-based model in a
second course, and then present the practice change to appropriate
stakeholders in a third course).
o Shadow a leader and reflect on the experience.
o Engage in quality improvement/patient safety activities to promote an
understanding of the organizational process, unit application, and
evaluation process.
4
o Participate in quality improvement activities and/or required
regulatory reporting systems.
o Participate in interprofessional performance improvement team
currently working on implementation/evaluation of national patient
safety goals.
o Propose an innovative solution to a system-related patient care
problem identified in one’s clinical practice.
o Conduct a mock root cause analysis on a near miss and share results
with staff or shared governance council.
o Participate in an actual Root Cause Analysis (RCA) and/or Failure
Mode Effects Analysis (FMEA).
o Role-play with nursing and medical students using Situation,
Background, Assessment, Recommendation (SBAR) communication
o Attend a professional nursing organization meeting and identify
personal development opportunities.
o As students examine various microsystem committees, identify one for
more in-depth exploration.
Essential III: Scholarship for Evidence-Based Practice
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•
•
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Ask students to select a clinical topic, search for evidence, and identify the level
of evidence for each sample of evidence.
Create journal clubs where students critique a primary nursing research article and
its relevance to their clinical practice.
Group students according to a clinical issue of interest, conduct a systematic
review, and debate the rigor of selected research studies.
Use controversial case studies to promote discussion about decision making and
the evidence that supports those decisions (e.g., If you dropped the patient’s last
pill, and each pill costs $35 …would you use it? or if a terminally ill patient asks
you if he is dying, would you be truthful?).
Collaborate with librarians to conduct comprehensive and efficient searches on
clinical topics.
Provide a sample of nursing journals and ask students to identify a research article
and determine the type and level of evidence included.
Assign student peer review of a student colleague’s paper.
Provide opportunities/assignments for student to:
o Identify clinical questions in PICO (Patient problem, Intervention,
Compare, Outcome) format and conduct searches for current evidence
using the PubMed PICO search feature.
o Examine the evidence for an existing policy or procedure using multiple
sources (e.g. Cochrane, AHRQ, CINAHL, PubMed).
o Apply specific criteria to evaluate health information resources for lay and
professional use as well as to discuss the ethical implications of
commercial sources that target laypersons.
5
o Collaborate with clinical partners to identify practice problems, formulate
evidence-based conclusions and recommendations, and present findings in
poster format to staff and class.
o Apply evidence-based practice models to assess the applicability and
feasibility of new findings to practice.
o Cite sources of evidence for planned interventions.
o For assigned patients, compare observed practices with published practice
standards.
o Link how individual nursing actions are related to recognized nurse
sensitive quality indicators.
Essential IV: Information Management and Application of Patient Care Technology
•
Provide opportunities/assignments for students to:
o Use information and patient care technology to communicate
effectively with members of the healthcare team.
o Use clinical evidence and research to base and validate practice
decisions related to information management and patient care
technology.
o Participate in quality improvement activities and required regulatory
reporting through information systems.
o Employ a range of technologies that support patient care, such as
electronic health and medical records, patient monitoring systems, and
medication administration systems.
o Use simulation and electronic medical records to access and analyze
data relevant to the patient situation.
o Use information technology resources such as Wiki, Second Life
simulation, or SkyScape.com to communicate with other healthcare
professionals or students in other disciplines regarding a joint project.
o Develop a professional e-portfolio.
Essential V: Healthcare Policy, Finance, and Regulatory Environments
•
Provide opportunities/assignments for students to:
o Observe a state board of nursing hearing and reflect on how the state
practice act protects the welfare and safety of the citizens.
o Participate with national or state nursing associations in activities such as
“lobby day”.
o Review proposed legislation affecting health care and provide written
comments.
o Attend national or state congressional hearings on healthcare issues.
o Observe testimony at a state legislative or regulatory hearing on a
healthcare issue focusing on access to care or patient advocacy.
6
o Provide written or verbal feedback on the ethical, financial, and social
implications of the testimony observed and recommended policy changes.
o Compare the costs of common diagnostic tests, procedures, and
medications charged to insurance companies vs. self-pay patients.
o Explore the costs and availability of care options for patients with
dementia or a psychiatric/mental health illness in your local community.
(What does private health insurance cover? Medicaid? Medicare?).
o Develop a lobbying plan for an identified issue that includes a concise (30
seconds or less) oral synopsis for a decision maker and a one-page policy
memo.
o Participate in advocating for change in policy related to a selected
healthcare issue at the local, state, or national level.
o As an interprofessional group, role play a legislator, proponent and
opponent for a healthcare or professional issue.
o Analyze a hospital bill for one day of care in an acute setting and identify
where nursing services are embedded.
o Compare one or more healthcare systems in other countries with the U.S.
system, including costs, services provided, and outcomes, (e.g., pre-and
postnatal care, role of midwife and other healthcare professionals/workers,
insurance coverage, maternity/paternity leave).
o As an interprofessional group, develop a policy (new or revised) to
address an issue identified in a practice setting. Delineate processes for
getting policy adopted and implemented within that practice setting.
Essential VI: Interprofessional Communication and Collaboration for Improving
Patient Health Outcomes
•
Provide opportunities/assignments for students to:
o Engage in case study discussions/dialogue with a variety of healthcare and
other professionals.
o Participate in interprofessional collaboration (e.g., grand rounds,
community coalition meetings).
o Work in interprofessional and intraprofessional teams on course
projects/assignments.
o Engage in interprofessional and intraprofessional care in simulation labs.
o Develop interprofessional community projects.
o Assess group dynamics of an interprofessional or intraprofessional group .
o After attending a professional meeting of another healthcare profession,
compare and contrast professional perspectives.
o Participate on interprofessional teams at national competitions (e.g.,
Clarion Interprofessional Team Case Competition at the University of
Minnesota, National Student Nurses Association).
o Participate in campus-wide student governance and committees.
o Organize activities for National Primary Care Week as a student
ambassador.
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Essential VII: Clinical Prevention and Population Health for Optimizing Health
•
Provide opportunities/assignments for students to:
o Analyze health behavior(s) of self or others using models or theories.
o Participate in individually-focused clinical prevention activities such as:
teaching about and providing immunizations
improving adherence to tuberculosis chemoprophylaxis through
health teaching and directly observed therapies
providing health counseling regarding smoking cessation, stress
management, exercise, and diet
teaching about and encouraging cancer screening
conducting basic environmental exposure history regarding
pesticides
conducting basic genetic health screening and referring high risk
individuals to genetic services
assessing a home environment and health counseling to prevent
falls in older adults
identifying and intervening in elder abuse;
o Use clinical practice guidelines for planning and/or evaluating clinical
prevention interventions.
o Participate in community or population-focused assessment.
o Participate in development of plans and policies to effectively prepare a
community for disasters or to protect vulnerable populations during
disasters.
o Help organizations and communities create healthy environments such as
smoke- free workplaces.
o Teach vulnerable populations about avoiding environmental risks.
o Collaborate with institutions, such as day care centers or homeless
shelters, to develop and implement policies to minimize transmission of
communicable diseases.
o Participate in a community disaster drill.
o Develop a policy memo to address a health issue identified in the
community.
o Advocate for policy change regarding a health issued identified in the
community.
o Initiate an interprofessional going-green campaign to improve
environmental health.
Essential VIII: Professionalism and Professional Values
•
Provide opportunities/assignments for students to:
o Write a letter to the editor or opinion editorial about the role of nursing in
improving health care and submit the letter to a local newspaper for
publication.
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o Observe and respond to focused questions about the proceedings of ethical
review committees, IRB, nursing practice councils, and state board of
nursing meetings and/or hearings.
o Participate in professional or community-based organizations that
advocate for quality and access to care.
o Use simulated vignettes that address ethical, legal. and moral patient care
situations such as:
provider abandonment of a patient
decision-making about reporting to work in the event of a disaster
reporting sexual assault or abuse
suspected drug use by a colleague
end-of-life decision-making
identification of a spiritual crisis
withdrawal of life support
o Participate in interprofessional service-learning projects such as student
visits to secondary schools, school career days, summer health camps, or
vulnerable populations in homeless shelters or homes for battered women
and children.
o Partner with a nursing school from another country to gain global
perspective; use the internet for global experiences.
o Engage in legislative state house visits to articulate professional nursing
role/perspective.
o Work with legislative staff at various levels.
o Participate in values clarification exercises, using poems, literature, and
video clips that illustrate bias, such as the “See Me Nurse” video on aging
(Southern Region Coalition).
o Participate in rounds with chaplains or other spiritual care professionals.
o Develop a self-care improvement plan. For example, use a tool such as the
“Circle of Human Potentials” (Dossey & Keegan, 2009) ) to conduct a
self-assessment and develop a self-care improvement plan that includes
measurable outcomes.
o Conduct a self-assessment in one or more of the following areas: physical,
emotional, spiritual, cultural, relationships, communications, and learning
style. Based on this assessment, develop an improvement plan that
includes measurable outcomes.
o Analyze the media’s portrayal of nurses and other aspects of health care.
o Discuss cultural and ethical variables in patient care scenarios using
software, such as The Neighborhood (Gidden, 2007) in interprofessional
and intraprofessional learning groups.
o Use reflective writing to discuss student use of moral agency and/or
patient advocacy.
o Create a student honor code to be adopted.
o Engage with a nurse actively involved in professional nursing practice for
more than 30 years to explore changes within the profession.
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Essential IX: Baccalaureate Generalist Nursing Practice
•
•
•
•
In a group of students, plan, provide and evaluate nursing care for a patient with
multiple co-morbidities and symptoms in a simulated or patient care environment.
In a group of interprofessional students, provide care that reflects patient preferences
and values in a simulated or patient care environment.
Arrange cultural immersion care giving experiences in settings such as homeless
shelters, migrant clinics, correctional facilities, and corporate health settings.
Provide opportunities/experiences for students to:
o Provide evidence-based, patient-centered end-of-life care to a dying patient
and their significant others.
o Interview volunteers with complex problems, such as HIV, psychiatric
conditions, tuberculosis, or substance abuse to explore patient preferences and
values.
o Provide care to a group of patients that incorporates delegation, supervision,
and outcomes evaluation.
o Administer and document administration of medications to groups of patients
in a patient care or simulated environment.
o Perform patient assessment and evaluation of a patient’s response to
pharmacological agents in a simulated or patient care environment.
o Use unfolding case study analysis to correlate a patient’s medical condition
and pathophysiology and design appropriate therapeutic interventions.
o Use a constructed genetic pedigree from collected family history information
to identify a risk profile and develop a plan of care, including patient
education and referral.
o Use simulation, case studies and patient assignments to make decisions about
the organization, prioritization, and appropriate delegation of care.
o Consult with other professionals to improve transitions of elderly patients
across care settings.
o Evaluate patient education materials for cultural and linguistic
appropriateness.
o Elicit a spiritual history and integrate a patient’s spirituality into the care plan.
10
OPPORTUNITIES FOR PROGRAM ENHANCEMENT
The following indicators of quality serve to guide baccalaureate nursing programs as they
strive for excellence. These suggestions are intended to go beyond required program
standards and to build upon the program components identified in AACN’s The
Essentials of Baccalaureate Education for Professional Nursing Practice (2008). In the
pursuit of continuous improvement, programs may use these indicators of quality to
develop action plans appropriate to their mission, philosophy, and core values. This
culture of continuous quality improvement fosters inquiry and creativity. While all
accredited programs engage in quality improvement processes, the indicators of quality
discussed in this document identify elements which can further enhance the quality of the
program. These indicators were not developed to be used as accreditation standards. This
document identifies elements believed to increase excellence in baccalaureate nursing
programs and offers strategies that are most promising for moving programs forward in
their quest for excellence.
Academic Infrastructure
Infrastructure refers to the platform of support provided by an institution to promote the
success of its academic programs. Attention to best practices in regards to infrastructure
can facilitate a program’s progress to a higher level of excellence. A strong academic
infrastructure provides a variety of learning opportunities for students to achieve the
Baccalaureate Essentials. Baccalaureate nursing programs moving toward excellence
invest in sufficient financial, personnel, instructional, and academic resources as well as
facilities to incorporate successful practices into their programs. In addition, programs
allocate resources to provide opportunities beyond those necessary for successful
program completion. Best practices include providing opportunities for students to attain
maximum potential for a successful career trajectory and professional successes, in
addition to fostering innovation, creativity, and new ways of thinking and doing.
The academic infrastructure reflects the unique qualities of the program and includes
exemplary student life and academic support services such as honors programs,
opportunities for student involvement in faculty research, internships, student
organizations, remediation, and other enhancement programs. Quality programs support
enrichment opportunities such as international study, service learning, and career
planning. Students have local or international experiences with diverse populations,
second-language immersion opportunities, or other experiences indicating involvement in
cultural or global issues. Student access to resources, such as scholarships and support for
scholarly projects or activities, is an additional indicator of quality. Resources and
opportunities are developed to support student goals and the needs of a diverse student
population. The presence of institutional resources for research, development, business
operations, public relations, marketing, and human resources reflects quality in
baccalaureate nursing programs. For example, exceptional programs develop processes
to expand and sustain resources in the areas of information technology, library holdings,
clinical laboratories and equipment, and space provided for student learning and faculty
scholarship.
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Institutional support for faculty development is evidenced by written policies and budget
allocations. Benchmarks for faculty development are established and evaluated for
quality improvement initiatives. Best practices may include strategies to attract faculty
with outstanding academic preparation and experience to enhance the program’s unique
mission or to serve a specific community of interest.
Academic Environment
Principled leadership is an important indicator of quality. This leadership supports and
rewards faculty collaboration for teaching, scholarship, and service. Effective leaders
create an environment that encourages faculty and staff to engage in reflective thinking
and critical analysis of professional contributions and program outcomes. Strategic
planning, resource allocation, and staffing to achieve program goals are guided by
effective leadership to produce supportive academic environments.
Excellent academic programs forge partnerships with practice organizations, such as
community agencies and healthcare systems that are mutually beneficial. Examples of
mutual benefits include collaborative research and practice initiatives, design of
educational experiences and curriculum, as well as the sharing of staff and faculty. The
partnership of education and practice, through a process of continuous evaluation, fosters
mutual accountability. Quality partnerships are successful when they clarify goals,
objectives, and responsibilities, as well as work toward the success of all stakeholders
(Gilliss & Fuchs, 2007). Strong partnerships provide opportunities for students to expand
and improve their practice and create an environment where teaching reflects best nursing
practices. Partners share a commitment to excellence in nursing practice and education.
Academic environments, while focused on the climate for student learning, support
faculty efforts to implement best practices. Best practices promote explicit opportunities
for the integration of liberal education and learning throughout the nursing curriculum.
Student application of principles of liberal learning as evidenced in nursing course syllabi
and course materials as well as teaching-learning activities are selected to match student
abilities and previous academic preparation. Students can articulate the value of their
liberal education courses to their preparation as professional nurses as well as educated
citizens. Students express accountability for their own learning throughout the academic
experience and beyond. In addition, students are actively engaged in learning and are
encouraged to question and seek answers through a variety of inquiry methods. A spirit
of inquiry and the excitement of discovery permeate such environments.
Academic environments that best support student success create high expectations for
student learning. Integrative learning strategies focus on the spirit of inquiry and the
development of a community of scholars. Students and faculty in quality programs
engage in synthesizing experiences in collaborative and service learning projects as well
as interdisciplinary work across departments. Best practices include the use of multiple
teaching strategies and methods of evaluation that provide ongoing feedback to enhance
student outcomes. Classroom experiences are relevant to students’ lives, aspirations, and
experiences. In addition, best practices produce retention, graduation, national licensure
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examination pass rates, and student successes that reflect the program’s admission
standards and academic support services.
Best practices regarding academic environments include support for faculty practice,
teaching, scholarship, and service roles as appropriate to the program’s mission. This
commitment is evident through systems that support a broad conceptualization of
scholarship and institutional reward systems for faculty scholarship. Congruence between
the parent organization’s definitions of these roles is paramount and the reward system
for scholarly activity is evident. Best practices include a plan for the dissemination of
faculty scholarly efforts to assure that outcomes have an impact beyond the school or
institution.
Indicators of best practices related to scholarship may include extramural grants in
support of practice innovations; peer-reviewed publications and presentations; practiceoriented grant review activities; editorial review activities; state, regional, national, and
international professional activities related to one’s practice area; policy involvement and
development; establishment of practice sites for underserved populations; and
dissemination of practice improvement products such as reports, guidelines, protocols,
and tool kits (AACN, 2006).
Another best practice in support of faculty is recognition given for teaching excellence
through support of innovation and creativity in designing and implementing learning
opportunities for diverse student populations and environments. Master teachers mentor
newer faculty to create an environment of support and continuous improvements in
teaching and student learning (Hutchings & Schulman, 1999). Again, best practices
would provide the resources to support an environment that advances excellent teaching.
An organizational culture that embraces continuous improvement is a key quality
indicator of programs implementing best practices. This culture is manifested through
processes and policies that promote systematic program evaluation and evidence-based
actions in response to findings. Although continuous improvement activities are required
for accreditation, programs that seek opportunities for continuous improvement can
demonstrate a direct link between ongoing improvement strategies and identified student
and program outcomes targeted for excellence.
Clinical Practice Environment for Students
Healthcare professionals have a collective responsibility to ensure collaborative practice,
including inter- and intraprofessional practice. Academic institutions provide nursing
students the opportunity to deliver patient-centered care as members of an
interprofessional team, emphasizing evidence-based practice, quality improvement
approaches, and informatics (Institute of Medicine, 2003).
When determining appropriate enrollment targets, quality programs demonstrate ongoing
engagement with the community of interest to match faculty resources and availability to
the best sites for optimizing clinical experiences. An ongoing collaborative academic
practice partnership is a quality indicator for promoting student learning. Practice
partnerships encompass a wide range of practice settings and experiences beyond
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traditional clinical sites. In addition, selected practice sites exemplify or aspire to best
nursing practices and achieve recognition via national accreditation or other programs for
excellence. The best practices for clinical environments in baccalaureate nursing
programs are predicated on the assumption that students are best served by opportunities
to work and learn together with professional nurse mentors, preceptors, and role models.
Nursing role models practice from an evidence base and promote student access to a wide
range of patient populations, experiences, and best practices. Partnership
Literature Review Assessment Description While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project. A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a review (750-1,000 words) that includes the following sections: Title page Introduction section A comparison of research questions A comparison of sample populations A comparison of the limitations of the study A conclusion section, incorporating recommendations for further research Note: I attached the PICOT Question Paper and Literature Evaluation Table needed to complete this assignment Prepare this assignment according to the guidelines found in the APA Style Guideplagiarism report (less than 10%)
Leaders use systems-based practice to empower other nurses. Considering your current or former clinical setting, share how you will use principles of systems-based practice to grow in your role as a leader in nursing. Include a scholarly outside source to support your answer.
Information:
Leaders in nursing empower others. In this discussion, you will be exploring the connection between systems-based practice and your growth as a leader in nursing. As you post this week be sure to include with leadership looks like across the continuum of care. How do you lead to advocate for staff or direct reports? How do you lead in advocating for patients that may be involved in care across a system, for example, outpatient clinic, surgical services, critical care, med/surg unit, skilled nursing facility might be an example of one journey.
For those of you how work in ambulatory, procedural or non-traditional settings it might look very different.
How do you lead from the bedside in an informal leadership position as nurses are all leaders by definition. If you are a Leader in a formal leadership position what does that look like?
By now, your APA Format should be shaping up so you have solid in-text citations and you are using the library for journal articles to support your posts
Method/Results Section- we are working on this part of the paper
Students are expected to conduct a meta-analysis of an issue in sport. The term meta-analysis
represents a research strategy in which the results of numerous studies using similar instruments
data sets and analytic methods can be reanalysed in the aggregate and can be used to synthesize
of a group of research findings into one explanatory theory, model, or description about the
phenomena. This provides a systematic focus on the underpinnings approaches and outcomes
central to sociological research.
The meta-analysis should comprise a minimum of 10 references. The meta-analysis is to be
written in 4 parts: the introduction (~2 pgs., <500 words); the method/results (~4 pgs., <1000
words); the discussion (~4 pgs., <1000); and the conclusion (~2 pgs., <500).
Please break your paper into 3 paragraphs with headings addressing the 3 parts of the rubric. I understand it was difficult if you were in child development centers, but you still need to explain how you demonstrated leadership, interprofessionalism, and basically how it helped you grow as a nurse. Your simulation also offers quite a bit of opportunities for you to think like an RN and prioritize and delegate. If you cannot match the rubric topics to your experience than say that and describe. (Reminder that a paragraph should be no more than 3/4 a page). This paper should be about 1 page in length. (ok if longer)i was at valley presbretarian hospital from 6:30-6:30 with clinical professor kathryn vick so please include that and theory instructor was mrs.dyer and mention that peds was the hardest class and was overwhemeled with school and family
Unformatted Attachment Preview
Running head: NURSING EVOLUTION
Nursing Evolution
Nicollete Juarez
NURS 307 – Developing Family and Community
West Coast University
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NURSING EVOLUTION
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Nursing Evolution
The theory class helped me understand the foundation of nursing pediatric care by
learning the basic information that served as my basic foundation knowledge I significantly
needed to become successful in my clinical experience during this term. Learning how children
transition through different stages of development, acquiring knowledge about major health
promotion and disease prevention concepts, application of nursing process to pediatric patient
population suffering from different types of acute and chronic diseases, nutritional requirements
for pediatric requirements and current issues regarding health care in theory class allowed me to
apply the concept of nursing process and critical thinking during patient care and support and
performed the therapeutic nursing interventions specific for the patients and families assigned to
me during clinical rotations.
During my clinical rotation this term, I have provided holistic patient centered care by
utilizing therapeutic communication not only with my patient but also to their family members. I
was able to prioritize their needs and provided it with the highest quality of care that meets the
standard protocol of my clinical site. I was able to participate in a collaborative care for the
patient assigned to me. I was assigned to an eight-year-old male patient who was admitted to the
pediatric intensive care unit of the hospital. The charge nurse asked me to take the patient’s
temperature and assisted her in providing personal care to the patient such as removing the soiled
diaper and changed it to a new one, provided oral care, and repositioned the patient. During the
care, the patient had an episode of seizure which lasted about three minutes. The charge nurse
who was with me at that time, instructed me to watch the clock to remember when the seizure
started and asked me to time the duration of the seizure. She also yelled out for the rest of the
staff to inform them that the patient was having a seizure. She asked me to help her turn the
NURSING EVOLUTION
3
patient to the left side while she gave instructions to the LVN and another RN nurse in the room.
The charge nurse also gave instructions to the Respiratory therapist as the patient’s oxygen
dropped to 72 %. I have never witnessed a child had a seizure prior to that day and it was really
intense. After the seizure stopped, the nurses and Respiratory therapist worked on the patient to
stabilized him. I assisted by attending to their every request such as getting them new towels,
diaper, wipes, etc.
I have seen a lot of situations where the application of leadership concepts and skills and
decision making were done to ensure that high quality nursing care, healthcare team coordination
and collaborative care happens. In addition to the seizure episode event that I already described
above, I wanted to share that the same team I mentioned above had shown excellent care to the
same patient while I was there throughout the day. They were able to assess the patient and
quickly identify that his health status was declining really fast. They were able to render and
implemented therapeutic nursing interventions by constantly and effectively communicating with
the primary doctor, the pharmacy, the laboratory and diagnostic department, and family. The
patient had three more episodes of seizure lasting about three to four minutes and the last
episode, the patient became unstable and unresponsive. The team followed protocol on what to
do during a seizure on every seizure episode the patient had. After the last seizure, they were
quick to determined that the patient’s status became unstable and the doctor decided that he
needed to intubate the patient. As soon as the doctor told them the plan, everyone worked into
action. The charge nurse called the pharmacy to order the medications needed for intubation, the
respiratory therapist gathered her equipment for ventilation support, the LVN and other RN
started another IV line on the patient and the primary doctor provided oversight and made sure
that everyone is up to the task. I witnessed how quickly everyone moved to gather all the
NURSING EVOLUTION
4
necessary tools, equipment and medications needed and completed the intubation procedure. The
situation was intense, emotional and chaotic but I would say that it was an organized chaos. I
could tell from everyone’s faces who collaborated in that patient’s care that they were under a lot
of pressure and stress, but they worked cautiously, effectively and safely trying to save the
patient’s life. The doctor took charged of the situation by respectfully telling his team on what
they needed to do. The team which included of two RNs, one LVN and one Respiratory
therapist, effectively communicated with one another, did the tasks assigned to them by the
doctor and most importantly, they showed support to one another during the entire ordeal and
setting their differences and emotions on the side.
Running head: NURS307 WEEK 9 NURSING EVOLUTION
1
The Joy in Pediatric Nursing
Vivian Toma
West Coast University
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NURS307 WEEK 9 NURSING EVOLUTION
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The Joy in Pediatric Nursing
Pediatric nursing is a specialty that requires patience and a special touch because it
involves children ranging from infants to adolescents. Their physical, mental, and emotional
needs vary throughout the different stages of growth and development. I, myself, have a 5-yearold son, and this class along with my clinical experience at Children’s Hospital of Los Angeles
(CHLA) have allowed me to gain insight on his growth and development. Understanding each
stage of growth and development from infancy to adolescence as taught by Professor Dyer
during the first week of class has been the key to providing effective holistic care to children. In
the short clinical rotation I had at CHLA, I experienced the most at 5 West and 6th floor. I was
able to care for toddlers and school-age children from different cultural backgrounds such as
Hispanics, Caucasians, and Arabs. I was also able to meet their parents who were at the bedside.
As discussed by Professor Dyer in class and reiterated by Professor Harris at the clinical site,
pediatric nursing not only involves the children but also the family/guardians. The family
dynamic differed depending on the cultural background of the patients which was concurrent
with my experiences from other nursing specialties such as maternal-newborn and medicalsurgical nursing from previous terms. I have noticed that the Hispanic families were frequently at
the bedside that includes the extended family such as the aunts and grandparents while Caucasian
families mostly involved just the mother and the father. At CHLA, many of the patients came
from foreign countries (Iraq, South America) to seek a second opinion regarding their child’s
condition. Meanwhile, my pediatric experience was way different from my maternal-newborn
experience in a way of communication and the skills to care for children with different
developmental levels. The infants and toddlers were unable to communicate verbally what was
bothering them especially their pain level so the FLACC scale had to be used for infants while
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NURS307 WEEK 9 NURSING EVOLUTION
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the FACES pain scale may be used for children ages 3 years old and older. Besides the pain,
pediatric vital signs also vary based on their growth and development stage which was very
challenging both during classroom lectures as well as during clinical rotations. Infants, toddlers,
preschoolers, school-age children, and adolescents have different heart/respiration and blood
pressure rates. I have noticed that the nurses I shadowed have a vital sign reference card along
with their ID badges to assist with determining an abnormal vital sign. This was extremely
difficult for me especially because I mostly dealt with adult vital signs as an LVN. Another
difference in my experience during this rotation has to do with physical assessment. Each
childhood stage has different growth and development features which meant that physically, an
infant’s physical characteristics will be different from a toddler or an adolescent. Learning these
differences during class lectures were helpful and applying them during the clinical rotation were
a great experience. Medication administration also seemed to be a struggle with the pediatric
population because most of them were not fond of taking off tasting medicines. Offering toys to
a toddler during the medication administration was a helpful distraction while allowing a schoolage child to involve himself in taking the medicine was a good solution for medication
adherence. Besides the nurses I shadowed at CHLA, I was also able to work with respiratory
therapists who administered breathing treatments, BIPAP/CPAP machines, and dealt with
respiratory issues. It was also a pleasure to speak with activity personnel who provided some
music therapy to a 2-year-old toddler with Down Syndrome. She played the ukulele and sang to
him to which the toddler enjoyed and fell asleep too afterwards. During this rotation, the parents
were expected to be involved during bedside care and even with medication administration when
they were present. The nurses provided so much parent education about the medications and
procedures while they were in the hospital to prepare them before patient discharge.
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NURS307 WEEK 9 NURSING EVOLUTION
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My first day of clinical rotation at CHLA was full of learning experiences. I was given
the assignment to take care of a 7-year-old s/p kidney transplant of the right kidney. He was a
courageous little kid who have experienced multiple surgical experiences since he was born and
was on dialysis for about 2 years prior to being given a new kidney. When I first met him, he was
suffering from a UTI and was on IV antibiotics, but he continued to remain happy. The nurse I
was assigned to shadow was receptive of me assisting her in taking care of this particular patient.
When I went to his room, he was sleeping and mom was at the bedside. He became furious when
he had to be awakened for the administration of his due antibiotics and was encouraged to use
the bathroom. He was crying, screaming, and fighting his mother including the nurse and myself.
The nurse and I were able to calm him down by showing him a drawing of a picture of his new
kidney whom he named “Tom.” Mom performed intermittent catheterization and halfway
towards the procedure, we were able to encourage him to urinate in the urinal to which he did.
Though the mom was at the bedside, she lacked the initiative to provide care to the patient. When
we came into the room, she was laying on the pull-out bed and talking on her phone. She was
already given a list of the medications the patient was taking and yet she seemed to forget the
medications’ indications and the frequency in which they have to be taken. I assisted my nurse in
getting an interpreter, since she was Spanish speaking, to explain to her again the importance of
being involved in her son’s care and the consequences of not following the orders. Along with
the interpreter, we explained to her the importance of encouraging the patient to urinate in the
toilet or in the urinal every 2 hours as well as defecating in the toilet instead of the diaper. My
nurse also contacted the provider in charge and explained to her the reasons to discontinue the
order for intermittent catheterization every 4 hours especially that the patient has a UTI, and that
the patient was able to urinate in the urinal and was not retaining urine based on bladder scan
This study source was downloaded by 100000790392484 from CourseHero.com on 10-13-2023 02:10:13 GMT -05:00
https://www.coursehero.com/file/47216618/WEEK-9-PEDS-NURSING-EVOLUTIONediteddocx/
NURS307 WEEK 9 NURSING EVOLUTION
5
results. Other nurses in the units helped tend to my nurse’s other patients as she was educating
the mother and speaking with the provider. The unit’s teamwork was remarkable and it was an
enjoyable experience. Documenting the pain assessment, nursing checklist, vital signs and intake
and output in ADHOC was also a great encounter because along with the nurse in charge, I was
considered to be a part of the team caring for the patient. Working in a pediatric unit was
definitely not easy because it was a new experience, however, it was memorable and unyielding.
These children were so brave because even though they were sick, they remained resilient and
continued to smile and play.
This study source was downloaded by 100000790392484 from CourseHero.com on 10-13-2023 02:10:13 GMT -05:00
https://www.coursehero.com/file/47216618/WEEK-9-PEDS-NURSING-EVOLUTIONediteddocx/
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The Ergonomic Challenge in Healthcare Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and healthcare worker. Describe the opportunity to improve this Ergonomic challenge. Please address the topics below: Background facts about the Ergonomic challenge including incidence and prevalenceThe impact of the Ergonomic challenge on the Healthcare workerThe impact of the Ergonomic challenge on the patientYour recommendations to improve this Ergonomic challenge based on evidence from the literature Your paper should meet the following structural requirements: 5-6 pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition.Provide support for your statements with in-text citations from a minimum of 6 scholarly articles. You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. Note: Please check the example to follow the guidance.
Unformatted Attachment Preview
The Ergonomic Challenge in Healthcare
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and
healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
•
•
•
•
Background facts about the Ergonomic challenge including incidence and prevalence
The impact of the Ergonomic challenge on the Healthcare worker
The impact of the Ergonomic challenge on the patient
Your recommendations to improve this Ergonomic challenge based on evidence from
the literature
Your paper should meet the following structural requirements:
•
•
•
•
5-6 pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition.
Provide support for your statements with in-text citations from a minimum of 6
scholarly articles.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check
prior to submitting them to your instructor for grading.
Note: Please check the example to follow the guidance.
Review Assignments
Critical Thinking Assignment
The Ergonomic Challenge in Healthcare
(105 points)
Identify one Ergonomic challenge in healthcare. Describe
the impact on the patient and healthcare worker. Describe
the opportunity to improve this Ergonomic challenge.
Please address the topics below:
•
Background facts about the Ergonomic challenge
including incidence and prevalence
•
The impact of the Ergonomic challenge on the
Healthcare worker
•
The impact of the Ergonomic challenge on the patient
•
Your recommendations to improve this Ergonomic
challenge based on evidence from the literature
Your paper should meet the following structural requirements:
5-6 pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition
Provide support for your statements with in-text citations from a minimum of 6 scholarly articles. You are strongly
encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for
grading.
Background Facts:
•
One prominent ergonomic challenge in healthcare is related to patient handling
and mobility. Healthcare workers, particularly nurses, caregivers, and other
medical staff, frequently engage in physically demanding tasks such as lifting,
transferring, and repositioning patients. Incidence and prevalence of
musculoskeletal injuries among healthcare workers due to poor ergonomics are
notably high. According to the U.S. Bureau of Labor Statistics, healthcare
workers suffer more musculoskeletal injuries and illnesses than any other
industry, with a rate of 80.1 cases per 10,000 full-time workers in 2020. Patient
handling-related injuries contribute significantly to this statistic.
Impact on Healthcare Worker:
•
The ergonomic challenge of patient handling and mobility places a substantial
physical and emotional burden on healthcare workers. Overexertion and
improper patient lifting techniques can lead to musculoskeletal disorders,
including back pain, herniated discs, and strains, causing discomfort, pain, and
long-term injuries. These injuries result in increased absenteeism, reduced work
productivity, and high healthcare costs. Moreover, healthcare workers who are
injured may suffer emotional distress, reduced job satisfaction, and a decreased
ability to provide effective patient care.
Impact on the Patient:
•
The impact of poor ergonomics in patient handling isn’t limited to healthcare
workers. Patients are also at risk of injury, discomfort, and emotional distress
when not handled properly. Improper lifting and transferring techniques can
lead to patient falls, skin tears, pressure ulcers, and fractures. Moreover,
patients may experience anxiety and fear when they sense the healthcare
worker is struggling, which can negatively impact their overall well-being and
trust in the healthcare system.
Opportunity to Improve Ergonomic Challenge:
To address the ergonomic challenge of patient handling and mobility, healthcare facilities can implement a multi-faceted approach:
1.
Education and Training: Provide comprehensive training to healthcare workers on proper body mechanics and patient handling techniques. This
includes using assistive devices like mechanical lifts and slide boards to reduce manual lifting.
2.
Equipment and Technology: Invest in ergonomic equipment like ceiling-mounted lifts, adjustable hospital beds, and patient transfer devices.
These tools can significantly reduce the physical strain on healthcare workers and improve patient safety.
3.
Staffing and Workload Management: Ensure appropriate staffing levels to distribute the workload evenly, reducing the need for rushed or
improper patient handling. Encourage staff to collaborate on patient transfers, which can help reduce the burden on any one individual.
4.
Regular Assessment and Feedback: Establish a system for assessing and providing feedback on ergonomic practices within the healthcare facility.
Encourage healthcare workers to report unsafe conditions and incidents.
5.
Workplace Ergonomic Design: Redesign healthcare facilities to incorporate ergonomic principles in patient rooms, hallways, and workspaces,
making it easier for healthcare workers to perform their tasks safely.
Recommendations Based on Evidence:
•
•
Numerous studies and guidelines support these recommendations. For instance, the
National Institute for Occupational Safety and Health (NIOSH) and the Occupational
Safety and Health Administration (OSHA) in the United States have published
guidelines on safe patient handling, emphasizing the importance of training,
equipment, and ergonomic design. Evidence indicates that implementing these
measures can reduce musculoskeletal injuries among healthcare workers and
enhance patient safety.
By addressing the ergonomic challenge of patient handling and mobility, healthcare
facilities can improve the well-being of both their healthcare workers and patients,
leading to better outcomes and reduced healthcare costs.
Review Assignments
Critical Thinking Assignment
The Ergonomic Challenge in Healthcare
(105 points)
Identify one Ergonomic challenge in healthcare. Describe
the impact on the patient and healthcare worker. Describe
the opportunity to improve this Ergonomic challenge.
Please address the topics below:
•
Background facts about the Ergonomic challenge
including incidence and prevalence
•
The impact of the Ergonomic challenge on the
Healthcare worker
•
The impact of the Ergonomic challenge on the patient
•
Your recommendations to improve this Ergonomic
challenge based on evidence from the literature
Your paper should meet the following structural requirements:
5-6 pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition
Provide support for your statements with in-text citations from a minimum of 6 scholarly articles. You are strongly
encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for
grading.
Background Facts:
•
One prominent ergonomic challenge in healthcare is related to patient handling
and mobility. Healthcare workers, particularly nurses, caregivers, and other
medical staff, frequently engage in physically demanding tasks such as lifting,
transferring, and repositioning patients. Incidence and prevalence of
musculoskeletal injuries among healthcare workers due to poor ergonomics are
notably high. According to the U.S. Bureau of Labor Statistics, healthcare
workers suffer more musculoskeletal injuries and illnesses than any other
industry, with a rate of 80.1 cases per 10,000 full-time workers in 2020. Patient
handling-related injuries contribute significantly to this statistic.
Impact on Healthcare Worker:
•
The ergonomic challenge of patient handling and mobility places a substantial
physical and emotional burden on healthcare workers. Overexertion and
improper patient lifting techniques can lead to musculoskeletal disorders,
including back pain, herniated discs, and strains, causing discomfort, pain, and
long-term injuries. These injuries result in increased absenteeism, reduced work
productivity, and high healthcare costs. Moreover, healthcare workers who are
injured may suffer emotional distress, reduced job satisfaction, and a decreased
ability to provide effective patient care.
Impact on the Patient:
•
The impact of poor ergonomics in patient handling isn’t limited to healthcare
workers. Patients are also at risk of injury, discomfort, and emotional distress
when not handled properly. Improper lifting and transferring techniques can
lead to patient falls, skin tears, pressure ulcers, and fractures. Moreover,
patients may experience anxiety and fear when they sense the healthcare
worker is struggling, which can negatively impact their overall well-being and
trust in the healthcare system.
Opportunity to Improve Ergonomic Challenge:
To address the ergonomic challenge of patient handling and mobility, healthcare facilities can implement a multi-faceted approach:
1.
Education and Training: Provide comprehensive training to healthcare workers on proper body mechanics and patient handling techniques. This
includes using assistive devices like mechanical lifts and slide boards to reduce manual lifting.
2.
Equipment and Technology: Invest in ergonomic equipment like ceiling-mounted lifts, adjustable hospital beds, and patient transfer devices.
These tools can significantly reduce the physical strain on healthcare workers and improve patient safety.
3.
Staffing and Workload Management: Ensure appropriate staffing levels to distribute the workload evenly, reducing the need for rushed or
improper patient handling. Encourage staff to collaborate on patient transfers, which can help reduce the burden on any one individual.
4.
Regular Assessment and Feedback: Establish a system for assessing and providing feedback on ergonomic practices within the healthcare facility.
Encourage healthcare workers to report unsafe conditions and incidents.
5.
Workplace Ergonomic Design: Redesign healthcare facilities to incorporate ergonomic principles in patient rooms, hallways, and workspaces,
making it easier for healthcare workers to perform their tasks safely.
Recommendations Based on Evidence:
•
•
Numerous studies and guidelines support these recommendations. For instance, the
National Institute for Occupational Safety and Health (NIOSH) and the Occupational
Safety and Health Administration (OSHA) in the United States have published
guidelines on safe patient handling, emphasizing the importance of training,
equipment, and ergonomic design. Evidence indicates that implementing these
measures can reduce musculoskeletal injuries among healthcare workers and
enhance patient safety.
By addressing the ergonomic challenge of patient handling and mobility, healthcare
facilities can improve the well-being of both their healthcare workers and patients,
leading to better outcomes and reduced healthcare costs.
The Ergonomic Challenge in Healthcare
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and
healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
•
•
•
•
Background facts about the Ergonomic challenge including incidence and prevalence
The impact of the Ergonomic challenge on the Healthcare worker
The impact of the Ergonomic challenge on the patient
Your recommendations to improve this Ergonomic challenge based on evidence from
the literature
Your paper should meet the following structural requirements:
•
•
•
•
5-6 pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition.
Provide support for your statements with in-text citations from a minimum of 6
scholarly articles.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check
prior to submitting them to your instructor for grading.
Note: Please check the example to follow the guidance.
Review Assignments
Critical Thinking Assignment
The Ergonomic Challenge in Healthcare
(105 points)
Identify one Ergonomic challenge in healthcare. Describe
the impact on the patient and healthcare worker. Describe
the opportunity to improve this Ergonomic challenge.
Please address the topics below:
•
Background facts about the Ergonomic challenge
including incidence and prevalence
•
The impact of the Ergonomic challenge on the
Healthcare worker
•
The impact of the Ergonomic challenge on the patient
•
Your recommendations to improve this Ergonomic
challenge based on evidence from the literature
Your paper should meet the following structural requirements:
5-6 pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition
Provide support for your statements with in-text citations from a minimum of 6 scholarly articles. You are strongly
encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for
grading.
Background Facts:
•
One prominent ergonomic challenge in healthcare is related to patient
handling and mobility. Healthcare workers, particularly nurses, caregivers,
and other medical staff, frequently engage in physically demanding tasks
such as lifting, transferring, and repositioning patients. Incidence and
prevalence of musculoskeletal injuries among healthcare workers due to
poor ergonomics are notably high. According to the U.S. Bureau of Labor
Statistics, healthcare workers suffer more musculoskeletal injuries and
illnesses than any other industry, with a rate of 80.1 cases per 10,000 fulltime workers in 2020. Patient handling-related injuries contribute
significantly to this statistic.
Impact on Healthcare Worker:
•
The ergonomic challenge of patient handling and mobility places a
substantial physical and emotional burden on healthcare workers.
Overexertion and improper patient lifting techniques can lead to
musculoskeletal disorders, including back pain, herniated discs, and
strains, causing discomfort, pain, and long-term injuries. These injuries
result in increased absenteeism, reduced work productivity, and high
healthcare costs. Moreover, healthcare workers who are injured may
suffer emotional distress, reduced job satisfaction, and a decreased ability
to provide effective patient care.
Impact on the Patient:
•
The impact of poor ergonomics in patient handling isn’t limited to
healthcare workers. Patients are also at risk of injury, discomfort, and
emotional distress when not handled properly. Improper lifting and
transferring techniques can lead to patient falls, skin tears, pressure
ulcers, and fractures. Moreover, patients may experience anxiety and fear
when they sense the healthcare worker is struggling, which can
negatively impact their overall well-being and trust in the healthcare
system.
Opportunity to Improve Ergonomic Challenge:
To address the ergonomic challenge of patient handling and mobility, healthcare facilities can implement a multi-faceted approach:
1. Education and Training: Provide comprehensive training to healthcare workers on proper body mechanics and patient handling
techniques. This includes using assistive devices like mechanical lifts and slide boards to reduce manual lifting.
2. Equipment and Technology: Invest in ergonomic equipment like ceiling-mounted lifts, adjustable hospital beds, and patient transfer
devices. These tools can significantly reduce the physical strain on healthcare workers and improve patient safety.
3. Staffing and Workload Management: Ensure appropriate staffing levels to distribute the workload evenly, reducing the need for
rushed or improper patient handling. Encourage staff to collaborate on patient transfers, which can help reduce the burden on any one
individual.
4. Regular Assessment and Feedback: Establish a system for assessing and providing feedback on ergonomic practices within the
healthcare facility. Encourage healthcare workers to report unsafe conditions and incidents.
5. Workplace Ergonomic Design: Redesign healthcare facilities to incorporate ergonomic principles in patient rooms, hallways, and
workspaces, making it easier for healthcare workers to perform their tasks safely.
Recommendations Based on Evidence:
•
•
Numerous studies and guidelines support these recommendations. For
instance, the National Institute for Occupational Safety and Health (NIOSH)
and the Occupational Safety and Health Administration (OSHA) in the United
States have published guidelines on safe patient handling, emphasizing the
importance of training, equipment, and ergonomic design. Evidence indicates
that implementing these measures can reduce musculoskeletal injuries
among healthcare workers and enhance patient safety.
By addressing the ergonomic challenge of patient handling and mobility,
healthcare facilities can improve the well-being of both their healthcare
workers and patients, leading to better outcomes and reduced healthcare
costs.
Discuss three methods of translation in terms of why the method was developed and what settings or types of problems each is best suited for.Which method would be good for a DNP project and why would it be a good fit? need apa references
Research a peer-reviewed article in the SEU library regarding workflow analysis in healthcare. Discuss the following aspects:
Strengths
Weaknesses
Opportunities
Threats
Risks that are identified in the workflow described.
What changes are recommended and provide additional recommendations you would make to improve the efficiency and effectiveness of this process.
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
In an ideal healthcare delivery system, all patients would have access to affordable, high-quality health services that are well coordinated to ensure the continuity and comprehensiveness of care. Patients may have different experiences based on their health problem or injury, the organizations that provide services close to where they live, and how the health services they need are financed.
Imagine that a 70-year old man has hypertension and diabetes in Autaugaville, Alabama. After a visit to the nearest emergency room, he is diagnosed with a stroke. Now think about how his situation might compare with that of a 70-year-old woman in Gilbert, Arizona, diagnosed with ovarian cancer and must have her ovaries removed. Both patients have received diagnosis from their respective care providers and must be admitted to a hospital for inpatient care. What services will he need through the duration of his recovery experience? How might the two patients’ experiences compare in terms of care coordination and the continuity and comprehensiveness of services they receive? Where will they receive care? Research Medicare’s Hospital Compare to research data related to their diagnosis, treatment, and outcomes. Compare three hospitals and based on your findings…
Assignment Instructions
For this assignment, you will examine the continuum of care a patient may need, research the services available in your area to support the patient, and evaluate information needs. Review information about continuum of care and coordination among various health services, and the concept of integrated healthcare. Your assignment will include a written report and PowerPoint presentation.
In a 2-page report:
Answer the questions in the scenario.
Assume the patients in the scenario live near your local area. Assess potential available services, based on their healthcare needs. Analyze specific services the patient might need, beginning with the onset or diagnosis of an illness or injury and concluding with an end-point of your choosing (i.e., recovery, symptom management, end of life).
Research the types of organizations that provide those services
Based on the services for patient needs, select at least three actual settings in which he/she would receive care.
Gather information related to the types of insurance each organization accepts. Typically, this would include Medicare, Medicaid, and various types of insurance programs. What challenges related to payment for services do you anticipate your selected patient may experience?
In an 8-10-slide PowerPoint presentation, include:
Title slide
Introduction slide
6-8 content slides
Describe the patient you have selected (including his or her health problem/injury) and identify the geographic area where this patient is located.
Analyze the continuum of care, including specific services the patient may require from three or four actual settings.
Describe a potential challenge related to payment for services this patient may encounter.
Explain why professionals in your selected settings need to be aware of the quality of services guidelines and requirements, in comparison to the continuum of care.
References slide
Find a private corporation that is a leader in corporate social responsibility (CSR) and post the company’s website link on the board. Explain why you chose it as a leader, including what type of activities or commitments it has made relating to CSR.
I want a systematic review with All research elements from different researches and rephrase the sentence from these researches . with abstract , and recommendations part in the end using your own words , and updated references . Check for plagiarism less than 10% . (Without using chat GPT please) I will check. The Ti(transitioning from student to professional nurse )
For this week’s discussion post, I am choosing to use CAUTIs as my clinical quality problem and I believe the application of quasi-experimental design for quality improvement would be the best route to derive a solution. The main difference between a quasi-experimental design and a true experimental design is the randomization factor. In a quasi, we are strictly looking at the cause and effect of specific nursing interventions. This would be beneficial in decreasing the number of CAUTIs on a unit of a hospital because the quality improvement team will be able to look at each different nursing intervention and compare them to a predetermined comparison group. In the case of CAUTIs, there would be two group of patients picked out from each age level on the unit (adolescent, middle-age, etc.) who are about to receive a urinary catheter, one group would receive the nursing intervention and one would receive the same standard of care that has been performed on the unit prior to the study. The strength to this design method is that if the nursing intervention were to prove as successful in all age categories, then it would be safe to presume that the prior nursing intervention was unsuccessful; however, if the intervention was only successful in specific populations such as greater than 65 years old, then this would give the quality improvement team knowledge that another intervention may be better suited for the different age populations. The weakness to this design method is that there could be unique individuals that do not respond to the treatment, and for that reason no conclusion could be drawn on whether or not the intervention was unsuccessful due to the intervention itself or due to the uniqueness of the individual. When looking at a true experimental design, the randomization could be a great application because it would look at the overall rates of a specific nursing intervention. While it would be helpful, I ultimately believe that urinary catheters hold their own variations in problems depending on the individual that receives them, with age being a big factor. The quasi – experimental design can help narrow down definitive nursing interventions for each age group to prevent the occurence of CAUTIs.
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The clinical quality problem I choose for a quality improvement project is the prevalence of Central Line-Associated Bloodstream Infections (CLABSI) in in-patient hospital settings. CLABSIs are a major life-threatening concern that can lead to an extended hospital stay, negative patient outcomes, and increased treatment costs. However, they can be prevented if advanced prevention measures are taken.
To address this quality problem, we will use a quasi-experimental study design. Quasi-experimental designs are helpful in this case in that they don’t require randomization of the participants but allow for including pre-existing individuals with their natural circumstances. This can help investigate individuals who are specifically at high risk for contracting CLABSI or who have already developed it and study the contributing variables.
Another reason for choosing this method is the practicality and validity of quasi-experimental study results. It is practical in that it doesn’t require modifying treatment variables around the patients to set a control group. This will help prevent causing any harm or unexpected outcomes for the patients participating in the study. Lastly, quasi-experimental designs may have more external validity in that the findings can be more applicable in other clinical settings because they reflect real-world conditions and a “normal” patient environment.
One weakness point of a quasi-experimental design is that it may be less effective at establishing causality. Due to the lack of randomization in the subjects, it would be challenging to attribute the results of the experiment to a certain intervention since there are many other factors that could have contributed to the results.
Overall, although experimental studies may provide very specific study findings, I still think that it’s difficult to implement randomization in a critical hospital setting. Therefore, I think that following a quasi-experimental approach will still allow for discovering nursing interventions that can help minimize the risk and occurrence of CLABSIs in a clinical setting.
Discussed experimental studies and explain randomization as it is used in experimental studies and give the types of randomization used in experimental studiesPlease prepare your topic and provide Your discussion should be a minimum of 15 slides or more if you need to.Use proper references in APA style
i need help with writing a Literature Review for a research
Unformatted Attachment Preview
Part 1: Watch videos on how to write a literature review
This website provides a video series that thoroughly describes
the process for writing a literature review. Watch the following
videos in the series: “Quick Run-through”, “Step 3”, “Step 4”, and
“Step 5”. It should take you under 30 minutes to watch the
videos.
Part 2: Rough Draft: Literature Review Introduction and
Identifying Themes
I want you to organize your final literature review
by concepts/themes (how to do this is explained in the video
series). You will likely have chosen articles that discuss similar
concepts related to your research area – state what the common
theme is. You will use your concept/themes as headers for your
Literature Review.
In a Word or Google Doc, begin a draft of your Literature
Review. Specifically:
•
Draft an introductory paragraph to your Literature Review
•
Identify one concept/theme that connects two or more of the
articles you use in your annotated bibliography. Write the
theme/concept as a header, and copy and paste the citations of
the articles under it (this is to help you remember which articles
you will write about in the section.)
Here is an example of what your Thursday assignment should
look like:
Literature Review Draft
This research study aims to quantitatively examine domestic
violence help-seeking strategies among a diverse sample of
American Muslim survivors of domestic violence. The research
questions guiding this study are: How do American Muslim
women seek help for domestic violence? and 2) Does race
influence their help-seeking strategies?
Previous studies have examined how American Muslim women
seek help for domestic violence. This literature review will focus
on two major themes in the research literature regarding help
seeking: 1) barriers to help-seeking and 2) facilitators to helpseeking.
Barriers to Help-Seeking
Oyewuwo-Gassikia, O.B. (2016). American Muslim women and
domestic violence service seeking: A Literature Review. Affilia,
31(4), 450-462. doi:10.1177/0886109916654731
Oyewuwo-Gassikia, O. B. (2020). Black Muslim women’s
domestic violence help-seeking strategies: Types, motivations,
and outcomes. Journal of Aggression, Maltreatment &
Trauma, 29(7), 856-875.
————————————————-
I’m also including an example of what your Literature Review
might look like when written in full. Use this as a guide for your
final draft (Major Assignment #4 due next week).
Literature Review
This research study aims to quantitatively examine
domestic violence help-seeking strategies among a diverse
sample of American Muslim survivors of domestic violence. The
research questions guiding this study are: how do American
Muslim women seek help for domestic violence? and 2) Does
race influence their help-seeking strategies?
Previous studies have examined how American Muslim women
seek help for domestic violence. This literature review will focus
on two major themes in the research literature regarding help
seeking: 1) barriers to help-seeking; and 2) facilitators to helpseeking.
Barriers to help-seeking
Recent studies on American Muslim women survivors of
domestic violence have explored barriers to seeking help for the
abuse they experience. Oyewuwo-Gassikia (2016) examined
American Muslim women’s social service help-seeking for
domestic violence. The researcher conducted a systematic
literature review and identified 10 articles and one dissertation
that examined American Muslim women’s domestic violence
service seeking. Results reveled that several factors facilitate
and hinder women seeking help for domestic violence.
Immigrant status, fear, having children, and lack of knowledge
of resources can create barriers to seeking help from social
services. One limitation the author found was the lack of
diversity in the samples of the studies reviewed, arguing that
more research is needed that reflects the diversity of the
American Muslim community.
In a more recent study qualitative that focused on Black Muslim
women who experienced domestic violence, Oyewuwo-Gasskia
(2020) examined Black Muslim women’s domestic violence helpseeking strategies. The study included a sample of 4 African
American and 2 West African women. In-depth interviews were
conducted with each of the participants, and the researcher
analyzed the data using grounded theory methodology. The
findings revealed that women sought help through family and
friends, religion and spirituality, legal system, and through
services. Women expressed varying levels of satisfaction for
each type of help-seeking strategy. For example, some women
found support in the religious community, while others did
not. Additionally, only half of the sample sought services. A
cited barrier to seeking services was the perception that service
providers would not be accommodating to the women’s
needs. Another barrier was viewing services as a last resort
measure. While only half of the sample sought services, all the
participants who sought services expressed favorable outcomes.
While the study is one of few that examines the domestic
violence experiences of Black Muslim women, the author
acknowledged that due to the sample size, the results cannot be
generalized to all Black Muslim women survivors.
A common finding between these two studies is that both
highlight challenges American Muslim women face in seeking
services, including a lack of knowledge of them and a perception
that they might not be useful to them. The current study adds
to this area of knowledge by examining if women utilize services
and asking questions about their beliefs about services.
While researchers have identified possible barriers to helpseeking, a noted gap in the literature is that studies in this area
have come from qualitative studies and small samples. Further,
the studies highlighted have all noted the lack of diversity –
particularly the lack of inclusion of Black women – in the study
of domestic violence among American women. The current
study aims to fill these gaps by qualitatively examining the
experiences of American Muslim survivors and by purposively
recruiting a sample reflective of the American Muslim
community.
1
Annotated Bibliography
Alen Abraham
2
Annotated Bibliography
Gerst-Emerson, K., & Jayawardhana, J. (2015). Loneliness as a public health issue: The impact
of loneliness on health care utilization among older adults. American Journal of Public
Health, 105(5), 1013–1019. https://doi.org/10.2105/ajph.2014.302427
In this journal article, Gerst-Emerson and Jayawardhana (2015) seek to establish if
loneliness is linked to increased healthcare care utilization among older people in the United
States. These researchers postulate that chronic loneliness among older adults impacts physician
visits and hospitalization, whereby socially isolated seniors are more likely to seek medical
attention and be hospitalized. The study uses panel data from the Health and Retired Study
(HRS) carried out from 2008 to 2012 among 3530 community-dwelling senior persons aged 60
and older in the United States. A key measure used by the authors is healthcare utilization, where
hospitalization and physician visits are examined to assess and understand the impact of
loneliness. Another measure is loneliness; Gerst-Emerson and Jayawardhana (2015) define this
variable twice, with the first definition comprising 3-items: lacking companionship, feeling left
out, and feeling isolated from others, while the second meaning contains four items: not lonely at
either time (2012 and 2018), lonely at both times, lonely only in 2018, and lonely in 2012. Using
regression analysis to measure the two definitions, this study determines that loneliness is a
significant public health concern, contributing to illnesses and healthcare use among older adults.
This article is helpful for the research topic since the authors indicate that loneliness should be
regarded as a public health concern, thus a barrier that may deter older adults from attending the
“Lunch with Us” program. The main limitation of this source is that it lacks generalizability to
the whole senior population, as not all respondents completed the questionnaires. This source
provides supplementary information for this research but does not form its basis.
3
Locher, J. L., Robinson, C. O., Roth, D. L., Ritchie, C. S., & Burgio, K. L. (2005). The effect of
the presence of others on caloric intake in homebound older adults. The Journals of
Gerontology Series A: Biological Sciences and Medical Sciences, 60(11), 1475–1478.
https://doi.org/10.1093/gerona/60.11.1475
In this descriptive study, Locher et al. (2005) understand that undernutrition is a
significanthealth concern among homebound elderly individuals and thus seek to explore the
impact of the presence of others on calorie intake in this population group. Numerous behaviors
influence eating behaviors among older adults, such as social networks, but the authors of this
current study aim to understand the impact of the presence of others during mealtimes and within
the household on caloric intake. Thus, this study posits that older adults are more likely to
increase their caloric intake when others are in the household and when they eat meals with
others. The study uses a sample of 50 elderly individuals, with an average age of 77.1, who have
recently recovered and are getting home health services from caregivers. The data collection
method used is structured interviews on eating behaviors and factors related to these behaviors.
Using a hierarchical modeling analysis to analyze the results, the study found that older people
who consumed their meals (breakfast, lunch, dinner, and snack) in the presence of others ate a
mean of 114.0 calories more per meal than those who ate alone. These researchers attribute
various reasons for increased calorie intake, including extended duration of meals, other persons
eating more, and participation of these individuals in meal consumption. These findings are
relative to this research’s topic because Locher et al. (2005) aim to find out barriers (loneliness)
preventing older adults from achieving a high caloric intake. The study is also slightly similar to
the findings by Gerst-Emerson and Jayawardhana (2015), who establish that loneliness among
the elderly population is a significant health concern. With no stated limitations, this resource
4
will form the basis of the research because it recommends the inclusion of family and friends in
the lives of older adults to provide nutritional support; this is one of the ways social engagement
can be improved, thus addressing the research question.
Mavegam Tango Assoumou, B. O., Coughenour, C., Godbole, A., & McDonough, I. (2022).
Senior food insecurity in the USA: A systematic literature review. Public Health Nutrition,
26(1), 229–245. https://doi.org/10.1017/s1368980022002415
Assoumou et al. (2022), in their systematic study, seek to review the published literature to
understand factors linked to food insecurity among the senior population in the United States,
with the aim of developing targeted interventions and reducing the incidence and prevalence of
the issue. As the first review to explore the literature on food insecurity among the older
population, this study includes 20 articles searched from five databases: EconLit, Scopus,
PubMed, JSTOR, and Web of Science. With food insecurity being the independent variable, the
researchers measure the impact of this factor on various variables, including government
assistance programs, weight status, cost-related medication use and healthcare utilization, mental
health, and physical health. Consistent with previous studies on food insecurity, this systematic
review of these factors establishes that lower household income, lower educational attainment,
being of a non-White ethnicity, and female gender are negatively associated with food insecurity.
As a result, these findings confirm that food insecure populations comprise younger (ages of 6480) and less educated females from African-American/Black ancestry who are low-income
earners, smoke, depend on government assistance programs, and have poor health or chronic
conditions. This review is helpful in the research topic because it identifies significant barriers
that could deter older adults from attending the “Lunch with Us” program. The main limitation
of the study is in its inclusion criteria, whereby the authors only reviewed the studies published
5
in the U.S. and English, eliminating studies in other languages and those conducted outside the
country. Despite this limitation, this source forms a significant basis for the research since it
identifies barriers pertinent to the population under study.
Van Orden, K. A., Bower, E., Lutz, J., Silva, C., Gallegos, A. M., Podgorski, C. A., Santos, E. J.,
& Conwell, Y. (2020). Strategies to promote social connections among older adults during
“social distancing” restrictions. The American Journal of Geriatric Psychiatry, 29(8), 816–
827. https://doi.org/10.1016/j.jagp.2020.05.004
In this qualitative study, Van Orden et al. (2020) posit that social connectedness is vital for
health and wellness among older adults. With that concept in mind and this study conducted
during the COVID-19 pandemic, these authors present a research question seeking to outline
various strategies that clinicians can use to assist the senior population in maintaining social
health in the wake of the social distancing restrictions. The study uses a collective case study
research design to generate an in-depth and comprehensive exploration of loneliness and social
isolation among older adults during the pandemic. This study employs a cognitive-behavioral
framework for social connectedness and creates “Connection Plans” that can guide healthcare
professionals to communicate with seniors virtually. The researchers state these strategies can be
implemented over the phone for brief periods (30 minutes). These strategies include engaging in
mindful activities to communicate with a sense of shared humanity, creating satisfying
sensations for the five senses, and participating in calming activities such as guided imagery
exercises and progressive muscle relaxation. This study is helpful in this research since Van
Orden et al. (2020) state that clinicians can use them to address loneliness and assist older adults
in maintaining social health. Therefore, this research is an authoritative study that will form the
foundation of the paper since it answers the research question.
6
Wang, Z., & Chen, S. (2023). Senior’s perceived barriers to accessing an urban charitable food
assistance program. Journal of Nutrition Education and Behavior, 55(7), 5–6.
https://doi.org/10.1016/j.jneb.2023.05.014
Wang and Chen (2023), in their research article, acknowledge that low income among
elderly individuals is a significant cause of food insecurity that limits this population from
accessing nutritious foods. Therefore, these researchers examine the senior population’s
perceived obstacles to utilizing charitable food assistance (CFA) programs as resources for
meeting this need. In this study, Wang and Chen (2023) focused on CFA programs serving more
than 1000 households and interviewed the participants. The participants indicated that perceived
barriers included lack of personal transportation, confusion in the distribution procedures, and
pre-packed food needing to be aligned with health and personal preferences. The author
recommended that these programs be improved by implementing various strategies, including
reducing canned foods, enacting a client-choice model, and increasing the distribution of fresh
meat, produce, and seafood. This journal article will form the foundation of the research topic
since it discusses barriers deterring the senior population from participating in the program and
offering solutions.
Research Proposal Guide
Dr. Angel Resto
2020
Contents
Section 1- Introduction …………………………………………………………………………………………………………………………3
Step 1: Defining the social problem ……………………………………………………………………………………………………3
Worksheet1: Defining the Social Problem ……………………………………………………………………………………3
Worksheet 2: Gathering evidence of the problem ……………………………………………………………………….4
Step 3: Identifying the cause of the problem ………………………………………………………………………………………5
Worksheet3: Identifying the causes of the problem …………………………………………………………………….5
Step 4 -Formulating Problem Statements ………………………………………………………………………………………….6
Worksheet 4 – Formulating Problem Statements………………………………………………………………………….6
Step 5: The Significance of the Study ………………………………………………………………………………………………….7
Worksheet 5: Significance/rationale of the study ………………………………………………………………………..7
Step 6: Measurement/Assessment of Variables/Constructs……………………………………………………………….8
Worksheet: Measurements/Assessments (Quantitative Research) …………………………………………….9
Worksheet: Measurements/Assessments (Qualitative Research) ……………………………………………. 10
Step 7: How to Write a Research Question ……………………………………………………………………………………… 11
Worksheet 7 – Research Question(s) ………………………………………………………………………………………… 12
Step 8- Formulating a Purpose Statement ……………………………………………………………………………………… 13
Worksheet 8 – Formulating Purpose statement ………………………………………………………………………… 14
Step 9: How to formulate the Hypothesis ………………………………………………………………………………………… 15
Worksheet 9 – Writing the Hypothesis………………………………………………………………………………………. 17
Step 9: Check up ……………………………………………………………………………………………………………………………… 18
Worksheet 9- Summary ……………………………………………………………………………………………………………… 19
Step 10: Put it all together ……………………………………………………………………………………………………………… 20
Section 2: Annotated Bibliography …………………………………………………………………………………………………… 21
Section 2: Literature Review ……………………………………………………………………………………………………… 26
Section 3: Methodology …………………………………………………………………………………………………………………….. 28
Description of Research Method and Research Design ………………………………………………………………………. 28
Population and sample …………………………………………………………………………………………………………………….. 29
Data collection procedures ………………………………………………………………………………………………………………. 30
Method of Statistical Data Analysis …………………………………………………………………………………………………… 30
SWK310 2020 DR. ANGEL RESTO
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NORTHEASTERN ILLINOIS UNIVERSITY
SOCIAL WORK PROGRAM
Research Proposal Guide
The Research Proposal is a complete description of the intended research, developed under the
supervision of the assigned supervisor. Through the full proposal, the student needs to demonstrate
convincingly that the study will make a contribution to a social work issue or problem. The full
research proposal must be between 5 and 10 pages and should present the following:
Section 1: Introduction
• Statement of the Problem
• Purpose/Significance/Rationale
• Research Questions
• Research Hypothesis (If applicable)
Section 2: Literature Review
• Methodology
• Study Population and Sampling
• Description of research design
• Instrumentation
Section 3: Data collection procedures
• Data analysis methods – if applicable statistical planning must be fully addressed or the
candidate should provide evidence that statistics are not required.
Study period – Timetable for completion of the project
References
Appendixes – (copy of questionnaire, consent forms, etc.)
SWK310 2020 DR. ANGEL RESTO
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Section 1- Introduction
The following pages present several worksheets that you must complete to create your introduction
session.
Step 1: Defining the social problem
As a researcher, you will first need to select a problem topic and then specifically define a social
problem. A social problem is a condition that at least some people in a community view as being
undesirable.
Worksheet1: Defining the Social Problem
1. In one or two sentences, state the nature of the social problem that you plan to study.
2. What is the specific community location of the social problem?
3. List at least three undesirable social conditions that result from this problem:
1.
2.
3.
4. Next, discuss why a research is necessary.
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Step 2: Gathering evidence of the problem –Visit the library
The goal of this step is to develop problem solving skills through using the library/Internet.
Therefore, this step requires you to use the Internet to locate at least one reference to support the
existence of your problem.
Suppose you are doing a social problem with your agency or your community as the geopolitical
location. Try to locate statewide or national data on the problem that best matches your agency or
community. Then, you can contend that the data is applicable to your agency or community as well.
Worksheet 2: Gathering evidence of the problem
Your problem (phrase):
Present evidence that a problem exists. Be as specific as possible and cite at least one source
of data:
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Step 3: Identifying the cause of the problem
Medical researchers try to identify the causes of various diseases. They can develop a vaccine to
immunize people from contracting that disease. For example, Dr. Jonas Salk virtually eliminated
polio when he identified the virus that caused it, and then developed a vaccine. Likewise, if
researchers can identify the causes or factors that contribute to a social problem, then they can try
to develop public policies to eliminate or lessen those causes or factors.
Unlike the specific virus that causes polio, most social problems have numerous causes and
contributing factors. Some of the Internet/library resources that you used to complete the previous
step probably also contain information about causes and contributing factors. Review those articles
and brainstorm the causes and factors that contribute to your social problem. Record that
information on Worksheet 3.
Worksheet3: Identifying the causes of the problem
Briefly list several underlying factors that contribute to the problem that you have identified
(support these factors with evidence):
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Step 4 -Formulating Problem Statements
A persuasive problem statement consists of three parts: 1) the ideal, 2) the reality, and 3) the
consequences for the reader of the proposal. Well constructed problem statements will convince
your audience that the problem is real and worth having you investigate. Your strategy is one of
contrast: by situating the ideal scenario next to the situation as it exists, you cannot only persuade
the reader that a problem exists, but then go on to emphasize the consequences of ignoring or
addressing the problem. Remember, your problem statement is the backbone of the proposal. By
giving careful consideration to how you construct it now (for the proposal), you can use it when
doing your research and writing for the proposal.
Worksheet 4 – Formulating Problem Statements
STATEMENT 1 (DESCRIPTION OF THE IDEAL SCENARIO)
Describe the goals, desired state, or the values that your audience considers important and that are
relevant to the problem.
(BUT)
Connect statements 1 and 2 using a term such as “but,” “however,” “Unfortunately,” or “in spite of”;
STATEMENT 2 (THE REALITY OF THE SITUATION)
Describe a condition that prevents the goal, state, or value discussed in statement 1 from being
achieved or realized at the present time.
STATEMENT 3 (THE CONSEQUENCES FOR THE AUDIENCE)
Using specific details, show how the situation in statement 2 contains little promise of improvement
unless something is done. Then emphasize the benefits of research by projecting the consequences
of possible solutions as well.
Source: http://www.personal.psu.edu/cvm115/proposal/propassign.htm
SWK310 2020 DR. ANGEL RESTO
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Step 5: The Significance of the Study
The Significance of the study describes the contributions of the study as new knowledge, make
findings more conclusive. It cites the usefulness of the study to the specific groups. Cite all the
persons and groups that benefited on your study/research. Include a short explanation regarding
how those persons and groups benefited from the study. (How the research study will help them?)
Worksheet 5: Significance/rationale of the study
Why you are doing the study?
What do you hope to achieve by completing the study?
What benefits will your research bring to the social work field?
How it will be helpful? To whom? And Why?
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Step 6: Measurement/Assessment of Variables/Constructs
Assignment goals:
• If quantitative methods are to be used in your research, your goal is to identify and define
variables/constructs, how they will be measured (that is, locating measures/instruments)
and assess their reliability and validity
• If qualitative methods are to be used in your research, your goal is to review the assessment
of constructs identified in for your research, along with issues of credibility, dependability,
and integrity.
Measurements/Assessments Assignment
For this assignment you will scan your annotated bibliography for information about how others
have identified and operationally defined the variables/constructs that are similar to the ones you
have identified for your research project.
• For qualitative research you will have to identify the variables and how the literature
addresses how these variables are measured. You need to also describe what data collection
tool will be use to collect this data.
For example: if you are interested in measuring “stress level”, you need to search for literature about
how stress can be measured, and what instrument can be used to measure stress. Make sure you
address how reliable and valid these instruments are to measure these variables.
• For qualitative research, you will need to focus on the way in which constructs/themes, etc.,
are to be assessed in a manner that establishes credibility, dependability, and integrity.
For example: If you are interested in describe how people feel after the death of a family member, you
need to search how the literature assess how people feel after the death of a family member. Then you
will replicate what the literature has done.
Use APA style in preparing your paper and citing references (i.e., the paper should follow APA for
all paper and text formatting). The paper should be a minimum of 2 pages in length, excluding the
title page and references. Revisions may be necessary based on faculty mentor feedback.
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Worksheet: Measurements/Assessments (Quantitative Research)
For this assignment you will scan your annotated bibliography for information about how others
have identified and operationally defined the variables/constructs that are similar to the ones you
have identified for your research project.
Dependent variable:
Definition: How does the literature define this variable?
Assessment:
Explain how does the literature measure this variable?
What data collection tool does the literature suggest to use to measure this variable?
Reference: List the source in APA style
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Worksheet: Measurements/Assessments (Qualitative Research)
If qualitative methods are to be used in your research, your goal is to review the assessment of
constructs identified in for your research, along with issues of credibility, dependability, and
integrity.
Describe the construct:
Discuss how the literature measures this construct in terms of credibility and dependability?
(How you as a researcher will ensure the exploration of this construct will maintain credibility,
and dependability).
Reference: List the source in APA style
Credibility
The credibility criteria involves establishing that the results of qualitative research are credible or
believable from the perspective of the participant in the research. Since from this perspective, the
purpose of qualitative research is to describe or understand the phenomena of interest from the
participant’s eyes, the participants are the only ones who can legitimately judge the credibility of
the results. (source; http://www.socialresearchmethods.net/kb/qualval.php)
Dependability
The traditional quantitative view of reliability is based on the assumption of replicability or
repeatability. Essentially it is concerned with whether we would obtain the same results if we
could observe the same thing twice. But we can’t actually measure the same thing twice — by
definition if we are measuring twice, we are measuring two different things. In order to estimate
reliability, quantitative researchers construct various hypothetical notions (e.g., true score theory)
to try to get around this fact.
The idea of dependability, on the other hand, emphasizes the need for the researcher to account
for the ever-changing context within which research occurs. The research is responsible for
describing the changes that occur in the setting and how these changes affected the way the
research approached the study. (source; http://www.socialresearchmethods.net/kb/qualval.php)
SWK310 2020 DR. ANGEL RESTO
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Step 7: How to Write a Research Question
Source: http://writingcenter.gmu.edu/resources-template.php?id=59
What is a research question?
A research question is a clear, focused, concise, complex and arguable question around which
you center your research. You should ask a question about an issue that you are genuinely curious
about.
Why is a research question essential to the research process?
Research questions help writers focus their research by providing a path through the research and
writing process. The specificity of a well-developed research question helps writers avoid the “allabout” paper and work toward supporting a specific, arguable thesis.
Steps to developing a research question:
Choose an interesting general topic. Even directed academic research should focus on a topic
in which the writer is at least somewhat personally invested. Writers should choose a broad
topic about which they genuinely would like to know more. An example of a general topic
might be “Slavery in the American South” or “Films of the 1930s.”
Do some preliminary research on your general topic. Do a few quick searches in current
periodicals and journals on your topic to see what’s already been done and to help you
narrow your focus. What questions does this early research raise?
Consider your audience. For most college papers, your audience will be academic, but always
keep your audience in mind when narrowing your topic and developing your question.
Would that particular audience be interested in this question?
Start asking questions. Taking into consideration all of the above, start asking yourself openended “how” and “why” questions about your general topic. For example, “How did the slave
trade evolve in the 1850s in the American South?” or “Why were slave narratives effective
tools in working toward the abolishment of slavery?”
Evaluate your question.
Is your research question clear? With
Find a NEWSPAPER ARTICLE from the past year on the topic of Human Resources in Healthcare. It can be about any current event in the news that deals with a topic covered somewhere in the textbook.Please NUMBER and use the following HEADINGS in your response: 1. LINK: Provide a link to the newspaper article for the class. 2. SUMMARIZE the article in detail. 3. CONNECTION TO TEXT: Draw a connection between the article and information covered in the textbook. Explain WHY this information is important and HOW it is related to the material covered in this class. Be sure to explain which chapter covers this topic, what is explained in that chapter, and how that material relates to your news article. 4. BEST PRACTICE: What is “Best Practice” in this area? Support your Initial Post with information from at least 3 peer reviewed journal articles. Note that the references must be from peer reviewed journals and provided in APA format. NOTE: Must be a NEWS article from a local, national or international news outlet… NOT a website, commercial or blog. Please contact me if you have questions, because credit will be provided only for newspaper articles.
For this assignment, list the parts of a comprehensive mental status examination (MSE) for mental health patients. Give examples of each and describe the significance to the advanced practice nurse.
Submission Instructions
The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
The paper should be formatted per current APA and 2-4 pages in length, excluding the title, abstract, and references page.
Incorporate a minimum of 5 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
Complete and submit the assignment by 11:59 PM ET Sunday.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
Grading Rubric
Your assignment will be graded according to the grading rubric.
Mental Exam Rubric
Criteria Ratings Points
Identification of Main Issues/Problems
Distinguished – 20 points
Identify and demonstrate a sophisticated understanding of the issues/problems.
Excellent – 18 points
Identifies and demonstrates an accomplished understanding of most of the issues/problems.
Fair – 16 points
Identifies and demonstrates an acceptable understanding of most of the issues/problems.
Poor – 8 points
Identifies and demonstrates an unacceptable understanding of most of the issues/problems.
20 points
Analysis and Evaluation of Issues/Problems
Distinguished – 20 points
Presents an insightful, thorough analysis and evaluation of issues/problems.
Excellent – 18 points
Presents a thorough analysis and evaluation of most of the issues/problems.
Fair – 16 points
Presents a superficial or incomplete analysis and evaluation of issues/problems.
Poor – 8 points
Presents unacceptable analysis and evaluation of issues/problems.
20 points
Demonstrates a Conceptual Understanding
Distinguished – 20 points
Provides a thorough, competent, and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.
Excellent – 18 points
Provides competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.
Fair – 16 points
Provides competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.
Poor – 8 points
Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.
20 points
Use of Citations to Course Readings and Additional Research/Literature
Distinguished – 20 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.
Excellent – 18 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
Fair – 16 points
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
Poor – 8 points
Ineffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing.
20 points
Writing Mechanics and APA Formatting Guidelines
Distinguished – 20 points
Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.
Excellent – 18 points
Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.
Fair – 16 points
Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.
Poor – 8 points
Demonstrates issues in writing and communicating clearly. APA style and writing mechanics need serious attention.
2 example pdf are provided for the same class so follow same format and write on the given word doc and make sure to include the peds ati book as reference and absolutely no plagiarism 6 topics to do
Unformatted Attachment Preview
lOMoARcPSD|13444472
3 Critical Points PEDS – Peds Remediations
Pediatrics (West Coast University)
Studocu is not sponsored or endorsed by any college or university
Downloaded by marina saroyan (marina.saroyann@gmail.com)
lOMoARcPSD|13444472
“3 Critical Points”
Identify the 3 critical (most important) points for every NCLEX Client Need Category below 76%. Use whatever reliable evidence-based resources
necessary to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per syllabus). Cite your sources (APA formatting not required).
Include the following reflection with each of your topics
How do the 3 critical (Most Important) points that you learned help you understand the following 6 Cognitive Functions (which follows the Nursing Process):
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment, urgency,
signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
o
Date
Student Name
Instructor Name
Assessment Name
# of incorrect topics
09/22/2023
Cassandra Stager
NCLEX Client Need Category
Topic
3 critical points
Topics to review (for
each sub-category)—
indicate # of topics to
review
3 new concepts you learned/now
understand about this topic
Dr. Alkhatib
RN Nursing Care of Children Online Practice 2019 A
21
Reflection on critical points using the
6 Cognitive Functions
Content Area
Sub-categories (under
Content Area)—indicate #
of categories to review
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Utilizing at least one of the 6
cognitive functions listed above),
reflect on your 3 critical points
lOMoARcPSD|13444472
Safety and Infection Control (4 items)
Accident/error/injury
prevention (2 items)
Head Injury: Planning
care for an Infant who
has an Epidural
Hematoma
1. I now understand that the need
to explain to the client actions
being made and why even when
there is a potential decrease in
the level of consciousness.
(Hearing is the last sense
affected by a head injury).
2. I learned that the biggest
precaution to take with a head
injury patient is to maintain
safety and seizure
3. I learned that the presence of
petechiae requires immediate
medical attention
Pediatric Emergencies:
Planning interventions
for Lead Exposure
1. I learned that there are three
types of lead exposures starting
with low-dose, then high-dose,
but other manifestations can
occur as well.
2. I now understand that low dose
exposure will cause symptoms
such as distractibility,
impulsiveness, hyperactivity,
hearing impairment, and mild
intellectual difficulty. High dose
exposure creates cognitive
delays varying in severity,
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Take Actions:
I need more practice on
identifying priority findings. I
often read the questions to fast
and thus think it’s asking me
what are symptoms of the
disease and not what the priority
intervention should be.
Analyze Cues:
I missed understanding the
significance of assessment
findings. I need to relearn the
times for routine screenings of
pediatric patients to ensure
those screenings and
immunizations are taking place at
the times they need to.
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blindness, paralysis, coma,
seizures, and death.
3. I learned that nursing actions
include educating parents on
the routine screenings that
need to take place for lead
levels at 1,2, and 3 years of age.
Standard Precautions/
Transmission-based
Precautions/ Surgical
Asepsis (2)
Communicable
diseases: Isolation
Precautions for a child
who has Pertussis
1. I learned what Pertussis is
known as the whooping cough.
I had not refreshed myself
about this disease.
2. I now understand that Pertussis
is spread through direct
contact, droplet, or indirect
contact with freshly
contaminated articles.
3. I learned that incubation
includes 6 to 20 days, but
usually 7 to 10 days and the
communicability is greatest
during catarrhal stage before
onset of paroxysmal stage.
Take Actions:
Infection Control:
Nursing action for an
infant who has
respiratory syncytial
virus
1. I learned that pediatric patients
with rsv should be placed under
contact precautions.
2. I now understand that contact
precautions are to protect
visitors and caregivers when
they are within 3 ft of the client
Take Actions:
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I read the question to fast and
did not understand that I need to
focus on isolation precautions. If
I slow down then I would have
been able to understand what
the question was asking.
I need to practice what types of
diseases require specific
precautions. I missed this
question because I was not able
to know what diseases need
lOMoARcPSD|13444472
against direct client and
certain precautions.
environmental infections.
3. I learned that contact
precautions require a private
room or a room with other
patients with the same
infection. Care teams should
wear gloves and gowns as well
as any visitors. Disposal of
infections dressing material into
a single, nonporous bag without
touching the outside of the bag.
Health Promotion and Maintenance (2 items)
Developmental Stages and
Transitions (1)
Health Promotion of
1. I learned that preschoolers have
Preschoolers (3-6
improvements on their fine
years) Developmental
motor skills for example things
Milestones of a 4-yearsuch as copying figures on
old child
paper and dressing
independently.
2. I understand now that
preschoolers age 3 should be
able to ride a tricycle, jump off
the bottom step, and stand on
one foot for a few seconds. A
four year old should be able to
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Analyze Cues:
I misread the question and
wasn’t focusing on the correct
age group. I need to review the
milestones for each age group as
categorized by Erikson and Piget.
lOMoARcPSD|13444472
skip and hop on one foot, throw
a ball overhead, and catch balls
reliably.
3. I learned that 5-year-old
preschoolers should be able to
jump ropes, walk backwards
with heel to tow, and throw and
catch a ball with ease.
Health Screening (1)
Musculoskeletal
congenital disorders:
Scoliosis assessment
1. I learned that Scoliosis is a
complex deformity of the spine
that also affects the ribs. It is
characterized by a lateral
curvature of the spine and
spinal rotation that causes rib
asymmetry.
2. I understand the risk factors for
Scoliosis are genetic tendency,
being female, and there is a
higher incidence between the
ages 8 to 15 years of age.
3.
Psychosocial Integrity (1 items)
Abuse/neglect (2 items)
Psychosocial issues of
infants, children, and
adolescents:
Identifying possible
indications of physical
abuse
1. xxx
2. xxx
3. xxx
Downloaded by marina saroyan (marina.saroyann@gmail.com)
lOMoARcPSD|13444472
Reduction of Risk Potential (4 items)
System Specific
Assessments (1)
Antibiotics Affecting
Protein Syntheses:
Identifying risk factors
for hearing Loss
Therapeutic Procedures (3) Discharge teaching for
a child who has major
burns
Musculoskeletal
congenital disorders:
Evaluating
understanding of Pavlik
Harness Use
Postoperative care for
a child following a skin
graft
1. xxx
2. xxx
3. xxx
1. xxx
2. xxx
3. xxx
1. xxx
2. xxx
3. xxx
1. xxx
2. xxx
3. xxx
Physiological Adaptation
Alterations in Body
systems (1)
Provider Prescriptions
to anticipate for a child
who has major burns
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Recognize Cues:
I misunderstood the question
asking for priority findings. I
thought the question was asking
for signs/symptoms. I will read
the question slower next time so
I can pay attention to the priority.
lOMoARcPSD|13444472
Illness Management (7)
Anticipating provider
prescriptions for a
child who has major
burns
Assessment Findings
requiring immediate
follow-up
Diabetes Mellitus:
Client teaching
Evaluating
effectiveness of
discharge teaching for
a child who has Atopic
Dermatitis
Identifying findings to
report to the provider
for a child who has
asthma
Identifying potential
complications for a
preschooler who has
an infectious disease
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Analyze Cues:
I missed understanding the
significance of assessment
findings. I read the question too
fast and missed the priority
finding for the patient
lOMoARcPSD|13444472
Pathophysiology (1)
Unexpected response to
therapies (1)
Prioritizing care for a
child who has major
burns
Gastrointestinal
structural and
inflammatory
disorders: identifying
the location of
McBurney’s point
Blood and blood
products: identifying
manifestations of
blood transfusion
reactions
Downloaded by marina saroyan (marina.saroyann@gmail.com)
lOMoARcPSD|13444472
3 Critical Points PEDS – Peds Remediations
Pediatrics (West Coast University)
Studocu is not sponsored or endorsed by any college or university
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lOMoARcPSD|13444472
“3 Critical Points”
Identify the 3 critical (most important) points for every NCLEX Client Need Category below 76%. Use whatever reliable evidence-based resources
necessary to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per syllabus). Cite your sources (APA formatting not required).
Include the following reflection with each of your topics
How do the 3 critical (Most Important) points that you learned help you understand the following 6 Cognitive Functions (which follows the Nursing Process):
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment, urgency,
signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
o
Date
Student Name
Instructor Name
Assessment Name
# of incorrect topics
09/22/2023
Cassandra Stager
NCLEX Client Need Category
Topic
3 critical points
Topics to review (for
each sub-category)—
indicate # of topics to
review
3 new concepts you learned/now
understand about this topic
Dr. Alkhatib
RN Nursing Care of Children Online Practice 2019 A
21
Reflection on critical points using the
6 Cognitive Functions
Content Area
Sub-categories (under
Content Area)—indicate #
of categories to review
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Utilizing at least one of the 6
cognitive functions listed above),
reflect on your 3 critical points
lOMoARcPSD|13444472
Safety and Infection Control (4 items)
Accident/error/injury
prevention (2 items)
Head Injury: Planning
care for an Infant who
has an Epidural
Hematoma
1. I now understand that the need
to explain to the client actions
being made and why even when
there is a potential decrease in
the level of consciousness.
(Hearing is the last sense
affected by a head injury).
2. I learned that the biggest
precaution to take with a head
injury patient is to maintain
safety and seizure
3. I learned that the presence of
petechiae requires immediate
medical attention
Pediatric Emergencies:
Planning interventions
for Lead Exposure
1. I learned that there are three
types of lead exposures starting
with low-dose, then high-dose,
but other manifestations can
occur as well.
2. I now understand that low dose
exposure will cause symptoms
such as distractibility,
impulsiveness, hyperactivity,
hearing impairment, and mild
intellectual difficulty. High dose
exposure creates cognitive
delays varying in severity,
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Take Actions:
I need more practice on
identifying priority findings. I
often read the questions to fast
and thus think it’s asking me
what are symptoms of the
disease and not what the priority
intervention should be.
Analyze Cues:
I missed understanding the
significance of assessment
findings. I need to relearn the
times for routine screenings of
pediatric patients to ensure
those screenings and
immunizations are taking place at
the times they need to.
lOMoARcPSD|13444472
blindness, paralysis, coma,
seizures, and death.
3. I learned that nursing actions
include educating parents on
the routine screenings that
need to take place for lead
levels at 1,2, and 3 years of age.
Standard Precautions/
Transmission-based
Precautions/ Surgical
Asepsis (2)
Communicable
diseases: Isolation
Precautions for a child
who has Pertussis
1. I learned what Pertussis is
known as the whooping cough.
I had not refreshed myself
about this disease.
2. I now understand that Pertussis
is spread through direct
contact, droplet, or indirect
contact with freshly
contaminated articles.
3. I learned that incubation
includes 6 to 20 days, but
usually 7 to 10 days and the
communicability is greatest
during catarrhal stage before
onset of paroxysmal stage.
Take Actions:
Infection Control:
Nursing action for an
infant who has
respiratory syncytial
virus
1. I learned that pediatric patients
with rsv should be placed under
contact precautions.
2. I now understand that contact
precautions are to protect
visitors and caregivers when
they are within 3 ft of the client
Take Actions:
Downloaded by marina saroyan (marina.saroyann@gmail.com)
I read the question to fast and
did not understand that I need to
focus on isolation precautions. If
I slow down then I would have
been able to understand what
the question was asking.
I need to practice what types of
diseases require specific
precautions. I missed this
question because I was not able
to know what diseases need
lOMoARcPSD|13444472
against direct client and
certain precautions.
environmental infections.
3. I learned that contact
precautions require a private
room or a room with other
patients with the same
infection. Care teams should
wear gloves and gowns as well
as any visitors. Disposal of
infections dressing material into
a single, nonporous bag without
touching the outside of the bag.
Health Promotion and Maintenance (2 items)
Developmental Stages and
Transitions (1)
Health Promotion of
1. I learned that preschoolers have
Preschoolers (3-6
improvements on their fine
years) Developmental
motor skills for example things
Milestones of a 4-yearsuch as copying figures on
old child
paper and dressing
independently.
2. I understand now that
preschoolers age 3 should be
able to ride a tricycle, jump off
the bottom step, and stand on
one foot for a few seconds. A
four year old should be able to
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Analyze Cues:
I misread the question and
wasn’t focusing on the correct
age group. I need to review the
milestones for each age group as
categorized by Erikson and Piget.
lOMoARcPSD|13444472
skip and hop on one foot, throw
a ball overhead, and catch balls
reliably.
3. I learned that 5-year-old
preschoolers should be able to
jump ropes, walk backwards
with heel to tow, and throw and
catch a ball with ease.
Health Screening (1)
Musculoskeletal
congenital disorders:
Scoliosis assessment
1. I learned that Scoliosis is a
complex deformity of the spine
that also affects the ribs. It is
characterized by a lateral
curvature of the spine and
spinal rotation that causes rib
asymmetry.
2. I understand the risk factors for
Scoliosis are genetic tendency,
being female, and there is a
higher incidence between the
ages 8 to 15 years of age.
3.
Psychosocial Integrity (1 items)
Abuse/neglect (2 items)
Psychosocial issues of
infants, children, and
adolescents:
Identifying possible
indications of physical
abuse
1. xxx
2. xxx
3. xxx
Downloaded by marina saroyan (marina.saroyann@gmail.com)
lOMoARcPSD|13444472
Reduction of Risk Potential (4 items)
System Specific
Assessments (1)
Antibiotics Affecting
Protein Syntheses:
Identifying risk factors
for hearing Loss
Therapeutic Procedures (3) Discharge teaching for
a child who has major
burns
Musculoskeletal
congenital disorders:
Evaluating
understanding of Pavlik
Harness Use
Postoperative care for
a child following a skin
graft
1. xxx
2. xxx
3. xxx
1. xxx
2. xxx
3. xxx
1. xxx
2. xxx
3. xxx
1. xxx
2. xxx
3. xxx
Physiological Adaptation
Alterations in Body
systems (1)
Provider Prescriptions
to anticipate for a child
who has major burns
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Recognize Cues:
I misunderstood the question
asking for priority findings. I
thought the question was asking
for signs/symptoms. I will read
the question slower next time so
I can pay attention to the priority.
lOMoARcPSD|13444472
Illness Management (7)
Anticipating provider
prescriptions for a
child who has major
burns
Assessment Findings
requiring immediate
follow-up
Diabetes Mellitus:
Client teaching
Evaluating
effectiveness of
discharge teaching for
a child who has Atopic
Dermatitis
Identifying findings to
report to the provider
for a child who has
asthma
Identifying potential
complications for a
preschooler who has
an infectious disease
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Analyze Cues:
I missed understanding the
significance of assessment
findings. I read the question too
fast and missed the priority
finding for the patient
lOMoARcPSD|13444472
Pathophysiology (1)
Unexpected response to
therapies (1)
Prioritizing care for a
child who has major
burns
Gastrointestinal
structural and
inflammatory
disorders: identifying
the location of
McBurney’s point
Blood and blood
products: identifying
manifestations of
blood transfusion
reactions
Downloaded by marina saroyan (marina.saroyann@gmail.com)
lOMoARcPSD|13444472
3 Critical Points (ATI Remediation)
Pediatrics (West Coast University)
Studocu is not sponsored or endorsed by any college or university
Downloaded by marina saroyan (marina.saroyann@gmail.com)
lOMoARcPSD|13444472
“3 Critical Points”
Identify the 3 critical (most important) points for every NCLEX Client Need Category below 76%. Use whatever reliable evidence-based resources
necessary to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per syllabus). Cite your sources (APA formatting not required).
Include the following reflection with each of your topics
How do the 3 critical (Most Important) points that you learned help you understand the following 6 Cognitive Functions (which follows the Nursing Process):
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment, urgency,
signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
o
Date
Student Name
Instructor Name
Assessment Name
# of incorrect topics
03/05/2023
Caryl Jeune Nolasco
Christine Dyer
NCLEX Client Need Category
Topic
3 critical points
Identifying Conditions
Based on Findings in
the Electronic Medical
Record
1. An expected finding in
nephrotic syndrome is the
blood pressure would be in
expected range or slightly
below (ATI book).
2. Hyperlipidemia would be
present in nephrotic syndrome
RN Nursing Care of Children Online Practice 2019 B
Reflection on critical points using the
6 Cognitive Functions
Physiological Adaptation (3)
Alterations in Body
Systems (2 items)
Downloaded by marina saroyan (marina.saroyann@gmail.com)
Recognizing cues:
The questions are usually about
signs and symptoms which are
usually a select all that apply
question. I need to memorize
and differentiate signs and
lOMoARcPSD|13444472
Physical Assessment
Findings: Identifying
Adventitious Lung
Sounds
Illness Management (1
item)
Anticipating Actions to
Take for an Adolescent
Who Is Experiencing a
Pneumothorax
(ATI book).
3. Expected findings in hemolytic
uremic syndrome are irritability,
lethargy, hallucinations, and
edema (ATI book).
1. Wheeze is a high-pitched
whistling, musical sound as air
passes through narrowed or
obstructed airways (ATI book).
2. Wheeze is usually louder on
expiration (ATI book).
3. Rhonchi is a course, loud, lowpitched rumbling sounds during
either inspiration or expiration
resulting from fluid or mucus
(ATI book).
1. First intervention for
pneumothorax is to administer
oxygen therapy (ATI book).
2. Chest tube insertion on pleural
space to drain fluid, blood, or
air, re-establish a negative air
pressure, and facilitate lung
function (ATI book).
3. Respiratory failure is when
there is inadequate gas
exchange due to lung collapse
(ATI book).
Downloaded by marina saroyan (marina.saroyann@gmail.com)
symptoms in order to answer
questions properly.
Recognizing cues:
There are a lot of questions
regarding the respiratory tract
and I need to recognize which
problem should be recognized
first and which intervention
should be done first to answer
the question properly
Recognizing cues:
The interventions for
pneumothorax can be
complicated but it is important to
facilitate ABC when choosing an
intervention for this question.
“3 Critical Concepts – Remediation Document”
Upon completion of the required Practice Assessment, conduct a focused review by downloading the “ATI Individual Performance Profile” Report.
Complete the “3 Critical Concepts – Remediation Document” by using each NCLEX Client Need Category, listed under the “Topics to Review
Section” in the report to identify 3 Critical Concepts learned and or understand better about the concept. Use reliable evidence-based resources
to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per Syllabus). Cite your sources (APA formatting not required).
8 NCLEX Client Need Categories
1) Management of Care, 2) Safety and Infection Control, 3) Basic Care and comfort, 4) Health Promotion and Maintenance, 5) Psychosocial Integrity, 6)
Pharmacological and Parenteral Therapies, 7) Reduction of Risk Potential, and 8) Physiological Adaptation
Reflection Section – include one of the 6 Cognitive Functions
•
Reflect on how the 3 critical concepts you learned, helped you gain a better understanding of the 6 Cognitive Functions of the National Council for State
Boards of Nursing (NCSBN) – Clinical Judgement Measurement Model (NCJMM) – which follows the Nursing Process:
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment,
urgency, signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
Topics To Review – F y h t y r om y o u r j oj g o 5 j o r j o t r6 5 h y 5 oj 5 o6
List the NCLEX Client Need Categories, Topics, and Concepts to review from your report here – as shown in the example provided.
NCLEX Client Need Category Topic Concept
Safety and Infection Control (1 item)
Reporting of Incident/Event/Irregular Occurrence/Variance (1 item)
Safe Medication Administration and Error Reduction: Priority Action Following a Medication Error
Remove the 5 lines above, add information from your report before submission.
Date
Student Name
Instructor Name
Assessment Name
# of Topics to Review
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
Reflection – Address 1 of the 6 Cognitive
understand better about this topic)
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
References:
Include your references here. Below is an example – delete this line and the examples below and add the references you used.
Halter, M. J. (2022). Varcarolis’ Foundations of Psychiatric Mental Health Nursing 9th ed. Publisher: Saunders/Elsevier. St. Louis, Missouri.
ATI Content Mastery Series Review Module: RN Mental Health 11.0 ed.
McCuistion, L.E., DiMaggio, K., Winton, M.B., & Yeager (2023). Pharmacology: A Patient-Centered Nursing Process Approach. 11th. Ed. Publisher: Elsevier.
ATI Content Mastery Series Review Module: RN Pharmacology 11.0 ed.
Title :Enhancing Donor Screening for Higher Blood Bank Levels: Investigating G6PD Examination Cancellation. I send all the document that you need to writ this project, the idea and criteria of writing also how the score will be done. in the data analysis I want to compare the G6PD Kit ( saving in reagent kit before and after ) between donors and patent in 2019 – 2020 – 2021 and 2022.also I send one of my friend example project to flow the criteria.
Unformatted Attachment Preview
King Fahad Armed Forces Hospital
ImpACT of ImplemenTAtion of ‘Sickle Cell DiSEASE Acute PAinful Crisis
CliniCAL PAthwAy’ AT KFAFH: On reducing the number of ER visits,
ADMIssion, rEAdmission rATes, opiods, consumption And cost
Dr. Iman Alhazmi
Dr. Ahmad Alhartini, Dr. Aseel Jambi
Contact No.: 0555773685
Email: iahazmi@hotmail.com
ABSTRACT
Sickle cell disease (SCD) is an autosomal recessive disorder of hemoglobin, associated with
consanguineous marriages in Saudi Arabia. The prevalence of SCD in Saudi Arabia varies from 1 % to
17 %. The vaso-occlusive crisis is the most common complication of sickle cell disease in adults, which
is the primary reason why these patients seek medical care in emergency departments. Adequate pain
management will result in fewer episode crisis and reduce readmission rates. The study goal is to ensure
proper pain management to prevent relapses, to a lower rate of admission, ED visits and to control the
consumption of narcotics through the implementation of a clinical pathway.
A total of 374 SCD Patients (12 years and above with isolated painful crisis) was identified by KFAFH
Emergency Department registration data. The diagnosis of SCD was confirmed by Hb electrophoresis.
The primary source of patient information was conducted from the patient file, ED registration, and
chart review for one year before (May 2016- April 2017) implementation of clinical pathway and one
year after (May 2017- April 2018) implementation of the clinical pathway.
Overall, the results showed a drop in ER visits/Patient, rate of admission/ patient, and readmission
rate by> 75.55%, 41.87 %, and 54.51 % respectively.
Decrease in Meperidine and Tramadol consumption by > 33%, and 54 % respectively.
Cost saved after implementation of the pathway is more than 410,709 S.R/year.
Proper pain management after implementation of painful crisis management clinical pathway showed a
lower rate of admission and a significant decrease in a number of ED visits. In addition to costeffectiveness from reducing hospital admission and opioids consumptions.
Keywords: Painful crisis management, Sickle cell anemia, Morphine, Opioid, Oxycodone.
INTRODUCTION
Problem Description
Sickle cell Disease (SCD) is the most common autosomal recessive disorder associated with
consanguineous marriages in Saudi Arabia. Data on SCD prevalence in Saudi Arabia is limited.
However, it considered the highest prevalence among the surrounding countries. According to a study
conducted between 2011 and 2015, the incidence rate was 49.6 (45.8 for carriers and 3.8 for cases) per
1000 persons (Alsaeed et al., 2018).
SCD is a chronic blood disorder that affects almost all organs with variable clinical manifestations. The
acute painful crisis is the hallmark manifestation of the SCD and the leading cause of emergency
department (ED) visits and hospitalization (S. K. Ballas & Lusardi, 2005). Much of the devastation
caused by the disease is due to the recurrent crisis. Vaso-occlusion, inflammation, and nociception are
the main pathophysiological mechanisms contribute to the acute painful crisis which can lead to serious
complications such as acute chest syndrome and multiorgan failure (Samir K Ballas, 2015).
At the present time, about 500 adult patients with SCD are following up at King Fahad Armed Forces
Hospital (KFAFH) in Jeddah. We have noticed an increasing number of ED visits together with an
increase in the consumption of opioids by SCD patients who are presented with a primary complaint of
an acute pain crisis. Opioids were often prescribed in the ED without blood testing or laboratory
monitoring. Moreover, patients who have been prescribed to take controlled-release opioids combined
with short-acting opioids to control the breakthrough pain, might experience frequent attacks of
breakthrough pain and result in the consumption of relatively large amounts of short-acting opioids.
Thus, SCD patients were at high risk of developing prescription opioids addiction, some cases of this
problem have been recorded of patients come to the ED at KFAFH about three times daily to ask for
opioids. Meperidine and Tramadol were the opioids of choice in such cases. The annual consumption
of Meperidine Injection, Tramadol injection, and Tramadol Capsules reached up to ( 22,488 vials /
16,275 vials / and 60,860 Capsules ) respectively. (May 2016-April 2017).
Unmanageable pain is the major cause of hospital readmissions as the pain has not been controlled
appropriately in the ED or with the prescribed pain relief medications at home. Discharging patients
from the hospital does not necessarily indicate the end of the crisis. Nearly 16% of all SCD patients
were readmitted to the ED within one week of discharge (Samir K Ballas, 2015). The average ED visits
by SCD patients reached up to 1600 visits/ month.
Available Knowledge
Different approaches have been implemented in different parts of the world for the management of
painful crisis. (Wright et al, 2004) reported a day case approach in painful crisis. Their Experience
showed positive impact on pain control and admission rates when cases of uncomplicated pain were
managed on outpatient bases.
Most of the guidelines recommend avoiding the use of Meperidine to manage the acute painful crisis
of SCD. The National Institute for Health Clinical Experts (NICE) made a strong recommendation to
ensure that Meperidine is not used to treat the SCD acute crisis. There are at least two reasons why
Meperidine shouldn’t be used; Firsts, Meperidine is associated with a high risk of seizures in SCD
patients. Second, Meperidine has a limited effective dose which may not provide enough analgesic
effects, resulting in pseudo-addiction or pseudo-drug-seeking behavior. Furthermore, according to the
British National Formulary (BNF), Meperidine is not indicated for continuous or ongoing pain such as
the recurrent acute painful crisis of the SCD patients (NICE, 2012).
Tramadol irrelatively considered as a safe analgesic with a low potential for dependence relative to
other opioids. However, tramadol dependence may occur when it used for prolonged periods of time
(more than several weeks to months) and especially when it used at supra-therapeutic doses. The recent
data revealed that the number of tramadol disabuses is growing up, especially among the Middle East
countries. (WHO, 2014)
According to World Health Organization (WHO), the choice of analgesia should be based on the pain
severity, where opioids should be used only for moderate (scale 4-6) to severe (scale 7- 10) pain.
Morphine is the opioid of choice for the SCD painful crisis (Telfer et al , 2014)
It is recommended to discontinue the use of Meperidine and replaced a protocol of intermittent doses
of short-acting opioids with intravenous morphine infusions and oral controlled-release morphine.
Rationale
A clinical pathway for the management of the SCD acute painful crisis has been initiated at KFAFH
in Jeddah. The aims of this clinical pathway management were to unify the practice, standardize the
care and judicious the use of opioids at KFAFH. The main objectives were to decrease the number of
ED visits, the admission rates, and the consumption of opioids.
Adequate pain management will result in fewer episode crisis, reduce the admission rates and ED visits.
Limited data exist about adults’ pain management for sickle cell anemia in Saudi Arabia.
The clinical pathway intends to provide advice on a basic, minimum standard of care for patients with
acute painful crises and SCA and pay particular attention to adequate Opioids consumption and
monitoring for complications.
Specific Aims
▪
▪
▪
To reduce the rate of ER visits/ patient by more than 50 % within one year.
To decrease the rate admission/ patient, and readmission rates by more than 30%, and 40%
respectively within one year.
To reduce the consumption of Meperidine and Tramadol by more than 25%, and 40 %
respectively within one year as secondary outcome.
METHODS
Context
The King Fahd Armed Forces Hospital is situated in the busy seaport of Jeddah on the western seaboard
of the Red Sea. the hospital has five city-wide satellite clinics form part of a KFAFH national network
of healthcare facilities directly managed by the Medical Services Division (MSD) of the Ministry of
Defense and Aviation (MODA). is the tertiary hospital, with more than 500 bed capacity One of the
primary concerns of the Ministry of Defense and Aviation is to provide medical care to all of the Armed
Forces personnel. Therefore, medical services have been established in all military locations. The
hospital provides a wide range of primary, secondary and tertiary medical services to members of the
Saudi Arabian Armed Forces and their dependents.
In-service training and education are actively promoted by the Departments of Medical Education and
Nursing Education and from within the individual departments. The hospital is also a designated
training center for junior medical and nursing staff.
Almost 500 adult patients with SCA are following up. The monthly visits reached up to 1600 visits.
We performed a retrospective review of the medical records of adults with sickle cell disease at KFAFH
through Emergency department registration data and admission records for one year periods before
(May 2016- April 2017) and one year periods (May 2017- April 2018) perspective after the institution
of the clinical pathway.
A total of 374 SCD Patients (12 years and above with painful crisis) was identified by KFAFH
Emergency department registration data. The diagnosis of SCD was confirmed by Hb electrophoresis.
The primary source of patient information was conducted from the patient file, ED registration, and
chart review.
Interventions
After review of the literature, a clinical pathway was drafted for the management of painful crisis
(Appendix 1).
Every patient who presents with acute painful crisis baseline laboratories will be drawn and analgesia
will be given within 30 minutes of arrival. Type of analgesia used is based on pain severity. Mild pain
(1-3) non-opioid like acetaminophen and NSAIDs is used. Morphine will be given for patients with
moderate to severe pain (≥ 4). If the patient is allergic, then hydromorphone is used. If the patient is
allergic to both, oxycodone is the medications of choice.
Initial laboratories include CBC, LFT, Renal profile and crossmatch should be requested for all patients
to evaluate them fully and objectively stratify the severity of the crisis.
Adult Sickle Cell Unit (ASU) was launched as a separate entity from the Emergency Department
concurrently to receive patients with an isolated painful crisis during working days from 8 am to 3 pm.
Patients with SCA who presented to the ED with the isolated painful crisis were referred to the unit for
management if their condition were stable.
The pathway includes two different parts. Initially, the patient will be given the first dose followed by
maximally 2 boluses if pain persists (each is 30 minutes apart). The second part for patients who did
not achieve satisfactory relief in the emergency department was admitted to the medical service. On the
medical ward, vital signs continued to be monitored every hour until the patient reported relief and no
longer required dose escalation.
Educational lectures about Sickle Cell Anemia (SCA), painful crisis and the pathway were given to all
involved physicians in Emergency and Internal Medicine Departments.
Patients with sickle cell disease who had used the new pathway were informed of the change in
treatment.
Staff: Iman Alhazmi, MD, Consultant Adult Hematology. Ahmad Alhartani, BPhm, Msc, Narcotics and
Controlled Manager. Aseel Jambi , Msc, Pharm.D. Patient safety specialist. Abdulaziz Alhadad,
Internal Medicine Resident. Amani Khalifa, Internal Medicine Resident. Sara Albesher, Internal
Medicine Resident.
Division of Hematology / Oncology, Department of Medicine; Department of Pharmacy; and
Department of CQI.
Study of Interventions
The pathway was applicable for patients: Twelve years and older, Transferred for adult hematology
care already, Presented with the isolated painful crisis.
The pathway was not applicable if: 1) Patient is still following up with pediatric hematology (between
12- 16 years old), Pregnant patients, and Other associated manifestations, e.g. fever, hypoxia, or
priapism.
All patients with SCA who presented to ED were registered by time in a specific record and statistics
were reviewed daily. Daily round on admitted cases with SCA was done by the project team.
Over a period of 2 months, we noticed a decrease in a number of the cases presenting during working
hours without changes on the frequency after hours (from 3:30 pm – 7:30 am) ( Figure1&2). Although
no more Tramadol or Meperidine was prescribed, patients were given morphine without laboratories
and regardless of pain severity. Also, we noted that all cases of SCA were admitted as a painful crisis
without consideration of the complexity and variable manifestations of the disease.
Figure 1
Figure 2
Because of the initial findings, the pathway was edited (Appendix 2). The first step aims to segregate
cases of SCA by different complaints. For each complaint, appropriate laboratories will be ordered and
needed specialty will be consulted. If the patient is presenting with the isolated acute painful crisis, nonopioid analgesia will be given initially until the laboratories confirm the severity of the crisis. If
laboratory results did not show changes from baseline, the patient will be given appointment at Sickle
Cell Anemia Clinic to be seen within a week at maximum.
Measures
▪
▪
Once data are collected, analyzed over a period of approximately one year (May 2016- April
2017) before and one year after (May 2017- April 2018) implementation of the clinical pathway.
Sample size: a convenience sample of all SCD Patients over 12 years old and had who had visited
ED at KFAFH will be included in the study. (N= 374)
▪
SPSS version 23 used to perform basic statistical functions such as descriptive statistics to
determine the variance (age, gender, WBCs, Hb, platelet count, LDH, total bi lirubin, conjugated
bilirubin.
▪
▪
▪
▪
Patients demographics data will be summarized by descriptive analysis for continuous variables
(age, gender, WBCs, Hb, Platelet count, LDH, bilirubin,..)
Means, median, SD, and interquartile calculated
For categorical variables, the frequency is listed.
Correlation coefficient used to measure the association between two variables (e.g., number of
admissions and the new pathway, the amount of opioids consumption and proper pain admission).
Table 1: Patients Demographics
Mean
(N=374)
Median
Range
Pain score
4
4
6
Temperature
36
36.7
4.9
O2 Saturation
94
96
14
WBCs
14
14
9
Hb
9.08
8.90
2.90
Ritecolocyte
0.32
0.25
0.77
Platelets
447
451
182
LDH
451
442
286
Bilirubin
47
46.5
27.1
Conjugated Bilirubin
19.5
18.5
22.3
4
8
Admission %
Yes= 10.23%
Length of Stay
4
Analysis
Data were collected from three sources: ED record of SCA patients visits, the Therefore electronic
system (all ED forms are scanned after completion), and Oasis electronic system (main electronic
system of the hospital) where all patients who were registered in ED department with risk factor indicate
“ Sickle cell Anemia” were captured.
A total of 374 ED forms were reviewed. The decision regarding each patient was evaluated. Most of
the cases were discharged with an outpatient appointment as their laboratory were stable.
Data were analyzed both qualitatively and quantitatively concerning differences among a number of
ED visits, the number of admission and readmission while descriptive statistics were used to compare
the differences in the variables in the study. A t-test was used to compare the means of gender, age, and
lab values (e.g. WBCs, Hb, MCV, HBF, Temperature, O2 saturation).
30
Table 2: Comparison of Study Population
Before 2016/2017
(N=316)
After 2017/2018
(N=374)
Male
55%
55%
Female
45%
45%
Age
32 years
33 years
HBs
67.7
85.4
HBF
8.9
9.4
MCV
82.1
81.8
HBA2
9.8
8.3
MCH
29.9
29.6
Hhydroxyurea
16.1%
16 %
Follow-up
26.26%
26.47 %
Ethical Considerations
The authors thank Dr. Reem Alqunfthi & Dr. Survana Raju to initiate the pain management pathway.
Therefore, we would like to extend our sincere gratitude to them.
This study was approved from the research and ethics committee, reference ethical number: (REC
217).
RESULTS
▪
Rate of Emergency Department Visits / Patient
•
During one-year (May 2017 to April 2018) total of 4861 visits for SCA patients compared to
14615 during the previous year (May 2016 to April 2017). After review of ED registration
forms, patients who were still following-up with pediatric or pregnant were excluded. The total
number of visits were 4508 and 14398 during 17/18 and 16/17 respectively. Hemoglobin
electrophoresis for all patients who were registered in ED as SCA was reviewed. Ninety-two
patients were excluded because 62 were sickle cell trait, 27 had normal electrophoresis and 3
no electrophoresis done at our hospital and their laboratories did not support the diagnosis of
SCA.
•
A total of 374 patients in 2017/18 visited ED (4319 visits) compared with 316 patients (14273)
in 2016/17. The eldest patient was 56 years old and the youngest was 13. The majority were
male. Thirty-two of the patients had thalassemia trait based on low MCV and MCH. only 26
% were following up regularly in the clinic and 17% were not a complaint on folic acid.
Patients demographic in details (Table 1).
31
•
The annual rate of ED visits/patient dropped by 75.55% (45 vs. 11.5) (Figure 3). There was a
progressive reduction in the frequency of ED visits over the year (Figure 4). It was more
evident after editing the pathway (third month), where it dropped by 51%. By the end of the
year, the visits dropped by 88.24%.
•
Figure 3&4: The frequency of ED visits by month during the year of implementing the clinical
pathway and the preceding year.
Figure 3
Rate of ED Visits/Patient
45
Before
After
Figure 4
Total ED Visits per Month
After
▪
Rate of Admission / Patient
•
The rate of Admissions/ patient dropped by 41.87% (Figure 5).
▪
Figure 5: Annual admission rate / patient for Sickle Anemia during 2016/2017 and 2017/2018.
Rate of Admission/ Patient
After
32
Not all admissions were isolated painful crisis. Underlying causes like Acute Chest
Syndrome (4%), osteomyelitis (1%), Fever (16%), Priapism (1%), abdominal pain (6%), no
pain (6%), Pregnant (11%) were noticed.
▪
Readmission Rate: Readmission Rate declined from 29.13 % to 13.25% by 54.51%.
Figure 6: Readmission Rate
Readmission rate
35
29.13
30
25
13.25
After
After
▪
Opioids Consumption:
•
Although Tramadol and Meperidine medications were still prescribed by other departments ,
consumption of Tramadol and Meperidine decreased collectively by 54 % and 33%
respectively. (Figure 7 & 8). Morphine had been used by another department also prior to
starting the pathway, but the increase was almost by 29% only. Other medications were not
available in the hospital earlier so the comparison is not feasible.
•
Figure 7&8: Annual Consumption of Tramadol and Meperidine before and after clinical
pathway implementation.
Figure 7
Tramadol Consumption
60860
27930
16275
10821
After
TRAMADOL INJECTION 100mg/2ml
33
TRAMADAOL CAPSULE 50mg
Figure 8
Meperidine Consumption
6094
After
Table 3: Comparison of Annual Opioids Consumption
Name of Medication
Before
After
Meperidine Injection
100mg/2ml
Meperidine Injection 50ml/ml
Tramadol Injection
100mg/2ml
Tramadol Capsule 50mg
12,053
8,032
% Decrease in
consumption
33%
10,435
16,275
6,094
10,821
41.60%
33%
60,860
27,930
54%
Cost of Narcotics:
Total saving = 68,709 SR
Table 4: Comparison of Annual Opioids Cost before and after implementing clinical pathway
for acute painful crisis
Medication
Before
After
Saving
Meperidine 100 mg
27,722 SR
18,474 SR
9,248 SR
Meperidine 50 mg
24,000 SR
14,016 SR
9,984 SR
Tramadol capsule
51,122 SR
23,461 SR
27,661 SR
Tramadol Injection
65,100 SR
43,284 SR
21,816 SR
Cost of Admission:
• Average Cost of ED Bed = 2,000 SR (without considering the overhead cost)
520 Admission (2016/2017) – 349 Admission (2017/2018) = 171×2,000 SR = 342,000 SR
34
DISCUSSION
Summary
Sickle cell Disease (SCD) is the most common autosomal recessive disorder associated with
consanguineous marriages in Saudi Arabia.
At King Fahad, Armed Forces Hospital (KFAFH) in Jeddah almost 500 adult patients with SCA are
following up.
During reviewing annual consumption of opioids from 2014 – 2017, the narcotics pharmacy noticed
the significant increase in consumption of meperidine and tramadol. While investigations most of those
medications were prescribed for SCA patients. subsequently, they evaluate the guidelines with the
hematologist. They found that the meperidine was not the drug of choice for treating painful crisis. In
addition, the monthly visits reached up to 1600 visits. In some cases, a patient would come to the ED
three times daily for opioids.
In the USA a shift in the management of sickle cell pain from meperidine to morphine occurred in the
1990’s. They recommend using morphine, rather than Meperidine, in acute pain management. (Ballas
et al, 2012). Pain in SCA is variable. Other than acute pain secondary to Vaso-occlusive crisis, It could
be neuropathic, chronic, or because of other associated conditions. Proper evaluation of pain types is a
must to initiate the appropriate management. Short-acting opioids are not the treatment of choice in all
of them.
One study found that Patients who received meperidine experienced more withdrawal. Meperidine is
more lipid soluble than morphine and has an elimination half-life of two to four hours and duration of
action of only two to three hours. Its increased lipid solubility means a more rapid onset of central
nervous system effects that increase its abuse potential and makes it more attractive to drug seekers.
With meperidine, the lack of analgesic potency, its short duration of action, abuse potential and adverse
effects with repeated doses, means that there is little to recommend this drug (O’Connor et al, 2000).
Moreover, Meperidine should not be used to treat acute sickle cell pain in patients with impaired renal
function, history of seizure disorder, or those on serotoninergic medications. (Ballas et al , 2007).
The usual opioids side effect profiles of morphine and meperidine are similar, with respiratory
depression, cough suppression, nausea and vomiting, urinary retention and constipation
The advantage of Morphine is being more water and lipid soluble, making it faster acting and easier to
inject in small volumes of water, as well as no central nervous system excitability or seizures in compare
to meperidine.
Previous studies reported that using intravenous and controlled release oral morphine instead of
meperidine reduced the frequency of hospital admissions of patients with painful crises and their length
of stay (Ballas et al , 2012).
Several months after the appliance of Clinical Pathway, some patients refused to take morphine and
they insist to receive intramuscular meperidine. The change in treatment was met with strong resistance
by most of the patient.
This study is the first study in Saudi Arabia that discussed how to manage the pain crisis for SCA
patient. The results can be generalized to all SCA patients.
This study showed that The rate of admissions / patient for sickle cell pain decreased by 41.87%, total
readmission by 54.51 %, and the rate of emergency department visits / patient by 75.55% after initiation
of the clinical pathway.
35
Analysis of the data showed that consumption of opioids was decreased by 33 %, and by 41.6 % for
meperidine 100 mg, and 50 mg respectively. For Tramadol capsule the consumptions were significantly
decreased by 54%, and 33% for Tramadol Injection.
The cost saved for admission after implementation of the clinical pathway is more than 410,709 SR.
These reductions were sustained in the second 6-month period of 2017 /2018.
Sickle cell disease Committee has been formed. Also, multidisciplinary Sickle cell anemia clinic was
created.
Interpretations
We did experience a decrease in emergency department visits once the protocol was established, the
decline in emergency visits is best explained by a decrease in the number of visits per painful crisis.
This was confirmed by reviewing the frequency of emergency visits that occurred before and after the
clinical pathway.
We think that hospital admission of sickle cell disease declined because we were providing effective
pain treatment, but the decrease was certainly not entirely attributable to the change in medications.
We believe that physicians, nurses and patients education sessions played a critical role in the success
of the clinical pathway. These sessions included information about pain control and the benefit of the
clinical pathway.
Limitations
The main limitation we have is that adherence was not 100% by physicians. Some admitted patients
received opioids without evidence of an acute painful crisis. In addition, we failed to measure changes
in pain, satisfaction, or quality of life. Further studies are needed.
Sickle cell patient have earned the label of “Problem Population” by emergency department, for sickle
cell pain often get mistaken for signs of drug addiction. Physicians should differentiate between
tolerance and addiction.
PCA (Patient control Analgesia) was not required in our hospital for SCD.
Conclusions
Proper pain management for sickle cell Anemia patients leads to a decrease in ED visits, reduce hospital
admissions, and readmission rates. Consequently, more than 400,000 SR was saved after the
implementation of the pathway.
Unfortunately, expenditure on researches and the clinical care of SCD patients is negligible.
Therefore, ministries of health, medical institutions, research organizations, and international agencies
should cooperate and work together for improvement.
36
References
1.
Alsaeed, E. S., Farhat, G. N., Assiri, A. M., Memish, Z., Ahmed, E. M.,
Saeedi, M. Y., Bashawri, H. (2018). Distribution of hemoglobinopathy
disorders in Saudi Arabia based on data from the premarital screening and
genetic counseling program, 2011-2015. J Epidemiol Glob Health, 7 Suppl
1, S41-s47. doi:10.1016/j.jegh.2017.12.001
2.
Ballas, S. K. (2015). Sickle cell pain: Lippincott Williams & Wilkins.
3.
Ballas, S. K., & Lusardi, M. (2005). Hospital readmission for adult acute
sickle cell painful episodes: frequency, etiology, and prognostic
significance. Am J Hematol, 79(1), 17-25. doi:10.1002/ajh.20336
4.
NICE, N. I. f. H. a. C. E. (2012). NICE clinical guideline 143 – sickle cell
acute painful episode Management of an acute painful sickle cell episode in
hospital.
Retrieved
from
https://www.nice.org.uk/guidance/cg143/evidence/full-guideline-pdf186634333
5.
WHO. (2014). Tramadol Update Review Report, 36th ECDD (2014)
Agenda item 6.1. Retrieved from
http://www.who.int/medicines/areas/quality_safety/6_1_Update.pdf
37
G6PD COUNT for donors BY MONTHS
MONTHS
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2019
Count of Sample No
883
984
721
1059
692
948
1186
745
744
861
877
920
MONTHS
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
G6PD COUNT for donors BY RESULT
2019
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
NEGATIVE
838
915
673
1007
657
890
1104
700
711
802
825
853
POSITIVE
45
69
48
52
35
58
82
45
33
59
52
67
TOTAL
883
984
721
1059
692
948
1186
745
744
861
877
920
2020
Count of Sample No
670
956
562
486
400
618
741
780
678
532
726
784
2020
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
MONTHS
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
2021
Count of Sample No
593
609
1015
423
734
766
502
902
33
NEGATIVE
621
895
529
456
372
570
700
726
631
491
681
749
POSITIVE
49
61
33
30
28
48
41
54
47
41
45
35
TOTAL
670
956
562
486
400
618
741
780
678
532
726
784
2021
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
NEGATIVE POSITIVE TOTAL
561
32
593
568
41
609
983
32
1015
417
6
423
694
40
734
727
39
766
486
16
502
866
36
902
32
1
33
COUNT BY MONTHS
MONTHS
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2019
Count of Sample No
883
984
721
1059
692
948
1186
745
744
861
877
920
TAT
Sample_No
AB-10000
AB-10001
AB-10002
AB-10013
AB-10014
AB-10015
AB-10016
AB-10017
AB-10019
AB-10020
AB-10021
AB-10022
AB-10023
AB-10024
AB-10025
AB-10026
AB-10027
AB-10028
AB-10029
AB-10030
AB-10031
AB-10032
2019-2020-2021
TAT
14
14
16
17
17
17
18
8
8
8
8
9
9
9
9
10
10
10
10
10
10
10
2020
MONTHS Count of Sample No
Jan
670
Feb
956
Mar
562
Apr
486
May
400
Jun
618
Jul
741
Aug
780
Sep
678
Oct
532
Nov
726
Dec
784
AB-10033
AB-10034
AB-10035
AB-10036
AB-10037
AB-10038
AB-10039
AB-10040
AB-10041
AB-10042
AB-10043
AB-10044
AB-10045
AB-10046
AB-10047
AB-10048
AB-10049
AB-10050
AB-10056
AB-10057
AB-10058
AB-10059
AB-10060
AB-10061
AB-10062
AB-10063
AB-10064
AB-10065
AB-10066
AB-10067
AB-10068
AB-10069
AB-10070
AB-10071
AB-10072
AB-10073
AB-10074
AB-10075
AB-10076
AB-10077
AB-10086
AB-10087
AB-10088
AB-10089
AB-10090
AB-10091
AB-10092
10
10
10
11
11
11
11
11
11
11
11
12
12
12
13
14
14
15
8
8
8
9
10
10
11
11
11
11
11
12
12
12
12
12
12
13
14
14
14
15
7
7
9
9
9
10
10
AB-10093
AB-10094
AB-10096
AB-10097
AB-10098
AB-10099
AB-10100
AB-10101
AB-10103
AB-10106T
AB-10106T
AB-10106T
AB-10107
AB-10115
AB-10116
AB-10117
AB-10118
AB-10119
AB-10120
AB-10121
AB-10122
AB-10123
AB-10124
AB-10141
AB-10142
AB-10143
AB-10144
AB-10145
AB-10146
AB-10147
AB-10148
AB-10149
AB-10151
AB-10152
AB-10153
AB-10154
AB-10155
AB-10157
AB-10158
AB-10160
AB-10161
AB-10163
AB-10164
AB-10172
AB-10173
AB-10174
AB-10175
10
10
11
11
11
11
11
11
12
12
12
12
13
13
14
14
14
16
16
16
16
16
16
9
9
9
9
10
10
10
10
10
12
12
12
12
14
16
16
8
9
9
9
10
10
10
10
AB-10176
AB-10177
AB-10178
AB-10179
AB-10180
AB-10182
AB-10183
AB-10184
AB-10185
AB-10186
AB-10187
AB-10188
AB-10189
AB-10190
AB-10191
AB-10192
AB-10193
AB-10194
AB-10195
AB-10196
AB-10197
AB-10198
AB-10199
AB-10200
AB-10201
AB-10202T
AB-10203
AB-10204
AB-10205
AB-10206
AB-10207
AB-10208
AB-10209
AB-10210
AB-10211
AB-10212
AB-10213
AB-10214
AB-10215
AB-10216
AB-10217
AB-10218
AB-10219
AB-10220
AB-10221
AB-10222
AB-10223
10
11
11
11
11
11
11
12
12
12
12
12
12
12
12
12
12
12
12
13
13
14
14
14
14
15
15
16
16
9
9
9
9
9
10
10
10
10
10
11
11
11
11
11
12
12
12
AB-10224
AB-10225
AB-10226
AB-10227
AB-10228
AB-10229
AB-10230
AB-10231
AB-10232
AB-10233
AB-10235
AB-10236
AB-10237
AB-10240T
AB-10241
AB-10242
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AB-10245
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AB-10277
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AB-10284
AB-10285
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AB-10287
AB-10288
AB-10289
AB-10290
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AB-10293
AB-10294
AB-10295
AB-10296
AB-10297
AB-10298
AB-10299
AB-10300
AB-10301
AB-10302
AB-10303
AB-10304
AB-10305
AB-10306
AB-10307
AB-10308
AB-10309
AB-10310
AB-10311
AB-10312
AB-10314
AB-10315
AB-10316
AB-10317
AB-10318
AB-10319
AB-10321
AB-10322
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AB-10324
AB-10325
AB-10326
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7
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AB-10326
AB-10327
AB-10328
AB-10329
AB-10330
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AB-10333
AB-10334
AB-10335
AB-10336
AB-10337
AB-10338
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AB-10340
AB-10341
AB-10342
AB-10342
AB-10343
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AB-10345
AB-10346
AB-10347
AB-10348
AB-10349
AB-10350
AB-10351T
AB-10352
AB-10353
AB-10354
AB-10355
AB-10356
AB-10357
AB-10358
AB-10359
AB-10361
AB-10362
AB-10363
AB-10364
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AB-10373
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AB-10425
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AB-10441
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AB-10445
AB-10445
AB-10446
AB-10447
AB-10448
Select one of the safety quality issues presented, For this assessment, you will analyze a safety quality issue in a health care setting and identify a quality improvement (QI) initiative.
Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you know what is needed for a distinguished score.
Explain factors leading to a specific patient-safety risk in a health care setting.
Explain evidence-based and best-practice solutions to improve patient safety and reduce costs.
Explain how nurses can help coordinate care to increase patient safety and reduce costs.
Identify stakeholders with whom nurses would coordinate to drive safety enhancements with a specific safety quality issue.
Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style
……………………………………………………………………………………………………………………………………………………..
Length of submission: 3–5 pages, plus title and reference pages.
Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: References and citations are formatted according to current APA style.
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• Healthcare-Associated Infections (HAIs): Healthcare-Associated Infections,
commonly referred to as HAIs, are infections that patients acquire while receiving
treatment for other conditions within a healthcare setting. These infections can occur
in any healthcare setting, from hospitals to outpatient clinics. Understanding the
significance of HAIs is crucial for nursing students for the following reasons:
o Patient Morbidity and Mortality: HAIs can lead to severe health complications.
Depending on the type of infection and the patient’s underlying health conditions,
HAIs can result in prolonged illness, the need for intensive treatments, or even
death. For instance, sepsis, which can arise from an HAI, is a life-threatening
condition that requires immediate intervention.
o Extended Hospital Stays: Patients with HAIs often require extended hospital
stays for additional treatments, such as antibiotics or surgeries. This not only
increases the patient’s risk of acquiring other complications but also adds to their
emotional and psychological stress.
o Increased Healthcare Costs: The extended hospital stays, additional
treatments, and interventions associated with HAIs result in significant financial
burdens. These costs are borne by healthcare systems, insurance providers, and
often, the patients themselves.
o Antibiotic Resistance: The overuse or misuse of antibiotics to treat HAIs can
lead to the development of antibiotic-resistant strains of bacteria. These
“superbugs” are harder to treat and can spread to other patients, posing a
significant public health threat.
o Emotional and Psychological Impact: Acquiring an infection while seeking
treatment for another condition can be distressing for patients. They may feel
betrayed by the very system they trusted to heal them. This can lead to feelings
of anxiety, fear, and mistrust towards healthcare providers.
o Reputation and Trust: Just as with falls, repeated incidents of HAIs can impact
the reputation of a healthcare facility. High rates of HAIs can lead to decreased
public trust and potential legal implications.
o Regulatory Implications: Healthcare facilities are held to strict standards by
regulatory and accrediting bodies. High rates of HAIs can result in penalties,
increased inspections, and challenges in maintaining accreditation.
Following the guidelines of the United States Preventive Service Taskforce (USPSTF), discuss and describe the screening recommendations for the following:
Cervical cancer
Breast cancer
Osteoporosis
Colorectal cancer
Lung cancer
Ovarian cancer
Intimate partner violence (IPV).
Submission Instructions:
The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
The paper is to be no shorter than 3-4 pages in length, excluding the title and references page.
Your paper should be formatted per current APA.
Incorporate current practice guidelines for diagnosis and treatment and a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).
Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.
What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?
Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.
Required readings to complete this discussion
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Chapter 5, “Public Policy Design” (pp. 87–95 only)
Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)
American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advoc…
Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a…
Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.
Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.
Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.
Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.
Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.
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10/14/23, 3:20 PM
Topic: Week 8: Discussion
This is a graded discussion: 100 points possible
due Oct 18 at 10:59pm
Back to Module at a Glance
(https://waldenu.instructure.com/courses/80874/modules/items/2426796)
THE ROLE OF THE RN/APRN IN POLICY-MAKING
Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to
input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms,
offering an image of the common thinking among participants of that role.
What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would
you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?
Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global
scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policymaking has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare
legislation.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/80874/modules/items/2426819)
To Prepare:
Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.
BY DAY 3 OF WEEK 8
Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the
challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you
might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide
examples.
BY DAY 6 OF WEEK 8
Respond to at least two of your colleagues’* posts by suggesting additional opportunities or recommendations for overcoming the challenges
described by your colleagues.
*Note: Throughout this program, your fellow students are referred to as colleagues.
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For this assignment, you will develop a presentation on a realistic clinical case on a topic that is of interest to you.
TOPIC TO USE: SCHIZOPHRENIA
SUBMISSION INSTRUCTIONS:
The presentation should be original work and logically organized, formatted, and cited in the current APA style, including citation of references.
The presentation should consist of 10-15 slides and be less than or about 5 minutes in length.
Voice-Over is required.
Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).
Complete and submit the assignment by 11:59 PM ET Sunday.
Content Requirements:
You will create a PowerPoint presentation with a realistic case study and include appropriate and pertinent clinical information that will cover the below aspects. Also, review the distribution of your points based on the assignment rubrics below.
Subjective data: Chief Complaint; History of the Present Illness (HPI)/ Demographics; History of the Present Illness (HPI) that includes the presenting problem and the 8 dimensions of the problem; Review of Systems (ROS)
Objective data: Medications; Allergies; Past medical history; Family history; Past surgical history; Social history; Labs; Vital signs; Physical exam.
Assessment: Primary Diagnosis; Differential diagnosis
Plan: Diagnostic testing/Labs to order; Pharmacological treatment plan; Non-pharmacologic treatment plan; Patient education, Anticipatory guidance (primary/secondary prevention strategies); Follow-up plan.
Other: Incorporation of current clinical guidelines; Integration of research articles; Role of the Nurse practitioner
Below is the distribution of your points based on assignment rubrics:
-Chief Complaint (Reason for seeking health care) 4/4
This criterion is linked to a Learning OutcomePatient Overview
18 pts
Meets or Exceeds Expectations
Accurately identifies demographic data, past health history. Medical diagnosis: identifies 2 priority nursing judgments
13.68 pts
Mostly Meets Expectations
Does not accurately Identify demographic data, past health history. Medical diagnosis: identifies 2 nursing judgments
9 pts
Approaches Expectations
Vaguely identifies demographic data, past health history. Medical diagnosis: identifies 1 priority nursing judgment
4.5 pts
Does Not Meet Expectations
Does not identify demographic data, past health history. Medical diagnosis: identifies 1 priority nursing judgment
18 pts
This criterion is linked to a Learning OutcomeMedication Overview (Select One Medication)
18 pts
Meets or Exceeds Expectations
Includes medication, classification and most indications, recommended dosing guidelines, administration routes, side effects and contra indications included
13.68 pts
Mostly Meets Expectations
Includes medication, classification and most indications, recommended dosing guidelines, administration routes, side effects and contra indications included
9 pts
Approaches Expectations
Includes medication, classification and most indications, recommended dosing guidelines, administration routes, side effects and contra indications included
4.5 pts
Does Not Meet Expectations
Includes medication, classification and most indications, recommended dosing guidelines, administration routes, side effects and contra indications included
18 pts
This criterion is linked to a Learning OutcomeNursing Implications
18 pts
Meets or Exceeds Expectations
Discusses 10 or more interventions for administration monitoring and effectiveness of medication
13.68 pts
Mostly Meets Expectations
Discusses 8-10 interventions for administration monitoring and effectiveness of medication
9 pts
Approaches Expectations
Discusses 6-8 interventions for administration monitoring and effectiveness of medication
4.5 pts
Does Not Meet Expectations
Discusses 1-5 interventions for administration monitoring and effectiveness of medication
18 pts
This criterion is linked to a Learning OutcomePatient Education Plan
18 pts
Meets or Exceeds Expectations
Develops a complete pertinent medication teaching plan including learning needs, educational goals, and learning outcomes
13.68 pts
Mostly Meets Expectations
Develops a somewhat complete pertinent medication teaching plan including learning needs, educational goals, and learning outcomes
9 pts
Approaches Expectations
Develops a safe but not complete pertinent medication teaching plan including learning needs, educational goals, and learning outcomes
4.5 pts
Does Not Meet Expectations
Develops a unsafe, incomplete medication teaching plan including learning needs, educational goals, and learning outcomes
18 pts
This criterion is linked to a Learning OutcomeAssignment
18 pts
Meets or Exceeds Expectations
Meets the following criteria 100%: typed APA format, correct grammar, spelling; maximum 3 pages body of paper; minimum 3 references
13.68 pts
Mostly Meets Expectations
Meets the following criteria 75%: typed APA format, correct grammar, spelling; maximum 3 pages body of paper; minimum 3 references
9 pts
Approaches Expectations
Meets the following criteria 50%: typed APA format, correct grammar, spelling; maximum 3 pages body of paper; minimum 3 references
4.5 pts
Does Not Meet Expectations
Meets the following criteria 25%: typed APA format, correct grammar, spelling; maximum 3 pages body of paper; minimum 3 references
Preparing the AssignmentFollow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.Family nurse practitioners often care for older adults as they experience changes in functional health. Assessments may reveal that clients are unsafe in their current environment or that they may require additional assistance to remain at home. Carefully read the questions below and address each in your initial post.Application of Course Knowledge: Answer all questions/criteria with explanations and detail. Discuss the laws in your state related to the nurse practitioner’s (NP) role and responsibility in creating and signing advanced directives (ADs). Indicate if the NP can independently complete AD documents or a physician is required to sign or cosign the documents. Consider clients you’ve encountered in practicum (or in your practice as a registered nurse). Identify at least ONE client who may have benefited from a referral to hospice or palliative care. Indicate why this client would have benefited from these services. Describe how as an NP you might approach the conversation with the client. Discuss at least TWO recommendations you have for improving palliative and hospice care access to vulnerable and underserved populations in your community. Engagement in Meaningful Dialogue: Engage peers and faculty by asking questions, and offering new insights, applications, perspectives, information, or implications for practice.Respond to at least one peer.Respond to a second peer. Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.Wednesday Participation Requirement: Provide a substantive response to the collaboration café topic (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. Total Participation Requirement: Provide at least three substantive posts (one to the initial question or topic and two to student peers) on two different days during the week.
Requirements:
Define a patient, family, or population health problem that’s relevant to your practice.
Summarize the problem you’ll explore.
Identify the patient, family, or group you intend to work with during your practicum.
Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
Explain how you would know if the data are unreliable.
Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policymaking to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.
Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policymaking to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.
Discuss research on the effectiveness of leadership strategies.
Define the role that you anticipate leadership must play in addressing the problem.
Describe collaboration and communication strategies that you anticipate will be needed to address the problem.
Describe the change management strategies that you anticipate will be required to address the problem.
Document the time spent (your practicum hours) with these individuals or group in the NURS4900 Volunteer Experience Form.
Organize content so ideas flow logically with smooth transitions.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style.
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it difficult for them to focus on its substance.
Research a peer-reviewed article regarding workflow analysis in healthcare. Discuss the following aspects: StrengthsWeaknessesOpportunitiesThreatsRisks that are identified in the workflow described. What changes are recommended and provide additional recommendations you would make to improve the efficiency and effectiveness of this process. Your paper should meet the following structural requirements: 5-6 pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition.Provide support for your statements with in-text citations from a minimum of 6 scholarly articles. You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading.
Write a paper in APA Style that discusses each of the AACN Essentials and describe how you met each essential. Incorporate evidence from your previous Nursing Evolution assignments, as well as detailed examples from your didactic, skills lab, and clinical rotations.For each essential include the following:A brief summary explanation of the essential that is cited with at least one scholarly sourceAt least one example of how you met the essential during your nursing programPLEASE FOLLOW INSTRUCTIONS, I WILL BE POSTING SOME FILES TAHT HAVE THE INSTRUCTIONS ON IT. I NEED THIS PAPER TO BE ABSOLUTELY PERFECT , PLEASE FOLLOW TEMPLATE
Unformatted Attachment Preview
1
AACN Essentials Summary Paper
Your Name
West Coast University
NURS 497: Nursing Capstone
Dr. Stephenson
Date
2
AACN Essentials Paper
Domain 1: Knowledge for Nursing Practice
First Paragraph for each Domain (Essential): The student provides an accurate and concise
summary paragraph for each domain. All summary descriptions expertly identify key aspects of each
domain. Every domain is supported with at least one scholarly source. You need to cite your source(s) like
the ACCN Essentials pdf that was provided.
Second Paragraph for each Domain: At least one detailed and explicit example of how the
student met each domain during the nursing program is provided for all ten Domains. The student
expertly synthesizes and incorporates significant feedback, concepts, and ideas from the week’s
discussion into the assignment. It is evident that the student has thoroughly reflected upon and met the
ten domains.
Domain 2: Person-Centered Care
Domain III: Population Health
Domain IV: Scholarship for the Nursing Discipline
Domain V: Quality and Safety
Domain VI: Interprofessional Partnerships
Domain VII: Systems-Based Practice
Domain VIII: Informatics and Healthcare Technologies
Domain IX: Professionalism
Domain X: Personal, Professional, and Leadership Development
3
References
American Association of Colleges of Nursing. (2021). Baccalaureate Essentials Tool Kit.
https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 2:
55-year-old Asian female living in a high-density poverty housing complex.
Pre-school aged white female living in a rural community
*********Once you received your case number, answer the following questions:
What are the barriers to interpersonal communication?
What are the procedures and examination techniques that will be used during the physical exam of your patient?
Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are
Submission Instructions:
Your instructor will assign you your case number and you will post on the case number you have been assigned.
You will reply to the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Grading Rubric
Your assignment will be graded according to the grading rubric.
Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts. Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts. Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts. Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts. 5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors. Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors. Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail. Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. 3 points
Response to Posts of Peers Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each. Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal. Poor – 0 points
Student provided no response to a peer’s post. 2 points
Total Points 10
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The purpose of this assignment is to complete a comprehensive treatment plan for a specific client (i.e., a client in your clinical practicum, a client in your place of employment, a family member or friend). Assessment, diagnosis, and treatment planning are components of the course and sections to be addressed in this assignment. You cannot use the same case used in another course.
Assignment:
The student will be required to provide a DSM-5 TR diagnosis, a treatment plan and a summary integrating evidence-based literature and justifying the treatment plan the student developed for the client. The student will also cross-reference the diagnosis with the DSM 5 TR and note all patient symptoms matching criteria.
This assignment should be 8 – 10 pages in length, excluding title page and reference pages. Incorporate at least 4 evidenced based research articles that support the diagnosis and treatment planning considerations. Follow the following criteria:
Subheadings
Identifying information such as demographic information – age, gender, ethnicity, education (DO NOT USE FULL NAMES)
Presenting problem
Mental status description
Medical problems
This is equal to the Introduction on the Grading Rubric
DSM 5 TR differential diagnoses with codes
Detailed treatment plan with rationale. Include
medications (psychotropic medications only).
DSM 5 TR Diagnosis compare patient symptoms with diagnostic criteria
This is equal to the Focus & Sequencing on the Grading Rubric
Client’s strengths
Goals
Expected outcomes
This is equal to the Conclusion on the Grading Rubric
Select one National Patient Safety Goal Create a 3-5-page scholarly paper to address the rubric expectations. Use a minimum of five scholarly sources, current within five years, to support your work. Should you choose to address a different external benchmark, remember to communicate with your instructor for approval.
Create a scholarly paper using Microsoft Word and current APA guidelines for scholarly writing.
Using an economy of words and synthesis of key information, the paper should be 3-5 pages in length (excluding the title and reference pages).
Include a minimum of five current scholarly sources to validate information in the scholarly-written paper.
Follow the assignment criteria and rubric expectations described below to address each of the following sections of the assignment:
Introduction
Quality Benchmark
Systems-focused Policy Strategy
Implications for Advanced Nursing Practice
Conclusion
Rubric:
Introduction
25 ptsDistinguishedDistinguished presentation of information evidenced by all of the following covered in a comprehensive and concise manner: • Introduce the value of external benchmarks to establish quality in healthcare delivery. • Explain the role of systems-focused policy strategies to support and assure quality. • Identify for the reader the sections of the paper that will follow. • Integrate sufficient support from valid, reliable sources to validate the information.
Quality Benchmark
50 ptsDistinguishedDistinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Describe the selected National Patient Safety Goal, • Explain the issue addressed in the benchmark and why it is a quality concern for people and for healthcare systems. • Examine how the benchmark is supportive of the following outcomes: o High-quality healthcare delivery o Positive health-related outcomes o Equity and inclusivity for recipients of care • Integrate sufficient support from valid, reliable sources to validate the information.
Systems-Focused Policy Strategy
75 ptsDistinguishedDistinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Propose one systems-focused policy strategy to support achievement of the benchmark. • Identify the systems and stakeholders. impacted by the proposed policy and determine why a systems-focused strategy is essential for successful achievement of the benchmark. • Explain how the proposed policy strategy will impact: o The quality of healthcare delivery o Health-related outcomes o Equity and inclusivity for recipients of care • Integrate sufficient support from valid, reliable sources to validate the information
This criterion is linked to a Learning OutcomeImplications for Advanced Nursing Practice
50 ptsDistinguishedDistinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Explain the role of the advanced practice nurse leader to facilitate the proposed strategy. • Describe the unique perspectives and expertise that the advanced practice nurse leader will contribute. • Analyze the congruence between your proposed strategy and the recommendations from the Future of Nursing 2020- 2030 publication. • Integrate sufficient support from valid, reliable sources to validate the information.
Conclusion
25 ptsDistinguishedDistinguished presentation of information evidenced by all of the following covered in a comprehensive and concise manner: • Provide a succinct summary of the identified external benchmark. • Briefly conclude how your proposed systems-focused policy can be used to support achievement of the benchmark. • Summarize how the advanced practice nurse can engage in systems-focused quality efforts to advance equity and inclusivity.
Graduate-Level Writing Style
25 ptsDistinguishedDistinguished graduate-level writing style is evidenced by meeting all of the following criteria with 0-1 errors total: • Correct use of spelling, grammar, punctuation, sentence and paragraph structure • Clarity, organization, and logical flow of ideas within writing • Scholarly, professional writing tone with no use of first person • Synthesis of information is present with no more than one short direct quote (15 words or less) • Correct APA format for the following: o Page numbering o Font style and size o Margins and spacing o Headings; subheadings o Citation and referencing sources, and o Mechanics of style (abbreviations, capitalization, italics, numbers)
Powerpoint poster with information provided with references and citations given
Unformatted Attachment Preview
Insert Title Here
Name
Course
Session
Cultural Community
This section should briefly in
clear/concise bullet points include
• approved specific culture/ethnic
population
• rationale for selection
• cultural/ethic need within your
area
• clinical practice, or community
• describe the approved health issue
from your chosen cultural
population.
Health Issue
This section should describe briefly in
clear/concise bullet points
• how the health issue is based on
the Leading Health Indicator (LHI)
priorities from Healthy People
• Describe the reason why the health
issue was selected and
• why it is important to focus on this
health issue.
Clinical Impact
Best Practice Tips
This section should include
clear/concise bullet points on
• how this content can be related
to clinical practice in general
• how it impacts your area, clinical
practice, or community.
This section should include
clear/concise bullet points on
• key knowledge from the scholarly
resources
• educational information related to
best practices
• potential ethical issues or conflicts
with care
• Please make sure to not stereotype
a cultural/ethnic group.
**Please note: Replace wording
with your own content (except
headers). Use short bullet points
(mini headlines, short description,
no sentences, keep it simple but
focused) in all boxes. Boxes will
expand as you type. Please delete
this box prior to submission.
Insert photo, graphic or
chart to increase visual
appeal
References
Provide APA references from two peer-reviewed scholarly professional nursing journal
articles related to your nursing issue, cultural focus and/or health indicator. Articles must
be published within the last five (5) years.
NR 394 Transcultural Nursing
Week 4: Course Project Part 2
Roni-Marie Poidamoni
Directions: Prior to completing this template, carefully review Week 4: Course Project
Part 2 Directions paying attention to how to name the document and all rubric
requirements.
1. Description of Issue, Indicator, and Focus
Transcultural Nursing Issue
The transcultural nursing issue addresses the disparities in HIV diagnosis rates among
African Americans. This issue encompasses the need to understand and address the
cultural, social, and structural factors contributing to African Americans’ higher
vulnerability to HIV.
Healthy People 2030 Leading Health Indicator (LHI)
The approved Healthy People 2030 Leading Health Indicator that aligns with this issue is
“Sexually Transmitted Infections.” This LHI focuses on reducing HIV-related disparities
and new diagnoses, emphasizing preventive measures, increased awareness, and access to
testing and treatment to enhance community health.
Cultural Focus
The cultural focus of this project is the African-American community. This community
has a unique cultural context, historical experiences, and health-seeking behaviors
influence their vulnerability to HIV and the disparities in HIV diagnosis rates.
2. References with Permalink
Vitsupakorn, S., Pierce, N., & Ritchwood, T. D. (2023). Cultural interventions addressing
disparities in the HIV prevention and treatment cascade among Black/African
Americans: a scoping review. BMC Public Health, 23(1), 1748.
https://doi.org/10.1186/s12889-023-16658-9
Walter, A. W., & Morocho, C. (2021). HIV-related Knowledge, HIV testing
decision-making, and perceptions of alcohol use as a risk factor for HIV among
black and African American women. International Journal of Environmental
Research and Public Health, 18(9), 4535. https://doi.org/10.3390/ijerph18094535
3. Summary
Article 1
Cultural interventions addressing disparities in the HIV prevention and
treatment cascade among Black/African Americans by Vitsupakorn et al. (2023)
identify a range of culturally specific interventions intended to improve HIV
prevention and treatment results. Nevertheless, the article highlights the critical value
of culturally sensitive methods, emphasizing that successful treatments must consider
the distinctive cultural elements, social determinants, and historical background that
substantially impact HIV-related behaviors within this community. Furthermore,
Vitsupakorn et al. (2023) discuss various interventions, from community-based
educational programs to peer support initiatives and healthcare provider training in
cultural competency. Consequently, these interventions aim to foster trust, improve
communication, and expand access to healthcare services.
Article 2
Alter and Morocho’s (2021) research centers on pivotal aspects of HIV-related
Knowledge, HIV testing decision-making processes, and perceptions concerning
alcohol use as a risk factor for HIV among Black and African American women. This
study provides crucial insights into the factors that shape HIV prevention behaviors
and decision-making within this specific demographic. Furthermore, the study’s
findings illustrate the central role of HIV-related knowledge in influencing
individuals’ decisions regarding testing and prevention measures..
Nevertheless, Alter and Morocho (2021) highlight the significance of
informed decision-making, emphasizing the importance of empowering individuals to
take control of their healthcare choices. This article underscores healthcare providers’
need to engage in open and non-judgmental discussions with patients regarding
substance use and its potential implications for HIV risk. Therefore, by discerning the
intricate interplay between alcohol use, risk perception, and prevention behaviors,
healthcare professionals can better tailor their interventions to meet the specific needs
of this population.
4. Educational Plan
Key Points to Share:
1. Highlight the importance of cultural interventions, as outlined in the scoping
review by Vitsupakorn et al. (2023), in addressing disparities in the HIV
prevention and treatment cascade within the African-American community.
2. Discuss the findings from Alter and Morocho’s (2021) study, emphasizing the role
of HIV-related knowledge and decision-making processes in shaping HIV
prevention behaviors.
3. Emphasize the need for culturally tailored approaches to HIV prevention and
treatment, considering the unique cultural factors and perceptions of the African
American community.
Best Practices:
1. Cultural competency in healthcare delivery, respectful communication, and
understanding of cultural beliefs.
2. Community engagement and partnerships to develop and implement culturally
sensitive interventions.
3. Increasing knowledge by discussing strategies for increasing HIV-related
expertise within the community, including educational campaigns and outreach
programs.
Ethical Issues and Conflict of Care:
1. Informed Consent – The ethical importance of obtaining informed consent when
conducting HIV testing and treatment.
2. Confidentiality – There is a need for maintaining patient confidentiality and
privacy in HIV-related care.
3. Non-Discrimination – The ethical obligation to provide non-discriminatory care to
all individuals, regardless of their HIV status or cultural background.
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project. Discuss the following: System approachResource allocation you identify as importantIdentify the executive sponsorIdentify the stakeholders and steering committee membersEnvironment for local team leaders to collaborate, and 6) governance of the metrics.The communication plan to coordinate the project team efforts. The paper should meet the following structural requirements: 5-6 pages in length, not including the cover sheet and reference page.Formatted according to APA 7th edition.Provide support for your statements with in-text citations from a minimum of 6 scholarly articles. You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading.
For this assignment, answer the following questions by using them as your headings for your paper.
What are the Pros and Cons of telehealth?
How will you approach and perform a telehealth assessment?
What are the limits to telehealth?
What is the difference between the provider’s need for a successful telehealth visit versus the Patient’s perspective?
Submission Instructions
The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.
The paper should be formatted per the current APA and 4-5 pages in length, excluding the title, abstract, and references page.
An abstract is required.
Incorporate a minimum of 5 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
Complete and submit the assignment by 11:59 PM ET Sunday.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
Sunday by 11:59pm
Points 50
Submitting a text entry box or a file upload
Unit 6Theory Chart
Unit 6: Introduction (1 of 4)
Unit 6: Reading and Activities (2 of 4)
Current Assignment: Unit 6: Assignment Theory Chart (3 of 4)
Unit 6: Discussion Crisis and Task Theories (4 of 4)
Instructions
Use the chart attached below each week to document theories covered in the class readings and films. You may copy and paste main points, definitions, and the theorist names from the readings. Do not copy information from your peers. The Application to practice section should be in your own words so you can demonstrate integration of theory to practice. The spaces in the chart will expand as needed. You will submit this chart each week throughout the semester. By the end of the semester, you will have a complete study guide of relevant theories and their application to Social Work practice. Each week is worth up to 50 points for a total of 700 points for the course.
In the chart, please address the following theories:
Crisis Theory – 5 models
Task-Centered Theory – Reid, Epstein
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete 2 hours
Assignment Resources
MSW600 Theory ChartDownload MSW600 Theory Chart
Rubric
Unit 6 Theory Chart Rubric
Unit 6 Theory Chart Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Main points of the theory
20 pts
Exceptional Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theory contributed to understanding people. Described in exceptional detail how the theories considers human differences and is culturally informed. Described the limitations of the theory in detail.
18 pts
Proficient Demonstration
Listed or summarized the main points of the theory in exceptional detail. Described how the theories contributed to understanding people. Described in profecient detail how the theory considers human differences and is culturally informed. Described the limitations of the theory in detail.
16 pts
Competent Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theories contributed to understanding people. Described in detail how the theory considers human differences and is culturally informed. Described the limitations of theories.
12 pts
Emerging Demonstration
Listed some of the main points of the theories. Described how the theory contributed to understanding people. Attempted to describe how the theories considers human differences and is culturally informed. Described the limitations of the theory. Or, only provided information on partial theories this week.
8 pts
Attempted Demonstration
Listed limited points of the theories. Described how the theories contributed to understanding people. Attempted to describe how applied to human differences. Described some limitations of the theories. Or only provided information on one theory this week.
0 pts
Not Competent
Did not complete
20 pts
This criterion is linked to a Learning OutcomeVocabulary
10 pts
Exceptional Demonstration
Clearly provided key words and exceptional definitions from each theory
8 pts
Proficient Demonstration
Clearly provided key words and definitions from each theory
7 pts
Competent Demonstration
Provided key words and definitions for each theory
5 pts
Emerging Demonstration
Provided key words and definitions for some theories this week.
3 pts
Attempted Demonstration
Attempted to provide some definitions for some theories this week.
0 pts
Not Competent
Did not complete
10 pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Application to practice
20 pts
Exceptional Demonstration
Exceptionally linked all theories to practice. Provided many examples of who theories apply to working with clients. Included information on how all theories will help prepare them to engage, assess, and intervene with clients.
18 pts
Proficient Demonstration
Clearly linked the theories to practice. Provided several examples of how theories apply to working with clients. Included information on how theory will help prepare them to engage, assess, and intervene with clients.
16 pts
Competent Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients.
12 pts
Emerging Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients. Only completed partial assigned theories this week.
8 pts
Attempted Demonstration
Provided superficial view of how theories apply to working with clients. No specifics or not all theories covered.
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1 Case 2 Case 3 Use this
Chief Complaint
(CC) A 57-year-old man presents to the office with a complaint of left ear drainage since this morning. A 45-year-old female presents with a complaint of an itchy red rash on her arms and legs for about two weeks. A 11-year-old female patient complains of red left eye and edematous eyelids. Her mother states the child complains of “sand in my left eye.”
Subjective Patient stated he was having pulsating pain on left ear for about 3 days. After the ear drainage the pain has gotten a little better. She has been going on a daily basis to the local YMCA with children for Summer camp. Patient noticed redness three days ago. Denies having any allergies. Symptoms have gotten worse since she noticed having the problem.
Objective Data
VS (T) 99.8°F; (RR) 14; (HR) 72; (BP) 138/90 (T) 98.3°F; (RR) 18; (HR) 70, regular; (BP) 118/74 (T) 98.2°F; (RR) 18; (HR) 78; BP 128/82; SpO2 96% room air; weight 110 lb.
General well-developed, healthy male healthy-appearing female in no acute distress well-developed, healthy, 11 years old
HEENT EAR: (R) external ear normal, canal without erythema or exudate, little bit of cerumen noted, TM- pearly grey, intact with light reflex and bony landmarks present; (L) external ear normal, canal with white exudate and crusting, no visualization of tympanic membrane or bony landmarks, no light reflex EYE: bilateral anicteric conjunctiva, (PERRLA), EOM intact. NOSE: nares are patent with no tissue edema. THROAT: no lesions noted, oropharynx moderately erythematous with no postnasal drip.
EYES: no injection, no increase in lacrimation or purulent drainage;
EARS: normal
TM: Normal
EYES: very red sclera with dried, crusty exudates; unable to open eyes in the morning with the left being worse than the right
Skin No rashes CTA AP&L CTA AP&L
Neck/Throat no neck swelling or tenderness with palpation; neck is supple; no JVD; thyroid is not enlarged;
trachea midline
mild edema with inflammation located on forearms, upper arms, and chest wall, thighs and knees; primary lesions are a macular papular rash with secondary linear excoriations on forearms and legs
Answer the following questions for your specific case study assigned:
What other subjective data would you obtain specific to your case?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient’s presenting symptoms.
Give rationales for each differential diagnosis.
Submission Instructions:
You have been assigned your case number (See Announcement), and you will post about the case number you have been assigned.
You will reply to your peers who have posted on the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
This assignment gives the MSN student the opportunity to apply information regarding providing constructive feedback to learners by developing a written evaluation. This summative evaluation will focus on a learner who is successful and a learner who is unsuccessful in demonstrating specific competencies. The MSN student may select between the practice setting of nurse professional development or a traditional academic setting, based upon the student’s career focus.
REQUIREMENTS
Description of the Assignment
This assignment has two major parts. The first part is the development of a written summative evaluation using the required template for a learner who is successful, but still needs improvement in one of the identified competencies. The second part is the development of a written summative evaluation for a learner who is unsuccessful. For both parts of this assignment, the following three competencies are to be used.
Demonstration of quality nursing care
Demonstration of professional behavior
Demonstration of information from evidence-based practice literature
You may select ONE of the following practice settings:
For the clinical practice setting focusing on the role of a nurse professional development specialist, the learner’s clinical competencies are being evaluated as part of a comprehensive orientation program.
For an academic setting focusing on the role of a clinical nurse educator, the learner is a student in an undergraduate nursing class that requires successful completion of the identified course clinical components.
For the selected practice setting, you are required to complete this assignment for one learner who has successfully demonstrated all required competencies, but has one competency that needs improvement AND one learner who has not successfully demonstrated all required competencies. Each competency must be evaluated regarding the knowledge, skills, and attitudes related to professional nursing practice of the competency, in the identified clinical/academic course setting.
Criteria for Content
This assignment consists of two required parts:
Part 1: Completion of the written Summative Performance Evaluation for one learner who is successfully demonstrating TWO of the required competencies but needs improvement in the third required competency.
Part 2: Completion of the written Summative Performance Evaluation for one learner who is unsuccessful in all two of the required competencies.
For each of the two learners, the written summative evaluation is completed using the Summative Performance Evaluation Form noted below. Specific fictional examples of learners’ expected behavior or absence of behavior are to be provided in the Educator’s Summative Assessment column in order to support the decision regarding satisfactory, improvement needed, or unsatisfactory. A comprehensive concluding statement must be provided that summarizes the decision. A separate Summative Performance Evaluation form must be completed for the satisfactory learner and for the unsatisfactory learner.
Part 1: Summative Performance Evaluation for the Successful Learner: The required content for the written summative evaluation is the following.
Identify the practice setting
Provide a fictional example identifying the behaviors of the successful learner in the clinical setting Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)Identify the evaluation score for each competency
Identify the competency that needs improvement
Demonstrate objective wording in the Educator’s Summative Assessment that supports the Evaluation Score
Provide specific fictional examples of learner’s behavior for knowledge, skills, and attitudes for each competency
Prepare a comprehensive concluding statement regarding the summative evaluation
Part 2: Written Performance Evaluation for the Unsuccessful Learner: The required content for the written summative evaluation is the following.
Identify the practice setting
Provide a fictional example identifying the behaviors of the unsuccessful learner in the clinical setting. Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)
Identify the evaluation score for each competency
Identify the two competencies that are unsatisfactory
Demonstrate objective wording present in the Educator’s Summative Assessment that supports the Evaluation Score
Provide specific fictional examples of learner’s behavior for knowledge, skills, and attitudes for each competency
Prepare a comprehensive concluding statement regarding the summative evaluation
PREPARING THE ASSIGNMENT
Criteria for Format and Special Instructions
Part 1 requires the use of the Summative Performance Evaluation Form: Successful Learner’s Summative Performance Evaluation, noted below.
Part 2 requires the use of the Summative Performance Evaluation Form: Unsuccessful Learner’s Summative Performance Evaluation, noted below.
Title page must follow APA guidelines as found in the current edition of the manual.
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.
Successful Learner’s Summative Evaluation
Practice setting:
Fictional example identifying the behaviors of the successful learner. Note: One competency needs improvement. Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)
Competencies
Evaluation Score
Satisfactory
Improvement Needed
Unsatisfactory
Educator’s Summative Assessment
Competency: Quality of Care
Demonstrated behaviors related to:
Knowledge
Skill
Attitude
Competency: Professional Behavior
Demonstrated behaviors related to:
Knowledge
Skill
Attitude
Competency: Evidence-based Practice
Demonstrated behaviors related to:
Knowledge
Skill
Attitude
Concluding statement by educator:
Unsuccessful Learner’s Summative Evaluation
Practice setting:
Fictional example identifying the behaviors of the unsuccessful learner. Note: Two competencies are unsatisfactory. Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)
Competencies
Evaluation Score
Satisfactory
Improvement Needed
Unsatisfactory
Educator’s Summative Assessment
Competency: Quality of Care
Demonstrated behaviors related to:
Knowledge
Skill
Attitude
Competency: Professional Behavior
Demonstrated behaviors related to:
Knowledge
Skill
Attitude
Competency: Evidence-based Practice
Demonstrated behaviors related to:
Knowledge
Skill
Attitude
Concluding statement by educator:
DIRECTIONS AND ASSIGNMENT CRITERIA
Assignment Criteria Points Percentage Description
Part 1: Written Performance Evaluation for the Successful Learner
85
47%
The required content includes the following.
Identify the practice setting
Provide a fictional example identifying the behaviors of the successful learner in the clinical setting Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)
Identify the evaluation score for each competency
Identify the competency that needs improvement
Demonstrate objective wording in the Educator’s Summative Assessment that supports the Evaluation Score
Provide specific fictional examples of learner’s behavior for knowledge, skills, and attitudes for each competency
Prepare a comprehensive concluding statement regarding the summative evaluation
Part 2: Written Performance Evaluation for the Unsuccessful Learner
85
47%
The required content includes the following.
Identify the practice setting
Provide a fictional example identifying the behaviors of the unsuccessful learner in the clinical setting. Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)
Identify the evaluation score for each competency
Identify the two competencies that are unsatisfactory
Demonstrate objective wording present in the Educator’s Summative Assessment that supports the Evaluation Score
Provide specific fictional examples of learner’s behavior for knowledge, skills, and attitudes for each competency
Prepare a comprehensive concluding statement regarding the summative evaluation
Scholarly Writing
10 6%
The required content includes the following.
Correct spelling, grammar, and punctuation
Exceptional writing style with clarity, flow, and organization of information throughout the paper
Congruence with APA mechanics of style
Comprehensive Mental Health ExaminationFor this assignment, list the parts of a comprehensive mental status examination (MSE) for mental health patients. Give examples of each and describe the significance to the advanced practice nurse.Submission InstructionsThe paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.The paper should be formatted per the current 7th edition APA and 3-4 pages in length, excluding the title, abstract, and references page. This paper requires an abstract.Incorporate a minimum of 5 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.Complete and submit the assignment by 11:59 PM ET Sunday.Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
The purpose of this assignment is to understand the principles of pharmacodynamics and pharmacokinetics and how they affect the delivery of prescription and non-prescription pharmacologic care.
Students will provide the best complete answer to each of the following questions:
Define the principles of pharmacodynamics and pharmacokinetics in the delivery of pharmacological care.
Discuss the importance of the pharmacokinetic processes of absorption, distribution, metabolism, and excretion during the administration of medications.
Explain the importance of identifying the pharmacodynamics and pharmacokinetics principles in the use of alternative, nutritional, and complementary medications.
To maximize beneficial responses and minimize harm, discuss how drug therapy must be adjusted to account for sources of individual variation; i.e. size, genetic factors, co-morbid conditions, etc.
Define the nurse’s role and legal responsibilities for medication administration.
Assignment Criteria:
A rationale for your answers must be supported by evidence from at least three (3) references. One reference must be the course textbook and the other two references can either be peer-reviewed scholarly journal articles (no older than five [5] years unless a classic source) and/or credible websites.
Use of the APA Student Paper format is required. Suggested paper length is 2 to 3 pages max! Excluding the title and reference pages.
The following Level 1 headings for your paper must be used:
Title of Your Paper
Introductory paragraph should be written between the title and the first Level 1 heading.
Pharmacodynamics and Pharmacokinetics
Importance of the Pharmacokinetic Processes
Drug Therapy Adjustment for Individual Variation
Nurse’s Role and Legal Responsibilities for Medication Administration
Conclusion
Rubric
Assignment #1 and #3 Spr 2021 (150 pts) (1) (1)
Assignment #1 and #3 Spr 2021 (150 pts) (1) (1)
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeTimely Submission
5 pts
Submits assignment by due date and time.
3 pts
Submits assignment less than 48 hours past the due date.
0 pts
Submitted more than 48 hours past the due date.
5 pts
This criterion is linked to a Learning OutcomeAddresses Assigned Topic
30 pts
Topic is covered in a complete and concise manner.
25 pts
Topic is covered and most pharmacological implications are discussed.
10 pts
Topic is only slightly covered and lacks substance. Limited pharmacological implications addressed.
0 pts
Incomplete or confusing.
30 pts
This criterion is linked to a Learning OutcomeEvidence of Critical Thinking
65 pts
Demonstrates clear understanding of the topic. Relates research and patient safety concerns thoroughly; applies information to professional nursing practice.
50 pts
Conveys understanding of the topic. Adequate discussion of related research and patient safety concerns. Some inconsistencies in making connections between information provided and professional nursing practice.
35 pts
Paper lacks substance; limited evidence of understanding of the topic. Connections between information provided and professional nursing practice are unclear, not firmly established, or are not obvious. Minimal or unclear references to related research and patient safety concerns.
0 pts
Lack of understanding. No evidence of connections between information provided (if provided) and professional nursing practice. Little or no reference to related research and patient safety concerns.
65 pts
This criterion is linked to a Learning OutcomeReferences/Resources
20 pts
At least three (3) references are required. One must be the course textbook and the other two either peer-reviewed scholarly journal articles (no older than five [5] years unless a classic source) and/or credible websites.
10 pts
Missing one of the following required references. At least three (3) references are required. One must be the course textbook and the other two either peer-reviewed scholarly journal articles (no older than five [5] years unless a classic source) and/or credible websites.
5 pts
Missing two of the following required references. At least three (3) references are required. One must be the course textbook and the other two either peer-reviewed scholarly journal articles (no older than five [5] years unless a classic source) and/or credible websites.
0 pts
Only one reference or references are not used.
20 pts
This criterion is linked to a Learning OutcomeSpelling, Grammar, and APA Format
20 pts
Proper grammar, and spelling. Proper APA format. 0 to 2 errors
10 pts
Contains minor errors in grammar and spelling. Minor errors in APA format. 3 to 4 errors
5 pts
Multiple errors in grammar and spelling. Multiple errors in APA format. 5 to 6 errors
0 pts
Lacks proper grammar, contains multiple misspelled words. Lacks proper APA format. Greater than 6 errors.
20 pts
This criterion is linked to a Learning OutcomeTurnitin Score
10 pts
Turnitin Score 20% or less.
5 pts
Turnitin Score 21% to 30%
3 pts
Turnitin Score 31% to 40%
0 pts
TTurnitin Score greater than 40%
10 pts
This criterion is linked to a Learning OutcomeLate Assignment SubmissionLate assignment submissions are built into the grading rubric. If not stated there, five (5) points will be deducted for each day up until five (5) days past the due date. Course work received over five (5) days past the due date will not be graded and students will receive a zero (0) for the assignment.
Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.Locating EvidenceUsing the Chamberlain University library, search for a recent (published within the last five years) evidence- based article from a scholarly journal that addresses one of the topics listed.SafetyDelegationPrioritizationCaringit does not have to be chamberlain library
What are the roles for advanced practice nurse in nursing research?
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 references from academic journals no older than five years.
Grading Rubric
Your assignment will be graded according to the grading rubric.
Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts
Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.
Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.
Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.
Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.
5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines
Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.
3 points
Response to Posts of Peers
Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.
Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.
Poor – 0 points
Student provided no response to a peer’s post.
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 5
Course name:
HCM
Course number:
101
CRN
•
•
Assignment title or task:
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
College of Health Sciences
Department of Public Health
Guidelines:
•
•
•
•
•
•
•
Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
all information will be given in the photos Diabetes Article https://usflearn.instructure.com/courses/1817688/files/156114464?verifier=Z0HjXMNDjEOWSMbzyQlww5srmtU1ndlw128O60VK&wrap=1Mental Health Article https://usflearn.instructure.com/courses/1817688/files/156114460?verifier=z1slNwcZfDBl1oPcLvoSVR9yR4rge5vtrzOzQbBs&wrap=1Don’t use other sites only one of the two articles provided. No plagiarism! Please. Use your own words!! Thank you 🙂
Cultural, Spiritual, Nutritional, & Mental Health Disorders
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1 Case 2 Case 3 here:
Subjective Data
Chief Complaint
(CC) “I came for my annual physical exam, but do not want to be a burden to my daughter.” “I am here for my annual physical exam and have been having vaginal discharge.” “Annual physical exam”
History of Present Illness (HPI) At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. 32-year-old pregnant lesbian – her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle.
PMH Hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis
PSH S/P cholecystectomy
Drug Hx Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and Cipro 100mg daily. Current Meds: prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion Current Meds: denied
Allergies No allergies to food or medications.
Family Hx She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0. He has a family history of diabetes, hypertension, and alcoholism.
Review of Systems (ROS)
General + weight loss of 25 lbs over the past year; no recent fatigue, fever, or chills. No fatigue, fever, or chills. No recent weight gains of losses, fatigue, fever, or chills.
Head, Eyes, Ears, Nose & Throat (HEENT) No changes in vision or hearing, no difficulty chewing or swallowing.
Neck No pain or injury No pain or injury
Respiratory
CV no chest discomfort or palpitations
GI
GU no urinary hesitancy or change in urine stream
Integument multiple bruises on his upper arms and back. multiple piercings, and tattoos. Old scars related to “cutting” history of eczema – not active
MS/Neuro + falls x 2 within the last 6 months; no syncopal episodes or dizziness no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements. no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements
Objective Data
PE B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8 B/P 128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98 B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6
General 23-year-old male appears well developed and well-nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.
HEENT Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous. Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip. Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, nasopharynx clear, poor dentition – multiple carries.
Lungs CTA AP&L CTA AP&L CTA AP&L
Card S1S2 without rub or gallop S1S2 without rub or gallop S1S2, +II/VI holosystolic murmur; without rub or gallop
Abd benign, normoactive bowel sounds x 4 benign, normoactive bowel sounds x 4 benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.
GU external genitalia intact, no lesions or masses. White copious discharge with an amine odor; no cervical motion tenderness; adnexa intact.
Ext no cyanosis, clubbing or edema no cyanosis, clubbing or edema no cyanosis, clubbing or edema
Integument multiple bruises in different stages of healing – on his upper arms and back. intact without lesions masses or rashes. intact without lesions masses or rashes.
MS
Neuro No obvious deformities, CN grossly intact II-XII No obvious deficits and CN grossly intact II-XII No obvious deficits and CN grossly intact II-XII
Answer the following questions about your specific case number assigned:
Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
Utilizing the five assessment domains, which ones would you utilize on your patient in conducting a comprehensive nutritional assessment?
Discuss the functional anatomy and physiology of a psychiatric mental health patient. Which key concepts must a nurse know in order to assess specific functions?
Submission Instructions:
You have been assigned your case number (See Announcement), and you will post about the case number you have been assigned.
You will reply to your peers who have posted on the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
Throughout this course, you will be developing a resource guide. Once completed, this guide will serve as a resource for you while working with individuals with mental health challenges.
For this unit, you will identify a minimum of 5 mental health disorders or challenges experienced by the aging population, at least one evidence-based treatment to treat each of those challenges, and a resource to support those experiencing the disorder or challenge.
Continue to add to the document you uploaded in the Unit 5 Resource Guide assignment.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 3 hours
Rubric
MSW628 Resource Guide Part II Rubric
MSW628 Resource Guide Part II Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIdentify mental health disorders or challenge
15 pts
Mastered
Clearly identifies five childhood challenges or disorders
13.5 pts
Excels
Clearly identifies four childhood challenges or disorders
12 pts
Competent
Clearly identifies three childhood challenges or disorders
10.5 pts
Low-Level Competency
Clearly identifies two childhood challenges or disorders
9 pts
Needs Improvement
Clearly identifies one childhood challenge or disorders
0 pts
Not Attempted
Does not identify challenges
15 pts
This criterion is linked to a Learning OutcomeEvidence-Based Practice
20 pts
Mastered
Identifies at least one evidence-based intervention that is clearly connected to each challenge or disorder and provides citation/ reference
18 pts
Excels
Identifies at least one evidence-based intervention that are somewhat connected to each challenge or disorder and provides citation/ reference
16 pts
Competent
Identifies at least one evidence-based intervention that is somewhat clearly connected to most of the challenges or disorders and provides citation/ reference
14 pts
Low-Level Competency
Identifies at least one evidence-based intervention that are somewhat connected to each challenge or disorder with limited or no citations
12 pts
Needs Improvement
Identifies at least one intervention that is connected to each challenge or disorder
0 pts
Not Attempted
Does not identify evidence-based intervention
20 pts
This criterion is linked to a Learning OutcomeResources
15 pts
Mastered
Identifies at least one resource that is clearly connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including a website
13.5 pts
Excels
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including website
12 pts
Competent
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including website to some of the issues identified
10.5 pts
Low-Level Competency
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder
9 pts
Needs Improvement
Identifies some resources that don’t have a clear connection to the challenge
Address disparities in health and health care in United States, who are the most affected and why? What are the remedies you think can be done to overcome them? Initial post minimum of 350 words with 2 scholarly references. Reply to each peer (2 or more) minimum of 150 words with 1 scholarly reference. As a tip: Type discussion board posts (initial and reply) on a word document so you are aware of the word count. Thank you.
Write 4 career trajectory plan (for nurse working in clinical areas and studying master of nursing education) in table including ( focus areas, goals and objectives , Strategies to Complete Goals/Objectives , Expected Outcomes , Date to be Initiated , Actual Completed Date , Evaluation of Outcomes ) * See the upload file.. there is table you should use to fill the career trajectory plan And there is also examples tablw
Complete the Chapter 16 question #8 (only question #8) – Review Questions and class activities section p. 473, make sure to include the questions, answer in great detail, specifics and elaborate on your response. This should be a lengthy response that should include a open ended response, that gives an indepth point of view as well as your personal opinion on the matter.8. Critically compare the use of isometric, isotonic and isokinetic exercises in rehabilitation and provide examples of each.
I need two different versions. each one must be different than the other. The attached files are the instructions and the article you need to finish this assignment.
Unformatted Attachment Preview
NURS 321
Nursing Research & Evidence-Based Practice
Module 2 Individual Case Study Discussion Questions
Chapter 5
Evan and Marlyce have a 4-year-old son (Micah) who has cerebral palsy. Their life is very
challenging because they both have to work and recently lost their home to foreclosure. Micah is
being discharged to home this afternoon, and Marlyce is obviously anxious. Marlyce states, “I
just feel like we are always out of touch when we go home. I have other children to care for, and
we are always on the go.“ This case study is based on a longitudinal qualitative study from
Canada (Woodgae, Edwards, & Ripat, 2012).
1. Propose a qualitative research study purpose that would help the nurse provide better care for
Micah’s family.
2. As the researchers set up a qualitative study for families of patients such as Micah, they used
purposive sampling. What does this mean, including some ideas for inclusion and exclusion
factors?
3. Now that inclusion and exclusion criteria are set for the study, how can the participants be
recruited? How many participants would be necessary?
Chapter 6
Simon is undergoing cardiac catheterization after a heart attack. Throughout his hospital stay,
the case manager asks about resources at home. Much to everyone’s amazement, it is discovered
that Simon is homeless. Simon is supposed to undergo extensive follow-up and cardiac
rehabilitation. Because of the location of this facility, the case manager knows that there are
other situations similar to Simon’s in this community.
1. If the case manager wanted to research Simon’s experience (managing cardiac disease while
being homeless), how might the researcher maintain rigor?
2. Describe a grounded theory study and an ethnographic study structure for Simon’s case.
3. The case manager is using an ethnographic research methodology for patients who are
homeless and have heart disease. Describe the data gathering process.
Chapter 7
Two teenaged girls visit the school nurse and are concerned about acne. Both have tried “things
and food” that their friends told them about, but nothing is working. They are asking for more
information and something that will help with “these totally annoying zits.”
1. Propose using social media to better understand how acne affects teenaged girls.
2. For a researcher collecting data through social media, how might their interaction affect the
results and how could this be avoided?
3. Discuss how the researcher could verify the findings from the qualitative research.
Chapter 8
The nurse recognizes that there has been an increase in the number of urinary tract infections
(UTIs) on one unit of the rehabilitation facility. He heard about a new type of peri-care bath
wipes. The nurse would like to try them as a way of seeing if they help decrease the incidence of
cystitis.
1. What are the independent and dependent variables in this study?
2. List some extraneous variables in this study.
3. How might the nurse ensure randomization of the participants to the experimental or control
groups?
Chapter 9
Mirlande is an 18-year-old woman in the clinic with asthma. She has been in the United States
for 6 months and has gone through three albuterol inhalers and two salmeterol inhalers. The
nurse practitioner is considering treatment strategies for the client.
1. As the nurse practitioner considers research studies about the best treatment option, she is
frustrated that she cannot find purely experimental studies. Is there value in reviewing a
study that used quasi-experimental methodology? Provide rationale for your answer.
2. If the nurse practitioner was unable to find research specifically about the young adult or
older adolescent, what may be an acceptable alternative? Provide rationale for your answer.
3. Propose a study for clients with asthma that would compare using a long-acting inhaler (antiinflammatory) with an oral medication (anti-inflammatory). Describe the methodology if a
Solomon four-group design was used.
Chapter 18
A woman brings in her 8-year-old child, who has a serious history of asthma. The nurse notes
that the mother is tired looking, and the child is very “clingy.” As the nurse asks questions of the
mother, the mother takes a deep breath and looks away. The nurse senses that there is something
concerning the parent. After the nurse says, “You seem pretty tired,” the mother states that she is
worn out from “chasing around all the kids.”
1. On the basis of an appraisal of the article by Cerdan et al (2012), can the nurse assume that
the client’s mother is likely to become divorced? Support your answer.
2. The nurse would like to compare the current research (Cerdan et al, 2012) to a known
evidence-base. What would you recommend?
3. As the nurse reviews the Cerdan et al article, she notes that in previous research, there was no
correlation between the number of emergency department visits and parental quality of life
scores. Conversely, in the Cerdan et al study data, there was a significant correlation. How
should the nurse use this information?
Available online at www.sciencedirect.com
Applied Nursing Research 25 (2012) 131 – 137
www.elsevier.com/locate/apnr
Original Articles
Asthma severity in children and the quality of life of
their parents
Noelle S. Cerdan, RN, CPNPa , Patricia T. Alpert, DrPH, APNb,⁎, Sheniz Moonie, PhDc ,
Dianne Cyrkiel, MSN, APNd , Shona Rue, MSN, CPNPd
a
Oshiro Pediatrics, Las Vegas, NV 89119-6183, USA
School of Nursing, University of Nevada, Box 453018, Las Vegas, NV 8154-3018, USA
c
School of Community Health Sciences, University of Nevada, Box 453063 Las Vegas, NV 89154-3063, USA
d
School of Nursing, University of Nevada, Box 453018, Las Vegas, NV 8154-3018, USA
Received 31 March 2010; revised 3 January 2011; accepted 17 January 2011
b
Abstract
This study examines the effect of asthma severity of children aged 7–17 years and sociodemographic
characteristics on the caregiver’s quality of life. For parents of asthmatic children, there was a
negative correlation between overall asthma severity and quality-of-life score. Measuring parental
quality of life enables the development of effective asthma programs.
Published by Elsevier Inc.
1. Introduction
2. Background
Quality of life (QOL) can be described as general
satisfaction with everyday living (Vila et al., 2004) and is
closely related to health status. Along with asthma
symptoms and other clinical indicators, QOL measurements are important when assessing asthmatic children
and their caregivers holistically (Juniper, Guyatt, Feeny,
Ferrie, & Townsend, 1996). This descriptive, crosssectional study examines the effect of asthma severity
on caregivers’ QOL using the Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) of
Juniper et al. (1996), which considers activity limitation
and emotional function. The PACQLQ also examines the
relationship between caregivers’ QOL and caregiver
sociodemographic characteristics.
Asthma is one of the most common chronic diseases in
the United States, affecting about 22.2 million people,
6.5 million of which were children, in 2005 (National
Center for Health Statistics [NCHS], 2007). School-age
children with asthma are affected by the frequency and
severity of episodes, hospital admissions, side effects of
medications, morbidity and mortality, and costs of hospitalizations (Vila et al., 2004). Asthma also affects other aspects
of life, such as school attendance, physical activity, family
dynamic, coping style, psychological functioning, and sleep
(Marsac, Funk, & Nelson, 2006; Moonie, Sterling, Figgs, &
Castro, 2006).
Parents as caregivers are responsible for many aspects of
their children’s care, including symptom observation,
medication administration, and transportation to health care
services (Halterman et al., 2004). Because asthma is a
chronic condition, parents can experience long-term stressors that impact work productivity, medical decisionmaking, and overall care and discipline issues (Halterman
et al., 2004; Laforest et al., 2004).
In addition, other sociodemographic factors such as
marital status, smoking status, educational level and income,
presence of family and support systems, presence of other
children in the household, and the parents being diagnosed
with asthma themselves can contribute to changes in parental
⁎ Corresponding author. Tel.: +1 702 895 3810; fax: +1 702 895 4807.
E-mail addresses: cerdann@unlv.nevada.edu (N.S. Cerdan),
patricia.alpert@unlv.edu (P.T. Alpert), sheniz.moonie@unlv.edu
(S. Moonie), dianne.cyrkiel@unlv.edu (D. Cyrkiel), shona.rue@unlv.edu
(S. Rue).
0897-1897/$ – see front matter. Published by Elsevier Inc.
doi:10.1016/j.apnr.2011.01.002
132
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
QOL. Many studies show that childhood morbidity and
mortality related to asthma are associated with being lowincome families, being a minority, and living in the inner city
(NCHS, 2007).
To date, research results relating asthma characteristics
including clinical measures and or symptoms and PACQLQmeasured QOL are inconsistent. Developed in Canada by
Juniper et al. (1996), the PACQLQ showed acceptable levels
of correlation between asthma status and parental QOL.
Results showed that the PACQLQ was able to detect QOL
changes over time (p b .001) and detect stability in those
who did not change (p b .0001). Following school-age
children through the school year in the United States.,
Halterman et al. (2004) showed that baseline asthma severity
measured by asthma severity symptoms (i.e., daytime and
nighttime symptoms, the need for rescue inhaler use, and the
number of symptom-free days) significantly correlated with
the PACQLQ score (range r = .23–.51, all p b .1). The
highest correlation was between symptom-free days and
parental QOL (r = .51, p b .001). At the end of the school
year, significant correlations were found with all measures
of asthma severity, except for rescue inhaler use. An
increase in symptom-free days over time correlated with an
improvement in PACQLQ scores (r = .30, p b .001).
Conversely, an increase in daytime (r = −.27, p = b.001) and
nighttime (r = −.22, p = .005) symptoms correlated with
lower PACQLQ scores.
Over a 3-month period, Osman, Baxter-Jones, and Helms
(2001) showed a significant correlation between a change in
children’s asthma symptoms and PACQLQ scores (r =
.54–.57, p b .001) even if the PACQLQ scores were not
clinically significant. This suggests that other social and or
psychological factors, in addition to asthma severity, may
influence PACQLQ scores (Vila et al., 2004).
Many studies relate children’s asthma prevalence to
sociodemographic characteristics such as minority families
living in low-income urban neighborhoods (Akinbami &
Schoendorf, 2002). One study suggests that the prevalence
and severity of asthma are associated with being African
American or Hispanic and to poverty-related factors such as
young maternal age, secondhand exposure to cigarette
smoke, low birth weight, and living in crowded inner cities
(Williams, Sternthal, & Wright, 2009).
Erickson et al. (2002) showed that household income
and lower perceived asthma severity were statistically
significant predictors of QOL as measured by the
PACQLQ. Longer length of time diagnosed with asthma,
longer length of time enrolled in a specialty clinic, fewer
siblings living in the household, and greater convenience
of seeing the physician were all related to higher QOL.
Using Carstair’s deprivation scores to describe the sociodemographics of the families in their study, Osman et al.
(2001) found that younger mothers, those who come from
less affluent families, and those with greater social
deprivation had lower PACQLQ scores. Parental work
absenteeism related to the child’s illness can have economical
implications for parents (Dean, Calimlim, Kindermann,
Khandker, Tinkelman, 2009; Laforest et al., 2004).
This study is different from other studies that utilized the
PACQLQ because this study used the current National
Asthma Education and Prevention Program (NAEPP)
guidelines in diagnosing asthma severity in children. The
guidelines categorize patients based on worsening physical
symptoms such as increased nighttime awakenings, increased use of rescue medication for symptom control,
interference with normal activity, and decreased lung
function. Very few studies have documented asthma severity
using NAEPP guidelines, and for those that did, they have
had inadequate sample sizes. In addition, this study uses
several measurement tools and clinical indices such as
pulmonary function tests (PFTs), whereas other studies
depended solely on self-reported asthma severity or
administrative records, which can underestimate asthma
prevalence. Lastly, the current QOL literature for asthma is
conflicted and not highly abundant, so this study lends
greater insight to the current research literature.
This study is important to nursing because it offers a more
holistic focus when addressing asthmatic children and their
parents in the clinical setting. Operationalizing parental QOL
measures as functional limitations and emotional dimensions
allows nurse researchers to quantify the degree of burden that
parents experience so that more effective asthma programs
can be developed (Halterman et al., 2004). In addition, being
familiar with the NAEPP (2007) guidelines in daily practice,
nurses can better identify at-risk parents of asthmatic
children to more quickly implement appropriate care. QOL
has been shown to be an important outcome measure, and
being aware of its effect on the individual is important for
adherence to medical treatment (Marsac et al., 2006). The
objective of this study was to examine the effect of children’s
asthma severity and sociodemographic factors on parental
QOL measured through the PACQLQ.
3. Research design and methodology
This correlational study utilized a convenience sample of
parents of children and adolescents, aged 7 to 17 years, with
medical diagnoses of mild intermittent to severe persistent
asthma. This study was reviewed and approved by the
institutional review board at the University of Nevada, Las
Vegas. From August 2008 to February 2009, participants
were chosen from a pediatric pulmonology outpatient clinic
located in Las Vegas, Nevada. Parents of children aged from
7 to 17 years were targeted because parents with children in
this age range were used to validate the PACQLQ (Juniper
et al., 1996). Parents surveyed were legal guardians of the
asthmatic children. The clinic was chosen by the investigators because the clinic had patients with a greater variety of
asthma severity (i.e., mild, moderate, or severe) and
sociodemographic factors (i.e., health insurance coverage,
parental age and ethnicity, and other variables). Children
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
with a diagnosis of other chronic conditions such as
depression, cerebral palsy, diabetes, hypothyroidism, and
cancer were excluded from the study. Because most children
with asthma also have atopic conditions such as eczema,
allergy, and rhinoconjunctivitis, patients with atopy were not
excluded from this study (Reichenberg & Broberg, 2001).
One of the researchers reviewed the charts of all
scheduled patients to verify asthma diagnosis and age.
Those deemed to be eligible to participate were approached
in the waiting room by the researcher as patients and parents
came in for their scheduled appointments. All potential
participants were told that the researcher was not an
employee of the clinic. They were also told that their
participation was voluntary and declining participation
would not jeopardize their relationship with their doctor or
office staff. Those who agreed to participate completed the
informed consent and their children offered assent. Participants were asked to confirm the age of their children and
their children’s asthma diagnosis. They were also asked their
relationship to the children and were excluded if they were
not the biological parents, adoptive parents, stepparents,
legal guardians, or foster parents. Only one set of
questionnaires were completed for each family.
Prior to completing the three questionnaires, the
researcher gave parents explicit instructions on how to
answer the items for each questionnaire, including the option
not to answer questions that made them feel uncomfortable.
If participants had questions after they started completing
the questionnaires, they were told to choose the answer that
they most strongly agreed with. To maintain participant
confidentiality, participant questionnaires were assigned
numbers, and participant names or any other identifying
information such as address, telephone number, or birth date
were not recorded. The parents returned the questionnaires
to the researcher in an unmarked manila envelope to further
ensure confidentiality.
The three questionnaires utilized were as follows: (1) the
PACQLQ (Juniper et al., 1996), (2) the asthma severity
questionnaire, and (3) the sociodemographic factors questionnaire. The PACQLQ, a 13-item questionnaire, measures
activity limitation and emotional function. This tool is
frequently utilized to measure the burden that parents
experience in caring for their asthmatic children (aged 7 to
17 years). Specifically, this tool measures how a child’s
asthma interferes with the parent’s daily activities (activity
limitation) and the emotions generated (emotional function).
The questionnaire contains four items addressing activity
limitations and nine items addressing emotional function,
with all questions being weighed equally. Parents respond
to this questionnaire using a 7-point Likert-type scale,
where 1 represents severe impairment and 7 represents no
impairment. Examples of questions include the following:
“How often did your child’s asthma interfere with your job
or work around the house?” and “How often were you
bothered because your child’s asthma interfered with family
relationships?” The PACQLQ score produced a mean
133
activity limitation score, a mean emotional function score,
and a total mean score (Juniper et al., 1996). The
questionnaire has been studied to be reliable and valid in
certain populations. The PACQLQ has good reliability, with
an intraclass correlation coefficient for overall QOL = .85,
emotional function = .80, and activity limitation = .84
(Juniper et al., 1996).
The Asthma Severity Questionnaire was developed by
the researchers for use in this study and includes 18
questions to categorize the child’s asthma severity, which
mirrors the 2007 NAEPP asthma classification guidelines.
The NAEPP asthma classifications include intermittent
asthma, mild persistent asthma, moderate persistent
asthma, and severe persistent asthma. The NAEPP guidelines to classify asthma severity were turned into
questions. Examples of questions included the following:
“In the past 30 days, how often has your child had asthma
symptoms such as wheezing, coughing, and shortness of
breath during the day? and “In the past 30 days, how often
did your child wake up during the night due to asthma
symptoms such as wheezing, coughing, and shortness of
breath?” Participants were also asked about medication use
within the past week to verify appropriate classification
severity-specific treatment based on NAEPP guidelines.
Other questions (not specific to the NAEPP guidelines),
such as the number of days of school the child has missed,
the number of days spent in the emergency room (ER) or
hospital, and parental perception of asthma severity and
control, were included based on findings of a literature
review. The questionnaire was reviewed by two content
experts but was not piloted prior to use in this study. In
addition, spirometry readings, including forced expiratory
volume in one second (FEV1) and Forced expiratory
volume in one second/forced vital capacity ration (FEV1/
FVC) ratios, were obtained from the children’s medical
records with the permission of the pediatric pulmonologist
and informed consent from the parents to further
categorize the children’s asthma severity based on the
NAEPP guidelines.
The Sociodemographic Factor Questionnaire, developed
by this study’s investigators, was based on literature
identification of the demographic variables associated with
asthma morbidity and mortality. This questionnaire asked 18
questions on age, ethnicity, income, education level, place of
residence, employment, health insurance coverage, social
support, and other variables.
3.1. Data analysis
Data entry and analyses were performed utilizing the
Statistical Package for the Social Sciences Version 17.0. To
assess the relationship between asthma severity and parental
QOL, Spearman’s correlation (ρ), analysis of variance
(ANOVA), and linear and multivariate regressions were
performed. To determine the relationship between sociodemographic factors and parental QOL, Spearman’s correlation (ρ), chi-square, and independent t tests were performed.
134
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
4. Results
Table 2
Demographic characteristics by percentages (n = 101)
A total of 112 parents who met the study criteria were
invited to participate in the study. Ten parents were not
interested in participating in the study and one parent did not
return the survey to the researcher. Of the original 114
parents invited, 101 (88.59%) participated in the study.
Tables 1 and 2 show the demographic characteristics of the
participants. The Cronbach alpha coefficient for the
PACQLQ was .89 of the total score, which suggests good
internal consistency.
Before correlation analyses on the data were performed,
scatterplots were generated and checked for violation of
assumptions of normality, linearity, and homoscedasticity.
Using Spearman’s correlation (ρ), significant negative
correlations were found between overall asthma severity
and mean activity limitation scores (ρ = −.400, p b .001),
mean emotional function scores (ρ = −.258, p b .001), and
mean total PACQLQ scores (ρ = −.342, p b .001).
Significant moderate, negative correlations were found
between PACQLQ scores and asthma day symptoms,
asthma night symptoms, and asthma exercise symptoms.
As asthma severity and other asthma factors increased,
PACQLQ scores decreased, indicating poorer QOL. No
significant relationships were found between PFT scores and
PACQLQ scores.
In addition, significant positive correlations were found
between employment income and mean activity limitation
scores (moderate correlation, ρ = .363, p b .001), mean
emotional function scores (small correlation, ρ = .291, p b
.05), and mean total PACQLQ scores (moderate correlation,
ρ = .346, p b .001). This indicates that parents with higher
incomes experience increased QOL. Table 3 provides the
details of these analyses.
ANOVA was used to compare mean PACQLQ scores for
each asthma severity group. Participants were divided based
on asthma severity rating prescribed according to NAEPP
guidelines. The assumption of homogeneity of variance was
not violated. The overall PACQLQ scores were statistically
significant for the four asthma severity groups, F(2, 101) =
4.942, p = .003. The effect size, calculated using eta squared,
was .132. Post hoc comparisons using Tukey’s honestly
Caregiver or child characteristics
Table 1
Demographic characteristics by means (n = 101)
Caregiver or child characteristics
Child
Age (years)
Length of diagnosis (years)
ER visits in the past year
Hospitalizations in the past year
School days missed in the past year
Caregiver
Age (years)
Workdays missed in the past year
Number of people living in home
Number of children living in home
M
SD
10.26
6.49
1.01
0.25
5.85
2.78
3.90
1.98
0.79
9.24
39.34
4.46
3.67
2.63
7.71
7.43
1.78
1.21
Child
Male
Female
Caregiver
Male
Female
Age
≤30 years
N30 years
Martial status
Single
Married
Separated/Divorced
Living with significant other
Ethnicity
White/Caucasian
Hispanic
Black/African
Other
Caregiver type
Mother
Father
Other
Parent perception of control
Owning a vehicle
Language
English
Spanish
English and Spanish
Parent with medically diagnosed asthma
Family history of asthma
Smokers
Employed
Work hours per weeka
b40
≥40
Education
High school
College
Graduate school
Annual incomea
Less than $30,000
$30,000 to $45,000
$45,000 to $60,000
$60,000 to $75,000
Greater than $75,000
Insurance
No insurance
Medicaid
Private insurance
Ability to pay for health expenses
Residence type
Own
Rent
Family or friend support
a
%
55.4
44.6
20.8
79.2
11.9
87.1
12.9
64.4
18.8
4.0
58.4
20.8
15.8
5.0
75.2
18.8
6.0
74.3
95
89.1
4.0
5.9
38.6
73.3
9.9
69.3
24.5
42.1
32.7
58.4
8.9
15.8
18.8
10.9
9.9
12.0
5.0
16.8
78.2
86.1
68.3
29.7
88.1
n = 72.
significant different (HSD) test indicated that the mean score
for the mild intermittent group (M = 5.25, SD = 1.18) was
significantly different from that of the moderate persistent
group (M = 4.31, SD = 1.21) and that of the severe persistent
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
Table 3
Correlation between asthma severity rating and PACQLQ scores
Table 5
Univariate regression model predicting QOL
Asthma severity
measure
Activity
limitation
subscale (ρ)
Emotional
function
subscale (ρ)
PACQLQ
summary
scores (ρ)
Asthma severity
Day symptoms
Exercise symptoms
Night symptoms
Rescue inhaler use
ER visits
Hospitalization days
Parental perception of
asthma severity
Parental perception of control
School days missed
Workdays missed
Annual income
−.40⁎⁎
−.43⁎⁎
−.44⁎⁎
−.48⁎⁎
−.31⁎⁎
−.45⁎⁎
−.22⁎
−.58⁎⁎
−.26⁎⁎
−.29⁎⁎
−.30⁎⁎
−.33⁎⁎
ns
−.41⁎⁎
−.20⁎
−.49⁎⁎
−.34⁎⁎
−.37⁎⁎
−.39⁎⁎
−.43⁎⁎
ns
−.46⁎⁎
−.24⁎
−.58⁎⁎
−.37⁎⁎
−.36⁎⁎
−.49⁎⁎
.36⁎⁎
−.28⁎⁎
−.24⁎⁎
−.24⁎
.29⁎
−.34⁎⁎
−.31⁎⁎
−.37⁎⁎
.35⁎⁎
Note. ρ = Spearman ρ; ns = not significant.
⁎ p b 0.05.
⁎⁎ p b 0.001.
group (M = 4.11, SD = 1.49). Table 4 provides the details of
these analyses.
ANOVAs to compare activity limitation scores showed
statistical significance in overall PACQLQ scores for the
four asthma severity groups, F(3, 101) = 7.56, p = .0005.
The effect size, calculated using eta squared, was .189. Post
hoc comparisons using Tukey’s HSD test indicated that the
mean score for the mild intermittent group (M = 5.37, SD =
1.31) was significantly different from that of the moderate
persistent group (M = 4.02, SD = 1.75) and that of the severe
persistent group (M = 3.55, SD = 1.91). The mild persistent
group (M = 5.13, SD = 1.25) was significantly different from
the severe persistent group (M = 3.55, SD = 1.91).
ANOVA comparisons of emotional function scores
showed statistical significance in PACQLQ scores for the
four asthma severity groups, F(3, 101) = 2.855, p = .041. The
effect size, calculated using eta squared, was .08. Post hoc
comparisons using Tukey’s HSD test showed no significant
differences among the four groups of asthma severity.
Univariate linear regression was used to determine which
asthma severity and sociodemographic factors predicted
Table 4
PACQLQ scores and researcher rating of asthma severity
Asthma
severity rating
by caregiver
Activity
limitation
subscale,
M (SD)a
Emotional
function
subscale,
M (SD)b
PACQLQ
summary
scores,
M (SD)c
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent
5.37 (1.31)
5.13 (1.25)
4.02 (1.75)
3.55 (1.91)
5.20 (1.22)
4.68 (1.14)
4.43 (1.14)
4.36 (1.51)
5.25 (1.18)
4.82 (0.95)
4.31 (1.21)
4.11 (1.49)
df = 3, F = 7.56, p = .0005, η2 = .189.
df = 3, F = 2.855, p = .041, η2 = .08.
c
df = 2, F = 4.942, p = .003, η2 = .132.
a
b
135
Predictor
Annual income
Hospitalization days
ER visits
School days missed
Workdays missed
Activity
limitation
subscale
Emotional
function
subscale
PACQLQ
summary
scores
B
R2
B
R2
B
R2
.23
−.57
−.33
−.08
−.11
.08⁎⁎⁎
.06⁎
.15⁎⁎
.18⁎⁎
.21⁎⁎
ns
ns
−.20
−.03
−.04
ns
ns
.09⁎⁎
.04⁎
.05⁎
.14
−.30
−.24
−.05
−.06
.05⁎
.03⁎⁎
.13⁎⁎
.10⁎⁎⁎
.12⁎
Note. B = unstandardized beta coefficient; R2 = adjusted r2; ns = not
significant.
⁎ p b 0.05.
⁎⁎ p b 0.005.
⁎⁎⁎ p b 0.001.
parental QOL scores. Prior to performing linear regression,
the data set was assessed for multicollinearity, singularity,
outliers, normality, linearity, homoscedasticity, and independence of residuals. Predictor of better QOL included
increased income. Factors predicting poor QOL included
increased hospitalization days, increased ER visits, and
increased school days and workdays missed (Table 5). The
significant variables (i.e., income, ER visits, hospitalization
days, school days missed, and workdays missed) were
further tested using multiple linear regression. Relationships
between ER visits and mean total PACQLQ scores, mean
activity limitation scores, and mean emotional function
scores were significant. The correlation between the mean
activity limitation score and workdays missed (β = −.069,
p b .043, r2 = .317) was also significant (Table 6).
Independent t tests were performed to compare the mean
PACQLQ scores between different paired groups of sociodemographic factors (i.e., male vs female, owning a home vs
renting, and other groups). Prior to performing the data
analyses, the samples were checked for normal distribution,
homogeneity of variance, independence of observations, and
level of measurement. Parents who were not Black or
African, owned a car, were able to pay health costs, owned a
home, and perceived their children’s asthma as under control
had higher mean total, mean activity limitation, and mean
emotional function PACQLQ scores.
Table 6
Multiple regression models predicting QOL
Predictor
ER visits
Workdays missed
Activity
limitation
subscale
Emotional
function
subscale
PACQLQ
summary
scores
B
R2
B
R2
B
R2
−.25
−.07
.32⁎
.32⁎
−.18
ns
.08⁎
ns
−.20
ns
.19⁎
ns
Note. B = unstandardized beta coefficient; R2 = adjusted r2; ns = not
significant.
⁎ p b 0.05.
136
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
5. Discussion
The main finding in this study is that higher levels of
asthma severity reflected decreased PACQLQ scores, or
decreased parental QOL. This current study affirms findings
by Williams et al. (2000), who also found a negative
correlation between PACQLQ scores for parents and their
children’s asthma severity scores over a period of 4 months
(r = −.39, p b .001). They also found that PACQLQ scores
were correlated negatively with the number of days missed
from school (r = −.24, p b .001), which this study supports.
One explanation may be that parental QOL is affected by
concerns of rising medical expenses with increasing asthma
severity, stress related to the disease process, availability of
social support, access to medical care and appropriate
medication, and the impact of asthma on daily activities in
the home (Annett, Bender, DuHamel, & Lapidus, 2003;
Erickson et al., 2002).
Participants grouped by asthma severity according to
NAEPP guidelines showed significant differences in
PACQLQ scores. As asthma severity increased, mean
parental PACQLQ scores decreased, indicating decreased
QOL (df = 3, F = 7.56, p = .0005, η2 = .189). This finding
indicates that parents of children with mild asthma claimed
better QOL. This suggests that children with higher asthma
severity require levels of care that place greater activity
restriction and emotional responsibility on parents.
In this current study, several sociodemographic factors
were shown to influence parental QOL, some of which do
not support current findings in the literature. For example,
increased ER visits were significantly related to decreased
overall QOL in this study. This is contrary to findings by
Halterman et al. (2004), who identified increased symptomfree days and the parental perceptions of asthma control.
They did not find ER visits to be a significant factor
associated with parental QOL. Instead, their predictive
factors of worse QOL included Hispanic ethnicity, use of
daily maintenance medication, and secondhand smoke
exposure in the home. Research by Erickson et al. (2002)
and Annett et al. (2003) were more closely aligned with
findings from this study.
Several studies suggested that the prevalence and severity
of asthma are associated with ethnicity and poverty-related
factors such as young maternal age, maternal cigarette
smoking, low birth weight, and living in crowded conditions
in the inner city (Williams et al., 2009). This study supported
the idea that sociodemographic factors also influence
parental perception of QOL. A family history of asthma;
being single, divorced, or widowed; and perceived poor
asthma control yielded significantly lower PACQLQ scores.
Correlational analyses of mean PACQLQ scores and
sociodemographic factors revealed different findings from
other studies. For example, Osman et al. (2001) found
sociodemographic factors such as being a
Part 1: Discussion: Write a 250- to 300-word response to the following: Identify 1 major health care legislation in the past 20 years that has had a significant impact on improving access, cost, and/or outcomes in the U.S. population. Describe the policy in terms of its stated policy goals. Include your own experience as well as 2 citations and references that align with or contradict your comments as sourced from peer-reviewed academic journals, industry publications, books, and/or other sources. Format your citations according to APA guidelines. If you found information that contradicts your experience, explain why you agree or disagree with the information. Part 2 Assignment Content his assignment and the Wk 5 – Annotated Bibliography (Part 2) assignment serve as a vehicle for you to write a brief description and critical review of articles relevant to your selected policy topic. You will then draw on these annotated bibliographies throughout this course for your integrative paper. Becoming proficient at writing concise annotated bibliographies that include the pertinent points from a scholarly article is a key skill needed before you write chapter 2 of your dissertation. Review the Integrative Paper Guidelines. See attached Locate 5 to 8 articles relevant to the health policy you chose in your Week 1 assignment. These articles must have been published in peer-reviewed journals. Some journals are provided in this week’s University Library Resources, but this is not a complete list of resources related to health policy; however, these journals have high impact scores concerning readership and citations. You may choose articles from other peer-reviewed journals available from the University Library. Prepare an annotated bibliography for the articles you selected. You are encouraged to include articles that report original research as part of your annotated bibliography. Format your annotated bibliography according to the Sample Annotated Bibliography. See attached
Unformatted Attachment Preview
DHA/722 v8
Integrative Paper Guidelines
The assignments in this course are designed around developing an integrative paper that takes you stepby-step through the research design and writing process. The approach to researching the scholarly
literature and writing a cohesive, integrated manuscript centered on a research problem is aligned with
the requirements for writing a dissertation proposal.
This integrative paper requires exclusive use of scholarly literature, (i.e., peer-reviewed articles as
sources, a scholarly voice, and adherence to APA format and style). Refer to the course resources and
grading rubrics for additional guidance.
For your Weeks 4, 6, and 8 assignments, you’ll complete sections of the paper, leading to the final paper
due at the end of Week 8 that incorporates all the integrative paper elements completed throughout this
course. The Wk 8 – Summative Assessment: Integrative Paper (Part 3) must be 3,250 to 4,900 words
total, excluding the title page, abstract, and references. You are required to use the Integrative Paper
Outline found at the end of this document. This means that you should have the pages and section
headings shown in the outline. Include all components of the outline in your Week 4 (Part 1) submission,
then populate the sections required for Parts 2 and 3 as those assignments become due. The breakdown
of the word count for each part of the integrative paper is shown below.
Integrative Paper Word Count
Minimum Word
Count
Maximum Word
Count
Wk 4 – Summative Assessment: Integrative Paper (Part 1)
1,250
1,750
Wk 6 – Summative Assessment: Integrative Paper (Part 2)
Note: This word count is specific to the Literature Review:
Introduction and Literature Review: Analysis sections.
1,250
1,750
Wk 6 – Summative Assessment: Integrated Paper (Revised Part
1 and Part 2)
Note: This word count is specific to the compilation of Parts 1
and 2, where feedback provided on your Week 4 submission is
addressed and re-submitted along with Part 2.
2,500
3,500
Wk 8 – Summative Assessment: Integrative Paper (Part 3)
Note: This word count is specific to the Literature Review:
Methods and Research Design and Recommendations and
Conclusion sections.
700
1,400
Wk 8 – Summative Assessment: Integrative Paper (Part 3)
Note: This word count is specific to the final integrative paper.
All sections of the integrative paper are submitted, with revisions
made to address feedback provided on your Weeks 4 and 6
submissions.
3,250
4,900
Assignment
Copyright 2022 by University of Phoenix. All rights reserved.
Integrative Paper Guidelines
DHA/722 v8
Page 2 of 2
Integrative Paper Outline
Integrative Paper Section
Integrative Paper Section Due In
Title
All weeks
Abstract
Wk 8 – Summative Assessment: Integrative Paper
(Part 3)
Introduction
Wk 4 – Summative Assessment: Integrative Paper
(Part 1)
Background
Wk 4 – Summative Assessment: Integrative Paper
(Part 1)
Problem Statement
Wk 4 – Summative Assessment: Integrative Paper
(Part 1)
Purpose Statement
Wk 4 – Summative Assessment: Integrative Paper
(Part 1)
Research Questions
Wk 4 – Summative Assessment: Integrative Paper
(Part 1)
Definition of Terms
Wk 4 – Summative Assessment: Integrative Paper
(Part 1)
Literature Review: Introduction
Wk 6 – Summative Assessment: Integrative Paper
(Part 2)
Literature Review: Analysis
Wk 6 – Summative Assessment: Integrative Paper
(Part 2)
Literature Review: Methods and Research Design
Wk 8 – Summative Assessment: Integrative
Paper (Part 3)
Recommendations and Conclusion
Wk 8 – Summative Assessment: Integrative
Paper (Part 3)
References
All weeks
Note: All sections are submitted as part of the Wk 8 – Summative Assessment: Integrative Paper (Part 3).
Copyright 2022 by University of Phoenix. All rights reserved.
1
[Cover Page: You may include a cover page for your annotated bibliography.]
Annotated Bibliography
Student Name
Institution Name
Course/Number
Faculty Name
Due Date
Copyright 2021 by University of Phoenix. All rights reserved.
2
[Annotated Bibliography Description: An annotated bibliography is a list of references of
books, articles, web pages, and other sources. The reference is listed first and is followed by a
summary, or annotation, of the source. The annotation informs the reader of the relevance and
quality of the sources. Each entry should be listed in alphabetical order by the author’s last name,
just like on a reference page, and formatted according to APA guidelines.]
DuFour, R. (2002). The learning-centered principal. Educational Leadership, 59(8), 12–15.
In this short article, DuFour describes his experience as a principal and the issues he
faced in that role regarding instructional leadership. DuFour promoted a shift from
instruction-oriented leaders to learning-oriented leaders, citing the need to focus on
outcomes rather than process in education. To facilitate this change, DuFour recommends
the implementation of a systemic method of monitoring and evaluating student progress.
[Annotation Point of View: The annotations should be written in third person point of
view just like an academic paper.]
Films for the Humanities and Sciences. (Producer). (2014). Internet research: What’s credible?
Films on Demand.
http://digital.films.com/PortalPlaylists.aspx?aid=7967&xtid=58373&loid=266720
This video examines the risks taken with using popular search engines to locate resources
for academic work. It shows that most resources available online are not guaranteed
reliable or peer reviewed. Some tips are offered to help alleviate some search issues and
to aid in locating appropriate resources. Detailed reasons to not use Wikipedia and like
sites are provided. [Sources: Academic sources should be relevant and credible. Include
sources that are more recently published so the research is up to date.]
Copyright 2021 by University of Phoenix. All rights reserved.
The use of spirituality in nursing practice is not new. However, it is more studied and utilized in a more structured format in nursing. Identify and discuss tools used to evaluate spirituality.Essay 450 words, APA style, 2 references, No plagiarism please or artificial intelligence. Thank you
Analyze the history, structure, and process of health-care-policy and policy and politics in nursing and the health care delivery systems in the United States.Discussion post should at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources. No AI please. Incorporate a minimum of 2 current (published within the five years) scholarly journal articles. Journal articles should be referenced according to the current APA style. Please No AI.
Respond to this question: Explain what cultural competency and humility mean to you and how you would apply evidence-based cultural considerations when caring for a group or individual whose background, beliefs, or values differ from your own.Provide an example. Provide data or inference on a cultural disparity and reasoning to potentially solve the problem.To answer this question, you should review published literature on the topic. Take special note of vocabulary and meaning of the terms, concepts, and applications. Use learned information in your response. Verbally cite one source. Reflect on how this applies to you personally as a provider of medical care.
Investigate the health consequences of obesity, including the increased risk of chronic diseases like diabetes, heart disease, and certain cancers. Guidelines: APA Format MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.Research paper must be 500 – 650 words. 3 or more scholarly sources must be utilizedSources must be within the last 5 years Must have a minimum of 3 Sources All article sources must be cited by including them in reference sheet (separate).
How is PDSA utilized in quality improvement? What are the different stages, and what stakeholders should be involved? How does technology support quality improvement processes?
Analyze the potential effectiveness resulting from professional or nurse-provided social support versus enhancement of social support provided by personal relationship and social networks for parents of children with chronic mental illness.
Please include 500 words , APA FORMAT, NO PLAGIARISM PLEASE, and
Correctly identify which student learning outcome you covered in the discussion post that you created for the Week.
Make sure that you include it in the beginning of the post and clearly state :”This week student learning outcome was ___” and include out of these five the one that corresponds.
Critically analyze the philosophical underpinnings of nursing theories.
Critique nursing’s conceptual models, grand theories and mid-range theories.
Examine the influence that nursing models and theories have upon research and practice.
Construct a nursing theory that represent current professional nursing practice
Apply nursing theory or theories to nursing research.
Review some nursing journals that deal primarily with education, research, or administration, such as the Journal of Nursing Education, Nursing Research, or the Journal of Nursing Administration, and discuss the current topics that are emphasized in these journals. You will select one for education, one for research and one for administration, each from a different nursing journal and briefly explain. Your answer should be formatted in APA style, 7 edition, 300-350 words. The discussion needs 2 peer responses that will be provided once the primary post is submitted.
PART 2 NURS510 Discussion 2
What is the difference between a protocol, standard of care delivery, and policy at the practice, state, and federal level? Briefly outline each. What are the perceptions of the health care delivery system from the perspectives of patients, providers, payers, and policy makers? Discuss at least one perception from one of the populations listed: patient, provider, payer, and policy maker. Your answer should be formatted in APA style, 7 edition, 300-350 words. The discussion needs 2 peer responses that will be provided once the primary post is submitted.
Please read instruction carefully. Use the guide provided and follow the rubrics
PART 3 Assignment details NURS510 Assignment:
Review of a Bill Assignment
Select an active bill at the state or federal level that impacts the professional practice of nursing. In a 3-4 page paper (excluding the title and reference pages), summarize the provisions of the bill and clearly explain what the bill will accomplish. The paper should be no more than 4 pages, typed in Times New Roman using 12-point font, and double-spaced with 1″ margins.
Your review of a bill paper should:
Discuss the major provisions of the bill.
Demonstrate an in-depth understanding of the legislation by explaining the background and all relevant facts.
Discuss any relevant history related to the legislation, pertinent votes, and issues that are stalling the legislation, etc.
Use primary sources for this information.
Identify key supporters and those who do not support the bill. Explain why some of these individuals support the bill and why some do not.
Explore the positions of the key stakeholders in the bill, both pros and cons. Do not make assumptions about potential key stakeholders. Examine this area carefully so you are correctly reflecting the stakeholders positions.
Discuss how the bill would impact a nurse’s ability to provide safe and quality care or to practice to the highest scope of the nursing license.
Explain specific actions that nurses can take to assist with the passage or defeat of the legislation
Use Current APA Style, headings and references as appropriate.
Below are your assignment details. I am also providing a PP with assignment details for those who need extra information:
Week 7 Assignment.pptx Review of a Bill Assignment ( IMPORTANT: If your Safe Assign Score is higher than 35% I will return it!)
Select an active bill at the state or federal level that impacts the professional practice of nursing. In a 3–4-page paper (excluding the title and reference pages), summarize the provisions of the bill and clearly explain what the bill will accomplish. The paper should be no more than 4 pages, typed in 12-point accepted APA font, and double-spaced with 1″ margins.
Your review of a bill must include these Bold Headers starting with Introduction Deductions will be given if they are absent!!!!
Introduction ( You MUST include this info in your introduction ) 5 Points will be taken off )
The purpose of this assignment is to select an active bill at the state or federal level that impacts the professional practice of nursing. The bill, this writer has chosen is………..
These additional 9 sections must be included with Bold headers before each section ( Points will be deducted if they do not appear.)
2. Major provisions of the bill.
3. Background and all relevant facts.
4. Relevant history related to the legislation, pertinent votes, and issues that are stalling the legislation,
5. Identify key supporters and those who do not support the bill. Explain why some of these individuals support the bill and why some do not.
6. Positions of the key stakeholders in the bill, both pros and cons
7. How the bill would impact a nurse’s ability to provide safe and quality care or to practice to the highest scope of the nursing license.
8. Specific actions that nurses can take to assist with the passage or defeat of the legislation
9. Conclusion ( see below)
Conclusion ( You MUST include this in your conclusion ) 5 Points will be taken off
In conclusion, this writer chose bill……, an active bill at the state or federal level, discussed were……….
10. References
NURS_510_DE – Review of a Bill
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeSummary of a Bill
22.5 to >18.45 pts
Accomplished
Clearly summarizes the bill’s major provisions and what the bill will accomplish.
18.45 to >16.88 pts
Emerging
The bill’s major provisions and what the bill will accomplish are included, but lacks clarity.
16.88 to >0 pts
Unsatisfactory
The bill’s major provisions and what the bill will accomplish are absent or severely lacking in detail
22.5 pts
This criterion is linked to a Learning OutcomeLegislation
30 to >24.6 pts
Accomplished
Demonstrates a clear understanding of the legislation by explaining relevant facts and background information.
24.6 to >22.5 pts
Emerging
Relevant facts and background regarding legislation are included, but lacks clarity.
22.5 to >0 pts
Unsatisfactory
Relevant facts and background regarding legislation are absent or severely lacking in detail.
30 pts
This criterion is linked to a Learning OutcomeHistory
22.5 to >18.45 pts
Accomplished
Relevant history related to the legislation, pertinent votes, and issues related to the legislation is clearly identified.
18.45 to >16.88 pts
Emerging
Relevant history related to the legislation, pertinent votes, and issues related to the legislation is included but lacks clarity.
16.88 to >0 pts
Unsatisfactory
Relevant history related to the legislation, pertinent votes, and issues related to the legislation is absent or severely lacking in detail
22.5 pts
This criterion is linked to a Learning OutcomeKey Supporters & Stakeholders
30 to >24.6 pts
Accomplished
Key supporters and stakeholders are identified. Position of stakeholders and key supporters is clearly and accurately explained.
24.6 to >22.5 pts
Emerging
Key supporters and stakeholders are identified, and positions are explained. Explanations lack clarity.
22.5 to >0 pts
Unsatisfactory
Key supporters and stakeholders are either absent or incorrectly identified. Positions are absent or incorrectly explained.
30 pts
This criterion is linked to a Learning OutcomeQuality Care Discussion
30 to >24.6 pts
Accomplished
Informative discussion on how the bill might impact a nurse’s ability to provide care is included. Nursing specific actions that can be taken to assist with the passage or defeat of the legislation are clearly explained.
24.6 to >22.5 pts
Emerging
Basic discussion on how the bill might impact a nurse’s ability to provide care is included, but lacks details and or clarity. Nursing specific actions that can be taken to assist with the passage or defeat of the legislation are explained but lack clarity.
22.5 to >0 pts
Unsatisfactory
Basic discussion on how the bill might impact a nurse’s ability to provide care is absent or severely lacking in clarity. Nursing specific actions that can be taken to assist with the passage or defeat of the legislation are absent or incorrectly explained.
30 pts
This criterion is linked to a Learning OutcomeOrganization, Writing & APA
15 to >12.3 pts
Accomplished
APA format is followed. Written in a clear, concise, formal, and organized manner. Information from sources is paraphrased appropriately and accurately cited.
12.3 to >11.25 pts
Emerging
APA format is mostly followed. Writing is generally clear and organized but is not concise or formal in language. Multiple errors exist in spelling and grammar with minor interference with readability or comprehension. Most information from sources is paraphrased and cited correctly.
11.25 to >0 pts
Unsatisfactory
APA format may not be followed. Writing is generally unclear and unorganized. Errors in spelling and grammar detract from readability and comprehension. Sources are missing or improperly cited.
( Bands,Weights , Pushing/Pulling) that you could modify or simulate on your own?
—————————————————————–
B/ 1- How many hours do you spend looking at your phone, sitting in front of a computer or driving in a typical day:
—————————————————————–
2- Name 3 of the numerous upper body muscles you are using when you do a push up.
———————————————————————————
C/ View as many exercises as you would like from the ACE Library in Chapter Four.
Choose three different exercises. Choose the ones you think you would realistically continue to practice.
Write and submit 3 brief paragraphs of 150-200 words each. For each paragraph, discuss your choice and why it is a good fit for you, how the experience was, or how it will fit into future workouts.
—————————————————————————
D/ Should women train differently than men? Is there any reason resistance training programs for women need to be different than those for men? Why, why not? In 50-75 words share your response, or why you agree or (politley) disagree with someone else’s response. Support your response with scientific findings or your personal experience.
Evaluate the cultural competence of the healthcare organization presented in the Integrated Safety-Net Health Care System case study using a population health approach. Please also read the supplemental Interpreting Services Program document to ensure that you have all of the information about the Montefiore Medical Center you will need to address the critical elements.
Specifically the following critical elements must be addressed:
Patient engagement activities and communication strategies
Critique the organization’s translation and interpretation services that may be available to non-English-speaking patients. In other words, does the organization provide such services? How many different languages are supported? How might the organization communicate with a speaker of a language that is not supported? Be sure to provide evidence that supports your claims.
Analyze the extent to which educational resources and materials are available in languages other than English. Be sure to provide specific examples.
Assess organizational staff training on patient engagement and communications for its potential to foster cultural competence. Be sure to provide evidence to support your claims.
Identify gaps or deficiencies that may exist in the organization’s patient engagement and communications strategies, and provide evidence to support your claims. If you feel there are none, be sure to explain your reasoning.
Health promotion and disease prevention and management strategies
Assess the organization on its efforts to promote healthy living by examining programs (e.g., fitness classes, blood pressure clinics, first aid training, nutrition education, etc.) that it may offer to patients. Be sure to provide evidence to support your claims.
How appropriate are the organization’s disease prevention and management programs and services (such as discharge planning, home health services, vaccination services, etc.) for addressing factors that determine population health status? Be sure to provide evidence to support your claims.
Assess non-programmatic services (such as transportation, on-site child care, etc.) that may be offered by the organization for their impact on factors that determine population health status.
Identify gaps or deficiencies that may exist in the organization’s health promotion and disease prevention and management efforts, and provide evidence to support your claims. If you feel there are none, be sure to explain your reasoning.
Financial incentives and quality improvement processes
Analyze population health-oriented policies (such as non-discrimination in hiring, care and treatment, Patient Bill of Rights, financial assistance, etc.) that the organization may have implemented for reducing costs and improving overall quality. Be sure to provide evidence to support your claims.
To what extent is the organization’s approach to care considered patient-centered? Be sure to cite specific examples to substantiate your claims.
What specific strategies (such as eliminating unnecessary procedures and providing only essential treatments or interventions) does the organization employ in its population health approach to reduce costs and improve overall quality?
Describe gaps or deficiencies that may exist in the organization’s use of the population health approach in reducing costs and improving quality of care, and provide evidence to support your claims. If you feel there are none, be sure to explain your reasoning.
Recommendations
Recommend strategies for improving the organization’s cultural competence with regard to patient engagement and communications. Be sure to use research to support your reasoning.
Suggest health promotion and disease prevention strategies for improving outcomes in terms of population health status. Be sure to use research to justify your suggestions.
Recommend policies and strategies that increase the organization’s use of a population health approach to reduce costs and improve overall quality of care. Be sure to use research to substantiate your recommendations.
Final Submission: Case Study Analysis and ProposalIn Module Seven, you will submit your case study analysis and proposal using a population health approach framework. It should be a complete, polished artifact containing all of the critical elements of the final product. It should reflect the incorporation of feedback gained throughout the course. This submission is graded with the Final Project Rubric.
What to Submit
Written components of the project must follow these formatting guidelines when applicable: double spacing, 12-point Times New Roman font, one-inch margins, and APA-style citations. The case study analysis and proposal should be 8 to 10 pages in length, not including cover page and resources. Please be aware that AI generated will be detected.
HLTH 241 Weekly Worksheet #3
NAME
Purpose: To familiarize yourself with immunization protocols and patient needs as well as refresh your
understanding of the top 50 prescribed medications.
Part One:
Using your Vaccine Resource Manual please answer the following questions:
1) What is the recommended injection site and needle size for administering an IM injection to an
infant age (1-12 months)?
2) What is the recommended injection site and needle size for administering an IM injection a male or
female patient weighing 130-152 lbs?
3) What is the dose and route for the PCV13 vaccine?
4) What should you do if you administer a vaccine outside of the ACIP recommended age/dose
schedule?
5) What is the dosing interval for the Hep B vaccine brand Engerix- B?
Part Two:
Use the internet or other appropriate resources find the requested information about each medication
listed below.
Diflucan
Generic Name and Classification:
Indications:
Patient Teaching:
Dilantin
Generic Name and Classification:
Indications:
Patient Teaching:
Flagyl
Generic Name and Classification:
Indications:
Patient Teaching:
Flexeril
Generic Name and Classification:
Indications:
Patient Teaching:
Flonase
Generic Name and Classification:
Indications:
Patient Teaching:
Fosamax
Generic Name and Classification:
Indications:
Patient Teaching:
Glucotrol XL
Generic Name and Classification:
Indications:
Patient Teaching:
Humulin
Generic Name and Classification:
Indications:
Patient Teaching:
Part Three: Vaccine of the week
Using your vaccine resource manual, internet, or textbook to answer the following questions about the
vaccines listed.
DTap:
1. What is the causative agent?
2.
3.
4.
5.
6.
7.
________________________________________________
How is this disease transmitted?
__________________________________________________________________________________
__________________________________________________________________________________
What is the incubation period?
__________________________________________________________________________________
What are the symptoms of this disease?
__________________________________________________________________________________
__________________________________________________________________________________
What are possible complications of this disease?
__________________________________________________________________________________
__________________________________________________________________________________
Is there a treatment for this disease? If so what is it?
__________________________________________________________________________________
__________________________________________________________________________________
How should the DTap Vaccine be stored?
8. What is the recommended schedule for the Dtap Vaccine?
9. What is the minimum age to begin the DTap vaccine? Is there a Maximum age to administer it?
Tdap:
10. What is the causative agent?
________________________________________________
11. How is this disease transmitted?
______________________________________________________________________________
______________________________________________________________________________
12. What is the incubation period?
______________________________________________________________________________
13. What are the symptoms of this disease?
______________________________________________________________________________
______________________________________________________________________________
14. What are possible complications of this disease?
______________________________________________________________________________
______________________________________________________________________________
15. Is there a treatment for this disease? If so what is it?
______________________________________________________________________________
_____________________________________________________________________________
16. What are the two brands of Rotavirus vaccines used in the United States? What is the dosage of
each?
17. How should the Tdap Vaccine be stored?
18. What is the recommended schedule for the Tdap Vaccine?
19. What is the minimum age to begin the Tdap vaccine? What is the maximum age for administration
of the Tdap vaccine?
short case study I need help to answer short questionssee the attachment
Unformatted Attachment Preview
You are selected to be a key member of an assay development team at your local hospital.
There has been an uptick of infections with a newly discovered spirochete. Physicians have
requested that an in-house serology assay to detect if someone has been previously infected
with this microbe. Researchers have discovered that the Z protein/antigen is very unique and
specific to this pathogen. You have been assigned to develop assays that can detect IgG
antibodies to this Z antigen.
1. Fortunately, researchers have already purified Z protein/antigen and have successfully
artificially adsorbed the antigen on a carrier latex bead. Which technique would be the
most useful: Direct Agglutination Assay, Passive Agglutination Assay, or Reverse
Passive Agglutination Assay? (1 pt)
2. Describe the principle of the assay you indicated in question 1. Indicate the steps
involved, the analyte, how the assay detects the analyte (e.g. purchased/kit antibodies or
antigens), and how to interpret the results? (3 pts)
3. One of your known undiluted “positive” samples does not cause agglutination for the
assay you have chosen. However, once you dilute the sample, agglutination is
observed. Explain the phenomenon that is occurring in this example (hint: think zone of
equivalence). (2 pts)
4. Your team is asked to develop a more sensitive ELISA assay. Z antigens/protein are
successfully adsorbed onto a microtiter plate. Knowing this, which technique would be
most useful for the detection of IgG antibodies against Z protein in a patient sample:
Sandwich ELISA (capture), Competitive EIA, or classical non-competitive EIA? (1 pt)
5. Describe the principle of the assay you indicated in question 4. Indicate the steps
involved, the analyte, how the assay detects the analyte (e.g. purchased/kit antibodies or
antigens, enzyme labelled antigens or antibodies, etc), and how to interpret the results?
(3 pts)
A 26 year-old male presented to urgent care complaining of open sores on his mouth
and penile area. He indicated having multiple sexual encounters with different
individuals over the past year. The physician ordered several STD tests. The rapid
plasma regain (RPR) test was reactive/positive. The HIV rapid was negative, and PCR
Panel for gonorrhea, chlamydia and trichomonas was also negative.
1. Based on patient’s history and symptoms, what disease do you suspect the
patient most likely has? (1 pt)
2. What is the causative microbe of this disease (genus and species)? (1 pt)
3. In addition to the RPR, what is another screening test that can be utilized to
detect this disease? (1 pt)
4. Because the RPR was positive, does that confirm the patient had the disease
indicated in question 1? If not, indicate a confirmatory test that could be ordered.
(2 pts)
5. If the RPR was negative, should the physician order a confirmatory test? (1 pt)
6. What stage of this disease do you suspect the patient to be in? (1 pt)
7. What would be the best treatment option for the patient? (1 pt)
A 46-year old female complained at a recent appointment of stiffness and pain in her
wrists, hands and fingers that had worsened over the past year. Serum was collected,
and a series of autoimmune tests were ordered. The fluorescent antinuclear antibody
results were positive (low titer) with a speckled pattern. Anti-SM and Anti-dsDNA ELISA
tests were negative. The rheumatoid factor (RF) test was positive, and her c-reactive
protein (CRP) levels were above normal.
1. Based on the results and history, what autoimmune disease does the patient
most likely have? (1 pt)
2. What is RF, and does the presence confirm the autoimmune condition you
indicated in question 1? (2 pts)
3. As an MLS, what ELISA test would you suggest the physician ordered to confirm
the disease indicated in question 1 (ie what antibody would be more specific for
this condition). (1 pt)
4. What type of hypersensitivity does this condition induce? Briefly explain your
answer. (2 pt)
5. What does high levels of CRP indicate in patients? (1 pt)
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project.
Discuss the following
System approach
Resource allocation you identify as important
Identify the executive sponsor
Identify the stakeholders and steering committee members
Environment for local team leaders to collaborate, and 6) governance of the metrics.
The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity” report makes recommendations for lifelong learning and achieving higher levels of education.
In 1,000-1,250 words, examine the importance of nursing education and discuss your overall educational goals.
Include the following:
Discuss your options in the job market based on your educational level.
Review “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity” report’s recommendations for achieving higher levels of education. Describe what professional certification or advanced degrees (MSN, DNP, etc.) you may want to pursue and explain your reasons for wanting to attain this education. Discuss the timeline for accomplishing these goals.
Discuss how increasing your level of education would affect how your competitiveness in the current job market and your role in the future of nursing.
Discuss the relationship of continuing nursing education to competency, attitudes, knowledge, and the ANA Scope and Standards for Practice and Code of Ethics.
Discuss whether continuing nursing education should be mandatory. Provide support for your response.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
I have these 2 case studies that I need help with (see the attachment)I need to get full mark
Unformatted Attachment Preview
CASE 10
A 17-year old male came into the ER with fatigue, a sore throat and a high fever. CBC
indicates relative leukocytosis and absolute neutrophilia. Swabs were sent for strep
testing, and results are pending. Nevertheless, the physician suspects a bacterial
infection based on CBC.
1. If this was indeed an extracellular bacterial infection, which MHC complex would
most likely be utilized the most to process the extracellular antigens? (1 pt)
2. If an antigen is to be processed and presented on MHC II complex, where do the
MHCII molecule and peptide (antigen) initially interact within the cell? (1 pt)
3. What does an MHC II molecule bind to initially in the endoplasmic reticulum to
prevent it from binding endogenous antigens? (1 pt)
4. Which adaptive T cell subtype will recognize antigens displayed on MHC II
molecules? Indicate one function of this lymphocyte. (2 pt)
5. What type of cells can present antigens on both MHC I and MHC II complexes?
Indicate 2 examples of these types of cells. (2 pt)
6. In theory, can antigens processed and displayed on MHC II complexes induce
antibody production of many isotypes? Please explain your answer. (2 pts)
CASE 9
A 23-year old male presented with fatigue and dark colored urine (especially in the
morning). Routine laboratory testing revealed decreased blood counts (anemia),
thrombosis, increased bilirubin and hemoglobinuria. Lastly, molecular testing revealed
a mutation in the CD55 gene.
1. What is the most likely diagnosis? (1 pt)
2. What complement regulatory protein is lacking in this patient? (1 pt)
3. What is the function of this regulator (answer from question 1)? (1 pt)
4. Which complement pathway(s) may be un-regulated in this patient? (2 pts)
5. In this patient, would you expect increased or decreased C3b levels on patient RBCs?
Please explain your answer (2 pts)
Review the AANP and the ANCC organizations. Identify the organization’s mission/vision, and advocacy activity involvement.Consider how joining a local or state NP organization would also help you to promote advocacy.
Please share your thoughts with any of the videos posted this week: you can discuss only one, two or all of them – whatever you prefer. In order to get full credit this week, please make sure your Discussion includes at least 100 words.https://www.ted.com/talks/rose_george_let_s_talk_c…https://www.ted.com/talks/rose_george_let_s_talk_c…
Reflection QuestionsDiscuss how state policies such as AB 1407 influence the practice of APRNs.Defend your agreement or disagreement with the mandatory implicit bias training. Discuss whether you would advocate or not for it.Discuss the advocacy strategies and techniques used by proponents/supporters of implicit bias mandatory training and how they can be used in Advanced Practice Registered Nursing.List the ethical principles that guide Advance Practice Nursing that are related to AB 1407.Examine the inter-relationships between ethics and economics that apply to AB 1407 (e.g., discuss the concept of “ethinomics”, and provide program cost analysis, cost-benefit, and cost-effectiveness data associated with AB 1407).Word Count: A minimum of 1,000 words are required for this assignment- Include a word count before the reference listReference List: At list five peer-reviewed references not older than five years in APA style
Unformatted Attachment Preview
Rubric for Papers
Course: NSG606 Health Policy & Finance
Criteria
Required
formatting/subheading
s for each section
Contents
Referencing
Outstandin
Commendable
Marginal
Marginal
Failing
1 point
0.8 points
0.7 points
0.6 points
0 points
Paper clearly contains the
subheadings/subtitles/se
ctions required in this
paper
Paper partially contains
the
subheadings/subtitles/se
ctions
It is unclear whether or
not the
subheadings/subtitles/se
ctions are included
Paper is missing two or
more
subheadings/subtitles/se
ctions
Paper is missing all
subheadings/subtitles
ctions
6 points
4.8 points
4.2 points
3.6 points
0 points
Clearly includes a
response for all the items
required in this section
Responses to each item
are comprehensive and
evidence-based
Includes a response for
most of the items
Includes a response for
some of the items
Includes a response for a
few of the items required
required in this section –
required in this section –
in this section – Three
One of the items
may be missingResponses to each
item are
comprehensive and
evidence-based
Two of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
or more of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
Missing all the respon
for the required items
Responses to each ite
are not comprehensiv
evidence-based
1 point
0.8 points
0.7 points
0.6 points
0 points
Citations and references
are in proper APA
format. Required number
of sources are cited. All
claims are supported
with a professional
reference.
Citations and references
are in proper APA
format. Most claims are
supported with a
professional reference.
Some citations and
references are in proper
APA format. Some claims
are supported with a
professional reference.
Citations and referenc
are limited, missing or
incorrect. Few claims
supported with a
professional reference
Paper has one less of the
required number of
references in APA style.
Paper has two less of the
required number of
references in APA style.
Most citations and
references are limited,
missing or incorrect.
Some claims are
supported with a
professional reference.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding reference.
1.6 points
1.4 points
The number of minimum
required references in
APA style are included in
the paper.
Writing organization
and style Timeliness
Required number of
words
2 points
Assignment was
submitted on time.
Complies with the
required minimum
number of words.
Includes the total
number of words
before the
reference list.
The paper is well
organized both
Assignment was
submitted within
one day after the
deadline.
Complies with the
required minimum
number of words
but it does not
include the total
number of words
before the
Assignment was
submitted within
two days after the
deadline.
Assignment has
less than the
required number
of words and/or it
does not include
the total number
of words before
Paper has 3 references
less of the required
number and
Paper includes less th
3 references in APA
style.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding referen
or paper is not in
compliance with
copyright guidelines.
1.2 points
0 points
in APA style.
Assignment was
submitted within
three days after
the deadline.
Assignment has
30% or less than
the required words
and/or it does not
include the total
number of words
before the
Assignment wa
submitted afte
four days beyo
the deadline.
Assignment ha
50% or less tha
the required
number of wor
and/or it does
include the tot
number of wor
overall and at the
paragraph and
sentence structure
level. Sentences
are smooth and
carefully crafted.
There are virtually
no errors in
punctuation,
spelling, grammar,
or usage.
reference list.
The paper is well
organized, but the
paragraphs and
sentence structure
may sometimes be
disjointed. The
paper may have a
few incorrect
passages and a
few errors in
punctuation,
spelling, grammar,
the reference list.
The paper is
basically well
organized, though
individual
paragraphs and
sentence
structures may be
disjointed or
misplaced. The
writing is
competent, but
often wordy,
overly general,
and usage.
Presentation has
between 15-19 pp
reference list.
The paper is
poorly organized.
Most sentences
are confusing and
their meaning
does not clearly
emerge. Words
may be imprecise,
incorrect, trite, or
vague.
imprecise, or trite.
before the
reference list.
The paper lack
clarity. The
language or
sentence struc
is incorrect and
unclear in seve
parts of the pa
Errors in
punctuation,
spelling, gramm
and usage are
constantly
present.
slides
Total
Overall Score
Outstanding
Commendable
Marginal
Unsatisfactory
10 points minimum
8 points minimum
7 points minimum
6 points minimum
Week7 Discussion NURS 676 Week 7 Discussion Select one of the following discussion prompts to address: Select a sexually transmitted disease and discuss the importance of appropriate dosing, administering, and monitoring drug therapy. How do pharmacokinetic and pharmacodynamic principles guide the selection of the optimal dosing regimen, and what factors must be considered when tailoring treatment plans for individual patients, such as renal and hepatic function, patient adherence, and potential drug interactions? The treatment of hepatitis, a viral infection affecting the liver, has evolved significantly over the past few decades with the introduction of new antiviral agents. Select and discuss one of the different classes of drugs used to treat various types of hepatitis (e.g., hepatitis B and C), their mechanisms of action, and the factors healthcare professionals must consider when selecting the most appropriate treatment regimen for a specific patient, such as the viral genotype, disease stage, and potential drug interactions.Penicillin allergy is a common concern among patients and healthcare professionals. Reflect on your experience as a healthcare professional or through a case example, and discuss the challenges of managing patients with suspected or confirmed penicillin allergies. How do you ensure the appropriate use of alternative antibiotics in these patients while minimizing the potential for further resistance development or adverse reactions?Managing peptic ulcer disease may require adjustments to patients’ treatment plans over time due to changes in their symptom severity, underlying health conditions, or comorbidities. Discuss the process of evaluating and monitoring patients with peptic ulcer disease to determine the most appropriate treatment plan and when modifications may be necessary. NURS 530 Week 7 Discussion Select one of the following discussion prompts to address: Analyze the unique aspects of digestive function in children compared to adults. How do developmental differences in the gastrointestinal tract, enzyme production, and nutrient absorption contribute to the pathophysiology of digestive disorders in pediatric patients?Discuss the pathophysiology of common gastrointestinal disorders, such as gastroesophageal reflux disease (GERD), peptic ulcer disease, and inflammatory bowel disease. How do alterations in mucosal integrity, acid secretion, and immune responses contribute to the development and progression of these conditions?Explore the factors contributing to the development and recurrence of UTIs, such as urinary stasis, urinary catheterization, and antibiotic resistance. How can nurse practitioners assess and address these risk factors in patient care to prevent UTIs and minimize recurrence?Discuss the pathophysiology of chronic kidney disease (CKD), including the mechanisms that lead to progressive kidney damage and decline in renal function. How do factors such as hypertension, diabetes, and immune-mediated processes contribute to the development and progression of CKD?
This week you will submit the final draft of your term paper. Your term paper should:
Discuss the technical aspects of your topic in general terms.
Discuss the public policy debates relevant to the topic you choose. This section should cover arguments that favor and oppose the use of the techniques or products.
Express your personal opinion regarding the topic’s importance and the validity of the pro and con arguments. Within the personal opinion/conclusion, frame your position with an ethical theory from the six workable theories covered in this course. (Kant; Act Utilitarianism; Rule Utilitarianism; Care Ethics; Virtue Ethics; and Social Contract)
Your submission must include:
A title page
The body of the paper, which includes 4–6 content pages, not including title or reference pages
At least three references from textbooks, websites, and articles that provide adequate justification and support your claim
Subheadings (technical aspects, public policy, and personal opinion/conclusion)
Appropriate in-text citations throughout the paper
A reference list with only the sources used in the body of the paper (All sources should be less than five years old unless recent research is not available, and at least one reference must be a peer-reviewed article from a professional journal. Do not use Wikipedia or an encyclopedia as they are not considered reliable academic sources and will not be accepted.)
APA7 style formatting throughout your paper, using 12-point Times New Roman
I attached both the topic and the outline for this paper. Please use that for the paper
Feel free to message for clarification
Unformatted Attachment Preview
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Week 2 Term Paper: Topic
Topic
How in vitro fertilization is beneficial for society.
Why I Chose This Topic
IVF is a technological advancement that has significantly improved countless people’s
lives by enabling singles and couples to overcome infertility and start creating their ideal
families.
Pro Arguments
Autonomy is an essential ethical principle that highlights an individual’s right to make
decisions regarding their body and reproductive choices (Asplund, 2020). IVF respects and
acknowledges the autonomy of individuals or couples who choose the treatment to address
infertility issues and exercise their reproductive rights. Utilitarianism is an ethical theory that
evaluates actions according to their complete utility or benefit to society (Chiu, 2018). IVF can
be acceptable according to utilitarian principles if it maximizes happiness and well-being by
enabling individuals to have children and start families.
Con Arguments
Natural law theory can raise ethical questions and objections regarding in vitro
fertilization (IVF) because it strongly emphasizes specific moral principles and the biological
order of reproduction (Turczynski et al., 2022). IVF is frequently criticized because it involves
manipulating the reproductive process. Religious ethics may also be opposed to assistive
reproductive technologies. Judaism is more accepting of these advancements, as they follow
God’s commandment of procreation. Christianity is less tolerant as their religion considers
embryos as human beings (Muñoz, 2023).
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My Current Stance on the Topic
The pro side is most compelling and has the best argument supporting the use of IVF.
Although I agree with IVF being used, Natural Law Theory brings up important issues that
should be discussed. Religious beliefs should be considered in this topic as well.
4
References
Asplund, K. (2020, May). Use of in vitro fertilization-ethical issues. Upsala journal of medical
sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721055/
Chiu, K. Y. (2018). Does rule utilitarianism support in vitro fertilization (IVF)?. The Asian
Conference on Ethics, Religion & Philosophy 2018 Official Conference
Proceedings. https://papers.iafor.org/wpcontent/uploads/papers/acerp2018/ACERP2018_40574.pdf
Muñoz, M. G. (2023, March). A reexamination of in vitro fertilization – researchgate. Christian
bioethics.
https://www.researchgate.net/publication/369821535_A_Reexamination_of_In_Vitro_Fe
rtilization
Turczynski, C., Dodd, A., & Urlakis, M. A. (2022, November). Assisted Reproductive
Technology and natural law: How seven years as an embryologist revealed IVF’s
disordered approach to patient care. The Linacre quarterly.
https://pubmed.ncbi.nlm.nih.gov/36518716/
2
Week 4 Term Paper: Outline
I.
Introduction
a. Background Information: The technological advancements in the medical field
have led to Vitro Fertilization (IVF) that boosts clinical practices. Robert Edwards
and Patrick Steptoe, a British physiologist and gynecologist, respectively invented
IVF. Since 1978, after the birth of Louise Brown, a test tube baby, and despite the
ethical concerns it raises about embryo status, this technology has shaped
reproductive medicine by solving fertility complications through intracytoplasmic
sperm injection (ICSI) and pre-implantation genetic testing.
II.
Body Paragraph 1 – Technical aspects of your topic
Topic Sentence IVF is an assisted reproductive technology (ART) that fertilizes an
egg extracted from the ovary through the ICSI technique to solve infertility issues.
i. Supporting detail 1: The IVF protocol creates an embryo that is cultured
in a laboratory incubator for some days, most three to five days, before
transferred to the uterus.
ii. Supporting detail 2: After the embryo transfer, a woman undergoes a
pregnancy test after 11 to 14 days (Cozzolino et al., 2019).
iii. Supporting detail 3: The success of this pregnancy has been evident in
Turkey, where, for at least 20 years, the country has recorded a significant
success rate in IVF treatment (Lee & Zhang, 2022). In the United States,
females under 35 doing their first IVF cycle have shown a 55.1% success
rate (Lee & Zhang, 2022).
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III.
Body Paragraph 2 – Description of public policy debates surrounding your topic
a. Transition: Despite the significant success rate of IVF treatment, there are
proposed anti-abortion laws and religious concerns intending to undermine its
progress.
b. Topic Sentence: The U.S. states are debating on passing “personhood” laws that
are likely to illegalize the practice of IVF.
i. Supporting detail 1: The law gives legal rights to embryos (fertilized
eggs) created through IVF and not implanted in a woman. These rights
mean embryos will have the same legal rights as children.
ii. Supporting detail 2: The law will make it illegal for IVF facilities to
freeze fertilized eggs (Letterie & Fox, 2023).
iii. Supporting detail 3: In 2019, Tadeusz Pacholczyk, a priest, termed IVF a
practice that contradicts the human dignity of offspring (Letterie & Fox,
2023). The priest stated that the treatment is intrinsically evil because it
allows for the ‘manufacturing’ of offspring.
IV.
Body Paragraph 3 – Pro Arguments
a. Transition: Even though public policy and religious debates appear to dismiss
IFV treatment, one’s autonomy gives the right to make decisions about one’s
body, and disputes cannot override reproductive choices.
b. Topic Sentence: Provides necessary medical and scientific information to
understand the issue. IVF is a clinical practice that recognizes the autonomy of
patients opting for it to solve their infertility complications and enjoy the exercise
of their reproductive rights.
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i. Supporting detail 1: From the Utilitarianism viewpoint, IVF maximizes
the happiness and well-being of sterile individuals in society who can
conceive and start families; hence, it remains acceptable. However, a
natural law rejects IVF since it contradicts the natural conception.
ii. Supporting detail 2: Since IFV’s introduction in America in 1981, about
1.9% of all babies are born through IVF (Tsigdinos, 2022). Couples
experiencing infertility issues after receiving IVF regain their mental wellbeing and start a happy family.
iii. Supporting detail 3: Nevertheless, IVF disregards divine command ethics
(Lott, 2020).
V.
Body Paragraph 4 – Con Arguments
a. Transition: Conversely, IVF presents religious and ethical issues. Under natural
law theory, the treatment raises ethical concerns since the theory embraces moral
principles and the biological order of reproduction.
b. Topic Sentence: IVF manipulates the whole reproductive system as characterized
by the extraction of an egg from the ovary for external fertilization in the lab. This
extraction violates natural law on reproduction and contradicts God’s commands.
Supporting detail 1: While the Vatican accepts IVF, traditional Christian views hold
that reproductive technologies remain forbidden. The views emphasize that a
fertilized egg acquires its moral status as a human being at the start of conception.
Supporting detail 2: Clinical practices of egg extraction from the ovary do not keep
the ideal of natural motherhood intact. As a result, the practices contravene the divine
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command that terms any action that goes against God’s command as morally wrong
(Lott, 2020).
Supporting detail 3: Nevertheless, Judaism accepts reproductive technologies
because they argue that these advancements comply with God’s commandment of
procreation (Farid & Tasnim, 2023).
VI.
Opinion and Conclusion
a. Transition: Undoubtedly, the pro side is the most compelling and has the best
argument that supports IVF treatment.
b. Statement of Opinion: IVF has brought grace, hope, and compassion toward
people struggling with infertility. It has shaped reproductive clinical practices by
solving infertility issues, overcoming medical challenges undermining natural
conception, and supporting same-sex couples (Keller et al., 2023). Although I
agree with IVF treatment, Natural Law Theory and Divine Command ethics,
bring up crucial issues that call for consideration of religious beliefs.
6
References
Cozzolino, M., Troiano, G., & Esencan, E. (2019). Bed rest after an embryo transfer: a
systematic review and meta-analysis. Archives of Gynecology and Obstetrics, 300, 11211130.
Farid, M. S., & Tasnim, S. (2023). Assisted Reproductive Technologies: Comparing Abrahamic
Monotheistic Religions. Asian Bioethics Review, 15(1), 53-67.
Keller, E., Botha, W., & Chambers, G. M. (2023). Does in vitro fertilization (IVF) treatment
provide good value for money? A cost-benefit analysis. Frontiers in Global Women’s
Health, 4, 971553.
Lee, E., & Zhang, J. (2022). Which assisted reproductive technology (ART) treatment strategy is
the most clinically and cost-effective for women of advanced maternal age: a Markov
model. BMC Health Services Research, 22(1), 1197.
Letterie, G., & Fox, D. (2023). Legal personhood and frozen embryos: implications for fertility
patients and providers in post-Roe America. Journal of Law and the Biosciences, 10(1),
lsad006.
Lott, M. (2020). Moral Duties and Divine Commands: Is Kantian Religion Coherent?. Faith and
Philosophy, 37(1), 57-76.
Tsigdinos, P. M. (2022). An IVF survivor unravels ‘fertility’industry narratives. Journal of
Marketing Management, 38(5-6), 443-459.
Life Span Development- Milestone ChartGuidelinesStudents are required to complete a Milestone Chart, previously referred to as “Human Development Chart,” which is worth 2.5% of their overall grade.Students need to fill in columns 1-5 in the chart below. Columns 6 and 7 will be completed during pediatric nursing. Begin with the age group in column 1, followed by the primary influences and milestones relative to physical, cognitive, emotional and social development in columns 2-4. Then include the theorists and summarize their theories as related to the given age group in column 5. Save this chart for reference and completion of the last two columns during pediatric nursing.The rubric below will be utilized to grade the paper.
Unformatted Attachment Preview
Human Development Chart Instructions
As part of the course students must develop a human development chart. Students need to fill in columns 1-5 in the chart below. Columns 6
and 7 will be completed during pediatric nursing. Begin with the age group in column 1, followed by the primary influences and milestones
relative to physical, cognitive, emotional and social development in columns 2-4. Then include the theorists and summarize their theories as
related to the given age group in column 5. Save this chart for reference and completion of the last two columns during Pediatric nursing.
1. Age Group
Infancy
Early Childhood
Middle Childhood
Adolescence
Early Adulthood
Middle Adulthood
Late Adulthood
2. Physical
3. Cognitive
4. EmotionalSocial
5. Theories &
Theorists
6. Usual
Childhood
Illnesses
7. Anticipatory
Guidance &
Teaching by the
Nurse
“You are a social work intern at a community mental health center in a large urban area where a significant number of residents are living in poverty. You are assigned by your supervisor to meet a single parent and their 4-year-old son at the family’s home for their initial intake assessment. The son’s daycare provider referred the family to the community mental health center following reports from several staff that the child is presenting a persistent pattern of inattention and hyperactivity. Further, the daycare provider noted potential developmental delays in language and social development. Although the single parent is a voluntary client, the client was initially ambivalent to meet with you. At the initial home visit, you observe the child eating pieces of paint from the wall. Using verbal following, exploring, and focusing skills, facilitate a conversation to identify and prioritize the client’s problem(s), its expressions, and other concerns.”You are to submit a 10-15-minute video recording and a 10-12 -page paper (not including the cover page and reference page) for this assignment. Please review the directions and grading criteria (see below) for instructions on completing this assignment. Please closely review the rubric (see below) that will be used to grade this assignment. All students are expected to adhere to Chamberlain University’s Academic Integrity Policy. All papers must conform to required elements (i.e., paper elements, format, organization) outlined in the 7th edition of the APA Publication Manual.Based on the scenario described above, record a role play where you will be the social work intern and another individual (e.g., family member, friend, classmate) will play the role of the client. The role-play may be done in-person or you may meet with the client virtually. Do not use a script for this role play. Please ensure there is adequate lighting and that the room and area are quiet and free of any distractions or background noises. Also, do not record yourself more than once (unless the viewer is unable to hear and see you). The client does not need to be seen; however, the viewer must be able to hear the client.
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1
Module 3: Videotape Assignment for Generalist Practice Skills
Enter Name
MSW Program, Chamberlain University
MSW 505: Direct Practice 1 Individuals and Families
Dr. Christopher Rocchio
Enter Date
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Module 3: Videotape Assignment for Generalist Practice Skills
Privacy, Limits to Confidentiality, Role, and Agency Services
Briefly describe whether you completed all tasks.
Agency’s Policy on Privacy
Identify where in the encounter you oriented the client to the agency’s policy on client
confidentiality. For example, at 1:52, I asked the client a closed-ended question on whether they were
familiar with the agency’s policy on confidentiality and privacy. The client indicated that they were not
familiar with the policy but assumed that it was like policies at other social service and health care
organizations. At 2:13, I asked the client for their permission for me to review the agency’s policy on
privacy and the limits to confidentiality. I informed the client that information shared with me would be
kept confidential. I clarified that as a social work intern, I was responsible and expected to describe each
case with my supervisor and to provide my supervisor with updates on each case. I asked the client at
2:30 whether they had any questions about my responsibility for reporting information about each case
to my supervisor. At 2:50, I briefly described the agency’s documentation process. I explained that I was
responsible for documenting each encounter using a secure electronic record which is only accessible to
agency staff. I reiterated that the system only allows certain individuals access to client records and that
the system tracks who has accessed the client’s files. I informed the client that they may choose to
review their records at any time. At 3:05, I asked the client a closed-ended question on whether they
would like instructions on how to request their records.
Limits to Confidentiality
How did you orient the client to the limits of confidentiality? Please consider the following
questions in your reflection:
•
How do you know whether the client understands when you are legally mandated to report
specific information?
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•
How did you describe neglect and abuse?
•
Are you possibly making any assumptions about the client’s understanding and definition of
neglect and abuse?
•
How would you describe these concepts in layman terms?
•
What is your state’s law on mandatory reporting?
•
Did you review this law with the client?
•
What might you have done different when reviewing the limits to confidentiality?
You are not expected or required to answer the above questions.
Role as Social Work Intern
How did you introduce yourself, your role, and your responsibilities as a social work intern? Why
is this important? For instance, what might be the client’s expectations of you and the agency? How
would you address these expectations? What might you have done different when orienting the client
to your role and responsibilities as a social work intern?
Array of Agency Services
How did you orient the client to the agency’s array of services? Please consider the following
questions:
•
Did the client have any questions about payment?
•
Are services free?
•
What is required from the client to receive services? For example, does the client have to submit
specific paperwork to initiate and maintain services.
You are not required or expected to answer the above questions.
In the past, students have informed their clients that their agencies provide outpatient behavior
health services. What does that mean? If you were not familiar with mental health or behavioral health
services, what questions or assumptions might you have about mental health or behavioral health
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services? What concerns does the client have about any of the services offered by the agency? Are
clients able to meet with agency staff virtually? What is the expected wait time for different types of
services? What resources does the agency offer? What questions might the client have about services
available through the agency? How do clients navigate the system? What might you have done different
and why?
Furthering Responses, Open-Ended Questions, and Closed-Ended Questions
Briefly describe whether you used furthering responses, open-ended questions, and closedended questions. Elaborate on how they were used and why. Please see below.
Furthering Responses
Briefly define and describe furthering responses (i.e., nonverbal minimal prompts, verbal
minimal prompts, and accent responses) in your own words. How did you demonstrate each of these
responses? Please remember to use timestamps. How did you apply this skill? What did you do well?
What might you do different in the future?
Open-Ended Questions
Briefly define open-ended questions in your own words. Where did you ask open-ended
questions? Please remember to use timestamps. You are communicating to me your understanding of
open-ended question and ability to use open-ended questions in practice. What did you do well? What
might you have done differently?
Closed-Ended Questions
Briefly define closed-ended questions in your own words. Where did you ask closed-ended
questions? Please remember to use timestamps. You are communicating to me your understanding of
closed-ended questions and ability to use closed-ended questions in practice. What did you do well?
What might you have done differently? For instance, what was your ratio of closed questions to open-
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ended questions? Why is this important? Did you stack questions? What happens when we ask too
many questions in a row? What might it feel like to a client?
Reflections and Summaries
Briefly describe whether you used reflections and summarizing responses. Elaborate on how
they were used and why. Please see below.
Reflections
Briefly define reflections in your own words. What is the difference between reflections of
content and reflections of affect? Which ones did you use and where in the encounter did you use
them? Specify the types of reflections used throughout the encounter. If you did not use reflections.
Reflections of content. Where and when did you use reflections of content. Please remember to
use timestamps.
Reflections of affect. Where and what types of reflections were used to reflect affect? Briefly
describe, at minimum, simple reflections, and complex reflections. After having defined both types,
identify where and when they were used. Please remember to use timestamps. For example. At 6:25,
the client stated that they felt overwhelmed and frustrated by the teacher’s reports. I offered a simple
reflection where I restated what they said. I offered “you were frustrated.” As I watched the video, I
thought that a complex reflection may have been more effective in communicating to the client that I
was listening to understand and to make a guess at their underlying emotions. I might have offered the
following complex reflection in response to the client’s frustration with their son’s teachers: “You felt
betrayed and somewhat blindsided by the teacher’s remarks.”
Summarizing Responses
Briefly define summarizing responses in your own words. Please reference the four facets of
summarizing responses. Please remember to use timestamps. You are communicating to me your
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understanding of summarizing responses and your ability to apply summarizing responses in practice.
Where and when were they used? If they were not used, how might you have used them and why?
Focusing and Seeking Concreteness
Briefly describe whether you used specific skills to focus and seek concreteness. Elaborate on
how they were used and why. Please see below.
Providing and Maintaining Focus
Briefly define focusing skills. Please consider identifying at least one of the three functions of
focusing skills and identify where and when they were used. If they were not used, why not? What went
well? What might you do differently in the future?
Seeking Concreteness
Briefly define seeking concreteness. The authors identify at least 9 instances where social
workers seek concreteness. Please consider identifying at least three and use fourth level headings. For
instance, how did you check out perceptions? What clarifying messages were used? What did you do
well? What might you have done different? What will you do different going forward? How did you
clarify the meaning of vague or unfamiliar terms? How did you elicit specific feelings? How did you
explore the basis of conclusions drawn by the client?
Opportunities for Improvement
I might recommend using the recording form for verbal following skills in section 6-8e in
Hepworth et al (2017) to help inform this section of the paper. Which responses were used too
frequently or too sparingly? Highlight opportunities for improvement. For example, I counted having
asked more than 15 closed-ended questions and only having asked four open-ended questions. Openended questions offer broad latitude and choice in how a client responds. I recognize that asking clients
a series of closed questions coaches them to give shorter answers.
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Strengths
What did you do well specific to your use of verbal following, exploring, and focusing skills? For
example, I recognize that I asked several open-ended questions to not make any assumptions regarding
several vague terms that were used by the client.
Learning Plan
Please be specific. What specific strategies or tasks will you engage in to improve your ability in
using verbal following, exploring, and focusing skills. For instance, I will aim to offer more reflections
than questions when asking my children about their days at school. I recognize that my questions may
be seen or felt like an interrogation. I want them to know and hear that I am listening to understand, not
to fix their problems or to assert my opinion or ideas on what they should do.
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Reference
Enter your references here. Please refer to Chapter 10 in the APA manual for guidance on APA
style and formatting.
REVIEW THE FILE ON SWOT ANALYSIS, based on the information provided on the startegic plan that we came upwith called homes fit for homless, create a swot analysis on an organization like this.
What are the strengths, weaknesses, opportunities and threats to your organization?
Strategic Plan:
This is the idea of Homes for the Homeless. Homesfitforhomeless.org
Name of Organization: Homes Fit for Homeless
Location: Los Angeles
Type of Organization: Non-Profit (Federally/State/Privately Funded)
Reason: Reduce the number of homeless people out on the streets, provide a foundation necessary for homeless people to better themselves and provide them with tools needed to apply for jobs, and fix old and/or broken homes (city renewal).
Mission:
We exist to be a community fit for the homeless and give hope, keeping families together, providing compassionate care, and guiding and facilitating those we serve on a path to life change.
Vision:
Our Vision is to end homelessness by building homes fit for homeless communities that will empower families to become resilient and independent.
Values:
Our goal is to bring about transformation in the lives of those who are hurting through the provision of housing solutions and support services; and to serve as a guiding partner in transforming, educating, creating stability and bringing the better and bright futures into relationships in these communities that we help.
Strategic Plan: Goals & Objectives
Goals:
Address the critical issues facing the organization
Reduce the number of homeless people out on the streets by providing them with permanent housing as a foundation to better their lives.
Focus on the needs of stakeholders
Find and organize the funding to renew the housing. Network and solidify the agreements with federal government agencies, local government agencies, and/or agencies in the private sector.
Objectives: (S.M.A.R.T)
Goal #1
Measurable: See if the number of homeless people lowers overtime with the addition of housing. Can measure (count) how many homeless people in a location (sample size) and compare it to a future count.
Specific: This goal is aimed towards a specific group of people, homeless people. This goal also has a specific plan of rebuilding and fixing homes that are in bad condition and specifically placing the homeless people into these homes.
Time-dated: In the city of Los Angeles there are about 75% of homeless that lack permanent shelter, the goal is to decrease by 10% the first year and by 50% by year 5.
Goal #2
1.Specific: We will seek funding from many private and public companies to support our organization in the amount of $15 million dollars to rebuild 100 homes at the cost of $150,000 for each home.
2. Attainable: Funding and support for example from government agencies like the US Department of Housing and Urban Development that can provide housing and community development assistance.
3.Measurable: To obtain $15 million dollars to rebuild 100 homes in order to decrease homeless people in Los Angeles by 400 averaging about $150,000 per home spent on renovations.
The assessment requirements, outlined below, correspond to the scoring guide criteria, so address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for supporting evidence.
Assess the contribution of your intervention to patient or family satisfaction and quality of life.
Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.
Explain how your intervention enhances the patient, family, or group experience.
Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.
Explain how the principles of evidence-based practice informed this aspect of your project.
Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.
Identify opportunities to improve health care technology use in future practice.
Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.
Note specific observations related to the baccalaureate-prepared nurse’s role in policy implementation and development.
Explain whether capstone project outcomes matched your initial predictions.
Discuss the aspects of the project that met, exceeded, or fell short of your expectations.
Discuss whether your intervention can, or will be, adopted as a best practice.
Describe the generalizability of your intervention outside this particular setting.
Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.
Address your provision of ethical care and demonstration of professional standards.
Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.Cite at least three scholarly or authoritative sources to support your assertions.
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10/14/23, 11:06 AM
Intervention Presentation and Capstone Video Reflection Scoring Guide
Intervention Presentation and Capstone Video Reflection Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Assess the
contribution of an
intervention to
patient, family, or
group satisfaction
and quality of life.
Does not assess
the contribution of
an intervention to
patient, family, or
group satisfaction
and quality of life.
Attempts to assess
the contribution of
an intervention to
patient, family, or
group satisfaction
and quality of life
based on
unfounded
assumptions.
Assesses the
contribution of an
intervention to patient,
family, or group
satisfaction and quality
of life.
Assesses the contribution
of an intervention to
patient, family, or group
satisfaction and quality of
life. The assessment is
fair, unbiased, and
supported by feedback
from the patient, family, or
group.
Describe one’s use
of evidence and
peer-reviewed
literature to plan and
implement a
capstone project.
Does not describe
one’s planning and
implementation of a
capstone project.
Attempts to
describe one’s
planning and
implementation of a
capstone project.
Describes one’s use of
evidence and peerreviewed literature to
plan and implement a
capstone project.
Succinctly describes one’s
use of evidence and peerreviewed literature to plan
and implement a capstone
project. Project planning
and implementation clearly
reflect the influence of
evidence-based practice.
Assess the degree
to which one
successfully
leveraged health
care technology in a
capstone project to
improve outcomes
or communication
with a patient,
family, or group.
Does not describe
how one used
health care
technology in a
capstone project.
Attempts to
describe how one
used health care
technology in a
capstone project.
Assesses the degree
to which one
successfully leveraged
health care technology
in a capstone project
to improve outcomes
or communication with
a patient, family, or
group.
Presents an articulate
assessment of the degree
to which one successfully
leveraged health care
technology in a capstone
project to improve
outcomes or
communication with a
patient, family, or group.
Offers keen insight into
prospective improvements
in health care technology
use.
Explain how health
policy influenced the
planning and
implementation of
one’s capstone
project, as well as
any contributions
the project made to
policy development.
Does not describe
health policies that
influenced the
planning and
implementation of
one’s capstone
project and any
contributions the
project made to
policy development.
Attempts to
describe health
policies that
influenced the
planning and
implementation of
one’s capstone
project and any
contributions the
project made to
policy development.
Explains how health
policy influenced the
planning and
implementation of
one’s capstone
project, as well as any
contributions the
project made to policy
development.
Presents an articulate
assessment of how health
policy influenced the
planning and
implementation of one’s
capstone project, as well
as on any contributions the
project made to policy
development. Offers keen
insight into the
baccalaureate-prepared
nurse’s role in policy
implementation and
development.
Explain whether
Does not describe
Attempts to
Explain whether
Provides an articulate and
capstone project
capstone project
describe capstone
capstone project
perceptive explanation of
outcomes matched
outcomes and does project outcomes
outcomes matched
whether capstone project
one’s initial
not document the
and/or does not
one’s initial predictions outcomes matched one’s
predictions
completion of nine
document the
and documents the
initial predictions. Exhibits
and documents the
practicum hours in
completion of nine
practicum hours spent clear insight into the
practicum hours
Capella Academic
practicum hours in
with these individuals
generalizability and bestspent
with
these
Portal
Volunteer
Capella
Academic
or
group
in
the
Capella
practice potential of1/2the
https://a21371-1105796.cluster223.canvas-user-content.com/courses/21371~6938/files/21371~1105796/course files/Scoring Guides/a05_scoring_gui…
individuals or group Experience Form.
Portal Volunteer
Academic Portal
intervention. Documents
10/14/23, 11:06 AM
CRITERIA
Intervention Presentation and Capstone Video Reflection Scoring Guide
NON-PERFORMANCE
BASIC
Volunteer
Experience Form.
Document the
completion of nine
hours of practicum
time.
PROFICIENT
DISTINGUISHED
completion of nine
hours of practicum
time.
individuals or group in the
Capella Academic Portal
Volunteer Experience
Form. Documents the
completion of nine hours
of practicum time.
Assess one’s
personal and
professional growth
throughout a
capstone project
and the RN-to-BSN
program.
Does not
summarize one’s
personal and
professional growth
throughout a
capstone project
and the RN-to-BSN
program.
Summarizes one’s
personal and
professional growth
throughout a
capstone project
and the RN-to-BSN
program.
Assesses one’s
personal and
professional growth
throughout a capstone
project and the RN-toBSN program.
Objectively assesses
one’s personal and
professional growth
throughout a capstone
project and the RN-to-BSN
program. Provides a
comprehensive and
detailed retrospective of
one’s overall performance
and growth.
Communicate
professionally in a
clear and wellorganized video.
Does not
communicate in a
video.
Communicates in a
video. Content
delivery is hesitant,
unclear, or read
from a script.
Communicates
professionally in a
clear and wellorganized video.
Communicates
professionally in a clear
and well-organized video.
Content delivery is
focused, smooth, and wellrehearsed. Information
sources are credited
appropriately.
https://a21371-1105796.cluster223.canvas-user-content.com/courses/21371~6938/files/21371~1105796/course files/Scoring Guides/a05_scoring_gui…
2/2
1 – start to Write a paragraphs content of 300 words about Important of networking with reference in APA style . 2- Identify at least two academic and at least two professional individuals or teams to collaborate with to be successful in the MSN program and as a practicing nurse 3- Explain why these individuals and/or teams were selected and how they will support success in the MSN program and as a practicing nurse. 4- Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in- text citations, and reference listPlz see the rubric in upload files
patient is a 17 yof that presents to the office because “my mom made me come here because im tired all the time (eyes are tearful, slightly annoyed voice)” During history intake patient reports dears of not making it into college because of difficulties concentration with school work, making poor grades, and reports she had a recent breakup with her boyfriend last year but states “i am over it now.” she reports concerns for being the reason the breakup occurred and reports crying everyday since but that she is not crying specifically due to the breakup, reports an increase in weight gain about 25-30 pounds, denies suicidal thoughts or self harm but does report she wishes she could disappear to escape the burden she feels from trying to please her family. Address the following questions: Providing anticipatory guidance is an important part of caring for adolescent clients. Using the Bright Futures Adolescence VisitsLinks to an external site. as a guide, identify 2 topics to include as anticipatory guidance for this client visit. How would your topic selection or guidance change if the client disclosed that she was bisexual? Include the following components:
Construct a 3-page decision memorandum to be distributed within the City Department of Health and Mental Hygiene to argue in favor of pivoting towards a social determinants of health framework in order to achieve health equity for the homeless population in the city. Define social determinants of health and explain why addressing the specific social determinants of this population’s poor health would improve their health outcomes, and thus should become a priority for the department.
Your goal is to effectively express a succinct thesis and subsequent analysis to advance a clear argument (and address potential counterarguments) to this defined audience using the format guidelines provided, while properly citing assigned readings thus far.
All work must follow the template below:
Title Page (APA)
12 pt. Times New Roman font
1” margins on all sides
Double spaced
APA citation
rubric attached
Unformatted Attachment Preview
Grading Rubric for Health Policy Memorandum
Grading Rubric for Health Policy Memorandum
Criteria
Ratings
This criterion is linked
to a Learning
OutcomeExecutive
Summary
20 to >14.0 pts
14 to >9.0 pts
9 to >0 pts
Exemplary
Satisfactory
Unsatisfactory
The one-paragraph executive
summary provides a concise
and clear overview of the main
issues and recommendations
with a succinct conclusion
summarizing the main points.
The executive summary
adequately provides an
overview of the main issues
with some recommendations
and a partial conclusion
summarizing the main points.
The executive summary is vague
and lacks clarity in presenting
the main issues and
recommendations, and does not
effectively provide a conclusion
summarizing the main points.
This criterion is linked
to a Learning
OutcomeProblem
Description
Pts
20 to >14.0 pts
14 to >9.0 pts
9 to >0 pts
Exemplary
Satisfactory
Unsatisfactory
Clearly identifies and
thoroughly explains the
problem with extensive
research and factual
information, free from
biases.
Adequately identifies and
explains the problem with some
supporting research with minor
factual information; minor
biases or values may be present.
Vaguely identifies and lacks
thorough explanation or
supporting research. It contains
unclear or biased descriptions
that hinder understanding.
20 pts
20 pts
Grading Rubric for Health Policy Memorandum
Criteria
Ratings
Pts
This criterion is linked
to a Learning
OutcomeOptions and
recommendations to
the policymakers
30 to >24.0 pts
24 to >17.0 pts
17 to >0 pts
Exemplary
Satisfactory
Unsatisfactory
Provides well-reasoned policy
alternatives backed up by
significant research and
evidence. Thoroughly considers
counterarguments and
potential consequences.
Presents minimal policy
options with some research
and evidence. Considers
counterarguments and
potential consequences but
lacks depth or strong evidence.
Presents policy options without
clear recommendations or
sufficient research and
evidence. Superficially
addresses counterarguments
and potential consequences.
This criterion is linked
to a Learning
OutcomeAudience
10 to >7.0 pts
7 to >5.0 pts
5 to >0 pts
Exemplary
Satisfactory
Unsatisfactory
Effectively addresses the
needs and interests of the
specific audience, aligning
with their obligations and
expectations.
Adequately addresses the
needs and interests of the
specific audience, mostly
aligning with their obligations
and expectations.
Fails to address the needs and
interests of the specific audience
effectively. Does not align with
their obligations and
expectations.
30 pts
10 pts
Grading Rubric for Health Policy Memorandum
Criteria
Ratings
This criterion is linked
to a Learning
OutcomeOrganization,
Style, Mechanics
15 to >10.0 pts
10 to >5.0 pts
5 to >0 pts
Exemplary
Satisfactory
Unsatisfactory
Excellently organized, with wellconstructed paragraphs, smooth
transitions, and clear
subheadings. Well-written
sentences with variety. No
grammatical, spelling, or
punctuation errors.
Well-organized with clear
paragraphs, transitions, and
subheadings. Well-written
sentences with some variety.
Minor grammatical, spelling,
or punctuation errors.
Lacks appropriate organization,
with poorly formed paragraphs,
abrupt transitions, or
ambiguous subheadings.
Numerous grammatical,
spelling, or punctuation errors
5 to >3.0 pts
3 to >1.0 pts
1 to >0 pts
Exemplary
Satisfactory
Unsatisfactory
Includes a minimum of five
high-quality sources, correctly
formatted using APA style.
Highly relevant, credible, and
significantly contribute to the
arguments and
recommendations.
Includes a minimum of five
sources, correctly formatted
using APA style. Relevant and
credible, contributing to the
arguments and
recommendations. Some
sources may lack significance or
quality.
Includes fewer than five
sources or fails to correctly
format them using APA style.
Sources lack relevance,
credibility, or sufficient
contribution to the arguments
and recommendations.
This criterion is linked
to a Learning
OutcomeSources
Pts
15 pts
5 pts
Grading Rubric for Health Policy Memorandum
Criteria
Total Points: 100
Ratings
Pts
all information will be attached https://usflearn.instructure.com/courses/1817018/files/157016752?verifier=l4LkyeRBDEsvb2MyOxXNhmucHDIESwvwM9BLOzP9&wrap=1
The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare:
By Day 1 of this week, you will be assigned to one of the following specific case studies for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.
Review the following case studies:
Case 1: Back Pain
A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: When you submit your initial post, please include a header as the first line indicating your assigned case study. For example, “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.
BY DAY 3 OF WEEK 8
Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
LEARNING RESOURCES
Required Readings
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 6, “Vital Signs and Pain Assessment” (Previously read in Week 6)
Chapter 22, “Musculoskeletal System”
This chapter describes the process of assessing the musculoskeletal system. In addition, the authors explore the anatomy and physiology of the musculoskeletal system.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
Chapter 22, “Lower Extremity Limb Pain”Download Chapter 22, “Lower Extremity Limb Pain”
This chapter outlines how to take a focused history and perform a physical exam to determine the cause of limb pain. It includes a discussion of the most common tests used to assess musculoskeletal disorders.
Chapter 24, “Low Back Pain (Acute)” Download Chapter 24, “Low Back Pain (Acute)”The focus of this chapter is the identification of the causes of lower back pain. It includes suggested physical exams and potential diagnoses.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 2, “The Comprehensive History and Physical Exam” (“Muscle Strength Grading”) (Previously read in Weeks 1, 2, 3, 4, and 5)
Chapter 3, “SOAP Notes”
This section explains the procedural knowledge needed to perform musculoskeletal procedures.
Document: Episodic/Focused SOAP Note Exemplar (Word document)Download Episodic/Focused SOAP Note Exemplar (Word document)
Document: Episodic/Focused SOAP Note Template (Word document)
I understand that this assignment involves recording a video instead I want this typed and then I
will record the video please
For this assessment, you will create a 5-10 minute video reflection that addresses either an
interprofessional collaboration you experienced or a collaboration case study scenario that you imagine
you experienced.
Using Kaltura, record a video (5–10 minutes) where you reflect on an interprofessional collaboration
experience, proposing recommendations for how to improve interprofessional collaboration that can be
shared with leadership and colleagues. Support these recommendations with references to the
literature.
➢ Be sure that your assessment addresses the following criteria. Please study the scoring guide
carefully so you will know what is needed for a distinguished score:
➢ Reflect on an interdisciplinary collaboration experience, noting ways in which it was successful
and unsuccessful in achieving desired outcomes.
➢ 3 Explain aspects of the collaboration that helped the team make progress toward relevant
goals or outcomes.
➢ Explain aspects of the collaboration that could have been improved.
➢ Identify how poor collaboration can result in inefficient management of human and financial
resources, citing supporting evidence from the literature.
➢ Discuss the ways in which the interdisciplinary team did not collaborate effectively.
➢ Discuss the negative implications for the human and financial resources of the interdisciplinary
team and the organization as a whole.
➢ Cite the literature for support.
➢ Identify best-practice leadership strategies from the literature that would improve an
interdisciplinary team’s ability to achieve its goals, citing at least one author from the literature.
➢ Identify at least one leadership best practice or strategy that you believe would improve the
team’s ability to achieve their goals.
➢ Identify the strategy and its source or author and provide a brief rationale for your choice of
strategy.
➢ Cite the literature for support.
➢ Identify best-practice interdisciplinary collaboration strategies to help a team achieve its goals
and work together, citing the work of at least one author.
➢ Identify at least one best practice or strategy for interdisciplinary collaboration to help the team
achieve its goals and work more effectively together.
➢ Identify the strategy, its source, and reasons why you think it will be effective.
➢ Communicate in a professional manner, is easily audible, and uses proper grammar. Format
reference list in current APA style.
➢ Submit an APA-formatted reference list for any sources that you cited specifically in your video or
used to inform your presentation.
➢ The Example Kaltura Reflection will show you how to cite scholarly sources in the context of an
oral presentation.
.
One of the senior leadership functions is strategic planning. Define what this term means. What are its concepts objectives? Why is it important for the senior leadership to possess this skill? In which ways it contributes to accomplishing the organizational mission, vision, and overall success when applied to health information management and technology integration in healthcare organizations? Your APA formatted MEMO comprising 2-4, double-spaced, typed in 12-point Times New Roman (or 11- point Calibri) excluding the Cover and Reference pages
On what policy issues might nurses lobby Congress? What strategies might nurse use to have their voices heard?The discussion must address the topic.Rationale must be provided400 words in your initial post
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1 Case 2 Case 3
Chief Complaint
(CC) “I am here today due to frequent and watery bowel movements” “I have pain in my belly” “neck swelling”
History of Present Illness (HPI) A 37-year-old European American female presents to your practice with “loose stools” for about three days. One event about every three hours A 25-year-old female presents to the emergency room (ER) with complaints of severe abdominal pain for 2 weeks . The pain is sharp and crampy It hurts if I run, sit down hard, or if I have sex A 42-year-old African American female who refers that she has been noticing slow and progressive swelling on her neck for about a year. Also she stated she has lost weight without any food restriction
PMH No contributory Patient denies Patient denies
PSH Appendectomy at the age of 14 Surgical removal of benign left breast nodule 2 years ago
Drug Hx
No meds Birth control No medication at the time
Allergies Penicillin NKA NKA
Subjective Fever and chills, Lost appetite Flatulence No mucus or blood on stools Nausea and vomiting, Last menstrual period 5 days ago, New sexual partner about 2 months ago, No condoms, he hates them No pain, blood or difficulty with urination Mild difficult to shallow, Neck feels tight, Pt states she feels Palpitations
Objective Data
PE B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8 B/P 138/90; temperature 99°F; (RR) 20; (HR) 110, regular; oxygen saturation (PO2) 96%; pain 5/10 B/P 158/90; Pulse 102; RR 20; Temp 99.2; Ht 5,4; wt 114; BMI 19.6
General well-developed female in no acute distress, appears slightly fatigued acute distress and severe pain 42-year-old female appears thin. She is anxious – pacing in the room and fidgeting, but in no acute distress.
HEENT Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.
Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip.
Bulging eyes
Neck Supple Diffuse enlargement of the thyroid gland
Lungs CTA AP&L
CTA AP&L
CTA AP&L
Card S1S2 without rub or gallop S1S2 without rub or gallop S1S2 without rub, Tachycardia
Abd positive bowel sounds (BS) in all four quadrants; no masses; no organomegaly noted; diffuse, mild, bilateral lower quadrant pain noted Mild diffuse tenderness.
INSPECTION: no masses or thrills noted; no discoloration and skin is warm to; no tattoos or piercings; abdomen is nondistended and round
• AUSCULTATION: bowel sounds (BS) are normal in all four quadrants, no bruits noted
• PALPATION: on palpation, abdomen is tender to touch in four quadrants; tenderness noted on light palpation, deep palpation reveals no masses, spleen and liver unremarkable
• PERCUSSION: tympany heard in all quadrants, no dullness noted in abdominal area
benign, normoactive bowel sounds x 4
GU Non contributory • EXTERNAL: mature hair distribution; no external lesions on labia
• INTROITUS: slight green-gray discharge, no lesions
• VAGINAL: normal rugae; moderate amount of green discharge on vaginal walls
• CERVIX: nulliparous os with small amount of purulent discharge from os with positive cervical motion tenderness (CMT)
• UTERUS: ante-flexed, normal size, shape, and position
• ADNEXA: bilateral tenderness with fullness; both ovaries without masses
• RECTAL: deferred
• VAGINAL DISCHARGE: green in color Non contributory
Ext no cyanosis, clubbing or edema no cyanosis, clubbing or edema no cyanosis, clubbing or edema
Integument good skin turgor noted, moist mucous membranes intact without lesions masses or rashes Thin skin, Increase moisture
Neuro No obvious deformities, CN grossly intact II-XII No obvious deficits and CN grossly intact II-XII No obvious deficits and CN grossly intact II-XII
Answer the below questions. Note that all your responses should apply to your specific patient from your assigned case study.
What other subjective data would you obtain?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient presenting symptoms.
Give rationales for each differential diagnosis.
Submission Instructions:
You have been assigned your case number (See Announcement), and you will post about the case number you have been assigned.
You will reply to your peers who have posted on the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
Gather and analyze data from your interviews and be ready to explain and present on ways to address or acknowledge your observations. What makes our community/ aspects of our community healthy or unhealthy? What are some of the needs of our community?
Unformatted Attachment Preview
Interviewed by Alen
Name: Alma Aguilar
1) How accessible are healthcare facilities and services within our community?
The community I belong to is known as Chicago Lawn. This community is very accessible to
different healthcare facilities. Most of them are accessible by public transportation. Which
makes it better for people that don’t drive.
2) Are there local organizations or initiatives focused on promoting physical fitness and
wellness?
In my community there is a local gym. I do not use that gym personally, so I do drive to the
second nearest gym which is only a couple blocks away. As for someone promoting physical
fitness and wellness, no I do not see that in my community.
3) What are the levels of air and water pollution in your area?
According to accuweather the air pollution is poor. I usually do check the levels of air
pollution daily just because my children have asthma. As for the levels of water pollution, I
am not sure. I have never checked the water pollution levels. According to the City of
Chicago website, Chicago’s tap water has met or exceeded all standards set by the U.S.
Environmental Protection Agency for safe, clean drinking water.
4) Are there opportunities for community members to access fresh and healthy food options,
such as farmers’ markets or grocery stores with a variety of produce?
Yes, there are a couple of grocery stores nearby that sell fresh fruit, vegetables, and produce.
There are also food pantries that are available for people in the community.
5) How well do community members understand and prioritize mental health?
Unfortunately, I am not sure how well the community understands and prioritizes mental
health. I do believe that this topic is something that has to be prioritize just because having a
stable mental health allows us to provide our best self.
6) What is the prevalence of chronic health conditions in our community, and are there support
systems in place to address them?
I am not sure of the prevalence of chronic health conditions in my community. I’ve seen
health centers in the community promoting for Prep. Which is prevention for the
transmission of HIV among people.
7) How is substance abuse, including alcohol and drug addiction, addressed within our
community?
8) Are there safe spaces and recreational facilities available for physical activities and exercise?
In my community there is a Chicago Park District available. There is also a nearby gym that
people can go to.
9) How inclusive and accessible are healthcare and wellness programs for individuals with
disabilities or special needs?
Like mentioned previously healthcare and wellness programs are in the area. There is also
facilities for youth such as the metropolitan center. From what I have seen so far in my
neighborhood I don’t really see a direct service provided for people with disabilities or
special needs.
10) What is the level of community engagement and participation in health-related events or
initiatives?
People in the community are always involved in community events. I think that is one of the
things I have enjoyed from this community.
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1 Case 2 Case 3
Chief Complaint
(CC) “It burns when I urinate” “I had a severe headache yesterday with difficulty to speak” “I have been having frequents headaches lately”
History of Present Illness (HPI) A 68-year-old Caucasian male who reports to have increase on the frequency of urination with urgency for the last 5 days. He also present dysuria and nocturia. A 64-year-old African American female who reports having a severe pulsatile diffuse headache yesterday with sudden difficulty to talk with last for about two hours. She did not seek medical attention. This morning she woke up with no problems but is here today due her husband advise. A 25-year-old Hispanic female presents to your clinic with a headache located on right temporal area, pulsatile.
PMH Benning prostatic hyperplasia diagnosed 3 years ago, UTI 6 months ago, Lithotripsy left kidney 10 years ago. No issues after treatment Atrial Fibrillation, Hypertension. Is allergic to Non-steroidal Anti-inflammatory drugs Aspirin Frequent headaches since I was 15, with menses.
Drug Hx Rosuvastatin 20 mg
Olmesartan 20 mg
Losartan 50 mg
Xarelto 15 mg BID
Ibuprofen for Headaches
Subjective
Fever and chills, no changes in vision or hearing, no difficulty chewing or swallowing. No sexually active, nocturia, dysuria.
Yellowish urethral secretion. Feels Palpitations, joint pain with yesterday’s episode Light makes headache worst Nausea associated with headaches. No vomiting, Headaches improve usually with rest, ibuprofen, and sleep, but it is annoying to have to sleep all-day
Objective Data
VS B/P 150/96; Pulse 89; RR 16; Temp 99.4; Ht 6,1; wt 180; B/P 131/80; temperature 98.2°F; (RR) 18; (HR) 84, irregular; oxygen saturation (PO2) 96%; B/P 108/64; Pulse 86; RR 16; Temp 98.6;
General well-developed male, no acute distress well-developed female, no acute distress 25-year-old female appears well developed and well-nourished, healthy appearing, wearing dark glasses in a dim room
HEENT Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.
Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition.
no injection, anicteric, PERRLA, EOMs intact, without pain to movement; normal vision
Lungs CTA AP&L
CTA AP&L
CTA AP&L
Card S1S2 without rub or gallop S4 present Irregular heart beat with normal rate S1S2 without rub or gallop
Abd No tenderness normoactive bowel sounds x 4; No tenderness normoactive bowel sounds x 4;
benign, normoactive bowel sounds x 4;
Rectal exam Warm, swollen and painful prostate gland Non contributory Non contributory
Integument good skin turgor noted, moist mucous membranes intact without lesions masses or rashes. intact without lesions masses or rashes.
Neuro No obvious deformities, CN grossly intact II-XII No obvious deficits and CN grossly intact II-XII Cranial nerves II to XII intact; sensation intact, DTRs 2+ throughout.
Functional neurological exam is WNL
Answer the below questions. Note that all your responses should apply to your specific patient from your assigned case study.
What other subjective data would you obtain?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient presenting symptoms.
Give rationales for each differential diagnosis.
What teachings will you provide?
Submission Instructions:
You have been assigned your case number (See Announcement), and you will post about the case number you have been assigned.
You will reply to your peers that have posted on the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
You are a perinatal unit coordinator at a large teaching hospital. In addition to your management responsibilities, you have been asked to fill in as a member of the hospital promotion committee, which reviews petitions from clinicians for a step-level promotion on the clinical specialist ladder. You believe that you could learn a great deal on this committee and could be an objective and contributing member.
The committee has been convened to select the annual winner of the Outstanding Clinical Specialist Award. In reviewing the applicant files, you find that one file from a perinatal clinical specialist contains many overstatements and misrepresentations. You know for a fact that this clinician did not accomplish all that she has listed because she is a friend and close colleague. She did not, however, know that you would be a member of this committee and thus would be aware of this deception.
When the entire committee met, several members commented on this clinician’s impressive file. Although you were able to dissuade them covertly from further considering her nomination, you are left with many uneasy feelings and some anger and sadness. You recognize that she did not receive the nomination, and thus, there is little real danger regarding the deceptions in the file being used inappropriately at this time. However, you will not be on this committee next year, and if she were to submit an erroneous file again, she could be highly considered for the award. You also recognize that even with the best of intentions and the most therapeutic of communication techniques, confronting your friend with her deception will cause her to lose face and will probably result in an unsalvageable friendship. Even if you do confront her, there is little you can do to stop her from doing the same in future nomination processes other than formally reporting her conduct.
ASSIGNMENT:
Determine what you will do. Do the potential costs outweigh the potential benefits? Be realistic about your actions.
List which Learning Exercise you are solving at the start of your analysis and provide a brief summary of the case. Be sure to apply an appropriate problem-solving/decision-making model (Traditional Problem-Solving Process, Managerial Decision-Making Model, The Nursing Process, or the Integrated Ethical Problem-Solving Model) in determining what you should do. Justify your decision with supporting evidence.
Writing Expectations—3 to 4 pages, double-spaced, in length, not counting title page and references. APA format required (title page, citations in body of paper, and reference list). The steps of the problem-solving or decision-making model chosen should be used as subheadings for the paper. Each analysis should include a brief introduction and conclusion. Be sure to identify numerically which Learning Exercise is being analyzed.
TITLE: End of Life
Discuss the technical aspects of your topic in general terms.
Discuss the public policy debates relevant to the topic you choose. This section should cover arguments that favor and oppose the use of the techniques or products.
Express your personal opinion regarding the topic’s importance and the validity of the pro and con arguments. Within the personal opinion/conclusion, frame your position with an ethical theory from the six workable theories covered in this course.
Your submission must include:
A title page
The body of the paper, which includes 4–6 content pages, not including title or reference pages
At least three references from textbooks, websites, and articles that provide adequate justification and support your claim
Subheadings (technical aspects, public policy, and personal opinion/conclusion)
Appropriate in-text citations throughout the paper
A reference list with only the sources used in the body of the paper (All sources should be less than five years old unless recent research is not available, and at least one reference must be a peer-reviewed article from a professional journal. Do not use Wikipedia or an encyclopedia as they are not considered reliable academic sources and will not be accepted.)
APA style formatting throughout your paper, using only one of these fonts: 11-point Calibri,11-point Arial,12-point Times New Roman, or 11-point Georgia.
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1 Case 2 Case 3
Chief Complaint
(CC) A 65-year-old male with chronic obstructive pulmonary disease (COPD) presents to the clinic with a cough he has had for the past 2 weeks. A 25-year-old Hispanic female, computer programmer presents to your clinic complaining of a 12-day history of a runny nose A 75-year-old female reports experiencing pain in her chest while walking up steps today.
Subjective denies chest pain, denies night sweats, admits to having a fever but does not know the temp. States that her symptoms began about 12 days ago. She suffers from allergies; she gets a runny nose during the spring-time, pollen season. However, in the winter, her allergies are not a problem. Could not sleep previous night. Feels like an ache or a burning sensation at the center of sternum. Denies any arm pain, pain was at a scale of 8 in the AM now it is at a 2. Suffers from History of hypertension, denies heart disease, denies leg swelling up, denies pain feeling worse when taking deep breath.
Objective Data
VS (BP) 115/75, (P) 89, (RR) 16, (T) 100.4°F (38°C), O2 sat 98% on room air. (BP) 115/75, (P) 89, (RR) 16, (T) 100.4°F (38°C), O2 sat 98% on room air BP 129/70, (HR) 72 and regular, (RR) 16 unlabored, temperature 98.8°F, oral pulse oximetry is 99%
General patient appears tired; skin color pale, patient is diaphoretic and sweaty, height 5′3″; weight 175 lbs No signs of acute distress. Patient appears mildly fatigued. She is breathing through her mouth. Breathing easily. Voice has a nasal quality to it. obese female, alert, in no acute distress.
HEENT EYES: no injection, no increase in lacrimation or purulent drainage;
EARS: normal
TM: Normal
NOSE: Bilateral erythema and edema of turbinates with significant yellow drainage on the right. Obstructed air passages
Ear canals: normal;
EYES: normal;
NOSE: Bilateral erythema and edema of turbinates with significant yellow drainage on the right. Nares: Obstructed air passages
Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, nasopharynx clear, poor dentition – multiple carries.
Respiratory lung crackles in LLL, no wheezes or rhonchi noted; does not clear with coughing; dullness to percussion over the LLL; shallow respirations and is 30, accessory muscles use not present CTA AP&L CTA AP&L
Neck/Throat no neck swelling or tenderness with palpation; neck is supple; no JVD; thyroid is not enlarged;
trachea midline
Posterior pharynx: mildly injected, scant postnasal drainage (PND), no exudate, tonsils 1+, no
cobblestoning
carotids are 2+ without bruits; thyroid is not palpable; no lymphadenopathy
Heart Regular rate and rhythm, no murmur, S3, or S4 Regular rate and rhythm, no murmur, S3, or S4 S1 and S2 normal without murmur, gallop, or rub
Answer the below questions. Note that all your responses should apply to your specific patient from your assigned case study.
What other subjective data would you obtain?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient’s presenting symptoms.
Give rationales for each differential diagnosis.
Submission Instructions:
You have been assigned your case number (See Announcement), and you will post about the case number you have been assigned.
You will reply to your peers who have posted on the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
All the instructions are in the filePlz; I want it to be unique and the plagiarism rate is 0%.
Unformatted Attachment Preview
Kingdom of Saudi Arabia
Ministry of Education
Jazan University
Department of Health Informatics
Course Name: Health Data Classification and Coding
Assignment
Semester Ist (2023-2024)
Total marks: 10
TOPIC: History of ICD.
INSTRUCTIONS FOR WRITING ASSIGNMENT
1. The content of the assignment must be relevant to the topic and free from plagiarism.
2. Writing must include an introduction, , detailed history, and summary.
3. Pages 2-3 only.
LANGUAGE & GRAMMAR
4. The content should be free of language, grammar and spelling errors.
FORMATTING & LAYOUT
1. Format style should follow the following criteria:
a. 12 size font with Times New Roman
b. 1.5 line spacing.
c. Spaces between paragraphs.
d. Give page numbers.
e. Keep wide margins
2. Cover page (Course name, Department, Group Assignment, Level, Group No. Student
name and ID )
0173342570 : – هاتف2820 – الرقم اإلضافي82817 – الرمزالبريدي6809 لمملكة العربية السعودية – جازان – رقم المبنى
Kingdom of Saudi Arabia – Jazan – Bulding 6809 – Zip 82817 – Additional No. 2820 – Tel: 0173342570
Kingdom of Saudi Arabia
Ministry of Education
Jazan University
Department of Health Informatics
Rubric for Assessment: 4 Point Rating Scale
S.N.
Items
Very satisfiedSatisfied
Dissatisfied
Very dissatisfied
Total
1.
Content relevance
1
0.75
0.5
0.25
1
2.
3.
1
3
0.75
2
0.5
1.5
0.25
1
1
3
2
1.5
1
0.5
2
5.
Plagiarism free
Introduction, definition, examples and
summary.
Free of language grammar and spelling
errors.
Formatting and layout
1
0.75
0.5
0.25
1
6
Cover page layout
1
0.75
0.5
0.25
1
7.
Date of submission
On time
(1)
1 day late 2 days late
(0.5)
(0.25)
4.
Total
After 2 days 1
(0)
10
DATE OF SUBMISSION
The due date for submission is 24th October 2023. It is strictly advised to submit assignment
on the deadline. Marks will be deducted for late submissions.
In case of queries, please feel free to contact me.
Ms.Wajiha Rehman
0173342570 : – هاتف2820 – الرقم اإلضافي82817 – الرمزالبريدي6809 لمملكة العربية السعودية – جازان – رقم المبنى
Kingdom of Saudi Arabia – Jazan – Bulding 6809 – Zip 82817 – Additional No. 2820 – Tel: 0173342570
I need two responses for these two discusions.1- CAUTI is an urgent clinical problem that warrants robust strategies for reducing morbidity and health costs. A quasi-experimental design such as Interrupted Time Series Analysis (ITSA) could potentially implement an all-encompassing catheter care bundle to reduce CAUTI rates. This perspective facilitates an ordered review of temporal dynamics and explores the immediate as well as long-term effects of the interventions (Zhong et al., 2020). It is thus useful in giving insights into specific actions aiming at improving patients’ care and control of infections, even as there is a smart use of resources inITSA is selected because of its ability to account for temporal patterns, strengthen statistical power compared to data at one point in time, and prove a certain cause (Zhong et al., 2020). The interventions comprise adherence to a catheter care bundle, which includes effective practices in the placement and management of catheters, periodic evaluations on the justification for the use of catheters, and training to physicians concerning the prevention of central line-associatedThe main strengths of ITSA are the ability to establish cause-and-effect relationships, detect short-term and long-term changes in the outcome, and provide valid results with minimum errors (Penney, 2023). Causal inference is more powerful than simple ‘pre-post’ designs and captures interventions’ short-term and long-term effects. Besides, the approach is less prone to bias, which makes it appropriate for assessing interventions in actual life clinical settings. However, ITSA has its limitations. This method requires significant amounts of data before and after the intervention, which could be a limitation in some instances. Furthermore, concerns about external validity could restrict generalization to environments and samples outside the limits of investigation (Penney, 2023).Finally, using an interrupted time series analysis to analyze the effect of a catheter care bundle on CAUTI rates is a strong method, considering temporal trends and attributing causation in the face of data and generalizability constraints. Thus, this quasi-experimental design, with its provision of tangible evidence for interventions that may aid in reducing the incidence of CAUTI, thereby improving patient outcomes, is promising among other advanced strategies for clinical quality enhancement.2-I am going to be picking catheter associated urinary tract infections. I am going to apply an experimental design such as a randomized clinical trial. I would use this design because we would directly be using urinary catheters on a randomized group without using preexisting patient characteristics. The experimental design would include patients in a hospital setting who require the use of urinary catheters. There would be 2 groups : one with the standard care and the other with the experimental catheter care protocol. The second group would receive the experimental catheter protocol that might include different disinfection techniques to reduce CAUTIs. The main outcome would be the number of CAUTI incidences in each group. I would use the randomized clinical trial experimental design because the 2 groups allow for comparison to assess the effectiveness of the new catheter care protocol. Some of the strengths with this experimental design include the minimizing of selection bias and allowing researchers to control variables and conditions to isolate the effects of the intervention. One weakness includes ethical considerations due to the clinical trial involving medical procedures on human subjects that raises ethical concerns. The most important aspect of the clinical trial is to obtain informed consent due to the experiment being on randomized people. Another weakness could be that the results may not fully represent diverse patient populations or real world clinical settings because the two groups, the hospital and the clinical trial setting, are two very different populations. A couple more weaknesses are cost and a placebo effect. Clinical trials can be time consuming and costly. The participants could also experience a placebo effect, affecting the outcomes. Despite the few limitations, a well designed clinical trial can provide valuable insights for the effectiveness of the interventions for reducing CAUTIs in a controlled clinical setting.
Identify some of the social, ethical, and economic reasons for addressing immigration policy reform.The discussion must address the topic.Rationale must be provided400 words in your initial post by Wednesday 23:59 pmMinimum of two scholarly references in APA format within the last five years published
To provide culturally diverse nursing care, describe the six cultural phenomena that are evident in all cultural groups.Discussion post should at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources. No AI please. Incorporate a minimum of 2 current (published within the five years) scholarly journal articles. Journal articles should be referenced according to the current APA style. I found two articles I would like for you to use listed below.Park, H. S., Jang, H. S. H. J., Jeong, H. S. H. J. G. H. (2019). Effects of a cultural nursing course to enhance the cultural competence of nursing students in Korea. Journal of Educational Evaluation for Health Professions, 16, 39. https://doi.org/10.3352/jeehp.2019.16.39Liu, T. T., Chen, M. Y., Chang, Y. M., & Lin, M. H. (2022). A Preliminary Study on the Cultural Competence of Nurse Practitioners and Its Affecting Factors. Healthcare (Basel, Switzerland), 10(4), 678. https://doi.org/10.3390/healthcare10040678
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.
Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.
In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
To Prepare:
Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
Select a healthcare program within your practice and consider the design and implementation of this program.
Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–4 Full Pages Times New Roman Size 12 Font Double-Spaced APA Form Excluding the Title and Reference Pages)
In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
Submit your interview transcript.
RESOURCES·
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.o Chapter 5, “Public Policy Design” (pp. 87–95 only)o Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)o Chapter 9, “Interprofessional Practice” (pp. 152–160 only)o Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)· American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advoc…· Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a…· Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/· Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.· Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.· Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.
Requirements: 2–4 Full Pages Times New Roman Size 12 Font Double-Spaced APA Form Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph
Please be sure to carefully follow the instructions.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each body paragraph written.
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1 Case 2 Case 3
Chief Complaint
(CC) A 57-year-old man presents to the office with a complaint of left ear drainage since this morning. A 45-year-old female presents with a complaint of an itchy red rash on her arms and legs for about two weeks. A 11-year-old female patient complains of red left eye and edematous eyelids. Her mother states the child complains of “sand in my left eye.”
Subjective Patient stated he was having pulsating pain on left ear for about 3 days. After the ear drainage the pain has gotten a little better. She has been going on a daily basis to the local YMCA with children for Summer camp. Patient noticed redness three days ago. Denies having any allergies. Symptoms have gotten worse since she noticed having the problem.
Objective Data
VS (T) 99.8°F; (RR) 14; (HR) 72; (BP) 138/90 (T) 98.3°F; (RR) 18; (HR) 70, regular; (BP) 118/74 (T) 98.2°F; (RR) 18; (HR) 78; BP 128/82; SpO2 96% room air; weight 110 lb.
General well-developed, healthy male healthy-appearing female in no acute distress well-developed, healthy, 11 years old
HEENT EAR: (R) external ear normal, canal without erythema or exudate, little bit of cerumen noted, TM- pearly grey, intact with light reflex and bony landmarks present; (L) external ear normal, canal with white exudate and crusting, no visualization of tympanic membrane or bony landmarks, no light reflex EYE: bilateral anicteric conjunctiva, (PERRLA), EOM intact. NOSE: nares are patent with no tissue edema. THROAT: no lesions noted, oropharynx moderately erythematous with no postnasal drip.
EYES: no injection, no increase in lacrimation or purulent drainage;
EARS: normal
TM: Normal
EYES: very red sclera with dried, crusty exudates; unable to open eyes in the morning with the left being worse than the right
Skin No rashes CTA AP&L CTA AP&L
Neck/Throat no neck swelling or tenderness with palpation; neck is supple; no JVD; thyroid is not enlarged;
trachea midline
mild edema with inflammation located on forearms, upper arms, and chest wall, thighs and knees; primary lesions are a macular papular rash with secondary linear excoriations on forearms and legs
Answer the following questions for your specific case study assigned:
What other subjective data would you obtain specific to your case?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient’s presenting symptoms.
Give rationales for each differential diagnosis.
Submission Instructions:
You have been assigned your case number (See Announcement), and you will post about the case number you have been assigned.
You will reply to your peers who have posted on the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
Please submit a link to an article of a lawsuit against a personal trainer, along with a summary of the lawsuit it in your own words (at least 4 – 6 sentences) with the verdict.
Read the following case study and answer the reflective questions. Please provide evidence-based rationales for your answers. APA, 7th ed. must be followed. Due Date: Saturday
Unformatted Attachment Preview
MSN 5550 Health Promotion: Prevention of Disease
Case Study Module 6
Instructions: Read the following case study and answer the reflective questions. Please provide
evidence-based rationales for your answers. APA, 7th ed. must be followed.
Due: Saturday by 23:59 pm
CASE STUDY: Albert
Albert Mitchell is a 36-year-old man who will be traveling to Dubai to give a business
presentation in 3 months. Although he has traveled widely in the United States as a consultant,
this is his first trip to the Middle East.
He requests information regarding immunizations needed before his trip. Albert states that as
he will be in Dubai for only a few days, he is unlikely to contract a disease in such a short time
and therefore believes that it is illogical to obtain immunizations.
Albert states that he has heard that the side effects of the immunizations might be worse than
the diseases they prevent. He is also concerned about leaving his wife at home alone because
she is 6 months pregnant.
Reflective Questions
How would you address Albert’s beliefs?
What learning would be needed in each domain?
What learning theories would you consider?
How might his family concerns be addressed?
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Explain the significance of the therapeutic relationship in object relations theory.
Discuss the concept of trauma bonding and how the attachment theory is connected to anxiety and depression in adulthood.
How might internalized oppression and implicit racism impact interpersonal relationships for clients?
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Sunday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Surveillance system paper Using the surveillance systems listed in the learning activities, and other surveillance systems you can locate, identify two data elements relevant to your proposed project or program. Analyze the trends in data over time. Discuss what external factors may be influencing these trends. Reflect on the relevance of your findings to your project/program.This 2-3 page paper should follow current APA guidelines. Provide a minimum of 3 references, with at least 1 reference not included in the course materials.Note: You will include elements of this paper in the M9 Program Presentation and the M10 Final Plan Paper.Learning Objectives:1. Employ surveillance systems to locate data relevant to a specific dental health project and describe the data elements.2. Interpret the data and statistics to determine their relevance to your public health project.
While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.
A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a review (750-1,000 words) that includes the following sections:
Title page
Introduction section
A comparison of research questions
A comparison of sample populations
A comparison of the limitations of the study
A conclusion section, incorporating recommendations for further research
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Assessment Description
Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented. Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal.
The assignment will be used to develop a written implementation plan.
Documentation of sources should be presented using APA formatting guidelines.
How do you typically respond to change? Do you embrace it? Seek it out? Accept it reluctantly? Avoid it at all cost? Is this behavior like that of your friends and that of your family? Has your behavior always fit this pattern, or has the pattern changed throughout your life? If so, what life events have altered how you view and respond to change? A brief introductory paragraph introduces the topic of the discussion. One or more succinct paragraphs are needed to answer each of the discussion board questions. Use current literature (5 years old or less) to support your views. Be sparing in your use of quotes. Learn to paraphrase the information you are sharing from a source. A paragraph at the end gives a brief summary of the discussion. The initial posting for each topic should be a minimum of 500 words in length (not including the references). Use APA formatting, 12-point type font, double spacing, indenting of each paragraph, and proper spelling and grammar. You do not need a title page or a separate “References” sheet, but a “References” section should be included at the end of your posting if you cite sources.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Think about your specialization area.
Describe client situations where you might use crisis theory or task theory to work with a client.
How will these theories prepare you to understand their behaviors and emotions?
Discuss the limitations of the theory including cultural differences when experiencing crisis.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Compare and contrast the growth and developmental patterns of two toddlers of different ages using Gordon’s functional health patterns. Describe and apply the components of Gordon’s functional health patterns as it applies to toddlers. Instructions: Post your discussion to the Moodle Discussion Forum. Initial post must be made by Day #3. Word limit 500 words. Reply to at least two other student posts with a reflection of their response. Please make sure to provide citations and references (in APA, 7th ed. format) for your work.
“Parenteral nutrition is the intravenous administration of nutrition outside of the gastrointestinal tract. Total parenteral nutrition (TPN) is when the IV administered nutrition is the only source of nutrition the patient is receiving. Total parenteral nutrition is indicated when there is impaired gastrointestinal function and contraindications to enteral nutrition. Enteral diet intake is preferred over parenteral as it is inexpensive and associated with fewer complications such as infection and blood clots but requires a functional GI system” (Hamden & Puckett, 2022, para. 3). According to the 2023 NCLEX-RN Test Plan, new graduate nurses must be able to do the following:
Identify side effects and adverse events related to total parenteral nutrition (TPN) and intervene as
appropriate (e.g., hyperglycemia, fluid imbalance, infection)
Educate client on the need for and use of TPN
Apply knowledge of nursing procedures and psychomotor skills when caring for a client receiving TPN
Apply knowledge of client pathophysiology and mathematics to TPN interventions
Administer parenteral nutrition and evaluate client response.
Research TPN and complete these concept map.the template and upload it below. Topics to be addressed include:
Indications for use
Contraindications
Administration
Side effects
What is in TPN?
Testing, ongoing monitoring
Nursing interventions
Client teaching
References
Completes concept map assignment
Full Marks Completes all sections (Indications for use, contraindications, administration, side effects, What is in TPN?, testing/ongoing monitoring, nursing interventions, and client teaching). Each section is addressed and contains accurate information.
This criterion is linked to a Learning References
Full Marks
Completes a reference section giving credit to sources using APA 7th edition format.
need you to edit this work to decrease the turnin percentages rate. This is a health assessment for Tina Jones via Shadow health environment. All the school use the same program so all the students pretty as the avatar the same questions. The turnin percentages is 62% just fix the attached document but you can not change a lot the information because the documentation is based on my assessment and interview with the avatar. The turnin percentages also including Walden preprint form. Run a turnin report for me and try to decreased the percentages.
Create one Word document containing all parts of the assignment.
Format your document with one-inch margins and 12-point Times New Roman font.
– One page, double-spaced for each part.
Instructions: Part 1: Work Flow
1. List each step in the workflow for the front desk, starting when the patient calls for the initial appointment, to when the patient is called back to the exam room by the clinical assistant.
Instructions: Part 2: Where is the Money?
1. Read the following scenario:
You have just completed your first six months as front desk supervisor, and are feeling pretty good about yourself, until the practice administrator arrives at your office on Friday morning, and says:
“The practice CPA just completed an audit, and said we have a real problem at the front desk. We are collecting only about 60% of the over the counter money that we should be. He says we have no internal controls for account for this money. He also says our front desk has not been trained to collect money from patients”
Assignment: “I want to have a plan on my desk the first thing Monday morning, which shows me that you understand the problem, and have a plan to solve it!” Assignment: “I want to have a plan on my desk the first thing Monday morning, which shows me that you understand the problem, and have a plan to solve it! Include four internal controls and/or training you will put into place.”
Review the articles attached on Internal Control:
Instructions Part 3
What are three traits/qualities you would be seeking in hiring front desk staff in a medical practice?
After the final selection of a candidate, his/her background and references are checked usually through an outsourced agency. In healthcare both – references and background- are of enhanced significance compared to other industries. Discuss why this is so. What types of background checks are specially made for healthcare hiring? What would you inquire about the references? What would be the consequences if they do not disclose some of the information that may affect the employee’s performance or jeopardize patients’ healthcare?Your initial post comprising a minimum of 250 words. followed by a minimum of two (2) responses to classmates’ posts comprising at least 150 words supporting, challenging, clarifying, or adding to the existing information. Use credible evidence to support your ideas
The use of spirituality in nursing practice is not new. However, it is more studied and utilized in a more structured format in nursing. Identify and discuss tools used to evaluate spirituality.Please include 500 words , APA FORMAT, NO PLAGIARISM PLEASE, and Correctly identify which student learning outcome you covered in the discussion post that you created for the Week.Make sure that you include it in the beginning of the post and clearly state :”This week student learning outcome was ___” and include out of these five the one that corresponds.Critically analyze the philosophical underpinnings of nursing theories.Critique nursing’s conceptual models, grand theories and mid-range theories.Examine the influence that nursing models and theories have upon research and practice.Construct a nursing theory that represent current professional nursing practiceApply nursing theory or theories to nursing research.
Guidelines: Word count: 300to 1000 words Follow APA format for your assignment must include Introduction, Body and ConclusionAll information must be mention in APA referenceFont and Size: Times New Roman (12)Color – Black, Spacing – 1.5, Heading and sub-heading – BoldFollow APA format your assignment must include Introduction, Body & ConclusionAvoid plagiarismSubmit as word document
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College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.—————————————————————————————————Please use the template to help answer the discussion and please use 3 resources from the learning resources document as references with the corresponding in text citations.
Case Study 3 & 4 (10 Points) Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.
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Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition
Adolescent With Diabetes Mellitus (DM)
Case Studies
The patient, a 16-year-old high-school football player, was brought to the emergency room in a
coma. His mother said that during the past month he had lost 12 pounds and experienced
excessive thirst associated with voluminous urination that often required voiding several times
during the night. There was a strong family history of diabetes mellitus (DM). The results of
physical examination were essentially negative except for sinus tachycardia and Kussmaul
respirations.
Studies
Serum glucose test (on admission), p. 227
Arterial blood gases (ABGs) test (on admission),
p. 98
pH
PCO2
HCO2
Serum osmolality test, p. 339
Serum glucose test, p. 227
2-hour postprandial glucose test (2-hour PPG), p.
230
Glucose tolerance test (GTT), p. 234
Fasting blood glucose
30 minutes
1 hour
2 hours
3 hours
4 hours
Glycosylated hemoglobin, p. 238
Diabetes mellitus autoantibody panel, p. 186
insulin autoantibody
islet cell antibody
glutamic acid decarboxylase antibody
Microalbumin, p. 872
Results
1100 mg/dL (normal: 60–120 mg/dL)
7.23 (normal: 7.35–7.45)
30 mm Hg (normal: 35–45 mm Hg)
12 mEq/L (normal: 22–26 mEq/L)
440 mOsm/kg (normal: 275–300
mOsm/kg)
250 mg/dL (normal: 70–115 mg/dL)
500 mg/dL (normal:
Purchase answer to see full
attachment
To review the Pre-Predictor Exam Summary Report: APEA OTC.
Expand all categories by clicking “Expand All” to see all categories under the topic areas.
Create a Word Document with headings that correlate with the missed Knowledge Area, Question Topic, and Domain on the Pre-Predictor Exam Summary Report. (See Diagram 1 below).
Use resources such as your textbook, or a reputable standard of care website, such as the American College of Cardiology, etc. to remediate. Summarize the missed content topic in 2-3 paragraphs and include a hyperlink to the reference.
All missed questions must be addressed to earn all points.
Summarize the missed content topic in 2-3 paragraphs and include a hyperlink to the reference.
The professor also posted the following announcement:
-You are required to address each section missed with 2-3 paragraphs of no less than 6 sentences per paragraph.
-You must address every section missed even if it is a duplicate(each section requires its own 2-3 paragraphs with a minimum of 6 sentences in each paragraph.) EX: You missed AP skills for depression four times. You would need to write about AP Skills four different times(each in a different section with at least 2-3 paragraphs in each section.) We need to address every section missed. There are times when the report is not very specific and will note that you have missed a certain section multiple times. For instance, you missed depression assessment four times. You must create four sections and target this area at a different angle for each section. So you could speak about depression assessment from the Psychiatric Mental Health Practitioner for the first time, the next section you could speak about depression in primary care environment, and then depression assessment in public schools. So each area must be addressed. Also, be sure that each paragraph has at least 6 sentences.
Part 1: NUR 500 Discussion (For this discussion, I’m gonna need an initial response with 250-300 words and 1 reference. I will need also the 2 peer responses with 100 words each plus 1 reference)
After your graduation, you will be in an academic or clinical field. Depending on your field choice, discuss one nursing theory and identify the effect that the implications of this theory could have on nursing administration, management, or education.
Part 2: NUR 510 Discussion(For this discussion, I’m gonna need an initial response with 250-300 words and 1 reference. I will need also the 2 peer responses with 100 words each plus 1 reference)
Nurse-managed health centers and clinics are providing care at more convenient locations. Please explain the need for this change, benefits, and possible solutions to any obstacles.
Part 3: Discussion Forum: Ethical Issue Debate (Please see the attachments) I will attach the video captions as I’m unable to download the actual video. I need 4 rebuttal (1 for each)
You should have a minimum of 4 rebuttal posts by Sunday.
Rebuttal Rules
In your rebuttals, argue against the position they have taken. Provide evidence in your rebuttals- why do you oppose their viewpoint?
You can choose a text or a video response. Do not create new thread. Go into a thread and respond to the video by clicking Reply.
No personal attacks or name calling. Add emojis if needed.
Remember that tone comes across differently online and in text.
Do not use all CAPS, and remember that the person’s stance may not be their personal views.
Argue the evidence, not the person.
Don’t forget to respond to comments on your own videos.
Review the board and reply to students that do not have rebuttals yet. It is your job to keep your peers engaged and the debate lively with rebuttals!
The main goal of conducting research is to uncover the truth. Think about the issue that you described and consider the following:Describe any assumptions that you may have about what the research-based evidence will reveal to be true.Are you receptive to research findings that do not agree with your assumptions? Please explain.Have you already formed your own conclusions and are you looking for evidence to support your claims? Please explain.Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.Please be sure to validate your opinions and ideas with citations and references in APA format.
Create a PowerPoint presentation of 16-18 slides for the Minnesota Multiphasic Personality Inventory (MMPI-2-RF).
Address and include the following in your PowerPoint:
A title, introduction, and conclusion slide.
What is the MMPI-2-RF and what does it measure?
What are the legal and ethical requirements for a professional to administer, interpret, and/or report the results of an MMPI-2-RF?
How would information gathered from the MMPI-2-RF assist in the intake and treatment planning process?
Describe potential treatment strategies that would likely be incorporated into a treatment plan based on results from an MMPI-2-RF.
Include speaker notes below each content-related slide that represent what would be said if giving the presentation in person. Expand upon the information included in the slide and do not simply restate it. Please ensure the speaker notes include a minimum of 50 words.
A reference slide with a minimum of four scholarly references in addition to the textbook.
MMPI-2-RF and What it Measures
22 points
Legal and Ethical Requirements (administration, interpretation, and reporting)
44 points
Intake and Treatment
This assignment will consist of your personal philosophy of leadership, a personal analysis of your current capacity to be a leader and a plan for improving your leadership. Note carefully the 3 following sections and the expectations for each section.
Personal Philosophy of Leadership: Students will type up their personal philosophy of leadership. In doing so they will answer the following questions: (target length approximately 1 – 1 1⁄2 pages)
What does it mean to be a leader?
What are some traits of a great leader? A minimum of 5 traits should be mentioned.
Provide an example of a great leader and explain your selection.
Personal Assessment of Current Leadership: Students will complete the Leadership Style Survey provided in our Moodle course. After completing the survey students will tally their scores and determine their leadership style. Students will then research their leadership style and provide an overview of the components associated with their leadership style. Students will point out the positives and negatives affiliated with style and they will draw 3 examples of how they match this style of leadership.
Plan for Improving Leadership: Students will then develop a detailed leadership plan that highlights some of their current weakness and how they can improve upon them. Two areas of improvement and guidelines for improvement must be included in this section (target length approximately 1 – 1 1⁄2 pages).
References: At least 4 specific, relevant resources should be included. The referenced material should be used when you describe your leadership style and in the plan for improving leadership section. Use of APA citation style is required.
Paper Format: Total minimum length: 3 pages plus a title and reference page. Assignments should be double-spaced, typed, in APA format, and submitted through the Moodle course. No abstract is required. Organized paper into sections with separate headings for each section.
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Personal Leadership Assessment (40 points)
This assignment will consist of your personal philosophy of leadership, a personal analysis of your current capacity to be
a leader and a plan for improving your leadership. Note carefully the 3 following sections and the expectations for each
section.
A. Personal Philosophy of Leadership: Students will type up their personal philosophy of leadership. In doing so they
will answer the following questions: (target length approximately 1 – 1 ½ pages)
a. What does it mean to be a leader?
b. What are some traits of a great leader? A minimum of 5 traits should be mentioned.
c. Provide an example of a great leader and explain your selection.
B. Personal Assessment of Current Leadership: Students will complete the Leadership Style Survey provided in our
Moodle course. After completing the survey students will tally their scores and determine their leadership style.
Students will then research their leadership style and provide an overview of the components associated with their
leadership style. Students will point out the positives and negatives affiliated with style and they will draw 3
examples of how they match this style of leadership.
C. Plan for Improving Leadership: Students will then develop a detailed leadership plan that highlights some of their
current weakness and how they can improve upon them. Two areas of improvement and guidelines for
improvement must be included in this section (target length approximately 1 – 1 ½ pages).
References: At least 4 specific, relevant resources should be included. The referenced material should be used when you
describe your leadership style and in the plan for improving leadership section. Use of APA citation style is required.
Paper Format: Total minimum length: 3 pages plus a title and reference page. Assignments should be double-spaced,
typed, in APA format, and submitted through the Moodle course. No abstract is required. Organized paper into sections
with separate headings for each section.
Guidelines:Word count: 300to 1000 words Follow APA format for your assignment must include Introduction, Body and ConclusionAll information must be mention in APA referenceFont and Size: Times New Roman (12)Color – Black, Spacing – 1.5, Heading and sub-heading – BoldFollow APA format your assignment must include Introduction, Body & ConclusionAvoid plagiarismSubmit as word document
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
Need 2 peer responses. Initial discussion question: Gabriela is a 32-year-old Latino woman with type 2 diabetes and hypertension who is working full time at a fast-food restaurant. She has a BMI of 32. Gabriela is studying to be a cosmetologist and lives with her mother, who helps out with child care and housekeeping. Gabriela’s knees are very sore and she is in the clinic to have them examined. She is very fearful that she will lose her job if she cannot stand for long hours. 1.What strategies could you suggest to Gabriela to attain a healthy weight and improve her health?2.What barriers to a healthy lifestyle do you think Gabriela may have? How would you discuss them with her?
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Latinos are a community of people that are considered to have numerous health issues. In their life span
a Latino will experience one or two health issues. These vary from obesity, diabetes, hypertension, or
even kidney diseases. This is the case in this discussion, in which Gabriela, a Latina woman, has type 2
diabetes and hypertension. She has sore knees, which could be due to many things including her weight,
her demanding job, or the amount of exercise that she does.
There are countless barriers that can be preventing Gabriela from succeeding in having a healthy
lifestyle. These can include lack of time, lack of resources like a gym, issues such as anxiety or
depression, or financial struggles. Since Gabriela works at a fast-food restaurant, it is safe to assume that
she does not make a lot of money. Healthy options of foods are expensive now a days, and Gabriela
might not be able to afford it considering she has a child to take care of as well. An article by the
Northeast Georgia health system states that the amount of money that a person earns directly affects
several aspects of life. The neighborhood they live in, the sort of food that they can afford, and whether
they can pay to see the doctor and purchase their medications are all determined by income
(Enikanolaiye & Schleifer, 2022). Gabriela’s income might be a big barrier as to why she might not be
able to achieve a healthier lifestyle.
To aid Gabriela in developing a healthy weight and improve her health, I would first suggest seeing a
doctor. A doctor will do an assessment on her and properly locate the areas in her health that need to
be worked on. A doctor will cooperate with Gabriela and plan with her to improve her health.
Developing a plan will motivate Gabriela to make healthy choices in her food intake, as well as provide
accountability to make progress when an appointment is made for a routine checkup with the doctor. In
addition, a doctor will help her keep her diabetes under control. This is a very crucial aspect of her
health because diabetes can become deadly exceedingly fast. According to an article by abbott.com
stress can cause your blood sugar to rise. Find activities you like that help you relax. Try taking a walk,
listening to your favorite music, or gardening, whatever helps you cope (Gifford, 2018). These are things
that a doctor can propose to Gabriela to do to lower her stress level, since she works in a fast-food
restaurant, which is a stressful job. Mental health directly affects one’s physical health, so making sure
that Gabriela is coping well mentally with the stresses of life will allow her to keep a healthy physical
state.
In conclusion, Gabriela is a Latina mother who has diabetes, hypertension, and is experiencing pain in a
sore knee. The biggest recommendation that I would give Gabriela to accomplish obtaining a healthier
lifestyle is to go to the doctor. The doctor will aid her in managing her diabetes and hypertension, and
they will give her some guidance as to what steps she needs to take in starting a diet of healthier foods.
Gabriela will embark in a difficult journey where she will experience a lot of different barriers such as
lack of time, lack of resources like a gym, issues such as anxiety and depression, and financial struggles.
However, with the right willpower she can successfully carry out her goal.
References:
Gifford, M. (2018). 10 tips for how to manage diabetes. Home.
https://www.abbott.com/corpnewsroom/nutrition-health-and-wellness/10-tips-for-how-to-managediabetes.html
Schleifer, D., & Enikanolaiye, M. I. (2022). Barriers to healthy living – why is it difficult for some?
Northeast Georgia Health System. https://www.nghs.com/2022/07/13/barriers-to-healthy-living-why-isit-difficult-for-some
Tello, M. (2020). Healthy lifestyle: 5 keys to a longer life. Harvard Health.
https://www.health.harvard.edu/blog/healthy-lifestyle-5-keys-to-a-longer-life-2018070514186
1. What strategies could you suggest to Gabriela to attain a healthy weight and improve her health?
I think the first step in order to help Gabriela to improve her status is to help her to be more resilient
and work on self-care. Resilience, defined as the capacity to rebound from adversity, is contingent upon
the interplay of cognitive processes, emotional responses, and dispositional tendencies. The cultivation
of resilience may facilitate the attainment of improved emotional, spiritual, and physical well-being prior
to embarking on the subsequent stage of one’s vocational journey. According to Barry and Sirois, the
cultivation of peacefulness, love, and engagement in activities that promote well-being has the potential
to foster the development of resilience (Hooten and Sapp, 2021).
The BMI of Gabriela is not consider healthy, and might be affecting her emotionally, and physically. The
NHS website (2019) suggests that persons who need to reduce weight drop 0.5–1 kg (1-2 lb) every week.
Many individuals would prefer to lose weight faster than this; it’s important to notice that the default
search suggestion from the web search stated above was “lose weight fast.” (Coutts, 2021).Make a list
of your priorities to keep you motivated and concentrated, whether it’s a future vacation or improved
general health. Then figure out a technique to guarantee that you can use your motivating elements
when faced with temptation. You could wish to leave a motivational note for yourself on the refrigerator
or pantry door, for example . Although you must be accountable for your own actions to lose weight, it
may be helpful to have assistance( “Weight loss: 6 strategies for success, 2021) .
In conclusion the patient must learn healthy ways to lose some weight that can help to alleviate the
pain, also she needs to know ways to cope with her fear and understand that without her health she
won’t be able to work at all. Furthermore, small problems like the ones that she experience can
represent minimum downtime for recovery whereas if she left her knees untreated can develop in more
serious problems.
2. What barriers to a healthy lifestyle do you think Gabriela may have? How would you discuss them
with her?
She might have some self confidence problems, or she might also experience stress related to her job as
working in a restaurant is very stressful. Not only she has a full time job and studies. But she might also
feel bad for not being able to spend more time with her child.
As a main nurse intervention for Gabriela, the nurse must use therapeutic forms of communication to
incentive the patient to find self-motivation in wanting to improve her health for her own sake and her
child’s. By using therapeutic communication the nurse can find the root of the problem for the fear she
experiences related to her misconceptions about her future. Also, by using this intervention she can
build rapport and even make a reference to a nutritionist that can assist her to have a healthy BMI.
Create a therapeutic alliance. Be accessible to your clients so they may discuss and listen. Help the client
become more conscious of their verbal and nonverbal behavior’s. By giving feedback and verifying the
meaning with the client, clarify the significance of the sentiments and behaviors. Recognize your dread
and worry most of all (Tabangcora, 2023).
REFERENCES:
Gartley, C. E. (2021). Job loss and preparing for the future. Retrieved from
Coutts, A. (2021, November 25). The Nurse’s role in providing strategies and advice on weight
management. British Journal of Nursing. https://www.britishjournalofnursing.com/content/weightmanagement/the-nurses-role-in-providing-strategies-and-advice-on-weight-management/
Mayo Foundation for Medical Education and Research. (2021, December 7). 6 proven strategies for
weight-loss success. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/weight-loss/indepth/weight-loss/art-20047752
Tabangcora, I. (2023, July 27). Stress and anxiety: Something we can all relate to. Nurseslabs.
https://nurseslabs.com/stress-and-anxiety/
UTILIZE THIS AS ONE OF YOUR READING RESOURCES:Article: Increasing supervisor savvy around culture, race, and identityDeAngelis, T. (2023, January). Increasing supervisor savvy around culture, race, and identity. Monitor on Psychology. https://www.apa.org/monitor/2023/01/culturally-res…PLEASE OPEN BOTH FILESAPA CITE
The purpose of Collaboration #2 is for you (the learner) to formulate a quantitative PICO(T) question that will guide your literature review and provide the basis of the hypothetical, quantitative nursing research study you will plan throughout the remainder of NS 812 and NS 813.
DIRECTIONS
Review thee examples of qualitative PICO(T) questions.
Craft an initial post in which you:
Draft one (1) quantitative PICO(T) question that addresses a nursing practice problem that you are interested in exploring.
Provide a rationale for using this PICO(T) question to conduct a study that is supported by at least two (2) scholarly sources. Note: Textbooks may not be used as sources in this activity.
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NS 812—Research Design & Methods I
Practicing PICO(T)—Quantitative Examples
EXAMPLES
In military veterans who are enrolled in a baccalaureate
nursing program
(population)
is there difference between perceptions about immigrants to the United States
(intervention or treatment)
compared with the perceptions of baccalaureate nursing students who are
NOT military veterans?
(comparison intervention or treatment)
For critical care nurses who have lived in more than one place
(e.g., city, state, country)
(population)
is there relationship between knowledge about culturally-competent nursing care
(intervention or treatment)
compared with/to critical care nurses who have lived in the same place (i.e.,
cite, state, country) throughout their lives?
(comparison intervention or treatment)
In nurses who work in the intensive care unit (ICU),
(population)
is there relationship between time management mentoring
(intervention or treatment)
compared with/to no time management mentoring
(comparison intervention or treatment)
on on-time medication administration?
(outcome)
Adapted from Melnyk & Fineout-Overholt, 2019
Revised on 12-Jul-21
CLARKSON COLLEGE GRADUATE NURSING DEPARTMENT
NS 812—NURSING RESEARCH DESIGN & METHODS I
COLLABORATION #2:
Quantitative PICO(T) Question Directions + Evaluation Rubric
PURPOSE
The purpose of Collaboration #2 is for you (the learner) to formulate a quantitative PICO(T)
question that will guide your literature review and provide the basis of the hypothetical,
quantitative nursing research study you will plan throughout the remainder of NS 812 and NS
813.
CONNECTIONS
• Successful completion of Collaboration #2 will contribute to your meeting Course
Competencies 3 and 7.
POINTS
36
Collaborations are considered late when EITHER the Initial or Response Post is not made by
the designated deadline.
DIRECTIONS
1. Review the examples of quantitative PICO(T) questions.
2. Craft an initial post in which you:
a. Draft one (1) quantitative PICO(T) question that addresses a nursing practice
problem that you are interested in exploring. (This topic will be the one you plan to
explore via the hypothetical quantitative study you plan throughout the remainder
of NS 812 and through NS 813.)
b. Provide a rationale for conducting this study that is supported by at least two (2)
scholarly sources. Note: Textbooks may not be used as sources in this activity.
3. Respond to at least two (2) classmates to offer constructive feedback to help them clarify,
streamline, or otherwise enhance their questions. Support your post with at least one (1)
scholarly source.
EVALUATION RUBRIC
Criteria
Initial Post—
Quantitative PICO(T)
Question
Initial Post—
Rationale for PICO(T)
Question
Drafted Fall, 2018
Revised 1-Jun-22
4 points
Initial post includes a
full PICO(T) question
2 points
0 points
No PICO(T) question
provided
Clear, concise
rationale provided
for PICO(T) question
Vague rationale
provided for PICO(T)
question
No rationale
provided for PICO(T)
question
CLARKSON COLLEGE GRADUATE NURSING DEPARTMENT
NS 812—NURSING RESEARCH DESIGN & METHODS I
COLLABORATION #2:
Quantitative PICO(T) Question Directions + Evaluation Rubric
Criteria
Scholarly Support for
Initial Post
Feedback to
Classmates
Quality of Feedback
Scholarly Support for
Response Posts
4 points
At least 2 credible
scholarly sources
supported initial post
Feedback provided to
at least two (2)
classmates
Feedback to both
classmates was
constructive and
substantive, and
contributed to the
other students’ work
(6 points)
At least 1 credible
scholarly source
supported each
response post
0 to 2 errors
(10 points)
Use of APA Format &
Mechanics (i.e.,
Spelling, Grammar, &
Punctuation)
TOTAL 36 points
2 points
1 scholarly source
supported initial post
0 points
No scholarly sources
supported initial post
Feedback provided to No feedback was
one (1) classmate
provided to
classmates
Feedback was
No feedback was
inconsistent*
provided to
classmates
No scholarly sources
supported initial
posts
3 to 4 errors
(5 errors)
More than 4 errors
*Feedback to 1 classmate was constructive AND substantive *AND* feedback to second
classmate was NOT constructive and/or substantive *OR* feedback to BOTH classmates was
NOT constructive and/or substantive.
Drafted Fall, 2018
Revised 1-Jun-22
Nurses are faced with situations where legal and ethical considerations are complex and sometimes don’t have a simple or clear solution. Unfortunately, nurses are frequently held accountable in these complex situations, which is why it is important for nurses to understand what they can and can’t do, what they will be accountable for, and what they are responsible for. In this assessment, you will analyze a complex topic from an ethical and legal perspective. You should also analyze its impact on nurses and accountability.
Select 1 of the following topics
Futile care
Whistleblowing
Euthanasia and assisted suicide
Clinical uses for illicit substances (e.g., medical marijuana, MDMA for PTSD)
Research your selected topic.
Analyze a nurse’s legal responsibilities related to your selected topic.
Analyze a nurse’s ethical responsibilities related to your selected topic.
Take a position on the topic and explain your position in detail.
Summarize the steps in the ethical decision-making model you employed and the process used to arrive at your position.
Discuss how your position affects nurses and how nurses can be held accountable in situations related to your selected topic.
Cite at least 3 evidence-based, peer-reviewed sources published within the last 5 years to support your position(s).
Format APA 875-paper
Include an APA-formatted reference list.
Rubric Details Grade
Legal and ethical responsibilities
25% of total grade
Accomplished
The assignment fully analyzed a nurse’s legal and ethical responsibilities related to the selected topic.
90 – 100%
Explanation of position
20% of total grade
Accomplished
The assignment fully explained the chosen position on the topic in detail.
90 – 100%
Decision-making model
25% of total grade
Accomplished
The assignment fully summarized the steps in the ethical decision-making model employed and the process used to arrive at the chosen position.
90 – 100%
Decision-making model
25% of total grade
Accomplished
The assignment fully summarized the steps in the ethical decision-making model employed and the process used to arrive at the chosen position.
Nurse accountability
25% of total grade
Accomplished
The assignment fully described how the chosen position would affect nurses and how nurses could be held accountable in situations related to the topic.
90 – 100%
Communication
3% of total grade
Accomplished
The assignment was concise, with exceptional attention to detail, and was free of errors.
These are the instructions: Submit a Problem-Focused SOAP note here for grading. You must use an actual patient from your clinical practicum. Review the rubric for more information on how your assignment will be graded. Be sure to use the SOAP note template for your program and view the rubric associated with your program for details on how your assignment will be graded.
I attached 2 a template, an example, plus the rubric.
Patient information:
Diagnostic Codes: F25.0 | Schizoaffective disorder, bipolar type
Patient Age: 68 Years
Race Category (NCI Classification): Hispanic
Gender: Male
Medication: List Medication Name, Dosage, Frequency, and Refill.: Risperidone 1mg take 1 tablet by mouth twice a day for psychosis.
Depakote DR 500mg take 1 tablet by mouth twice a day for mood.
Trazadone 100mg take 1 tablet by mouth at bedtime for sleep.
Vistaril 50 mg take one tablet by mouth every 8 hours for anxiety.
Unformatted Attachment Preview
PMHNP– SOAP Note Rubric
Criteria
S
(Subjective)
O
(Objective)
A
(Assessment)
Ratings
10 points
Accomplished
6 points
Satisfactory
4 points
Needs Improvement
0 points
Unsatisfactory
Symptom analysis is
well organized in a
SOAP format, with
C/C, Past Psychiatric
Hx, Social Hx, and
other pertinent past
and current
diagnostic details.
Symptom analysis is
well organized in a
SOAP format, with
C/C, Past Psychiatric
Hx, Social Hx, and
other pertinent past
and current
diagnostic details.
Symptom analysis is
not well organized or
presented in a varied
format. Required data
is missing.
Symptom analysis is
inadequate and is
not organized.
Objective or other
data is mixed into
the subjective data.
SOAP Note is
complete, concise,
relevant with no
extraneous data.
10 points
Accomplished
Some extraneous
data present with 1
minor data point
missing.
6 points
Satisfactory
Mental Status Exam is
complete, concise,
well-organized, and
well-written. Includes
pertinent psychiatric
information.
Organized by MSE list
format.
Mental Status Exam
is partially
incomplete,
organized, and
satisfactorily written.
Includes pertinent
psychiatric
information with
additional extraneous
information included.
Important data is
missing.
4 points
Needs Improvement
0 points
Unsatisfactory
Mental Status Exam is
incomplete, loosely
organized with
improvements
required. Relevant
psychiatric information
is omitted.
Mental Status Exam
is absent,
disorganized in
presentation,
adheres to no
specific format, or
grossly omits
relevant or pertinent
psychiatric
information.
No extraneous
information is
included.
Somewhat organized
in MSE list format.
10 points
Accomplished
6 points
Satisfactory
4 points
Needs Improvement
0 points
Unsatisfactory
Diagnosis and
Differential Dx are
correct with DSM-5
code(s) and supported
by subjective and
objective data.
Diagnosis and
Differential Dx are
correct with DSM-5
code(s) and mostly
supported by
subjective and
objective data.
Diagnosis and
Differential Dx are
correct with DSM-5
code(s) and mostly
supported by
subjective and
objective data.
Missing at least one
(1) pertinent
differential diagnosis
not listed according
to subjective and
objective data.
Working diagnosis is
correct.
All diagnoses
(working diagnosis
and differential
diagnoses) are
incorrect or is
missing based on
the subjective and
objective data
presented.
Includes: 1 working
Dx and 2 Differential
Dx.
P
(Plan)
There is too much
extraneous data
present or 2-3 minor
data points are
missing.
10 points
Accomplished
6 points
Satisfactory
Missing up to two (2)
pertinent differential
diagnoses based on
subjective and
objective data
presented. Or
differential diagnoses
are adequate with an
incorrect working
diagnosis.
4 points
Needs Improvement
Plan is well-organized,
complete, evidence-
Plan is organized,
complete, evidencebased and patient-
Plan is less organized,
is not based on
evidence. Fails to
Pts
10
pts
0 points
Unsatisfactory
Plan is disorganized,
absent, or is missing
10
pts
10
pts
10
pts
based, and patientcentric. Fully
addresses each
diagnosis and is
individualized to the
specific patient.
*Plan requirements:
prescribed
medications, if any;
explanation of offlabel medication use,
if prescribed; risks
and benefits of
medications
identified; therapy
recommendations;
patient education;
referral/follow-up;
and health
maintenance.
Total
centric. Fully
addresses each
diagnosis and is
individualized to the
specific patient.
Plan is missing 1-2 of
the required items.
address each diagnosis
sufficiently or is not
individualized or
patient-centric
all the required
items.
Plan is missing more
than 2 of the required
items.
40
pts
PMHNP Problem-Focused SOAP Note
(Use this template for this Assignment)
Demographic Data
o
o
Patient age and Patient’s gender identity
MUST BE HIPAA compliant.
Subjective
Chief Complaint (CC):
o
Place the patient’s CC complaint in Quotes
History of Present Illness (HPI):
o Reason for an appointment today.
o The events that led to hospitalization or clinic visits today.
o Include symptoms, relieving factors, and past compliance or noncompliance with medications
o Any adverse effects from past medication use
o Sleep patterns – number of hours of sleep per day, early wakefulness, not
being able to initiate sleep, not able to stay asleep, etc.
o Suicide or homicide thoughts present
o Any self-care or Activity of Daily Living (ADL) such as eating, drinking
liquids, self-care deficits or issues noted?
o Presence/description of psychosis (if psychosis, command or noncommand)
Past Psychiatric History (PSH):
o Past psychiatric diagnoses
o Past hospitalizations
o Past psychiatric medications use
o Any non-compliance issues in the past?
o Any meds that didn’t work for this patient?
Family History of Psychiatric Conditions or Diagnoses:
o Mother/father, siblings, grandparents, or direct relatives
Social History:
o Include nutrition, exercise, substance use (details of use), sexual
history/preference, occupation (type), highest school achievement,
financial problems, legal issues, children, history of personal abuse
(including sexual, emotional, or physical).
Allergies:
o
to medications, foods, chemicals, and other.
Review of Systems (ROS) (Physical Complaints):
o Any physical complaints by body system? (Respiratory, Cardiac, Renal, etc.)
Objective
Mental Status Exam:
o This is not physical exam.
o Mini-Mental Status Exam (MMSE) – Full exam
Assessment (Diagnosis)
Differentials
o
o
o
Two (2) differential diagnoses with ICD-10 codes.
Must include rationale using DSM-5 Criteria (Required)
Why didn’t you pick these as a major diagnosis?
Working Diagnosis
o
o
Final or working diagnosis (1), with ICD-10 code.
Must include rationale using DSM-5 criteria required – Which symptoms/signs
in the DSM-5 the patient matches mostly)
Plan
Treatment Plan (Tx Plan):
o Pharmacologic: Include full information for each medication(s) prescribed
o Refill Provided: Include full information for each medication(s) refilled
Patient Education:
o including specific medication teaching points
o Was risk versus benefit of current treatment plan addressed for meds or
treatment
o Risk versus benefit of non-FDA approved for working diagnosis – Off-label use
of medication education to patient addressed?
Prognosis:
o Make Decision for prognosis: Good, Fair, Poor
o Provide brief statement lending support for or against the decided prognosis.
Therapy Recommendations:
o Type(s) of therapy recommended.
Referral/Follow-up:
o Did you recommend follow-up with Psychiatrist, PCP, or other specialist or
healthcare professionals?
o When is the subsequent follow-up?
o Include rationale for the F/U recommendation or referral.
Reference(s):
o
o
o
Include American Psychological Association (APA) formatted references.
Include a reference from the American Psychiatric Association’s Diagnostic
and Statistical Manual of Mental Health Disorders (DSM-5) or the
accompanying Desk Reference of Diagnostic Criteria from DSM-5.
Minimum 2 references are required.
Need 2 peer responses. Initial discussion post: After reading chapters 14 ,answer the next question. Discuss the characteristics and requirements that research tools should have on quantitative research to give validity to the study. Give some examples
Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.
Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.
In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.
Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
Select a specific personality or paraphilic disorder from the DSM-5-TR to use for this Assignment.
Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
In 2–3 pages:
Explain the controversy that surrounds your selected disorder.
Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
Gabriela is a 32-year-old Latino woman with type 2 diabetes and hypertension who is working full time at a fast-food restaurant. She has a BMI of 32. Gabriela is studying to be a cosmetologist and lives with her mother, who helps out with child care and housekeeping. Gabriela’s knees are very sore and she is in the clinic to have them examined. She is very fearful that she will lose her job if she cannot stand for long hours. 1.What strategies could you suggest to Gabriela to attain a healthy weight and improve her health?2.What barriers to a healthy lifestyle do you think Gabriela may have? How would you discuss them with her?
In this project, you will demonstrate your mastery of the following course outcomes:
Analyze the various components of wellness for investigating the influence of wellness on one’s discipline of study or chosen profession
Integrate interdisciplinary approaches for determining the impact that contemporary issues in healthcare systems have on modern society
Describe contemporary issues surrounding wellness for their relevance to and impact on the individual and society by employing appropriate research strategies
Recommend potential applications of strategies for monitoring and enhancing personal and public wellness
Articulate informed viewpoints on contemporary issues surrounding wellness issues through effective communication skills
Assess cultural and social attitudes, choices, and behaviors for their implications to lifelong health and wellness through the incorporation of diverse perspectives and viewpoints informed by relevant literature and peer experiences
Overview
This course explores wellness and its impact on the world around us. Wellness influences society, and society influences wellness, creating a feedback loop between them. You will critically analyze a specific issue or event in wellness and how it impacts individuals and society using the four general education lenses: history, humanities, natural and applied sciences, and social science. From this enhanced understanding, you will be equipped to draw connections between wellness, self, and engagement with your community. You will demonstrate your ability to think critically, investigate, and communicate clearly. These skills are often necessary to achieve personal and professional goals across many disciplines.
Directions
For this project, you will write a 10-page paper that examines your chosen research topic and how it affects individuals and society. In the paper, you will describe your topic, present a thesis statement, perform a critical analysis, and reflect on how your topic informs your personal life and experience. You will demonstrate your ability to think critically, investigate, and communicate clearly.
Specifically, you must address the following rubric criteria:
Evidence: You will use evidence to support your analysis throughout the project.
Integrate reliable evidence from varied sources throughout your paper to support your analysis. Use at least two resources from the module resources sections of this course and two resources that you find through your own research using the Shapiro Library.
It is important to draw from a more diverse pool of perspectives from varied sources to support the analysis, which is different from the Citations and Attributions rubric criterion.
Reliable evidence from varied sources should be interwoven throughout the paper itself. Citing and attributing sources will be represented as APA in-text citations and a reference list at the end of your work.
You will be evaluated on both criteria.
Topic Description: In this section, you will identify and discuss the factors that shape your thesis statement.
Describe a social or global issue or event that is related to issues of wellness. Include information such as the origin of the issue and what it is about.
Describe a population significant to your topic. Include information such as demographics, cultural practices, social identity, and key challenges.
Assess how society impacts the chosen issue or event.
Explain your choice of general education interdisciplinary lens for analyzing your topic.
Construct a thesis statement that combines your topic, population, cultural situation, and choice of general education interdisciplinary lens.
Critical Analysis: In this section, you will analyze your topic using one of the general education lenses and recommend strategies for using this kind of analysis to meet your personal and professional goals.
Analyze your chosen issue or event through one of the general education interdisciplinary lenses to determine its impact on various institutions.
Analyze how social practices have been shaped by issues and events in wellness in modern culture.
Describe at least one specific element that could benefit from change within your topic.
Explain how at least one potential obstacle could interfere with the population’s engagement with your topic.
Assess at least two significant factors that could impact your topic, such as biases, beliefs, assumptions, and/or values.
Assess the benefits and challenges of addressing issues in wellness.
Recommend strategies for using this kind of critical analysis for meeting your personal and professional goals.
What might this look like in your everyday life? Consider how wellness can be used to address the day-to-day responsibilities or questions faced by practitioners in your field or discipline.
Reflection: In this section, you will describe how using critical analysis tools influences your personal experience, your field of study or profession, how you interact with others.
Describe how critically analyzing your issue/event in wellness has informed your individual framework of perception.
Consider how your analysis has altered the way you perceive the world.
Describe how examining your bias has altered the way you perceive the world.
Reflect on your own bias and then consider how an awareness of one’s bias can change our perceptions.
Explain how critically analyzing wellness can influence your field of study or profession.
How can studying wellness inform your understanding of the next big topic of study in your field or profession?
Explain at least one way in which your analysis might have been different if you had used one of the other general education lenses to analyze your topic.
Explain how analyzing wellness can help interactions with people with a different viewpoint, culture, or perspective.
What to Submit
To complete this project, you must submit a Word document of 10 pages in length (plus a reference page) with 12-point Times New Roman font, double spacing, and one-inch margins. Use at least two resources from course materials and two resources from the library. Sources should be cited according to APA style. Consult the Shapiro Library APA Style Guide for more information on citations.
Needs editing and adding details paper is started.
Health Promotion Plan
Choose a specific health concern or health need as the focus of your hypothetical health promotion plan. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.
Sudden Infant Death (SID).
Create a scenario as if this project was being completed face-to-face.
Identify the chosen population and include demographic data (location, lifestyle, age, race, ethnicity, gender, marital status, income, education, employment).
Describe in detail the characteristics of your chosen hypothetical individual or group for this activity and how they are relevant to this targeted population.
Discuss why your chosen population is predisposed to this health concern or health need and why they can benefit from a health promotion educational plan.
Based on the health concern for your hypothetical individual or group, discuss what you would include in the development of a sociogram. Take into consideration possible social, economic, cultural, genetic, and/or lifestyle behaviors that may have an impact on health as you develop your educational plan in your first assessment. You will take this information into consideration when you develop your educational plan in your fourth assessment.
Identify their potential learning needs. Collaborate with the individual or group on SMART goals that will be used to evaluate the educational session (Assessment 4).
Identify the individual or group’s current behaviors and outline clear expectations for this educational session and offer suggestions for how the individual or group needs can be met.
Health promotion goals need to be clear, measurable, and appropriate for this activity. Consider goals that will foster behavior changes and lead to the desired outcomes.
Document Format and Length
Your health promotion plan should be 3-4 pages in length.
Supporting Evidence
Support your health promotion plan with peer-reviewed articles, course study resources, and Healthy People 2030 resources. Cite at least three credible sources published within the past five years, using APA format.
Graded Requirements
The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Analyze the health concern that is the focus of your health promotion plan.
Consider underlying assumptions and points of uncertainty in your analysis.
Explain why a health concern is important for health promotion within a specific population.
Examine current population health data.
Consider the factors that contribute to health, health disparities, and access to services.
Explain the importance of establishing agreed-upon health goals in collaboration with hypothetical participants.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Write with a specific purpose and audience in mind.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
attatched is started paper
Unformatted Attachment Preview
Introduction
Sudden infant death (SID) is a leading cause of death among infants under the age of one year in
the United States and other industrialized countries. The Centers for Disease Control and
Prevention report that in 2018, there were 3,600 reported cases of Sudden Infant Death
Syndrome (SIDS) in the United States; these numbers demonstrate the urgency of creating health
promotion plans aimed at reducing the rates of SIDS. This essay will discuss a health promotion
plan for SIDS prevention, including the strategies used, the populations targeted, and the
outcomes expected.
Strategies
The health promotion plan will utilize four strategies, including education, counseling,
immunization, and legislation. Education will involve providing fact sheets and brochures that
discuss the risk factors for SIDS, the signs and symptoms of SIDS, and recommended infant care
practices. Counseling may be provided to mothers through prenatal and postpartum visits, as
well as through nurse visits during home visits, community support groups, and telephone lines.
It is important to include fathers and other family members in these conversations as well, since
they are important in providing infant care and support. Immunization will also be a focus of the
health promotion plan, as certain vaccinations are known to reduce the risk of SIDS. Finally,
legislation can be used to ensure that parents are following recommended infant care practices.
This could include banning baby cribs with unsafe mattress designs, implementing legislation
that requires babies sleep in their parents bedrooms, or mandating certain kinds of
immunizations.
Populations Affected
The primary populations targeted in this health promotion plan will be pregnant women, female
and male caregivers of infants, and their extended family members. Special attention should be
given to mothers at risk of SIDS, such as those who use tobacco, alcohol, or recreational drugs,
as well as those who are under stress or have depression. For those mothers who are pregnant for
the first time, special attention should be given to ensure they understand the risk factors and
recommended infant care practices and receive the necessary immunizations. It is also important
to reach out to those who may be at risk due to cultural beliefs or lack of access to health care
services.
Outcomes
The expected outcome for this health promotion plan is a reduction in the number of SIDS cases
and an increase in health literacy on SIDS among targeted populations. Additionally, it is
expected that more infants will receive proper immunizations to reduce their risk of SIDS. It is
also hoped that with improved education and counseling on infant care, more infants will be put
to sleep in a safe manner, decreasing their risk of SIDS. Ultimately, these outcomes contribute to
better overall health outcomes for infants in the United States.
Conclusion
Sudden Infant Death Syndrome is a significant cause of infant mortality, and health promotion
efforts are a crucial tool for reducing SIDS risk. This health promotion plan – which includes
four strategies, three populations, and three outcomes – aims to reduce SIDS cases and improve
infant health outcomes. By investing in education
Review the Course Outcomes for this assignment, which are listed above.For this assignment you will assess the primary ethical concerns involving research with human subjects- voluntary participation, informed consent, physical and mental harm, confidentiality, privacy and withholding treatment.For each concern, identify if it can be a concern for your study and how it would be minimized. State any methods or additional precautions that would be implemented. If it is not an issue, state that.In a summary paragraph, defend the study in terms of the risk/benefit ratio.The paper should be no more than 3 pages in length.
Unformatted Attachment Preview
Considering the Ethical Considerations of Your
Design
Assignment
Purpose
Anticipating potential ethical concerns and developing procedures to mitigate these are
an important part of the development a research plan. This assignment will provide the
opportunity to think about ethical implications of a research study and develop plans to
mitigate those risks.
Course Outcomes
This assignment provides documentation of student ability to meet the following course
outcomes:
•
•
•
CO 1: Demonstrate proficiency in the use of selected research methods and tools.
CO 6: Examine ethical issues related to research.
CO 8: Judge the usefulness of various research approaches: content analysis,
survey and field research, quantitative and qualitative analysis, and case studies.
Total Points Possible
This assignment is worth 100 points.
Due Date
Please see the due dates below. The Late Assignment Policy applies to this assignment.
Requirements and Guidelines
1. Review the Course Outcomes for this assignment, which are listed above.
2. For this assignment you will assess the primary ethical concerns involving
research with human subjects- voluntary participation, informed consent,
physical and mental harm, confidentiality, privacy and withholding treatment.
3. For each concern, identify if it can be a concern for your study and how it would
be minimized. State any methods or additional precautions that would be
implemented. If it is not an issue, state that.
4. In a summary paragraph, defend the study in terms of the risk/benefit ratio.
5. The paper should be no more than 3 pages in length.
Grading Criteria
Your paper will be graded based on following criteria:
•
•
•
•
•
Content
Organization and Coherence of Ideas
Support
Style and Mechanics
Page Length Requirements
Detailed grading rubric can be found below.
Assignment Rubric
Assignment Rubric
Criteria
This criterion is
linked to a Learning
OutcomeContent
Ratings
25 pts
Highest Level
of
performance
Excellent
response to
assignment;
response is
well developed
and
communicated;
presents
information
that is factually
correct,
reflective, and
substantive;
demonstrates
sophistication
of thought
behind central
idea; shows
evidence of
having read,
reflected on,
and applied
course
readings and
materials;
incorporates
content from
text and class
discussions.
23 pts
Very Good
or High
Level of
Performance
Well rounded
response
appropriate
to
assignment,
but may have
minor lapses
in
development;
clearly states
response and
begins to
acknowledge
the central
idea and
main details;
presents
information
that is
factually
correct;
shows
evidence of
having read
and reflected
on course
readings and
materials;
shows
willingness
to
incorporate
content
discussed in
text and class
discussions.
19 pts
Acceptable
Level of
Performance
Does not
appropriately
respond to
assignment
prompt; may
provide only
a basic
summary of
one or more
concepts;
does not
include a
clear central
idea; thesis
may be too
vague to be
developed
effectively;
shows little
evidence of
understanding
course
materials;
shows no or
only slight
willingness to
incorporate
content
discussed in
text and or
class
discussions.
Pts
18 pts
Failing
Level of
Performance
18-0 Points:
Does not
properly
respond to
assignment
prompt;
presents
information
that is offtopic,
factually
incorrect, or
irrelevant;
lacks a thesis
or central
idea; shows
no evidence
of having
read or
interacted
with course
materials;
shows no
willingness
to
incorporate
content
discussed in
text and or
class
discussions.
25 pt
s
Assignment Rubric
Criteria
This criterion is
linked to a Learning
OutcomeOrganizatio
n & Coherence of
Ideas
Ratings
25 pts
Highest
Level of
performanc
e
Logical
structure
appropriate
to paper’s
subject,
purpose, and
audience;
substantive
introduction
including
clear thesis
statement;
paper is
structured so
that ideas
logically
flow and
build
throughout;
fully
developed
paragraphs;
effective
transitions
between
paragraphs;
logical
conclusion
that clearly
summarizes
ideas and
adds final
thoughts
and/or
reflections.
23 pts
Very Good
or High
Level of
Performance
Shows logical
progression of
ideas;
includes
introduction
and thesis
statement, but
they may be
unclear or not
fully
developed;
paragraphs are
complete
thoughts;
some
transitions
between
paragraphs;
conclusion is
present but
may not
provide a
comprehensiv
e summary of
ideas.
19 pts
Acceptable
Level of
Performance
Lacking
internal
paragraph
coherence;
underdeveloped
introduction
and thesis
statement;
organization of
ideas is difficult
to understand;
paragraphs
need further
development;
few transitions
between
paragraphs;
conclusion is
too brief and/or
underdeveloped
.
Pts
18 pts
Failing
Level of
Performanc
e
18-0 Points:
Lacks
coherence;
no clear
introduction
or thesis
statement;
unclear
organization
throughout;
paragraphs
are
disjointed;
no
transitions
between
paragraphs;
conclusion is
weak or
missing.
25 pt
s
Assignment Rubric
Criteria
This criterion is
linked to a Learning
OutcomeSupport
Ratings
17 pts
Highest
Level of
performance
Uses
evidence
appropriately
and
effectively;
makes
several
references to
course
material (e.g.,
readings,
lecture,
videos, audio
clips,
scripture,
etc.);
provides
sufficient
evidence and
explanation
to support
main ideas;
documents
sources
appropriately.
15 pts
Very Good
or High
Level of
Performance
Offers
relevant
reasons and
evidence to
support ideas;
makes
adequate
references to
course
material;
begins to
explain
connections
between
evidence and
main points;
documents
most sources
appropriately.
13 pts
Acceptable
Level of
Performance
Uses
generalizations
to support
ideas; makes
few or
inadequate
references to
course
material; may
use examples,
but they are
obvious or
irrelevant;
often depends
on
unsupported
opinion or
personal
experience;
documents
few or no
sources
appropriately.
Pts
11 pts
Failing
Level of
Performance
Uses
irrelevant
details or
lacks
supporting
evidence
entirely;
makes little
or no
reference to
course
material.
17 pt
s
Assignment Rubric
Criteria
This criterion is
linked to a Learning
OutcomeStyle &
Mechanics
This criterion is
linked to a Learning
OutcomePage
Length Requirements
Total Points: 100
Ratings
Pts
23 pts
Highest
Level of
performance
Style &
Mechanics
23 Points
Well
organized;
may contain
fewer than
three errors;
errors do not
impede
meaning;
uses
professional
and scholarly
language
throughout;
exemplifies
collegiate
level writing;
adheres to
proper APA
style
requirements.
19 pts
Very Good
or High
Level of
Performance
Fairly well
organized;
contains
fewer than
five errors;
errors do not
impede
meaning;
uses
professional
and scholarly
language
throughout;
meets most
APA style
requirements.
18 pts
Acceptable
Level of
Performance
Somewhat
disorganized;
contains
more than
five errors;
errors may
confound
meaning;
lacks
professional
or scholarly
language;
may meet
some APA
style
requirements.
15 pts
Failing Level
of
Performance
Disorganized;
contains
many errors
that confound
meaning;
language is
not at a
collegiate
level; does
not adhere to
APA style
requirements.
10 pts
Highest
Level of
performance
Adheres to
all word
count or page
length
requirements.
8 pts
Very Good
or High
Level of
Performance
Exceeds half
and almost
meets
minimum
word count
or page
length
requirement.
7 pts
Acceptable
Level of
Performance
Completes
approximately
half of
required word
count or page
length for
assignment.
5 pts
Failing
Level of
Performance
Completes
less than half
of required
word count
or page
length for
assignment.
23 pt
s
10 pt
s
Prior to beginning this assignment, read Chapters 6 and 7 from the course textbook, the Educational and Community-Based Programs, What Is Hospice?, What Is Palliative Care?, What Are Palliative Care and Hospice Care?, and What Is End-of-Life Care? web pages, and this week’s Instructor Guidance.
For this assignment, you will prepare a PowerPoint presentation with detailed speaker’s notes that is written from the perspective of being a practice manager for a community health center within a safety net hospital. Recall from HCA205 that a safety net hospital is one that provides care for patients regardless of their insurance status or ability to pay. The federal government provides subsidies to safety net hospitals to help care for non-paying patients.
The goal of this presentation is to prepare an in-service training for clinic staff members to fully understand the challenges faced by cancer or HIV/AIDS patients as they near the end-stage of their disease along with support options for patients and caregivers.
You may choose to create this assignment covering patients with end-stage cancer or end-stage HIV/AIDS. Once you have chosen the disease focus, choose the patient’s age range from one of the following:
Childhood/Adolescence: 0–18 years
Adult: 19–64 years
Elderly: 65+ years
Introduction:
Begin your presentation by including a title slide that includes the following:
Title of the presentation
Student name
Course name and number
Instructor name
Date submitted
Next, create an overview slide that briefly describes the required components covered within the presentation. Add bulleted points for each of the topics covered. Briefly describe each bulleted point in the speaker’s notes section. It is also recommended that you review the PowerPoint Instructions Handout as guidance for properly building this presentation. See the bullet points and speaker’s notes information below. The remaining slides will address the content of the presentation and the references.
The content must address the following required components:
Identify the disease you chose. Include a brief description of the disease itself.
What is the disease (e.g., lung cancer, colon cancer, breast cancer, prostate cancer, leukemia, HIV, AIDS, etc.)?
Explain the following changes that can occur due to the disease:
Biological
Psychological
Social
Explain Western Medicine and Complementary and Alternative Medicine (CAM) treatment options available for the patient.
Explain the way treatment options affect the patient and caregivers based on the following factors:
Physical toll
Emotional toll
Social toll (changes in social interactions)
Financial toll (socioeconomic status)
Based on the age-range chosen, discuss the patient’s perception related to the disease on the following factors:
Thoughts, beliefs, and fears that may be held by the patient.
The role culture (race/ethnicity, religion/spirituality) plays in quality of life as the disease progresses.
Why is it important for health care workers to understand these perspectives?
Discuss biases and stigmas associated with the disease.
Identify where those biases and stigmas may present within micro- and meso-level interactions (e.g., family, friends, colleagues, medical providers, etc.).
Analyze the needs of a person and their caregivers facing the end-stage of the disease.
What changes need to occur in the home to support the patient and the caregiver(s)?
What services are needed to assist in the care and management of the home?
What are the emotional needs of the people within the micro level? How will they be addressed?
What other types of health care providers may be enlisted to support the patient’s quality of life?
Research community-based programs that can possibly meet the needs of those receiving palliative, Hospice, and/or end-of-life care.
Discuss the availability of the services you identified within your community.
Identify costs and payment methods for the services.
How will the family/caregivers be burdened by enlisting additional services?
Discuss the rationale behind collaborative efforts in health care.
Summary
Explain your rationale as to why the information in this presentation is important for the staff to know.
Explain why this information is important to the patient, caregivers, and family to know as they navigate the health care system and community resources.
References
Creating the Final Presentation
The Final Presentation must:
Must be 20 to 22 slides in length (not including title and references slides) with speaker’s notes for all content slides, and formatted according to APA style as outlined in the Writing Center’s How to Make a PowerPoint Presentation.
See the Citing Within Your Paper and Formatting Your References Listresources in the Writing Center for APA guidelines.
Consider these help tools:
PowerPoint Best Practices
Don McMillan: Life After Death by PowerPoint (click on the following links to view theaccessibility statement or theprivacy policy)
Wikimedia Commons can also help you explore creative commons images (privacy policy)
Use at least five scholarly or credible sources (at least two should be from the University Library).
The Scholarly, Peer Reviewed, and Other Credible Sources table offers additional guidance on appropriate source types. You may also want to review What Is CRAAP? A Guide to Evaluating Web Sources. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Watch the following video case study.
For this discussion question, please discuss:
What comes next for this family?
Identify the issue you would want to focus on for this family.
Then discuss what your recommendation would be and why you would take this approach.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
The clinical quality problem that needs more attention in healthcare with continuous improvement and monitoring is CLABSI. This is a major patient safety issue as this catheter has access to the major vein of the heart, which can cause serious problems. CDC states that “A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line” (2011). CLABSI is usually an indicator of the ICU’s quality of care. However, “there have been thousands of deaths each year and billions of dollars in added costs in the U.S. healthcare system, but the infections are preventable” according to the CDC (2011). Therefore, we need improvement and monitoring of people who have a central line in them. We can reduce the rate of CLABSI by performing safe/sterile central insertion, staff education, compliance with hygiene, and timely removal of the central venous catheter (CVC). A quasi-experimental study can help measure monitoring effectiveness using a good infection control team and continuous feedback about performance indicators that reduce CLABSI rates. This study compares the selected beds in various wards, including the ICU, measuring the type of infection, the type of intervention, written policies and procedures, and adherence to central venous catheter care (CVC) to measure the reduction rate in the CLABSI quality rate. “Quasi-experimental designs are used to test whether a treatment or intervention affects patient outcomes” (LoBiondo-Wood & Haber, 2022, p.164). The strength of this study is that it uses only experiments to provide high-level evidence without randomization, it helps follow the ethical concern when choosing participants. However, it does not use a randomized trial, which limits the study’s ability to make interventions and achieve the outcome. This is what LoBiondo-Wood & Haber said about the quasi-experimental study’s strengths and weaknesses: “Researchers turn to quasi-experimental designs to test cause-and-effect relationships because experimental designs may be impractical or unethical. Quasi-experiments may lack the randomization and/or the comparison group characteristics of true experiments (2022, p.187). Quasi-experimental study design in CLABSI monitors the behavioral parameters with outcomes indicators, analyzes the benefits of using an infection control program, and finds which strategic plan is significant to promote long-term effects using evidence-based practice for infection prevention.
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2# student
For my clinical quality problem, I am focusing on a hospital-acquired infection (HAI). The hospital-acquired infection that I am focusing on is called a surgical site infections, or also known as a SSI. A patient can acquire a SSI in the surgical incision site, with the infection being superficial, which involves only the skin, or they can also involve tissues under the skin and organs. If it were to involve anything under the skin or organs that would be considered a more serious infection that could possibly affect the patient systemically. To improve the ongoing problem of surgical site infections in the healthcare system, I would apply an experimental design for quality improvement instead of the quasi-experimental design. I chose the experimental design for quality improvement because, as it states in the online e-book “Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice”, “the experimental design is considered the gold standard for providing information about cause-and-effect relationships” (p.g 176). The experimental design also has many strengths that swayed my decision in choosing that type of experiment. The strengths include randomization, control, and manipulation. When talking about randomization in a study, this refers to having the participants be put into the experimental or controlled group at random. The control portion refers to the stipulations of all of the portions in an experiment remaining constant throughout. The manipulation portion refers to changing or doing something different to the independent variable. All of these strengths help a study reduce the error bias. In the experimental design I did not find ay weaknesses, that is why it is the better option for my clinical quality problem of surgical site infections.
In your rebuttals, argue against the position they have taken. Provide evidence in your rebuttals- why do you oppose their viewpoint?
You can choose a text response. Do not create new thread. Go into a thread and respond to the video by clicking Reply.
No personal attacks or name calling. Add emojis if needed.
Remember that tone comes across differently online and in text.
Do not use all CAPS, and remember that the person’s stance may not be their personal views.
Argue the evidence, not the person.
Don’t forget to respond to comments on your own videos. (Comments will be provided in the order that peers start comment)
Review the board and reply to students that do not have rebuttals yet. It is your job to keep your peers engaged and the debate lively with rebuttals!
Peer 1 Dahlia
Peer 2 Acosta
Peer 3: Hermes. Please find script below.
presenting the ethics of drug pricing.0:03
Why should drug companies should not charge whatever they want?0:12
In the. The U.S. pharmaceutical companies can set the prices of drugs, whatever they believe will be profitable and the market will bear.0:18
So nations like Australia and Germany utilize value based prices on making their drugs more valuable and cheaper for patients.0:29
So I do not permit drug companies to chart what they want because of ethical and societal and economic reasons.0:39
There’s a rationale for our stance behind that so that our ethical principles, economic considerations and societal implications.0:52
Well, healthcare is not a privilege because it is a fundamental right.1:05
There should be justice and fairness in prices. So having a fair price ensures that the cost of drugs is justifiable and reasonable,1:09
and it isn’t ethical for drug entities to set prices that focus on exploiting suffering patients.1:18
My stance advocates for justice and fairness in drug pricing.1:25
The process should be controlled because of healthcare budgets or health care1:32
systems incur significant costs as a result of expensive pharmaceuticals.1:35
The price prices should be controlled to avoid the monopoly power of pharmaceutical companies.1:40
And, you know, certain lifesaving medications are within the total control of those pharmaceutical companies.1:46
And when a business has complete control over a center, certain good or service, it is unrestricted in its ability to raise prices.1:53
Societal implications. We can mention that, you know, high drug prices have negative effects on public health.2:07
When people cannot afford medications, they may decide against seeking treatment or delay, seek any longer, which can harm public health.2:17
And if illnesses are not addressed, they may worsen impose greater health risk to everyone in society.2:27
Um, so we can mention that the United Nations in 1948, um, when.2:38
They created the Universal Declaration of Human Rights.2:46
It contained the idea that access to health care should be regarded as a fundamental2:54
right and everyone has the right to a reasonable quality of life in good health,3:00
including access to medical treatment.3:07
On equity and justice. Drug prices should be reasonable, and they should not discriminate against people based on their income or place of origin.3:12
There is some monopoly power.3:25
So due to their patents and exclusivity rights, several pharmaceutical companies,3:29
they can set prices without being concerned about competition from other companies thanks to the monopoly strength in.3:34
Lack of this competition leads to higher prices.3:44
So the high cost of pharmaceutical creates a significant financial problem.3:49
There are also some health disparities where vulnerable populations are disproportionately affected.3:57
The impact of pharmaceuticals being expensive and out of reach of people who are vulnerable and disadvantaged.4:05
Such as those who are low income or members of minority groups is greatest.4:15
So this difference have the greatest detrimental effect on them.4:21
And. Thus preventing them from receiving necessary medical care.4:25
There is also a negative public health outcome.4:34
So delay or foregone treatment due to cost.4:38
Patients who cannot afford expensive medications may decide not to receive4:44
therapy in resource decisions may worsen on which makes life more difficult.4:48
And it raises the cost of health care in the long run.4:57
It increases disease,5:03
transmission and morbidity where the spread of diseases and the number of sick people can increase when people cannot access the necessary therapies.5:04
And in consequence, communities may become less healthy as.5:14
As a result. And some theories supporting the position.5:22
So in this section, we shall discuss the moral principle that supports our conviction that medication5:30
firms should not be allowed to charge exorbitant prices without limitations.5:35
We will examine rules, theories of utilitarianism and justice.5:42
So on Rawls Theory of Justice, according to this theory.5:52
Fair resource distribution is crucial for society.6:03
An equitable society is one where inequalities are accepted only if they benefit the least fortunate.6:08
This notion contends that regardless, though, regardless of financial circumstances, everyone should have access to necessary medications.6:15
The goal of roles theory is to eliminate disparities in access to health care.6:26
It is unjust for everyone to have equal access to pharmaceuticals due to high prices, which is against the principle of justice and fairness.6:33
Utilitarianism.6:47
Well, we can mention that, um, according to the utilitarian ethical theory, the proposition is the one that would benefit society as a whole.6:50
It makes sense to support reasonable drug prices from a perspective that prioritizes serving society.7:01
The international drug price comparisons we can see on.7:15
And the table that the United States typically charges substantially higher prices for medicine is done.7:22
Other industrialized nations, according to to the table.7:29
This significant discrepancy highlights the need for change and provides clear evidence.7:37
There are also some economic studies that have demonstrated that it is more difficult for7:45
people to access the health care they require when medicine prices are excessively high.7:53
These may result in treatment delays and detrimental health effects.8:00
There are also some patient stories were real life examples of individuals.8:13
Explain. Struggling. Um. You know, the struggle.8:23
Um. To afford medication. In conclusion, drug companies should not be allowed to set prices without regulation.8:27
Understands is supported because of the economics, society and ethic.9:53
Rational people have the right to access quality health care.9:58
While companies should maintain the principle of justice and fairness.10:03
And the prices of drugs should be linked to the benefits.
I’m going to talk. If all hospitals should be for non profit in this location.0:17
I am against that. Whatever for profit or nonprofit hospital.0:26
Hospitals are institutions in charge of that community’s welfare, and by providing medical care and people must have choices of money.0:33
Most U.S. hospitals are nonprofit institutions.0:45
However, we can deny that for profit hospitals provide many benefits that might not be found in nonprofit hospitals.0:49
Hearing this feature, you can get an idea of how many hospitals.1:02
Ah, for a nonprofit. How many for profit?1:08
And the number government of operate a hospitals.1:12
One of the reasons they are against nonprofit hospitals.1:20
Number one, how expensive? Percocet costing more money to operate, often fewer medical specialties and limited services,1:24
how less flexibility in the services they provide some billions of dollars in losses.1:35
They also receive tax rebates and grants that in many cases have not invested back in health projects or patient care improvement.1:46
Rather they use it. To pay more money to the board of trustees or CEOs.1:59
But the money cannot be redistributed or allocated.2:10
What is needed. So this created a bigger problem because doesn’t necessarily mean they losing money.2:16
They might be earning a lot of money, but they still function as a nonprofit.2:26
We also have the reason why for profit institutions are better for profits,2:34
health care and what efficient in terms of employees investing in equipment.2:43
And being more accurately using the resources for profit Hospitals are also more likely to offer parity in the services they provide for profit,2:53
often more flexibility in their services.3:06
For example, patients can choose from primary care physicians in hospitals for profit,3:10
so more a significant proportion of Medicaid patients for profit hospitals offer better through analogy.3:17
Markets to perform surgeries are less invasive and safer due to the technology they have to support their care.3:28
For profit hospitals invest more in technology and finding more care, and also research toward newer medications and procedures.3:41
For profit Hospitals also had the potential to serve as institutions, in other words, to work with community engagement.3:56
Ethical considerations are important when providing care autonomy.4:12
Which means respecting the wishes of patients so that their dynamic can be protected, been beneficial,4:18
to seek to act in the best interests of justice, to navigate through the due process, to determine where the limits on health care lie.4:28
Non moral efficiency. Investing may harm and determine how to avoid.4:41
In conclusion, nonprofit hospitals and for profit hospitals are institutions that have the same mission to be the best health providers,4:51
but that people are having for profit.5:03
Healthcare institutions give people more access to technology, more choices and flexibility in the health care services they demand.5:05
So for profit, hospitals have more than the just.5:16
Over in nonprofits hospitals.5:22
Just like in nonprofits, hospitals for profits, Hospitals also had the potential to serve as anchor institutions in other ways,5:25
as institutions, white community can get involved.5:34
Policy makers should grant the incentives to for profit hospitals to support community engagement.5:39
But also policymakers could do reforms that change the way.5:47
Hospitals that get paid to get better incentives to invest.5:56
Back to that community and maybe get discounts for the services for a large number of policyholders.6:03
And make a better health care system. Thank you.
Unformatted Attachment Preview
HEALTHCARE AS A RIGHT
An Argument for Healthcare as a Right
By Carey Acosta
PROBLEM STATEMENT
All individuals born in America should be entitled to
healthcare from birth, as stipulated in Article 25 of the
Second Bill of Rights. This article asserts that every American
has the fundamental right to access healthcare and mandates
states to establish a comprehensive healthcare system.
INTRODUCTION
• Healthcare should not be a luxury since it is a basic need
• The United States should be obligated to provide access
to healthcare for all people
• Equitable access to healthcare:
• Reduces the strain placed on hospital emergency rooms
• Improves the population health of communities
• Lowers overall financial burden of healthcare costs in
the United States
• Recognizing healthcare as a right shows that we recognize
the responsibility as communities to care for one another
HEALTHCARE AS A HUMAN RIGHT
• Healthcare as a human right is:
• Franklin D. Roosevelt introduced the 2nd Bill Of Rights in 1944 (Gerisch, 2018)
• The right to the highest attainable standard of health (WHO, 2022)
• Main components of healthcare as a human right:
• Accessibility
• Availability
• Quality
• Eliminating healthcare disparities is one of the Healthy People 2030 goals (Healthy
People 2030, 2023)
• Access to healthcare should not depend on a person’s socio-economic status
ETHICS
• Ethics is important in healthcare
• Healthcare as a right follows the ethical principles of dignity and beneficence
1 in 5 uninsured people
have had to go without
needed healthcare due to
cost (Tolbert et al., 2022)
• They are not given the dignity to
choose healthcare
Healthcare professionals are ethically
obligated to promote well-being and
do no harm (Haddad & Geiger, 2023)
• Healthcare as a right is the way to
promote well-being of all people in the
country
THEORY
• Social contract theory suggests that wellbalanced societies agree to principles that are
beneficial for all
• Healthcare as a right will create a more wellbalanced, healthy, and stable society that can
benefit from one another (Nunes et al., 2017)
• While there may be opposition to healthcare
as a right, 6 out of 10 Americans believe that
the government should provide healthcare
coverage to all (Kiley, 2018)
HOW HEALTHCARE AS A RIGHT CAN
HELP
Reduce the strain on hospitals
Access to urgent care centers led to a
21% decrease in the overall volume of
visits to the emergency department (ED)
made by individuals without insurance
and those covered by Medicaid
(Cummings & Hockenberry, 2021)
Decrease the financial burden for
the cost of uncompensated care in
the United States
Providing equitable access to
healthcare can improve population
health by providing education,
screening services, and preventative
care to underserved communities
(Thorton & Yang, 2023)
Uncompensated care can cost up to $33.6
billion in public funds to help cover costs
(Coughlin et al., 2021)
PROPOSED RESOLUTION
• The United States is the only high-income
country without universal healthcare coverage
(Mollman, 2022)
• The proposed resolution is to continue to
advocate to policymakers to recognize healthcare
as a human right
• We can use our professional experiences to
support the right policymakers who will
understand how recognizing healthcare as a
human right and providing equitable access can
improve our society’s well-being
REFERENCES
Coughlin, T. A., Samuel-Jakubos, H., & Garfield, R. (2021, April 6). Sources of Payment for Uncompensated Care for the Uninsured. KFF. https://www.kff.org/uninsured/issuebrief/sources-of-payment-for-uncompensated-care-for-the-uninsured/
Cummings, J. R., & Hockenberry, J. M. (2021). The impact of urgent care centers on nonemergent emergency department visits. Health Services Research, 56(4), 721–730.
Gerisch, M. (n.d.). The state of healthcare in the United States – American Bar Association. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-ofhealthcare-in-the-united-states/state-of-healthcare/
Haddad, L. M. (2023, August 14). Nursing ethical considerations. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK526054/
Healthy People 2030. (2023). Health equity in Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/priority-areas/health-equityhealthy-people-2030
Kiley, J. (2018, October 3). Most continue to say ensuring health care coverage is government’s responsibility. https://www.pewresearch.org/short-reads/2018/10/03/most-continue-
to-say-ensuring-health-care-coverage-is-governments-responsibility/
REFERENCES
Mollman, M. (2022, August 9). Healthcare is a human right – but not in the United States. Harvard Public Health. https://harvardpublichealth.org/equity/health-care-is-a-humanright/
Nunes, R., Nunes, S. B., & Rego, G. (2017). Health care as a universal right. Journal of Public Health, 25(1), 1–9. https://doi.org/10.1007/s10389-016-0762-3
Thornton, R. L. J., & Yang, T. J. (2023). Addressing population health inequities: investing in the social determinants of health for children and families to advance child health
equity. Current Opinion in Pediatrics, 35(1), 8–13. https://doi.org/10.1097/MOP.0000000000001189
Tolbert, J., Drake, P., & Damico, A. (2022, December 19). Key facts about the uninsured population. KFF. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsuredpopulation/
World Health Organization. (2022, December 10). Human rights. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/human-rights-and-health
Should There Be
Physician-Assisted
Suicide?
DAHLIA BOYD
Introduction
Professor and fellow classmates, today we gather to discuss a
highly contentious topic: physician-assisted suicide. This issue
raises critical questions regarding the sanctity of life, medical
ethics, and the role of healthcare professionals. As a
representative against the legalization of physician-assisted
suicide, I firmly believe that the practice should not be allowed. I
will present my rationale based on ethical principles, theories,
and evidence, highlighting the potential risks and offering
alternative solutions.
Stance
I argue against the legalization of physician-assisted suicide. It is
crucial to prioritize preserving life and promoting compassionate
care for terminally ill patients. Instead of endorsing a practice that
potentially compromises the sanctity of life, we should focus on
enhancing palliative care and support systems to alleviate
suffering.
Rational Sanctity of Life
The principle of the sanctity of life forms the foundation of
medical ethics. Allowing physicians to actively participate in
ending a patient’s life challenges this principle and may lead to a
slippery slope where the value of life is diminished. Legalizing
physician-assisted suicide risks devaluing the vulnerable and
marginalized members of society.
Potential for Abuse
Legalizing physician-assisted suicide creates the possibility of
abuse and coercion. It becomes challenging to ensure that
patients are freely making the decision without external
influences, such as financial burdens or family pressures.
Safeguards may not be sufficient to prevent wrongful deaths or
protect vulnerable individuals, particularly those with mental
health issues or limited access to adequate healthcare
Palliative Care Solutions
Instead of resorting to physician-assisted suicide, we should
prioritize improving palliative care services. Palliative care
focuses on enhancing the quality of life for terminally ill patients
through pain management, emotional support, and holistic care.
By investing in palliative care, we can offer compassionate
alternatives to end-of-life suffering, ensuring that patients are
supported with dignity and respect until their natural death.
Ethical Principles
I draw upon the ethical principles of beneficence, nonmaleficence, and autonomy to support my stance. Beneficence
and non-maleficence emphasize the duty to promote well-being
and prevent harm to patients. Legalizing physician-assisted
suicide risks violating these principles by introducing potential
harm and undermining the trust between patients and healthcare
providers. Additionally, autonomy is essential, but it must be
considered in the context of the greater societal implications and
the potential consequences for vulnerable individuals.
Theories and Evidence
The slippery slope argument warns that the legalization of
physician-assisted suicide may lead to an expansion of the
criteria beyond terminally ill patients, potentially including nonterminal conditions or even non-voluntary cases. This concern is
supported by evidence from countries where physician-assisted
suicide is legal, such as the Netherlands and Belgium, where the
criteria have gradually expanded.
Theories and Evidence
The slippery slope argument warns that the legalization of
physician-assisted suicide may lead to an expansion of the
criteria beyond terminally ill patients, potentially including nonterminal conditions or even non-voluntary cases. This concern is
supported by evidence from countries where physician-assisted
suicide is legal, such as the Netherlands and Belgium, where the
criteria have gradually expanded.
Proposed Solution
Rather than embracing physician-assisted suicide, we should
advocate for comprehensive palliative care programs that
prioritize patient comfort, emotional support, and pain
management. By investing in these services and ensuring their
widespread availability, we can provide a compassionate and
dignified approach to end-of-life care.
Citations
1. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 7th ed. Oxford University Press; 2019.
2. Emanuel EJ, Onwuteaka-Philipsen BD, Urwin JW, Cohen J. Attitudes and Practices of Euthanasia and PhysicianAssisted Suicide in the United States, Canada, and Europe. JAMA. 2016;316(1):79-90.
3. Ganzini L, Goy ER, Dobscha SK. Prevalence of depression and anxiety in patients requesting physicians’ aid in dyin
cross sectional survey. BMJ. 2008;337:a1682.
4. Oregon Public Health Division. Death with Dignity Act Annual Reports. Accessed July 2023.
[https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNIT
CT/Pages/index.aspx]
How are specialty agencies different from full-service sport management and marketing agencies?Find examples of important issues in sport management. You must use the example issues when you explain the benefits of applying critical thinking skills to important issues in sport management.All components
of discussion
prompt
addressed.
Clear, accurate,
and complete
answers
The Problem chosen is: Ostomy Patients and their rough transition into their new life with their new ostomy bag
Assignment- Written Part no more than 3/4 of a page in APA form
1) Describe a plan to address the practice problem/issue. Give ONE specific and measurable outcome objectives. How is the theory integral in formulating the plan. Detail how the outcomes will be evaluated.
The measurable outcome will be-
Patient now knows how to safely and confidently manage new ostomy bag… Please incorporate how the patient will achieve this for example, wound care nurse consults, practice, teach back method etc.
Part 2
Then, the information written above will also be transferred into 4 PowerPoint slides for a presentation. Please adjust the writing to be fit into a more visual/ presentful way, including pictures and diagrams with shortend literature.
Please include 2 refrences in APA format
Essentially two things will be submitted back to me
1. The written portion of the measurable outcome no more than 3/4 of a page in text citations 2 refrences
2. The 4 PowerPoint slides
Please see attached documents to see overview of the full paper.
Unformatted Attachment Preview
Please note this is an overview of the entire
project, I only need assistant on step 3 and 6
Along with 2 references and page in APA 7TH ED Format
Overview
Advance Practice Registered Nurses (APRNs) and nursing leaders in healthcare settings use best
practices to provide safe and quality care to patients to ensure optimal health outcomes. Theories
from nursing and other disciplines are used by nurses to guide practice and explain thought
processes for nursing care.
Purpose
The purpose of this group assignment is to choose a clinical practice problem/issue or diagnosis
and demonstrate how a selected theory from nursing or another discipline is applicable to the
situation. Your grade for this group assignment will depend on your ability to clearly express the
rationale for theory selection and its application to the practice problem. This assignment will
draw on your ability to use:
a.
b.
c.
d.
e.
f.
g.
Prescribed assignment instructions
Cohesive team dynamics
Informational technology for presentation
Microsoft Word
Defined elements from APA Style
Appropriate grammar and writing mechanics
Clarity and logical organization in writing/presentation
Written Assignment Process
1) Choose a practice problem/issue/diagnosis- describe the issue and its significance.
The Problem chosen is
Ostomy Patients and their rough transition into their new life with
their new ostomy bag
2) Select an alternative theory to address the practice situation- name of theory/theorist, origins,
description.
1st Theory Merle Mishel’s Theory of uncertainty in illness
Alternate Theory Modeling and Role Modeling Theory by Erikson
3) Describe a plan to address the practice problem/issue. Give ONE specific
and measurable outcomes objectives. How is the theory integral in
formulating the plan? Detail how the outcomes will be evaluated.
The outcome focused on is: Patient now knows how to safely and confidently
manage ostomy bag” Please incorporate how the patient will achieve this,
would care nurse consults, practice, teach back method etc.
4) Submit a detailed APA 7th ed. paper of your Integration of Theory and Practice assignment.
5) Your paper should include the following
a. Format elements from APA Style:
i. Double-spacing.
ii. 1-inch margins.
iii. Times New Roman 12-point font.
iv. Title page (student paper format).
v. Citations (within the paper).
vi. Reference page(s) 2 references
6. PowerPoint Process
•
Then Transfer the information in this write up to 4 PowerPoint slides to be presented to
an audience
GRADING RUBRIC:
Point Value
Area
5
Practice problem/issueClarity of issue and significance
5
Theory selection
5
Alternative theory
5
Plan to address practice problem
10
Group presentation
(e.g.: originality, effectiveness, organization, graphics, spelling grammar,
professionalism, clarity, flow, participation)
5
Write up of group participation
5
Readability
(e.g.: grammar, spelling, writing conventions)
Organization
(e.g.: use of topic sentences, logical flow of ideas)
Formatting (APA)
(e.g.: title page; font/point, margins, page limit, references)
40 points
See both attachement for the instructions. 500 words minimum. No need to go over 600 words. Same population- High School linebackers in varsity football.
Unformatted Attachment Preview
Reflection 2: Theory, Summary, and Application
How do you address Behavioral Change? Start by looking at Theories….
In general, forcing someone to change is not sustainable. For long term behavior change
to occur, the individual needs to be part of this process. Although we cannot and should
not force people to change, we can and should, observe and make appropriate
suggestions. In order for people to make sustainable behavior changes, various theories
and models are used as strategies. For example, we cannot force a person to loose weight,
but if they come to you asking for advice, as a kinesiologist, you can make educated and
appropriate recommendations. It is important to know your client/athlete so you can
make the appropriate suggestions using the correct theory.
The AthleticDISC Profile (pictured above) is a great example of an assessment used to
bring about behavioral change. As a certified DISC Assessment Analyst I use this
assessment as one of the building blocks when beginning a sport psychology consulting
session. Though there are theories behind it’s use, it is a tool sport psychologists can use
to help bring about behavioral change. It provides the student-athlete with a great view
into their ‘Natural” and “Adapted” styles and how those impact their performance. Here is
an example of a student-athlete’s score:
As a high “SC” this information provides me, as a consultant, ways to motivate this studentathlete in an effort to seek behavioral change towards performance growth. I know from studying
the DISC assessment that a High “S” is very loyal and enjoys serving. A High “C” informs me
that this athlete is also very analytical and likes the systematic approach to things. Combined
with more data and details I could then build a mental performance program for the athlete to
bring about the cognitive change or behavior he or she is seeking. Keep in mind that this is but
just one tool that can be used to assess and bring about behavioral change. As you explore the
topic I encourage you to see what other options are out there that could help your population.
1 identify and briefly summarize a behavioral theory and discuss how that theory would apply
towards your chosen demographic (population) from the CAP assignments. Be sure to elaborate
on how this theory would be utilized with your population and how it may provide you insight
into the intervention you chose to provide in the final CAP.
2. Complete the attached DISC Assessment and answer the questions.
See Simple DISC for OPS 12 20 PDF
Once you have completed the assessment, total up the columns and come up with a score. Your
high score is your behvaioral style. You may be close or tie in two. For this reflection answer the
following: Do you agree with your results? What are some behaviors listed below that are “You”?
Are there any behaviors that you wish you could change or modify? Why? You are welcome to
explore the DISC more through the web to find aditional information regarding how you scored.
Dominance
•
Very goal-driven
•
Like authority and are very resourceful
•
Self-sufficient, working well in an individual setting
•
Like challenging tasks and competition
•
Tend to be a direct person
Influence
•
Very optimistic
•
Like to persuade people
•
Relate well to others
•
Emotional
•
Talkative and personable
Steadiness
•
Tend to be steady and stable
•
Will be a good team player
•
Prefer close, personal relationships
•
Sympathetic
•
Will resist change
Compliance
•
Will be very independent
•
•
•
•
Tend to feel restrained by regulations
Like to be judged on your results
Detail-oriented
Precise and accurate in the things they do
What is due
Original Post:
• Minimum 500 words
• Must include at least two additional peer-reviewed sources (text/research) as
primary support for writing
DISC Assessment for Performance Enhancement
Instructions: Focus on you in your work or athletic environment as you move from
row to row. For the best results, go with your instincts and avoid second guessing as you
progress.
How to Respond: Rank each horizontal row of words on a scale of 4 to 1, with 4 being
what MOST DESCRIBES you and 1 being what LEAST DESCRIBES you. You must use each
number only once in each row. When finished, total each row to see you DISC score.
Below is an example the instructor will use to demonstrate:
1
D
Independent
2
Enthusiastic
4
Good Listener
3
High Standards
Forceful
Lively
Modest
Thoughtful
Aggressive
Emotional
Helpful
Reliable
Direct
Energetic
Agreeable
Accurate
Strong-willed
People-oriented
Gentle
Perfectionist
Daring
Impulsive
Kind
Cautions
Competitive
Expressive
Supportive
Detailed
Risk Taker
Talkative
Cooperative
Truthful
Argumentative
Fun Loving
Patient
Logical
Bold
Unplanned
Stable
Organized
Take Charge
Optimistic
Peaceful
Thorough
Straightforward
Cheerful
Loyal
Serious
Independent
Enthusiastic
Good Listener
High Standards
Total
Total
Total
Total
_______
I
_______
S
_______
C
_______
Created by Dr. Ed Garrett for use with PPE Training
This week, re-review the materials you gathered on your chosen medical error case, your prior paper, and my feedback on that paper. To complete the final stage of the project, address the following:
First, Select your solution.
Describe your proposed solution.
What would it entail?
What resources are needed?
Next, be sure that your solution addresses the following:
How do we use what we have learned to improve the organizational culture of safety and quality?
In module 5, you identified a team of people/roles who could help fully understand what happened and/or assist in finding solutions. What role can interprofessional communication and/or collaboration play in preventing recurrences of this type of medical error?
What role can technology play in preventing the recurrence of this situation? Please share two specific technologies and the role each one can play.
What steps would you recommend the organization take to repair the damage to relationships with external stakeholders?
Lastly, in 1-2 closing paragraphs, reflect on the Quaid situation and briefly share your thoughts about similarities between what happened with the Quaid twins back in 2007 and what happened in your recent case in terms of process, requirement, or policy breakdowns.
Are there lessons to be learned from the mistakes of the past?
What lessons can be learned from your chosen error to prevent recurrence?
Requirements
Your paper should be at least 6 pages (this is 6 new pages, not reused from module 5) double spaced, APA formatted, not including your title and reference pages. You will need to use a minimum of 5 external credible, relevant resources. These will ideally be the same sources you used in module 5, though you may need to find more information about best practices to support your solution.
Use the free resources from the Excelsior University Library TutorMELinks to an external site. tutoring service, and the Excelsior University Online Writing Lab.Links to an external site.
HCM 490 Final Project Guidelines and Rubric
Overview
The final project for this course is the creation of a Strategic Plan Presentation and Professional Reflection. The healthcare industry is constantly changing and healthcare professionals should be prepared for the challenge. As the final stop in your journey toward your Bachelor of Science in Healthcare Administration, you will integrate the knowledge and skills you have developed in previous coursework and over the duration of the term into a Capstone Assessment. Your assessment will consist of two components that will allow you to evidence knowledge, skills, abilities, and dispositional growth you have experienced during your program.
In the first component, you will select an existing healthcare organization that fits one of the following areas of opportunity and develop a comprehensive strategic plan for this change.
Option 1: Organization is Offering a New Service – Create a strategic plan that will guide the organization in bringing to fruition a new service, such as offering portable MRIs, starting a new urgent care clinic, opening a new outpatient surgery center, etc.
Option 2: Organization is Expanding an Existing Service Area – Create a strategic plan that will guide the organization in expanding an existing service to an underserved population that needs attention in this area. Examples include: population that has limited access to primary care services, population-to-provider ratio indicating a shortage, groups of persons who face economic, cultural, or linguistic barriers to healthcare in the local area and reside in a specific geographic area, and so on
The second component of your Capstone assessment is a professional reflection, in which you will reflect upon your capstone, program, and professional experiences and draw connections and inferences about your growth, ethical practice, and professional goals.
Evaluation of Capstone
This capstone will be assessed somewhat differently than other courses you have taken online at SNHU. There are two (2) separate components which will be submitted at different times during the course; however, they all operate together to comprise the whole capstone experience and are not assessed separately. You will be evaluated on both as a unit in determining whether you have demonstrated proficiency in each outcome. Your instructor will guide you through this process, keeping a running narrative of your strengths and weaknesses in relation to the outcomes as you progress through the class. You must demonstrate proficiency in all six (6) outcomes to pass this capstone course. Your work is expected to meet the highest professional standards.
The project is divided into five milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Two, Three, Four, and Five. The final product will be submitted in Module Seven and Eight.
In this assignment, you will demonstrate your mastery of the following course outcomes:
Engage diverse healthcare stakeholders using communications that reflect keen interpersonal skills, effective collaboration practices, and deep cultural competence
Demonstrate knowledge of microeconomic, macroeconomic and financial principles through monitoring and utilization of financial and economic data for decision-making and strategic planning
Utilize principles and functions of management to interpret market analyses for strategic planning and to foster organizational development, promote effective use of human resources, and enhance operations
Propose recommendations to improve the effectiveness and integration of information management systems at the various levels of healthcare organizations and achieve organizational goals
Assess contemporary policies, regulations, and governance structures relevant to the United States healthcare delivery system for their impacts to populations’ health and their implications for ethical decision-making
Promote dynamic organizational cultures that establish strategic visions, methodically analyze and interpret data based on sound epidemiological and statistical principles, and embrace change for continuous healthcare quality improvement
Prompt
After choosing the topic for your course project, you will work to develop the three phases of your strategic plan: the introduction and assessment phase, the implementation, communication, and management phase, and finally the evaluation phase. The final strategic plan consists of a PowerPoint presentation including speaker notes and voice over. This first component will also inform your professional reflection, in which you will evaluate your experiences in this program, capstone experience, and field of interest, and discuss the importance and impact of ethical practice in healthcare.
Capstone Component 1: Strategic Plan
Your strategic plan must be submitted in the form of a comprehensive presentation to the Board of Directors of your selected institution for approval and buyin. You have the flexibility to utilize PowerPoint or another comparable presentation tool as long as your instructor approves the submission file. Your presentation is expected be professionally crafted to the needs and specifications appropriate for the discipline, area of interest, and type of initiative you are proposing. Because your strategic plan will be different from others’ in your capstone experience, you will likely include different additional resources, information, visuals, and strategies for progress. At minimum, your presentation must address/include the following:
Phase I – Introduction and Assessment — In this section you will give background on your organization, introduce the project that precipitates the strategic plan and what your assessment tools and approach will be. Your introduction and assessment should include:
The mission, vision, values statements, structure, and current community position of the organization.
Project topic that is the focus of the strategic plan, including the goal(s) of this project.
An appropriate analysis tool to assess the impact of your project on your organization.
The effect of internal and external factors on the feasibility and development of the project.
Phase II – Implementation and Communication Plans
Target area or intended population and establish the goals.
The timeline and implementation milestones of the initiative.
Financial impact of the initiative, including any necessary capital expenditures, necessary fundraising, or potential financial benefits.
Resources needed to effectively implement the initiative, including staffing, equipment, technology needs, and so forth.
Compliance with all federal and state regulations relevant to the proposed plan.
Potential ethical challenges and formulate plans for monitoring behavior, practices, procedures, and so forth.
Implementation Plan: Provide a comprehensive plan for implementation that includes:
Communication and Management Strategy: Your total communication plan should address the strategies and practices you will employ to communicate to the proper stakeholders at the proper times. In this section you should detail your comprehensive approach for how you will communicate this change and its impact, how you will keep people informed of the project’s progress, and how you will keep them informed of the project’s ongoing results.
Phase III – Evaluation Strategy: This plan for managing and measuring progress and success of your initiative should include the following:
A discussion of the specific goals and milestones of implementation of the initiative. Lay out your goals in a clear, obtainable fashion and to ensure that progress milestones are clear, reasonable, and consistent.
Specific definitions of measures of progress towards obtaining the intended goals and a description of the tools that you would use to measure progress. What strategies will be used to measure success, and how will adjustments be made should progress towards these goals fall short or change?
How do you intend to collect and analyze information to ascertain stakeholder satisfaction with the initiative? What information will be looked at, and who are the stakeholders that will be considered?
Capstone Component 2: Professional Reflection
For the second and final component of your capstone, you will write an essay in which you discuss the process and outcomes of this project and your overall Healthcare Administration Program journey and experiences. You will also speak more specifically about how the project relates to your area of expertise/interest and your desired career path. Writing reflectively allows you to think deeply and consciously about your experiences, which is invaluable to successful practice in the field of healthcare administration.
You should envision this component as a personal reflection on the capstone and your experience in the Healthcare Administration program as a whole. For instance, relative to the capstone, you could discuss what you did—or intended to do—and then consider what worked well, what challenges you faced, and what you would change or do differently to make your experience better. In reflecting on your time here at SNHU, you might discuss where you started, where you have ended up, where you see yourself going, etc. Note that this component is not about evaluating the capstone itself, but rather, your experience within the capstone project.
Some of the issues to address in this final component of this capstone may include, but are not limited to:
Overall, what was your capstone experience like?
Reflect on the significance of the capstone in relation to your own experience at SNHU.
How will you relate cultural competence or maintain cultural principles in your profession?
How does your application of interpersonal skills and collaborative processes relate to your professional goals?
How will you promote continuous healthcare quality improvement in your professional life?
What to Submit
Your Strategic Plan will be submitted in the form of a presentation. You may use Powerpoint to prepare the visuals for your presentation. You also have submit presentation speaker notes. Your Professional Reflection should be submitted in the form of a well-crafted, reflective essay, most likely consisting of 3 pages. For both submission artifacts, you should properly cite research and references in discipline-appropriate format.
The “Possible Indicators of Success” are examples for you and the instructor of the types of concepts to look for to demonstrate proficiency. They are neither exhaustive nor prescriptive, and should be used as guides for illustrating how your capstone embodies the outcome. You must show proficiency in all six (6) outcomes to be successful in the capstone course.
Is there a need for reform of the malpractice system in the US? Consider if this should be done state by state or by national mandates. Consider the roles of patients, patient families, physicians, hospitals, lawyers, insurance companies in any change.3 – 4 pages double spaced that do not include a cover page or reference pageuse at least 2 referencesuse APA format.
i am in my bachelor program and i need help writing some papers for this class: assignment is attached and an example of each paper is attached .. assignment label 2 will be used to complete assignment 4 as labeled.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Describe some myths of Obsessive Compulsive Disorder.
Identify ways that society has influenced the definition of this disorder.
Explain your understanding of OCD and OCPD.
Be sure to watch the videos and read all materials to include information to support your answer.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Assigned Readings:
Campinha-Bacote, J. (2002). Cultural competence in psychiatric nursing: Have you “ASKED” the right questions? Journal of the American Psychiatric Nurses Association, 8(16), 183–187. doi: 10.1067/mpn.2002.130216
Berlin, E., & Fowkes, W. (1982). A teaching framework for cross-cultural health care. The Western Journal of Medicine, 139(6), 934–938. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10110…
Putsch, R & Joyce, M. Dealing with Patients from Other Cultures: Methodology in Cross-cultural Care, 229, 1050–1065. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK340/pdf/Book…
Discussion Questions:
Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right” and any specific instructions for this topic.
Before the end of the week, begin commenting on at least two of your classmates’ and instructor responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area. Complete this discussion in a 150–300 word response.
Healthcare Diversity
The concept of healthcare diversity extends beyond cultural, racial, and religious personal identity. Healthcare professionals need to develop the ability to understand the extent of individual differences commonly referred to as diversity. The differences must be recognized, but to what extent is the healthcare provider’s obligation to accommodate? It must also be recognized that some cultures from around the globe view sickness through a different lens and are accustomed to different healthcare approaches and outcomes. Finally, the spectrum of diversity must be recognized as ranging from race and religion to amputee or the hearing impaired.
Based on your readings and research, answer the following:
What is the best approach to understanding diversity and why?
To what extent should the healthcare organization/professional accommodate?
Do you believe there are specific categories of diversity that must be recognized? What are they and why?
Do you believe the difference in defining diversity is within the lived experience of the patient?
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Your initial posting should be addressed in 150–300 words. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.
Respond to your classmates throughout the week. Justify your answers with examples, research, and reasoning. Follow up posts need to be submitted by the end of the week.
Please read the following: Healthy People in Healthy Communities, or A Strategy for Creating a Healthy Community: MAP-IT, so that you will understand the MAP-IT program before you start this SLP. Also please read this article: Melany Mack, Ron Uken, Jane Powers (2006) People Improving the Community’s Health: Community Health Workers as Agents of Change, Journal of Health Care for the Poor and Underserved. Nashville: Feb 2006. Vol. 17, Iss. 1; p. 16 (10 pages). To begin to achieve the goal of improving health, a community must develop a strategy. That strategy, to be successful, must be supported by many individuals who are working together.
In much the same way you might map out a trip to a new place, you can use the MAP-IT technique to ‘map out’ the path toward the change you want to see in your community.
For the Session Long Project (SLP) of this course, you will follow this family:
An English-speaking American family located in Prince George’s County, MD. The parents (42-year-old father and a 40-year-old mother) have two children, a 14-year-old son and an 18-year-old daughter. They (the parents) are obese, smokers, and have a history of heavy drug use in their late teen and early adult years. The father has only a high school education while the mother has a BA in English Literature. Due to their weight, the mother has diabetes and high blood pressure, and the father has high blood pressure and liver aliments. The son suffers from asthma while the daughter has had two previous abortions. She may be drug dependent. The parents are a moderate-low income family with minimal insurance. You will guide the parents on how to achieve the minimum state health requirements for both the children and themselves (i.e., vaccinations, good nutrition, a safe and healthy home environment, etc.).
Module 3 tasks: 5 pages (not including title and reference page), 5 peer-reviewed reference citations, double spaced, APA format, Introduction and conclusion paragraphs.
For this module you will discuss how you will plan your approach. Be sure to reference and use resources in Prince George’s County, MD
Start with a vision of where you want the community to be, and then add strategies and action steps to help you achieve that vision.
You can be a health educator, a health care provider, a nutritionist, a social worker, etc. However, base your vision and approach on your targeted family located in Prince George’s County, MD.
Additionally, be sure to focus on the health issues related to your targeted family located in Prince George’s County, MD.
Module 4 tasks: 5 pages (not including title and reference page), 5 peer-reviewed reference citations, double spaced, APA format, Introduction and conclusion paragraphs.
Be sure to reference and use resources in Prince George’s County, MD
Discuss how you will implement your plan using concrete action steps that can be monitored and will make a difference. Discuss how you will track your progress over time. Present any tables or charts if you believe they will assist you in effectively tracking your progress (and of course, the progress of the target family). Provide sufficient detail.
SLP Module Requirements
You are to use MAP-IT: Mobilize, Assess, Plan, Implement, and Track to respond to this SLP.
Before you begin the SLP please review: Choosing the Right Approach for Health
Steps in MAP-IT are:
Mobilize individuals and organizations that care about the health of your community into a coalition.
Assess the areas of greatest need in your community, in this case, assisting new immigrants to access health care], as well as the resources and other strengths that you can tap into in order to address those areas.
Plan your approach: start with a vision of where you want to be as a community, then add strategies and action steps to help you achieve that vision: you can be a health educator, a health care provider, a nutritionist, a social worker etc.
Implement your plan using concrete action steps that can be monitored and will make a difference.
Track your progress over time.
KEY Criteria for this SLP
In addition to demonstrating that you are applying the MAP-IT steps, you must demonstrate personal development or competency in developing appropriate objectives for your targeted family based on needs and the ability to appraise the appropriateness of resources and materials required to meet their needs. You should also incorporate the results of the needs assessment of your targeted family into the planning process within MAP-IT. This is why it is so important to identify an actual community that your targeted family resides. You will find that almost all of the resources found or available in a community can be identified online.
Using this MAP-IT approach, a step-by-step, structured plan can be devised to tailor one’s community needs.
The first step in building a healthier community is to mobilize key individuals and organizations to form a community-wide coalition. Most communities already have health departments and other governmental agencies that are responsible for public health services. Many communities also have coalitions of key individuals and organizations that are organized to address specific issues, for example, block associations or neighborhood watch groups. These groups often represent diverse interests and resources for addressing issues that are vital to building and maintaining the health and stability of the entire community. A coalition will often, of course, work with the health department and other health organizations in the community. However, it can also help mobilize a wider range of other resources to address health issues.
Unformatted Attachment Preview
Healthy People
in
Healthy
Communities
A Community Planning Guide Using
Healthy People 2010
Dear Community Leader:
More than 20 years ago the Nation embarked on a significant
journey to make our communities healthier and happier places.
Using the HEALTHY PEOPLE Initiative, which began in 1979, we have
learned that we can make a difference. The current phase, HEALTHY
PEOPLE 2010, has two overarching goals: to increase the quality and
years of healthy life of all Americans and to eliminate disparities in
health status. Its vision is deceptively simple: Healthy People in
Healthy Communities. But to reach these goals, to achieve this
vision, we must all work together–individuals and communities
alike.
The road to improving health for all is wrought with obstacles. We
cannot let our resolve fail. We must continue to work together to
make certain the benefits of health are available to all.
This guide is designed to help you—someone who has decided to
make your community a healthier place to live. This guide provides
information about the steps involved in forming and running a
healthy community coalition. It also includes “Strategies for Success,” to help you get activities started in your community, plus
resources, references, and a one page ‘quick-aid’ with hints for
putting HEALTHY PEOPLE 2010 to work for your community.
I applaud your efforts thus far and challenge you to forge ahead on
the journey toward our ultimate destination, becoming an entire
Nation of Healthy People.
Sincerely yours,
David Satcher, M.D., Ph.D.
Surgeon General
Healthy People
in
Healthy
Communities
A Community Planning Guide Using
Healthy People 2010
Office of Disease Prevention and Health Promotion
Office of Public Health and Science
Department of Health and Human Services
Acknowledgments
This publication was developed by the Office of Disease Prevention and Health
Promotion (ODPHP) in the U.S. Department of Health and Human Services (HHS).
Primary authors: Matthew Guidry, Tom Vischi, Raymond Han, and Omar
Passons. Additional assistance was provided by Randolph F. Wykoff, Linda
Meyers, Debbie Maiese, Janice T. Radak, Mary Jo Deering, Gloria Barnes, Tami
Lambert, and Valere Byrd. In addition, the contributions of the following reviewers are greatly appreciated:
Phillip Caillouet
Health Informatics Center of Acadiana
University of Louisiana
Melissa Clarke
Health Resources and Services
Administration/HHS
Regan Crump
Health Resources and Services
Administration/HHS
Michael Hatcher
Centers for Disease Control and
Prevention/ HHS
Tim Jeffries
U.S. Department of Housing and
Urban Development
John Kesler
Coalition for Healthier Cities and
Communities
Kathy Kremer
Senior Management Assistant
Anne Arundel County
Marilyn Layman
Superintendent of Schools
De Soto, Kansas
Sigrid Melus
Office of National Drug Control Policy
White House
Marc Meringoff
The Fordham Institute
II
Tyler Norris
Community Initiatives
Emmeline Ochiai
Public Health Advisor
Office of Disease Prevention and
Health Promotion/HHS
Steve Potsic
Regional Health Administrator/HHS
Ruth Sanchez-Way
Center for Substance Abuse
Prevention/ HHS
Alvin Schexnider
Office of Health Policy Development
Wake Forest University
Jerry Schultz
Work Group on Health Promotion and
Community Development
University of Kansas
Valerie Welsh
Office of Minority Health/HHS
Richard Young
Regional Health Administrator/HHS
Sharon Zolner
Assistant Superintendent of Schools
De Soto, Kansas
Table of Contents
I. Is Yours a Healthy Community?
1
What Is a Healthy Community? …………………………………………… 1
What Is HEALTHY PEOPLE 2010? ……………………………………………. 2
II. A Strategy for Creating a Healthy Community: MAP-IT
7
Mobilize Key Individuals and Organizations …………………………… 8
Assess Community Needs, Strengths, and Resources ……………….12
Plan for Action ………………………………………………………………….15
Implement the Action Plan ………………………………………………….18
Track Progress and Outcomes ……………………………………………..20
I’ve Learned About MAP-IT. Now What? ………………………………21
III. Strategies for Success:
23
Community Members ………………………………………………………..23
Health Professionals …………………………………………………………..24
Local Government and University Partners …………………………….25
References and Resources
27
Appendices
30
Appendix A:
HEALTHY PEOPLE 2010 Leading Health Indicators ……………….30
Appendix B:
Select HEALTHY PEOPLE 2010 Objectives for Communities ……32
Access to Health Care …………………………………………………..33
Worksites ……………………………………………………………………34
Schools ………………………………………………………………………34
Environmental Health …………………………………………………..36
Health Communication …………………………………………………36
III
U.S. Department of Health and Human Services. Healthy People in Healthy Communities.
Washington, DC: U.S. Government Printing Office, February 2001.
IV
I. Is Yours a Healthy Community?
Are the people in your community as healthy and safe as they could
be? If not, would you like to change that? This guide can help you
make positive changes in your community, whether you are a
physician, government official, business owner, truck driver, store
clerk, retired person, or almost anybody
else.
Indeed, this guide can help you:
Learn how to build and run a healthy
community coalition;
Find information about your community
on many health problems, such as drug
abuse, teen pregnancy, depression, and infectious disease; and
Use HEALTHY PEOPLE 2010 to improve the quality of life of the
people in your community.
But, first, take a moment to congratulate yourself. Because deciding
to make this kind of change is an important first step to making your
community a healthier and happier place in which to live, work, and
play. And because YOU can make a difference!
What Is a Healthy Community?
A healthy community is one that embraces the belief that health is
more than merely an absence of disease; a healthy community
includes those elements that enable people to maintain a high quality
of life and productivity. For example:
n
A healthy community offers access to health care services that
focus on both treatment and prevention for all members of the
community.
n
A healthy community is safe.
1
n
A healthy community has
roads, schools, playgrounds,
and other services to meet the
needs of the people in that
community. (These items are
often referred to as
“infrastructure.”)
Goal I: Increase Quality
and Years of Healthy Life
HEALTHY PEOPLE 2010 seeks
to increase life expectancy
and quality of life by helping
individuals gain the
knowledge, motivation, and
opportunities they need to
n
A healthy community has a
make informed decisions
healthy and safe environment.
about their health. At the
same time, HEALTHY PEOPLE
2010
encourages local and
What Is HEALTHY PEOPLE
State leaders to develop
2010?
communitywide and
statewide efforts that
One tool to help a community
promote healthy behaviors,
create a dynamic vision for its
create healthy environments,
future is HEALTHY PEOPLE 2010.
and increase access to highHEALTHY PEOPLE 2010 is a comquality health care. Given the
prehensive set of health objectives fact that individual and
to be achieved over the first
community health are often
inseparable, it is critical that
decade of the century. It is deboth the individual and the
signed to serve as a roadmap for
improving the health of all people community do their parts to
increase life expectancy and
in the United States. It includes
improve quality of life.
national health promotion and
Healthy People 2010: Understanding and
Improving Health, 2nd Edition, November 2000.
disease prevention goals, objectives, and measures that can help
serve as a model for you to develop your own goals and objectives to
improve the health of everyone in your community.
HEALTHY PEOPLE 2010 was developed by citizens from throughout
the Nation, in a multiyear process that was coordinated by the U. S.
Department of Health and Human Services (HHS). For two decades,
HHS has used HEALTHY PEOPLE objectives to improve the health of
the American people. HEALTHY PEOPLE 2010 is the third set of health
promotion and disease prevention objectives for the Nation.
HEALTHY PEOPLE 2010 is designed to achieve two overarching goals:
(1) to increase the quality and years of healthy life and (2) to elimi2
Goal II: Eliminate Health
Disparities
nate health disparities. (A health
disparity is a gap in the health
status of different groups of
people, in which one group is
healthier than the other group or
groups.) These two goals are
supported by 467 objectives in
28 focus areas. For details, see
www.health.gov/healthypeople/
document/tableofcontents.htm.
HEALTHY PEOPLE 2010
recognizes that communities,
States, and national
organizations will need to
take a multidisciplinary
approach to achieve health
equity–an approach that
involves improving health,
education, housing, labor,
justice, transportation,
HEALTHY PEOPLE 2010 also
agriculture, and the
identifies a smaller set of health
environment, as well as data
collection itself. However, the priorities that reflect 10 major
greatest opportunities for
public health concerns in the
reducing health disparities
United States.These 10 topics
are in promoting
highlight individual behaviors,
communitywide safety,
physical and social environmeneducation, and access to
tal factors, and important health
health care, and in
system issues that greatly affect
empowering individuals to
make informed health care
the health of individuals and
decisions.
communities. Examined toHEALTHY PEOPLE 2010 is firmly gether, they constitute a set of
dedicated to the principle
“Leading Health Indicators” that
that–regardless of age,
provides a snapshot of the health
gender, race or ethnicity,
of the Nation and serves to
income, education,
provide guidance and focus for
geographic location,
the public, media, and elected
disability, or sexual
officials.
orientation–every person in
every community across the
Nation deserves equal
access to comprehensive, A health disparity is an inequality
or gap that exists between two
culturally competent,
or more groups. Health
community-based health
disparities are believed to be the
care systems that are
result of the complex interaction
committed to serving the
needs of the individual and of personal, societal, and,
promoting community health. environmental factors.
Healthy People 2010: Understanding and
Improving Health, 2nd Edition, November 2000.
3
In a Snapshot…
HEALTHY PEOPLE 2010 identifies a set of health priorities that reflect 10
major public health concerns in the United States. These 10 Leading
Health Indicators are intended to help everyone more easily understand the importance of health promotion and disease prevention.
Motivating individuals to act on just one of the indicators can have a
profound effect on increasing the quality and years of healthy life and
on eliminating health disparities–for the individual, as well as the
community overall.
Subject/Topic
Public Health Challenge
Physical Activity
Promote regular physical activity.
Overweight and Obesity
Promote healthier weight and
good nutrition.
Tobacco Use
Prevent and reduce tobacco use.
Substance Abuse
Prevent and reduce substance
abuse.
Responsible Sexual Behavior
Promote responsible sexual
behavior.
Mental Health
Promote mental health and
well-being.
Injury and Violence
Promote safety and reduce
violence.
Environmental Quality
Promote healthy environments.
Immunization
Prevent infectious disease
through immunization.
Access to Health Care
Increase access to quality health
care.
For more on the Leading Health Indicators, go to
http://www.health.gov/healthypeople/LHI.
4
You can select from one or more
chapters in Healthy People 2010
or use the Leading Health
Indicators to help shape your
own visions of where you want
your community to be in the
future. These broad visions can
help shape your efforts to improve the health of your
community.
You can use a variety of techniques, documents, and other
resources to help you make a
healthy community. This guide
will briefly describe some easyto-understand approaches that
can help you get started or help
you improve what you have
already started.
5
HEALTHY PEOPLE 2010: 28 Focus Areas
1. Access to Quality Health
Services
15. Injury and Violence
Prevention
2. Arthritis, Osteoporosis, and
Chronic Back Conditions
16. Maternal, Infant, and Child
Health
3. Cancer
17. Medical Product Safety
4. Chronic Kidney Disease
18. Mental Health and Mental
Disorders
5. Diabetes
6. Disability and Secondary
Conditions
7. Educational and
Community-Based
Programs
6
19. Nutrition and Overweight
20. Occupational Safety and
Health
21. Oral Health
8. Environmental Health
22. Physical Activity and
Fitness
9. Family Planning
23. Public Health Infrastructure
10. Food Safety
24. Respiratory Diseases
11. Health Communication
12. Heart Disease and Stroke
25. Sexually Transmitted
Diseases
13. HIV
26. Substance Abuse
14. Immunization and
Infectious Diseases
27. Tobacco Use
28. Vision and Hearing
II. A Strategy for Creating a Healthy Community
To begin to achieve the goal of improving health, a community must
develop a strategy. That strategy, to be successful, must be supported
by many individuals who are working together.
In much the same way you might map out a trip to a new place, you
can use the MAP-IT technique to ‘map out’ the path toward the
change you want to see in your community.
The process of creating a healthy community will take time, much
effort, and many steps. This guide recommends that you MAP-IT–
that is, Mobilize, Assess, Plan, Implement, and Track. This MAP-IT
approach will help you understand and remember the specific steps
you will need to take and the order in which you should take them.
Keep in mind, though, that there is no one way to do this, and many
of these steps will need to be taken again and again.
Mobilize individuals and organizations that care about
the health of your community into a coalition.
Assess the areas of greatest need in your community, as
well as the resources and other strengths that you can tap
into to address those areas.
Plan your approach: start with a vision of where you
want to be as a community; then add strategies and
action steps to help you achieve that vision.
Implement your plan using concrete action steps that
can be monitored and will make a difference.
Track your progress over time.
7
Using this MAP-IT approach, your coalition can devise a step-bystep, structured plan that is tailored to your community’s needs.
MOBILIZE Key Individuals and Organizations
Mobilize individuals and organizations into a community coalition that cares about the health of
its community.
A public health nurse in a
small New England suburban community is greatly
concerned about the alarming increase in obesity in
school-aged children. She
needs action models and
guidance she can use to
help her mobilize the community and put together a
healthy weight educational
program to use in the
community and in the local
public schools. The nurse
needs to mobilize others in
her community to act.
The first step in building a
healthier community is to
mobilize key individuals and
organizations to form a
communitywide coalition. Most
communities already have health
departments and other governmental agencies that are responsible for public health services.
Many communities also have
coalitions of key individuals and
organizations that have organized
to address specific issues, for example, block associations or neighborhood watch groups. These groups often represent diverse interests and resources for addressing issues that are vital to building and
maintaining the health and stability of the entire community. A
coalition will often, of course, work with the health department and
other health organizations in the community. However, it can also
help mobilize a wider range of other resources to address health issues.
How do you organize such a coalition in your community? Usually,
it is easier to engage potential coalition members around issues that
are already of special concern to them and the community. Successful community coalitions have been built, for example, around
8
special issues such as substance abuse, HIV/AIDS, teen pregnancy,
maternal and child health, environmental health, domestic violence,
and neighborhood crime.
Coalitions have also been built around a broader range of issues, not
all of which have yet become of the highest concern to community
leaders. It is recommended that you have sufficient data to show
community leaders that these issues are of real and immediate
importance.
While it is sometimes possible to start building a coalition with a
very general communitywide event (such as a town hall meeting or a
media event), it is often necessary to target specific individuals and
organizations and to work with them over a period of time until they
become committed to working with you and others in the coalition.
Individuals. Many effective coalitions are built around a core of
committed individuals. Coalition members must be willing to work,
express themselves openly, and serve as catalysts to improve community conditions. The real key is to have members who have the
energy, commitment, and willingness to collaborate with others to
inspire and sustain action. Coalition members can be more easily
motivated to work hard when they work in areas that they know are
directly affecting their lives.
Organizations. Many individuals in effective coalitions come from
and represent community organizations. These community organizations can include religious institutions, businesses, schools, social
service programs, hospitals, clinics, community groups, unions, and
the like. Local organizations are valuable because of their influence,
their resources, their involvement in the community, and the respect
they command. They can support needed actions and they can
mobilize resources to help implement such actions.
9
Helpful Hint: Talk to local businesses, charities, and religious
organizations. They can be great members of your team.
One of the biggest challenges in creating a healthy community
coalition is to sustain the members’ involvement in the process. This
challenge can be overcome in part by agreeing as early as possible
on a vision for the community.
Creating a vision: Your vision should originate from your
community’s most important needs, values, and goals. It should be
an idealized description of how your coalition would like your
community to be. It should reflect the goals of the members of the
coalition, and it should be consistent with their values.
Indiana – Healthy Hoosiers
The challenge of Healthy Hoosiers 2000 is to use the combined
strength of scientific knowledge, professional skill, individual
commitment, community support, and political will in order to
enable the citizens of Indiana to achieve their potential to live
full, active lives. It means preventing premature death and
preventing disability, preserving a physical environment that
supports human life, cultivating family and community support,
enhancing each individual’s inherent abilities to respond and to
act, and assuring that all Hoosiers achieve and maintain a maximum level of functioning.
Healthy Hoosiers 2000: Health Promotion and Disease Prevention Objectives, 1992.
10
The vision can be created at the very start of the process–for example, when you are mobilizing others to work with you. Creating
the vision early on allows all members of the coalition to feel committed to the long-term process. There may be disagreements
because of the different values or different expectations of various
community leaders. It is important, nevertheless, for the coalition to
work toward a consensus on the vision and to enter the next stage in
the process with a common mission.
Roseville, California – California Healthy
City Coalition
“We recognize that health improvement involves more than the
diagnosis and treatment of disease. Rather, health results from
the proper care of body, mind and spirit. To accomplish our
vision, we will adopt a new view of health. We will shift from
health care providers to the community for visionary direction;
we will shift from State and Federal control, to local control; we
will define health according to wellness instead of illness; we
will focus on prevention and health promotion instead of acute,
episodic treatment; leadership in our community will shift from
autocratic to participative; and program implementation will
shift from vertical to horizontal.”
Profiles of Participating California Healthy Cities and Communities, April 2000.
11
ASSESS Community Needs, Strengths, and Resources
Assess the health issues of
greatest importance in your
community, as well as the
resources and other strengths that
you can tap into to address those
health issues.
An urban core neighborhood in Kansas City,
Missouri, had become
concerned about crime and
safety. The neighborhood
decided to do something,
but wanted to know when
its efforts made a difference. They decided to use
HEALTHY PEOPLE 2010
objectives for assaults as
their measure of success,
and they began to collect
crime reports for their
neighborhood.
To get a better sense of what you
can do, versus what you would
like to do, you will need to take
stock of the needs, strengths, and
resources in your community.
Because most healthy community coalitions will have limited
resources to address all their
needs, they must try to use their
resources wisely. When coalition members work together to set
priorities and to allocate resources to those priorities, they are far
more likely to continue to participate in the process and to achieve
measurable results.
Using HEALTHY PEOPLE 2010 to get started: Before you can set
priorities, you must first determine what issues you want to improve.
What kinds of things might you look at? Appendix A lists the 10
Leading Health Indicators. These 10 topics represent the major
public health priorities facing this Nation as a whole. Appendix B
offers selected HEALTHY PEOPLE 2010 objectives to give you an idea
of the kinds of health and community safety issues facing the
Nation. After reviewing Appendices A and B and surveying coalition
members, you can identify the health issues that your community
would like to address. So, for example, your coalition may have 5
community-specific topics, plus 23 more from the HEALTHY PEOPLE
12
list that your coalition wants to work on. Can you work on all 28?
Probably not. So, setting priorities becomes a must.
How to set priorities? Because resources for addressing issues will
most likely be limited, your coalition may need to set priorities for
where to begin. Setting priorities should be a matter of consensus; all
coalition members should make an effort to agree on which issues
will be addressed immediately and which will be put off until a
specified later date.
Gathering and evaluating data: Whenever possible, either before or
after you set priorities, gather and evaluate available information
about the major health issues in your community. Data about some
health issues may not be immediately available for your county, city,
or neighborhood. When this happens, your coalition may have to
collect the information for itself. See the inset and Strategies for
Success sections for tips about where you can find the information
you need. Whatever its source, it is important that your coalition
have accurate information about what is really happening in your
community so that you can clearly understand the community’s
needs and create a reasonable target for improvement. Be specific
about who will gather what information from whom and when–and
how it will be reported to the group.
Ideally, your coalition should obtain baseline information on each
issue before it initiates any actions to address those issues. Baseline
information comprises information gathered before an action or
program is started. By comparing this information with information
collected after you have begun some actions, you can determine how
successful your actions have been. Evaluators from a university or
government agency may be able to help your group deal with data
analysis and measurement issues. Documentation of progress can
be a strong tool for enhancing your coalition action.
13
Helpful Hint: Work with your evaluator early and often. This will
help you keep tabs on your community’s program.
Resources: Once you have identified your community’s major areas
of concern and need, develop a list of strengths and resources. The
list can include available technology, communication, “infrastructure” (such as supermarkets, roads, bus lines, housing, and office
space), funding, professional expertise, and data. Don’t think of
money as your only resource. Every community has a wealth of nonmonetary resources that can be used to address areas of concern.
Information, too, is a resource. And a strong partnership with State
and local governmental agencies may help to ensure that the data
you will need are available and obtainable on a timely basis.
Downers Grove, Illinois
“We’ve been able to do some pretty remarkable things without
very much money simply by knowing who had what and who
could share their resources. Good Samaritan Hospital did the
writing, the municipal government did the printing, and the
newspaper did the distribution, and it didn’t cost anybody any
additional money.”
A Message to America from America’s Communities: A Call to Action, January 2000.
The value of working with strong community-based organizations
should not be underestimated. Local businesses, service organizations, medical associations, civic groups, faith communities, and
community leaders are themselves resources that should be identified. Groups such as these are vital to the success of community
efforts–because of what they know about the community as well as
whom they know.
14
PLAN for Action
Once you have set your priorities
and gathered your data, you will
need to plan your approach. This
involves creating an action plan
with concrete steps and deadlines.
With your vision as your guide,
create an action plan with concrete steps that will help you
achieve that vision.
ACTION PLAN:
A social worker in a rural
town is concerned by the
increase in reported child
endangerment cases
attributed to the use of
methamphetamine by
parents. The town has also
seen an increase in the
number of household fires
in trailer park homes. The
social worker contacts local
police officials to help the
local community health
coalition develop an action
plan.
The plan of action should include
action steps, assignment of
responsibility, information
collection, and a timeline. Objectives should have specific targets.
What, specifically, do you want to achieve? For example,
Increase the proportion of adults who engage regularly, preferably daily, in moderate physical activity for at least 30 minutes
per day.
Target: 30 percent.
Baseline: 15 percent of adults aged 18 years and older engaged in moderate physical activity for at least 30 minutes 5 or
more days per week in 1997 (age adjusted to the year 2000
standard population).
15
The target is a measurable outcome that you want to achieve within
a given amount of time. HEALTHY PEOPLE 2010’s timeframe is the
decade but you may want to work in smaller increments. Wherever
possible, each objective should be measurable. While it is possible to
have a target that cannot be directly measured, such as self-assessed
quality of life, perceived safety, and the like, you will have difficulty
assessing your progress without some degree of measurability. It is
important early on to determine how you will measure such a target
so that you can properly track your progress.
An important note about target setting: Be realistic! If drug abuse is
running at 25 percent among high school kids in your community,
don’t set the target at 0 percent by next year. Setting unrealistic
targets sets you up for a demoralizing failure that can jeopardize
your coalition, as well as your achievement of the vision.
Action steps: What concrete actions will you take to achieve the
target? For example, do you intend to invite the mayor and city or
county council plus local media people to a 5K run/walk to promote
your coalition’s efforts? Could the schools offer “adult nights” at
their athletic facilities? How will you collect data on this? Will you
need monthly reports? How will those be collected and by whom?
Don’t hesitate to spend time–a good deal of time–identifying the
specific action steps needed to reach your desired targets. The more
specific you can be, the better. And recognize that some objectives
may be too big at first glance to achieve in a single action step. For
example, reducing infant mortality is an objective that may require
numerous action steps over several years to achieve a very small
targeted improvement.
Action steps may be developed independently or as part of an overall
strategy. Strategies can be helpful for topics that may be controver16
sial in your community because they allow disparate groups to work
toward the same goal while following unique paths. This approach
allows coalition members to find their own comfort level and still
work as part of the coalition.
Strategies can serve as umbrellas under which all coalition members
can contribute in some way to a given target. And don’t forget to
include ongoing data collection in your action plan–often called
monitoring because it refers to the collection of data.
Assignment of responsibility: Which member or members will
complete which action steps or part of the action steps? For example,
who will take responsibility for planning the 5K run? Who will
create the program to teach abstinence?
The action plan also needs to indicate who will be responsible for
overseeing and following up on specific action steps. Assigning
specific individuals to well-defined and agreed-upon roles will
facilitate the action plan. It also will help the coalition members feel
that they are important parts of the team, with responsibility to fulfill
their roles and help realize the vision.
A timeline: How much time will it take for each part of the plan to
be completed?
An important note about setting deadlines and/or schedules: If it is
February 1, don’t expect to plan a communitywide 5K run by
March 1 and have all the dignitaries there. There simply isn’t enough
time. So be realistic! Maybe by March 1 you could have in place the
list of dignitaries to be invited and your plan for the run. Remember,
failing to prepare is preparing to fail.
17
IMPLEMENT the Action Plan
Initiate action: Once the action
plan is established, coalition
members can begin to implement
the strategies and action steps set
forth in the plan. Coalition members who have accepted responsibility for specific tasks will need
to complete those tasks in a timely
manner, consistent with the
schedule agreed upon in the
action plan.
After the Columbine tragedy, concerned citizens in
Lafayette, Louisiana,
formed a community task
force on the prevention of
violence in schools. In
concert with local school
officials and psychologists,
the task force proposed
closer monitoring of cases
of anger and early intervention with professional help
to defuse potentially dangerous situations. HEALTHY
PEOPLE 2010’s Focus Area
on Injury and Violence
Prevention has been helpful
as a guide for assessing
workable solutions.
This part of the process is helped
by having a diversified and
cooperative group of community
leaders who share the same
vision. For example, having the
school superintendent as a coalition member and supporter of the
healthy community initiative
could make it easier to implement proposed actions in the schools.
Implement your plan by taking concrete actions that will make a
difference.
Another key to implementation is monitoring or routine tracking of
events. For example, if your action plans calls for weekly reports to
be created by a given group on a set topic, monitoring will let you
know that this is, indeed, occurring. A good monitoring system will
help you understand if the action plan is being implemented as
18
anticipated. Also, remember that it is best to plan how to monitor an
initiative before the in
In an Excel Spreadsheet:Submit a finalized copy of your capital budget that includes any changes I have recommended.EvaluationThis assignment will be graded using the HSC528 Finance Project Part III Rubric Download HSC528 Finance Project Part III Rubric, located in the previous M7.5 assignment. It is also located on the Course Rubrics page within the Course Introduction module of this course. Please review this rubric prior to beginning your work. Your project is worth 50% of your overall grade. The average grade of all three parts will be used to calculate your grade.
Topic: Fatty acid oxidation disorders – All the instructions are in the file – plz; I want it to be unique and the plagiarism rate is 0%.
Unformatted Attachment Preview
Metabolic and Genetic Nutritional Disorders Assignment Instructions
Long Essay Assignment
Write a long Essay regarding any of the Inherited Metabolic Disorders (IMDs) you’ve
learned. Explain the background and pathophysiology of the disorder and the importance of
nutritional assessment and intervention on the diagnosis and treatment of nutrition-related
diseases. Then, write the appropriate nutritional management.
You can choose one of the following topics:
Phenylketonuria
Maple syrup urine disease
Fatty acid oxidation disorders
Learning objectives of the assignment:
1. Analyse the genetic background and pathophysiology of the disorder.
2. Identify the importance of nutritional assessment and intervention on the
diagnosis and treatment of nutrition-related diseases
3. Demonstrate professional behaviour represented in time management and
organizational skill.
The due date is week 10 (Sunday 27/3/2022) at 11:55 pm.
Linkage to the CLOs:
S1: critically analyse the genetic background, clinical presentation, pathophysiology and
prognosis of IMDs that rely on dietary treatment to correct metabolic derangement.
S3: Demonstrate in-depth understanding of the effects of nutrition assessment and
interventions on the diagnosis, treatment and prevention of specific nutrition-related diseases
of stages of lifecycle development.
V1: Develop professional behaviours, including organizational skills time management skills.
Instructions of the Assignment
•
•
All assignments should be typed.
All essay/ papers should have the following heading:
Name:__________
ID Number_________
Course:____________
Essay Title: __________
•
•
•
•
All papers should be double-spaced with 1-inch margins. Use A4 size and Font Color
black. Indent to show new paragraph.
The essay assignment is 1-3 pages in length (minimum: halfway down the second
page)
Spell check and proofread everything. A poorly edited paper is hard to read; it can be
very difficult to get past the surface errors to see the ideas of the paper. Grammar
plays a significant role in the assignments. Not only does it factor into the overall
grade, but without clear and precise language, the ideas can lose the impact or might
even be misunderstood entirely.
Font Type:
o Main text: 12-point Time New Roman,
o Subtitles/heading: 14-point Time New Roman.
Format of the Assignment
The essay format is described below;
1. Introduction:
In this section, the student should provide a bit of background about the essay and
identify the questions.
This section should answer the reader’s question: What is this essay about?
2. Body Paragraph:
In this section, the student should describe and explain the essay. Try to organize
the information.
3. Conclusions:
Wrap up the ideas and restate the topic sentence.
Evaluation: The essay paper will be assessed based on rubrics.
Rubrics
•
•
Name and student ID number on the top right of each page.
Use at least 3 sources (website, books, journals, etc…). Properly cited sources for
the information using APA format.
•
An image, illustrations or pictures must be on a separate page. The image should
be properly labelled with legend.
•
Papers submitted late will be downgraded. The paper must be completed to pass
the course.
Grading Rubrics:
Student Conduct:
Academic dishonesty, including cheating and plagiarism are not permitted. Students should
comply with Jazan University rules and regulations. For more information, read the “Students
rights and duties” and “The executive rules for the undergraduate study and examination
regulations”.
Plagiarism:
According to Oxford English Dictionary, plagiarism is the action or practice of taking
someone else’s work, idea, etc., and passing it off as one’s own; literary theft. For more
information about plagiarism refer to this article. To avoid plagiarism, follow these steps:
1. While writing, separate your own ideas from the ideas of others. You can paraphrase
or quote from your sources.
2. In paraphrasing, you will write the author’s work in your own words. You need to
properly cite the original author’s work by using both in-text citation and its
corresponding reference at the end of your paper (reference list).
3. In quoting, you can write the author’s exact words, but you need to put it between
parenthesis. For example: “Tell me and I forget. Teach me and I remember. Involve
me and I learn.” -Benjamin Franklin.
4. Use a plagiarism check software before submitting your paper. The software will
detect if you didn’t use in-text citation properly, didn’t paraphrase the original work
properly, or missed a quotation mark. One of the plagiarism checkers is available in
Blackboard. You can also use another software: free and paid checks, only free
checks.
Electronic resources:
https://www.eatright.org/ – Academy of Nutrition and Dietetics
www.nutrition.org – American Society for Nutrition
https://www.genome.gov/For-Patients-and-Families/Genetic-Disorders – National Human
Genome Research Institute
https://www.nih.gov/ – National Institute of Health
https://www.fao.org/home/en – Food and Agriculture Organization of United Nations
www.pubmed.ncbi.nlm.nih.gov – PubMed
www.usda.gov – U.S. Department of Agriculture
As you complete the gathering and evaluation of the evidence, it’s important to review the significance and next steps related to EBP.Consider the following questions in your discussion post:How does a nurse know what (if any) knowledge in a research study is usable for clinical practice?What would a critical thinker look for in the evidence before deciding to change?What influence do credibility and clinical significance have on your decisions to integrate research-based evidence into your practice?Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.Please be sure to validate your opinions and ideas with citations and references in APA format.
To ensure the sustainability of standardizing emergency nursing education and training in the healthcare system change project after my leave, it is essential to put in place the following resources and considerations:
Comprehensive Documentation: Compile all relevant project information, including the project goals, strategies, methodologies, key findings, and lessons learned. This documentation will guide future staff members and ensure continuity (U.S. Office of Personnel Management, 2022).
Standard Operating Procedures (SOPs): Develop SOPs outlining standardized processes and protocols for emergency nursing education and training. These SOPs should cover curriculum development, training methods, assessment processes, and ongoing professional development. Ensure these SOPs are accessible and regularly updated (Federal Emergency Management Agency, 2023).
Dedicated Staff: Assign a dedicated team or individual responsible for overseeing and managing the standardized emergency nursing education and training initiatives. This person should have expertise, leadership skills, and a deep understanding of emergency nursing practices (U.S. Office of Personnel Management, 2022)
Training and Development Programs: Establish ongoing training and development programs to support the staff members involved in emergency nursing education and training. This includes providing opportunities for continuous learning, staying updated with evidence-based practices, and fostering professional growth (Federal Emergency Management Agency, 2023)
Collaboration with Stakeholders: Engage key stakeholders, including educators, trainers, healthcare professionals, and nursing associations, to ensure their continued involvement and support. Collaborative efforts will help sustain the standardization efforts and foster a culture of continuous improvement (U.S. Office of Personnel Management, 2022)
Quality Assurance and Evaluation: Implement a robust quality assurance and evaluation process to monitor the effectiveness and impact of standardized education and training initiatives. Regularly assess and review curriculum materials, instructional methods, and outcomes to identify areas for improvement and ensure ongoing relevance (U.S. Office of Personnel Management, 2022).
When leaving someone in charge of the change after my leave, it would be advisable to identify a competent and dedicated individual with the necessary qualifications and expertise in emergency nursing education and training. This person should understand the project goals, methodologies, and the organization’s culture. To ensure a smooth transition, provide comprehensive training and knowledge transfer to the individual, including detailed handover documentation, access to relevant resources, and ongoing support during the initial stages. This will help them effectively oversee the standardized emergency nursing education and training initiatives and make informed decisions to sustain the project’s success.
By implementing these resources, assigning a dedicated team, and providing comprehensive documentation and training, I can ensure the organization’s sustainability of the standardized emergency nursing education and training project after my leave.
Reference
The Workforce Planning (Ed.). (2022, November). Workforce Planning Guide – U.S. Office of Personnel Management. Workforce Planning Guide. https://www.opm.gov/policy-data-oversight/human-ca…
Federal Emergency Management Agency (Ed.). (2023, April). Public Assistance SOPs and Operations Manuals. FEMA.gov. https://www.fema.gov/assistance/public/policy-guid…
Post 2
To ensure proper sustainability for the project it is important to understand what the frameworks are for. Between the conceptual and the theoretical framework, quite a bit of what needs to be done in all aspects of the project is essentially dictated there. Considering that frameworks exist to provide a blueprint, or structural guidelines for the implementation of processes to ensure accuracy in repetition, as well as function as a project or system skeleton (Nazeri et al., 2019). That being said, the most important aspect of ensuring and maintaining sustainability is to develop the project to truly reflect the selected theoretical and conceptual frameworks. In my change project’s case, the Betty Neuman Systems Model and the Donabedian Quality model work great because between the two they encompass all patients needs coupled with facility-based resources, and a strict quality assurance feedback loop. The best person to remain in charge of this process is the APRN, therefore it would be prudent to find another AGACNP with similar experience in the relating field to lead the interprofessional team and abide by the selected frameworks as they pertain to the many facets and caveats of the project. As far as information goes, or training/orienting to the role of the team lead, the new APRN will be guided on project expectations, goals, desired benchmarks, and how to navigate the complex dynamics between the patient’s needs and the interventions of the interprofessional team. Another matter to consider is the solidification of the project as a set of policy and procedures where implementation takes place, this way it ensures it becomes a norm to apply to any patient that is categorically eligible to participate. When a process becomes rooted as a policy and procedure it may be difficult to change without complex steps, but this project will have fairly detailed instructions on the matter of the quality assurance process and the consequent needs for any alterations in practices. It may sound difficult, but it is feasible to attain the necessary stability in complex processes as long as there is a framework to which everyone can adhere.
Reference:
Nazari, E., Shahriari, M. H., & Tabesh, H. (2019). Applications of framework in Health Care: A Survey. Frontiers in Health Informatics, 8(1), 16. https://doi.org/10.30699/fhi.v8i1.186
A 28-year-old woman visits a healthcare facility with reports of weakness and pain in the calves that occurs when walking and is relieved with rest. Please answer the following questions in at least 500 words with 2 outside reliable sourcesWhat assessment techniques should the nurse use to obtain related data from the client?Discuss how the nurse will document the assessment findings.What teaching opportunities does the nurse have with this client?
Please view and use the sample paper attached for this paper. The reference and article you will use are also attached because you wont be able to access my school library.
For this assessment, Create a 3-5 page annotated bibliography and summary based on your research related to best practices addressing Limited Access to Healthcare .
Side note: To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.
1) a brief overview of Limited Access to Healthcare problem. In your overview:
Summarize the health care problem or issue.
Describe the professional relevance of this topic.
Describe any professional experience you have with this topic.
2) Identify peer-reviewed articles relevant to this health care issue or problem..
Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.
Use the information in below to form a paragraph for number 2 question;
I used the search engine called Summon from the Capella University Library. Summon looks through almost all of the library’s materials. I refined my search for my peer review article and full text online. I search for keywords like “barriers in accessing health services” and “limited access to healthcare” I also chose a Journal article for the content type. I chose Nursing and medicine as the discipline filter. Also I chose article published within five years.
3) Assess the credibility and explain relevance of the information sources you find.
Determine if the source is from an academic peer-reviewed journal.
Determine if the publication is current.
Determine if information in the academic peer-reviewed journal article is still relevant.
4) Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide a rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:
a. Identify the purpose of the article.
b. Summarize the information.
c. Provide rationale for inclusion of each article.
d. Include the conclusions and findings of the article.
e. Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.
f. List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
g. Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
5) Summarize what you have learned while developing an annotated bibliography.
a. Summarize what you learned from your research in a separate paragraph or two at the end of the paper.
b. List the main points you learned from your research.
c. Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.
Your assessment should also meet the following requirements:
Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
Font and font size: Times New Roman, 12 point.
Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Content: Provide a title page and reference page following APA style.
References: Use at least four scholarly or academic peer-reviewed journal articles.
APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
Instructions: Submit a problem-focused SOAP note for grading. You must use an actual patient from your clinical practicum who presents with one or more chief complaints.
37 y/o female presents to clinic complaining of redness, irritation, yellowish discharge, foul odor and itching in her vaginal area. please make up and fill the bulletin points that associate with these symtopms.
Use the format below for your SOAP note.
Use the current APA format to style your paper and cite your sources. Review the rubric for more information on how your assignment will be graded.
Problem-Focused SOAP Note Format
Demographic Data
Age and gender (must be HIPAA compliant)
Subjective
Chief Complaint (CC): A short statement about why they are there
History of Present Illness (HPI): Write your HPI in paragraph form. Start with the age, gender, and why they are there (example: 23-year-old female here for…). Elaborate using the acronym OLDCART: Onset, Location, Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment
Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies, immunizations, and preventative health maintenance
Family Hx: any history of CA, DM, HTN, MI, CVA?
Social Hx: Including nutrition, exercise, substance use, sexual hx, occupation, school, etc.
Review of Systems (ROS) as appropriate: Include health maintenance (e.g., eye, dental, pap, vaccines, colonoscopy)
Objective
Vital Signs
Physical findings listed by body systems, not paragraph form- Highlight abnormal findings
Assessment (the diagnosis)
At least Two (2) differential diagnoses (if applicable) with rationale and pertinent positives and negatives for each
Final diagnosis with rationale, pertinent positives and negatives, and pathophysiological explanation
Plan
Dx Plan (lab, x-ray)
Tx Plan (meds): including medication(s) prescribed (if any), dosage, frequency, duration, and refill(s) (if any)
Pt. Education, including specific medication teaching points
Referral/Follow-up
Health maintenance: including when screenings eye, dental, pap, vaccines, immunizations, etc. are next due
Reference
Compare care given to the patient with the National Standards of Care/National Guidelines. Cite accordingly.
Points: 50
Problem-focused SOAP Note Format
Rubric
Problem-focused SOAP Note Rubric
Problem-focused SOAP Note Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeSubject
12.5 to >11.5 pts
Accomplished
Symptom analysis is well organized, with C/C, OLDCART, pertinent negatives, and pertinent positives. All data needed to support the diagnosis & differential are present. Is complete, concise, and relevant with no extraneous data.
11.5 to >10.25 pts
Satisfactory
Symptom analysis well organized with C/C, OLDCART, pertinent negatives, and pertinent positives. Some extraneous data present and/or one minor data point missing.
10.25 to >8.64 pts
Needs Improvement
Symptom analysis is not well organized. Data is missing. There is too much extraneous data and/or 2-3 minor data points missing.
8.64 to >0 pts
Unsatisfactory
Symptom analysis is inadequate, is not organized. Objective or other data is mixed into the subjective data. Important data is missing.
12.5 pts
This criterion is linked to a Learning OutcomeObject
12.5 to >11.5 pts
Accomplished
Complete, concise, well organized, and well written and includes pertinent positive and pertinent negative physical findings. Organized by body system in list format. No extraneous data.
11.5 to >10.25 pts
Satisfactory
All relevant exams were done thoroughly but extraneous exams were also done. Somewhat organized in list format.
10.25 to >8.64 pts
Needs Improvement
Omitted important relevant exams and/or not in list format.
8.64 to >0 pts
Unsatisfactory
Omitted important relevant exams and/or subjective data are included. Lacking organization.
12.5 pts
This criterion is linked to a Learning OutcomeAssessment
12.5 to >11.5 pts
Accomplished
Diagnosis and differential dx are correct with ICD code and supported by subjective and objective data.
11.5 to >10.25 pts
Satisfactory
Diagnosis is correct with ICD codes and is supported by subjective and objective data, however, the most accurate differential diagnosis is not listed according to subjective and objective data.
10.25 to >8.64 pts
Needs Improvement
Diagnosis is correct but either does not include ICD code or is missing two or more important differential diagnoses according to the subjective and objective data provided.
8.64 to >0 pts
Unsatisfactory
Diagnosis is not correct, is not provided, or is not reflective of the subjective and objective data provided.
12.5 pts
This criterion is linked to a Learning OutcomePlan
12.5 to >11.5 pts
Accomplished
Plan is organized, complete, and evidence-based according to the National Standards of Care. Addresses each diagnosis and is individualized to the specific patient and includes medication teaching and all 5 components: (Dx plan, Tx plan, patient education, referral/follow-up, health maintenance).
11.5 to >10.25 pts
Satisfactory
Plan is organized, complete, and evidence-based according to the National Standards of Care. Addresses each diagnosis and is individualized to the specific patient and includes medication teaching but may be missing 1-2 minor points.
10.25 to >8.64 pts
Needs Improvement
Plan is less organized and not based on evidence according to the National Standards of Care. Does not address each diagnosis or may not be individualized to the specific patient. Missing medication teaching or one of the 5 components.
8.64 to >0 pts
Unsatisfactory
No Plan is provided or is not organized. Does not address all diagnoses identified and/or does not include all 5 components of plan, including medication teaching.
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please review the two articles provided before starting. No outside sources, please. Just use the two articles provided.
Before taking your test, please start here:
About True Colors Discover True Colors Trainings | Global Consulting & Training Company (truecolorsintl.com) Please write an essay regarding your True Colors Personality quiz results. Include personality traits that will be beneficial to you working in the healthcare field and as a fellow co-worker. Then include some personality traits that might be a roadblock or a hindrance when working with patients and co-workers. This essay should be thought out and self-reflective. Please see below rubric. A minimum of three paragraphs is required for full credit.
Please click on the below link to download your personality assessment:
true_colors_test printable.pdf
Requirements: 1 Full Page Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages | .doc file
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to carefully follow the instructions.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each paragraph written.
Please review the two articles provided before starting. No outside sources, please. Just use the two articles provided.
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Discovering Our Personality Style Through TRUE COLORS
Outcomes
In this module participants will :
Discover the qualities and characteristics of their own particular personality style
or type;
Gain an understanding of other personality styles.
Key Concepts
True Colors is a metaphor.
Each person is a unique blend of the four colors or styles—a spectrum.
There are no bad or good colors.
There are wide individual variations within each color spectrum.
Each of us has a different and unique personality; however, there are commonalities
that we share. True Colors is an attempt to identify various personality styles and label
them with colors. This model of categorizing personality styles is based on many years
of work by other researchers and psychologists. Essentially it draws heavily on the work
of Isabel Briggs-Myers, Katherine Briggs, and David Keirsey. Don Lowry, a student of
Keirsey, developed the system called True Colors which uses four primary colors to
designate personality types and behavioral styles.
Lowry’s objective was the application of temperament or personality style to facilitate
deeper communications and understanding. He hoped it would result in positive selfworth and self-esteem. The True Colors program was designed to maximize the
application of psychological style in the workplace, in the family and in education and in
other types of communities. The ease of understanding and use in all human
relationships and interactions make this model very functional.
The belief is that with increased understanding of ourselves and others that conflict will
decrease. Once you learn your color and that of your co-workers, you will have a better
understanding of why they behave the way they do!
Each color is associated with certain personality traits or behaviors. Everyone has some
degree of each color, but one color is predominant. The following quiz will identify your
color spectrum. Print out the following two pages. Follow the directions carefully and
transfer your scores to the score sheet. If you have two colors with the same score, you
pick which one you think more accurately describes you.
Instructions: Compare all 4 boxes in each row. Do not analyze each word; just get a sense
of each box.Score each of the four boxes in each row from most to least as it
describes you: 4 = most, 3 = a lot, 2 = somewhat, 1 = least.
Row 1
A
B
C
D
Active
Organized
Warm
Learning
Variety
Planned
Helpful
Science
Sports
Neat
Friends
Quiet
Opportunities
Parental
Authentic
Versatile
Spontaneous
Traditional
Harmonious
Inventive
Flexible
Responsible
Compassionate
Competent
Row 2
Row 3
Row 4
Row 5
Score
E
Curious
Ideas
Questions
Conceptual
Knowledge
Problem Solver
Score
F
Caring
People Oriented
Feelings
Unique
Empathetic
Communicative
Score
G
Orderly
On-time
Honest
Stable
Sensible
Dependable
Score
H
Action
Challenges
Competitive
Impetuous
Impactful
Score
I
Helpful
Trustworthy
Dependable
Loyal
Conservative
Organized
Score
J
Kind
Understanding
Giving
Devoted
Warm
Poetic
Score
K
Playful
Quick
Adventurous
Confrontive
Open Minded
Independent
Score
L
Independent
Exploring
Competent
Theoretical
Why Questions
Ingenious
Score
M
Follow
Rules
Useful
Save Money
Concerned
Procedural
Cooperative
Score
N
Active
Free
Winning
Daring
Impulsive
Risk Taker
Score
O
Sharing
Getting Along
Feelings
Tender
Inspirational
Dramatic
Score
P
Thinking
Solving Problems
Perfectionistic
Determined
Complex
Composed
Score
Q
Puzzles
Seeking Info
Making Sense
Philosophical
Principled
Rational
Score
R
Social Causes
Easy Going
Happy Endings
Approachable
Affectionate
Sympathetic
Score
S
Exciting
Lively
Hands On
Courageous
Skillful
On Stage
Score
T
Pride
Tradition
Do Things Right
Orderly
Conventional
Careful
Score
Score
Score
Score
Total Orange Score
Total Green Score
Total Blue Score
Total Gold Score
A,H,K,N,S
D, E, L, P, Q
C, F, J, O, R
B, G, I, M, T
If any of the scores in the colored boxes are less than 5 or greater than 20 you have
made an error. Please go back and read the instructions.
Congratulations! You now know your color spectrum. Here are some general descriptions of each color:
Greens
Oranges
Are innovative and logical
Seek to understand the world
Need to be competent
Require intellectual freedom
Are curious
Question authority
Push themselves to improve
Seek perfection in play
May become intellectually isolated
Are slow to make decisions
Value concise communication
Look for intellectual stimulation
Enjoy intriguing discussions
Are sometimes oblivious to
emotions
Are detached
Believe work is play
Are drawn to technical occupations
Analyze and rearrange systems
Focus on the future
Bring innovation to society
Are free and spontaneous
Are impulsive risk-takers
Are active
Are optimistic
Resist commitment
Can become virtuosos
Thrive on crises
Are drawn to tools
Like to be the center of attention
Have great endurance
Are drawn to action jobs
Need variety
Are dynamic, animated
communicators
Are competitive
Deal with the here and now
Are bold in relationships
Are generous
Have difficulty finding acceptance
Like to live in a casual atmosphere
Bring excitement to society
Golds
Are dutiful and stable
Need to be useful
Want to be self-sufficient
Value organization
Desire punctuality
Schedule their lives
Make and keep commitments
Measure worth by completion
Are goal-oriented
Value rules
Prepare for the future
Are inclined to join groups
Believe work comes before play
Safeguard tradition
Prefer order and cleanliness
Are responsible and dedicated
Are drawn to respected
occupations
Enjoy positions of authority
Desire structure
Bring stability to society
http://hsgd.org (Head Start of Greater Dallas)
Blues
Are in search of themselves
Need to feel unique
Must be true to themselves
Look for symbolism
Value close relationships
Encourage expression
Desire quality time with loved ones
Need opportunities to be creative
Compromise and cooperate
Nurture people, plants and animals
Look beyond the surface
Share emotions
Make decisions based on feelings
Need harmony
Are adaptable
Are drawn to literature
Are drawn to nurturing careers
Get involved in causes
Are committed to ideals
Bring unity to society
playing the “role” of a nurse who is teaching another novice nurse about blood transfusion who has never done it before. a. purpose of why we give blood transfusion and when should we not give itb. what are the different blood components and why are they importantc. as a nurse giving the blood transfusion what is our responsibility (ex. getting consent, pre vital signs, preparation, etc.)d. what is the step-by-step process when we administer BT- (include pre-, during-, & post-BT administration)e. briefly explain the different types of reaction and what we should do if in case it happens.
Instructions: Read the following case study and answer the reflective questions. Please provide evidence-based rationales for your answers. APA, 7th ed. must be followed.TWO bibliography references ,400 words . case study is in upload files
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MSN 5550 Health Promotion: Prevention of Disease
Case Study Module 6
Instructions: Read the following case study and answer the reflective questions. Please provide
evidence-based rationales for your answers. APA, 7th ed. must be followed.
Due: Saturday by 23:59 pm
CASE STUDY: Albert
Albert Mitchell is a 36-year-old man who will be traveling to Dubai to give a business
presentation in 3 months. Although he has traveled widely in the United States as a consultant,
this is his first trip to the Middle East.
He requests information regarding immunizations needed before his trip. Albert states that as
he will be in Dubai for only a few days, he is unlikely to contract a disease in such a short time
and therefore believes that it is illogical to obtain immunizations.
Albert states that he has heard that the side effects of the immunizations might be worse than
the diseases they prevent. He is also concerned about leaving his wife at home alone because
she is 6 months pregnant.
Reflective Questions
How would you address Albert’s beliefs?
What learning would be needed in each domain?
What learning theories would you consider?
How might his family concerns be addressed?
Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. In a separate written deliverable, write a 5–7 page analysis of your intervention.
Please submit both your solution/intervention and the 5–7 page analysis to complete Assessment 4.
Expand All
Introduction
In your first three assessments, you applied new knowledge and insight gleaned from the literature, from organizational data, and from direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your assessment of the problem. You’ve examined the problem from the perspectives of leadership, collaboration, communication, change management, policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources. Now it’s time to turn your attention to proposing an intervention (your capstone project), as a solution to the problem.
Preparation
In this assessment, you’ll develop an intervention as a solution to the health problem you’ve defined. To prepare for the assessment, think about an appropriate intervention, based on your work in the preceding assessments, that will produce tangible, measurable results for the patient, family, or group. In addition, you might consider using a root cause analysis to explore the underlying reasons for a problem and as the basis for developing and implementing an action plan to address the problem. Some appropriate interventions include the following:
Creating an educational brochure.
Producing an educational voice-over PowerPoint presentation or video focusing on your topic.
Creating a teaching plan for your patient, family, or group.
Recommending work process or workflow changes addressing your topic.
Plan to spend at least 3 direct practicum hours working with the same patient, family, or group.
In addition, you may wish to complete the following:
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct sufficient research of the scholarly and professional literature to inform your work and meet scholarly expectations for supporting evidence.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Complete this assessment in two parts: (a) develop an intervention as a solution to the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.
Part 1
Develop an intervention, as a solution to the problem, based on your assessment and supported by data and scholarly, evidence-based sources.
Incorporate relevant aspects of the following considerations that shaped your understanding of the problem:
Leadership.
Collaboration.
Communication.
Change management.
Policy.
Quality of care.
Patient safety.
Costs to the system and individual.
Technology.
Care coordination.
Community resources.
Part 2
Submit your proposed intervention to your faculty for review and approval.
In a separate written deliverable, write a 5–7 page analysis of your intervention.
Summarize the patient, family, or population problem.
Explain why you selected this problem as the focus of your project.
Explain why the problem is relevant to your professional practice and to the patient, family, or group.
In addition, address the requirements outlined below. These requirements correspond to the scoring guide criteria for this assessment, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
Define the role of leadership and change management in addressing the problem.
Explain how leadership and change management strategies influenced the development of your proposed intervention.
Explain how nursing ethics informed the development of your proposed intervention.
Include a copy of the intervention/solution/professional product.
Propose strategies for communicating and collaborating with the patient, family, or group to improve outcomes associated with the problem.
Identify the patient, family, or group.
Discuss the benefits of gathering their input to improve care associated with the problem.
Identify best-practice strategies from the literature for effective communication and collaboration to improve outcomes.
Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of your proposed intervention.
Cite the standards and/or policies that guided your work.
Describe research that has tested the effectiveness of these standards and/or policies in improving outcomes for this problem.
Explain how your proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Cite evidence from the literature that supports your conclusions.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Explain how technology, care coordination, and the utilization of community resources can be applied in addressing the problem.
Cite evidence from the literature that supports your conclusions.
Write concisely and directly, using active voice.
Apply APA formatting to in-text citations and references.
Additional Requirements
Format: Format the written analysis of your intervention using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Portfolio Prompt: Save your intervention to your ePortfolio. After you complete your program, you may want to consider leveraging your portfolio as part of a job search or other demonstration of your academic and professional competencies.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
Define the role of leadership and change management in addressing a patient, family, or population health problem and includes a copy of intervention/solution/professional product.
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention.
Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem.
Competency 8: Integrate professional standards and values into practice.
Write concisely and directly, using active voice.
Apply APA formatting to in-text citations and references.
Guidelines:Word count: 300to 1000 words Follow APA format for your assignment must include Introduction, Body and ConclusionAll information must be mention in APA referenceFont and Size: Times New Roman (12)Color – Black, Spacing – 1.5, Heading and sub-heading – BoldFollow APA format your assignment must include Introduction, Body & ConclusionAvoid plagiarismSubmit as word document
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
Dr. Ahmed Hazazi
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
This week we have examined workplace safety in healthcare environments. Consider what you have learned and respond to the following directives:Discuss initiatives in healthcare to protect healthcare providers against workplace violence.Discuss a local or national news story involving the safety of healthcare providers.Identify two risk factors and two prevention strategies involving workplace violence.Please be sure to validate your opinions and ideas with citations and references in APA format.
Apply and integrate the concepts and knowledge gained in prior general management and health care administration courses to industry-relevant challenges.
Assess the relevant strategic decision-making and implementation issues within a health care organization.
Camp Fire, 2018
The California Wildfire of 2018 called the “Camp Fire” was the deadliest and most destructive wildfire in California’s history and the most expensive natural disaster in the world in 2018 in terms of insured losses. Named after Camp Creek Road, its place of origin, the fire started on Thursday, November 8, 2018, in Northern California’s Butte County. Ignited by a faulty electric transmission line, the fire originated above several communities and an east wind drove the fire downhill through developed areas. The fire caused at least 85 civilian fatalities, with one person still missing as of August 2, 2019, and injured 12 civilians, two prison inmate firefighters, and three other firefighters. It covered an area of 153,336 acres, and destroyed 18,804 structures, with most of the destruction occurring within the first four hours.
Adventist Health Feather River, also known as Feather River Hospital, is a 101-bed acute care hospital located in the town of Paradise, in Butte County, California, with a wide array of outpatient departments and services designed to meet the health care needs of Paradise, Magalia, and neighboring communities. Feather River Hospital was severely damaged in the November 2018 Camp Fire and is currently closed. The hospital was forced to evacuate after the fire jumped a road going to the hospital. Some people were trapped under Adventist Health Feather River in a tunnel until they could escape. Employees at Adventist Health Feather River evacuated 60 patients the morning of November 8, 2018. The patients were transported in ambulances, by helicopter, and in employee vehicles.
Your assignment: In a MEMO format, in 800-1000 words, please discuss the following about the Camp Fire 2018 Disaster Response:
What went well with the response?
What were the significant challenges with the response?
In which ways could the response have been improved?
As the Chief Operating Officer (COO) at Adventist Health Feather River Hospital, how would you augment your healthcare facility’s disaster preparedness?
During Week One, we discussed Fayol’s Five Functions of Management: (a) Planning, (b) organizing, (c) coordinating, (d) commanding, and (e) controlling. Discuss which ways you, as COO, would utilize Fayol’s Fourth Function of Management, commanding into enhancing your facilities’ disaster preparedness, response, and continuity of operations (COOP) plan.
Make certain that your assignment is in the APA 7th edition format with a cover page, separating your sections by the appropriate APA Level Headings. Also, make sure you include a reference page and at least five references.
Submit 1 Mini-SOAP note on a patient that you saw in clinic this week. Submit here as a Word Document. See the example template below for the required format.
69 y/o male presents to clinic for slip and fall at home. Patient is concern he fracture his right ankle. Pain has been going on for 3 days now and gradually getting worse. For the rest of the history you can make it up. please fill most bulletins with information.
Review the rubric for more information on how your assignment will be graded.
Problem-Focused SOAP Note Format
Demographic Data
Age, and gender (must be HIPAA compliant)
Subjective
Chief Complaint (CC) unless an Annual Physical Exam (APE)
History of Present Illness (HPI) in paragraph form (remember OLDCART: Onset, Location, Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment)
Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies, immunizations, and preventative health maintenance as applicable
Family Hx: As applicable
Social Hx: Including nutrition, exercise, substance use, sexual hx, occupation, school, etc.
Review of Systems (ROS) as appropriate: Include health maintenance (e.g., eye, dental, pap, vaccines, colonoscopy)
Objective
Vital signs
Physical findings listed by body systems, not paragraph form
Assessment (Diagnosis/ICD10 Code)
Include all diagnoses that apply for this visit
Plan
Dx Plan (lab, x-ray)
Tx Plan: (meds)
Pt. Education, including specific medication teaching points
Referral/Follow-up
Health maintenance (including when screenings, immunizations, etc., are next due):
*Based on population focus, some additional details may be required by faculty Problem-Focused SOAP Note Rubric
This criterion is linked to a Learning OutcomeSubject
6 to >5.3 pts
Accomplished
Symptom analysis is well organized, with C/C, OLDCART, pertinent negatives, and pertinent positives. All data needed to support the diagnosis & differential are present. Is complete, concise, relevant with no extraneous data.
5.3 to >4.7 pts
Satisfactory
Most subjective data is included (HPI, nutrition, meds, allergies, PMH, FH, SH). Some extraneous data is present and/or one minor data point missing.
4.7 to >4.1 pts
Needs Improvement
Subjective data is missing. There is too much extraneous data and/or 2-3 major data points missing.
4.1 to >0 pts
Unsatisfactory
Subjective data is missing or is not organized. Objective or other data is mixed into the subjective data.
6 pts
This criterion is linked to a Learning OutcomeObject
6 to >5.4 pts
Accomplished
Complete, concise, well organized, and well written with applicable vital signs. Organized by body system in list format. No extraneous data.
5.4 to >4.7 pts
Satisfactory
All relevant exams were done thoroughly but extraneous exams were also done. Somewhat organized in list format. Includes some but not all applicable vital signs or other required information.
4.7 to >4.21 pts
Needs Improvement
Omitted important relevant exams, vital signs, and/or not in list format.
4.21 to >0 pts
Unsatisfactory
Omitted important relevant exams, vital signs, and/or subjective data are included. Lacking organization.
6 pts
This criterion is linked to a Learning OutcomeAssessment
6 to >5.3 pts
Accomplished
Preventative care or applicable coding of visit and ICD10 is correct and includes additionally applicable preventative diagnoses based on age/population-specific recommendations.
5.3 to >4.7 pts
Satisfactory
Assessment is correct with ICD10 codes; however, some minor additional applicable preventative diagnoses based on age/ population-specific recommendations are missing.
4.7 to >4.1 pts
Needs Improvement
Assessment is correct but either does not include ICD10 code or is missing major additional applicable preventative diagnoses based on age/ population-specific recommendations
4.1 to >0 pts
Unsatisfactory
Assessment is not correct or is not provided. Missing applicable preventative diagnoses based on age/population-specific recommendations
6 pts
This criterion is linked to a Learning OutcomePlan
6 to >5.3 pts
Accomplished
Plan is organized, complete, and evidence-based according to the National Standards of Care. Individualized to the specific patient and all 5 components: (Dx plan, Tx plan, patient education, referral/follow-up, health maintenance).
5.3 to >4.7 pts
Satisfactory
Plan is organized, complete and evidence-based according to the National Standards of Care. Addresses each diagnosis and is individualized to the specific patient and includes medication teaching but may be missing 1-2 minor points.
4.7 to >4.2 pts
Needs Improvement
Plan is less organized and not based on evidence according to the National Standards of Care. Does not address each diagnosis or may not be individualized to the specific patient. Missing medication teaching or one of the 5 components.
4.2 to >0 pts
Unsatisfactory
No plan is provided or is not organized. Does not address all diagnoses identified and/or does not include all 5 components of plan, including medication teaching.
6 pts
This criterion is linked to a Learning OutcomeProfessional Documentation, Communication, and Engagement
6 to >5.3 pts
Accomplished
Addresses all instructor/preceptor comments and makes all changes and applies feedback as needed. Maintains a positive attitude toward faculty feedback.
5.3 to >4.7 pts
Satisfactory
Responds to and addresses some instructor/preceptor comments or questions and applies most instructor feedback to work. Maintains a positive attitude toward faculty feedback.
4.7 to >4.2 pts
Needs Improvement
Responds to some instructor/preceptor comments or questions but does not apply that feedback to work. A positive attitude toward faculty feedback needs improvement.
4.2 to >0 pts
Unsatisfactory
Does not respond to any instructor/preceptor comments and questions. Does not address instructor/preceptor comments and does not make the needed changes. Fails to respond and communicate with instructor.
Select one of the following case studies and corresponding Differentials Table to complete. In the subject line of your post, please identify which case study you are responding to.
Select one of the following case studies.
Complete the corresponding “Differentials Table” to align your clinical reasoning – include 5 differentials (excluding the example provided).
In SOAP format, discuss what questions you would ask the patient (Review of Systems), what physical exam elements you would include, what further testing you would want to have performed (if any), differential and working diagnosis, treatment plan, including the addition of complementary and OTC therapy, referrals and other team members needed to complete patient care.
Upload your Differentials Table and SOAP note to the Discussion Board
Note: Document at least one scholarly source to connect your response to national guidelines and evidence-based research in support of your ideas.
In your peer replies, please reply to at least one peer who chose a different case study.
***Important Considerations – As you dive deeper into your clinical practice, challenge yourself to formulate well-thought-out differentials prior to arriving at your final diagnosis. Diseases, despite their common features, can become unique and dynamic. This means that symptomatology can easily be affected by different modifying factors such as age, co-morbid conditions, environmental factors, and the like.
Case Studies
Mildred is a 45-year-old married female with three children. She presents to the clinic with complaints of fatigue and difficulty sleeping. She states she wants to get a good night’s sleep and is requesting a prescription to help her sleep. Mildred tells you she is awake off and on during the night, frequently thinking about her husband’s recent layoff from construction work and the effect this is having on the family. She lies down often during the day and has been so fatigued that she took some time off from work during the last two weeks. She is tearful at times during the visit and looks sad and anxious. On further discussion, she says she feels overwhelmed, helpless, and anxious. She tells you about an episode where she felt her heart beating rapidly, had difficulty catching her breath, felt she was going to have a heart attack, and became frightened until her husband was able to help calm her down. She is not eating as much as usual, and when she reads the newspaper, she does not remember what she has read.
Kylie, a 24-year-old female patient, comes to your office for a refill of her allergy medication. Before going into the room, you note that her Patient Health Questionnaire – Depression (PHQ-9) score is 20, and that she is not currently on any medication for depression. When you enter the room, you notice that Kylie is easily startled, and she is sitting in the corner of the room very close to the wall.
Dale, a 40-year-old construction worker, lost his 4-year-old daughter in a car accident six months ago, in which his sister was driving and he was a passenger. He is at this visit for a follow-up of a shoulder injury sustained last month. You notice that he has lost about eight pounds since his last visit, and he is somewhat disheveled in his appearance. Dale has not been back to work, and has not been able to get into a car since the accident. Before going into the room, your nurse pulled you aside to let you know that the patient was very rude to the front office staff, and was also rude to her while he was being processed for his visit. This is not Dale’s usual behavior.
If you chose case study 1, 2, or 3 complete the below Differentials Table
Differential Signs/Symptoms Gold Standard Diagnostics Gold Standard Treatment
Ex: PTSD Flashbacks, nightmares, intrusive thoughts, avoidance of reminders of trauma, agoraphobia, sleep disturbance and hypervigilance, feelings of detachment. Clinician-Administered PTSD Scale (CAPS-5) First-line treatment with a trauma-focused psychotherapy such as eye movement desensitization and reprocessing (EMDR). In individuals with comorbid disorders (ex., depression, psychosis) that affect the person’s ability to work in trauma-focused therapy (ex., concentration, motivation), treat with pharmacologic management; SSRI first line such as sertraline or paroxetine.
1.
2.
3.
4.
5.
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Adult Gero SOAP Note Template
Use this template for Comprehensive Notes (Initial Comprehensive/Annual visit)
and Problem-Focused Notes (Episodic/progress notes). For the Problem-Focused
Notes, only include pertinent problem-focused information related to the chief
concern (CC).
Demographic Data
o
o
Patient age and gender identity
MUST BE HIPAA compliant
Subjective
Chief Complaint (CC)
O
O
O
Place the complaint in Quotes
Brief description -only a few words and in the patient’s words
Example: “My chest hurts,” “I cannot breath,” or “I passed out,” etc.
History of Present Illness (HPI) – the reason for the appointment today
Use the OLDCARTS acronym to document the eight elements of a chief
concern (CC):
Onset, Location/radiation, Duration, Character, Aggravating
factors, Relieving factors, Timing, and Severity
O Briefly describe the general state of health prior to the problem.
O
PAST MEDICAL HISTORY:
O List current and past medical diagnoses (in list format)
PAST SURGICAL HISTORY:
O List all past surgeries including dates (in list format)
FAMILY HISTORY:
O Include medical/psychiatric problems to include 2 generations (parents,
grandparents, siblings, or direct relatives (in list format).
CURRENT MEDICATIONS:
O Include current prescription(s), over-the-counter medications,
herbal/alternative medications as well as vitamin/supplement use.
O Include Name of medication, Dosage, Route, frequency.
ALLERGIES:
O Include medications, foods, and chemicals such as latex.
O Include reaction type in parenthesis.
O Example: Penicillin (Hives)
IMMUNIZATIONS HISTORY: list current immunization status and address
deficiency
HEALTH MAINTENANCE: (See Table below – Appendix A)
o List any age appropriate health maintenance due/recommended in list
format.
SOCIAL HISTORY:
An acronym that may be used here is HEADSS which stands for Home
and Environment; Education, Employment, Eating; Activities;
Drugs/Alcohol; Sexuality.
O Employment/Education should include: occupation (type), exposure
to harmful agents, highest school achievement
O
REVIEW OF SYSTEMS:
O A ROS is a question-seeking inventory by body systems to identify
signs and/or symptoms that the patient may be experiencing or has
experienced that may or may not correlate with the CC.
*If a + finding is found not related to the cc this may represent an
additional problem that will need to be detailed in the HPI.
O Must include any physical complaint(s) by the body system that is
relevant to the treatment and management of the current concern(s).
List only the pertinent body systems specific to the CC.
O Remember to include pertinent positive and negative findings when
detailing the ROS related to a chief concern (cc).
O Pertinent positives should be documented first.
O Do not repeat the information provided in HPI
O Documented as “Reports” or “Denies”
Example of an exemplary negative ROS for a Comprehensive Note.
General: Denies malaise, weakness, fever, or chills. Denies recent weight gains or
losses of >20 pounds over the last 6 months.
Eyes: Denies change in vision or loss of vision, eye pain, sensitivity, or discharge.
Ears, nose, mouth & throat: Denies ear pain, loss of or decreased hearing, ringing
of the ears, drainage from the ears. Denies change in sense of smell, nose bleeds,
sinus or facial pain, speaking problems, hoarseness or choking, dry mouth, dental
problems, or difficulty chewing or swallowing.
Cardiovascular: Denies chest discomfort, heaviness, or tightness. Denies abnormal
heartbeat or palpitations. Denies shortness of breath, denies having to sleep
elevated on 2 pillows or more, no swelling of the feet, no passing out or nearly
passing out. Denies history of heart attack or heart failure.
Respiratory: Denies cough, phlegm production, coughing up blood, wheezing,
sleep apnea, exposure to inhaled substances in the workplace or home, no known
exposure to TB or travel outside the country. Denies history of asthma,
COPD/emphysema or any other chronic pulmonary disease.
Gastrointestinal: Denies nausea, vomiting, abdominal discomfort/pain. Denies
diarrhea, constipation, blood in the stool or black stools. Denies hemorrhoids,
trouble swallowing, heartburn or food intolerance. Denies history of liver or
gallbladder disease. No recent weight gains or losses of > 20 pounds within the
last year.
Skin & Breasts: Denies rash, itching, abnormal skin, or recent injury. Denies breast
pain, discharge, or other abnormality was reported by the patient.
Musculoskeletal: Denies muscle or joint pain, back or neck pain, and denies
recent accidents or injuries. Denies physical disability or condition that limits
activity or ADLs.
Allergic: Denies history of seasonal allergies, allergic rhinitis, watery eyes, or
wheezing. Denies history of HIV, hepatitis, shingles, or recurrent infections
Immunologic: Denies history of HIV, TB, hepatitis, shingles, or other recurrent
infectious diseases. Denies history of cancer – radiation or chemotherapy.
Endocrine: Denies polyuria, polydipsia, and polyphagia. Denies history of blood
sugar instability. Denies temperature intolerance to hot or cold. Denies swelling
of the neck or nodules.
Hematopoietic/Lymphatic: Denies unusual lumps or masses. Denies bruising
quickly or bleeding easily. Denies history of anemia or recent blood transfusions.
Denies sickle cell disease or trait. Denies blood dyscrasias.
Genitourinary: Denies dysuria, frequency, or urgency. Denies abnormal
vaginal/penile discharge or bleeding. Denies recent history of bladder or kidney
infections/stones. Denies sexual dysfunction or concerns.
Neurological: Denies unusual headaches, history of head injury or loss of
consciousness, lightheadedness, dizziness, vertigo. Denies numbness of a body
part or weakness on one side of the body. Denies pins and needle sensation,
abnormal movements, or seizure disorder. Denies previous strokes, seizures or
neurological disorders.
Psychiatric/Mental Status: Denies history of depression or anxiety. Denies
difficulty sleeping, persistent thoughts or worries, decrease in sexual desire,
abnormal thoughts, visual or auditory hallucinations. Denies history of psychosis
or schizophrenia. Denies difficulty concentrating or change in memory.
Objective
PHYSICAL EXAMINATION:
VITAL SIGNS: Blood pressure. Heart rate. Respirations. SaO2 (on room air or O2).
Temperature. Weight. Height. BMI.
Example of exemplar PE for a Comprehensive Note with no abnormal findings.
CONSTITUTIONAL/GENERAL APPEARANCE: Vital signs stable, in no acute distress.
Alert, well developed, well nourished.
HEENT:
Head: Atraumatic, normocephalic.
Eyes: Sclerae were white. Conjunctivae and lashes were clear. No lid lag.
Extraocular movements were intact (EOMI). PERRLA.
ENT: Ears, nose, mouth, and throat: Mucous membranes were pink, moist and intact.
External ear canals were clear without cerumen. TMs were clear, pearly gray with
good light reflex bilaterally. Hearing was intact to whisper. Nares patent and
mucosa is pink, moist and intact. Mouth, lips and tongue, gums were intact with no
lesions. Good dentition. Hard and soft palates intact. Tongue and uvula midline.
NECK: Supple. No JVD, thyromegaly or lymphadenopathy.
RESPIRATORY/CHEST: Unlabored. Chest rise is equal and symmetric. Lungs are CTA
bilaterally with no adventitious breath sounds.
CARDIOVASCULAR: S1, S2 without murmurs, rubs or gallops appreciated.
BREASTS: Skin intact without lesions, masses, or rashes. No nipple discharge. Breasts
with slight asymmetry, no dimpling, retractions or peau d’orange appearance.
GI: Normoactive bowel sounds. No hepatosplenomegaly on exam. No tenderness,
masses, or hernias appreciated.
GENITAL/RECTAL: no suprapubic tenderness or bladder bulges. No lesions, rashes,
masses or swelling.
LYMPH NODES: No enlarged glands of the neck, axilla or groin.
MUSCULOSKELETAL: Gait and station were within normal limits. Full range of
motion in all joints. Muscle strength and tone were 5/5 all groups. Equal arm swing.
INTEGUMENTARY: Skin was warm and intact. No rashes, lesions, masses or
discoloration. No abnormalities to fingers or toenails noted.
EXTREMITIES: No cyanosis or clubbing. No edema of the extremities. Pulses +2
bilaterally radial and pedal.
NEURO: Cranial nerves are intact grossly, II-XII. DTRs intact, +2 bilaterally with
symmetric response. Sensation intact to light touch. No motor or sensory deficits.
PSYCH: A&O x3. Recent and remote memory intact. Mood and affect appropriate
during visit. Judgment and insight were within normal limits at the time of visit.
*Full mini-mental status exam may be indicated based on the CC or findings in the
ROS or physical exam.
Assessment (Diagnosis)
Differential Diagnosis (DDx)
O
Include two (2) differential diagnoses you considered but did not select
as the final diagnosis. Why were these 2 diagnoses not selected?
Support with pertinent positive and negative findings for each
differential with an evidence-based guideline(s) (required).
Working or Final Diagnosis:
O Final or working diagnosis (1) (including ICD-10 code)
O Provide a rational explanation supported by evidenced-based guidelines
(required). List the pertinent positive and negative symptoms/signs that
support your final diagnosis.
Plan
Treatment (Tx) Plan: pharmacologic and/or nonpharmacologic
Diagnostics. Any labs, imaging, ordered? Remember you are managing
this patient in the outpatient/clinic setting, not the hospital.
O Pharmacologic -include full prescribing information for each
medication(s) ordered. Name of Medication, Dosage, Route, Frequency,
Duration, number of tabs prescribed, number of refills.
O
Patient Education:
O include specific education related to each medication prescribed.
O Was risk versus benefit of current treatment plan addressed for
medication(s) and interventions? Was the patient included in the
medical decision making and in agreement with the final plan?
O NPs should not be prescribing non-FDA approved medications or
medications related to off-label use. If a physician prescribed a nonFDA-approved medication for working diagnosis or recommended offlabel use, was education provided and was the risk to benefit of the
medication(s) addressed in the patient’s education?
Referral/Follow-up
O When would you like the patient to be seen in clinic again. Did you
recommend follow-up with PCP, or other healthcare
professionals/specialists?
O When is the subsequent follow-up?
Reference(s)
o Include APA formatted references for written assignments.
o Minimum 2 references are required from evidence-based resources.
APPENDIX A
Health Maintenance (Example – not all-inclusive)
Preventive Care
Pap
Mammogram
A1C
Eye Exam
Monofilament Test
Urine
Microalbumin
Diet/Lifestyle Changes
Digital Rectal Exam (DRE)
PSA
Colonoscopy or FOBT
Dexa Scan
CXR
BNP
ECG
Echo
Stress
Test
Vaccines
The Prevention TaskForce (formerly ePSS) application assists primary care clinicians to
identify the screening, counseling, and preventive medication services that are appropriate
for their patients.
Download this app and be sure to reference when assessing Health Maintenance priorities
for your patients:
https://www.uspreventiveservicestaskforce.org/apps/
Hi, I am attaching the exact guidelines to this email. PLEASE look over them VERY CAREFULLY so the assignment is done correctly. The first attachment is the grading criteria. Please use the following theory as I was assigned it… I was assigned: Shana Spratt Leininger’s Cultural Care Theory
Unformatted Attachment Preview
MID-RANGE or NURSING PRACTICE THEORY PRESENTATION
GRADING CRITERIA
PowerPoint Presentation: You should complete this assignment by preparing and presenting a
5-10 minute PowerPoint presentation with voiceover OR a recorded Zoom presentation. In
addition to your textbook, you must use two (2) additional references.
Avoid using only word-for-word information from the text – Use your own words, as well
as textbook information, to explain the following:
Background of the Theorist/Theory (brief synopsis) (15%)
Purpose and Major Concepts (20%)
Context for Use and Nursing Implications (20%)
Evidence of Empirical Testing and Application to Practice (20%)
Annotated Bibliography reference (5%)
• Identify a nursing research article that uses the mid-range or nursing practice
theory that your presentation discusses. Create an annotated bibliography on a
slide at the end of the presentation (before your reference slide).
•
Examples of annotated bibliographies:
http://guides.library.cornell.edu/annotatedbibliography
https://owl.english.purdue.edu/owl/resource/614/01/
APA & Grammar/Spelling (10%) You must include APA formatted citations within your
slides when warranted. Additionally, you should include an APA formatted reference
slide. No grammar or spelling errors.
Quality of PowerPoint slides (5%)
Slides are professional in appearance
Presentation Skills (5%)
Speaker uses a clear, audible voice. Delivery is poised, controlled, and smooth. Good
language skills and pronunciation are used. Length of presentation is within the assigned time
limits (5-10 minutes).
Elms College School of Nursing
MSN Program
NUR 5005 Nursing Knowledge and Practice – Fall 1 2023
Mid-Range and Nursing Practice Theory Presentation Assignment
Professor: Dr. Laurie Downes
Week 6 Presentation: Please create a PowerPoint with voice over or recorded Zoom presentation of
your assigned theory. Upload in Moodle.
Name
Shana Spratt
Theory
Leininger’s Cultural Care Theory
Kayla Cardona
Meleis Transitions Theory
Winnie Olivo
Kolcaba’s Theory of Comfort
Advances in Nursing Science
Vol. 42, No. 3, pp. 206–215
c 2019 The Authors. Published by Wolters Kluwer Health, Inc.
Copyright
Integrating Symptoms Into the
Middle-Range Theory of
Self-Care of Chronic Illness
Downloaded from https://journals.lww.com/advancesinnursingscience by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3wX04VDhDA67eAI3DnCyu4CWEnAA9qjJGuH/5uHUzwvQ= on 09/08/2019
Barbara Riegel, PhD, RN, FAAN; Tiny Jaarsma, PhD, RN, FAAN;
Christopher S. Lee, PhD, RN, FAAN; Anna Strömberg, PhD, RN, FAAN
The Middle-Range Theory of Self-Care of Chronic Illness has been used widely since it was
first published in 2012. With the goal of theoretical refinement in mind, we evaluated the
theory to identify areas where the theory lacked clarity and could be improved. The concept
of self-care monitoring was determined to be underdeveloped. We do not yet know how
the process of symptom monitoring influences the symptom appraisal process. Also, the
manner in which self-care monitoring and self-care management are associated was thought
to need refinement. As both of these issues relate to symptoms, we decided to enrich the
Middle-Range Theory with knowledge from theories about symptoms. Here, we propose a
revision to the Middle-Range Theory of Self-Care of Chronic Illness where symptoms are clearly
integrated with the self-care behaviors of self-care maintenance, monitoring, and management.
Key words: nursing theory, self-care, symptoms
N
URSING theory and nursing research are
engaged in a dance that moves each forward with the goal of advancing nursing sci-
Author Affiliations: School of Nursing, University
of Pennsylvania, Philadelphia (Dr Riegel);
Department of Social and Welfare Studies
(Dr Jaarsma), and Department of Medical and
Health Sciences, Division of Nursing (Dr Strömberg),
Linköping University, Linköping, Sweden; and
Connell School of Nursing, Boston College, Boston,
Massachusetts (Dr Lee).
The authors gratefully acknowledge Karen Huss, PhD,
RN, FAAN, for her review of a prior version of this
article.
This is an open-access article distributed under the
terms of the Creative Commons Attribution-Non
Commercial-No Derivatives License 4.0 (CCBY-NC-ND),
where it is permissible to download and share the
work provided it is properly cited. The work cannot
be changed in any way or used commercially without
permission from the journal.
The authors have disclosed that they have no significant relationships with, or financial interest in, any
commercial companies pertaining to this article.
Correspondence: Barbara Riegel, PhD, RN, FAAN,
School of Nursing, University of Pennsylvania,
418 Curie Blvd, Philadelphia, PA 19104 (briegel@
nursing.upenn.edu).
DOI: 10.1097/ANS.0000000000000237
206
ence. Nursing theory is defined as “a creative
and rigorous structuring of ideas that project a
tentative, purposeful, and systematic view of
phenomena.”1(p155) Nursing research refers to
research that provides evidence used to support nursing practice. Nursing theory needs
to be based on and driven by research, and,
in turn, nursing research needs to be derived
from and contribute to theory if we are to
successfully explain and predict patient experiences surrounding health and illness.
The theory-data cycle of development specifies that the empirical data derived from research serve to develop, revise, and refine
theory whereas theory helps shape research
questions, establish hypotheses, develop interventions, and select outcome variables
(Figure 1). Theoretical propositions posed to
describe or explain a complex reality can be
tested in research, and the results of these
studies can be used to further alter, expand,
modify, or refine theory. Even in established
and well-tested nursing theories, propositions
remain tentative. When new research accumulates, theories may be revised or refined
with the goal of creating solid evidence-based
Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness
Statement of Significance
• We know that self-care involves a
process of health maintenance,
monitoring for changes in signs
and symptoms, and management
of those changes when they
occur.
• We know that symptoms
influence self-care behaviors.
• This article describes how
symptoms influence self-care
behaviors. Specifically, this
article describes the importance
of symptom detection,
interpretation, and response as
core elements of the self-care
process.
knowledge useful for guiding clinical practice. In this approach to theory development,
there is a need for exploration, refinement,
and critical reflection on the place and value
of existing concepts and the need for expanding or developing others.
With the goal of theoretical refinement
in mind, the purpose of this article was to
evaluate the Middle-Range Theory of Self-Care
Figure 1. Graphic illustration of the manner in which
the theory-data cycle of development builds science.
Research questions are derived primarily from existing research literature. When these questions are
tested empirically, the research findings are used to
develop, revise, and refine theory. Theory helps shape
subsequent research questions, establish hypotheses,
develop interventions, and select outcome variables.
207
of Chronic Illness2 to identify areas where
empirical tests of the theory are likely to be
problematic. We used Weber’s3 framework
for theory development and evaluation to
determine where the Middle-Range Theory
of Self-Care of Chronic Illness2 lacked clarity
so that we could rectify issues by integrating
concepts from other models and theories.
CURRENT STATE OF THE
MIDDLE-RANGE THEORY OF SELF-CARE
OF CHRONIC ILLNESS
The Middle-Range Theory of Self-Care of
Chronic illness has gained the attention of
clinicians and researchers worldwide, already
resulting in 244 citations in the 6 years since
publication. Work to date on the theory has
successfully described the process of self-care
behaviors in various populations and identified numerous factors affecting the self-care
process.4-6
As described in the original theory, self-care
is performed in both healthy and ill states. It
is important to note that everyone engages in
some level of health-promoting self-care daily.
However, self-care might have another meaning to patients with a chronic illness, since
living optimally with a chronic illness often requires a set of behaviors to control the illness
process, decrease the burden of symptoms,
and improve survival.
Self-care is essential in the long-term management of chronic illnesses, and the purpose of the Middle-Range Theory of Self-Care
of Chronic Illness2 was to capture a holistic
view of the manner in which patients with
varied or multiple chronic conditions care
for themselves. Self-care influences both clinical and person-centered outcomes in patients
with chronic conditions. Those who engage
more effectively in self-care have better quality of life,7-9 lower hospitalization rates,10-13
and less mortality than those who report poor
self-care.14
In the Middle-Range Theory of Self-Care
of Chronic Illness,2 self-care is defined as a
process of maintaining health—the central
208
ADVANCES IN NURSING SCIENCE/JULY–SEPTEMBER 2019
phenomenon—through
health-promoting
practices and managing illness. These behaviors are performed in both healthy and ill
states. Self-care can be seen as an overarching
construct built from the 3 key concepts
of self-care maintenance (eg, adherence to
self-care behaviors such as regular exercise
and taking medication as prescribed), selfcare monitoring (eg, regular measurement
of changes, routine testing), and self-care
management (eg, changing the diet or
medication dose based on detection and
interpretation of symptoms). The 3 concepts
of self-care maintenance, monitoring, and
management are closely related; therefore,
the performance of sufficient self-care
encompasses all 3 behaviors.
For patients with chronic disease, it may
be necessary to regulate and adapt self-care
during the course of the disease, for example, with illness exacerbation, if a comorbid
illness occurs, or if an advanced treatment is
needed.2 The goal of self-care maintenance is
to maintain health and prevent symptom exacerbations, the goal of self-care monitoring is
recognition that a change has occurred, and
the goal of self-care management is effective
treatment of symptoms.
Self-care behaviors reflect a sequence that
builds on a foundation of self-care maintenance. That is, most patients first master selfcare maintenance and later build expertise in
self-care monitoring and management. People
who perform all 3 behaviors are most proficient in self-care. However, for a variety of reasons, people with chronic illness often skip
elements of the process, leading to problems
in the successful performance of self-care.
After a thorough analysis of existing parts
of the theory (eg, concepts, associations), we
identified 2 important issues needing further
development. First, the concept of self-care
monitoring was determined to be underdeveloped. Relatively, little research has been conducted on the process of self-care monitoring,
so more research may reveal what patients
think about monitoring (eg, their response
to engagement in body listening and routine
appraisal for bodily changes) if monitoring of
signs (eg, blood pressure) differs from that of
symptoms (eg, fatigue). We do not yet know
how the process of monitoring interacts with
the appraisal process. Are patients who monitor routinely more adept at judging changes?
We anticipate that more research will lead to
further revisions of the theory in the area
of self-care monitoring. Second, the manner
in which self-care monitoring and self-care
management are associated is underdeveloped in the existing theory. Logically, those
who do not monitor well probably do not
management well, but this hypothesis has not
been tested. As the Middle-Range Theory of
Self-Care of Chronic Illness aims to describe
and explain the process of maintaining health
within the context of the symptom management required of those with a chronic illness
and their families,2 we decided to enrich the
theory with knowledge from other theories
about symptoms.
DESCRIPTION OF SYMPTOM THEORIES
There are numerous classic symptom theories used to guide research in nursing
and related disciplines. We considered the
Dynamic Symptom Model,15,16 the Theory
of Unpleasant Symptoms,17 the Model of
Pathways to Treatment,18 the Illness Action
Model,19 the Symptoms Experience in Time
Model,20 the Situational Adaption Model,21
Self-Regulation Theory,22 the Symptom Interpretation Model,23 the Cognitive Perceptual
Model of Symptom Perception,24 Cue Competition Theory,25 Kolk’s Symptom Perception Model,26 and the Psychophysiological
Comparison Theory,27,28 because they complement the central arguments of the MiddleRange Theory of Self-Care of Chronic Illness in
their description of symptoms or position selfcare as an antecedent or consequence related
to symptoms. Below we describe elements of
the major symptom theories in nursing.17,29,30
In general, these theories aim to explain and
predict symptoms as well as to describe how
patients and caregivers appraise and act to
control symptoms when they occur.
Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness
209
Self-care and symptom theories often address the same concepts. In the Dynamic
Symptom Model,15,16 self-care is described
as an antecedent of the symptom experience, symptom trajectory, and symptom consequences. However, self-care is not specially
mentioned as an element of the intervention
strategy to relieve symptoms. In the MiddleRange Theory of Self-Care of Chronic Illness,
symptoms are described as important to monitor and as giving direction to self-care management behavior. That is, when symptoms
increase, patients can use different management strategies, such as changing medication
or diet or consulting a clinician. Detection, interpretation, and response are important elements of many symptom appraisal theories,31
and these concepts are vital parts of self-care
monitoring and management in the MiddleRange Theory of Self-Care of Chronic Illness.
the detection of bodily changes.31 Bodily
changes may be localized (eg, mid-sternal
chest pain) or generalized (eg, fatigue) and
can be detected by any of the body’s senses.
Theoretical discussions of symptoms specify
that detection of bodily changes may reflect a
difference in intensity and/or frequency of the
patient’s normal sensations that is sufficient
in magnitude, novelty, or significance to be
perceived.18,31 Detection of bodily changes
causes a disturbance in equilibrium19 that
drives patients to engage in self-care.32 As
symptoms are detected, they must be interpreted with meaning applied to bodily
changes, labeling them as symptoms. By definition, if a bodily change is not perceived, it
is not a symptom.
The symptom experience
The interpretation of bodily changes frequently involves characterizing the change
and applying meaning. As an example of characterization, Lenz et al17 defined symptoms as
entailing intensity (ie, severity, strength, and
amount), quality (ie, what a symptom feels
like, and location), duration (ie, frequency
and duration of intermittent and persistent
symptoms, and the temporal relationship between symptoms and activity), and distress
(ie, the degree to which the person is bothered by the symptom(s)—reflective of how
the patient interprets and experiences the
meaning he or she assigns to it). Armstrong30
defined the symptom experience as the perception of the frequency, intensity, distress,
and meaning of symptoms as they are produced and expressed. Furthermore, Henly
et al20 defined the symptom experience as
a flow process of evaluating and reevaluating
symptom perception, timing, distress, intensity, and quality.
A salient theme across multiple symptom
theories is that multiple symptoms frequently
occur simultaneously and are multiplicative17
or catalytic in effect.30 Moreover, certain
symptoms (particularly those that are serious, unpleasant, or inexplicable)20 draw
Across existing symptom theories, symptoms are defined as subjective physical or
mental experiences, appraised and defined by
the patient, and reflective of an altered health
state or change therein. For example, Lenz
et al17 defined symptoms as subjective experiences and indicators of change in function
as experience by the person. Dodd et al29 defined symptoms as based on the perception of
the individual experiencing the symptom and
his or her self-report. Armstrong30 stated that
each symptom was individually defined by the
patient. Insights from numerous lines of inquiry related to symptoms can be synthesized
into the categories of detecting, interpreting,
and responding to bodily changes (ie, symptoms). In the following section, we focus our
attention on the detection and interpretation
of bodily changes as symptoms. We address
the response to symptoms as they occur during self-care, as described in the Middle-Range
Theory of Self-Care of Chronic Illness.
Detecting bodily changes as symptoms
Several symptom theories are explicitly focused on symptom appraisal and start with
Interpreting bodily changes
as symptoms
210
ADVANCES IN NURSING SCIENCE/JULY–SEPTEMBER 2019
more energy in interpretation and eventual
management.
With respect to the meaning applied to
symptoms, bodily changes may be interpreted within social and cultural norms21 ;
this can lead to stoicism or concealment of
certain symptoms and overexpression of others as a function of what is perceived to
be acceptable. Bodily changes may be interpreted as a function of emotion and illness
representations22 including attribution (eg, fatigue from heart failure vs pulmonary disorder vs a normalized function of aging).22-24
Thus, the condition to which a symptom is attributed by the patient is inextricably linked
to the meaning that is applied to the experience. Bodily changes may be interpreted
differently depending on cognitive resources
and external sensory input24-26 ; this includes
external stress that may cause patients to be
unaware of major body changes. Finally, bodily changes may be interpreted on the basis of motivation to maintain physiological
stability.27,28
Recently, Whitaker et al31 harmonized findings across many symptom theories to
categorize antecedents preceding the detection and interpretation of bodily changes
as knowledge (ie, familiarity, awareness,
or understanding of bodily sensations acquired through experience or education),
attention (ie, focusing on relevant stimuli
while ignoring distractors), expectation
(preexisting beliefs, contextual biases,
and general heuristics or shortcuts), and
identity (ie, distinct characteristics of an
individual and his or her role in society).
Specific to nursing symptom management
theories, antecedents to interpreting bodily
changes have been categorized as being
physiological/disease-health related,17,20,29,30
personal,20,29,30 psychological,17,29 situational/ environmental,17,20 sociological,29
and developmental factors.29
Simply put, the process of detection, characterization, and meaning applied to bodily
changes as symptoms is complicated. Hence,
it is not surprising that the interpretation of
bodily changes may be inaccurate (ie, mis-
interpretation of a bodily change or the absence thereof as a symptom)25,31 and highly
variable among patients living with the same
condition. Importantly, there is room for improvement in how the detection and interpretation of bodily changes as symptoms are
incorporated into theories of self-care, which
we address further in our discussion of future
research.
Example integration of self-care and
symptom theories
In the following, we provide an example
to illustrate how to link the self-care perspective with the symptom management perspective. What would it look like if we studied
heart failure from a self-care perspective? The
patient with heart failure commonly experiences a variety of disabling symptoms that
are exacerbated by missing medication doses,
dietary indiscretions, and failure to maintain
an active lifestyle. Using a self-care perspective, the patient and the clinician would focus on self-care with the goal of preventing symptoms. That is, symptoms are something to be avoided and self-care is a primary
means of doing so. If symptoms occur, poor
self-care might be suspected. The clinician
might focus an assessment on reasons for poor
self-care and interventions to improve various aspects of self-care, including monitoring of symptoms and responding to symptoms
when they occur. Without more in-depth information on the symptoms experience, the
patient and the clinician might overlook the
complexity of symptom clusters33,34 and the
different dimensions of the symptom experience. Advice might be focused on “what
actions to take with this specific symptom”
without seeing the total picture of how symptoms and the management of symptoms with
self-care might interact. For example, increasing diuretics in response to dyspnea—a common self-care intervention—without considering the diurnal variation of the symptom
experience could affect sleep patterns.
What would it look like if we studied
heart failure from a symptom perspective?
Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness
Using symptom theory to guide care, attention would be given to the symptom itself
(eg, severity and interference thereof) rather
than addressing why it occurred. As noted in
the National Institutes of Health (NIH) Symptom Science Model, complex symptoms,
sequelae, and clusters of symptoms are
studied through a disease agnostic lens.35
The symptom phenotype is characterized
using physiologic and biologic measures
derived from genomics, proteomics, and
metabolomics (ie, omics). Thorough understanding of the symptom experience may result, but the patient and the clinician also
might overlook other important aspects of
the situation that are not directly related to
the symptom experience. For example, as described in a recent qualitative study, missing
medication doses or dietary indiscretions may
not be suspected if not temporally related to
the symptom experience.36
What would it look like if we studied heart
failure from an integrated approach? An
integrated approach might entail a more complete appreciation of the impact of symptoms
on self-care and the influence of self-care
on symptoms. For example, in the SituationSpecific Theory of Heart Failure Self-Care,37
the concept of self-care monitoring from the
Middle-Range Theory of Self-Care of Chronic
Illness was operationalized in a unique and
specific fashion for patients with heart failure
because of their symptom issues. In the
Middle-Range Theory, self-care monitoring is
defined as the process of “observing oneself
for changes in signs and symptoms.”2(p196)
But heart failure causes problems with the
ability of patients to detect and interpret
changes in signs and symptoms. Specifically,
the insular cortex is the area of the brain responsible for interoception or the perception
of sensations originating within the body.38
However, lesions of the insular cortex have
been found in patients with heart failure.39
Even those patients with heart failure who are
diligent in observing themselves for changes
may not be successful in self-care monitoring
because of these cognitive changes. Thus, we
proposed a process that we named symptom
211
perception in the Situation-Specific Theory
of Heart Failure Self-Care.37 In that theory,
symptom perception was said to involve body
listening, monitoring, recognition, interpretation, and labeling of signs and symptoms. This
is an example of how self-care and symptom
theories can be integrated to achieve a more
complete theory relevant to patients with
heart failure. Importantly, an integrated
approach would involve robust measurement
of both symptoms and self-care, as advocated
in the NIH Symptom Science Model.35
PROPOSING A REVISION OF THE
MIDDLE-RANGE THEORY INTEGRATING
SYMPTOMS
At this point, recognizing the role of
symptoms in patients’ decisions regarding
self-care behaviors, we propose that incorporating symptoms more explicitly into the
Middle-Range Theory of Self-Care of Chronic
Illness can help refine the theory and improve
our ability to explain self-care and predict
performance of self-care and the outcomes
achieved. In the following, we use existing
research to support proposed associations in
the revised theory.
Self-care is fundamentally a decisionmaking process influenced by reflection.40
Self-care theory is broader than symptom theory, but here we acknowledge the strong influence of symptoms on the self-care decisionmaking process. Symptoms themselves can
be indicators of a bodily change, but research has confirmed that changes in the illness may not always cause symptoms.41,42 We
also note that symptoms may or may not reflect an objective change in the chronic illness because detection and interpretation of
bodily changes are complicated and imprecise processes.43,44 That is, some people may
not be aware of changes in illness by objective measures because they do not detect or
interpret those changes as symptoms. Conversely, symptoms may escalate in frequency
and/or intensity in the absence of an objective change in illness. It is not unusual to see a
212
ADVANCES IN NURSING SCIENCE/JULY–SEPTEMBER 2019
patient presenting to the clinician with a complaint of symptoms that cannot subsequently
be attributed to a change in objective data. All
of these factors influence the decisions that
people make about self-care.
As shown in Figure 2 illustrating a proposed integration of symptoms into the
Middle-Range Theory of Self-Care of Chronic
Illness, symptoms influence various element
of the self-care process. Specifically, people
may be more willing to perform self-care
maintenance and follow the treatment plan
if they have symptoms. Research has shown
that the experience of having symptoms can
motivate chronically ill individuals to perform
self-care.32 However, depressive symptoms
and cognitive decline can blunt self-care by
decreasing motivation to engage in healthy
behaviors.45-47
We propose that symptoms interact
most directly with self-care monitoring and
self-care management. Active monitoring
for symptoms is needed for awareness and
interpretation of bodily changes as symptoms. At this point, we have integrated these
processes into self-care monitoring. That is,
even in someone who engages in tracking
of his or her activity, signs, and symptoms,
the self-care management response is not
generated without awareness and interpretation of bodily changes as symptoms and the
recognition of symptoms as being linked to
or attributed to a chronic condition. These
processes have been shown to differ by clinical phenotype.48,49 For example, personality
traits, gender, and age are known to influence symptom awareness, interpretation,
and recognition.50 Aging may blunt symptom
perception.51 Somatic awareness has been
found to be blunted in older persons with
heart failure.52,53 Cultural and societal factors
may influence the expression of symptoms.54
There are also gender differences. For
example, women may be more willing to
acknowledge symptoms than men.55
Logically, without symptom detection and
interpretation, self-care management or the
response to symptoms will not occur. Ideally, any self-care management behavior is followed by evaluation—a process of judging
whether the behavior was helpful and should
be repeated. The evaluation process is better
in patients with better somatic awareness.50
To summarize, symptoms are both an antecedent and a consequence of self-care. The
experience of having symptoms can build
skill in self-care maintenance, monitoring,
and management.56 As an antecedent, symptoms often motivate individuals to engage
in self-care behaviors. Other antecedents include experience,57 skill,58 and self-care confidence or self-efficacy,59 all of which can be
influenced by the symptom experience, as
described later. Cultural beliefs,60 values,61
Figure 2. Model integrating symptoms with self-care as defined by the Middle-Range Theory of Self-Care of
Chronic Illness. Although depicted here as linear, we see the self-care process as including feedback loops. Note
that the overlap between the bottom arrows and core self-care model is both theoretical and imperfect and
indeed a target of further refinement.
Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness
reflection,40 habits,62 cognitive and functional
abilities,63 support from others,63-65 and access to health care60 all influence the self-care
process.
Consequences of self-care are shown in
Figure 2 as outcomes. These outcomes
include illness stability,63 health,66 well-being,
quality of life,7 perceived control,67 and
clinical outcomes such as the need for
hospitalization,63 health care costs,68 and
symptom burden.69 Mortality risk is lower
in patients receiving longer duration selfcare interventions.70 Perceived health, wellbeing, and quality of life are largely a function of symptoms. Although many people
with chronic illness tolerate symptoms, severe symptoms were associated with poor
quality of life.7 In another sample, symptoms
were the primary reason why patients sought
acute care.71 Thus, the control of costs associated with chronic illness may be addressed
with symptom management strategies.
CONCLUSION
Weber3 argues that the most important
contributions to knowledge development are
theories that are developed sufficiently to
allow for explanation and prediction. Thus,
213
our goal was to refine the Middle-Range Theory of Self-Care of Chronic illness to address
2 identified issues: (1) further development
of the concept of self-care monitoring, and
(2) further development of the manner in
which self-care monitoring and self-care
management are associated. We approached
these issues by integrating symptom theory
into the Middle-Range Theory of Self-Care
of Chronic Illness.2 The 2 perspectives—
self-care and symptoms—are clearly related.
By explicitly integrating them, our hope is
that the contribution of symptom theory to
self-care theory will be further developed and
the ability of self-care to mitigate symptoms
will be appreciated. Both perspectives are
central to a holistic approach to patient care.
We believe that this integrated theory will
be of use to both clinicians and scientists.
Clinicians working with people with chronic
illness are encouraged to embrace an assessment and intervention approach that integrates the impact of symptoms on self-care.
Scientists are encouraged to test hypotheses
derived from this refined theory to further
our understanding of how the detection, interpretation, and response to symptoms can
and should be incorporated into interventions
designed to improve self-care.
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2. Riegel B, Jaarsma T, Stromberg A. A Middle-Range
Theory of Self-Care of Chronic Illness. ANS Adv Nurs
Sci. 2012;35(3):194-204.
3. Weber R. Evaluating and developing theories in the
information systems discipline. J Assoc Inf Syst.
2012;13(1):1-30.
4. Ausili D, Rossi E, Rebora P, et al. Socio-demographic
and clinical determinants of self-care in adults with
type 2 diabetes: a multicentre observational study.
Acta Diabetol. 2018;55(7):691-702.
5. Iribarren S, Siegel K, Hirshfield S, et al. Selfmanagement strategies for coping with adverse
symptoms in persons living with HIV with HIV associated non-AIDS conditions. AIDS Behav. 2018;22(1):
297-307.
6. Lycholip E, Thon Aamodt I, Lie I, et al. The dynamics
of self-care in the course of heart failure management:
data from the IN TOUCH study. Patient Preference
Adherence. 2018;12:1113-1122.
7. Auld JP, Mudd JO, Gelow JM, Hiatt SO, Lee CS.
Self-care moderates the relationship between symptoms and health-related quality of life in heart failure.
J Cardiovasc Nurs. 2018;33(3):217-224.
8. Buck HG, Lee CS, Moser DK, et al. Relationship between self-care and health-related quality of life in
older adults with moderate to advanced heart failure. J Cardiovasc Nurs. 2012;27(1):8-15.
9. Lee CS, Mudd JO, Hiatt SO, Gelow JM, Chien C, Riegel
B. Trajectories of heart failure self-care management
and changes in quality of life. Eur J Cardiovasc Nurs.
2015;14(6):486-494.
10. Vellone E, Fida R, Ghezzi V, et al. Patterns of selfcare in adults with heart failure and their associations with sociodemographic and clin
assignment about policy that not applicable in Saudi Arbia why its not? in the future ?prcpactive toward ?I already finish of most of work but i need it to be more orignized and more information under subtitles also new subtitles 1- need of index page 2- need of abstract 3- need of more information under subtitles ( Euthanasia in Saudi
Arabia, Perspectives toward Euthanasia , Future Direction to Euthanasia) 4- also new subtitles beside that i mention 5- more in Conclusion 6- follow APA7 style 7- page should not be less then 10 without reference and cover page 8- don’t forgot citation and References
Week 6 discussions. Each questions should include 250-300 words and 1 reference. Each discussion will need 2 peer responses of 150 words and 1 reference.Discussion 1 (NUR500) -I will be working in the clinical field.After your graduation, you will be in an academic or clinical field. Depending on your field choice, discuss one nursing theory and identify the effect th at the implications of this theory could have on nursing administration, management, or education.Discussion 2 (NUR510) Nurse-managed health centers and clinics are providing care at more convenient locations. Please explain the need for this change, benefits, and possible solutions to any obstacles.
The purpose of this assignment is to demonstrate the skills of the professional nurse as an educator. You are to prepare a patient scenario based on the required assigned topic. You will choose an already developed and reliable mHealth app to use in the education of your patient.
Based on your accepted Milestone 1 assignment, use the information to identify teaching areas to improve patient outcomes and ways to evaluate the success of the patient’s use of the mHealth app. You will include both the citations and references in APA format.
You will develop the Patient Education Technology Guide using Microsoft PowerPoint OR a Poster in Microsoft Office format. You must use either a PowerPoint presentation or the Poster template provided, depending on which option you choose. Only complete one assignment: PowerPoint or Poster.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes:
CO 1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO1)
CO 5: Identify patient care technologies, information systems, and communication devices that support safe nursing practice. (PO5)
DUE DATE
The Milestone 3 PowerPoint OR Poster assignment is due by Sunday at 11:59 pm MT, at the end of Week 6. Submit your completed assignment. You may consult the Policies section in the Introduction & Resources module for details regarding late assignments. Post questions about this assignment in the Course Q & A Forum.
TOTAL POINTS POSSIBLE
The entire project is worth 600 points. Milestone 3 is worth 225 points of this total.
PREPARING THE ASSIGNMENT
Required Assignment Topic
Note: You will use the same scenario you developed and same mHealth app you identified in Week 2.
Directions
Select a Microsoft PowerPoint OR a Poster presentation for this assignment. See the Guidelines below for each of the options.
You are required to complete this assignment using the productivity tools required by Chamberlain University, which is Microsoft Office 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.pptx” format. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.eduLinks to an external site.
PowerPoint Assignment Guidelines
You are required to cite your source(s) as it relates to your application slide. Other citations are permitted, but this is not a requirement for the assignment.
Title slide (first slide): Include a title slide with your name and the title of the presentation.
Scenario Slide (one slide): This slide should include the approved patient scenario from Milestone 1 and 2. You will use the approved patient scenario and include a disease process, diagnosis, OR identify a patient with a desire to maintain good health and prevent illness and who would benefit from an already developed and reliable mHealth app. Include the nurse’s assessment of learning needs and readiness to learn.
mHealth application slide (one slide): Identify a developed and reliable mHealth app that could benefit the patient. Describe the app, including the following.
Name of app
Purpose of app
Intended audience
Mobile device(s) upon which the app will operate
Where to download or obtain it (include a working link if it is to be downloaded from a website)
Any other information you believe would be pertinent to this situation
Be sure to cite all sources you use.
Teaching slide(s) (one to three slides): Prepare slides that contain important points about the app that you want to teach to the patient, such as how to use the app safely and effectively (including how to interpret and act on the information that is provided).
Evaluation slide(s) (one to three slides): Describe how you would determine the success of the patient’s use of this app. For example, include ways to evaluate the effectiveness of the teaching plan that are a good fit for the type of app and focus on specific ways that this app benefits the patient’s health and wellness.
References (last slide): List any references for sources that were used and cited in the presentation.
Number of PowerPoint slides: 6-10 slides total
Writing and design: There should be no spelling or grammatical errors. Writing is concise and clear. Avoid words that the patient may not understand. Slides are visually appealing, incorporating graphics, photographs, colors, and themes.
Review the section on Academic Integrity Policy found in the RNBSN Policies. All work must be original (in your own words) unless properly cited.
Best Practices in Preparing PowerPoint Slideshows
Be creative but realistic.
Incorporate graphics, color, themes, or photographs to increase interest.
Make each slide easy to read with short bullet points and large font. You may use speaker notes for full sentences.
Review directions thoroughly.
Cite all sources within the slides with (author, year), as well as on the reference slide.
Proofread prior to final submission.
Check for spelling and grammar errors prior to final submission.
Abide by the Chamberlain academic integrity policy.
Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx.Links to an external site. The Chamberlain Student Success Strategies (SSPRNBSN) offers a module on Computer Literacy that contains a section on PowerPoint. SSPRNBSN is a course tile on your dashboard.
Poster Assignment Guidelines
Download and use the Poster TemplateLinks to an external site.. This should only be one page.
Complete all boxes on the template.
Best practice for Poster Presentations
Be creative but realistic.
Incorporate graphics, color, themes, or photographs to increase interest.
Make the poster easy to read with short bullet points and appropriate sized font.
Review directions thoroughly.
Cite all sources with (author, year) and reference.
Proofread prior to final submission.
Unformatted Attachment Preview
Insert Title Here
Name
Course
Session
Scenario
This section should include the
approved patient scenario that
includes a disease process, diagnosis,
a desire to maintain good health and
prevent illness. Include the nurse’s
assessment of learning needs and
readiness to learn.
mHealth Application
Identify the developed and reliable
mHealth app that could benefit the
patient. Describe the app, including the
following: name, purpose, intended
audience, mobile device(s) upon which it
will operate, where to download or obtain
it, and any other applicable information.
Be sure to cite all sources you use in APA
format. The mHealth app source is a
required citation.
Evaluation
Teaching
This section should contain important
points about the mHealth app that you
want to teach to the patient. Include
the 3 areas from Milestone 2.
• Information about the mHealth app
• Safety guidelines
• How to interpret and act on the
information that is provided
**Please note, you are to remove
all red wording and replace with
your own content. Use short bullet
points in all boxes. Boxes will
expand as you type. Please delete
this box prior to submission.
Describe how you would determine
the success of the patient’s use of this
app. For example, include ways to
evaluate the effectiveness of the
teaching plan that are a good fit for
the type of mHealth app and focus on
specific ways that this app benefits the
patient’s health and wellness. Include
the 3 evaluation strategies you used in
Milestone 2.
Insert photo, graphic or
chart to increase visual
appeal
References
Provide all references for all sources utilized in APA format, though a
hanging indent is not needed.
use the Illinois Certification Board (ICB) Code of Ethics to choose the correct section and code. Only choose one code which the counselor may be violating.
1. John a counselor and Joan his former client met accidentally at a restaurant. Joan has 20 months clean and has begun nursing school. She no longer attends groups at the place John works and in fact has moved 20 miles away into the suburbs with her parents?
Code # ________________________________________
2.Phil a counselor cursed his client out after he returned from a relapse and told the other client’s in group how much of a loser Bob was and constantly put him down because he struggled staying sober?
3. Bill a counselor who denies ever having any problem with alcohol or drugs, works at the ABC out-patient methadone clinic and often arrives early to conduct his out-patient group. He usually stops across the street and has a beer or two with his friend Dan the bar owner before his group starts at 1 p.m.?
4. Linda’s keeps her client’s charts in her office; however she lost the key to her office door about one month ago, and being a new employee she’s afraid to tell her supervisor because she still has two more months before her probationary period is over. So when she leaves for lunch she pulls the door and turns off the light?
5. Joan’s boyfriend was on parole and stopped for suspicion of possession of drugs last year. He dropped a bag on the floor of the rental car which was in Joan’s name. Joan pleads guilty to keep him out of jail. As a result she can no longer drive and catches the bus to work. Joan continues to conduct her group but follows the law and catches the bus until her driving privileges are reinstated in 6 months.
6. Art the supervisor at the internship site and Ann his student take an interest in each other and decide to go to a concert together because they have a fondness for country music. He eventually ask her out because she seemed interested in him?
Code #____________________________
Unformatted Attachment Preview
Illinois Certification Board (ICB) Code of Ethics
For Certified Alcohol and other Drug Abuse (AODA) Professionals
SECTION1 – NAME AND PURPOSE.
1.01: Name: This Code shall be known and may be cited as the Illinois Certification Board (“ICB”) Code
of Ethics for Certified Alcohol and other Drug Abuse (AODA) Professionals (“Code of Ethics”), and it shall
supersede any and all prior ethics codes.
1.02: Purpose: The ICB’s mission is to protect the public by providing competency based credentialing
of human service professionals. An essential element of this protection is the requirement that Certified
AODA Professionals maintain high ethical standards based on the principles of integrity, objectivity,
professionalism, and respect. Consistent application of these standards protects the welfare and dignity
of AODA clients, improves the outcome of AODA services, and advances the public standing of the AODA
profession.
1.03: ICB Code of Procedure: The ICB Code of Procedure (“Code of Procedure”), supplements this Code
of Ethics as described in Section 3, below.
SECTION 2 – ETHICAL STANDARDS OF CONDUCT.
Certified AODA Professionals shall adhere to the following ethical standards as a condition of attaining
and maintaining ICB Certification:
2.01:
Personal Conduct Standards:
2.01.01: Certified AODA Professionals shall not abuse alcohol or legal drugs. This includes but is
not limited to alcohol or drug related legal problems or any other alcohol or drug related conduct
that reflects poorly on them or the AODA profession.
2.01.02: Certified AODA Professionals shall not possess or use illegal drugs.
2.01.03: Certified AODA Professionals who become aware that their personal use of alcohol or
drugs may be problematic shall seek appropriate assistance and promptly notify the Illinois
Certification’s Executive Director (“Director”) of that decision. Certified AODA Professionals shall
cease their involvement in the provision of AODA services until any problematic use of alcohol or
drugs is stable or resolved and does not affect their professional competency.
2.01.04: Certified AODA Professionals who become aware that serious personal issues may be
problematic shall seek appropriate assistance and promptly notify the Director of that decision.
Serious personal issues include but are not limited to physical or mental health concerns, process
ICB Code of Ethics (Rev. 10/2014)
Page 1 of 5
addictions, active legal charges, or any other issue that reflects poorly on them or the AODA
profession. Certified AODA Professionals shall cease their involvement in the provision of AODA
services until their personal issues are stable or resolved and do not affect their professional
competency.
2.01.05: Certified AODA Professionals must inform the ICB if convicted of a felony, or any sexual
or drug related offense, in any court of competent jurisdiction in this or any other state, district,
or territory of the United States or of a foreign country and cease their direct provision of any
AODA clinical or intervention services in Illinois for two (2) years from the date of conviction or
any related subsequent incarceration, whichever occurred first. The provisions of this Section
shall in no way be deemed to waive or limit any right or remedy of the ICB under any other
provision of the Code of Ethics and/or the Procedure Code.
2.01.06: Certified AODA Professionals must inform the ICB if they have a suspension or revocation
of driving privileges for any alcohol or drug related driving offense and cease their direct provision
of DUI evaluation or Risk Education in Illinois for two (2) years from the date of conviction or DUI
summary suspension. The provisions of this Section shall in no way be deemed to waive or limit
any right or remedy of the ICB under any other provision of the Code of Ethics and/or the
Procedure Code.
2.02:
Professional Conduct Standards:
2.02.01: Certified AODA Professionals shall not misrepresent their professional qualifications.
2.02.02: Certified AODA Professionals shall submit accurate information to ICB for the purposes
of obtaining and maintaining certification.
2.02.03: Certified AODA Professionals shall consider the welfare of the public and the profession
when making recommendations for positions, advancement, and certification.
2.02.04: Certified AODA Professionals who teach AODA counseling or supervise AODA counselors
shall discharge these responsibilities with the same regard for standards required for all Certified
AODA Professional activities.
2.02.05: Certified AODA Professionals shall adhere to high standards and follow appropriate
scientific procedures when conducting research, including but not limited to adhering to current
evidence informed practice and be in compliance with Institutional Review Board requirements.
2.02.06: Certified AODA Professionals shall not take credit for professional substance abuse
services done by others. This includes services done by other Certified AODA Professionals, noncertified staff, or interns.
2.02.07: Certified AODA Professionals shall not charge or collect a private fee or other form of
compensation for services to a client who is charged for those same services through the
counselor’s organization. Certified AODA Professionals shall not engage in fee-splitting.
2.02.08: Certified AODA Professionals shall not use their relationship with their clients to promote
personal gain, profit for an organization, or commercial enterprise of any kind for at least three
(3) years after termination of services.
ICB Code of Ethics (Rev. 10/2014)
Page 2 of 5
2.02.09: Certified AODA Professionals shall not engage in any sexual relationship, conduct,
contact, exploitation, or harassment with clients, former clients, clients’ partners, clients’
relatives, or any active client of any Office as defined in Section 2.20 of the Code of Procedure.
This prohibition is in effect during the time of any active counseling relationship and in perpetuity
once the counseling relationship has ended.
2.02.10: Certified AODA Professionals shall not engage in any sexual relationship, conduct,
contact, exploitation, or harassment with students or supervisees.
2.02.11: Certified AODA Professionals shall not practice or condone discrimination against clients,
clients’ partners, clients’ family, or other professionals based on age, culture, disability, ethnicity,
race, religion/spirituality, gender, gender identity, sexual orientation, marital status/partnership,
language preference, social economic status, or any basis prescribed by law.
2.02.12: Certified AODA Professionals shall not knowingly solicit the clients of other
colleagues/professionals or accept for treatment a person who is receiving services from another
professional except by mutual agreement or after termination of services.
2.02.13: Certified AODA Professionals shall fully cooperate with all local, state, and federal
authorities having jurisdiction in regard to routine onsite compliance inspections, investigations
for cause, and requests for information.
2.02.14: Certified AODA Professionals may use social media (e.g. Facebook, Twitter, internet web
pages or website, etc.) to advertise the offering of “Certified AODA Professional Services” as
defined in Section 2.04 of the Code of Procedure, to promote human service professional work in
general or the AODA profession in particular, or for any educational purposes relating to the
foregoing. Certified AODA professionals may not use any social media for the making of any
misleading or false claims, other improper advertising relating to Certified AODA Professional
Services, or for any other purpose prohibited by (or that is otherwise in violation of) this Code of
Ethics, the Code of Procedure, or any other canon, rule or regulation promulgated by the Director
from time-to-time.
2.02.15: Certified AODA Professionals shall not engage in any other conduct or behavior which
would bring the ICB and/or AODA profession into disrepute.
2.03:
Confidentiality Standards:
2.03.01: Certified AODA Professionals shall be familiar and comply with all federal and state laws
regarding confidentiality.
2.03.02: Certified AODA Professionals shall inform clients at the beginning of the counseling
relationship the limits of confidentiality laws and the foreseeable uses of information generated
through counseling services.
2.03.03: Certified AODA Professionals shall maintain confidentiality unless it is in the best interest
of the clients, the welfare of others, an obligation to society, or legal requirements demand that
confidential material be revealed. Certified AODA Professionals shall consult with his or her
Managing AODA Professional as defined in Section 2.19 of the Code of Procedure and/or legal
counsel, when unsure if an exception to confidentiality exists.
ICB Code of Ethics (Rev. 10/2014)
Page 3 of 5
2.03.04: Certified AODA Professionals shall only reveal essential information when circumstances
require the disclosure of confidential material. To the extent possible, clients will be informed
before confidential material is disclosed.
2.03.05: Certified AODA Professionals shall accurately document all AODA services and safely
store client records according to state and federal confidentiality laws.
2.04
Service Delivery Standards:
2.04.01: Certified AODA Professionals must exercise clinical discretion when prescribing
substances with abuse potential to clients with known or suspected substance related and
addictive disorders.
2.04.02: Certified AODA Professionals shall not enter into counseling relationships with members
of their own family, close friends, persons closely connected to them, or others whose welfare
might be jeopardized by such a dual relationship.
2.04.03: Certified AODA Professionals shall not initiate a counseling relationship and shall
terminate any active counseling relationship when the client no longer needs services, the client
is not benefiting from services, other services are more appropriate, the client does not pay
agreed upon fees, or the Certified AODA Professional has personal issues preventing the effective
delivery of services. Certified AODA Professionals shall be knowledgeable about referral
resources and suggest appropriate alternatives. If clients decline the suggested referrals, Certified
AODA Professionals are not obligated to continue the relationship.
2.04.04: Certified AODA Professionals shall not abandon or neglect clients in treatment and shall
assist in making appropriate arrangements for the continuation of treatment, if appropriate,
following termination of treatment.
2.04.05: Certified AODA Professionals shall ensure that services are offered in a respectful
environment that meets all local, state, and Federal safety and accessibility requirements.
2.04.06: Certified AODA Professionals shall not physically, emotionally, financially or verbally
abuse their clients.
2.04.07: Certified AODA Professionals shall not offer services outside their range of competency.
2.04.08: Certified AODA Professionals shall not offer services outside the boundaries of the AODA
profession unless otherwise qualified through education, training, licensure, or certification.
2.05:
Ethics Violation Reporting Standards:
2.05.01: Certified AODA Professionals with personal knowledge of another Certified AODA
Professional’s possible violation of ethical standards shall attempt to clarify or rectify the situation
if practical. If such attempts fail and they possess information that raises doubts as to whether
another Certified AODA Professional is acting in an ethical manner, Certified AODA Professionals
shall promptly submit an ethics Complaint to the ICB Executive Director.
ICB Code of Ethics (Rev. 10/2014)
Page 4 of 5
2.05.02: Certified AODA Professionals shall not initiate, participate in, or encourage the filings of
ethics complaints that are frivolous or intended to harm a Certified AODA Professional rather than
to protect clients or the public.
2.05.03: Certified AODA Professionals shall fully and completely cooperate with investigations,
proceedings, and requirements of any ICB ethics investigation or any other investigations of any
ethics committees of other duly constituted associations or boards having jurisdiction over
matters under this Code of Ethics or the Code of Procedure.
SECTION 3 – VIOLATIONS-CODE OF PROCEDURE
3.01: Code of Procedure: All alleged violations of this Code of Ethics and any complaints filed
there under shall be administered pursuant to the Code of Procedure, as amended from time-totime.
3.02: Conflict: The provisions of the Code of Procedure (including any definitions therein) are
incorporated into this Code of Ethics by reference. The intent of the Code of Procedure is to
supplement this Code of Ethics and in the event of any direct conflict between the terms of this
Code of Ethics with any provisions of the Code of Procedure, the provisions of this Code of Ethics
shall control.
ICB Code of Ethics (Rev. 10/2014)
Page 5 of 5
1. A 45 yo diabetic female complains of recurrent whitish vaginal discharge with itching. Patient is not sexually active and denies the possibility of STIs. She reports that she has been diagnosed with vaginal candidiasis 5x already for the past 6 months. Patient has always been treated with one time Diflucan which affords relief albeit temporarily. How would you proceed with the treatment during today’s visit?
2.Case Study Chosen: Case study #3
Demographics: 56 Y/O MALE
SUBJECTIVE
CC: “My mental status has declined over the last several months. I first developed numbness in my finger tips and balls of my feet but now it has progressed to a decrease in overall motor control of my hands causing me to drop objects, or flinging objects when trying to pick them up. I also have been experiencing visual tracking problems that have caused issues with driving, and I have noticed memory loss.”
HPI: 56 y/o male pt presenting to the clinic with decreased mental status over the last several months accompanied by numbness in fingertips and balls of feet. Pt ℅ decreased motor control of hands, and visual disturbance with increased memory loss.
O- When did you first start noticing a decline in motor control and numbness in your hands and feet? When did you start noticing a problem with driving? When did you start noticing visual disturbance? When did you start noticing a decrease in memory?
L- Where in the body are you feeling numbness or motor control loss?
D- How long have you noticed these symptoms?
C- Do you have any other symptoms related to this issue?
A- Does anything make your symptoms worse that you have noticed?
R- Have you tried anything to relieve your symptoms?
T- Have you tried anything on your own to treat this condition? Have you taken any medications? If yes, what, and how long did you take it and how frequent were you taking it? Did it resolve any of the symptoms or decrease the severity?
S- Do you feel like the motor skills, numbness and memory loss is getting better or worse? Do you feel like this is affecting any other part of the body? Is there anyone that you have in your family who suffers from this?
Past medical hx: Do you have any past medical hx?
Past surgical Hx: Do you have any past surgical hx? If so, what are the dates of the surgeries?
Family hx? Do you have any family history on either side (mother/father)?
Current Medications: Are you currently taking any medications other than the antacid post meal? Are you taking any OTC pain relievers, or OTC supplements?
Allergies: Do you have any medication, food, or chemical allergies? If so, what is the reaction?
Immunization hx: Do you currently have all of your up-to-date immunizations including flu, covid-19 + boosters?
Health Maintenance: When was your last dental, eye, physical examination?
Social HX: Are you currently employed? What are your eating habits? Do you smoke tobacco products, drink alcohol, or use illicit drugs? Where are you currently living? Who do you live with? Are you married, single? Are you sexually active?
Subjective:
General: Are you experiencing any malaise, weakness, fever, or chills? Have you noticed a change in your weight over the last 6 months?
Neurological: (+) Numbness of fingers, and balls of feet, (+) for change in memory. Are you experiencing any headaches, hx of head injury or loss of consciousness, lightheadedness, dizziness or vertigo? Are you having trouble sleeping? Persistent thoughts or worries? Decrease in sexual desire, abnormal thoughts, visual or auditory hallucinations. Are you having a history of psychosis or schizophrenia? Are you having difficulty concentrating ?
Cardiovascular: Have you noticed SOB? Are you experiencing any chest discomfort, heaviness, or tightness? Have you noticed any abnormal heartbeat or palpitations? Are you having to sleep elevated on 2 pillows or more? Have you noticed any swelling of the feet? Have you passed out or have been feeling like you were going to pass out? Do you have a history of heart attacks or heart failure?
Respiratory: Are you experiencing a cough? Do you have any phlegm production, coughing up blood, wheezing, sleep apnea, exposure to inhaled substances in the workplace or home? Have you been exposed to TB or have you traveled outside the country? Do you have a history of asthma, COPD/Emphysema or any other chronic pulmonary disease?
Musculoskeletal: Do you have any muscle or joint pain, back or neck pain? Do you have recent accidents or injuries? Do you have a condition that limits activities or ADLS?
General: (+) Malnourished. Vital signs are stable, in no acute distress. Alert, well developed.
Neurological: Assess cranial nerves. Assess DTRS. Assess sensation to touch, and motor/sensory deficit.
Cardiovascular: Listen to the heart. Listen for S1, S2 and ensure no murmurs, rubs or gallops appreciated.
Respiratory: Listen to lung sounds, observe chest rise and fall.
Musculoskeletal: Assess for ROM in the neck and arms, for any stiffness, pain, or muscle tightness. Assess balance and gait. Assess gait and station. Assess muscle strength and tone 5/5 in all groups. Assess for equal arm swing.
POC Testing: N/A in clinic need to refer patient out for repeat labs
ASSESSMENT
Working Diagnosis:
Vitamin B12 Deficiency (D51.9)
(+) pins and needles (paraesthesia)
(+) Disturbed vision
(+)changes in the way that you walk and move around.
(+) fatigue
(+) muscle weakness
(-) Depression
(-) Irritability
(-) a sore and red tongue (glossitis)
B12 deficiency manifests as macrocytic anemia, and thus, the presenting symptoms often include signs of anemia, such as fatigue and pallor. Due to the increased hemolysis caused by impaired red blood cell formation, jaundice may also be a presenting symptom (Langan, 2020).
(-) Frequent feeling that a foot or hand has “fallen asleep”
(-)Sharp, aching or burning pain, which may radiate outward.
PLAN
Diagnostic studies:
Serum B12 measurement and a complete blood count (CBC).
MMA and homocysteine levels should also be measured to confirm.
(NHS, 2023).
Treatment: Pt to receive b12 injection (hydroxocobalamin) in office every other day until symptoms begin to improve. Then patients can get b12 injections every week or move to oral supplements. Oral and injectable vitamin B12 are effective means of replacement, but injectable therapy leads to more rapid improvement and should be considered in patients with severe deficiency or severe neurologic symptoms (Langan, 2020).
Referrals: Refer patient out to a
Hematologist
Gastroenterologist
Dietitian.
Education:
Good sources of vitamin B12 include: meat, salmon + cod, milk and other dairy products, and eggs!
Work with a nutritionist or dietitian to help get more vitamin B12 from food.
Understand you will probably need to take the supplements for the rest of your life. Refrain from driving.
Health maintenance:
Eye exam (yearly)
Colonoscopy (Q10 years w/ no hx).
PSA (Q2 years).
Dexa Scan (70+ years old)
Diet/Lifestyle changes
Vaccines
COVID-19 w/ boosters in 2022.
Influenza (declines)
RTC: Repeat blood work within 7-10s after starting IM injections of hydroxocobalamin. F/U in office in 2 weeks to go over blood work. Plan to repeat labs 8 weeks after this and ensure f/u with referrals.
3. Case Study #2 Week 6
#2 Tim is a 22 y/o male who is complaining of lethargy, cold sensitivity, weight gain of 10 lbs over the last 3 months with an unnoticeable change in appetite, brain fog, constipation, and muscle weakness that he feels has become progressively more noticeable over the last several months. Tim is a heterosexual, single, full-time college student and works part-time at a coffee shop. His last annual physical examination was 2 years ago and was WNL. His current vital signs are 110/70, 62, 98.6, 12, Ht 5’9” Wt 190 lbs.
Demographics: Age/Gender
22-year-old/Male
SUBJECTIVE
CC: “I feel lethargic, have cold sensitivity, gained over 10 pounds in weight in the last 3 months, experiencing changes in appetite, brain fog, constipation, and muscle weakness that has gotten progressively worse over the last several months.”
HPI: The patient states that over the past few months, he has been feeling a multitude of different symptoms, including lethargy, sensitivity to colds, weight gain (10 pounds over the last 3 months) with a noticeable change in his appetite, constipation, and muscle weakness. No particular location has been the issue’s focus (more systemically). He has not been doing anything to aggravate or relieve the factors.
Past Medical History
Medical/Surgical
None
Hospitalizations
Broken Leg in 6th grade
Medication
Over the Counter
Tylenol is needed for headache or pain 500mg PRN Q6H
Allergies
None
Immunizations
COVID 19’ (Booster 2023)
Flu (2022)
Preventative Health Maintenance
None
Family History
Maternal (Age 50)
None
Fraternal (Age 56)
Hypertension
Sister (Age 25)
None
Social History
Nutrition
Regular Diet
Exercise
Plays soccer with his dormmates on the weekend
Sexual History
Single, not in a monogamous relationship
Occupation
Full-Time Student and Part-Time worker at a coffee shop
School
In college for Business
Subjective: (What questions will you ask? Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent).
General
Do you have a family history of thyroid disease?
Do you have trouble sleeping?
How much weight have you gained?
Have you ever had radiation in the neck?
HEENT
Have you ever experienced a goiter?
Does your voice have a hoarseness to it?
Have you noticed pain or enlargement in your neck?
Cardiovascular
Have you experienced a lower heart rate?
Respiratory
Do you have difficulty breathing?
Do you often get shortness of breath?
Gastrointestinal
Do you experience constipation?
Skin & Breast
Do you experience dry skin?
Musculoskeletal
Do you experience muscle cramps?
Do you experience body weakness?
Do you experience any swelling?
Allergic
Any allergies?
Immunologic
Do you have an autoimmune disease
Endocrine/Lymphatic
Do you have any endocrine diagnosis?
Genitourinary
N/A
Neurological
Do you experience headaches?
Psychiatric/Medical
N/A
ROS
General
Reports feeling lethargic and having cold sensitivity. Reports gaining 10 pounds over the past 3 months that has not been unnoticeable in a change in appetite. Reports having brain fog and has noticed these issues over the past several months.
HEENT
Reports having hoarseness when speaking. Declines choking, dry mouth, or dental carries. Declines change in vision, eye pain, sensitivity, or discharge. Declines ear pain, loss/decrease in hearing, ear ringing, or ear drainage. Declines in senses of smell, nose bleeds, or sinus/facial pain. Declines difficulty chewing or swallowing.
Cardiovascular
Declines chest pain, tightness, or heaviness. Declines heartbeat or palpations.
Respiratory
Declines shortness of breath or difficulty sleeping. Declines coughing or phlegm production. Declines wheezing, crackles, or rhonchi.
Gastrointestinal
Reports constipation and unnoticeable changes in appetite. Reports 10 pounds of weight gain in the last 3 months. Declines diarrhea. Declines blood in the stool. Declines hemorrhoids or trouble swallowing. Declines nausea and vomiting. Declines abdominal discomfort/pain.
Skin & Breast
Reports having cold sensitivity. Declines rashes, itching, or abnormal skin injury.
Musculoskeletal
Reports feeling muscle weakness that has become progressively more noticeable over the last several months. Declines recent accidents or injuries. Declines physical disabilities or conditions that limit ADLs.
Allergic
Declines any allergies, including medication or seasonal allergies.
Immunologic
Declines history of HIV, TB, hepatitis, or Herpes Zoster. Declines history of cancer or radiation or chemotherapy.
Endocrine/Lymphatic
Reports cold sensitivity. Declines history of Diabetes Type 1 or 2. Declines instability of blood sugars.
Genitourinary
N/A
Neurological
Reports experiencing brain fog. Declines history of head injury or loss of consciousness. Declines lightheadedness, dizziness, or vertigo. Declines previous strokes, seizures, or neurological issues.
Psychiatric/Medical
N/A
OBJECTIVE
General:
VS BP, HR, RR, Weight, Height, BMI
Blood Pressure: 110/70
Temperature: 98.6F
Heart Rate: 55
Respiration: 12
Weight: 190 lbs / Weight prior 175 (3 months ago)
Height: 5’9”
BMI: 28.1
Physical Exam Elements: (Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent.)
Head: Positive for dry, coarse hair and thinning of the eyebrows. Positive for facial puffiness. The head is atraumatic and normocephalic.
Eyes: Positive for periorbital edema and puffy eyes. The sclera is white, and the conjunctive and lashes are clear. No lid lag noted.
Ears: Ears are clear with your cerumen. TM is clear and pearly gray.
Nose: Patent and mucosa is pink, moist, and intact.
Throat/Mouth: Positive for hoarseness in voice noted. Positive for enlarged tongue. Mouth and lips were intact with no lesions. Good dentition. Hard/Soft palates intact. The tongue and uvula are midline. No goiter noted.
N/A
Unlabored Breathing. The chest was equal and symmetrical rise. No adventitious breath sounds were heard.
Bradycardia noted. S1/S2 without murmur, gallops, and rubs.
Hypoactive bowel sounds were noted. No hetosplenomegaly on exam. No tenderness or masses were noted.
No lymph nodes or glands on the neck, axilla, or groin were noted.
Positive for muscle weakness, noted bilaterally. +4/5 noted on lower and upper extremities.
Positive for dry, thick, coarse skin. Positive for brittle nails. No rashes, lesions, or masses were noted.
No cyanosis or clubbing were noted. No edema noted on extremities noted. Pulses +2 bilaterally on radial and pedal pulses.
Positive for slower speech, hyporeflexia, and bradykinesia. Cranial nerves intact II-XII.
Mood and affect were appropriate during the visit. Judgment and insight were within normal limits at this time.
General Appearance: Appearance is lethargic but is alert and oriented x3. Weight gain noted from previous 15lbs on record.
HEENT:
Neck:
Respiratory
Cardiovascular
GI
Lymph Nodes
Musculoskeletal
Integumentary
Extremities
Neurology
Psych
POC Testing (any Point of Care (POC) testing specifically performed in the office): What tests (if any) did you perform during the visit (urine dip, rapid strep, urine pregnancy test, Glucose finger-stick, etc.)? Leave blank if none.
Not Applicable
ASSESSMENT
Working Diagnosis: (Must include ICD 10)
Hypothyroidism happens when the thyroid gland does not make enough thyroid hormone. The severity of hypothyroidism is dependent on the severity of the conditions that can develop. Symptoms include tiredness, sensitivity to colds, constipation, goiter, dry skin, and others (Ross, 2022).
Hypothyroidism
ICD 10: E03.9
Differential Diagnosis:
Pertinent Positive: “presents similar to no difference except lab results.” Similarities are fatigue, tiredness, body weaknesses, constipation, intolerance to cold, puffiness in the face, and weight gain.
Pertinent Negative: Acute illness, not considered to be a thyroid disorder. It is a change in thyroid levels due to another illness (**While clinical hypothyroidism is more chronic)
Why Not? ESS has low, normal, or slightly elevated TSH levels, unlike the significance of clinical hypothyroidism.
Pertinent Positive: Weakness, tiredness, irritability, headaches.
Pertinent Negative: Loss in appetite, numbness or tingling of hands and feet, shortness of breath, and pale color.
Why Not? Labs results will show which diagnosis would be better suited for the patient. CBC, TSH, T3, and T4 should be ordered so that differentials can be ruled out of the working diagnosis.
**Due to the subtle symptoms of the disease, many of the prognosis is based on a laboratory basis.
Euthyroid Sick Syndrome (ESS) (Shomon, 2023).
ICD-10: E07.81
Anemia (Means & Brodsk, 2022).
ICD-10: D64.9
PLAN
Diagnostic studies: If any, will be ordered (Labs, X-ray, CT, etc.). Only include if you will be ordering for your patient. Remember the importance of appropriate resource utilization. Remember you are managing this patient in the CLINIC setting, NOT THE HOSPITAL.
**for hypothyroidism TSH (increased); T4/T3 (decreased)
TSH, T4, T3 (Ross, 2022).
Treatment: Must include full Sig/Order for all prescriptions and OTC meds (Name of medication, dosage, frequency, duration, number of tabs, number of refills). CANNOT only list drug class. Should follow evidence-based guidelines.
Goals of Treatment: (Ross, 2023).
Relieve Symptoms
Normalize TSH
Reduction of Goiter if present
Avoid Overtreatment
Prescription Drugs (Woo & Robinson, 2019).
Synthetic Thyroxine
Name: levothyroxine
Dosage: 50mcg-125mcg (This patient 125mcg/day)
Frequency: QAM before breakfast
Duration: QDaily
Number of Tabs: 30 tabs
Refills: 3
Referrals (Ross, 2023).
If unable to manage after 6 months, will be referred to an Endocrinologist
Endocrinologist Referral: 22-year-old male diagnosed with hypothyroidism. The patient is on 125mcg of Levothyroxine QDaily AM. Patients persist with hypothyroid symptoms even with medication, so I have referred him to your services for assistance in managing his condition.
Education (Ross, 2023).
Levothyroxine is very important with the dosage timing; take on an empty stomach with water 30-60 minutes before breakfast.
It can take 2-4 weeks to improve symptoms and several months to treat severe hypothyroidism.
Health maintenance (Cedars Sinai, n.d.).
Since the patient is a young college student, health maintenance may be needed for:
Alcohol Misuse
Depression
Diet and Exercise
Smoking/Drugs
STI
Vaccines
Flu
COVID (patient is UpToDate)
RTC (Ross, 2023). (Dunphy et al., 2022).
Schedule for lab draw and clinic appointment with the primary provider 4-6 weeks after the start of medication for possible adjustments to medicines based on laboratory result
For this assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 4. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.
Select one of the health care problems or issues presented in the Assessment 02 resource. Write a brief overview of the selected health care problem or issue. In your overview:
Summarize the health care problem or issue.
Describe the professional relevance of this topic.
Describe any professional experience you have with this topic.
Identify peer-reviewed articles relevant to this health care issue or problem.
Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.
Refer to the NHS-FPX4000: Developing a Health Care Perspective Library Guide to help you locate appropriate references.
Use keywords related to the health care problem or issue you are researching to select relevant articles.
Assess the credibility and explain relevance of the information sources you find.
Determine if the source is from an academic peer-reviewed journal.
Determine if the publication is current.
Determine if information in the academic peer-reviewed journal article is still relevant.
Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide a rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:
Identify the purpose of the article.
Summarize the information.
Provide rationale for inclusion of each article.
Include the conclusions and findings of the article.
Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.
List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
Summarize what you have learned while developing an annotated bibliography.
Summarize what you learned from your research in a separate paragraph or two at the end of the paper.
List the main points you learned from your research.
Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.
Students will develop a narrated pp presentation addressing the issues below. To comply with universal design principles and to maximize accessibility for special populations (e.g., hard of hearing/deaf, visually challenged etc.), along with the narrated pp slides (at least 20 pp slides and at a maximum 20 min presentation), students should submit a word document with the transcription of the narration for each of the slides.
Instructions
Describe the state of the United States Healthcare System as we know it today– Describe the Patient Protection Affordable Care Act (PPACA) and the current events affecting it.
Define and analyze how the three legs of the healthcare system are interrelated– Identify three initiatives to take place under the PPACA and/or current opposing legislation– Analyze the advantages and disadvantages of those three initiatives.
Describe barriers to healthcare access today and how these barriers are associated with determinants of health –Analyze how APRNS can improve quality, cost, and access to health care.
Propose at least one evidence-based, fiscally sound policy for use in your clinical practice based on the guidelines of the PPACA.
Examine and list the ethical and value-based frameworks that guide policy making for healthcare: Provide examples of at least three ethical principles applicable to health policy and finance.
Identify a health policy and the tools used by the institution/agency to implement the policy.
Determine policy variables affecting the selected policy from item 6 and the potential for success or failure of the policy.
Address each potential variable in the implementation process that could impact in success or failure of the policy.
Discuss ways to find the most current information about individual states and restrictions on the scope of practice.
Discuss the advantages of having an advanced practice nurse design and implement an evaluation of a healthcare program.
References: At least five peer-reviewed references not older than five years
For your presentation, you will record your speech on each of the PPT slides and transcribe your speech in the “Notes” area in the PPT. Transcribe exactly what you are saying in the narration into the “Notes” section (this is very important for universal design principles and to increase accessibility to special needs populations.) Limit your entire speech to 20 minutes. A minimum of 20 narrated PP slides are required, not including title and reference slides.
Select a patient for whom you conducted psychotherapy for an impulse control or conduct disorder during the last 6 weeks. Create a Comprehensive Psychiatric Evaluation Note on this patient using the template provided in the Learning Resources. There is also a completed template provided as an exemplar and guide. All psychiatric evaluation notes must be signed by your Preceptor. When you submit your note, you should include the complete comprehensive evaluation note as a Word document and pdf/images of the completed assignment signed by your Preceptor. You must submit your note using Turnitin.Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Grading Policy.Then, based on your evaluation of this patient, develop a video presentation of the case. Plan your presentation using the Assignment rubric and rehearse what you plan to say. Be sure to review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.Include at least five scholarly resources to support your assessment and diagnostic reasoning.Ensure that you have the appropriate lighting and equipment to record the presentation.THE ASSIGNMENT
Submit an evidence-based practice GROUP (4-6) PPT about cultural competency in mental health nursing (Varcarolis CH-8, p. 100). An evidence-based practice Group PPT allows you to explore best practice and help improve client outcomes on a psychiatric unit. Your PPT should describe how you, as a nurse, will include – or have included – cultural awareness in a client diagnosed with a certain mental illness. The person you describe could be someone you have worked with in the past, or a theoretical client. Remember that culture can also include gender equality, sexual orientation, and other cultures besides race and religion – including cultures unique to one family. Your PPT should be at least 8 slides (double-spaced, not including the title or reference slides) in APA Format and include: WK 3 Rubric: Cultural Paper requirements – Describe ONE person of a culture on a mental health unit with a Diagnosis; uses these 6 headings to format PPT: Assessment; NANDA DX; Patient objectives; Nursing actions; Evaluation; Summary Points 1 ASSESSMENT: Discuss what you would/ did assess regarding your client’s culture. Dietary requirements? Schedule changes for religious practices? Spokesperson for the family 1 NANDA 3-part diagnosis: list 2 MH nursing diagnoses (DX)that this person has or may be at risk for AND one cultural DX 2 Planning/Patient Objectives: What planning needs to be made to insure the cultural and emotional safety of the client (SMART goals). Use numbers and rating scales to measure. “The Patient will do……” 2 Implementation/Nursing actions: What are interventions that would ensure the safety of your client regarding culture? Address the patient objectives. For example, if your client has religious beliefs that affect the ability to take medications, what interventions would you create to ensure their safety or cultural needs are met? “The nurse will do….” 1 Evaluation: How did you evaluate whether your implementation was effective? Make sure parameters are measurable (numbers and scales) 1 Summary: discuss whether your interventions were successful. What should be changed or improved? 1 APA format, 3 references with in-text citations, at least 8 PPT slides. 1 Zero grade may be given for plagiarism per student handbook. 10 Your PPT should utilize proper APA guidelines for title slide, references and citations and include at least three scholarly sources to support your PPT. A scholarly source is a source that has been peer reviewed and has appropriate authors that are credentialed. For more information on APA7, please visit the Online Library. Link for APA7 in Library resources: https://guides.rasmussen.edu/ld.php?content_id=51943126 Revised: PBowman, 10.13.22
Available online at www.sciencedirect.com
Applied Nursing Research 25 (2012) 131 – 137
www.elsevier.com/locate/apnr
Original Articles
Asthma severity in children and the quality of life of
their parents
Noelle S. Cerdan, RN, CPNPa , Patricia T. Alpert, DrPH, APNb,⁎, Sheniz Moonie, PhDc ,
Dianne Cyrkiel, MSN, APNd , Shona Rue, MSN, CPNPd
a
Oshiro Pediatrics, Las Vegas, NV 89119-6183, USA
School of Nursing, University of Nevada, Box 453018, Las Vegas, NV 8154-3018, USA
c
School of Community Health Sciences, University of Nevada, Box 453063 Las Vegas, NV 89154-3063, USA
d
School of Nursing, University of Nevada, Box 453018, Las Vegas, NV 8154-3018, USA
Received 31 March 2010; revised 3 January 2011; accepted 17 January 2011
b
Abstract
This study examines the effect of asthma severity of children aged 7–17 years and sociodemographic
characteristics on the caregiver’s quality of life. For parents of asthmatic children, there was a
negative correlation between overall asthma severity and quality-of-life score. Measuring parental
quality of life enables the development of effective asthma programs.
Published by Elsevier Inc.
1. Introduction
2. Background
Quality of life (QOL) can be described as general
satisfaction with everyday living (Vila et al., 2004) and is
closely related to health status. Along with asthma
symptoms and other clinical indicators, QOL measurements are important when assessing asthmatic children
and their caregivers holistically (Juniper, Guyatt, Feeny,
Ferrie, & Townsend, 1996). This descriptive, crosssectional study examines the effect of asthma severity
on caregivers’ QOL using the Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) of
Juniper et al. (1996), which considers activity limitation
and emotional function. The PACQLQ also examines the
relationship between caregivers’ QOL and caregiver
sociodemographic characteristics.
Asthma is one of the most common chronic diseases in
the United States, affecting about 22.2 million people,
6.5 million of which were children, in 2005 (National
Center for Health Statistics [NCHS], 2007). School-age
children with asthma are affected by the frequency and
severity of episodes, hospital admissions, side effects of
medications, morbidity and mortality, and costs of hospitalizations (Vila et al., 2004). Asthma also affects other aspects
of life, such as school attendance, physical activity, family
dynamic, coping style, psychological functioning, and sleep
(Marsac, Funk, & Nelson, 2006; Moonie, Sterling, Figgs, &
Castro, 2006).
Parents as caregivers are responsible for many aspects of
their children’s care, including symptom observation,
medication administration, and transportation to health care
services (Halterman et al., 2004). Because asthma is a
chronic condition, parents can experience long-term stressors that impact work productivity, medical decisionmaking, and overall care and discipline issues (Halterman
et al., 2004; Laforest et al., 2004).
In addition, other sociodemographic factors such as
marital status, smoking status, educational level and income,
presence of family and support systems, presence of other
children in the household, and the parents being diagnosed
with asthma themselves can contribute to changes in parental
⁎ Corresponding author. Tel.: +1 702 895 3810; fax: +1 702 895 4807.
E-mail addresses: cerdann@unlv.nevada.edu (N.S. Cerdan),
patricia.alpert@unlv.edu (P.T. Alpert), sheniz.moonie@unlv.edu
(S. Moonie), dianne.cyrkiel@unlv.edu (D. Cyrkiel), shona.rue@unlv.edu
(S. Rue).
0897-1897/$ – see front matter. Published by Elsevier Inc.
doi:10.1016/j.apnr.2011.01.002
132
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
QOL. Many studies show that childhood morbidity and
mortality related to asthma are associated with being lowincome families, being a minority, and living in the inner city
(NCHS, 2007).
To date, research results relating asthma characteristics
including clinical measures and or symptoms and PACQLQmeasured QOL are inconsistent. Developed in Canada by
Juniper et al. (1996), the PACQLQ showed acceptable levels
of correlation between asthma status and parental QOL.
Results showed that the PACQLQ was able to detect QOL
changes over time (p b .001) and detect stability in those
who did not change (p b .0001). Following school-age
children through the school year in the United States.,
Halterman et al. (2004) showed that baseline asthma severity
measured by asthma severity symptoms (i.e., daytime and
nighttime symptoms, the need for rescue inhaler use, and the
number of symptom-free days) significantly correlated with
the PACQLQ score (range r = .23–.51, all p b .1). The
highest correlation was between symptom-free days and
parental QOL (r = .51, p b .001). At the end of the school
year, significant correlations were found with all measures
of asthma severity, except for rescue inhaler use. An
increase in symptom-free days over time correlated with an
improvement in PACQLQ scores (r = .30, p b .001).
Conversely, an increase in daytime (r = −.27, p = b.001) and
nighttime (r = −.22, p = .005) symptoms correlated with
lower PACQLQ scores.
Over a 3-month period, Osman, Baxter-Jones, and Helms
(2001) showed a significant correlation between a change in
children’s asthma symptoms and PACQLQ scores (r =
.54–.57, p b .001) even if the PACQLQ scores were not
clinically significant. This suggests that other social and or
psychological factors, in addition to asthma severity, may
influence PACQLQ scores (Vila et al., 2004).
Many studies relate children’s asthma prevalence to
sociodemographic characteristics such as minority families
living in low-income urban neighborhoods (Akinbami &
Schoendorf, 2002). One study suggests that the prevalence
and severity of asthma are associated with being African
American or Hispanic and to poverty-related factors such as
young maternal age, secondhand exposure to cigarette
smoke, low birth weight, and living in crowded inner cities
(Williams, Sternthal, & Wright, 2009).
Erickson et al. (2002) showed that household income
and lower perceived asthma severity were statistically
significant predictors of QOL as measured by the
PACQLQ. Longer length of time diagnosed with asthma,
longer length of time enrolled in a specialty clinic, fewer
siblings living in the household, and greater convenience
of seeing the physician were all related to higher QOL.
Using Carstair’s deprivation scores to describe the sociodemographics of the families in their study, Osman et al.
(2001) found that younger mothers, those who come from
less affluent families, and those with greater social
deprivation had lower PACQLQ scores. Parental work
absenteeism related to the child’s illness can have economical
implications for parents (Dean, Calimlim, Kindermann,
Khandker, Tinkelman, 2009; Laforest et al., 2004).
This study is different from other studies that utilized the
PACQLQ because this study used the current National
Asthma Education and Prevention Program (NAEPP)
guidelines in diagnosing asthma severity in children. The
guidelines categorize patients based on worsening physical
symptoms such as increased nighttime awakenings, increased use of rescue medication for symptom control,
interference with normal activity, and decreased lung
function. Very few studies have documented asthma severity
using NAEPP guidelines, and for those that did, they have
had inadequate sample sizes. In addition, this study uses
several measurement tools and clinical indices such as
pulmonary function tests (PFTs), whereas other studies
depended solely on self-reported asthma severity or
administrative records, which can underestimate asthma
prevalence. Lastly, the current QOL literature for asthma is
conflicted and not highly abundant, so this study lends
greater insight to the current research literature.
This study is important to nursing because it offers a more
holistic focus when addressing asthmatic children and their
parents in the clinical setting. Operationalizing parental QOL
measures as functional limitations and emotional dimensions
allows nurse researchers to quantify the degree of burden that
parents experience so that more effective asthma programs
can be developed (Halterman et al., 2004). In addition, being
familiar with the NAEPP (2007) guidelines in daily practice,
nurses can better identify at-risk parents of asthmatic
children to more quickly implement appropriate care. QOL
has been shown to be an important outcome measure, and
being aware of its effect on the individual is important for
adherence to medical treatment (Marsac et al., 2006). The
objective of this study was to examine the effect of children’s
asthma severity and sociodemographic factors on parental
QOL measured through the PACQLQ.
3. Research design and methodology
This correlational study utilized a convenience sample of
parents of children and adolescents, aged 7 to 17 years, with
medical diagnoses of mild intermittent to severe persistent
asthma. This study was reviewed and approved by the
institutional review board at the University of Nevada, Las
Vegas. From August 2008 to February 2009, participants
were chosen from a pediatric pulmonology outpatient clinic
located in Las Vegas, Nevada. Parents of children aged from
7 to 17 years were targeted because parents with children in
this age range were used to validate the PACQLQ (Juniper
et al., 1996). Parents surveyed were legal guardians of the
asthmatic children. The clinic was chosen by the investigators because the clinic had patients with a greater variety of
asthma severity (i.e., mild, moderate, or severe) and
sociodemographic factors (i.e., health insurance coverage,
parental age and ethnicity, and other variables). Children
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
with a diagnosis of other chronic conditions such as
depression, cerebral palsy, diabetes, hypothyroidism, and
cancer were excluded from the study. Because most children
with asthma also have atopic conditions such as eczema,
allergy, and rhinoconjunctivitis, patients with atopy were not
excluded from this study (Reichenberg & Broberg, 2001).
One of the researchers reviewed the charts of all
scheduled patients to verify asthma diagnosis and age.
Those deemed to be eligible to participate were approached
in the waiting room by the researcher as patients and parents
came in for their scheduled appointments. All potential
participants were told that the researcher was not an
employee of the clinic. They were also told that their
participation was voluntary and declining participation
would not jeopardize their relationship with their doctor or
office staff. Those who agreed to participate completed the
informed consent and their children offered assent. Participants were asked to confirm the age of their children and
their children’s asthma diagnosis. They were also asked their
relationship to the children and were excluded if they were
not the biological parents, adoptive parents, stepparents,
legal guardians, or foster parents. Only one set of
questionnaires were completed for each family.
Prior to completing the three questionnaires, the
researcher gave parents explicit instructions on how to
answer the items for each questionnaire, including the option
not to answer questions that made them feel uncomfortable.
If participants had questions after they started completing
the questionnaires, they were told to choose the answer that
they most strongly agreed with. To maintain participant
confidentiality, participant questionnaires were assigned
numbers, and participant names or any other identifying
information such as address, telephone number, or birth date
were not recorded. The parents returned the questionnaires
to the researcher in an unmarked manila envelope to further
ensure confidentiality.
The three questionnaires utilized were as follows: (1) the
PACQLQ (Juniper et al., 1996), (2) the asthma severity
questionnaire, and (3) the sociodemographic factors questionnaire. The PACQLQ, a 13-item questionnaire, measures
activity limitation and emotional function. This tool is
frequently utilized to measure the burden that parents
experience in caring for their asthmatic children (aged 7 to
17 years). Specifically, this tool measures how a child’s
asthma interferes with the parent’s daily activities (activity
limitation) and the emotions generated (emotional function).
The questionnaire contains four items addressing activity
limitations and nine items addressing emotional function,
with all questions being weighed equally. Parents respond
to this questionnaire using a 7-point Likert-type scale,
where 1 represents severe impairment and 7 represents no
impairment. Examples of questions include the following:
“How often did your child’s asthma interfere with your job
or work around the house?” and “How often were you
bothered because your child’s asthma interfered with family
relationships?” The PACQLQ score produced a mean
133
activity limitation score, a mean emotional function score,
and a total mean score (Juniper et al., 1996). The
questionnaire has been studied to be reliable and valid in
certain populations. The PACQLQ has good reliability, with
an intraclass correlation coefficient for overall QOL = .85,
emotional function = .80, and activity limitation = .84
(Juniper et al., 1996).
The Asthma Severity Questionnaire was developed by
the researchers for use in this study and includes 18
questions to categorize the child’s asthma severity, which
mirrors the 2007 NAEPP asthma classification guidelines.
The NAEPP asthma classifications include intermittent
asthma, mild persistent asthma, moderate persistent
asthma, and severe persistent asthma. The NAEPP guidelines to classify asthma severity were turned into
questions. Examples of questions included the following:
“In the past 30 days, how often has your child had asthma
symptoms such as wheezing, coughing, and shortness of
breath during the day? and “In the past 30 days, how often
did your child wake up during the night due to asthma
symptoms such as wheezing, coughing, and shortness of
breath?” Participants were also asked about medication use
within the past week to verify appropriate classification
severity-specific treatment based on NAEPP guidelines.
Other questions (not specific to the NAEPP guidelines),
such as the number of days of school the child has missed,
the number of days spent in the emergency room (ER) or
hospital, and parental perception of asthma severity and
control, were included based on findings of a literature
review. The questionnaire was reviewed by two content
experts but was not piloted prior to use in this study. In
addition, spirometry readings, including forced expiratory
volume in one second (FEV1) and Forced expiratory
volume in one second/forced vital capacity ration (FEV1/
FVC) ratios, were obtained from the children’s medical
records with the permission of the pediatric pulmonologist
and informed consent from the parents to further
categorize the children’s asthma severity based on the
NAEPP guidelines.
The Sociodemographic Factor Questionnaire, developed
by this study’s investigators, was based on literature
identification of the demographic variables associated with
asthma morbidity and mortality. This questionnaire asked 18
questions on age, ethnicity, income, education level, place of
residence, employment, health insurance coverage, social
support, and other variables.
3.1. Data analysis
Data entry and analyses were performed utilizing the
Statistical Package for the Social Sciences Version 17.0. To
assess the relationship between asthma severity and parental
QOL, Spearman’s correlation (ρ), analysis of variance
(ANOVA), and linear and multivariate regressions were
performed. To determine the relationship between sociodemographic factors and parental QOL, Spearman’s correlation (ρ), chi-square, and independent t tests were performed.
134
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
4. Results
Table 2
Demographic characteristics by percentages (n = 101)
A total of 112 parents who met the study criteria were
invited to participate in the study. Ten parents were not
interested in participating in the study and one parent did not
return the survey to the researcher. Of the original 114
parents invited, 101 (88.59%) participated in the study.
Tables 1 and 2 show the demographic characteristics of the
participants. The Cronbach alpha coefficient for the
PACQLQ was .89 of the total score, which suggests good
internal consistency.
Before correlation analyses on the data were performed,
scatterplots were generated and checked for violation of
assumptions of normality, linearity, and homoscedasticity.
Using Spearman’s correlation (ρ), significant negative
correlations were found between overall asthma severity
and mean activity limitation scores (ρ = −.400, p b .001),
mean emotional function scores (ρ = −.258, p b .001), and
mean total PACQLQ scores (ρ = −.342, p b .001).
Significant moderate, negative correlations were found
between PACQLQ scores and asthma day symptoms,
asthma night symptoms, and asthma exercise symptoms.
As asthma severity and other asthma factors increased,
PACQLQ scores decreased, indicating poorer QOL. No
significant relationships were found between PFT scores and
PACQLQ scores.
In addition, significant positive correlations were found
between employment income and mean activity limitation
scores (moderate correlation, ρ = .363, p b .001), mean
emotional function scores (small correlation, ρ = .291, p b
.05), and mean total PACQLQ scores (moderate correlation,
ρ = .346, p b .001). This indicates that parents with higher
incomes experience increased QOL. Table 3 provides the
details of these analyses.
ANOVA was used to compare mean PACQLQ scores for
each asthma severity group. Participants were divided based
on asthma severity rating prescribed according to NAEPP
guidelines. The assumption of homogeneity of variance was
not violated. The overall PACQLQ scores were statistically
significant for the four asthma severity groups, F(2, 101) =
4.942, p = .003. The effect size, calculated using eta squared,
was .132. Post hoc comparisons using Tukey’s honestly
Caregiver or child characteristics
Table 1
Demographic characteristics by means (n = 101)
Caregiver or child characteristics
Child
Age (years)
Length of diagnosis (years)
ER visits in the past year
Hospitalizations in the past year
School days missed in the past year
Caregiver
Age (years)
Workdays missed in the past year
Number of people living in home
Number of children living in home
M
SD
10.26
6.49
1.01
0.25
5.85
2.78
3.90
1.98
0.79
9.24
39.34
4.46
3.67
2.63
7.71
7.43
1.78
1.21
Child
Male
Female
Caregiver
Male
Female
Age
≤30 years
N30 years
Martial status
Single
Married
Separated/Divorced
Living with significant other
Ethnicity
White/Caucasian
Hispanic
Black/African
Other
Caregiver type
Mother
Father
Other
Parent perception of control
Owning a vehicle
Language
English
Spanish
English and Spanish
Parent with medically diagnosed asthma
Family history of asthma
Smokers
Employed
Work hours per weeka
b40
≥40
Education
High school
College
Graduate school
Annual incomea
Less than $30,000
$30,000 to $45,000
$45,000 to $60,000
$60,000 to $75,000
Greater than $75,000
Insurance
No insurance
Medicaid
Private insurance
Ability to pay for health expenses
Residence type
Own
Rent
Family or friend support
a
%
55.4
44.6
20.8
79.2
11.9
87.1
12.9
64.4
18.8
4.0
58.4
20.8
15.8
5.0
75.2
18.8
6.0
74.3
95
89.1
4.0
5.9
38.6
73.3
9.9
69.3
24.5
42.1
32.7
58.4
8.9
15.8
18.8
10.9
9.9
12.0
5.0
16.8
78.2
86.1
68.3
29.7
88.1
n = 72.
significant different (HSD) test indicated that the mean score
for the mild intermittent group (M = 5.25, SD = 1.18) was
significantly different from that of the moderate persistent
group (M = 4.31, SD = 1.21) and that of the severe persistent
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
Table 3
Correlation between asthma severity rating and PACQLQ scores
Table 5
Univariate regression model predicting QOL
Asthma severity
measure
Activity
limitation
subscale (ρ)
Emotional
function
subscale (ρ)
PACQLQ
summary
scores (ρ)
Asthma severity
Day symptoms
Exercise symptoms
Night symptoms
Rescue inhaler use
ER visits
Hospitalization days
Parental perception of
asthma severity
Parental perception of control
School days missed
Workdays missed
Annual income
−.40⁎⁎
−.43⁎⁎
−.44⁎⁎
−.48⁎⁎
−.31⁎⁎
−.45⁎⁎
−.22⁎
−.58⁎⁎
−.26⁎⁎
−.29⁎⁎
−.30⁎⁎
−.33⁎⁎
ns
−.41⁎⁎
−.20⁎
−.49⁎⁎
−.34⁎⁎
−.37⁎⁎
−.39⁎⁎
−.43⁎⁎
ns
−.46⁎⁎
−.24⁎
−.58⁎⁎
−.37⁎⁎
−.36⁎⁎
−.49⁎⁎
.36⁎⁎
−.28⁎⁎
−.24⁎⁎
−.24⁎
.29⁎
−.34⁎⁎
−.31⁎⁎
−.37⁎⁎
.35⁎⁎
Note. ρ = Spearman ρ; ns = not significant.
⁎ p b 0.05.
⁎⁎ p b 0.001.
group (M = 4.11, SD = 1.49). Table 4 provides the details of
these analyses.
ANOVAs to compare activity limitation scores showed
statistical significance in overall PACQLQ scores for the
four asthma severity groups, F(3, 101) = 7.56, p = .0005.
The effect size, calculated using eta squared, was .189. Post
hoc comparisons using Tukey’s HSD test indicated that the
mean score for the mild intermittent group (M = 5.37, SD =
1.31) was significantly different from that of the moderate
persistent group (M = 4.02, SD = 1.75) and that of the severe
persistent group (M = 3.55, SD = 1.91). The mild persistent
group (M = 5.13, SD = 1.25) was significantly different from
the severe persistent group (M = 3.55, SD = 1.91).
ANOVA comparisons of emotional function scores
showed statistical significance in PACQLQ scores for the
four asthma severity groups, F(3, 101) = 2.855, p = .041. The
effect size, calculated using eta squared, was .08. Post hoc
comparisons using Tukey’s HSD test showed no significant
differences among the four groups of asthma severity.
Univariate linear regression was used to determine which
asthma severity and sociodemographic factors predicted
Table 4
PACQLQ scores and researcher rating of asthma severity
Asthma
severity rating
by caregiver
Activity
limitation
subscale,
M (SD)a
Emotional
function
subscale,
M (SD)b
PACQLQ
summary
scores,
M (SD)c
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent
5.37 (1.31)
5.13 (1.25)
4.02 (1.75)
3.55 (1.91)
5.20 (1.22)
4.68 (1.14)
4.43 (1.14)
4.36 (1.51)
5.25 (1.18)
4.82 (0.95)
4.31 (1.21)
4.11 (1.49)
df = 3, F = 7.56, p = .0005, η2 = .189.
df = 3, F = 2.855, p = .041, η2 = .08.
c
df = 2, F = 4.942, p = .003, η2 = .132.
a
b
135
Predictor
Annual income
Hospitalization days
ER visits
School days missed
Workdays missed
Activity
limitation
subscale
Emotional
function
subscale
PACQLQ
summary
scores
B
R2
B
R2
B
R2
.23
−.57
−.33
−.08
−.11
.08⁎⁎⁎
.06⁎
.15⁎⁎
.18⁎⁎
.21⁎⁎
ns
ns
−.20
−.03
−.04
ns
ns
.09⁎⁎
.04⁎
.05⁎
.14
−.30
−.24
−.05
−.06
.05⁎
.03⁎⁎
.13⁎⁎
.10⁎⁎⁎
.12⁎
Note. B = unstandardized beta coefficient; R2 = adjusted r2; ns = not
significant.
⁎ p b 0.05.
⁎⁎ p b 0.005.
⁎⁎⁎ p b 0.001.
parental QOL scores. Prior to performing linear regression,
the data set was assessed for multicollinearity, singularity,
outliers, normality, linearity, homoscedasticity, and independence of residuals. Predictor of better QOL included
increased income. Factors predicting poor QOL included
increased hospitalization days, increased ER visits, and
increased school days and workdays missed (Table 5). The
significant variables (i.e., income, ER visits, hospitalization
days, school days missed, and workdays missed) were
further tested using multiple linear regression. Relationships
between ER visits and mean total PACQLQ scores, mean
activity limitation scores, and mean emotional function
scores were significant. The correlation between the mean
activity limitation score and workdays missed (β = −.069,
p b .043, r2 = .317) was also significant (Table 6).
Independent t tests were performed to compare the mean
PACQLQ scores between different paired groups of sociodemographic factors (i.e., male vs female, owning a home vs
renting, and other groups). Prior to performing the data
analyses, the samples were checked for normal distribution,
homogeneity of variance, independence of observations, and
level of measurement. Parents who were not Black or
African, owned a car, were able to pay health costs, owned a
home, and perceived their children’s asthma as under control
had higher mean total, mean activity limitation, and mean
emotional function PACQLQ scores.
Table 6
Multiple regression models predicting QOL
Predictor
ER visits
Workdays missed
Activity
limitation
subscale
Emotional
function
subscale
PACQLQ
summary
scores
B
R2
B
R2
B
R2
−.25
−.07
.32⁎
.32⁎
−.18
ns
.08⁎
ns
−.20
ns
.19⁎
ns
Note. B = unstandardized beta coefficient; R2 = adjusted r2; ns = not
significant.
⁎ p b 0.05.
136
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
5. Discussion
The main finding in this study is that higher levels of
asthma severity reflected decreased PACQLQ scores, or
decreased parental QOL. This current study affirms findings
by Williams et al. (2000), who also found a negative
correlation between PACQLQ scores for parents and their
children’s asthma severity scores over a period of 4 months
(r = −.39, p b .001). They also found that PACQLQ scores
were correlated negatively with the number of days missed
from school (r = −.24, p b .001), which this study supports.
One explanation may be that parental QOL is affected by
concerns of rising medical expenses with increasing asthma
severity, stress related to the disease process, availability of
social support, access to medical care and appropriate
medication, and the impact of asthma on daily activities in
the home (Annett, Bender, DuHamel, & Lapidus, 2003;
Erickson et al., 2002).
Participants grouped by asthma severity according to
NAEPP guidelines showed significant differences in
PACQLQ scores. As asthma severity increased, mean
parental PACQLQ scores decreased, indicating decreased
QOL (df = 3, F = 7.56, p = .0005, η2 = .189). This finding
indicates that parents of children with mild asthma claimed
better QOL. This suggests that children with higher asthma
severity require levels of care that place greater activity
restriction and emotional responsibility on parents.
In this current study, several sociodemographic factors
were shown to influence parental QOL, some of which do
not support current findings in the literature. For example,
increased ER visits were significantly related to decreased
overall QOL in this study. This is contrary to findings by
Halterman et al. (2004), who identified increased symptomfree days and the parental perceptions of asthma control.
They did not find ER visits to be a significant factor
associated with parental QOL. Instead, their predictive
factors of worse QOL included Hispanic ethnicity, use of
daily maintenance medication, and secondhand smoke
exposure in the home. Research by Erickson et al. (2002)
and Annett et al. (2003) were more closely aligned with
findings from this study.
Several studies suggested that the prevalence and severity
of asthma are associated with ethnicity and poverty-related
factors such as young maternal age, maternal cigarette
smoking, low birth weight, and living in crowded conditions
in the inner city (Williams et al., 2009). This study supported
the idea that sociodemographic factors also influence
parental perception of QOL. A family history of asthma;
being single, divorced, or widowed; and perceived poor
asthma control yielded significantly lower PACQLQ scores.
Correlational analyses of mean PACQLQ scores and
sociodemographic factors revealed different findings from
other studies. For example, Osman et al. (2001) found
sociodemographic factors such as being a young mother,
being from less affluent families, and having increased
socioeconomic deprivation scores also scored lower on the
PACQLQ. Dalheim-Englund, Rydstrom, Rasmussen, Moller, and Sandman (2004) found another set of sociodemographic factors; place of residence, age of the child,
and severity of the child’s asthma impacted PACQLQ
scores. These findings suggest that many factors in addition
to asthma severity can influence parental QOL, which is
similar to this study’s findings.
The strengths of this study included the close timing of
actual events and responses to the questionnaires. The
PACQLQ and asthma severity questionnaires ask questions
within the past week and past month, respectively. Because
parents would better remember important events related to
their children’s asthma within these time frames, this reduced
the risk of recall error and improved accuracy of reporting
the data (Reichenberg & Broberg, 2001). The PACQLQ was
studied to be both reliable and responsive with moderate
validity (Juniper et al., 1996), which strengthened the results
obtained. Many studies used the PACQLQ showing
reliability and validity (Dalheim-Englund et al., 2004;
Laforest et al., 2004; Osman et al., 2001; Reichenberg
et al., 2001).
This study had several limitations. First, utilizing a crosssectional study design provides a snapshot of the lives of
children with asthma and their parents at a specific point in
time, and answers to the questionnaires could have been
different if a longer period or a different period (seasonal
influence of certain types of asthma) was used (DalheimEnglund et al., 2004; Reichenberg et al., 2001). Ideally, a
longitudinal research study would provide ongoing changes
in QOL as related to changes in life events related to asthma.
Another limitation is selection bias because some parents
were more willing to participate in the study due to the
manifestation of their children’s asthma severity.
6. Conclusion and recommendations
The evidence presented in this study supports the idea that
numerous factors such as asthma severity and sociodemographic factors are capable of influencing QOL. Measuring
parental QOL can help to develop more effective asthma
programs that take the experiences of parents into consideration (Halterman et al., 2004), an important component for
successful medical and nursing care.
One area for future research is to test a larger number of
participants over a longer period in multiple settings.
Examining a larger number of participants in different
settings allows assessment for study consistency, and the
longitudinal design may account for changing sociodemographic and asthma severity on QOL. Several other measures
such as parents’ own physical disabilities, coping abilities,
psychological health, family context, and other unknown
factors may be revealed in a longitudinal study design. Recent
studies suggest that psychological factors and parents’ mental
health influence PACQLQ scores and health care utilization
for their asthmatic children (Dalheirm-Englund et al., 2004;
N.S. Cerdan et al. / Applied Nursing Research 25 (2012) 131–137
Vila et al., 2004). Thus, another area for future research
should be to examine other factors besides asthma severity
and sociodemographic factors that may influence QOL. To
determine if other factors influence QOL, instrumentation
research to develop other measurement tools aside from the
PACQLQ needs to occur.
Supporting previous research findings, this current study
helped affirm the idea that nurses working with families of
asthmatic children need to aggressively provide care
through patient education and vigilant monitoring. This
study showed that asthma severity is closely aligned with
parental QOL. Understanding this relationship, nurses can
positively influence care by assuring tight control of asthma
severity, and even reversing the asthma severity category of
patients has the potential to elevate QOL for both parents
and asthmatic children especially in families that are the
most vulnerable.
References
Akinbami, L. J., & Schoendorf, K. C. (2002). Trends in childhood asthma:
Prevalence, health care utilization, and mortality. Pediatrics 110,
315–322.
Annett, R. D., Bender, B. G., DuHamel, T. R., & Lapidus, J. (2003). Factors
influencing parent reports on quality of life for children with asthma.
Journal of Asthma 40, 577–587.
Dalheim-Englund, A., Rydstrom, I., Rasmussen, B. H., Moller, C., &
Sandman, P. (2004). Having a child with asthma—Quality of life for
Swedish parents. Journal of Clinical Nursing 13, 386–395.
Dean, B. B., Calimlim, B. M., Kindermann, S. L., Khandker, R. K., &
Tinkelman, D. (2009). The impact of uncontrolled asthma on
absenteeism and health-related quality of life. Journal of Asthma 46,
861–866.
Erickson, S. R., Munzenberger, P. J., Plante, M. J., Kirking, D. M., Hurwitz,
M., & Vanuya, R. Z. (2002). Influence of sociodemographic factors on
the health-related quality of life of pediatric patients with asthma and
their caregivers. Journal of Asthma 39, 1
Read this case study: Hilliard, R. (2013). An extended stayLinks to an external site.. Institute for Healthcare Improvement.Propose an improved process to reduce the likelihood of similar errors in the future.Discuss how this process would be implemented and evaluated for outcomes.Please be sure to validate your opinions and ideas with citations and references in APA format.
Respond to the following in a minimum of 175 words:
There are several types of waste generated in the health care industry: infectious, pathological, sharps, chemicals, pharmaceuticals, genotoxic, radioactive, and non-hazardous or general waste.
Create an infographic that illustrates the type of waste that your sustainability initiative will eliminate.
Include the following in your infographic:
Description of the waste
Sources for the waste
The amount of waste generated per yearHow it is disposed
Solutions for reducing it
The financial impact of the waste reduction initiative
Part I: Share Your ExperienceThere have been many healthcare initiatives implemented that are intended to address the COVID 19 pandemic. How have some of these initiatives affected you? You can share your thoughts from the perspective of a provider, advocate, or healthcare consumer. If you have not been impacted, share what you have observed around you. Part II: Apply Your KnowledgeNow applying what you’ve learned from the readings, let’s go through the rest of the discussion together. Think of a healthcare organization of interest to you (employer, personal provider, one that you read about in your local media, or one profiled in your readings over the term, e.g.). How has this organization responded to procedures for COVID 19 in general? How has this organization addressed groups facing health disparities during the pandemic? As you discuss your chosen organization, please provide specific examples related to the organization, the pandemic response, and a vulnerable group. As an emerging leader, please share a recommendation you might give the organization’s leadership about leveraging these changes to improve quality for its healthcare consumers. Write this as if you were sharing it with your leadership. Add references
Marijuana Opportunity Reinvestment and Expungement Act of 2019 or the MORE Act of 2019
Directions
For this assessment, you will create a slide and audio presentation in which you will present information in support of your position, whether pro or con, on S.2227 Marijuana Opportunity Reinvestment and Expungement Act (MORE) of 2019.
Please visit Congress.gov for more information on the MORE Act.
You may use PowerPoint, Google Slides, Prezi, or another presentation software of your choosing. Your audio presentation should put forth a convincing argument based on your searches designed to address a group of senators whose support you are trying to obtain.
Your slide and audio presentation will address:
Title slide with audio
Introduction of self as a registered voter, professional experience, and position for or against S.2227
Briefly address S.2227 legislation
Your state’s current public policy addressing marijuana usage
Use of medical marijuana
Pros and cons of recreational usage
Two nursing organization’s stances
Stakeholders
Financial implications
Your position on S.2227 to support how you want your senators to vote when it comes before the senate
Conclusion: Takeaway points
Assessment Requirements
Before finalizing your work, you should:
be sure to read the assessment description carefully (as displayed above);
consult the Assessment Rubric (under the Course Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing assessment should:
A maximum of 15 slides (not including the title or reference slide).
Professional in appearance and tone, reflecting a thoughtful and meaningful application to your arguments.
Speak clearly and convincingly and at a measured pace.
Presentation no longer than 10 minutes.
follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
use 7th edition APA formatting and citation style.
The presentation is about medication errors in nursing. The PowerPoint should mention the errors in the
RoDonda Vaught case the nurse from Tenenessee who had a med error that resulted in a person’s
death. Please let me know whatever else you need. The presentation should reference the Tenenessee
Nurse RaDonda Vaught. Ten content slides, with 100 words of speaker notes per slide. Use visuals and
images throughout the presentation.
Please read below very carefully so that the paper is done exactly how she wants it. I will attach my NP interview because as you will read it needs to be included in this.
You are going to reflect back on what you have learned throughout these
last eight weeks in this course through the assignments, lecture and
class time combined with your courses from last fall and complete the
following:
Learning Objective: To explore the role of the APRN in depth as she /he
functions in the context of the institution in which he/she is employed
using the data from the NP Interview.
Methods: Compare and contrast the ideal and the observed/evaluated
advanced practice nursing roles according to professional guidelines,
theory, and research reviewed in this course and past courses and in the
literature. (See Interview Guide and Interviews for the first part of
this assignment). Include the following headings:
Introduction
Analysis of two themes (each theme has its own heading) with supporting exemplars
Personal reflection
Conclusions
References. (should have a minimum of five references and may be your course books or journal articles)
Include your Interview Guide/NP Interview as an appendix.
Use APA 7th edition style. Papers should be 5-6 pages, double spaced, 12
point font. Page count does not include the reference page and
appendix.
I want you to think about your first assignment from this
course….”What is a nurse practitioner?” What thoughts, ideas, ideals
have changed over these 8 weeks? Do you view the role differently than
when you first entered this course 8 weeks ago? What is different from
your readings to the “real life” interviews you conducted? How does
“real life” differ from what you have learned so far in Theory, Research
and Role courses? What did you “hear” from the NP you interviewed that
made you pause and think….hmmmm that is different than from our
Please refer to the attachments for grading rubic and the template!
Instructions
Locate a peer-reviewed journal article in the PubMed database on an abdominal pathology we can image with ultrasound.
This article must be:
Located in the CIHNAL PubMed database.
Published in a peer-reviewed journal within the last 5 years and written in English.
Contain the full-text document, saved as a .pdf,
Summarize in one paragraph by using the template attached.
Attach the journal along with the article assignment.
Make sure to use APA format when citing a peer-reviewed journal article
***Grading rubic and template attached***
Unformatted Attachment Preview
Article Summation (DUE OCT 14TH 10AM)
Instructions
Locate a peer-reviewed journal article in the PubMed database on an abdominal pathology we can image
with ultrasound.
•
This article must be:
• Located in the CIHNAL PubMed database.
• Published in a peer-reviewed journal within the last 5 years and written in English.
• Contain the full-text document, saved as a .pdf,
• Summarize in one paragraph by using the template on the last page.
• Attach the journal along with the article assignment.
•
Make sure to use APA format when citing a peer-reviewed journal article:
Typically, the following format is used:
Author, A. A., Author, B. B., & Author, C. C. (Year). Title of article. Title of Periodical in
italics, volume number (issue number), pages. https://doi.org/xx.xxx/yyyy
Refer to the rubric below
1
Article Summation Example
(Template)
Article Title
Decision-making based on 3D printed models in laparoscopic liver resections with intraoperative ultrasound: a
prospective observational study.
Article Author(s)
Witowski, Jan; Budzyński, Andrzej; Grochowska, Anna; Ballard, David H.; Major, Piotr; Rubinkiewicz, Mateusz;
Złahoda-Huzior, Adriana; Popiela, Tadeusz J.; Wierdak, Mateusz; Pędziwiatr, Michał
Publishing Journal and Year
European Radiology, 2020
APA Citation
Witowski, J., Budzyński, A., Grochowska, A., Ballard, D., Major, P., Rubinkiewicz, M., Złahoda-Huzior, A.,
Popiela, T., Wierdak, M., Pędziwiatr, M. (2020). Decision-making based on 3D printed models in
laparoscopic liver resections with intraoperative ultrasound: a prospective observational study.
European Radiology, 30(3): 1306-1312. DOI: 10.1007/s00330-019-06511-2
Summation
The peer-reviewed journal article titled Decision-making Based on 3D Printed Models in Laparoscopic Liver
Resections with Intraoperative Ultrasound: A Prospective Observational Study was published in 2020. The
authors of this article printed 3D models of specific patient pathologies to assist the surgeon during the
preoperative decision-making process. 19 patients with liver malignancies had their liver and liver pathology
printed into a 3-dimensional anatomically correct model. 26.3% (5 out of 19) patient’s surgeons altered their
preoperative surgical plan after evaluating the 3D models.
2
Use the link above as reference to get information for the assignment starting pg 66 you can get information on the topic
https://www.ahcpofva.com/ This link is for the internship site in case you need information on the organization.
The attachment has the project question and description just needs to elaborate more on it. Submit an Executive Summary which outlines and summarizes your experience and accomplishments regarding your internship project. APA referencing is required; at least 2 references must be used. The paper should be 3-4 pages, not including the title page and references page.
Use these bolded words as headings in your paper:
Title of the project
Project Question: State your project in the form of a question: Will doing XXX result in XXX?
Project Description: Explain what you did in completing this project
Necessity: Explain why this project was needed
Scope: Explain which departments/areas of the organization which were impacted by this project
Methods: Describe how you structured your work for this project and the data that you used
Result: Identify the findings of this project and your analysis of the data; compare “before” and “after” data for the project
Outcomes: Explain how findings of this project will help the organization
Sustainability: How can the organization use the findings of your project in the future?
Reflection:
In your internship, how did you apply skills and abilities obtained through all of your Health Administration degree coursework?
What did you learn from your internship experience, in this project specifically and the entire internship?
Unformatted Attachment Preview
HAP 498 Internship Project Fall 2023
Date
Student Name
Organization Name
Project Question:
State your project in the form of a
question: Will doing XXX result in
XXX?
Project Description:
Explain what you will be doing in
completing this project
Necessity:
Explain why this project is needed
Scope:
Explain which departments/areas
of the organization which will be
impacted by this project
Methods:
Describe how you will structure
your work for this project and the
data that will be involved
Result:
Identify the intended findings of
this project, how you will analyze
the data—need to be able to
compare “before” and “after” data
for the project
Need to have a quantifiable data
comparison to information before
the project and after the conclusion
of the project
Outcomes:
Explain how findings of this project
will help the organization
Sustainability:
Predict how the organization might
be able to the findings of your
project in the future
Reflection:
*In your internship, how do you
think that you will be able to apply
skills and abilities obtained through
all of your Health Administration
degree coursework?
*What skills do you hope to acquire
through this internship project?
September 12, 2023
Nida Ahmad
American healthcare professionals
By creating a training pathway will it help students to become certified for
telemedicine/telehealth?
Help create training pathway for becoming certified for telemedicine/telehealth.
This project is needed because it will help students prepare to become certified for
telemedicine/telehealth.
The telemedicine and telehealth department will be impacted.
I will structure my work by creating a PowerPoint and putting all my research in there.
Telemedicine/telehealth programs require identifying the individuals goals, objectives,
strategies, and timeline. Telehealth/telemedicine increases access to healthcare,
better health outcomes as it can lead to early diagnosis and treatment, it can improve
cost efficiency as it can lower healthcare costs, and patient satisfaction.
The findings of this project will help the organization because it will prepare and help
other students who will be coming in to intern at the organization and my project would
give them a guide/ idea of what to expect of the internship certification.
The organization might be able to use my findings of my project in the future by
showing it to future interns and having them become aware of the training pathway
that is needed to become certified for telehealth/telemedicine.
In my internship I think I will be able to apply the skills and abilities obtained through
all of my health administration degree coursework because I feel like everything, I
learned throughout my degree coursework was to prepare me for in life careers and
jobs and I feel like now during my internship it would be like putting what I learned to
the test. The skills that I hope to acquire through this internship project is the
importance and use of telemedicine and telehealth as I know that is something that Is
becoming more common nowadays.
American
Healthcare
Professionals
Nida Ahmad
Background/history
of organization,
goal/mission,
governance, and
primary functions
American healthcare professionals was founded in 1995 by Dr
Clishia Taylor.
’A home health and hospice company in Great Falls, Virginia. In
2009, the company’s vision expanded to include a comprehensive,
patient-centric model inclusive of: Home Health, hospice,
telehealth, mobile health, global health, and wellness programs.’
I am working as an administrator/telehealth intern
Where I am
working within
the
organization
My role is to send orders for patients
To fax over orders to physicians and attach them into the
system
I do jobs within the EMR system as well along with
inputting data into excel sheets to keep track of patient
record.
How is the
organization
funded
Dr Clishia Taylor had informed me that the organization is funded
by the home health care provider billing Medicare and Medicaid or
any other private insurance.
What the
preceptor does
and envision
the field in five
years in health
care
All Dr Taylor had
mentioned was that
it is more community
based programs.
She envisions the
field of healthcare to
be more consumer
directed in five years.
What the
preceptor
thinks all
healthcare
management
students
should know
about
organization
She thinks that people should
know about the vision of the
organization and the
population that is being
served along with the
operation guidelines.
Education and
training the
preceptor wish
they had prior
to working
current job
It is helpful that she has been providing health care for over 30
years as a clinician and has a MBA in health care
management/finance and has worked as a GMU instructor for 4
years with nursing students.
Reference
American Health Care Professionals. (2022, January 13). Management American Health care
professionals. https://www.ahcpofva.com/overview/management/
Purpose
The purpose of this assignment is to explore a critical concept in nursing.
Identify characteristics of professional behavior including emotional intelligence,
communication, and conflict
resolution.
1) Locating Evidence
a. Using the Chamberlain University library, search for recent (published within the
last five years) evidencebased article from a scholarly journal that addresses one of the topics listed.
• Safety
• Delegation
• Prioritization
• Caring
2) Include the following sections.
a. Introduction
• Clearly establishes the purpose of the paper
• Includes key points to be covered
• Captures the reader’s interest
b. Body of Paper
• Complete, well-developed discussion of key points
• Supports the purpose or main idea of the paper
• Logical development of ideas with clear and accurate information
• Ideas and statements are supported by three or more examples from personal
and/or professional
experiences
• Provides own perspectives on the topic that is reflective, insightful, and original
c. Conclusion • Clear and concise
• Summarizes key points discussed in the paper
• Leaves a strong impression, message, or idea on the reader
d. Writing Style –
e. Correct use of standard English grammar, paragraph, and sentence structure
f. No spelling or typographical errors
g. Organized around required components
h. Information flows in a logical sequence that is easy for the reader to follow
i. APA Format, and References – 25 points/17%
• There is correct and appropriate use of margins, spacing, font, and headers
• Document setup includes title and reference pages in correct APA format
NR103 Transition to the Nursing Profession
Transitions Paper Guidelines
NR103_Transitions_Paper_Guidelines 2
• Citation of sources included in the body of the paper uses correct APA format for
direct and indirect quotes
• All elements of each reference are included in the correct order
• All information taken from the source, even if summarized, is cited and listed on the
Reference page
• All sources used are nursing journals published within the last five years
For writing assistance (APA, formatting,
Write a 4-5 page paper describing the use of a specific screening tool. Discuss what diagnosis you are using the tool for, how to score the tool, and support use of the tool with evidence and rationale. Next, develop a treatment plan for the patient based on your findings in the diagnostic test and interpretation.Sections should include: Introduction to the diagnostic tool Discussion of Tool: why it is used, how, and for what diagnosis Discussion of Interpretation of Scoring for the Tool Treatment Plan for patient with positive results from the tool, include non-pharmacological and pharmacological approaches, patient education, additional testing required, and follow-up as needed.
Professor’s Comment:
The referencing and citing of scholarly work is mandatory to support the idea that is being
presented in the participation discussion. ALL peer responses require an in text citation, a
reference, and 6 or more sentences. References should be between 2018 to 2022.
Post 1:
Contributing to the reengineering of healthcare by nurse managers and executives is a valuable
technique that assists businesses in defining priorities, delivering more cost-effective
treatment, and enhancing consumer value. A nurse leader plays a crucial role in reengineering
healthcare by establishing goals, policies, and processes for quality improvement that will
result in positive changes within the nursing profession and improved patient outcomes
(Thomas et al., 2016). Nurse leaders have been charged with participating in and contributing
to healthcare transformation to satisfy the demand for safe, high-quality, and patient-centered
care. In the past, nurses could not effectively contribute to large-scale, significant change due
to various barriers, including cultural disparities, legal restrictions, and policy limitations.
Nurse leaders are urged to use their knowledge and skills to propose inventive new approaches
to health care reform.
The nurse manager or leader can reengineer healthcare and may be accountable for modifying
present policies, practices, and procedures. The significant alteration many hospitals underwent
due to the COVID-19 outbreak is a good example. To remedy the situation, it was required to
develop new processes for observing safety and avoiding infection. The Reengineered
Discharge (RED) program, according to Popejoy et al. (2020), “prepares hospitalized patients
for home discharge” (p. 158). Consequently, all internal logistics for implementing these
processes became the duty of nurse leaders and managers.
Developing new strategic immunization programs for the population is another instance of
nursing managers utilizing reengineering. According to Bloom et al. (2017), “vaccines are now
universally recognized as a cost-effective and low-cost means of promoting health” (p. 214).
To satisfy the government’s vaccine regulations, it was required to fully adopt a new workflow
in which nurses may vaccinate all willing patients. Occasionally, immunizations were
administered outside hospital grounds, which considerably complicated the procedure.
Consequently, it can be asserted with certainty that nursing managers and leaders conduct
crucial healthcare reengineering duties.
References
Bloom, D. E., Canning, D., & Weston, M. (2017). The value of vaccination. Fighting the
Diseases of Poverty, 214-238. https://doi.org/10.4324/9780203791950-8
Popejoy, L. L., Wakefield, B. J., Vogelsmeier, A. A., Galambos, C. M., Lewis, A. M.,
Huneke, D., Petroski, G., & Mehr, D. R. (2020). Reengineering skilled nursing facility
discharge. Journal of Nursing Care Quality, 35(2), 158164. https://doi.org/10.1097/ncq.0000000000000413
Thomas, T., Seifert, P., & Joyner, J. (2016). Registered nurses leading innovative
changes. OJIN: The Online Journal of Issues in
Nursing, 21(3). https://doi.org/10.3912/ojin.vol21no03man03
Post 2:
Nursing managers and leaders have a significant role to play in the reengineering of healthcare. It
is anchored in the 2010 healthcare reform act which offers nurses avenues for delivering
healthcare and playing a significant role in leading the reforms process in the health sector
(Crewe & Girardi, 2019). The first aspect is to comprehend these opportunities and advocate for
ways to reduce disease prevention, chronic patient care and costs. Some of the emerging reengineering process include adoption of nurse-led innovations, generation of evidence and
engagement in research, redesigning of nurse education and qualifications, expansion of the
scope of practice, diversification of workforce, embracing of technology, and fostering inter
professional connections. Additionally, nurses play important roles as innovators who help shape
quality and safety. It is the role of the nurse leaders and managers to track data which helps to
boost nursing practices as a part of the broader efforts to improve the health of the patients.
Besides, in re-engineering, it is crucial to redesign the nursing education and ensure that nursing
practitioners have the requisite requirements and training which helps to improve the quality and
safety, evidence-based practice, research, and leadership. The scope of nursing can also be
expanded in the reengineering process in healthcare. It can be adjusted to allow Advanced
practice nurses (APNs) to practice to the full extent of their education and licensure. It will allow
them to work in partnership with physicians as they provide cost-effective care and help address
the primary care shortage (Steaban, 2016). It is necessary to adopt these changes because,
currently, statutory, and regulatory barriers prevent them from practicing to the full extent of
their licensure. Again, the workforce can be diversified to be able to reduce the present health
disparities. To be able to achieve these, nurse leaders and managers have to put efforts to
ensure that the nursing workforce reflects patient’s diverse backgrounds and cultural values.
References
Crewe, S., & Girardi, A. (2019). Nurse managers: being deviant to make a difference. Journal of
Management & Organization, 1-16.
Steaban, R. L. (2016). Health care reform, care coordination, and transformational
Leadership Nursing administration quarterly,40(2), 153-163.
Post 3:
Healthcare reengineering involves devising methodologies that seek to improve the efficiency
of care delivery, reduce costs, and improve customer experience and satisfaction. The
healthcare system is ever-changing and hence requires close attention to address emerging
issues. Approaches or methodologies to be employed must adhere to market needs as well as
customers’ expectations. System reengineering entails methodologies that consolidate all
recurring functions or processes to avoid redundancy that compromises efficiency.
Concurrently, it enhances the management of all functional units and plans in healthcare, thus
fostering smooth operation and care delivery (Helbig, 2018).
Nurse managers and leaders are the major decision-makers in the healthcare system. They are
responsible for the smooth and efficient delivery of healthcare services. They ensure that
healthcare policies are adhered to and followed. Nurse leaders advocate for the affairs of both
healthcare staff and patients or customers. They ensure that customers’ rights are respected and
their needs are addressed, while at the same time addressing staff issues. They do this by
empowering them to speak and act independently. Similarly, they stand and fight for those
lacking the power of self-advocacy (Crewe & Girardi, 2019). For instance, during the outbreak
of COVID-19, nurse managers and leaders ensured that healthcare staff was well-protected
from infection when caring for infected patients.
Managers are responsible for managing daily activities and ensuring that every function is
executed as required. They give directions on what to do and ensure that nurses are competent
in providing care services at the expected levels. They also solve cases and conflicts that may
arise among staff members or between staff and clients. In this case, they ensure that harmony,
unity, and normalcy prevail at all times. On the other hand, leaders are more concerned with
spearheading functions in a specific direction. They ensure that no one strays and that everyone
is focused on a single goal. Leaders are dedicated to certain goals and ensure that they are
achieved. Managers and leaders play separate roles in healthcare delivery; however, there is a
need to integrate both aspects of nursing leadership for outstanding outcomes (Lai et al., 2019).
In conclusion, healthcare reengineering refers to the reinvention of methodologies intended to
improve care delivery and efficiency in the healthcare system. Nurse managers and leaders are
responsible for the daily activities of the healthcare setting, hence ensuring that all policies are
implemented to the fullest. They advocate for everyone’s right to act independently or feel free
to air their issues of concern. They do this by empowering them to stand tall in times of need.
Nurse managers ensure that normalcy and harmony are ever-present in the healthcare setting.
They solve conflicts involving various parties. Leaders, on the other hand, are more concerned
with staff unity and participation to achieve set goals. The two aspects can be integrated to
realize effective results.
References
Crewe, S., & Girardi, A. (2019). Nurse managers: being deviant to make a difference. Journal
of Management & Organization, 26(3), 1–16. https://doi.org/10.1017/jmo.2019.72
Helbig, J. (2018). Reengineering Health Care
Management. https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leadingand-serving/v2.1/#/chapter/5
Lai, M., Kuan, P., Lai, P., Mai, C., Sulaiman, H., Kim, P., & Lim, C. (2019). Healthcare Big
Data Analytics: Re-engineering Healthcare Delivery through Innovation.
https://iejsme.imu.edu.my/wp-content/uploads/2021/08/5.-IRDI-PH-Policy-Series-3.pdf
Create a 2-4 page resource that will describe databases that are relevant to EBP around a diagnosis you choose and could be used to help a new hire nurse better engage in EBP.
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Introduction
Evidence-based practice (EBP) integrates the best evidence available to guide optimal nursing care, with a goal to enhance safety and quality. EBP is crucial to nursing practice because it incorporates the best evidence from current literature, along with the expertise of the practicing nurse. The concern for quality care that flows from EBP generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise. To gain the knowledge, you require a good understanding of how to search for scholarly resources, as well as identify which databases and websites are credible for the purposes of implementing evidence-based changes in practice.
Your Online e-Portfolio
Creating an ePortfolio is not required in the BSN program, but you may find it helpful to create one to attach to your professional resume while job hunting. Online ePortfolios serve two key purposes: 1) to support learning and reflection, and 2) to be used as a showcase tool. Your learning journey can be documented, and ePortfolios contribute to lifelong learning and growth through reflection and sharing. Online ePortfolios can also be shared with employers and peers to present artifacts that demonstrate your accomplishments at Capella.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for providing patient-centered, competent care based on current evidence-based best practices. You will be required to do research, analysis, and dissemination of best evidence to stay abreast of these best practices. Understanding where to go to find credible sources and locate evidence, as well as which search terms to use, is the foundation of incorporation of best practices.
Scenario
You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.
To select the diagnosis for the patient in this scenario, review the three diagnoses presented in the Assessment 01 Supplement: Locating Credible Databases and Research [PDF] Download Assessment 01 Supplement: Locating Credible Databases and Research [PDF]resource and select one. You will use this same diagnosis to complete the next two assessments.
Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, journal article, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.
Preparation
To help ensure you are prepared to complete this assessment, review the following resources related to the Capella library. These resources will provide you an overview of the types of tools, resources, and guides available in the library. This may be useful in forming a better understanding of the library to apply to the hypothetical situation laid out in the scenario of this assessment.
BSN Program Library Research Guide.
Evidence-Based Practice in Nursing & Health Sciences.
Databases A-Z: Nursing & Health Sciences.
Get Critical Search Skills.
Remember, it is also appropriate to look toward databases and resources outside of the Capella library, such as organizational policies, professional organizations, and government health care resources.
You are encouraged to complete the Evaluating the Credibility of Evidence activity. This activity offers an opportunity to practice evaluating the credibility of evidence. These skills will be necessary to complete Assessment 1 successfully and is for your own practice and self-assessment. Completing this activity is also a way to demonstrate course engagement.
Instructions
The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.
For this assessment:
Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to the diagnosis in this scenario and describe to which of these you would direct a nurse colleague to search for evidence.
Describe where you might go in the work place to complete this research and how you would access the desired, relevant research within research databases or other online sources.
Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.
Describe communication strategies to encourage nurses to research the diagnosis/practice issue, as well as strategies to collaborate with the nurses to access resources.
Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis/health care issue within the context of a specific health care setting.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis/practice issue.
Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis/health care issue.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis/practice issue, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
Assessment 1 Example [PDF] Download Assessment 1 Example [PDF].
Additional Requirements
Your assessment should meet the following requirements:
Length of submission: 2-4 pages (not including the title page or the reference page) description of communication, collaboration, and evidence location process, including a list of databases or other sources with description of why they are appropriate for clinical scenario diagnosis/health care issue (that is, something that would be useable in professional practice for other nurses). Be sure to include an APA-formatted reference page at the end of your submission.
Number of references: Cite a minimum of three sources of scholarly or professional evidence that supports your findings and considerations. Resources should be no more than five years old.
APA formatting: References and citations are formatted according to current APA style.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
Explain why the sources selected should provide the best evidence for the chosen diagnosis/health care issue.
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision within the context of a specific health care setting.
Describe the best places to complete research within the workplace environment and what types of resources one would want to access to find pertinent information for the diagnosis/health care issue.
Competency 4: Plan care based on the best available evidence.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a diagnosis/health care issue and three out of five should be specific to the diagnosis/health care issue.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Describe communication strategies to encourage nurses to research a diagnosis/health care issue, as well as strategies to collaborate with the nurses to access resources.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
.
.
.Assessment 2
Develop a 2-4 page scholarly paper in which you describe the diagnosis you researched for the previous assessment, and then identify and analyze credible evidence that could be used as the basis for applying EBP to the issue.
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Introduction
The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon to hear a nurse say, “why change it as we’ve always done it this way.” However, this is no longer acceptable in today’s practice environment. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in health care transformation, baccalaureate-prepared nurses are expanding taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria and makes a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into health care settings. The nurse will need to incorporate the use of evidence-based practice models. EBP models are designed to assist the nurse in developing a plan to gather evidence to answer a practice problem or question. It is a systematic approach to direct the user to incorporate scholarly findings into current practice. These EBP models lead the nurse through the decision-making process of evaluating the literature to determine the best practice evidence for the practice issue or question.
It would be an excellent choice to complete the Vila Health Determining the Credibility of Evidence activity prior to developing the report. The activity is a media simulation that offers an opportunity to review a scenario and work on determining the credibility of presented evidence. These skills will be necessary to complete Assessment 2 successfully. This media simulation is one potential source of context on which to base your assessment submission. This will take just a few minutes of your time and is not graded.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.
Scenario
For this assessment, use the specific diagnosis/health issue you selected for the first assessment.
Instructions
The purpose of this analysis is to better understand what constitutes credibility of journal articles as well as websites. The role of the baccalaureate-prepared nurse in incorporating evidence-based research continues to growth in clinical practice. As quality improvement (QI) measures to reduce safety risks continue to be emphasized, the need for evidence-based models and evidence-based templates is growing. This type of systematic approach to incorporating evidence-based findings allows nurses to make clinical and operational decisions based upon the best available evidence. When the most up-to-date evidence-based findings are utilized, patient-centered care improves outcomes and enhances the patient experience.
Below is a quick review table of several well-known Evidence-Based Practice Models used to guide exploration:
Evidence-Based Practice Models
Iowa Model of Evidence-Based Practice
Stetler Model
Ottawa Model
PARiHS (Promoting Action on Research Implementation in Health Services) Model
ACE (Academic Center for Evidence-Based Practice) Star Model
ARCC (Advancing Research and Clinical Practice Through Close Collaboration) Mode
John Hopkins Model
KTA (Knowledge-to-Action) Model
For this assessment:
Explain the criteria that should be used when determining the credibility of journal articles as well as websites.
Support your explanations with references to the literature or research articles that describe criteria that should be used to determine credibility.
Your identification and determination of credibility should be done within the context of your chosen diagnosis for this assessment. Your initial identification of resources should be of resources that will best help address the presented diagnosis you selected. Since you are locating resources to help provide evidence-based care for the diagnosis/health care issue you identified in the first assessment, you may want to begin your literature and evidence search from the databases that were identified.
Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.
Describe a chosen diagnosis that could benefit from an evidence-based approach.
Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
Analyze the credibility and relevance of evidence and resources within the context of a chosen diagnosis.
This is where you are selecting the specific resources to help address the diagnosis you selected for the first assessment.
Identify the Evidence-Based Practice model and explain the importance of incorporating credible evidence into the EBP model used to address a chosen diagnosis. Review the literature below and choose the appropriate model for your diagnosis.
Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Models help explain the various evidence-based nursing models.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Additional Requirements
Your assessment should meet the following requirements:
Length of submission: 2-4-page scholarly paper, this does not include the APA-formatted title page and reference list.
Number of references: Cite 3-5 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than five years old.
APA formatting: References and citations are formatted according to current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.
Competency 3: Apply an evidence-based practice model to address a practice issue.
Identify an evidence-based practice model (such as Iowa, Stetler, John Hopkins, etc.) and explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis/health care issue.
Competency 4: Plan care based on the best available evidence.
Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
.
.
assessment 3
Create a 3-5 page submission in which you develop a PICO(T) question for the diagnosis you worked with in the first two assessments and evaluate the evidence you locate, which could help to answer the question.
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Introduction
PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.
It stands for:
P – Patient/population/problem.
I – Intervention.
C – Comparison (of potential interventions, typically).
O – Outcome(s).
T – Time frame (if time frame is relevant).
The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. When applying the PICO(T) approach, the nurse can isolate the interventions of interest and compare to other existing interventions for the evidenced impact on the outcome of the concern.
You are encouraged to complete the Vila Health PICO(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.
REFERENCE
Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Jones & Bartlett Learning.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.
PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question. When writing a PICO(T)-formatted research question, you want to focus on the impact of the intervention and the comparison on the outcome you desire.
Scenario
For this assessment, please use the diagnosis you worked with in the first two assessments.
Instructions
After reviewing the materials you created to research a specific diagnosis in the first two assessments, apply the PICO(T) process to develop a research question and research it.
Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your chosen diagnosis, and explain how the evidence would help you plan and make decisions related to your question.
If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.
In your submission, make sure you address the following grading criteria:
Define a practice issue to be explored via a PICO(T) approach. Create a PICO(T)-formatted research question
Identify sources of evidence that could be potentially effective in answering a PICO(T) question (databases, journals, websites, etc.).
Explain the findings from articles or other sources of evidence as it relates to the identified health care issue.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
Assessment 3 Example [PDF] Download Assessment 3 Example [PDF].
Additional Requirements
Your assessment should meet the following requirements:
Length of submission: Create a 3-5 page submission focused on defining a research question and interpreting evidence relevant to answering it.
Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to the current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
Explain the findings from articles or other sources of evidence that are relevant to the health care issue.
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Competency 3: Apply an evidence-based practice model to address a practice issue.
Define a practice issue to be explored via a PICO(T) approach and develop a PICO(T)-formatted research question.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
.
.
.assessment 4
Create a 5-10 minute video of yourself, as a presenter, in which you will propose an evidence-based plan to improve the outcomes the patient in the provided case study, and examine how remote collaboration provided benefits or challenges to designing and delivering the care.
Collapse All
Introduction
As technologies and the health care industry continue to evolve, remote care, diagnosis, and collaboration are becoming increasingly more regular methods by which nurses are expected to work. Learning the ways in which evidence-based models and care can help remote work produce better outcomes will become critical for success. Additionally, understanding how to leverage EBP principles in collaboration will be important in the success of institutions delivering quality, safe, and cost-effective care. It could also lead to better job satisfaction for those engaging in remote collaboration.
Professional Context
Remote care and diagnosis is a continuing and increasingly important method for nurses to help deliver care to patients to promote safety and enhance health outcomes. Understanding best EBPs and building competence in delivering nursing care to remote patients is a key competency for all nurses. Additionally, in some scenarios, while you may be delivering care in person you may be collaborating with a physician or other team members who are remote. Understanding the benefits and challenges of interdisciplinary collaboration is vital to developing effective communication strategies when coordinating care. So, being proficient at communicating and working with remote health care team members is also critical to delivering quality, evidence-base care.
Preparation
Before beginning this assessment, it would be helpful to review the following media activity to examine another example of remote collaboration:
Vila Health: Remote Collaboration on Evidence-Based Care.
You may also wish to review Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Models, which help explain the various evidence-based nursing models.
Scenario
Review the case study in the Assessment 04 Supplement: Remote Collaboration and Evidence-Based Care [PDF] Download Assessment 04 Supplement: Remote Collaboration and Evidence-Based Care [PDF]resource. You will use this case study as the focus for this assessment.
Instructions
For this assessment, you are a presenter! You will create a 5–10-minute video using Kaltura or similar software. In the video:
Propose an evidence-based care plan that you believe will improve the safety and outcomes of the patient in the case study presented in the Assessment 04 Supplement: Remote Collaboration and Evidence-Based Care [PDF] Download Assessment 04 Supplement: Remote Collaboration and Evidence-Based Care [PDF]resource. Add your thoughts on what more could be done for the patient and what more information may have been needed.
Discuss the ways in which an EBP model and relevant evidence helped you to develop and make decisions about the plan you proposed
Wrap up your video by identifying the benefits of the remote collaboration in the scenario, as well as discuss strategies you found in the literature or best practices that could help mitigate or overcome one or more of the collaboration challenges you observed in the scenario.
Be sure you mention any articles, authors, and other relevant sources of evidence that helped inform your video. Discuss why these sources of evidence are credible and relevant. Important: You are required to submit an APA-formatted reference list of the sources you cited specifically in your video or used to inform your presentation. You are required to submit a narrative of all your video content to this assessment and to SafeAssign.
The following media is an example learner submission in which the speaker successfully addresses all competencies in the assessment.
Exemplar Kaltura Reflection.
Please note that the scenario that the speaker discusses in the exemplar is different from the Vila Health scenario you should be addressing in your video. So, the type of communication expected is being model, but the details related to the scenario in your submission will be different.
Make sure that your video addresses the following grading criteria:
Propose your own evidence-based care plan to improve the safety and outcomes for a patient in the provided case study.
Explain the ways in which you used an EBP model to help develop your plan of care for the client.
Reflect on which evidence you found in your search that was most relevant and useful when making decisions regarding your care plan.
Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.
Communicate in a professional manner that is easily audible and uses proper grammar, including a reference list formatted in current APA style.
Refer to Using Kaltura as needed to record and upload your video.
Note : If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations. If, for some reason, you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.
Additional Requirements
Your assessment should meet the following requirements:
Length of video: 5-10 minutes.
References: Cite at least three professional or scholarly sources of evidence to support the assertions you make in your video. Include additional properly cited references as necessary to support your statements.
APA reference page: Submit a correctly formatted APA reference page that shows all the sources you used to create and deliver your video. Be sure to format the reference page according to current APA style. Submit a narrative of all of your video content.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course compete
Unformatted Attachment Preview
10/11/23, 2:14 PM
Locating Credible Databases and Research Scoring Guide
Locating Credible Databases and Research Scoring Guide
CRITERIA
NONPERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Describe
communication
strategies to
encourage nurses to
research a diagnosis,
as well as strategies
to collaborate with
the nurses to access
resources.
Does not
describe
communication
strategies to
encourage
nurses to
research a
diagnosis, as
well as strategies
to collaborate
with the nurses
to access
resources.
Lists communication
strategies to encourage
nurses to research a
diagnosis, as well as
strategies to
collaborate with the
nurses to access
resources.
Describes
communication
strategies to
encourage nurses to
research a diagnosis,
as well as strategies to
collaborate with the
nurses to access
resources.
Describes
communication
strategies to encourage
nurses to research a
diagnosis, as well as
strategies to
collaborate with the
nurses to access
resources. Additionally,
notes specific benefits
of strategies in helping
to build professional
competence or a
positive professional
relationship. Cites
literature to support
discussion.
Describe the best
places to complete
research within the
workplace
environment and
what types of
resources one would
want to access to find
pertinent information
for a diagnosis.
Does not
describe the best
places to
complete
research within
the workplace
environment and
what types of
resources one
would want to
access
resources to find
pertinent
information for a
diagnosis.
Lists the best places to
complete research
within the workplace
environment and what
types of resources one
would want to access
resources to find
pertinent information
for a diagnosis.
Describes the best
places to complete
research within the
workplace environment
and what types of
resources one would
want to access
resources to find
pertinent information
for a diagnosis.
Describes the best
places to complete
research within the
workplace environment
and what types of
resources one would
want to access
resources to find
pertinent information for
a diagnosis. Notes one
or more reasons for
utilizing the places
within the health care
setting.
Identify five sources
of online information
(medical journal
databases, websites,
hospital policy
databases, et cetera)
that could be used to
locate evidence for a
clinical
diagnosis/health care
issue, and three out
of five should be
specific to the
diagnosis/health care
issue.
Does not identify
sources of online
information
(medical journal
databases,
websites,
hospital policy
databases, et
cetera) that
could be used to
locate evidence
for a clinical
diagnosis/health
care issue.
Identifies less than five
sources of online
information (medical
journal databases,
websites, hospital
policy databases, et
cetera) that could be
used to locate evidence
specific to a clinical
diagnosis/health care
issue, or one or more
of the identified
sources of online
information is
inappropriate for
professional nursing
practice.
Identifies five sources
of online information
(medical journal
databases, websites,
hospital policy
databases, et cetera)
that could be used to
locate evidence
specific to a clinical
diagnosis/health care
issue, and ensures
three out of five are
specific to the
diagnosis/health care
issue.
Identifies five sources
of online information
(medical journal
databases, websites,
hospital policy
databases, et cetera)
that could be used to
locate evidence specific
to a clinical
diagnosis/health care
issue, and ensures
three out of five are
specific to the
diagnosis/health care
issue. Ranks the
sources from most
useful for nurses to
least.
Explain why the
sources selected
should provide the
best evidence for the
chosen
Does not explain
the sources
selected.
Identifies the sources
selected, but does not
provide a full or clear
explanation as to the
relevance or
Explains why the
sources selected
should provide the best
evidence for the
chosen
Explains why the
sources selected
should provide the best
evidence for the
chosen
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1/2
10/11/23, 2:14 PM
CRITERIA
Locating Credible Databases and Research Scoring Guide
NONPERFORMANCE
diagnosis/health care
issue.
BASIC
PROFICIENT
DISTINGUISHED
usefulness of the
sources selected within
the context of the
chosen
diagnosis/health care
issue.
diagnosis/health care
issue.
diagnosis/health care
issue. Notes criteria
used to determine the
relevance and
usefulness of the
sources.
Organize content so
ideas flow logically
with smooth
transitions; contains
few errors in
grammar/punctuation,
word choice, and
spelling.
Does not
organize content
for ideas. Lacks
logical flow and
smooth
transitions.
Attempts to organize
content with some
logical flow and smooth
transitions. Contains
several errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content so
ideas flow logically with
smooth transitions;
contains few errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content with
a clear purpose.
Content flows logically
with smooth transitions
using coherent
paragraphs, correct
grammar/punctuation,
word choice, and free
of spelling errors.
Apply APA formatting
to in-text citations
and references
exhibiting nearly
flawless adherence to
APA format.
Does not apply
APA formatting to
headings, in-text
citations, and
references. Does
not use quotes
or paraphrase
correctly.
Applies APA formatting
to in-text citations,
headings and
references incorrectly,
detracting noticeably
from the content.
Inconsistently uses
headings, quotes,
and/or paraphrasing.
Applies APA formatting
to in-text citations and
references exhibiting
nearly flawless
adherence to APA
format.
Exhibits strict and
flawless adherence to
APA formatting of
headings, in-text
citations, and
references. Quotes and
paraphrases correctly.
https://a21371-1315364.cluster223.canvas-user-content.com/courses/21371~9991/files/21371~1315364/course files/Scoring Guides/a01_scoring_gui…
2/2
10/11/23, 2:17 PM
Determining the Credibility of Evidence and Resources Scoring Guide
Determining the Credibility of Evidence and Resources Scoring Guide
CRITERIA
NONPERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Describe a quality or
safety issue, or a
chosen diagnosis,
that could benefit
from an evidencebased approach.
Does not
describe a
quality or safety
issue, or a
chosen
diagnosis, that
could benefit
from an
evidence-based
approach.
Lists a quality or safety
issue, or a chosen
diagnosis, that could
benefit from an
evidence-based
approach.
Describes a quality or
safety issue, or a
chosen diagnosis, that
could benefit from an
evidence-based
approach.
Describes a quality or
safety issue, or a
chosen diagnosis, that
could benefit from an
evidence-based
approach. Provides a
specific rationale for the
importance or benefit of
applying an evidencebased approach. Uses
literature to support
discussion.
Explain criteria that
should be considered
when determining
credibility of
resources such as
journal articles and
websites.
Does not explain
criteria that
should be
considered when
determining
credibility of
resources such
as journal
articles and
websites.
Lists criteria that
should be considered
when determining
credibility of resources
such as journal articles
and websites.
Explains criteria that
should be considered
when determining
credibility of resources
such as journal articles
and websites.
Explains criteria that
should be considered
when determining
credibility of resources
such as journal articles
and websites. Notes
one or more ways the
criteria could be applied
to a specific resource.
Analyze the credibility
and relevance of
evidence and
resources within the
context of a quality or
safety issue, or a
chosen diagnosis.
Does not
analyze the
credibility or
relevance of
evidence or
resources.
Describes the
credibility or relevance
of evidence or
resources, but does
not offer a complete
analysis. The specific
context of a quality or
safety issue, or a
chosen diagnosis may
be unclear as well.
Analyzes the credibility
and relevance of
evidence and
resources within the
context of a quality or
safety issue, or a
chosen diagnosis.
Analyzes the credibility
and relevance of
evidence and resources
within the context of a
quality or safety issue,
or a chosen diagnosis.
Additionally, identifies
the most useful
evidence or resource
based upon the
analysis.
Identify an evidencebased practice model
(such as John
Hopkins, Stetler,
Iowa, etc.) and
explain the
importance of
incorporating credible
evidence into an EBP
model used to
address a quality or
safety issue, or a
chosen
diagnosis/health care
issue.
Does not identify
an evidencebased practice
model used to
address a quality
or safety issue,
or a chosen
diagnosis/health
care issue.
Identifies an evidencebased practice model
used to address a
quality or safety issue,
or a chosen
diagnosis/health care
issue. Does not explain
the model or the
importance of
incorporating credible
evidence.
Identifies an evidencebased practice model
and explains the
importance of
incorporating credible
evidence into an
evidence-based
practice model used to
address a quality or
safety issue, or a
chosen
diagnosis/health care
issue.
Explains the importance
of incorporating credible
evidence into an
evidence-based
practice model used to
address a quality or
safety issue, or a
chosen
diagnosis/health care
issue. Notes specific
examples of how the
model could help
improve the chosen
issue or
diagnosis/health care
issue.
Organize content so
ideas flow logically
with smooth
transitions; contains
few errors in
Does not
organize content
for ideas. Lacks
logical flow and
Attempts to organize
content with some
logical flow and smooth
transitions. Contains
several errors in
Organizes content so
ideas flow logically with
smooth transitions;
contains few errors in
grammar/punctuation,
Organizes content with
a clear purpose.
Content flows logically
with smooth transitions
using coherent
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1/2
10/11/23, 2:17 PM
CRITERIA
Determining the Credibility of Evidence and Resources Scoring Guide
NONPERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
grammar/punctuation, smooth
word choice, and
transitions.
spelling.
grammar/punctuation,
word choice, and
spelling.
word choice, and
spelling.
paragraphs, correct
grammar/punctuation,
word choice, and free of
spelling errors.
Apply APA formatting
to in-text citations
and references
exhibiting nearly
flawless adherence to
APA format.
Attempts to apply APA
formatting to in-text
citations, headings and
references incorrectly,
detracting noticeably
from the content.
Inconsistently uses
headings, quotes
and/or paraphrasing.
Applies APA formatting
to in-text citations and
references exhibiting
nearly flawless
adherence to APA
format.
Exhibits strict and
flawless adherence to
APA formatting of
headings, intext
citations, and
references. Quotes and
paraphrases correctly.
Does not apply
APA formatting
to headings,
intext citations,
and references.
Does not use
quotes or
paraphrase
correctly.
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2/2
10/11/23, 2:19 PM
PICO(T) Questions and an Evidence-Based Approach Scoring Guide
PICO(T) Questions and an Evidence-Based Approach Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Define a practice
issue to be explored
via a PICO(T)
approach and
develop a PICO(T)formatted research
question.
Does not define a
practice issue to be
explored via a
PICO(T) approach.
Identifies a practice
issue, but does not
frame it within the
context of a PICO(T)
question or approach.
Defines a practice
issue to be explored
via a PICO(T)
approach. Develops a
PICO(T)-formatted
research question.
Defines a practice
issue to be explored
via a PICO(T)
approach. Develops a
PICO(T)-formatted
research question.
Notes how the
exploration of the
practice issue will
benefit from a
PICO(T) approach.
Identify sources of
evidence that could
be potentially
effective in answering
a PICO(T) question.
Does not identify
sources of evidence
that could be
potentially effective in
answering a PICO(T)
question.
Attempts to identify
sources of evidence,
but does not connect
them to the PICO(T)
question, or the
connection is unclear.
Identifies sources of
evidence that could
potentially be
effective in answering
a PICO(T) question.
Identifies sources of
evidence that could
be potentially
effective in answering
a PICO(T) question.
Presents criteria or
rational used to
determine potential to
answer the PICO(T)
question.
Explain the findings
from articles or other
sources of evidence
that are relevant to
the health care issue.
Does not explain the
findings from articles
or other sources of
evidence that are
relevant to the health
care issue
Lists the findings from
articles or other
sources of evidence,
but does not offer a
full explanation.
Explains the findings
from articles or other
sources of evidence
that are relevant to
the health care issue.
Explains the findings
from articles or other
sources of evidence
that are relevant to
the health care issue.
Notes which sources
are the most credible.
Explain the relevance
of the findings from
chosen sources of
evidence to making
decision related to a
PICO(T) question.
Does not explain the
relevance of the
findings from chosen
sources of evidence.
Identifies the
relevance of the
findings from chosen
sources of evidence,
but does not offer a
full explanation of
how it relates to the
PICO(T) question.
Explains the
relevance of the
findings from chosen
sources of evidence
to making decision
related to a PICO(T)
question.
Explains the
relevance of the
findings from chosen
sources of evidence
to making decision
related to a PICO(T)
question. Notes which
findings are the most
relevant or likely to
lead to positive
outcomes.
Organize content so
ideas flow logically
with smooth
transitions; contains
few errors in
grammar/punctuation,
word choice, and
spelling.
Does not organize
content so ideas flow
logically with smooth
transitions. Contains
errors in
grammar/punctuation,
word choice, and
spelling.
Attempts to organize
content with some
logical flow and
smooth transitions.
Contains several
errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content so
ideas flow logically
with smooth
transitions; contains
few errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content
with a clear purpose.
Content flows
logically with smooth
transitions using
coherent paragraphs,
correct
grammar/punctuation,
word choice, and free
of spelling errors.
Apply APA formatting
to in-text citations
and references
exhibiting nearly
Does not apply APA
formatting to
headings, intext
citations, and
references. Does not
Applies APA
formatting to in-text
citations, headings
and references
incorrectly and/or
Applies APA
formatting to in-text
citations and
references exhibiting
nearly flawless
Exhibits strict and
flawless adherence to
APA formatting of
headings, intext
citations, and
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1/2
10/11/23, 2:19 PM
CRITERIA
PICO(T) Questions and an Evidence-Based Approach Scoring Guide
NON-PERFORMANCE
flawless adherence to use quotes or
APA format.
paraphrase correctly.
BASIC
PROFICIENT
DISTINGUISHED
inconsistently,
detracting noticeably
from the content.
Inconsistently uses
headings, quotes
and/or paraphrasing.
adherence to APA
format.
references. Quotes
and paraphrases
correctly.
https://a21371-1315370.cluster223.canvas-user-content.com/courses/21371~9991/files/21371~1315370/course files/Scoring Guides/a03_scoring_gui…
2/2
10/11/23, 2:24 PM
Remote Collaboration and Evidence-Based Care Scoring Guide
Remote Collaboration and Evidence-Based Care Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Propose your
evidence-based care
plan to improve the
safety and outcomes
for the Vila Health
patient with a
discussion of new
content for the care
plan.
Does not propose an
evidence-based care
plan to improve the
safety and outcomes
for the Vila Health
patient.
Describes an
evidence-based
care plan, but the
relevance to the Vila
Health patient or
how the plan would
improve outcomes
is absent or unclear.
Proposes your own
evidence-based care
plan to improve the
safety and outcomes
for the Vila Health
patient with a
discussion of new
content for the care
plan.
Proposes your
evidence-based care
plan to improve the
safety and outcomes for
the Vila Health patient
with new content added.
Notes areas in which
further information or
data could have been
useful in developing the
plan.
Explain the ways in
which you used the
specific evidencebased practice
model to help
develop the care
plan, identifying
what interventions
would be necessary.
This requires a
particular evidencebased model, such
as the Johns
Hopkins, Iowa,
Stetler, or other.
Does not explain the
ways in which you
used the specific
evidence-based
practice model to
help develop the
care plan, identifying
what interventions
would be necessary.
Identifies an EBP
model and lists the
ways in which you
use the specific
evidence-based
practice model to
help develop the
care plan.
Explains the ways in
which you used the
specific evidencebased practice model
to help develop your
care plan, identifying
what interventions
would be necessary.
Uses a particular
evidence-based model,
such as the Johns
Hopkins, Iowa, Stetler,
or other.
Explains the ways in
which you used the
specific evidence-based
practice model to help
develop your care plan.
Notes ideas for how to
evaluate the positive
benefits to patient
outcomes.
Reflect on which
evidence you
collected that was
most relevant and
useful when making
decisions regarding
the care plan.
Does not reflect on
which evidence you
collected that was
most relevant and
useful when making
decisions regarding
the care plan.
Lists which
evidence you
collected that was
most relevant and
useful when making
decisions regarding
the care plan.
Reflects on which
evidence you collected
that was most relevant
and useful when
making decisions
regarding the care plan.
Reflects on which
evidence you collected
that was most relevant
and useful when making
decisions regarding the
care plan. Discusses
the rationale or criteria
that was used to
determine relevance
and usefulness.
Identify benefits and
propose strategies
to mitigate the
challenges of
interdisciplinary
collaboration to plan
care within the
context of a remote
team.
Does not identify
benefits or propose
strategies to mitigate
the challenges of
interdisciplinary
collaboration to plan
care within the
context of a remote
team.
Identifies benefits or
proposes strategies
to mitigate the
challenges, but not
both, of
interdisciplinary
collaboration to plan
care within the
context of a remote
team.
Identifies benefits and
proposes strategies to
mitigate the challenges
of interdisciplinary
collaboration to plan
care within the context
of a remote team.
Identifies benefits and
proposes strategies to
mitigate the challenges
of interdisciplinary
collaboration to plan
care within the context
of a remote team.
Discusses how
interdisciplinary
collaboration could be
better leveraged to
improve outcomes in
future care situations.
Communicate via
video with clear
sound and light, and
include a narrative
of video content.
Does not
communicate
professionally in a
well-organized
presentation and
does not include a
Does not
communicate via
video or video is
difficult to hear and
see, but does
Communicates via
video with clear sound
and light and does
include a narrative of
video content.
Communicates via
video with clear sound
and light. Content
delivery is focused,
smooth, and wellrehearsed. Includes a
https://a21371-1315367.cluster223.canvas-user-content.com/courses/21371~9991/files/21371~1315367/course files/Scoring Guides/a04_scoring_gui…
1/2
10/11/23, 2:24 PM
CRITERIA
Provide a full
reference list that is
relevant and
evidence-based
(published within
five years),
exhibiting nearly
flawless adherence
to APA format.
Remote Collaboration and Evidence-Based Care Scoring Guide
NON-PERFORMANCE
BASIC
narrative of video
content.
include a narrative
of video content.
Does not provide a
reference list of
relevant and/or
evidence-based
sources (published
within five years).
Provides reference
list that is not
relevant and/or
evidence-based with
several APA errors.
PROFICIENT
DISTINGUISHED
narrative of the video.
Video presentation is
between 5 to 10
minutes.
Provides a reference
list that is relevant and
evidence-based
(published within five
years) sources,
exhibiting nearly
flawless adherence to
APA format.
The reference list is
from relevant and
evidence-based
(published within five
years) sources,
exhibiting flawless
adherence to APA
format.
https://a21371-1315367.cluster223.canvas-user-content.com/courses/21371~9991/files/21371~1315367/course files/Scoring Guides/a04_scoring_gui…
2/2
Hi,Assignment is as follows:Synthesize and briefly (no more than 2-3 paragraphs) describe a theory from another discipline and discuss how you could use this theory in your current practice.I am attaching several articles that were given for this week.
Unformatted Attachment Preview
Available online at www.sciencedirect.com
Nurs Outlook 63 (2015) 41e47
www.nursingoutlook.org
Advancing Health Through Nursing: Progress of the Campaign for Action
A bold new vision for America’s health care system
The Future of Nursing report becomes a catalyst for change.
Susan B. Hassmiller, PhD, RN, FAAN*, Susan C. Reinhard, PhD, RN, FAAN
The 2010 Institute of Medicine (IOM) report, The Future
of Nursing: Leading Change, Advancing Health (IOM, 2011),
offers a bold vision for a new kind of health care system
in America. The report redefines the field of nursing
and asserts that nurses should be full partners in
reforming health care. It recognizes the invaluable
contributions nurses make as both acute care and
primary care providers and envisions pivotal roles for
nurses in public health, education, research, business,
governance, and public policy. The report challenges
the nation’s 3 million nurses, the largest segment of
the professional health care workforce, to learn more
and lead moredand it urges decision makers to create
circumstances that will help nurses to succeed in all of
these roles.
Issued at a time when the United States was reinventing its health care system through unprecedented national reform, the IOM report generated both
broad and deep interest. It quickly became the primary
reason people visited the IOM website, and it has been
the IOM’s most-read report. Since its release, it has
generated conversation among a wide array of stakeholders, including policymakers, and has set in motion
not just incremental changes but significant momentum toward a new U.S. health care delivery
systemdone that offers the promise of improving access and quality while lowering costs.
Less than two months after the report’s release in
early October 2010, the Robert Wood Johnson Foundation (RWJF) and AARP teamed up to launch the farreaching, multifaceted Future of Nursing: Campaign
for Action to implement the IOM’s recommendations.
Risa Lavizzo-Mourey, MD, the president and chief executive officer of the RWJF, noted the importance of the
campaign, which was announced during the National
Summit on Advancing Health Through Nursing in
Washington, DC, by declaring it “the first day of a new
future for nursing.”
The IOM report asserted that a transformed nursing
profession would lead to an improved health care
systemdone that was more accessible, affordable, and
patient- and family-centered, and, at the same time,
safe, effective, and efficient. The joint initiative between the RWJF, the nation’s largest philanthropy
devoted to health, and AARP, one of the nation’s largest
Risa Lavizzo-Mourey, president and chief executive
officer of the Robert Wood Johnson Foundation
(RWJF), center, and Susan B. Hassmiller, director of
the Future of Nursing: Campaign for Action and
senior adviser for nursing at the (RWJF), center right,
meet with members of the District of Columbia and
New Jersey action coalitions during the Campaign
for Action’s Summit 2013: Transforming Health Care
Through Nursing, in Washington, DC. Photo by Greg
Gibson from Greg Gibson Photography, on behalf of
AARP.
Reprinted with permission from the American Journal of Nursing. Hassmiller, SB, Reinhard, SC. A bold new vision for America’s health
care system. Am J Nurse 2015 Feb; 115(2):65-71.
* Corresponding author: Dr. Susan B. Hassmiller, Robert Wood Johnson Foundation, Senior Adviser for Nursing, P.O. Box 2316, Route 1,
Princeton, N.J. 08543, United States.
E-mail address: shassmi@rwjf.org (S.B. Hassmiller).
0029-6554/$ – see front matter Copyright Lippincott Williams & Wilkins. All rights reserved.
http://dx.doi.org/10.1016/j.outlook.2014.11.017
42
Nurs Outlook 63 (2015) 41e47
consumer organizations, was intended to help make
this vision a reality.
In the four years since, the Campaign for Action has
helped to make the Future of Nursing report a genuine
catalyst for change. From the start, it was envisioned
that the work of the campaign would take place at the
state level, carried out by Action Coalitions. These state
coalitions quickly multiplieddfrom just a handful at
the time of the campaign’s launch to 51 today. They
have had a nationwide impact.
This article, which is also reprinted in AJN and freely
available online, examines the progress, barriers, and
not inconsiderable work still needed to implement the
IOM’s recommendations. Subsequent articles, which
will be published in AJN and Nursing Outlook, examine
the IOM report’s recommendations and detail the
progress that has been madedoffering an in-depth
look at the achievements of the Campaign for Action
as well as a roadmap for the work that lies ahead.
Promoting Lasting Change
The Campaign for Action was intended to transform
and diversify the nursing profession. Because building
awareness of this work is essential, those involved in
the campaign began educating the public by speaking to
groups across the country, often using one of their
greatest assets: the members of the IOM committee that
produced the Future of Nursing report. Former U.S.
Health and Human Services Secretary Donna E. Shalala,
PhD, president of the University of Miami and chair of
the IOM committee, and Linda Burnes Bolton, DrPH, RN,
FAAN, vice president and chief nursing officer of
Cedars-Sinai Medical Center and IOM committee vice
chair, both devoted considerable time to ensuring that
leaders in nursing, health care, education, business, and
other fields recognized the importance of implementing
the IOM recommendations.
Other high-profile leaders, too, have spoken out in
support of the campaign’s work, almost from the start.
Former Pennsylvania governor Ed Rendell, a Democrat,
was an early supporter and advocated to expand
nurses’ scope of practice; more recently, New Mexico
governor Susana Martinez, a Republican, advocated for
the education and scope of practice recommendations.
The campaign has also sought to use social media to
engage key communities, generated thousands of news
stories, and contributed articles and commentaries to
prestigious journals, including AJN, the Journal of Professional Nursing, AARP International: The Journal, BoardRoom Press, Frontiers of Health Services Management, Health
Affairs, the Journal of Change, and the Journal of Healthcare
Management, among others (Hassmiller, 2013;
Hassmiller & Combes, 2012; Hassmiller & Truelove,
2014; Lumpkin, 2013; Reinhard & Hassmiller, 2009,
2012; Shalala, in press; “Six Sites Meet”, 2013).
Awareness was critical, but the campaign aimed
even higher: it wanted to inspire nurses, other health
care workers, and educational leaders to help implement the IOM’s recommendations and bring about
lasting change. Although elaborate plans were made to
advance each IOM recommendation, it was clear from
the start that only a sustained commitment and a shift
in attitude about nurses and nursing could secure the
progress the campaign envisioned.
To begin addressing this challenge, the campaign
brought in powerful partners. It created a strategic
advisory committee led by Sheila Burke, MPA, RN,
FAAN, of the Harvard School of Public Health, and
including leaders in business, health care, and education to guide the national implementation of the IOM
recommendations and to serve as campaign ambassadors (Future of Nursing, n.d.).
The campaign also engaged two entities created
by the Center to Champion Nursing in America
(CCNA), a joint initiative of the RWJF and AARP
created in 2007 to strengthen the nursing workforce,
in the effort to advance the IOM report’s recommendations: the Champion Nursing Council (Future
of Nursing, n.d.), which brought together 23 leading
nursing associations, and the Champion Nursing
Coalition (Future of Nursing, n.d.), which engaged
national business, consumer, and health professional organizations.
These efforts generated significant national momentum. For example, in 2011 the Leapfrog Group, a
nonprofit organization made up of large purchasers of
health care, began considering Magnet status when
scoring hospital safety. Additional action, however,
was needed at the state level through the passage of
state laws and regulations. Therefore, the campaign
began to establish Action Coalitions in each state that
were modeled after similar entities created for the
CCNA. Within two years, each state and the District of
Columbia had an Action Coalition working to advance
the goals of the Future of Nursing report.
These state coalitions were deliberately structured
to ensure a variety of perspectives, and each was coled by a nurse and a non-nurse. Leaders of the Indiana Action Coalition, for example, are Kimberly J.
Harper, MS, RN, chief executive officer of the Indiana
Center for Nursing, and Richard Kiovsky, MD, director
of the state’s Area Health Education Centers network.
All Action Coalitions include nurses, other health care
providers, consumers, educators, businesses, and
other stakeholders.
With grants from the RWJF totaling nearly $18
million to datedand supplemented by more than $11
million in additional funding raised within the
statesdthese 51 Action Coalitions have formed a
powerful community that tests strategies, shares
lessons learned, and achieves goals. The RWJF has
also provided substantial financial resources to the
CCNA to give Action Coalitions technical assistance in
addition to communications and research and evaluation support. Finally, generous in-kind resources
have been devoted to the campaign by the states and
AARP.
Nurs Outlook 63 (2015) 41e47
Progress on IOM Recommendations
The Campaign for Action is making progress implementing the recommendations in the Future of Nursing
report (see Table 1), particularly in regard to education,
scope of practice, workforce diversity, nurse leadership, and workforce data collection.
Education
The campaign is focusing on three IOM education
recommendations: to increase the number of nurses
with baccalaureates, to double the number of nurses
with doctoral degrees, and to encourage interprofessional education, in which students from different
health specialties are educated together, at least some
of the time, in classrooms or during academic
activities.
Baccalaureate-Prepared Nurses
The IOM report noted that the United States needs
many more highly educated nurses. This is because
Americans are living longer and with more chronic
conditions; there is a fast-growing need to provide
preventive and primary care at home, in schools, and
in the community; and there is a debilitating nurse
faculty shortage. And although the report recognized
the enormous contributions of nurses with an associate’s degree in nursing (ADN), the IOM issued a call to
make it easier for nurses to obtain bachelor of science
in nursing (BSN) and more advanced degrees (IOM,
2011).
When the Campaign for Action launched in 2010,
49% of employed nurses in the United States had BSNs
(according to figures compiled from the U.S. Census
Bureau’s American Community Survey Public Use
Microdata Sample). The IOM report recommends that
80% of RNs have a bachelor’s or more advanced degree
by 2020 (IOM, 2011).
The Action Coalitions set out to advance this
recommendation by encouraging strong partnerships
between community colleges and universities to
make it easier for nurses to transition to programs
that confer higher degrees. Every Action Coalition is
working to advance the IOM’s education recommendations. However, nine of thesedTexas, California,
Washington, Hawaii, North Carolina, New York,
Montana, Massachusetts, and New Mexicodwere
chosen to be part of the RWJF’s Academic Progression
in Nursing program, which is helping to lead this
work.
The campaign has established measurable goals
that are tracked through the use of “dashboard indicators” to assess progress (Future of Nursing, n.d.).
These focus on nurse education, barriers to practice
and care, interprofessional collaboration, RN leadership, and the collection of workforce data. The
campaign collects information from various data
43
sources and uses this to measure progress regarding
these indictors.
In 2014, for instance, the campaign was able to
show that the percentage of employed nurses with a
baccalaureate is on the rise: in 2013, 51% of the nation’s employed nurses had a BSN, and there was a
10% rise in the number of RNs with bachelor’s degrees between 2010 and 2012, from 1.37 million to
1.52 million (according to figures compiled from the
U.S. Census Bureau’s American Community Survey
Public Use Microdata Sample). More nurses are
enrolling in baccalaureate programs, according to
the American Association of Colleges of Nursing
(AACN, 2014a), and the number of enrollees in RNto-BSN programs is ballooning, rising 57% from
2010 to 2014.
Doctoral Degrees
A second IOM education recommendation is to double
the number of nurses with doctoral degrees by 2020
(IOM, 2011). The IOM report notes that only 1% of the
nation’s 3 million nurses had doctoral degrees in 2010.
It recommends that this number double, because
nurses with doctorates are needed to conduct scientific research, provide advanced care, assume leadership roles in health care, end the critical shortage of
nursing faculty, and educate the next generation of
nurses.
The dashboard indicators revealed significant
progress toward this goal. From 2010 to 2013, the
number of nurses enrolled in doctoral programs rose
70%, from 11,645 to 19,828. Much of this growth was
in doctor of nursing practice (DNP) programs: the
number of students enrolled in these practiceoriented programs jumped from 7,304 in 2010 to
14,688 in 2013. Enrollment in research-oriented PhD
programs has also grown: in 2013, 5,140 students
were enrolled in these programs, up from 4,611
in 2010.
To accelerate the progress, the RWJF has created
the Future of Nursing Scholars program, which is
supported by the Independence Blue Cross Foundation, UnitedHealth Group, the Rhode Island Foundation, North Shore-LIJ Health System, the Johnson and
Johnson Campaign for Nursing’s Future, Cedars- Sinai
Medical Center, and Ascension Health and is
providing grants to schools of nursing to support a
growing number of nurse PhD candidates each school
year.
Interprofessional Education
The IOM also called for an end to “educational silos,” in
which students of one health profession are isolated
from those in other fields (IOM, 2011). According to the
dashboard indicators, in the 2013-2014 academic
school year, of the 10 nursing schools at universities
with graduate health professional schools that were
surveyed, nine required at least one interprofessional
clinical course or activitydup from four during the
2010-2011 academic year.
44
Nurs Outlook 63 (2015) 41e47
Table 1 e Recommendations of the IOM’s Future of Nursing Report
Recommendation
1. Remove scope-of-practice barriers.
2. Expand opportunities for nurses to lead and diffuse
collaborative improvement efforts.
3. Implement nurse residency programs.
4. Increase the proportion of nurses with a baccalaureate to
80% by 2020.
5. Double the number of nurses with a doctorate by 2020.
6. Ensure that nurses engage in lifelong learning.
7. Prepare and enable nurses to lead change to advance
health.
8. Build an infrastructure for the collection and analysis of
interprofessional health care workforce data.
Details
Advanced practice RNs should be able to practice to the full
extent of their education and training.
Private and public funders, health care organizations,
nursing education programs, and nursing associations
should expand opportunities for nurses to lead and
manage collaborative efforts with physicians and other
members of the health care team to conduct research
and to redesign and improve practice environments and
health systems. These entities should also provide
opportunities for nurses to diffuse successful practices.
State boards of nursing, accrediting bodies, the federal
government, and health care organizations should take
action to support nurses’ completion of a transition-topractice program (nurse residency) after they have
completed a prelicensure or advanced practice degree
program or when they are transitioning into new clinical
practice areas.
Academic nurse leaders across all schools of nursing
should work together to increase the proportion of
nurses with a baccalaureate from 50% to 80% by 2020.
These leaders should partner with education accrediting
bodies, private and public funders, and employers to
ensure funding, monitor progress, and increase the
diversity of students to create a workforce prepared to
meet the demands of diverse populations across the
lifespan.
Schools of nursing, with support from private and public
funders, academic administrators and university
trustees, and accrediting bodies, should double the
number of nurses with a doctorate by 2020 to add to the
cadre of nurse faculty and researchers, with attention to
increasing diversity.
Accrediting bodies, schools of nursing, health care
organizations, and continuing competency educators
from multiple health professions should collaborate to
ensure that nurses and nursing students and faculty
continue their education and engage in lifelong learning
to gain the competencies needed to provide care for
diverse populations across the lifespan.
Nurses, nursing education programs, and nursing
associations should prepare the nursing workforce to
assume leadership positions across all levels, while
public, private, and governmental health care decision
makers should ensure that leadership positions are
available to and filled by nurses.
The National Health Care Workforce Commission, with
oversight from the Government Accountability Office
and the Health Resources and Services Administration
(HRSA), should lead a collaborative effort to improve
research and the collection and analysis of data on
health care workforce requirements. The workforce
commission and the HRSA should collaborate with state
licensing boards, state nursing workforce centers, and
the U.S. Department of Labor in this effort to ensure that
the data are timely and publicly accessible.
Source: Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, 2011.
Scope of Practice
Advanced practice RNs (APRNs) provide highly skilled
care to an increasingly complex population of patients.
The IOM report said that the United States needs more
APRNs, but in many states, overly restrictive laws and
regulations prevent APRNs from practicing to the full
extent of their education and training. This has led to
what an appendix to the IOM report calls a “crazy quilt of
widely varied, often inconsistent, sometimes contradictory licensure and payment laws” (IOM, 2011).
Opponents of lifting restrictions on APRN practice
sometimes claim that doing so will compromise the
quality and safety of care. However, the IOM report
Nurs Outlook 63 (2015) 41e47
notes that there is no evidence that care is better in
states with more restrictive scope-of-practice laws or
that APRNs are any less able than physicians to provide
safe, effective, and efficient care. The National Conference of State Legislatures has noted that removing
APRN restrictions benefits patients by improving access to care, especially in regions in which there are
shortages of primary care providers (Ewing & Hinkley,
2013). In many states, the local AARP offices are
bringing consumers’ voices to these debates, as staff
write letters and visit state legislatures to emphasize
the need for access to nursing care.
Since 2010, seven stateseConnecticut, Kentucky,
Minnesota, Nevada, North Dakota, Rhode Island, and
Vermont have removed statutory barriers that prevented NPs from providing care to the full extent of
their education and training. Other states have passed
laws toward guaranteeing full practice authority for
NPs. Texas, for example, has removed a restriction
requiring on-site physician supervision of nurse-led
retail health clinics, and Utah has allowed NPs to be
reimbursed by Medicaid for services they provide to
beneficiaries.
Diversify the Nursing Workforce
The nursing workforce has historically been, and remains, predominantly white and female. A more diverse
workforce is needed to provide culturally and linguistically appropriate health care services to an increasingly
diverse population. Racial and ethnic diversity among
nurses can also strengthen the relationship between
nurses and minority communities and is an important
step toward reducing disparities in health and health
care, according to the IOM, which also notes that greater
gender diversity among nurses would be beneficial (IOM,
2011). Currently, men make up less than 10% of the
nursing workforce (U.S. Census Bureau, 2013).
The number of minorities in the nursing workforce
is gradually rising, as is the share of the nursing
workforce they represent, according to the Campaign
for Action. In 2010, approximately 24% of the nation’s
RNs identified themselves as minorities (AACN, 2014b);
that percentage inched up closer to 25% in 2012. Data
collection is improving, too. In 2011, 34 states collected
race and ethnicity data regarding their nursing workforces; in 2013, that number jumped to 45.
Nurse Leadership
Nursing is consistently ranked as the nation’s most
trusted profession (Gallup, 2014). Nurses represent the
largest group of health care professionals, and they are
the providers who spend the most time with patients.
As such, they have unique and valuable insights into
health and health care. Nevertheless, the IOM report
pointed out that nurses are often overlooked during
discussions and decisions about health care reform,
even though patients, providers, and payers would
benefit from their input.
45
One principal reason for this is that relatively few
nurses occupy positions of influence in the health care
system or society. The nursing profession, the IOM
report argues, must do its part to correct this. It calls on
the profession to “produce leaders throughout the health
care system, from bedside to boardroom, who can serve
as full partners with other health professionals and be
accountable for their own contributions to delivering
high-quality care while working collaboratively with
leaders from other health professions” (IOM, 2011).
Action coalitions around the country are working to
do just that, putting in place programs that train nurses
to serve on a variety of health and health care boards,
and keeping track of board openings and encouraging
nurses to apply. Progress toward this goal is difficult to
measure because the American Hospital Association
last issued survey results in 2011, when it found that 6%
of the nation’s hospital boards included nurse members
(Van Dyke et al., 2011). A new study has confirmed that
the number is probably even lower, with about 2% of
nurses included as voting members on hospital, health
system, and academic medical center boards (Szekendi
& et al., 2014). The Campaign for Action, with the support of Action Coalitions, is working with nursing associations nationwide to meet its ambitious goal of
putting 10,000 new nurses on boards by 2020.
Workforce Data Collection
Policymakers need comprehensive data on the health
care workforce to make informed decisions about
policies that can influence the supply of and demand
for nurses and other health professionals. At present,
such analysis is hampered by gaps in data on the
numbers and types of health professionals currently
employed, where they are employed, and in what role.
To address this lack of consistent data, the IOM report
calls for the creation of a national health care workforce commission, state and regional workforce centers, and funding for workforce data collection and
studies. This was authorized under the Affordable Care
Act but remains an unfunded mandate.
Action Coalitions are helping to ensure that this
recommendation is realized by working with state
boards of nursing to increase the number of data items
collected when nurses are licensed or renew their
licenses. From 2010 to 2014, 24 states increased the
number of data items collected about the nursing
workforce, including information about race and
ethnicity, entry-level education, and employment
setting. This is helping to build the national infrastructure for the collection and analysis of interprofessional health care workforce data.
More Work Ahead
Although the progress made during these first four
years of the Campaign for Action has been
46
Nurs Outlook 63 (2015) 41e47
TEN WAYS YOU CAN HELP
Implementing the Recommendations of the IOM’s
Future of Nursing Report.
1. Read the Future of Nursing report and encourage
colleagues to do the same.
2. Follow the Future of Nursing: Campaign for Action on
Twitter and “like” it on Facebook.
3. Learn what your state Action Coalition is doing and
get involved by visiting www.campaignforaction.org.
4. Invite your state Action Coalition to send a speaker to
an upcoming forum at your place of employment or to the
local chapter of a nursing or other association to which you
belong.
5. Seek out a mentor who will help you to develop as a
nurse.
6. Dedicate yourself to mentoring and supporting a nurse
in the next generation.
7. Contact the dean at the school(s) where you studied
nursing and ask if the school has integrated the IOM report
into its curricula. Ask if there is an opportunity to speak to
students about how the IOM report is shaping their future.
8. Consider obtaining a more advanced degreeda BSN,
MSN, PhD, or DNPdor encourage a colleague to do so.
9. Seek an appointment to a board of directorsdof a
community group, nonprofit organization, health clinic, or
similar entitydin your local community, or encourage
another nurse to do so.
10. Blog about Future of Nursing: Campaign for Action
activities and goals. Submit a letter to the editor of your
local newspaper about the IOM’s Future of Nursing report.
impressive, it has been predictably uneven, and
considerable work remains. To fully realize the
IOM’s vision for the future of nursing, the campaign
must expand its leadership, strengthen its Action
Coalitions, increase and stabilize its resources, and
win the hearts and minds of many more stakeholders.
Even among nurses, campaign leaders know there is
more work to do. The community of highly educated
nurses has embraced the IOM vision and many nursing
students are engaged, but some staff-level nurses
remain unaware of the report. Further, the recommendation that 80% of nurses have BSNs by 2020 has
been polarizing, alienating some nurses who have
ADNs.
To more fully engage the nursing community and
create a sustained force for change, campaign
leaders are appealing to nurses’ social mandate to
contribute to the good of society. Many nurses take
the Florence Nightingale pledge in recognition of
their mission to contribute to society through
research and evidence-based practice and to do all
they can to elevate professional nursing standards.
The IOM report outlined a way to fulfill this oath. The
campaign is thus asking all nurses, “How are you
going to implement the IOM report in your institution and state?” The goal is to inspire each nurse to
become an active participant in implementing the
IOM recommendations.
Another priority is to strengthen the Action Coalitions across the country. Somedincluding those
in California, New Jersey, North Carolina, and
Texasdhave been extremely successful, bringing in
diverse and powerful stakeholders and large grants
to support their work. They have set up active
workgroups that are advancing a range of IOM
recommendations.
Other Action Coalitions have started more slowly,
encountered more barriers, and made more modest
progress. Some are raising money through bake sales
and other small events, still building their infrastructure and seeking to engage stakeholders. Most
continue to rely on in-kind support.
The campaign is using a model of evidence-based
indicators of success (Raynor, 2011) to identify
effective coalitions. The goal is to share lessons
learned about the most effective ways to strengthen
the infrastructure of Action Coalitions across the
country.
To learn how you can implement the IOM recommendations, see Ten Ways You Can Help.
Conclusion
The IOM’s groundbreaking Future of Nursing report
called for a radical overhaul of the nursing profession
as a way to transform U.S. health and health care. Five
years after its release, it is clear that the IOM did much
more than chronicle an ongoing conversation about
expanding the role of nurses. It imagined a world in
which all nurses could become lifelong learners, practice to the extent of their education and training, and
serve as full partners in providing care and promoting
health on the front lines as well as in boardrooms.
The IOM did not simply suggest that nurses
contribute to changing our health care systemdit
warned that change would not succeed unless nurses
helped shape and lead it. It said that a highly educated,
skilled, diverse nursing workforce is a prerequisite for a
high-quality health care system poised to meet current
and emerging needs.
In doing so, one of the nation’s most prestigious
institutions launched a new era for health care in the
United States. But the promise of that era will only be
fully realized if the progress to implement the Future of
Nursing recommendations continues.
Susan B. Hassmiller is director of the Future of Nursing:
Campaign for Action and senior adviser for nursing at the
Nurs Outlook 63 (2015) 41e47
Robert Wood Johnson Foundation, Princeton, NJ. Susan C.
Reinhard is senior vice president of the AARP Public Policy
Institute and chief strategist at the Center to Champion
Nursing in America, Washington, DC. Contact author: Susan
B. Hassmiller, shassmi@rwjf.org. The authors have disclosed
no potential conflicts of interest, financial or otherwise.
references
American Association of Colleges of Nursing. (2014a). AACN Finds
Slow Enrollment Growth at Schools of Nursing [press release].
Retrieved from http://www.aacn.nche.edu/news/articles/
2014/slow-enrollment.
American Association of Colleges of Nursing. (2014b). Fact sheet:
enhancing diversity in the workforce. Retrieved from http://www.
aacn.nche.edu/media-relations/diversityFS.pdf.
Committee on the Robert Wood Johnson Foundation Initiative on
the Future of Nursing, at the Institute of Medicine. (2011). The
Future of Nursing: Leading Change, Advancing Health.
Washington, DC: National Academies Press. Retrieved from
http://www.nap.edu/catalog.php?record_id¼12956.
Ewing, J., & Hinkley, K. N. (2013, April). Meeting the primary care
needs of rural America: Examining the role of non-physician
providers. Denver: The Rural Health Connection. http://www.ncsl.
org/documents/health/RuralBrief313.pdf.
Future of Nursing. (n.d.) Campaign for action: campaign
progressd dashboard indicators. Center to Champion Nursing in
America. Retrieved from http://campaignforaction.org/
dashboard.
Future of Nursing (n.d.). Campaign for action: who’s involvedd
strategic advisory committee. Center to Champion Nursing in
America. Retrieved from http://campaignforaction.org/whosinvolved/strategic-advisory-committee.
Future of Nursing (n.d.). Campaign for action: who’s involvedd
champion nursing council. Center to Champion Nursing in
America. Retrieved from http://campaignforaction.org/whosinvolved/champion-nursing-council.
Future of Nursing (n.d.). Campaign for action: who’s involvedd
champion nursing coalition. Center to Champion Nursing in
America. Retrieved from http://campaignforaction.org/whosinvolved/champion-nursing-coalition.
47
Gallup. (2014). Americans rate nurses highest on honesty, ethical
standards. Retrieved from http://www.gallup.com/poll/180260/
americans-rate-nurses-highest-honesty-ethical-standards.
aspx
Hassmiller, S., & Combes, J. (2012). Nurse leaders in the
boardroom: a fitting choice. Journal of Healthcare Management,
57(1), 8e11.
Hassmiller, S. B. (2013). The RWJF’s investment in nursing to
strengthen the health of individuals, families, and
communities. Health Aff (millwood), 32(11), 2051e2055.
Hassmiller, S. B., & Truelove, J. (2014). Are you the best leader you
can be? Am J Nurs, 114(1), 61e67.
Lumpkin, J. (2013). The missing voices. Boardroom Press,
24(6), 1e2. Retrieved from http://library.
governanceinstitute.com/Research- Publications/
ResourceLibrary/tabid/185/CategoryID/34/List/1/Level/a/
ProductID/1427/Default.aspx?SortField¼DateCreated
þDESC%2cDateCreatedþDESC.
Looking ahead: trends and challenges in the future of nursing.
(2013). Journal of Change, 2(1), 8e9. Retrieved from http://
webversion.staywellcustom.com/ibc/2013/spring.
Raynor, J. (2011). What Makes an Effective Coalition? Evidence-based
Indicators of success. Philade
As a group, you will collaborate to create a presentation on Pediatric Cardiac Diseases. You should select one specific disease to focus on. In addition to presenting in class, you must also submit a written copy of your work to Moodle Dropbox. Your paper should follow the APA format and include at least three reliable sources. You may choose to present your work in either Word or PowerPoint format.
Quality Improvement InitiativeQuality Improvement (QI) Initiative Project Description: You are an advanced practice nurse (APN) leader at a local non-profit community hospital, St. Mary’s General Hospital (this is a created hospital system and not meant to be associated with any real hospital system). You have been approached by your Chief Nursing Officer (CNO) as a leader to create and develop a hospital-wide initiative promoting Quality Improvement among nurses. This paper will focus on implementing a hospital wide QI initiative. Please follow the specific grading rubric below as this outline how you will be graded. The first section generally outlines the assignment and may provide some additional guidance on points that need additional clarification for the student above what is described in the grading rubric. Develop a hospital-wide initiative that promotes QIengagement and skill development by nurses. The nurse leader is expected to befamiliar with QI process and what is needed to ensure successful engagement bynurses within the facility. This assignment requires that students be familiarwith concepts that have been introduced at the undergraduate level such asquality improvement and leadership styles and approaches. The difference at thegraduate level is active engagement in learning rather than passive learning andwill require the student to evaluate, analyze and develop the concepts learnedat the undergraduate level. The introduction and conclusion sections areclearly outlined in the grading rubric below (refer to the grading rubric).Each section of the paper is expected to be well supported by the literature,evidence, best practice and research. This means that students are expected tointegrate multiple literature sources and not rely on one source to inform themajority or even a large part of the paper. Minimally the paper should includeat least 12 references but will likely include more. I check references soplease make sure that the references align and are actually used to support thestatements and viewpoints that you are making in the paper otherwise they failto be ‘supporting’ evidence to back these statements and are therefore opinionand have no place in an academic graduate level paper.Few key points.Review and follow the grading rubric andmake sure that you are meeting each of the points outlined in the gradingrubric; failure to do so results in lower grade. The vaguer and morenon-specific the student is in the paper the lower the grade. The reason forthis is that vagueness suggests failure to understand the concept in the paper.Clear and detailed is not synonymous with lengthy, actually detailed andsuccinct is the preferable approach because being both too brief and failing toprovide an adequate understanding of the concepts will suggest lack ofunderstanding and too lengthy and writing as much as possible hoping that youhit upon something that matches the grading rubric criteria is also failure tounderstand the concepts. Do not submit vague and nonspecific information oryour grade will reflect failure to demonstrate understanding. Failure to followthe grading rubric will result in a non-passing grade and you have 1opportunity to submit assignments in this class, refer to the syllabus forgrading policy and submissions guidelines.For instance, the background and significancesection outline clearly the following in the grading rubric: Identifiesand describes quality improvement (QI); its importance to healthcarefacilities, patients, and stakeholders. How this links QI to all levels ofnursing practice and specifically it’s importance to nurse leaders. What is thefirst step the nurse leader needs to take to fulfill the task assigned by theCNO with a detailed rationale that provides information about the specifictools and measures, interpretation, and application of the findings to guidethe nurse leader’s decision making about the QI initiative. This suggeststhat you are looking for a specific first step that involves a tool or measure,so that is hinting and suggesting the student should be familiar with how QI knowledge,skills and engagement are determined by a nurse leader.St. Mary’s General Hospital Mission, Vision &Strategic Development Plan are provided for you along with this assignmentin Blackboard under the Assignments Tab. Please make sure that you are usingthe provided document to complete the assignment when the syllabus asks thatyou align the QI initiative with St. Mary’s mission, vision and strategic plan.The page requirement for this project will be a MINIMUM of 10 pages not counting references and the cover page. PLEASE adhere to all APA formatting requirements.
I am uploading few articles that can be used in my paper and presentation. also, I am uploading a policy that the paper will be talking about. The rubric and the requirements for the paper are attached as well. at first, it will talk about the policy which is (arterial puncture Blood Gas Sample Technique and Allen test) and then talk about whether the articles (studies) support the policy or not as explained in the rubric
I am attaching a Therapy Journal #1 initial notes Word document that we must transform to look like the Therapy Journal Sample with scholarly references cited using proper APA no older than 5 years old.I recommend using at least 4-5 references with in-text citations, overcitation and use of references is even better.There is no such thing as overcitation for me
You can also use the references I shared with you from the course syllabi last time.I have included them again here for your convenience or you can use entirely scholarly referenced as in the Therapy Journal Sample.
I am also attaching the Therapy Journal template and rubric.As you can see the Therapy Journal Sample is about 6 pages, if it were double-spaced, as it should be, and 7 pages, if we add in a title page.
Let me know if you have any questions.
References
American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental
Disorders DSM 5-TR (5th ed. Text Revision). American Psychiatric Association: Arlington, Virginia. ISBN-10: 0890425760
Carlat, D. (2017). The Psychiatric Interview (4th Ed.). Lippincott Williams & Wilkins: Philadelphia, ISBN-13: 978-1496327710 ISBN-10: 9781496327710
Stahl, S.M. (2020). Stahl’s Essential Psychopharmacology Prescriber’s Guide (7th Ed.). Cambridge University Press: New York, NY. ISBN-13: 978-1108926010 ISBN-10: 1108926010
Zimmerman, M. (2013). Interview Guide for Evaluating DSM-5 Psychiatric Disorders and the Mental Status Examination. Psych Products Press: East Greenwich, RI. ISBN-13: 978-0963382115 ISBN-10: 096338211X
American Psychiatric Association (2022). Desk Reference to the Diagnostic Criteria from DSM- 5TR. Arlington, Virginia: APA ISBN-10 : 089042580 ISBN-13 : 978-0890425800
Boland, R., Verduin, M.L & Ruiz, P. (2022). Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (12th Ed,). Lippincott Williams & Wilkins: Philadelphia, PA. ISBN-13: 978-1975145569; ISBN-10: 1975145569
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental
Disorders DSM 5 (5th ed.).America Psychiatric Association: Arlington, Virginia
Boland, R., Verduin, M.L & Ruiz, P. (2022). Kaplan and Sadock’s Synopsis of Psychiatry:
Behavioral Sciences/Clinical Psychiatry (12th Ed,). Lippincott Williams & Wilkins:
Wheeler K. (2022). Psychotherapy for the Advanced Practice Psychiatric Nurse: A
How-To Guide for Evidence-Based Practice. 3rd Edition. Springer Publishing; New York,ISBN-13: 978-0826193797 ISBN-10: 082619379X
American Psychiatric Association (2013). Desk Reference to the Diagnostic Criteria from DSM-5 Arlington, Virginia: Author.
American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). Washington, DC: Author.
Corey, G. (2015). Theory and Practice of Counseling and Psychotherapy (10th ed.). Brooks/Cole Publishing Company: Belmont, CA.
Unformatted Attachment Preview
Therapy Clinical Log FA21
Therapy Clinical Log
Criteria
Ratings
Pts
This criterion is
linked to a
Learning
OutcomeGoals
clearly identified
10 pts
Goal fully
idenitifed
10 points
5 pts
Goal partially
identified
9-5 points
0 pts
Little to no Goals10 p
Identified
ts
4-0 points
This criterion is
linked to a
Learning
OutcomeThemes
Idenitifed
10 pts
Themes fully
idenitfied
10 points
5 pts
Themes partially
identified
9-5 points
0 pts
Little to no themes
10 p
identified
ts
4-0 points
This criterion is
linked to a
Learning
OutcomeType of
Therapy defined
and described
20 pts
Therapy
defined and
described in a
thorough and
complete
manner
20 points
12 pts
Type of
therapy with
main concepts
and techniques
are mostly
identified
19-12 points
5 pts
Less than
partial
descriptions of
therapy type,
concepts and
techniques
11-5 points
0 pts
Poor
description of
the type20
of p
therapy,tsit’s
concepts and
techniques
4-0 points
This criterion is
linked to a
Learning
OutcomeExplana
tion of why this
therapy was an
appropriate
choice
20 pts
Explanation is
through and
complete
20 points
12 pts
Choice is
partially
explained
19-12 points
5 pts
Choice is less
than partially
explained
11-5 points
0 pts
Explanation of
20 p
choice is poorly
ts
explained
4-0 points
This criterion is
linked to a
Learning
OutcomeDescrip
tion of
therapeutic
intervention
20 pts
Description
is thorough
and
complete
20 points
12 pts
Description
of therapeutic
intervention
is described
with fair
detail
19-12 points
5 pts
Description
of
therapeutic
intervention
is vague
11-5 points
5 pts
Poor
description
of
therapeutic
intervention
4-0 points
0 pts
No
Marks
20 p
ts
Therapy Clinical Log
Criteria
This criterion is
linked to a
Learning
OutcomeAssess
ment of the
therapy
intervention
This criterion is
linked to a
Learning
OutcomeMechan
ics of writing,
use of
professional
refrences
Total Points: 100
PreviousNext
Ratings
15 pts
Thorough
assessment
effectiveness of
this type of
therapy. If not
effective
disucssion of
what should be
changed
15 points
8 pts
Mostly
complete
assessment
with
discussion of
changes
14-8 points
5 pts
Journal is written in a
professional and neat
manner, no errors in in
APA Citation and writing
mechanics
5 points
Pts
4 pts
Missing
assessment
of therapy or
suggestions
for change
0 pts
No assessment of
the intervention or
recommendation
for change
15 p
ts
4 pts
Writing mechanics need
improvement and/or use
APA citations need
improvement
4-1 points
0 pts
No APA
citations or
references
5 pts
0 points
Individual, Family, Group or Couple’s Therapy Log
DATE: 2/4/2020
TIME: 1300-1330
SITE: Taravista Behavioral Health Center (Devens, MA)
LEVEL OF SUPERVISION: Observation
THERAPISTS/Co-THERAPISTS: Kate NP
CPT CODE/TYPE of VISIT: Individual
PATIENT INITIALS: KM
DIAGNOSIS: MDD, Borderline Personality Disorder
AGE: 22
GENDER: Transgender Female to Male, prefers He/Him pronouns
GOALS FOR THERAPY: Emotion Regulation, Interpersonal Effectiveness
THEMES TO BE ADDRESSED:
KM reports conflict with girlfriend’s family who he lives with. He engages in NSSI by cutting
self frequently after interactions with specifically her mother; this type of therapy will help him improve
relationship with girlfriend’s family and learn positive coping strategies to manage stress. KM also has
engaged in SIB while inpatient. SIB occurs after staff redirects patient and sets limits with patient.
THERAPY UTILIZED (Define and describe therapy. Include important techniques used with this
therapy):
Dialectical behavior therapy (DBT) is a subtype of cognitive behavioral therapy developed in the
late 1980s by Dr. Marsha Linehan and her team. CBT alone is ineffective for the treatment of Borderline
Personality Disorder. The team developed techniques that would be helpful for meeting the specific
needs of this personality disorder based on the Linehan Biosocial Theory of emotional dysregulation. The
Biosocial Theory explains that emotional dysregulation develops from repeated exchanges between
biological vulnerabilities and a rejecting environment that occur during childhood development. No one is
born with borderline personality disorder, this maladaptive pattern of thinking and perception develops
typically after traumatic experiences. The term dialectical is based on defining reality, using the
assumptions that every thing is interconnected, change is a constant that cannot be fought, opposites can
be brought together to be closer to reality. For borderline personality d/o, there is difficulty between
accepting oneself and change, and DBT works to close the contradiction between the two to benefit the
person by accepting reality and changing destructive behaviors. The four treatment modes include
individual therapy, group therapy, phone coaching, and therapist consultation team (Prada et. al, 2018).
DBT functions to improve coping/grounding skills, integrate these skills to the person’s
environment, enhance and maintain patient’s motivation for change, improve therapist’s motivation and
skills, and providing a supportive environment to optimize the implementation of this treatment. DBT
strives to change maladaptive patterns in regulating emotions, impulses, identity, and interpersonal
relationships by learning new skills. The four skill modules are mindfulness, distress tolerance,
interpersonal effectiveness, and emotion regulation (Prada et. al, 2018).
Completing a behavior change analysis helps the patient identify patterns of interactions and
environment that lead to destructive behaviors. This helps the patient understand what is going on, what is
needed to change, provides validation, and also helps the provider better understand the behavior as well
(Landes, 2016). Identifying emotions and the actions linked to that emotion will help identify the opposite
action to complete. Mindfulness can be achieved using sensory items, such as a frozen orange or frozen
washcloth. When a patient places a frozen item on their wrists, this has assisted them in combating
dissociative symptoms, grounding themselves. A weighted blanket can be used to help ground a patient as
well. Sensory items are helpful in bringing a person back to reality. Distress tolerance worksheets are
helpful resources.
Improving interpersonal skills can be done by first completing a skills assessment handout that
one rates themselves on a scale of 1 to 5 (very poor to always good). Skills include introducing oneself,
listening, responding to praise, and responding to negative feedback. This baseline will help the patient in
seeing improvements and identifying communication skills that need work. The patient can also complete
interpersonal effectiveness skills handouts, which outlines how to effectively communicate with others
through objective, relationship, and self respect effectiveness (Ackerman, 2019).
THERAPEUTIC INTERVENTIONS (Describe how this therapy was implemented for this client,
be specific):
DBT was implemented for this client by having him first complete a behavior chain analysis. KM
is able to identify that staff working on the unit saying, “No”and girlfriend’s mom’s expectations to be
precipitating factors to cutting. KM was able to identify three emotions (anxious, angry, sad) and then
action urges (run away, attack, isolate). Emotion regulation involves having the opposite action of what
one feels they should do. Instead of cutting, KM is interested in trying a frozen item which would help
found him. KM also expressed interested in drawing on oneself with a red marker instead of cutting as a
step towards being able to reach out to staff and asking for a frozen wash cloth or orange. The NP worked
with the patient to identify three opposite actions (Stick with whatever is happening, walk away or
approach staff kindly, stay out in community area) as alternatives and integrate using sensory items to self
soothe.
EXPLANATION (Why this therapy was an appropriate choice for this client?):
KM reports feeling “filled with rage” when his girlfriend’s mom tells him he is a bad influence
and engages in SIB after most interactions with her. This client has exhibited frequent emotion
dysregulation while inpatient. Even though KM is on a sharps restriction, KM has still had access to
pencils, plastic knife, and has engaged in cutting behaviors after staff has set limits and boundaries with
patient. KM has an extensive SIB history, the introduction of emotion regulation and alternatives could be
the start for KM to decrease SIB. KM should follow up on discharge continuing to work on DBT skills
with an outpatient therapist or attending a day program that has DBT groups.
ASSESSMENT OF THERAPY (Include effectiveness and suggestions for change):
The average length of stay at TV is 5-10 days, typically people with borderline
personality disorder have tried to sabotage their discharge and regress. Chronic NSSI such as
cutting is unlikely to be resolved during an inpatient stay. KM could benefit from learning DBT
skills, yet to see a real change, this will most likely happen outpatient from individual
psychotherapy and group therapy. KM should work on distress tolerance skills, as he endorses
several misperceived slights from staff, and one cannot be sure of the dynamic living with his
girlfriend and her family has as KM is not a reliable historian per clinical referral. KM was able
to tolerate a half hour meeting and had a bright affect while completing worksheets.I did not find
this to be a very effective session as evidenced by KM making several provocative comments
during the meeting about obtaining an undisclosed item during lunch that he could use to cut.
While inpatient, KM will benefit from group therapy more than individual 1:1 therapy, as he
seems to act out more after 1:1 attention.
References
Ackerman, C. E. (2019, June). Interpersonal effectiveness: 9 worksheets & examples. In Positive
Psychology. Retrieved from https://positivepsychology.com/interpersonal-effectiveness/
Landes, S. J. (2016, May). Chain analysis . In Central Arkansas Veterans Healthcare System.
Retrieved from https://www.ptsd.va.gov/professional/consult/2016lecture_archive/
05182016_Chain_Analysis.pdf
Prado, P., Perroud, N., Rufenacht, E., & Nicastro, R. (2018, December 17). Strategies to deal
with suicide and non-suicidal self-injury in borderline personality disorder, the case of DBT.
Frontiers in Psychology, 9. doi:http://0-dx.doi.org.lib.rivier.edu/10.3389/fpsyg.2018.02595
Individual, Family, Group or Couple’s Therapy Log
DATE:
TIME:
SITE:
LEVEL OF SUPERVISION: Observation/Collaborative/Autonomous
THERAPISTS/Co-THERAPISTS:
CPT CODE/TYPE of VISIT: Individual/Family/Group
PATIENT INITIALS:
DIAGNOSIS:
AGE:
GENDER:
Goals for THIS therapy session:
Themes to be addressed during THIS session:
Therapy utilized (Define the type of therapy being utilized. Include important concepts and
techniques used with this therapy):
Therapeutic interventions (Describe how this therapy was implemented for this client/group be
specific):
Explanation (Why this therapy was an appropriate choice for this client?):
Assessment of therapy (Are there drawbacks to this kind of therapy? Include the effectiveness for
the client/group and suggestions for change):
I am attaching a Therapy Journal #1 initial notes Word document that we must transform
to look like the Therapy Journal Sample with scholarly references cited using proper APA
no older than 5 years old. I recommend using at least 4-5 references with in-text citations,
overcitation and use of references is even better. There is no such thing as overcitation for
me
You can also use the references I shared with you from the course syllabi last time. I have
included them again here for your convenience or you can use entirely scholarly referenced
as in the Therapy Journal Sample.
I am also attaching the Therapy Journal template and rubric. As you can see the Therapy
Journal Sample is about 6 pages, if it were double-spaced, as it should be, and 7 pages, if
we add in a title page.
Let me know if you have any questions.
References
American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental
Disorders DSM 5-TR (5th ed. Text Revision). American Psychiatric Association:
Arlington, Virginia. ISBN-10: 0890425760
Carlat, D. (2017). The Psychiatric Interview (4th Ed.). Lippincott Williams & Wilkins:
Philadelphia, ISBN-13: 978-1496327710 ISBN-10: 9781496327710
Stahl, S.M. (2020). Stahl’s Essential Psychopharmacology Prescriber’s Guide (7th
Ed.). Cambridge University Press: New York, NY. ISBN-13: 978-1108926010 ISBN10: 1108926010
Zimmerman, M. (2013). Interview Guide for Evaluating DSM-5 Psychiatric Disorders and
the Mental Status Examination. Psych Products Press: East Greenwich, RI. ISBN-13: 9780963382115 ISBN-10: 096338211X
American Psychiatric Association (2022). Desk Reference to the Diagnostic Criteria from
DSM- 5TR. Arlington, Virginia: APA ISBN-10 : 089042580 ISBN-13 : 9780890425800
Boland, R., Verduin, M.L & Ruiz, P. (2022). Kaplan and Sadock’s Synopsis of Psychiatry:
Behavioral Sciences/Clinical Psychiatry (12th Ed,). Lippincott Williams & Wilkins:
Philadelphia, PA. ISBN-13: 978-1975145569; ISBN-10: 1975145569
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental
Disorders DSM 5 (5th ed.).America Psychiatric Association: Arlington, Virginia
Boland, R., Verduin, M.L & Ruiz, P. (2022). Kaplan and Sadock’s Synopsis of Psychiatry:
Behavioral Sciences/Clinical Psychiatry (12th Ed,). Lippincott Williams & Wilkins:
Philadelphia, PA. ISBN-13: 978-1975145569; ISBN-10: 1975145569
Carlat, D. (2016). The Psychiatric Interview (4th Ed.). Lippincott Williams & Wilkins:
Philadelphia, PA. ISBN-13: 978-1496327710 ISBN-10: 9781496327710
Wheeler K. (2022). Psychotherapy for the Advanced Practice Psychiatric Nurse: A
How-To Guide for Evidence-Based Practice. 3rd Edition. Springer Publishing; New
York, ISBN-13: 978-0826193797 ISBN-10: 082619379X
American Psychiatric Association (2013). Desk Reference to the Diagnostic Criteria from
DSM-5 Arlington, Virginia: Author.
American Psychological Association. (2020). Publication manual of the American
Psychological Association (7th ed.). Washington, DC: Author.
Corey, G. (2015). Theory and Practice of Counseling and Psychotherapy (10th ed.).
Brooks/Cole Publishing Company: Belmont, CA.
Individual, Family, Group or Couple’s Therapy Log
DATE:
10/10/2023
TIME: 10:00 am
SITE: Integrated Healthcare Systems
LEVEL OF SUPERVISION: Observation/Collaborative/Autonomous
THERAPISTS/Co-THERAPISTS:
CPT CODE/TYPE of VISIT: Individual/Family/Group
PATIENT INITIALS: RD
DIAGNOSIS: Schizoaffective Bipolar Type and
AGE:
22
GENDER: Male
Goals for THIS therapy session:
Mental Health
Themes to be addressed during THIS session:
Medication Compliance
Therapy utilized (Define the type of therapy being utilized. Include important concepts and
techniques used with this therapy): Therapist utilized CBT, Motivational Interviewing, and Person
Centered techniques to gather information and provide support to client when needed.
Therapeutic interventions (Describe how this therapy was implemented for this client/group be
specific): Therapist psycho educated client about Medication Compliance involving: the meaning,
it’s purpose, benefits, how it correlated with Mental Health, and different ways to improve and
maintain Medication Compliance. Therapist and client processed information with client, stating
his thoughts, feelings, and experiences with Medication Compliance. Afterwards, client brain
stormed with Therapist different approaches he will utilize to consistently comply to his
Medication. Client was given homework to journal daily his daily commitment to Medication
Compliance.
Explanation (Why this therapy was an appropriate choice for this client?): Client stop taking his
medication for a week without speaking to his psychiatrist and being tapered down which puts
client at risk for major side effects.
Assessment of therapy (Are there drawbacks to this kind of therapy? Include the effectiveness for
the client/group and suggestions for change): Client therapy session was successful and he had an
encouraging response. Client developed a better understanding of the importance of Medication
Compliance and now has a plan that can improve his compliance along with support.
The goal of this assignment is to allow you to critically compare treatment options for depression. You will also reflect on how social networks impact treatment strategies. So I will be asking you to do the following:
Please create a client scenario you might experience where the individual is experiencing depression.
Please describe how depression and despair impact the client’s health.
Please describe a theory that can guide your strategy to decrease the social comparison and enhance social networks.
Critically compare treatments of social networking and comparison to social skills and combating depression tendencies to your client.
This assignment should be
500-750 words,
conform to APA format,
12-point, times new roman font
include references and citations.
Create a 3-5 page annotated bibliography and summary based on your research related to best practices addressing a current health care problem or issue.
Unformatted Attachment Preview
Introduction
In your professional life, you will need to find credible evidence to support your decisions and your plans
of action. You will want to keep abreast of best practices to help your organization adapt to the everchanging health care environment. Being adept at research will help you find the information you need.
For this assessment, you will research a health care problem or issue faced by current health care
organizations.
Instruction
The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum,
be sure to address each point. In addition, you are encouraged to review the performance-level
descriptions for each criterion to see how your work will be assessed.
For this assessment, research best practices related to a current health care problem. Your selected
problem or issue will be utilized again in Assessment 4. To explore your chosen topic, you should use the
first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.
Select one of the health care problems or issues presented in the Applying Research Skills
[PDF]resource. Write a brief overview of the selected health care problem or issue. In your overview:
Summarize the health care problem or issue.
Describe the professional relevance of this topic.
Describe any professional experience you have with this topic.
Identify peer-reviewed articles relevant to this health care issue or problem.
Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe
the criteria you used to search for articles, including the names of the databases you used. You will
select four current scholarly or academic peer-reviewed journal articles published during the past 3–5
years that relate to your topic.
Use keywords related to the health care problem or issue you are researching to select relevant articles.
Assess the credibility and explain relevance of the information sources you find.
Determine if the source is from an academic peer-reviewed journal.
Determine if the publication is current.
Determine if information in the academic peer-reviewed journal article is still relevant.
Analyze academic peer-reviewed journal articles using the annotated bibliography organizational
format. Provide a rationale for inclusion of each selected article. The purpose of an annotated
bibliography is to document a list of references along with key information about each one. The detail
about the reference is the annotation. Developing this annotated bibliography will create a foundation
of knowledge about the selected topic. In your annotated bibliography:
Identify the purpose of the article.
Summarize the information.
Provide rationale for inclusion of each article.
Include the conclusions and findings of the article.
Write your annotated bibliography in a paragraph form. The annotated bibliography should be
approximately 150 words (1–3 paragraphs) in length.
List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA
format for the annotated bibliography.
Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
Summarize what you have learned while developing an annotated bibliography.
Summarize what you learned from your research in a separate paragraph or two at the end of the
paper.
List the main points you learned from your research.
Summarize the main contributions of the sources you chose and how they enhanced your knowledge
about the topic.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating
on the scoring guide would look like:
Additional Requirements
Your assessment should also meet the following requirements:
Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
Font and font size: Times New Roman, 12 point.
APA tutorial: Use the APA Style Paper Tutorial [.
Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation,
and mechanics.
Content: Provide a title page and reference page following APA style.
References: Use at least four scholarly or academic peer-reviewed journal articles.
Competencies Measured
using the code of ethics attached: Address the questions below in your discussion post this week:Does the law require you to respond in disaster situations?Do RNs have a contractual responsibility to respond in disaster situations?Are you familiar with the laws in your state?Support your answers with evidence from scholarly sources.
To complete the Case 2 clinical assignment follow these steps:
Go to the following website: https://games.de.torontomu.ca/hospital/
Select “Enter”
You are now in the virtual hospital. Please select “Pediatrics”.
There are TWO scenarios here. You need to complete scenario “2”. To go to this scenario click on the “2” at the bottom of the screen.
You are now at the starting page for the “Post-Op Pediatric Clinical Simulation”. You should see the summary for a 10 year old boy who has just had an emergency appendectomy. Click on “Play Game”.
You are now on the scenario menu page. You should do the following BEFORE starting a new game:
Review the learning objectives (what you should learn from this scenario) by clicking on “Learning Objectives”. Click on “Close” when you are done reading these.
Review how this scenario process works by clicking on “How to Play”. Click on “Close” when you are done reading the instructions.
Click on “New Game” to begin the scenario.
You will work through multiple videos and questions that ask you what to do next at many points throughout the scenario. If you make an error you will be brought back to the question last asked to allow you to think about your clinical reasoning and prioritization. Please select a different option. Keep going until you complete the scenario.
Once you complete the scenario you will be provided a summary of your “game play” with all of your selections (including incorrect and correct options chosen). You will receive a “Congratulations!” notice. Select “Download Summary”. This document is a PDF.
Save the document to your computer and upload your summary into the drop box provided on the NURS 461 Moodle page titled “Case 2 Clinical Assignment”
Click on the link for “Self-debriefing questions.” This will download a Word document. Answer ALL of the questions on this document. Save the document with YOUR name.
Develop a plan of care for this client at the end the Word document saved in step 11 above. Upload your self-debriefing answers and plan of care to the same drop box. Remember that your plan of care MUST meet the needs of both the patient and the family. Remember to prioritize your nursing diagnoses.
Two (2) documents for completion of this alternative clinical assignment are due not later than
For this activity, you are going to choose one fat-soluble vitamin, one water-soluble vitamin, and one mineral out of those listed below to research further. You will look up information on its roles in the body, food sources, deficiencies, toxicities, and any additional pertinent information. There are different fact sheets for consumers and health professionals, and you can use either for this activity-the health professional fact sheets are more detailed and technical, so you may find it beneficial to take a look at both to see the differences.
Step One
Choose one micronutrient to research further from each of these three lists. It would be beneficial for one of these to be the vitamin or mineral you are focusing on for your Applied Exercise 2 — Supplement Critique because the information compiled for this activity can serve as background information for that assignment.
Micronutrients
Fat-Soluble Vitamins
Water-Soluble Vitamins
Select Minerals
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Vitamin C
Thiamin
Riboflavin
Niacin
Folate
Vitamin B12
Vitamin B6
Calcium
Phosphorus
Magnesium
Potassium
Iodine
Iron
Zinc
Step Two
For the three micronutrients you chose, visit the corresponding fact sheet and take notes on the topics below. TEMPLATE ATTACHED
Micronutrient Name
Roles in the Body
Food Sources
Deficiencies
Toxicity
Website: National Institutes of Health-Office of Dietary Supplements-Vitamin and Mineral Supplement Fact Sheets
Unformatted Attachment Preview
Micronutrient _____________________________
Roles in the Body
Food Sources
Deficiencies
Toxicity
For this Performance Task Assessment, you will develop a PowerPoint presentation explaining the role of a nurse as a knowledge worker and as a nurse informaticist specialist.
Submission Length: 8- to 9-slide PowerPoint presentation.
Your response to this Assessment should:
Reflect the criteria provided in the Rubric.
Adhere to the required assignment length.
Instructions
Access the following to complete this Assessment:
PowerPoint Presentation Template
The Nurse as Knowledge Worker
Develop an 8- to 9-slide PowerPoint presentation that addresses the following:
Explain the concept of a knowledge worker in general. (1 slide)
Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker. (1 slide)
Develop one simple infographic to help explain both the concept of nursing informatics and the role of a nurse leader as a knowledge worker. (1 slide)
Note: For guidance on infographics, including how to create one in PowerPoint, see “How to Create an Infographic in PowerPoint” as presented in the Resources.
Present a hypothetical scenario based on your own nursing practice or healthcare organization that would require or benefit from the access/collection and analysis of data. Your scenario may involve a patient, staff, or management problem or gap. (1–2 slide)
Describe the problem from the viewpoint of a nurse informaticist by:
Describing the data that could be used (1 slide)
Describing how the data might be accessed/collected (1 slide)
Describing what knowledge might be derived from that data (1 slide)
Indicating how a nurse leader would use clinical reasoning and judgment in formation of knowledge from this experience (1 slide)
* NOTE: The response must synthesize and integrate at least two outside resources and two competency-specific resources that fully support the responses provided.
Select 5 of the 10 questions to respond to and complete the case. Respond to at least 2 other classmates’ posts on at least 2 different days.
Describe how you might try to avoid “informational overload” during a new employee’s first few days.
Much of the material in the chapter conveys the need to imbue the new employee with a sense of the organization’s mission, vision, and values. Why is this important?
Why do we need to offer a relatively formal orientation complete with checklists of items to cover?
Why do we need to bother with individual orientation for a new employee who is a trained specialist hired to perform exactly the same tasks performed at a previous job?
Why is it claimed that we should be more interested in developing employee potential than in obtaining immediate output?
What do you see as the primary advantages of a strong new-employee orientation? Why?
Explain why the chapter states that new-employee orientation begins before the new employees arrive.
What are the primary advantages of a mentoring relationship as part of a new employee’s orientation?
What is wrong, if anything, with the apparently time-honored practice of letting new employees learn by trial and error and by watching others?
Why not simply have the department supervisors provide all of a new employee’s orientation rather than having a separate organization-wide orientation as well as a departmental orientation?
CASE: NO DEPARTMENTAL ORIENTATION?
Assume you have just been hired from outside of the organization to serve as a first-line supervisor in one of the clinical support areas (such as laboratory, radiology, pharmacy, etc.). Staffing in the department has been lean, with a couple of staff positions having been open for some weeks. But as luck would have it, you were able to fill both open positions during your first two weeks on the job.
Being new to supervision and new to this organizational environment, the Friday before the two new employees were scheduled to start work you asked a more experienced supervisor, “Is there anything special I’m supposed to do with these new employees when human resources turns them over to me on Monday?”
The response was simply, “Nothing other than your standard departmental orientation.”
You asked each of your employees in turn about their departmental orientation. Their answers were consistent: There was no departmental orientation; they were simply shown their workstations and told where the cafeteria and restrooms were located. Other than that, nothing.
Instructions:
In written form, describe what you intend to do:
concerning the two new employees who start work on Monday;
concerning other new employees who join your department in the future
AHLT 310 Healthcare Manager/Leader Portfolio Project
Course Objectives Relevant to this Portfolio Project
Upon successful completion of AHLT 310, you will be able to:
1. Identify and explain the challenges of transitioning from working as a clinician to a
supervisory/managerial position.
2. Identify and explain the basic managerial functions of planning, organizing, coordinating,
controlling, and policy development and their applications in healthcare organizations.
3. Describe the effective use and challenges of delegation, empowerment, decisionmaking, problem-solving, and budgeting in high-performing healthcare organizations.
4. Describe the value and effective use of communication skills and customer service
principles in healthcare organizations.
Portfolio Project Objective
By the end of this portfolio project, you will have created a comprehensive body of work
designed to enhance your skills and understanding in healthcare management and leadership.
This project specifically targets the first four objectives of the course, aiming to:
• Equip you with a solid grounding in various healthcare leadership styles through
academic research.
• Enable you to identify and analyze your personal leadership strengths using the Clifton
Strengths assessment.
• Provide you with the opportunity to synthesize academic and personal insights into a
research paper that explores leadership in healthcare settings.
The portfolio is segmented into three main parts:
1. Article Summaries and Critiques: This section is focused on leadership styles, allowing
you to explore scholarly perspectives on healthcare leadership.
2. Clifton Strengths Self-Assessment and Leadership Styles Paper: In this part, you will
identify your individual strengths and explore leadership styles that resonate with you.
3. Research Paper on Leadership: This final segment encourages you to meld academic
theories with your own strengths, providing a comprehensive perspective on leadership
in healthcare.
Through active engagement in each part of this portfolio, you will gain essential knowledge and
skills directly aligned with the course’s first four objectives, preparing you for effective
managerial roles in healthcare settings.
Part I: Article Summaries and Critiques on Leadership Styles (5%)
Due: End of Week 6
Course Objectives Covered: #1, #2
Brief Overview:
In this part, you will focus on understanding various leadership styles in healthcare by reviewing
three articles from peer-reviewed journals.
Instructions:
• Choose three articles related to various leadership styles/theories in healthcare from
peer-reviewed journals.
• For each article, use the APA citation as the heading.
• Include the following headings for each article:
• Summary
• Professional Critique
• Personal Critique
• Questions for Research Paper – what question(s) about your leadership paper
does this article answer? Try to aim to have 3 questions per article
Grading Rubric:
Criteria
Excellent (5)
Good (4)
Satisfactory (3) Needs
Improvement (1-2)
Article
Selection
Peer-reviewed
and highly
relevant
Peer-reviewed
and relevant
Peer-reviewed
but less
relevant
Summary
Concise, insightful Adequate
Vague or
summary for each summaries with incomplete
article
minor omissions summaries
Missing or
irrelevant
summaries
Critique
Balanced, wellargued critique
for each article
Mostly balanced One-sided or
but lacks depth lacks clarity
Missing or
irrelevant critiques
Grammar
& Style
No errors; clear
and professional
Few minor
errors; mostly
clear
Poor grammar and
style affecting
comprehension
Several errors
affecting
readability
Not peer-reviewed
or irrelevant
Part II: Clifton Strengths Self-Assessment and Leadership Styles Paper (15%)
Due: End of Week 8
Course Objectives Covered: #1, #2, #3
Brief Overview:
In this part, you will conduct a Clifton Strengths self-assessment to better understand your
leadership strengths. You will also choose three leadership styles that you are interested in and
reflect on how your strengths align with these styles.
Instructions for Self-Assessment (Clifton Strengths) (5%):
• Complete the Clifton Strengths self-assessment.
• Write a one-page reflection on your top strengths and their relation to leadership.
Instructions for Leadership Styles Paper (10%):
•
•
•
Choose three leadership styles you’re interested in.
Write a 3-4 page paper discussing these styles and their relevance to healthcare.
Discuss how your Clifton Strengths align with these leadership styles.
Grading Rubric:
Criteria
Excellent (15)
Good (12)
SelfAssessment
Insightful
Adequate
reflection; well- reflection;
integrated results some
integration
Leadership
Styles Paper
Excellent
synthesis;
insightful
Good synthesis; Satisfactory
somewhat
synthesis;
insightful
limited insight
Poor synthesis;
lacks insight
Grammar &
Style
No errors; clear
and professional
Few minor
errors; mostly
clear
Poor grammar and
style affecting
comprehension
Part III: Research Paper on Leadership (10%)
Due: By the end of Week 14
Course Objectives Covered: #1, #2, #3, #4
Brief Overview:
Satisfactory (9)
Needs
Improvement (1-8)
Vague
Missing or
reflection; lacks irrelevant
integration
reflection
Several errors
affecting
readability
For this part, you will write a research paper focused on leadership. The paper should discuss
three leadership styles you feel you resemble, based on the Clifton Strengths assessment and
articles you’ve read.
Instructions:
• Write a 10-12 page research paper discussing three leadership styles you feel you
resemble, supported by at least 2 of the articles reviewed in Part I and 5 additional
articles.
• Reflect on the Clifton Strengths assessment results, discussing what seems accurate and
what doesn’t.
• Final submission must include the following:
• Cover page to include the title of your portfolio, name of the course, Fall 2023,
your name
• Table of Contents – should be formatted in APA
• Executive Summary
• Article Reviews and Critiques (modified based on feedback)
• Clifton Strengths Reflection Paper
• Leadership Paper
• Reference page
• Appendix – anything you would like to include (Optional). If you include
something here, you have to cite it.
Grading Rubric:
Criteria
Excellent (10)
Good (8)
Satisfactory (6)
Content
Comprehensive;
well-researched
Thorough;
mostly wellresearched
General; limited Shallow; poorly
research
researched
Organization Well-organized;
logical flow
Mostly
organized;
minor issues
Somewhat
disorganized;
lacks flow
Poorly organized;
lacks coherence
Grammar &
Style
Few minor
errors; mostly
clear
Several errors
affecting
readability
Poor grammar and
style affecting
comprehension
No errors; clear
and professional
Needs
Improvement (1-5)
i am in my bachelor program . assignment is attched below i have attached three documents one of whats needed for the assignment , the other is case study which you will pick one , then lastly an example of how the paper should look like.
Access the CDC Atlas Plus Links to an external site. site.Select STD from the STEP 1 prompt: What data do you want to see?Select Charts from the STEP 2 prompt: How do you want to see them?Access STD chart Links to an external site..Navigate to the left-hand search box titled Select Data
Select STD from the indicator category.Select the state in which you will practice from the geography category.Include the following sections: Application of Course Knowledge: Answer all questions/criteria with explanations and detail. Examine the CDC Atlas Plus website data presented in the charts and address the following: Explain what the data indicates about infections rates based on age, race, and gender. Identify evidence of disparities. Explain your rationale. Discuss biases or barriers that may contribute to disparities in STD rates in your state. Return to the left side of the screen and change the geography indicator category to the United States. Discuss how rates in your state compare to those of the U.S. as a nation. Describe two person-centered actions the nurse practitioner can use to promote STD self-care management for marginalized clients. Discuss opportunities for interprofessional collaboration to address disparities in STD rates.
Respond to two discussion post separately. disucssion will be provided. Disucssion post is about the following. Pharmacokinetics and Pharmacodynamics describes the relationship between drugs and the body. It is important to consider factors that might influence a patient’s Pharmacokinetic and Pharmacodynamics processes such as gender, genetics, age, ethnicity, and behaviors.responses need to be APA format
Develop a 2- to 3-page paper comparing humanistic-existential therapy to another psychotherapeutic approach of your choice, address the followingBriefly describe humanistic-existential psychotherapy and the second approach you selected. Explain at least three differences between these therapies. Include how these differences might impact your practice as a PMHNP.Focusing on one video you viewed, explain why humanistic-existential psychotherapy was utilized with the patient in the video and why it was the treatment of choice. Describe the expected potential outcome if the second approach had been used with the patient. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
Create a PowerPoint Presentation to evaluate the challenges that today’s leadership faces when creating a strategic plan for a healthcare organization. Your presentation should include the following topics:
Strategic direction elements of the strategic plan
Other elements of the strategic and operational plan
Challenges: institutional, resource-dependent, and contingent environments
Determining value alignment
Evaluate clinician performance as part of the strategic plan
Your presentation should meet the following structural requirements:
Organized, using professional themes and transitions.
It should consist of 7 slides, not including the title and reference slides.
Each slide must provide detailed speaker’s notes, with a minimum of 100 words per slide. Notes must draw from and cite relevant reference materials.
Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two sources may be from the class readings, textbook, or lectures, but the other four must be external. The Saudi Digital Library is a good place to find these references.
Follow APA 7th edition and Saudi Electronic University writing standards.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
Respond below in BOLD or colored font on this document
1. (2) Explained why the Medicare fee schedule is used to benchmark to compare
reimbursement rates received from other payers.
2. (3) a. Name three ways the training and background of physicians and administrators
differ?
(2) . b. Why do these present challenges in working with physicians?
3. . Board of Directors in a medical practice:
a. (3) Name three responsibilities an administrator has in working with the Board of
Directors in the board meeting.
b. (3) What are three potentials pitfalls an administrator must be aware of in working
with the Board of Directors in the board meeting?
4. a. (1) Define a buy/sell agreement for owners in a private medical practice.
b. (2) Provider two examples of method/criteria in how a medical practice is valued.
5 (5). List five key financial reports reviewed in class which should be presented and explained
to the physicians. Include a brief description and/ or formula for each report.
6. (2) a. Write and explain the formula for Days in Accounts Receivable.
(2) b. Why is accounts receivable usually the highest valued asset category for a
medical group based on how the healthcare system operates?
7.
(2) Provide an explanation of the concept of a physician compensation plan.
8.
For the fiscal year ending 12/31/22.
Billed charges $300,000
Insurance and patient collections/payments $210,000
Insurance contractual adjustment $80,000
Patient bad debts write off $5,000.
Charity Care writes off $5,000
a. (2) Collection ratio =_________________%.
b. (2) Total dollar discount per insurance contract____________.
9. (1) Balance Sheet, Practice OB/GYN, March 31, 2013
Assets
$190,000
Liabilities
$170,000
Owners’ Equity
X ______________
b. (2) Would you describe this as a healthy balance sheet? Explain….
.
10(2)
Cash Flow Statement, cash accounting
basis, Month end Feb. 28, 2023
Beginning Cash Balance, Feb. 1
$300,000
DR
Deposit, Feb. 11
CR
$100,000
Payment for supplies, Feb. 15
$40,000
Payment for Payroll, Feb 18
$70,000
Deposit, Feb. 28
$90,000
Ending Cash Balance, Feb. 28,
2023
X
11. (2) Calculate days in accounts receivable:
-Gross accounts receivable as of 12/31/22 = $700,000
-Gross billing for the year was $9,000,000
a) Showing the formula, what is days in AR as of 12/31/22. (Use the full year of 360
days in calculation average daily revenue needed to complete the calculation)
12.a. (1) What is the difference between volume- based vs. value- based reimbursement
b. (2) Provide an example of a clinical standard for valued based reimbursement
which relates to a health or wellness outcome?
13.. (3) List the five elements of emotional intelligence.
14.(3) Name three tasks you would do in preparation for a managed care negotiation with an
insurance company.
15. (2)
Explain a Consumer Directed Health Plan (CDHP) / also called High Deductible
Health Plan (HDHP) how it is structured, and why it is a popular option for those purchasing
health insurance?
16. (3) Name three internal financial controls which should be implemented to guard against
embezzlement.
Tell us about any interaction you have had with healthcare law. Examples – HIPAA, surgical consent, medical office “privacy” statement or practices, malpractice. If not you, then find a relative or friend with an experience – good or bad – with a law or regulation. One reference!
The focus of this exercise is an analysis of a vitamin or mineral supplement.You will analyze a supplement of your choice (multivitamin, single vitamin or mineral, or another supplement) focusing on nutrients included, appropriate/inappropriate amounts of nutrients, the safety of the supplement, and general impression of its utility.
Step One
Choose a supplement to analyze — either a supplement you have at home, one you purchase, or a picture of the label of a supplement container. If you have questions about if the supplement you’ve chosen meets the assignment requirements or if there is enough literature/research on the topic, please reach out to the instructor.
Step Two
You may create a one-page double-spaced summary including a written summary of the supplement reviewing the items outlined below.
Deliverables
Written reflection on the supplement
Overview of the supplement including who its branded consumer is (gender or age-specific?) and the vitamins, minerals, or other ingredients it contains.
Based on the branded consumer and the appropriate RDA (Recommended Dietary Allowance or AI (Adequate Intake) for the included vitamin or minerals (if it is a multivitamin, pick one to focus on), discuss if the supplement includes appropriate or inappropriate amounts of nutrients based on it’s branded/targeted consumer.
If RDA’s do not exist, discuss the existing scientific literature or professional consensus on the supplement.
It is not sufficient to say “there is no research on this topic” so if you choose a less common supplement, please think critically about how you will present the information.
Description of the safety of the supplement and general impression of its utility.
Are there any concerns about the amount of the vitamin or mineral in the supplement? Are there other ingredients or additives that could be harmful?
Based on who the supplement is branded for and the information you have on the RDA and research you’ve done, is it necessary or useful for individuals to take?
A brief discussion of a news article/peer-reviewed journal article focusing on the nutrients included in your supplement (if it is a multivitamin choose one to focus on).
For example: If it is a biotin supplement are the claims for skin/hair/nail support true? If it is a prenatal vitamin does it have folate vs. folic acid and what does research show about these?
You should be able to tie in the peer-reviewed article you include to the question above on either supplement safety or utility.
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem.
Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:
Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population.
Following the PICOT format, write a PICOT question in your selected area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. Note: This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology.
Articles must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. The PICOT question will also provide a framework for your capstone project.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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.
You are not required to submit this assignment to LopesWrite.
Why is the hospital emergency department sometimes used for nonurgent conditions? What are the consequences?Discussion Post Directions:This discussion response should be at least 250 words in length (excluding references WHICH ARE REQUIRED). You must make sure that your initial discussion response addresses all aspects of the discussion question/statement. Initial discussion post are due 11:59 PM on Fridays.In addition to the weekly initial discussion response(s), you will need to respond to at least twoof your peer’s weekly discussion responses per essay. These peer responses should be at least 100 written words in length and include support (in text citations and a reference page) in at least one of your responses. They must be posted by 11:59 PM on Sundays. There is, of course, no upper limit on your peer responses.
Nowadays, obesity has become a serious health problem among university students. What are the factors that contribute to obesity among university students? In your opinion what is the best strategies to reduce or prevent obesity among university students?
Instructions for Completing the Discussion Questions:
Please post your original response by Wednesday at 11:59 pm. Your response should be a minimum of
five sentences but should not exceed 250 words.
Appropriately cite any of the references that you
use to fully answer the questions.
Respond to at least one of your classmates by Saturday at 11:59 pm.
What are questions you might to ask your classmates to determine if our community is healthy? Cite the reasons you would ask the aforementioned questions Add as many as question https://neiu.desire2learn.com/d2l/wcs/mp/mediaplay…
The instruction are attached on the picture uploaded. You also need to do two replies on two classmates. The discussion needs to be 200 words with a reference, 100 words with a reference for replying on two classmates’ posts.
Propose at least 2 goals for the client that are specific, measurable, action-oriented, realistic, and timely (SMART). In 6 – 10 pages, you will (1) identify the client’s presenting problem(s); (2) identify and explain the process and rationale for proposing 2 SMART goals; (3) identify and describe at least 2 objectives or steps for each goal; and (4) describe quantitative, qualitative, or mixed methods for monitoring and evaluating progress for each goal. Please review the directions and grading criteria (see below) for instructions on completing this assignment. Please closely review the rubric (see below) that will be used to grade this assignment. All students are expected to adhere to Chamberlain University’s Academic Integrity Policy. All papers must conform to required elements (i.e., paper elements, format, organization) outlined in the 7th edition of the APA Publication Manual.
Unformatted Attachment Preview
You are a social work intern at a community mental health center in a large urban area
where a significant number of residents are living in poverty. You are assigned by your
supervisor to meet a single parent and their 4-year-old son at the family’s home for
their initial intake assessment. The son’s daycare provider referred the family to the
community mental health center following reports from several staff that the child is
presenting a persistent pattern of inattention and hyperactivity. Further, the daycare
provider noted potential developmental delays in language and social development.
Although the single parent is a voluntary client, the client was initially ambivalent to
meet with you. At the initial home visit, you observe the child eating pieces of paint
from the wall. Using verbal following, exploring, and focusing skills, facilitate a
conversation to identify and prioritize the client’s problem(s), its expressions, and other
concerns.
Requirements
Propose at least 2 goals for the client that are specific, measurable, action-oriented,
realistic, and timely (SMART). In 6 – 10 pages, you will (1) identify the client’s
presenting problem(s); (2) identify and explain the process and rationale for proposing
2 SMART goals; (3) identify and describe at least 2 objectives or steps for each goal;
and (4) describe quantitative, qualitative, or mixed methods for monitoring and
evaluating progress for each goal. Please review the directions and grading criteria (see
below) for instructions on completing this assignment. Please closely review the rubric
(see below) that will be used to grade this assignment. All students are expected to
adhere to Chamberlain University’s Academic Integrity Policy. All papers must
conform to required elements (i.e., paper elements, format, organization) outlined in the
7th edition of the APA Publication Manual.
Directions and Grading Criteria
Category
Points
Description
Presenting problem(s)
10
Identify and elaborate on the client’s presenting
problem(s).
Goals
30
Identify and explain the process and rationale for
2 SMART goals.
Category
Points
Description
Objectives or tasks
25
Identify and describe at least 2 objectives or steps
for each goal.
Monitoring progress
25
Describe quantitative, qualitative, or mixed
methods for monitoring and evaluating progress
for each goal.
Clarity of writing
5
Use of standard English grammar and sentence
structure. No spelling errors or typographical
errors.
APA format
5
Conforms to required elements outlined in the
7th edition of the APA Publication Manual.
Total
100
A quality essay will meet or exceed all of the
above requirements.
When was the last time you read Meditation XVII of John Donne’s Devotions Upon Emergent Occasions?
Unless you are a student of seventeenth-century poetry, you may not be all that familiar with this piece. However, you may be much more familiar with one of its well-known phrases: “No man is an island…”.
As you begin your journey toward achieving your academic and professional goals, you have a great opportunity to network with academics and professionals who can help ensure you do not travel alone. This network can help to clarify your own vision for success and can help guide you now and in the future. To paraphrase Donne, no one is an island.
Begin creating an academic and professional network by identifying which academic and professional connections and resources with which you need to collaborate to succeed in your MSN program and as a practicing nurse.
To Prepare:
Consider individuals, departments, teams, and/or resources within Walden University and within your profession that you believe can support your academic and professional success.
Identify at least two academic and at least two professional individuals, colleagues, or teams that might help you succeed in your MSN program and as a practicing nurse.
Download the Academic Success and Professional Development Plan Template.
The Assignment:
Academic and Professional Network
Complete Part 1 of your Academic Success and Professional Development Plan Template. Be sure to address the following:
Identify at least two academic and at least two professional individuals or teams to collaborate with to be successful in your MSN program and as a practicing nurse.
Explain why you selected these individuals and/or teams and how they will support your success in the MSN program and as a practicing nurse.
Unformatted Attachment Preview
NURS 6002: Transition to
Graduate Study for Nursing
Academic and Professional Success Plan Template
Prepared by:
This document is to be used for NURS 6002 Transition to Graduate Study for
Nursing to complete Assessments 1-4. Just as importantly the document serves to
organize your thoughts about planning for your academic and professional success.
For specific instructions see the weekly assessment details in the course or ask your
instructor for further guidance.
Week 1 | Part 1: Developing an Academic and Professional Network
I have identified and secured the participation of the following academic (at least two)
and professional (at least two) individuals and/or teams to form the basis of my network.
This network will help me to clarify my vision for success and will help guide me now
and in the future.
Directions: Complete the information below for each member of your network. For more
than four entries repeat the items below with details of your additional network
member(s) in the ‘ADDITIONAL NETWORK MEMBERS’ section.
NETWORK MEMBER 1
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
NETWORK MEMBER 2
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
NETWORK MEMBER 3
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
NETWORK MEMBER 4
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
Week 2 | Part 2: Strategies to Promote Academic Integrity and
Professional Ethics
I have analyzed the relationship between academic integrity and writing, as well as the
relationship between professional practices and scholarly ethics. I have also identified
strategies I intend to pursue to maintain integrity and ethics of my academic work while
a student of the MSN program, as well as my professional work as a nurse throughout
my career. The results of these efforts are shared below.
Directions: In the space below craft your analysis/writing sample, including Part 1 (The
Connection Between Academic and Professional Integrity) and Part 2 (Strategies for
Maintaining Integrity of Work).
Part 1: Writing Sample: The Connection Between Academic and Professional
Integrity
In the space below write a 2- 3-paragraph analysis that includes the following:
•
•
•
•
•
Explanation for the relationship between academic integrity and writing
Explanation for the relationship between professional practices and scholarly
ethics
Cite at least 2 resources that support your arguments, being sure to use proper
APA formatting.
Use Grammarly and SafeAssign to improve the product.
Explain how Grammarly, Safe Assign, and paraphrasing contributes to academic
integrity
PART 2: Strategies for Maintaining Integrity of Work
Expand on your thoughts from Part 1 by:
•
Identifying and describing strategies you intend to pursue to maintain integrity
and ethics of your 1) academic work while a student of the MSN program, and 2)
professional work as a nurse throughout your career. Include a review of
resources and approaches you propose to use as a student and a professional.
Week 3 | Part 3: Research Analysis
I have identified one topic of interest for further study. I have researched and identified
one peer-reviewed research article focused on this topic and have analyzed this article.
The results of these efforts are shared below.
Directions: Complete Step 1 by using the table and subsequent space below identify
and analyze the research article you have selected. Complete Step 2 by summarizing in
2-3 paragraphs the results of your analysis using the space identified.
Step 1: Research Analysis
Complete the table below
Topic of Interest:
Research Article:
Include full citation
in APA format, as
well as link or
search details (such
as DOI)
Professional
Practice Use:
One or more
professional practice
uses of the
theories/concepts
presented in the
article
Strengths of the
Research
Research Analysis
Matrix
Add more rows if
necessary
Limitations of
the Research
Relevancy to
Topic of Interest
Notes
Step 2: Summary of Analysis
Craft a summary (2-3 paragraph) below that includes the following:
• Describe your approach to identifying and analyzing peer-reviewed research
• Identify at least two strategies that you would use that you found to be effective in
finding peer-reviewed research
• Identify at least one resource you intend to use in the future to find peer-reviewed
research
Week 6 | Part 4: Finalizing the Plan
I have considered various options for my nursing specialty, including a close look at my
selected (or currently preferred) specialty and second-preferred specialty. I have also
developed a justification of my selected (or preferred) specialty. Lastly, I have examined
one professional organization related to my selected or preferred specialty and
considered how I can become a member of this organization.
The results of my efforts are below.
Directions: Complete Step 1 by writing 2-3 paragraphs in the space below comparing
the nursing specialty you have selected – or the one you prefer if your choice is still
under consideration – to your second preference. Identify each specialty and describe
the focus and the role that graduates are prepared for. Identify any other differentiators
you feel are significant, especially those that helped or may help you reach a decision.
Complete Step 2 by writing a paragraph identifying and justifying your reasons for
choosing your MSN specialization. Be sure to incorporate any feedback you received
from colleagues in this week’s Discussion Forum.
Complete Step 3 by examining and identifying one professional organization related to
your selected or preferred specialty. Explain how you can become a member of this
organization.
Step 1: Comparison of Nursing Specialties
Use the space below to write 2-3 paragraphs comparing the nursing specialty you have
selected – or the one you prefer if your choice is still under consideration – to your
second preference. Identify each specialty and describe the focus and the role that
graduates are prepared for. Identify any other differentiators you feel are significant,
especially those that helped or may help you reach a decision.
Step 2: Justification of Nursing Specialty
Use the space below to write a paragraph identifying and justifying your reasons for
choosing your MSN specialization. Be sure to incorporate any feedback you received
from colleagues in this week’s Discussion Forum.
Step 3: Professional Organizations
Use the space below to identify and examine one professional organization related to
your selected or preferred specialty. Explain how you can become a member of this
organization.
– END –
Using the article attached: Do you think it is possible to protect this vulnerable population during a research study? How do the authors apply the four ethical principles when dealing with a vulnerable population such as incarcerated pregnant women?
Unformatted Attachment Preview
Aim: To stimulate discussion and debate about the inclusion of vulnerable populations in
primary research to inform practice change and improve health outcomes. Background: Current
research practices to safeguard vulnerable people from potential harms related to power
imbalances may in fact limit the generation of evidence‐based practice. Evaluation: The authors
draw on their experience working and researching with a recognized group of vulnerable
people, incarcerated pregnant women, to provide insight into the application of ethics in both
research and clinical practice. In a novel approach, the ethical principles are presented in both
contexts, articulating the synergies between them. Suggestions are presented for how
individuals, managers and organizations may improve research opportunities for clinical
practitioners and enhance the engagement of vulnerable people to contribute to meaningful
practice and policy change. Key Issues: Ethical practice guidelines may limit the ability to create
meaningful change for vulnerable populations, who need authentic system change to achieve
good health outcomes. Conclusion: Inclusive research and practice are essential to ensuring a
strengths‐based approach to healthcare and addressing health needs of the whole population.
Health systems and models of care recognizing the diverse lives and health needs of the
broader population demand practical, sustainable support from clinical managers. Implications
for Nursing Management: Practical suggestions for clinical managers to support point of care
research is provided, embedding vulnerable voices in policy, practice development and care
provision.
Keywords: case study; ethical nursing practice; research ethics; vulnerable populations
INTRODUCTION
Nursing and midwifery practice is framed by professional codes of conduct, ethics and
standards of practice. These frameworks seek to ensure the provision of care meets the
expectations of the community, the professions and individuals, contributing to the best possible
health outcomes for the recipient. The International Council of Nurses (ICN) and the
International Confederation of Midwives (ICM) provide the overarching ethical frameworks within
which all nurses and midwives must practise. Specifically, the ICN Code of Ethics for Nurses
(ICN, [21]) identifies four principal elements for ethical conduct: nurses and patients or other
people requiring care or services; nurses and practice; nurses and the profession; and nurses
and global health (p. 3). The ICM ([20]) International Code of Ethics for Midwives bases its core
ethical code on the recognition of women’s human rights and the role of the midwife in
supporting and advocating for women. Point 1c of the code states ‘Midwives empower
women/families to speak for themselves on issues affecting the health of women and families
within their culture/society’ (ICM, [20] p.1).
The concept of advocacy is foregrounded throughout both professional frameworks, explicitly as
per Element 1.7 of the ICN Code of Ethics (ICN, [21], p.7) or in a more nuanced manner
throughout the International Code of Ethics for Midwives (ICM, [20]). Accordingly, it is expected
that nurses and midwives build trusting relationships with the recipients of care, support them in
their healthcare decision making and advocate for change to provide the best possible health
outcomes.
People from disadvantaged or vulnerable backgrounds are over‐represented in poor health
statistics (Ford et al., [16]) and are often the most frequent seekers of care (Cruwys et al., [15]).
For many, engaging with health care providers is fraught with challenges, including, but not
limited to, access to care, understanding of need and adaptability of services (Byrne et al., [13];
Lewis et al., [25]). For many, non‐engagement with healthcare providers is reflective of an
overall disengagement with institutions more broadly and demonstrates a level of structural
vulnerability for the individual. Structural vulnerability is a term that describes the complex social
determinants that contribute to factors that result in poor health outcomes (Bourgois et al., [10]).
Further Bourgois et al describes structural vulnerability as ‘the outcome of a combination of
socioeconomic and demographic attitudes, in conjunction with assumed or attributed status’ (p.
4). Therefore, the vital role that nurses and midwives play in confronting these factors and in
facilitating patient engagement cannot be overstated.
Contemporary healthcare practice is based on evidence‐based knowledge (Boswell & Cannon,
[ 9]). However, in order to build an appropriate evidence base, rigorous and credible research
that meets a strict ethical criterion is essential. The fundamental importance of research
informing clinical practice is mentioned, albeit briefly, in both aforementioned codes of ethics.
Howe
ever, despite this, the role of nursing and midwifery researchers is often overlooked. Whilst
there is a strong focus on the ethics of providing quality clinical care, less consideration is given
to nurses and midwives involved in research. Hayes ([19]) clearly links the Code of Ethics
requirement that nurses should treat all people as equals, considering individual circumstances
to promote inclusivity and addressing ‘hidden coercive influences’ (p. 87). It is therefore
imperative that nurse and midwife researchers contribute to the building of a body of knowledge
in order to best advocate for all recipients of care.
The authors draw on their experiences of evaluating a project that included working alongside
and conducting research with a vulnerable population of pregnant women in prison (Baldwin et
al., [ 5]). Pregnant women in prison are considered vulnerable by their gender, incarceration,
pregnancy, culture and socio‐economic background (Baldwin, Sobolewska, et al., [ 6]). The
juxtaposition of clinical practice and the importance of engaging vulnerable populations in
primary research to hear the voices of those who may be silenced by complex social, cultural
and political influences is explored. The authors’ new insights demonstrate how practice and
research with vulnerable people are aligned, enhancing outcomes for theoretical understanding
and practical application. The need for primary research, centred around the most vulnerable is
highlighted, and suggestions will be made for future research involving vulnerable people,
without compromising the research process or compounding the participants vulnerabilities.
BACKGROUND
Ethical practice in research is not a new concept. In the aftermath of WWII, the urgent need to
protect the vulnerable resulted in the Nuremberg Code, followed in 1964 by the Helsinki
Declaration (Mandal et al., [26]). It is beyond doubt that the events leading up to the
development of these cornerstone documents dictated the need for regulation to prevent further
research activity that could result in harm, maim or even kill innocent participants. Since then,
formal ethics committees have become embedded into organizations that engage in research
(Brown et al., [12]). Alongside the growth of ethics committees, the definition of vulnerability has
evolved to recognize the many layers of vulnerability more accurately across communities.
Over time, restrictions on vulnerable people participating in research due to concerns about
causing them harm have increasingly been called into question, raising issues about the
exclusion of vulnerable groups from being represented in research (Hayes, [19]). For example,
non‐participation or exclusion from participating in research may in fact be placing vulnerable
populations at a further increased risk of harm (Juritzen et al., [22]). Using healthcare provision
in prison as an example of vulnerability in context, the lack of primary research with offenders is
apparent. There is an overall dearth of research about health in prisons, with most of the
evidence being drawn from statistical data provided by health services or research around
medical chart audits and reviews. This absence of the person and their lived experience of
healthcare delivery within prison indicates a significant gap in knowledge, particularly when
considered from the perspective of person‐centred care.
The complexities of vulnerability are well illustrated in the cases of incarcerated pregnant
women, with the recent development of formal recommendations to improve health and well‐
being outcomes for this group of mothers and babies (Baldwin, Capper, et al., [ 4]; Birth
Companions, [ 8]). The number of incarcerated women around the world is increasing, many of
which are of childbearing age, (Alirezaei & Roudsari, [ 3]; Gibson, [17]), are from poor socio‐
economic backgrounds and have higher levels of emotional and mental health trauma than the
general population (World Health Organization, [28]). Often women moving through the criminal
justice system lead chaotic lives, involving complex social issues, resulting in prison sentences
related to illicit drugs, violence and robbery (Breuer et al., [11]).
Pregnant women are regarded as a vulnerable population due to a perceived lack of capacity to
give informed consent for an unborn child and thereby are seen to pose a greater potential for
harm. Because of this classification of vulnerability, there has been a reluctance to undertake
research involving them. Despite this hesitancy, it has been suggested that the exclusion of
vulnerable populations may, in fact, cause them more harm as it further suppresses their voices,
thereby contributing further to their marginalization (Aldridge, [ 1]). Incarcerated women have
been described as ‘the most vulnerable population of women’ (Hayes, [19], p. 84). Therefore,
incarcerated pregnant women may be categorized as an evenmore vulnerable population.
The paradox of this situation is that pregnancy alone should not be considered the causation of
increased vulnerability as it is considered a state of well‐being rather than illness. Therefore, it
could be argued that it is in fact unethical not to undertake research with vulnerable populations,
such as pregnant incarcerated women as the need to elicit meaningful findings is paramount
with enormous potential benefits (Alexander, [ 2]; Krubiner & Faden, [23]). Further, current
evidence suggests that the prison environment may contribute to improved birthing outcomes
and being pregnant whilst ‘inside’ provides the incentive for a woman to transform her life with
positive birthing and effective parenting experiences offering an opportunity to interrupt the cycle
of recidivism (Shaw et al., [27]).
This is a continuation of the health promotion program proposal, part one, which you submitted previously. Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.
Directions
You have already completed the steps 1-4. Make sure you revise this initial submission according to your instructor’s comments.
1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measurable.
2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified.
3. Provide a review of literature from scholarly journals of evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search.
4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide rationale for your selection which includes discussion of the concepts of the selected model For this assignment add criteria 5-8 as detailed below:
5. Propose a health promotion program using an evidence-based intervention found in your literature search to address the problem in the selected population/setting. Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role. Be certain to include a timeline. (2 to 4 paragraph. You may use bullets if appropriate).
6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach. (1 paragraph).
7. Provide a detailed plan for evaluation for each outcome. (1 paragraph).
8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (1 paragraph).
9. Conclude the paper with a Conclusion paragraph. Don’t type the word “Conclusion”. Here you will share your insights about this strategy and your expectations regarding achieving your goals. (1 paragraph). Please
Please see attached first half of the paper
Paper Requirements
Your assignment should be 7-8 pages (excluding title page, references, and appendices), following APA standards.
Remember, your Proposal must be a scholarly paper demonstrating graduate school level writing and critical analysis of existing nursing knowledge about health promotion.
Nursing Plan of Care
Student name:
Patient initials:
Age:
Date of Care:
All material submitted must be typed in the space provided!
Patient’s Admitting Diagnosis:
List patient’s past medical history related to admission:
PATHOPHYSIOLOGY Provide brief/key aspects of pathophysiology related to your patient’s admitting diagnosis in the
space provided below.
Instructions for
assessment:
In the space below enter the subjective and objective data gathered during your patient
assessment based on systems, including laboratory and diagnostic assessments.
Subjective Data Entry
A
S
S
E
S
S
M
E
N
T
TIME OUT!
Objective Data Entry
To be sure your patient diagnostic statement written below is accurate, you need to review the
assessment data and determine if it is appropriate and relevant for the diagnostic statement
below. Do you have an accurate match or is additional data required or does another nursing
diagnosis need to be investigated? Have you appropriately categorized the subjective and
objective data? Have you prioritized and clustered your assessment data to formulate the
nursing diagnosis? List at least one (1) actual and one (1) at risk nursing diagnosis for your
patient.
LAST UPDATED: 12/28/2017 KD & SM
1
Nursing Diagnostic
Statement:
Nursing Diagnostic Label:
Related to:
As Evidenced By:
Nursing Diagnostic
Statement:
Nursing Diagnostic Label:
Related to:
As Evidenced By:
TIME OUT!
Expected
Goals/Outcomes:
TIME OUT!
I
N
T
E
R
V
E
N
T
I
O
N
The diagnostic label must be NANDA approved and describes the patient’s response to health
conditions. Is there a possibility that the diagnostic label can be misunderstood as a medical
diagnosis? Are the related factors displaying the reason why the patient is exhibiting the
diagnostic label? Are the defining characteristics (“as evidenced by”) show the evidence of the
problem? List two (2) short term goals (STG) for each nursing diagnosis.
Diagnosis A:
STG #1:
STG #2:
Diagnosis B:
STG #1:
STG #2:
The desired outcome must meet criteria to be accurate. The outcome must be specific, realistic,
measurable, and include a time frame for completion. Does the action verb describe the patient’s
behavior to be evaluated? Can the outcome be used in the evaluation step of the nursing process
to measure the patient’s response to the nursing interventions listed below? List at maximum of
three (3) interventions for each goal.
Interventions
Rationale for Selected Intervention Using
A1
Evidence-Based Practice (EBP) references
1.
A1
1.
2.
2.
3.
3.
A2
1.
A2
1.
2.
2.
3.
3.
B1
B1
LAST UPDATED: 12/28/2017 KD & SM
2
1.
1.
2.
2.
3.
3.
B2
TIME OUT!
B2
1.
1.
2.
2.
3.
3.
Do your interventions assist in achieving the desired outcome? Do your interventions address
further monitoring of the patient’s response to your interventions and to the achievement of the
desired outcome? Are qualifiers: when, how, amount, time, and frequency used? Is the focus of
the actions of the nurse and not on the patient? Do your rationales provide sufficient reason,
directions, and best evidence-based practice?
Was the desired outcome achieved? Include data and if not, or partially met, what revisions to
either the desired outcome, goals, or interventions would you make?
Yes No Partially met
E
V
A
L
U
A
T
I
O
N
Complete this care plan using a minimum of four scholarly resources outside of your textbook and your ATI resources.
These resources must be easily available if requested. Attach a reference list using APA format on a separate sheet of
paper to this document. All resources must be current within the last 3-5 years.
LAST UPDATED: 12/28/2017 KD & SM
3
You already completed the A3 tool and project charter, just needing the slide deck complete now! The slide deck is worth 100pts.
Unformatted Attachment Preview
HAD 522 – Health Care Operations and Quality Management
Process Improvement Project Description and Rubric
Process Improvement Project [100 points]
Students will be assigned a case in the Pruitt et al. text and assume the role of a Process Improvement
(PI) Team Leader. As the PI Team Leader, each student will develop an A3 Process Tool and Project
Charter, both of which are due Week 4, based on the case. Each student will also develop a project slide
deck (in Powerpoint format only) using the notes feature to outline / highlight concepts to present to
organization executives, which is due Week 7. Further details and the specific deliverables are in the
HAD 522 PI Project Description and Rubrics file found in the Rubrics folder in the Getting Started
Module.
This assignment has 100 possible points and items due on Week 4 and Week 7.
Refer to Case Study 6 and the accompanying data files from the Pruitt et al. text.
You have been brought in by the new parent health system as a Process Excellence coach to assist
Lakefront Regional Medical Center (LRMC). You assisted Amy Haskell with the ED kaizen event and will
now be taking over further process excellence activities for LRMC. Using the information presented in
the case, the accompanying data files, and your experience as a Process Improvement Team Leader, you
will complete the following:
1) Assemble an A3 Process Tool that will guide the team in understanding the current issue(s) and
identify the desirable future state. This is due Week 4 and worth 25 points;
2) Develop a Project Charter taking care to outline the project, the team, and specific scope. This is
also due Week 4 and worth 25 points;
3) Identify and apply two process improvement (PI) tools to the issue that will assist the
organization in moving from the current to future state (ie. solutions or A3 countermeasures);
[Please note the A3 Process Tool and Project Charter from 1) & 2) above or any tools presented in
the case do not count toward your two process improvement tools.]
4) Assemble a slide deck (using PowerPoint only) using the notes feature to assist in relaying
information that you would use to update Frank Seda and health system executives on this
project (Due Week 7 and worth 50 points)*.
*You learn shortly after beginning this project that LRMC is not the only facility in the health system that
is having these or similar problems. The health system executives, especially the Vice-President of
Performance Improvement, to whom you report, are proponents of the application of health
informatics to process improvement. You plan to apply for a new Regional Director of Performance
Improvement position, reporting directly to the Vice-President of Performance Improvement. The LRMC
project would be a great opportunity to demonstrate your ability to utilize data and develop a solution
that could be diffused throughout the organization. SO, recalling Discussion Forum 1-2 and your
understanding of implementation science, ensure that you include in the slide deck identification of how
human and technical barriers and facilitators may impact the implementation plan for the solutions.
Team Charter
Category
Business
Case
Problem
Statement
Goal
Statement
Project
Scope
Project
Team
Writing &
Use of APA
Style
Total
Unacceptable
0
Acceptable
3
Good
4
Excellent
5
More than one
of the required
elements is
missing or
requires
substantial
improvement
One of the
required
elements is
missing or
requires
substantial
improvement
All required
elements
present but
improvement
is required on
one or more
Strong reason
for doing the
project and
financial
impact are
present
0
4
5
Required
element is
missing or
requires
substantial
improvement
Required
element
present but
improvement
is required
Clear
articulation of
the problem
to be solved is
present
0
3
4
5
More than one
of the required
elements is
missing or
requires
substantial
improvement
0
Required
element is
missing or
requires
substantial
improvement
0
Required
element is
missing or
requires
substantial
improvement
One of the
required
elements is
missing or
requires
substantial
improvement
All required
elements
present but
improvement
is required on
one or more
Desired
outcomes and
measurements
of success are
present
4
5
Required
element
present but
improvement
is required
Boundaries of
the project are
clearly
delineated
4
5
Required
element
present but
improvement
is required
The project
team is clearly
delineated
-4
-3
-1
0
Errors in writing
or APA style
detract
substantially
from the
project
Minimal,
noticeable
errors in
writing and
APA style
present
Rare errors in
writing and
APA style
that do not
detract from
the paper
No errors in
writing and
APA style
(Includes
references,
citations, and
formatting)
Score
A3 Process Tool
Use Appendix E (A3 Problem-Solving Template) in the Pruitt, Smith, & Perez-Ruberte text as the
template for the A3 Process Tool. This assignment is worth 25 points maximum.
Process Improvement Slide Deck
Category
Grammar /
Mechanics /
Graphics
Appropriate
&
Professional
Content
(30 points
total)
Data Usage
Applicability
Total
Unacceptable
0
Acceptable
3
Good
Materials /
graphics errors
are abundant
and detract from
presentation
Materials /
graphics have
errors and
somewhat
explain and
reinforce
presentation
topic
Materials /
graphics have
errors but are
used properly
to explain and
reinforce
presentation
topic
0
4
Excellent
5
Materials /
graphics are
error free and
used properly
to explain and
reinforce
presentation
topic
3
4
5
Required
elements are
missing or
requires
substantial
improvement
One of the
required
elements is
missing or
requires
substantial
improvement
Required
elements
present but
improvement is
required
Deck is
professionally,
developed and
assembled in a
way that is
appropriate for
presentation to
senior
leadership /
executives
Process
Improvement
tools are
correctly
described and
appropriately
used in relation
to the project
1) A3 Process Tool (5 points) 2) Project Charter (5 points) 3) ______________ (10 points) 4) ______________ (10 points) –
0
3
4
5
More than one
of the required
elements is
missing or
requires
substantial
improvement
One of the
required
elements is
missing or
requires
substantial
improvement
All required
elements
present but
improvement is
required on one
or more
Tools and
solutions are
based on data,
appropriate for
the project, and
demonstrate an
understanding
of the use of
and factors
influencing
informatics /
analytics
0
3
4
5
More than one
of the required
elements is
missing or
requires
substantial
improvement
One of the
required
elements is
missing or
requires
substantial
improvement
All required
elements
present but
improvement is
required on one
or more
Tools and
solutions are
applicable to
other projects
and other
facilities
Score
I want you to pick any clinical quality problem and apply either an experimental or quasi-experimental design for quality improvement. Which design would you use and why? What are the strengths and weakness of this chosen design method? (Make sure when you answer, you tell me what quality problem you are trying to improve –CAUTI, CLABSI, FALL’s, are some examples) I NEED TWO DIFFERENT VERSIONS, AND EACH VERSION SHOULD HAVE AT LEAST 300 WORDS AND TWO RESOURCES.
Mixed methods research designs combine quantitative and qualitative research methods to answer research questions requiring both perspectives. Describe the pros and cons of a mixed method research design. Please include 400 words in your initial post with two scholarly references .apa style .
Write a 4-6 page analysis of Limited Access to Healthcare., including a proposed solution and possible ethical implications 1)Describe these health care problem and provide details about it.Explore your chosen topic; Limited Access to Healthcare. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. Identify possible causes for the problem or issue
2) use scholarly information to describe and explain the health care problem and identify possible causes for it. *Articles and reference are attached* Review the Think Critically About Source Quality to help you complete the following: Assess the credibility of the information sources. Assess the relevance of the information sources.
3) Analyze the health care problem or issue. Describe the setting or context for the problem or issue. Describe why the problem or issue is important to you. Identify groups of people affected by the problem or issue. Provide examples that support your analysis of the problem or issue. 4.
Discuss potential
solutions for the health care problem or issue.
o
Describe what would be
required to implement a solution.
o Describe potential
consequences of ignoring the problem or issue.
o
Provide the pros and
cons for one of the solutions you are proposing.
5) Explain the ethical principles
(Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution
was implemented.
Describe what would be necessary
to implement the proposed solution.
Explain the ethical principles
that need to be considered (Beneficence, Nonmaleficence, Autonomy, and
Justice) if the potential solution was implemented.
Provide examples from the
literature to support the points you are making.
Your assessment should also meet the following requirements: Length: 4–6 typed, double-spaced pages, not including the title page and reference page. Font and font size: Times New Roman, 12 point. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics. Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style. References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper. APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.Organize your paper using the following structure and headings: Title page. A separate page. Introduction. A brief one-paragraph statement about the purpose of the paper. Elements of the problem/issue. Identify the elements of the problem or issue or question. Analysis. Analyze, define, and frame the problem or issue. Considering options. Consider solutions, responses, or answers. Solution. Choose a solution, response, or answer. Ethical implications. Ethical implications of implementing the solution. Implementation. Implementation of the potential solution. Conclusion. One paragraph.
Case Study 5: Disorders of Endocrine Control of Growth and Metabolism
Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she became tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha’s voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow. Suspecting low thyroid hormone levels were causing the signs, her husband called for an ambulance.
When testing for hypothyroidism, why is the free T4 level an important measurement? What would the TSH and T4 test results indicate in someone with primary hypothyroidism?
Using your knowledge of the function of thyroid hormone in the body, explain why Bertha’s respiratory rate was decreased? Why might pleural effusion be present in someone with hypothyroidism?
What factors in Bertha’s history leave her susceptible to myxedematous coma? What are the physiologic aspects involved in myxedematous coma?
In your discussion, be sure to discuss developing collaborative relationships with clients when teaching concepts concerning pathological states to individuals and families.
Case Study Assignment Requirements
Make sure all of the topics in the case study have been addressed.
Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Locating Evidence a. Using the Chamberlain University library/ google scholar, search for a recent (published within the last five years) evidence- based article from a scholarly journal that addresses one of the topics listed. • Safety
2) Include the following sections.
a. Introduction –
Clearly establishes the purpose of the paper
Includes key points to be covered
Captures the reader’s interest
b. Body of Paper –
Complete, well-developed discussion of key points
Supports the purpose or main idea of the paper
Logical development of ideas with clear and accurate information
Ideas and statements are supported by three or more examples from personal and/or professional experiences
Provides own perspectives on the topic that is reflective, insightful, and original
c. Conclusion –
Clear and concise
Summarizes key points discussed in the paper
Leaves a strong impression, message, or idea on the reader
d. Writing Style –
e. Correct use of standard English grammar, paragraph, and sentence structure
f. No spelling or typographical errors
g. Organized around required components
h. Information flows in a logical sequence that is easy for the reader to follow
i. APA Format, and References –
There is correct and appropriate use of margins, spacing, font, and headers
Document setup includes title and reference pages in correct APA format
i am currently in bachelor program . this assignment is a sequence of part A,B,C as labelled in the documents.
Unformatted Attachment Preview
This assessment is the first of three related assessments in which you will gather interview
information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment
3); and report on how an interdisciplinary improvement plan could be implemented in a place of
practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan
based on the PDSA cycle that he or she could present to stakeholders to address an
interdisciplinary problem in the workplace.
For this assessment, you will create a 2–4 page report on an interview you have conducted with a
health care professional. You will identify an issue from the interview that could be improved with
an interdisciplinary approach, and review best practices and evidence to address the issue.
•
•
•
•
•
•
•
Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired
patient and systems outcomes.
o Summarize an interview focused on past or current issues at a health care
organization.
o Describe collaboration approaches from the literature that could be relevant in
establishing or improving an interdisciplinary team to address an organizational
issue.
Competency 3: Describe ways to incorporate evidence-based practice within an
interdisciplinary team.
o Identify an issue from an interview for which an evidence-based interdisciplinary
approach would be appropriate.
Competency 4: Explain how change management theories and leadership strategies can
enable interdisciplinary teams to achieve specific organizational goals.
o Describe change theories and a leadership strategy that could help develop an
interdisciplinary solution to an organizational issue.
Competency 5: Apply professional, scholarly, evidence-based communication strategies to
impact patient, interdisciplinary team, and systems outcomes.
o Organize content so ideas flow logically with smooth transitions; contains few
errors in grammar/punctuation, word choice, and spelling.
o Apply APA formatting to in-text citations and references, exhibiting nearly flawless
adherence to APA format.
Length of submission: Use the provided template. Most submissions will be 2–4
pages in length. Be sure to include a reference page at the end of the plan.
Number of references: Cite a minimum of 3 sources of scholarly or professional
evidence that support your central ideas. Resources should be no more than 5
years old.
APA formatting: Make sure that in-text citations and reference list follow current
APA style.
Continuation of Assessment 2.
For this assessment, use the context of the organization where you conducted your interview to develop
a viable plan for an interdisciplinary team to address the issue you identified. Define a specific patient or
organizational outcome or objective based on the information gathered in your interview.
The goal of this assessment is to clearly lay out the improvement objective for your planned
interdisciplinary intervention of the issue you identified. Additionally, be sure to further build on the
leadership, change, and collaboration research you completed in the previous assessment. Look for
specific, real-world ways in which those strategies and best practices could be applied to encourage buyin for the plan or facilitate the implementation of the plan for the best possible outcome.
Using the Interdisciplinary Plan Proposal Template [DOCX] Download Interdisciplinary Plan Proposal
Template [DOCX]will help you stay organized and concise. As you complete each section of the template,
make sure you apply APA format to in-text citations for the evidence and best practices that inform your
plan, as well as the reference list at the end.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in
the scoring guide. Please study the scoring guide carefully so you understand what is needed for a
distinguished score.
• Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a
specific goal related to improving patient or organizational outcomes.
• Explain a change theory and a leadership strategy, supported by relevant evidence, that is most
likely to help an interdisciplinary team succeed in collaborating and implementing, or creating
buy-in for, the project plan.
• Explain the collaboration needed by an interdisciplinary team to improve the likelihood of
achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the
literature.
• Explain organizational resources, including a financial budget, needed for the plan to succeed
and the impacts on those resources if the improvements described in the plan are not made.
• Communicate the interdisciplinary plan, with writing that is clear, logically organized, and
professional, with correct grammar and spelling, using current APA style.
•
•
•
Length of submission: Use the provided template. Remember that part of this
assessment is to make the plan easy to understand and use, so it is critical that
you are clear and concise. Most submissions will be 2–4 pages in length. Be
sure to include a reference page at the end of the plan.
Number of references: Cite a minimum of 3 sources of scholarly or
professional evidence that support your central ideas. Resources should be no
more than 5 years old.
APA formatting: Make sure that in-text citations and reference list follow
current APA style.
This exam consists of Chapter 1 -3, Chapter 8 and 9Short Answer questions: This is due at 11:59pm on October 13th .
Unformatted Attachment Preview
z
Chapter 3 – Fight and Flight of stress
The
Science of
Stress
z
What is the purpose of the fight-or-flight
response to stress?
▪ Protects us from danger
▪ Helps us survive danger
z
Learning
Objectives
By the end of this chapter you should be able
to:
3.1 Describe the human fight-or-flight
response.
3.2 List the physiological changes associated
with the stress response.
3.3 Name the stages of the general
adaptation syndrome.
3.4 Explain how the science of stress relates
to stress management and prevention.
z
The Human Fight-or-Flight Response
z
Scientific Foundations of Stress
▪ Knowledge and theory provides:
▪ An understanding of how stress affects the body
▪ An understanding of the mechanics of stress
prevention
▪ An understanding of stress reduction techniques
z
▪
Why do you feel Stress?
Stress is a complex interaction between:
▪
Nerves
▪
Hormones
▪
Muscles
▪
Organs
▪
Body systems
When faced with stress, the body decides to “fight” or to “run”
z
The Fight-or-Flight Response
▪ Awareness of danger creates a state of hyperarousal
▪ The release of stress hormones creates an immediate
physiological response
– Avoid danger by running
– Confront danger by fighting
z
▪
Activity 1
Review the immediate physiological effects of the fight-or-flight
response. Think about how each response is designed to help a
person survive physical danger. List one reason why each of the
following immediate physiological responses would happen when
we need to deal with a real threat.
z
Activity 1 Response
▪ Increase in heart rate
▪ Increase in breathing rate
▪ Large (fighting and running) muscles become tense
▪ Increase in tolerance for pain
▪ Increase in blood sugar levels
▪ Suppressed immune system
▪ Digestive system stops metabolizing food normally
z
Physiological Changes
z
Physiological Response to Stress
▪ Autonomic nervous system:
– Digestion
– Heart rate
– Blood pressure
– Body temperature
z
Autonomic Nervous System Responses
Autonomic Nervous System Responses
z
Activity 2
▪ The stress response becomes your best friend when in a
dangerous situation. The immediate speed, power, and quickness
that comes from fight-or-flight can save your life.
▪ Write down a time when your life, or the life of someone you know,
was really in danger, where the only desire was to stay alive by
escaping.
z
General Adaptation Syndrome
z
Types of Stress
▪ Acute stress
– The demand, danger, or threat is
immediate and real
▪ Being chased by a dog, a
flat tire, lightning, or a fall
▪ Chronic stress
– Continued sympathetic nervous
system activation
z
The Science of Stress and Stress
Management and Prevention
z
How Stress Impacts Your
Life
▪ Frequency—how often your stress response is triggered
▪
Intensity—how severe your stress response is when triggered
▪
Time or duration—how long the stress response is activated
z
Activity
▪
Consider situations that can be stressful.
Evaluate whether the event calls for activation of the
stress response to escape from it to stay alive.
First, list the situations in which there is no real
physical threat involved.
Next, list the potentially life-threatening situations.
z
Activity 4: Potentially Stressful Situations
▪
Taking a test
▪
Having an argument
▪
Getting ready for a crucial ballgame
▪
Giving a prepared speech to a crowded room of people
▪
Sliding down a steep mountainside while hiking
▪
Escaping from a house fire
▪
Arriving late for a class
▪
Being chased by a mugger
▪
Getting a bad score on a test
z
Myths About Stress
z
Myth 1 and Myth 2
Myth 1: In an ideal world, there would be no stress.
▪ Stress is not always bad for us.
▪ Too little stress leads to boredom.
▪ Stress can add spice if we learn to manage it.
▪ Managed stress makes us productive and happy.
Myth 2: What is stressful for me is stressful for you.
▪
Stress is different for each of us.
▪
Stress is something we create and depends on how we interpret
situations
z
Myth 3 and Myth 4
Myth 3: Only unpleasant situations are stressful.
▪ Situations can be both positive and negative.
▪ How we view the challenge or opportunity is what causes stress.
Myth 4: No symptoms, no stress.
▪
Symptoms are warning signs that the body is responding to stress.
▪
An absence of symptoms does not mean an absence of stress.
z
Myth 5
Myth 5: Stress in inevitable, so you can’t do anything about it.
▪ You can change your approach to life.
▪ You can learn techniques that help you cope with
stress.
▪ You can learn to prevent some stress from happening.
z
Question
What is true about the experience of stress?
1.
What is stressful to me is stressful to you.
2.
If you have no symptoms, you have no stress.
3.
Stress is not always a bad thing.
4.
Stress is caused by the people around you.
z
Summary
▪ Fight-or-flight is the body’s way of helping us survive.
▪ Fight-or-flight involves the interaction of many body systems and organs. The body activates
some functions and minimizes others at it responds to danger.
▪ The autonomic nervous system (ANS) oversees involuntary body functions such as digestion,
heart rate, and blood pressure.
▪ Two branches of the ANS are the sympathetic nervous system and the parasympathetic nervous
system.
– The sympathetic nervous system handles the release of energy.
– The parasympathetic nervous system handles the conservation of energy.
z
Summary 2 of 2
▪ The autonomic nervous system is controlled by the hypothalamus.
▪ Fight-or-flight is essential to survival during times of acute danger, but it
can have negative consequences when psychological and social
concerns are ongoing.
▪ The general adaptation syndrome is a process where the body tries to
accommodate stress. There are three stages of general adaptation
syndrome:
– Alarm
– Resistance
– Exhaustion
Chapter 8: Managing
Emotions
Ice Breaker
What do you fear?
How do you overcome that
fear?
What are positive functions
associated
with fear?
What negative functions are
associated with fear?
Learning Objectives
By the end of this chapter, you should be able to:
• Explain how negative motions such as guilt, worry, fear, anger, and
hostility relate to stress.
• Describe the physiological manifestations of certain emotions.
• Distinguish between guilt and worry.
• Explain the differences between anger and hostility.
• Act to prevent and control stress-causing emotions.
Managing Emotions
Emotions
• Emotions are a part of the human experience.
• Negative emotions include:
• Anger
• Fear
• Guilt
• Worry
• We cannot eliminate emotions but
• we can learn to express and control them.
The Physiology of Emotion
Physiological and Biochemical Effects
• Emotions are used to protect us and activate the fight-or-flight
response.
• Some emotions make us susceptible to stress and disease.
– Worry, guilt, fear, anger, shame, and other strong emotions
• Chronic negative emotions:
– Affect our well-being
– Increase vulnerability to disease
– Disrupt normal homeostasis
Biochemical Effects of Emotion
• Somaticizing
– Turning mental stress into a physical issue
• Chronic worry and stress can compromise the:
– Immune system
– Nervous system
– Hormone system
Benefits of Positive Emotions
Emotions are a part of the
human experience.
Positive emotions include:
• Happiness
• Compassion
• Optimism
Guilt and
Worry
Guilt
• Guilt:
– Expression of self-anger
• Worry:
– Keeps the mind negatively focused on events yet to come
•
Anxiety
– Outcome, when combined with worry, is fear
Knowledge
• Most worries never happen.
A. True
B. False
Knowledge Answer
• Most worries never happen
– A. True
• Most things we worry about are out of our control, and most
worries never happen. Move your worries from your mind to
paper, and remember, worrying is a habit.
Letting Go of Worry
• Guidelines to help manage worry
• Reducing test anxiety
• Letting go of guilt
Guidelines to Manage Worry
• Most things we worry about are out of our control.
• Worry is different from caring.
• Worry is different from planning.
• Most worries never happen.
• Practice mindfulness.
• Move worries from your mind to paper.
• Remember, worry is a habit.
Worry Activity
• Look at the following ideas when you feel the urge to worry. Which is
most helpful to you? Least helpful?
• Most things we worry about are out of our control.
• Worry is different from caring.
• Worry is different from planning.
• Most worries never happen.
• Practice mindfulness.
• Move worries from your mind to paper.
• Remember, worry is a habit.
Worry Activity Debrief
• Stress emotions can affect our cognitive abilities.
• When we are overcome with emotions, we have trouble thinking
clearly and long-term worrying can produce lasting decline.
• This activity will help you to manage worry and determine its proper
place in your life.
Reducing Test Anxiety (1 of 2)
Tips to overcome test-taking worries:
1. Prepare—Instead of using time to worry, use the time to focus on
preparation.
2. Descriptive writing—Take a minute to write down thoughts and feelings.
3. Ask—If you are unsure about what to study, ask.
4. Sleep on it—Study over several days instead of cramming the night
before, and get a good night’s sleep the day before the test.
5. Eat well—To think more clearly, eat protein-rich foods, and avoid eating
too many carbohydrates and bad fats.
Reducing Test Anxiety (2 of 2)
6. Exercise—Take a brisk walk to get your blood pumping before the
test.
7. Try a relaxation technique—relaxation breathing, meditation,
imagery, yoga.
8. Practice mindfulness—Keep your mind focused on the question at
hand.
9. Move on—If you don’t know the answer, move to the next question.
10. Know when enough is enough—At some point, permit yourself to feel
good.
11. Let it go—A lot of worry occurs after the test is done, when you
cannot change your efforts on that particular test.
Letting Go of Guilt
• Reflect on your actions
• Mindful thinking
• Learning from experiences
• Planning for the future
Fear
What is Fear
• Fear is an escalation about the future
• Types of fear
• Grow from fear responses
• Understand comfort and discomfort zones
Type of Fear
• Change
• Pain or physical suffering
• Failure
• Some thing or object
• The unknown
• Death
Growing Activity
It’s about growing!
Have students break into small groups and discuss why they are here and
what their purpose is. This might include:
• To learn everything they can
• To enjoy life to the fullest
• To make a difference in other people’s lives
• To serve others
• To have and support a family and provide a quality life for them
• To develop skills, talents, and natural abilities
• To have an enjoyable time
• To be happy
• To work toward and reach their goals
Growing Activity Debrief
• All of these activities are worthwhile and have value.
• There is a general tendency among humans to grow, to develop, to
serve, and to enjoy.
• We have a natural urge to become more of who we are.
Comfort and Discomfort Zones
• Comfort zone:
• Place, situation, relationship, or experiences where we don’t feel threatened,
such as our home, jobs, family, and friends
• Discomfort zone:
– Places we do not naturally gravitate to
– Where we experience growth
Fear and Guilt
1. Most believe we are here to grow and achieve potential.
2. Our inclination is to be comfortable and remain in our comfort
zone.
3. We need to balance our desire for comfort with our inherent
tendency to grow.
4. Overcoming fear is necessary to grow, and growth takes effort.
5. Most of what we fear involves imaginary pain we think we want to
avoid.
Fear Factors
• Fear can motivate decisive action.
• Nothing in the world is inherently fearful.
• Fear is learned.
• We can learn to overcome our fears.
Strategy for Overcoming Fear
1. Admit you are afraid—list the things that cause fear and try to
imagine them without the emotion of fear.
2. Confront your fear—do what it is you are afraid of. Realize your fear
will intensify, but do it anyway. Try to imagine the situation is not
fearful.
3. Do what you are afraid of at least three times—chances are you will
be less afraid each time.
4. As you confront your fear, rename it—call it something else such as
excitement or a challenge.
The Fear–Faith Connection
• We fear because we lack trust in ourselves.
• Alleviate fear with a sense of self-assurance and self-efficacy.
• The more we believe, the more courageous and less fearful we are.
• The stronger our faith in ourselves and our abilities, the less we fear.
What is Anger
• An emotional response based on how
we choose to think about events,
people, or circumstances
Effects of Anger
• Increase in cortisol and adrenaline
• Increase in blood pressure
• Increase in blood sugar
• Increased risk of coronary heart disease
• Increased risk of diabetes
• Insomnia and fatigue
• Bulimic behavior
• Decreased eyesight
• Increase in muscle tension
• Faster pulse
• Constriction of blood vessels
• Elevated serum cholesterol levels
• Decreased immune function
• Increased risk of cancer
Reasons we Get Angry
• Anger is the result of our interpretation of what should happen:
• Based on the perception of what is happening
• Based on the perception of how it should occur differently
• Anger is the reaction when expectations are not met.
Anger Blocker 1 of 2
• To keep anger in check:
• Remind yourself you don’t have to respond as you always have
• Try postponing your anger
• Understand you can dislike something and not have to be angry about it
• Remember that everyone has the right to their choices, and we can’t demand
that anyone act differently
• Ask someone you trust to help you identify when you are angry and what you
are doing
• Keep an anger journal and choose to be angry less often
Anger Blocker 2 of 2
• If you have an angry outburst, announce you slipped and that one of
your goals is to think differently to avoid experiencing anger.
• Try to be physically close to someone you love when you feel angry to
neutralize your hostility.
• Defuse anger by labeling how you feel.
• Get rid of unrealistic expectations.
• Love yourself and get rid of the burden of self-destructiveness.
• See how long you can go without getting angry.
• Challenge yourself to change circumstances that make you angry.
• Remember that an expression of anger might be healthy, but it is
healthier to avoid anger all together.
What is Hostility
• Hostility and anger are not interchangeable terms.
• Hostility is an attitude motivated by hatefulness and animosity.
• Anger is a temporary emotion usually in response to a specific event.
Summary 1 of 3
• Emotional well-being includes the proper expression of a wide
range of emotions.
• Chronic guilt and worry, fear, and an attitude of hostility and anger
are damaging and stress producing.
• Guilt is a conscious preoccupation with undesirable past
thoughts and behaviors.
• Worry is an indicator of fear that keeps the mind focused on imagined
painful events yet to come.
• Worry is different than planning. Planning puts future events
into the present so that we can appropriately control those events.
Summary 2 of 3
• The most effective way to be free of guilt and worry is through the
practice of mindfulness.
• Fear is a state of escalated worry that causes distinct physical and
emotional reactions.
• Anger is an emotional response based on how we choose to
think about events, often triggered by our perceived provocation
or mistreatment.
• Anger is considered a temporary emotion. It is usually a response to a
specific event. Hostility is an attitude motivated by hatefulness and
animosity.
Summary 3 of 3
• Researchers have found that certain emotions can make a person
susceptible to stress and disease. These negative emotions include
anger, worry, guilt, fear, and hostility.
• Positive emotions like gratitude and happiness are good for our wellbeing and will be explained in other chapters. Just as negative
emotions contribute to unhealthy outcomes, positive emotions
contribute to good health and less stress. You are responsible for
controlling your thoughts and feelings, both positive and negative.
Stress Management Online Midterm – Fall 2023 Name:_________________________
For each question 1-14 be sure to put your answer IN YOUR OWN WORDS. You may
refer to the class notes and PowerPoints, but DO NOT COPY directly from the class
notes. Give YOUR OWN EXPLANATIONS to these questions.
Questions 1 – 3: Time Management -Name three time management strategies we have
discussed in class. Explain exactly how each strategy is carried out. (4 points each)
1) Time Management Strategy: _________________________________
Explanation:_____________________________________________________________
________________________________________________________________________
________________________________________________________________________
2) Time Management Strategy: ___________________________________
Explanation:_____________________________________________________________
________________________________________________________________________
________________________________________________________________________
3) Time Management Strategy: _____________________________________
Explanation:_____________________________________________________________
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Questions 4-7: Assertive Communication – Write an assertive communication script for
the following situation. Use the D.E.S.C. method. Be sure to include each letter, and
write as if you are talking to Mr. Jones, the bus driver in the story. ( 4 points each)
Situation: Your child gets picked up every morning by the school bus. On the first
day you noticed that the bus driver, Mr. Jones, drove away before your child was seated.
It is now the second day. What would you say to Mr. Jones?
4)D:____________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5)E:____________________________________________________________________
________________________________________________________________________
________________________________________________________________________
6)S:____________________________________________________________________
________________________________________________________________________
________________________________________________________________________
7)C:____________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
Questions 8-10: Communication Styles – Explain each of these styles of
communication, including the non-verbal behaviors that accompany them. (4 points)
8) Aggressive:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
9) Passive:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
10) Assertive:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Questions 11 and 12: Anger Management – Explain two necessary requirements for
successful anger management that we discussed in class. (4 points each)
11) Effective anger management requirement 1:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
12)Effective anger management requirement 2:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Question 14: The Fight/Flight Reaction – What happens to you when you have a
fight/flight reaction? When and why is the Fight/Flight Reaction important? When
and why is it unhelpful? (2 points)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Chapter 9: The Importance of
Values
Ice breaker
What do you value most?
Do your actions support
your values?
Learning Objectives
By the end of this chapter, you should be able to:
Describe mediocrity as it relates to feeling stuck in your life.
Explain the connection between values clarification and stress
management.
Clarify and prioritize your highest values.
Differentiate between instrumental values and terminal values.
Participate in values clarification activities.
The Importance of Values
Values
• Value:
− A way of thinking that guides choices by evoking a feeling of basic principles of right and
wrong.
• Values:
− Guide our actions
− Provide direction
− Give meaning to life
Your Values
• When values and actions are not aligned, the consequence is stress
and inner chaos.
• Discovering your values
• Cognitive dissonance
Discovering Your Values
• Dharma
– When you find your place in life, you find satisfaction
in life.
– It results in inner peace, wisdom, and happiness.
Discovering Value Activity
• In small groups, brainstorm a list of those things you value most.
• When the list has been finished, try to identify who was responsible
for shaping those values in you.
Discovering Value Activity Debrief
• When we live by an agenda set by others, we easily get caught up in
living someone else’s life. One primary task involved in becoming an
adult is to become independent and self-directed in our thoughts and
actions.
• Separating from the control and influence of parents and others and
moving toward self-direction is a fundamental right of passage into
adulthood.
Source of Values
Source of Influence
• Values are influenced by:
• Culture
• Friends
• Television
• The Internet
• Social media
• Parents
• Family
• Teachers
Values within Cultures
• Culture is a pattern of learned behavior based on values, beliefs, and
perceptions within a community.
• Cultures are based on underlying values that encourage or
discourage actions and beliefs.
• Your identity becomes linked with the work you do
Predominant Values in the United States
• Personal achievement and success
• Activity and work
• Moral orientation
• Efficiency and practicality
• Progress
• Material comfort
• Personal freedom and individualism
• External conformity
• Science and rationality
Predominant Alaska Native Values (1 of 2)
• Show respect to others
• Share what you have
• Know who you are
• Accept what life brings
• Have patience
• Live carefully
Predominant Alaska Native Values (2 of 2)
• Take care of others
• Honor your elders
• Pray for guidance
• See connections
The Dynamic Quality of Values
• Values are not static; they change over time.
• When young, we have values similar to our parents.
• As we grow, values become a mix of what we learned from
family, cultures, coworkers, and relationships
Acquiring Values
• Values are assimilated from family, friends, religion, and society.
• Values acquisition: we assume new values consciously.
Beliefs about Values
1. We can change our thoughts and actions.
2. We are responsible for creating long-term change in our lives.
3. When we set our sights in a new direction, we have the power to
move in that direction.
4. Our values determine our actions and behaviors.
Types of Values
• Instrumental values:
– Those that consist of personal characteristics and character traits
▪ Hardworking, capable, cheerful, forgiving, responsible
• Terminal values:
– Outcomes of efforts, those we feel are essential and desirable
▪ Self-respect, security, inner harmony, freedom
Values Clarification
• Values Clarification:
• The process of discovering and applying what we genuinely value
• Reduces the stress of making decisions that are inconsistent with our values
• Mental and spiritual process to help close the gap between what we value and
what we do
Creating Your Personal Constitution
To clarify and apply your fundamental values, create a personal
constitution:
1. Identify your values
2. Prioritize your values
3. Write a clarifying paragraph for your values
Step 1: Identify Your Values
• Review the list of instrumental and terminal values
• Identify which are most important to you
• What is your most important value?
Your funeral Activity
• With your eyes closed, imagine what you would like others to say,
think, and feel about you and how you lived your life.
• Brainstorm these ideas on paper.
• Which of these values are you living right now? Which do you need
to continue to work on?
Your Funeral Activity Debrief
• Students can use the Instrumental and Terminal Values list and apply
those values to how they would like to be thought of.
• What came to mind as the highest, most important value?
• There are likely inconsistencies. There might be some values that are
not being work on right now. This activity will help students prioritize
their values as they move into step two of the Creating Your Personal
constitution process.
Values Clarification and Realization
• It is an ongoing process.
• Values should be reflected in how
• we live each day.
• Our personal constitution can be
• a private guide to decision making.
Ben Franklin’s 13 Virtues
Temperance
Silence
Justice
Moderation
Cleanliness
Tranquility
Chastity
Humility
Order
Resolution
Frugality
Industry
Sincerity
Summary (1 of 2)
• A value can be defined as a belief upon which one acts by
preference. Values give us direction and meaning in life.
• Clarifying our values and understanding what is central to defining us
as individuals helps to reduce our stress.
• Dharma teaches us that when we find our place in the puzzle of life,
we attain satisfaction with our lives, and we feel fulfilled, happy,
content, and worthwhile.
• Cognitive dissonance happens when our behavior is inconsistent with
our values, beliefs, and our self-image.
• Most of our values are at the unconscious level unless we work to
examine them consciously.
Summary 2 of 2
• Values acquisition, which is the conscious assumption of a new
value, has 6 criteria.
• Instrumental values primarily consist of our personal values and
character traits.
• Terminal values are goals, or end states, that we work toward.
These make our lives fulfilling, satisfying, and worthwhile.
• Values clarification, which is the process of applying what we
genuinely value, helps reduce the stress that comes from making
decisions that are inconsistent with what we value.
• The three-step action plan for values clarification results in the
development of one’s personal constitution.
Stress in
Todays World
Chapter 1
Learning Objectives
By the end of this Chapter you should be able to:
• 1.1 Define the terms stress and stressor.
• 1.2 Define and explain the similarities and differences between
eustress and distress.
• 1.3 Differentiate among acute, acute episodic, and chronic stress.
• 1.4 Relate stress to the five dimensions of holistic health—physical,
mental, emotional, spiritual, and social.
• 1.5 Discuss some of the most common stressors college students
experience today
Ice breaker
How often do you experience stress?
1. Almost never
2. Rarely (2-4 times a month)
3. Sometimes (2-4 times a week)
4. Often (nearly every day or more)
What is Stress
Stress is a demand made upon the adaptive capacities of the mind
and body.
• The mind’s perceived pressure
• The body’s physiological response to this stimulus
• Understanding the meaning helps to understand:
− Perception of pressure and the positive or negative affect it has on the body.
− Overall reaction to life events determines if we feel stress and not the event
itself.
− Healthy, robust ability to handle stress results in positive outcomes; inability
to meet the demands of stress results in negative or poor outcomes.
Terminology of Stress
Stressor
• Any situation or event that causes a
person to feel challenged or
threatened
• Triggers stress response – either
adapting to or stimulating
Distress
Eustress
• Adverse effects of stress
• Positive, desirable stress
• Drain us of energy and
• Keeps life exciting and
exceed our coping capacity
• “Threat” or “Bad” stress
• As stress increases, health
and performance decline
helps to motivate and
inspire
• “Challenge” or “Good”
stress
• Stress is managed
successfully
Relationship between Stress, Health and performance
Acute Stress
• Comes on quickly
Stress –
Acute Stress
• Quite intense – a “rush”
• Is rapidly resolved
• Can be beneficial in some circumstances
• High-risk sports, getting a speeding
ticket
Stress: Chronic Stress
Chronic Stress
• Brought on by long-term, ongoing stress
• Exacerbated by inability to deal with stress in a healthy
manner
• Wears on the body both physically and mentally
• Example: Increasing debt, chronic illness
Episodic Acute Stress
• Seen in those who are in constant panic or crisis
• Frequent episodes of acute stress
• Often blame stress on outside sources
• Tend to be short-tempered, irritable, and overly anxious
• Habitual with chronic health issues such as headaches,
gastrointestinal disorders, and hypertension
Poll 1
Which statement best describes how you manage stress?
a) I step away from the situation so I can look at it from an
outsider’s point of view before I make any decisions.
b) I practice wholistic rituals such as yoga and meditation as
well as eat a healthy balanced diet.
c) I tend to dive headfirst into the problem and deal with any
issues so the stressor will be removed.
d) I don’t handle stress very well and often feel overwhelmed
Knowledge Check
Question
• Stress always has an impact
on physical health
A. True
B. False
Knowledge check
Answer
• Stress always has an impact on physical health
• False
• Stress does not always have an impact or affect
on physical health, but it does have a
physiological reaction to a stressor whether it is
eustress or distress.
Understanding Health as a whole
• In order to understand stress and develop healthy management
of stress, the relationship between health and stress must be
examined.
• Health is more than being free from disease and illness
• Holistic Health encompasses more than just the physical
element
− Mind
− Body
− Spirit
− Social
Interdependence of
Dimensions of Health
• Each domain of ourselves is
connected and intertwined
• This interdependence creates a
holistic being
• Fatigue
• Emotional Health
• Low
• Mental Health
productivity
Match
effects of
stress
• Worrying
• Depression
• Lashing out
• Physical Health
• Social Health
• Spiritual Health
Nature or Nurture
Knowledge Check Question
• Holistic health combines which of the following aspects to
develop an optimal healthy individual free from disease and
illness?
A. Mind
B. Body
C. Spirit
D. Social
Knowledge Check Answer
• Holistic health involves the mind, body, spiritual, and social to
promote an optimal setting for a healthy individual free of
disease and illness,
All answers are correct
Time Management
Personal
Expectations
Stress and
College
Home Environment
Family Life and
Expectations
Academic
Demands
Physical Health
Environmental
Stressors
Relationships,
Employment and
Choices, and
Finances
Hassles
Technology and stress
Informed overload
• Technostress is prominent in today’s society
• Manifested in two ways:
− anxiety experienced with new and unfamiliar
technology
− stress as a result of the over identification with
technology.
• Partial attention from texting and technology use adds
to the stress due t
1)— Describe a time you faced an academic challenge and how you managed it. Is there anything you would have done differently?2)— Describe a defining moment that fueled your passion for and commitment to becoming a nurse.
For this paper you must cite and reference at least two (2) scholarly resources. The paper should be 2–3 pages and written using the current 7th ed. APA student format (must have a title page and reference page). List word count as the last line of your Reflection/Conclusion. (word count # ).
See Rubric for additional details. Your paper should address the following:
Title Page
Introduction – Family Disaster Plan Scenario
You must include research on the dangers and explain the recommended safety measures in a tornado emergency.
How would you prepare for the following situation?
(Scenario) At this moment, you are sitting at home working on your assignemt. Suddenly, the National Weather Bureau sends an alert across your cell phone—a tornado is headed your way. You have 15 minutes before touchdown in your neighborhood.
A.What is your plan? This is a ‘shelter in place’ scenario, you cannot outrun the tornado. Identify a safe place in your home (residence) to take shelter.
Provide realistic examples and explain how you would apply the safety and survival measures you learned in your research of a tornado emergency to your specific living arrangements.
Example: “I will turn off my utilities before I shelter in place to mitigate damage to my residence.”
Example: “I will take by “go-bags” with me to my shelter in place.
How prepared are you in the event of a disaster?
Describe your level of disaster preparedness using specific examples and references to:
Potential disasters in your area.
Your 72 hour “go-bag” assignment.
Family Disaster Plan Checklist.
Example: “I am more prepared for a water-related disaster than a fire-related disaster even though I live in a highly secluded, forested area. I have a boat as transportation in the event of flooding, but I do not have rain barrels or fire barrier supplies on hand.”
Example: “There were many missing items on my preparedness checklist. I realized that I do not own a flashlight. If I had to use my phone as a light it would drain the battery very quickly.
Reflection/Conclusion
Reflect on how prepared you were before this class and compare it with how prepared you are now.
Have you acquired any new emergency items?
Do you plan to take any additional training or certification courses?
Have you shared your knowledge with friends and family?
B. How does what you have learned in this course impact you as a future nurse?
Reference Page
Cite and reference at least two (2) scholarly resources using 7th ed APA format.
Need help with APA Style? Visit the Student Resources page.
Unformatted Attachment Preview
Week 8 Assignment: Family Disaster Plan – Tornado Scenario – Revised Summer 2023
Family Disaster Plan – Tornado Scenario
•
For this paper you must cite and reference at least two (2) scholarly resources. The paper should be 2–3 pages and
written using the current 7th ed. APA student format (must have a title page and reference page). List word count as
the last line of your Reflection/Conclusion. (word count # ).
See Rubric for additional details. Your paper should address the following:
Title Page
Introduction – Family Disaster Plan Scenario
A. You must include research on the dangers and explain the recommended safety measures in a tornado
emergency.
How would you prepare for the following situation?
(Scenario) At this moment, you are sitting at home working on your assignemt. Suddenly, the National
Weather Bureau sends an alert across your cell phone—a tornado is headed your way. You have 15
minutes before touchdown in your neighborhood.
A. What is your plan? This is a ‘shelter in place’ scenario, you cannot outrun the tornado. Identify a safe place in
your home (residence) to take shelter.
B. Provide realistic examples and explain how you would apply the safety and survival measures you learned in
your research of a tornado emergency to your specific living arrangements.
Example: “I will turn off my utilities before I shelter in place to mitigate damage to my residence.”
Example: “I will take by “go-bags” with me to my shelter in place.
How prepared are you in the event of a disaster?
A. Describe your level of disaster preparedness using specific examples and references to:
1. Potential disasters in your area.
2. Your 72 hour “go-bag” assignment.
3. Family Disaster Plan Checklist.
Example: “I am more prepared for a water-related disaster than a fire-related disaster even though I live in a
highly secluded, forested area. I have a boat as transportation in the event of flooding, but I do not have rain
barrels or fire barrier supplies on hand.”
Example: “There were many missing items on my preparedness checklist. I realized that I do not own a
flashlight. If I had to use my phone as a light it would drain the battery very quickly.
Reflection/Conclusion
A. Reflect on how prepared you were before this class and compare it with how prepared you are now.
• Have you acquired any new emergency items?
• Do you plan to take any additional training or certification courses?
• Have you shared your knowledge with friends and family?
B. How does what you have learned in this course impact you as a future nurse?
Reference Page
A. Cite and reference at least two (2) scholarly resources using 7th ed APA format.
• Need help with APA Style? Visit the Student Resources page.
1
Develop a hypothetical health promotion plan, 3-4 pages in length, addressing a specific health concern for an individual or a group living in the community that you identified from the topic list provided.
Bullying.
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Immunization.
Tobacco use (include all: vaping, e-cigarettes, hookah, chewing tobacco, and smoking) cessation.
Collapse All
Introduction
The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to plan a hypothetical clinical learning experience focused on health promotion associated with a specific community health concern or health need. Such a plan defines the critical elements of who, what, when, where, and why that establish the foundation for an effective clinical learning experience for the participants. Completing this assessment will strengthen your understanding of how to plan and negotiate individual or group participation. This assessment is the foundation for the implementation of your health promotion educational plan (Assessment 4).
Note: Assessment 1 must be completed first before you are able to submit Assessment 4. Complete the assessments in this course in the order in which they are presented.
Preparation
You will need to satisfactorily pass Assessment 1 (Health Promotion Plan) before working on your last assessment (Assessment 4).
To prepare for the assessment, consider a various health concern or health need that you would like to be the focus of your plan from the topic list provided, the populations potentially affected by that concern or health need, and hypothetical individuals or groups living in the community. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.
As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Effective Interpersonal Communications activity. The information gained from completing this activity will help you succeed with the assessment. Completing activities is also a way to demonstrate engagement.
For this assessment, you will propose a hypothetical health promotion plan addressing a particular health concern or health need affecting a fictitious individual or group living in the community. The hypothetical individual or group of your choice must be living in the community; not in a hospital, assistant living, nursing home, or other facility. You may choose any health issues or need from the list provided in the instructions.
In the Assessment 4, you will simulate a face-to-face presentation of this plan to the individual or group that you have identified.
Please choose one of the topics below:
Bullying.
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Immunizations.
Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (MUST address all tobacco products).
In addition, you are encouraged to:
Complete the Vila Health: Effective Interpersonal Communications simulation.
Review the health promotion plan assessment and scoring guide to ensure that you understand the work you will be asked to complete.
Review the MacLeod article, “Making SMART Goals Smarter.”
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Note: Assessment 1 must be completed first before you are able to submit Assessment 4.
Health Promotion Plan
Choose a specific health concern or health need as the focus of your hypothetical health promotion plan. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.
Bullying.
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Immunizations.
Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (MUST address all tobacco products).
Create a scenario as if this project was being completed face-to-face.
Identify the chosen population and include demographic data (location, lifestyle, age, race, ethnicity, gender, marital status, income, education, employment).
Describe in detail the characteristics of your chosen hypothetical individual or group for this activity and how they are relevant to this targeted population.
Discuss why your chosen population is predisposed to this health concern or health need and why they can benefit from a health promotion educational plan.
Based on the health concern for your hypothetical individual or group, discuss what you would include in the development of a sociogram. Take into consideration possible social, economic, cultural, genetic, and/or lifestyle behaviors that may have an impact on health as you develop your educational plan in your first assessment. You will take this information into consideration when you develop your educational plan in your fourth assessment.
Identify their potential learning needs. Collaborate with the individual or group on SMART goals that will be used to evaluate the educational session (Assessment 4).
Identify the individual or group’s current behaviors and outline clear expectations for this educational session and offer suggestions for how the individual or group needs can be met.
Health promotion goals need to be clear, measurable, and appropriate for this activity. Consider goals that will foster behavior changes and lead to the desired outcomes.
Document Format and Length
Your health promotion plan should be 3-4 pages in length.
Supporting Evidence
Support your health promotion plan with peer-reviewed articles, course study resources, and Healthy People 2030 resources. Cite at least three credible sources published within the past five years, using APA format.
Graded Requirements
The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Analyze the health concern that is the focus of your health promotion plan.
Consider underlying assumptions and points of uncertainty in your analysis.
Explain why a health concern is important for health promotion within a specific population.
Examine current population health data.
Consider the factors that contribute to health, health disparities, and access to services.
Explain the importance of establishing agreed-upon health goals in collaboration with hypothetical participants.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Write with a specific purpose and audience in mind.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
Before submitting your assessment for grading, proofread it to minimize errors that could distract readers and make it difficult for them to focus on the substance of your plan.
Context
Historically, nurses have made significant contributions to community and public health with regard to health promotion, disease prevention, and environmental and public safety. They have also been instrumental in shaping public health policy. Today, community and public health nurses have a key role in identifying and developing plans of care to address local, national, and international health issues. The goal of community and public health nursing is to optimize the health of individuals and families, taking into consideration cultural, racial, ethnic groups, communities, and populations. Caring for a population involves identifying the factors that place the population’s health at risk and developing specific interventions to address those factors. The community/public health nurse uses epidemiology as a tool to customize disease prevention and health promotion strategies disseminated to a specific population. Epidemiology is the branch of medicine that investigates causes of various diseases in a specific population (CDC, 2012; Healthy People 2030, n.d.).
As an advocate and educator, the community/public health nurse is instrumental in providing individuals, groups, and aggregates with the tools that are essential for health promotion and disease prevention. There is a connection between one’s quality of life and their health literacy. Health literacy is related to the knowledge, comprehension, and understanding of one’s condition along with the ability to find resources that will treat, prevent, maintain, or cure their condition. Health literacy is impacted by the individual’s learning style, reading level, and the ability understand and retain the information being provided. The individual’s technology aptitude and proficiency in navigating available resources is an essential component to making informed decisions and to the teaching learning process (CDC, 2012; Healthy People 2030, n.d.).
It is essential to develop trust and rapport with community members to accurately identify health needs and help them adopt health promotion, health maintenance, and disease prevention strategies. Cultural, socio-economical, and educational biases need to be taken into consideration when communicating and developing an individualized treatment and educational plan. Social, economic, cultural, and lifestyle behaviors can have an impact on an individual’s health and the health of a community. These behaviors may pose health risks, which may be mitigated through lifestyle/behaviorally-based education. The environment, housing conditions, employment factors, diet, cultural beliefs, and family/support system structure play a role in a person’s levels of risk and resulting health. Assessment, evaluation, and inclusion of these factors provide a basis for the development of an individualized plan. The health professional may use a genogram or sociogram in this process.
What is a genogram? A genogram, similar to a family tree, is used to gather detailed information about the quality of relationships and interactions between family members over generations as opposed to lineage. Gender, family relationships, emotional relationships, lifespan, and genetic predisposition to certain health conditions are components of a genogram. A genogram, for instance, may identify a pattern of martial issues perhaps rooted in anger or explain why a person has green eyes.
What is a sociogram? A sociogram helps the health professional to develop a greater understanding of these factors by seeing inter-relationships, social links between people or other entities, as well as patterns to identify vulnerable populations and the flow of information within the community.
References
Centers for Disease Control and Prevention. (2012). Lesson 1: Introduction to epidemiology. In Principles of Epidemiology in Public Health Practice (3rd ed.). https://www.cdc.gov/csels/dsepd/ss1978/lesson1/sec…
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2030. https://health.gov/healthypeople
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Analyze health risks and health care needs among distinct populations.
Analyze a community health concern or need that is the focus of a health promotion plan.
Competency 2: Propose health promotion strategies to improve the health of populations.
Explain why a health concern or need is important for health promotion within a specific population.
Establish agreed-upon health goals in collaboration with hypothetical participants.
Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Health Promotion Plan Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Analyze a community health concern or need that is the focus of a health promotion plan. Does not identify a community health concern or need that is the focus of a health promotion plan. Identifies a community health concern or need that is the focus of a health promotion plan. Analyzes a community health concern or need that is the focus of a health promotion plan. Provides an in-depth analysis of a community health concern or need that is the focus of the health promotion plan, and articulates underlying assumptions and points of uncertainty in the analysis.
Explain why a health concern or need is important for health promotion within a specific population. Does not describe a health concern or need that is important for health promotion within a specific population. Describes a health concern or need that is important for health promotion within a specific population. Explains why a health concern or need is important for health promotion within a specific population. Conclusions are not supported by relevant or current health data. Explains why a health concern or need is important for health promotion within a specific population. Conclusions are well supported by current and relevant population health and demographic data and based on a perceptive analysis of the factors that contribute to health, health disparities, and access to services.
Establish agreed-upon health goals in collaboration with hypothetical participants. Does not establish agreed-upon health goals in collaboration with hypothetical participants. Establishes health goals without hypothetical participant collaboration. Establishes agreed-upon health goals in collaboration with hypothetical participants. Establishes agreed-upon health goals in collaboration with hypothetical participants. Goals are realistic, measurable, and attainable.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Does not organize content for ideas. Lacks logical flow and smooth transitions. Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling. Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly. Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes, and/or paraphrasing. Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly.
Hi , Thank you for your work on this assessment #1. This assessment provided you with an opportunity to plan a hypothetical health promotion plan focused on a specific health concern in your community for a hypothetical individual or group who live in your community, not a facility. Goods start addressing the scoring guide criteria. Thank you for allowing me to evaluate the assessment. look forward to working with you throughout the course! Dr. Goozee
-Denys Goozee
Scoring Guide
Competency 1
Analyze health risks and health care needs among distinct populations.
Criterion
Analyze a community health concern or need that is the focus of a health promotion plan.
Your Result:DISTINGUISHED
Provides an in-depth analysis of a community health concern or need that is the focus of the health promotion plan, and articulates underlying assumptions and points of uncertainty in the analysis.
Faculty Comments:You did a great job describing a health concern that you chose from the list provided in the assessment guidelines for your hypothetical population living in your community, not in a facility. This is a growing concern in our health care system, especially for the community.
Show all Performance Ratings
Competency 2
Propose health promotion strategies to improve the health of populations.
Criterion
Explain why a health concern or need is important for health promotion within a specific population.
Your Result:DISTINGUISHED
Explains why a health concern or need is important for health promotion within a specific population. Conclusions are well supported by current and relevant population health and demographic data and based on a perceptive analysis of the factors that contribute to health, health disparities, and access to services.
Faculty Comments:Nice work explaining why the health concern you identified is important for health promotion within your hypothetical population. Your conclusions were well supported by current and relevant health data.
Show all Performance Ratings
Criterion
Establish agreed-upon health goals in collaboration with hypothetical participants.
Your Result:NON_PERFORMANCE
Does not establish agreed-upon health goals in collaboration with hypothetical participants.
Faculty Comments:Please be sure to identify SMART goals with a bold heading, clear goals, what are SMART goals, and what does the literature say about this. Be sure to establish measurable, and attainable SMART health goals for your hypothetical participants with sources cited to show research was done. This will help you to further develop, present, and evaluate your final #4 assessment which is the implementation of this plan.
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Competency 5
Apply professional, scholarly communication strategies to lead health promotion and improve population health.
Criterion
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Your Result:BASIC
Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling.
Faculty Comments:I hope you will use the Essay Example I provided in the Announcements! I like that your writing was clear and logical but there were just a few errors noted: Missing the appropriate introduction heading and the entire Introduction paragraph (about 4-5 sentences to clearly outline the main points the paper will discuss). Missing the bold Conclusion heading and the entire Conclusion paragraph (4-5 sentences) to summarize each main point in the essay. Also please be sure each bold heading matches each answer in the order asked (use a few of the same words from each question/ point) to be very clear as to what you are addressing. Be sure each bold heading meets capitalization rules. Please be sure all content on the title page is centered. I hope you will use the Essay Example I provided in the Announcements or the Academic writer website: https://academicwriter-apa-org.library.capella.edu… to help you with this. You have the potential to be an excellent writer.
Show all Performance Ratings
Criterion
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Your Result:PROFICIENT
Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Faculty Comments:Great start with citations and references but please be sure to cite sources in each paragraph to show research was done, strengthen the assignment, and avoid (unintentional plagiarism). I hope you will use the Essay Example I provided to you in my Announcements! and http://www.apastyle.org/learn/tutorials/basics-tut… to help you with this. You have the potential to be an excellent writer.
Pick a local service business (a gym, a
restaurant or a hotel, etc.) on a major business review platform (Yelp,
TripAdvisor, Google, etc) with more than 50 reviews and 3-star or lower overall
rating. Identify a handful of categories of issues after reading through the
complaints, create an affinity diagram of the complaints about these issues,
and draw a Pareto chart based on your analysis. Submit your diagram and chart
in excel format
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Course: what is informatics?
Overview
For this Performance Task Assessment, you will develop a PowerPoint presentation explaining the role of a nurse as a knowledge worker and as a nurse informaticist specialist.
Submission Length: 8- to 9-slide PowerPoint presentation.
Your response to this Assessment should:
Reflect the criteria provided in the Rubric.
Adhere to the required assignment length.
Instructions
Access the following to complete this Assessment:
PowerPoint Presentation Template
The Nurse as Knowledge Worker
Develop an 8- to 9-slide PowerPoint presentation that addresses the following:
Explain the concept of a knowledge worker in general. (1 slide)
Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker. (1 slide)
Develop one simple infographic to help explain both the concept of nursing informatics and the role of a nurse leader as a knowledge worker. (1 slide) (Do not copy and paste an infographic from the internet. You must create one yourself).
Note: For guidance on infographics, including how to create one in PowerPoint, see “How to Create an Infographic in PowerPoint” as presented in the Resources.
Present a hypothetical scenario based on your own nursing practice or healthcare organization that would require or benefit from the access/collection and analysis of data. Your scenario may involve a patient, staff, or management problem or gap. (1–2 slide)
Describe the problem from the viewpoint of a nurse informaticist by:
Describing the data that could be used (1 slide)
Describing how the data might be accessed/collected (1 slide)
Describing what knowledge might be derived from that data (1 slide)
Indicating how a nurse leader would use clinical reasoning and judgment in formation of knowledge from this experience (1 slide)
* NOTE: The response must synthesize and integrate at least two outside resources and two competency-specific resources that fully support the responses provided.
Requirements: 8 to 9 slides with at least 100 words of speaker notes on each slide | .ppt file
Be sure to include an introduction with a clear thesis statement along with a conclusion
Please be sure to carefully follow the instructions
Please be sure to include at least one in-text citation on each slide
Please be sure to include title, conclusion, and reference slides in the ppt
Please be sure to include a background and at least one image on each ppt slide whether its a photograph, statistic, graph, document etc.
Please use the 5×5 rule for the ppt slides
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool
Please be sure to use credible or scholarly sources published within the last 5 years
In 2003, the Medicare Modernization Act (MMA), called for the CMS to add recovery audit contractors and the use for their purpose to be demonstrated (Fritz et al., 2013). The use of the RACs was blended in with a demonstration project. “In response to the legislative directive, CMS developed a 3-year demonstration project for the RAC initiative, which began in March 2005. CMS is required to evaluate the effectiveness of the initiative and provide a report to Congress at the end of the demonstration project” (CMS Recovery Audit Contractor Initiative, 2007, p. 255). Thanks to this initiative, the use of Recovery Audit Contractors (RACs) allowed for the identification of overpayments and underpayments, and recoup of overpayments made by the Medicare program, and to see if the use of RACs is cost-effective. RACS was used for this very intended purpose in order to avoid any negative impact it may cause on a healthcare organization. Romans 8:28 says, “And we know that all things work together for good to them that love God, to them who are the called according to his purpose” (King James Bible, 1769/2016). Aligning ourselves with His will will allow us to grow His kingdom and grow our fellow brothers and sisters. RACs allowed for the protection of the Medicare Trust Fund and a cost-effective way to add resources.
RACs Process
Now as with any process in healthcare, the process of RACs is a team effort with many different steps. Once an improper payment is identified, an RACs contacts the provider in question in regards to the overpayment or underpayment (Harrington, 2021). Redetermination can be requested by any provider, supplier or even beneficiary (Harrington, 2021). A provider must comply with the review, requiring them to send medical documentation in regards to the audited claims. This step also sets the tone for what level of review must be completed, complex or automated. The automated review does not require further review of prescription or other documentation (Harrington, 2021). This also is changed based on levels of review.
With this understanding, RACs can move on to step two of the process. RACS will use automated process algorithms to review all PDE records and identify overpayments and underpayments. If further examination is necessary with the complex process, the third step will take place. This will allow RACs to request and receive any additional information to refute all or some of the RAC’s findings (Harrington, 2021). Once the RAC finalizes a decision and their decision has been confirmed, RACs will send out a Notification of Improper Payment (NIP) (Fritz et al., 2013). The RACs will then work with the Data Validation Contractor (DVC) program to assess the validation of an RACs claims. This is in order to create an Improper Payment Review Package (IPRR). Now, the steps can continue to go further and further into detail depending on the level of appeal.
Conclusion
Now, after review of the RACS, their purpose, and the appeals process, it is clear to see the level of importance that RACs carry in the healthcare industry. RACs must use a team of key players in order to review any and all oversights within the payment process (Harrington, 2021). This is important in the process that still needs further growth. It is up to us as healthcare administrators to see the importance of the process and to ensure accurate documentation and coding for this process (Harrington, 2021).
References
CMS’s Recovery Audit Contractor Initiative. (2007). Journal of oncology practice, 3(5), 255. https://doi.org/10.1200/JOP.0752502Links to an external site.
Fritz, J. V., Setlock, S., & Grooms, D. P. (2013). Recovery audits: Practical update for neurology practices. Neurology. Clinical practice, 3(3), 224–232. https://doi.org/10.1212/CPJ.0b013e318296f2ac
Harrington, Michael K. Health care finance and the mechanics of insurance and reimbursement. (2nd ed.). Burlington, MA: Jones & Bartlett, 2021.
King James bible. (2016). Thomas Nelson. (Original work published 1769).
2. Alesha
The Center’s for Medicaid and Medicare (CMS) use the term “Recovery Audit Contractors” (RACs) to refer to the organizations tasked with finding and fixing errors in Medicare Payments (Harrington, 2021). Harrington (2021) also mentions that this initiative grew out of a trial run that found that sending auditors into healthcare facilities reduced the number of erroneous payments made and the total number of errors made when processing Medicare claims. To verify that Medicare is only paying for truly essential and enumerated services, RACs conduct post-payment reviews of claims. Review efforts must be concentrated on CMS-identified problem regions with high rates of mistaken or inaccurate payments. With the Recover Audit Contractor (RAC) program being initially implemented as a pilot project, it was then expanded to encompass the entirety of fee-for-service Medicare in 2009 and Medicare Advantage in 2010, as mandated by the Tax Relief and Health Care Act of 2006. Wright et al., (2023) indicates that the extension of this program is closely aligned with the post-ACA period. The available evidence indicates that Recovery Audit Contractors (RACs) and Medicare Administrative Contractors (MACs) have prioritized the identification of instances where hospitals have billed brief inpatient admissions as outpatient observation stays (Wright et al., 2023). Consequently, hospitals have responded by escalating their utilization of observation stays as a means to circumvent audits.
Harrington (2021) explains the process for RACs with numerous crucial phases to conducting an audit for the RAC program. To begin, an RAC will be chosen by the CMS to conduct audits in a given area (Harrington, 2021). The Medicare fee-for-service claims database is searched by the RAC for overpaid claims (Harrington, 2021). When audits are conducted of any kind, medical policies, coding guidelines, and payment regulations are all applied to claims data analysis which is important those are set in place before hand. Harrington (2021) further explains, the contractor conducting the recovery audit will contact the provider whenever it suspects billing irregularities and request additional information to determine if an error payment was made. If the auditor requests medical records or other documentation, the provider has 30 days to furnish it (CMS.gov, 2023). In order to determine if an overpayment or an underpayment occurred, the RAC looks over the supplementary materials. A claim decision letter is sent to the provider or supplier when a RAC discovers an incorrect payment during an audit. Overpayments can be refunded or disputed by submitting paperwork from the provider. CMS.gov (2023) also indicates that the provider has 60 days to repay any overpayments if it agrees with the findings. The provider can use the regular Medicare appeals procedure to dispute any incorrect payment findings. Only when the auditors find instances of waste, fraud, or abuse do RACs receive compensation (CMS.gov, 2023). The goal of this setup is to have RACs concentrate their audit efforts where they are most likely to find fraudulent payments. Some doctors, however, say the RACs incentives to find cases of poor care under this system of payments are perverse (CMS.gov, 2023).
Due to the complex nature of audits and the extensive amounts of data and evidence that must be collected in order to conduct one, it is crucial for healthcare executives and administrators to collect the necessary documents for each, and every claim submitted. Harrington (2021) states that in 2007, the RAC succeeded in correcting over 1.03 billion dollars of improper Medicare payments, that is over 96 percent being overpayments, and the remaining 4 percent underpayments, all being repaid by providers. The utilization of an audit can serve as an opportunity to foster healthcare personnel’s provision of feedback to one another, while also facilitating the expression of concerns to organizational leaders and promoting active involvement in the governance of the healthcare institution (Hut-Mossel et al., 2021). This in a sense shines a light on the healthcare administrators and its leaders to ensure all proper procedures are followed and regulations are implemented to prepare for audits, and to simply be well organized so that overpayment or underpayment does not occur at all.
Matthew 7:16-17 teaches, “The come to you in sheep’s clothing, but inwardly they are ferocious wolves. By their fruit you will recognize them. Do people pick grapes from thornbushes, or figs from thistles? Likewise, every good tree bears good fruit, but a bad tree bears bad fruit” (The English Standard Version Bible, 2001). Sincerity and lack of deception are significant qualities of honesty. We all sin and find it easy, thus honesty is something we must work for despite the fact it should be a Christian trait. Integrity is important in relationships with not only those in our personal lives, but also those in our professional lives.
References
CMS.gov. (2023). Medicare Program Integrity Manual. Chapter 3 – Verifying Potential Errors and Taking Corrective Actions. CMS.gov. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/pim83c03.pdfLinks to an external site.
CMS.gov. (2023). Part D RAC Audit Processes. CMS.gov. https://www.cms.gov/data-research/monitoring-programs/part-c-d-recover-audit-program/part-d-rac-audit-processLinks to an external site.
Harrington, M. (2021). Healthcare Finance and the Mechanics of Insurance and Reimbursement. Jones & Bartlett Learning.
Hut-Mossel, L., Ahaus, K., Welker, G., & Gans, R. (2021). Understanding how and why audits work in improving the quality of hospital care: A systematic realist review. Plos One. https://doi.org/10.1371/journal.pone.024867Links to an external site.
The English Standard Version Bible. (2001). Crossway Bibles.
Wright, B., Parrish, C., Basu, A., Maddox, K., Liao, J., Sabbatini, A. (2023). Medicare’s hospital readmissions reduction program and the rise in observation stays. Health Services Research. https://doi.org/10.111/1475-6773.14142Links to an external site.
Each reply must incorporate at least 2 scholarly citations, course textbook and 1 instance of biblical integration in current APA format.
course textbook:
Harrington, M. K. (2021). Health Care Finance and the mechanics of Insurance and Reimbursement. Jones & Bartlett Learning.
I want you to pick any clinical quality problem and apply either an experimental or quasi-experimental design for quality improvement. Which design would you use and why? What are the strengths and weakness of this chosen design method? (Make sure when you answer, you tell me what quality problem you are trying to improve –CAUTI, CLABSI, FALL’s, are some examples)
Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Patricia was called at work by a woman at the local day care center. She told Patricia to come and pick up her son because he was not feeling well. Her son, 3½-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red, and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.
Why did Marshall’s presentation lead Patricia to think he had influenza and not a cold? Why is it important to medically evaluate and diagnose a potential influenza infection?
Describe the pathophysiology of the influenza virus. Outline the properties of influenza A antigens that allow them to exert their effects in the host.
Marshall may be at risk of contracting secondary bacterial pneumonia. Why is this so? Explain why cyanosis may be a feature associated with pneumonia.
In your discussion, be sure to evaluate the presence and effects of alterations in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.
Case Study Assignment Requirements
Make sure all of the topics in the case study have been addressed.
Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Wendy is a 30-year-old, unemployed white female. She is no stranger to therapy, having seen counselors for most of her teen and adult years. Her friends would describe her as a “wild woman” who takes no crap from anyone. She has held various part-time jobs for the last few years because she usually gets angry at her boss or coworkers and quits. While she has had a string of boyfriends over the years, she has been seeing one man for the last year or so. He too is unemployed and has both an alcohol and methamphetamine problem. She describes the relationship as “addictive and dysfunctional, yet exciting and hot.” Wendy is back in treatment at the urging of her parents, who describe her behavior as erratic and unpredictable. They also claim that she has periods where she “sleeps little and parties lots.” There were also several occasions in the last five years when she was so depressed she didn’t eat or want to leave the house. Her father also admits to periods of depression, and Trisha’s grandfather was diagnosed with manic depression, resulting in numerous hospitalizations in the 1950s and 1960s. Wendy’s only brother died in a car accident several years ago. He was drunk at the time, but she claims he had a long history of depression. Recently Trisha was arrested for disorderly conduct at a friend’s party. She had not slept for nearly 24 hours and was drunk and combative. When she was first approached by police, she solicited them for sex. They report that she was rather hyperverbal and hyperactive. They later had to investigate a complaint from local storeowners for bad checks she wrote in excess of $7,000.
Summarize the clinical case.
Create a list of the patient’s problems and prioritize them.
Which diagnosis should be considered/ Depressive disorder with manic episodes
What is your rationale for the diagnosis
What differential diagnosis should be considered/ MDD, Bipolar I Disorder, Bipolar II Disorder
What test or screening tools should be considered to help identify the correct diagnosis/Mood Disorder Questionnaire (MDQ)/Young Mania Rating Scale (YMRS):
What treatment would you prescribe and what is the rationale (consider psychopharmacology, diagnostics tests, referrals, psychotherapy, psychoeducation) Combination of medication and psychotherapy. /Mood stabilizers, such as lithium or anticonvulsant medications like valproate or lamotrigine, are often prescribed to manage manic symptoms. Antidepressants may also be prescribed for the depressive symptoms, but caution is needed as they can potentially trigger or worsen manic episodes. Psychotherapy: Different forms of psychotherapy can be beneficial for individuals with MDD and mania.CBT, IPT.
What standard guidelines would you use to assess or treat this patient
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Submission Instructions
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 evidence-based sources.
Please follow the instructions provided in the document, and refer to the example given at the bottom for guidance. Utilize the nursing diagnosis page to assist in answering the provided questions.
Unformatted Attachment Preview
NAANDA APPROVED NURSING DIAGNOSES
PHYSICAL PROBLEMS
BOWEL
• Bowel incontinence
• Constipation
• Colonic constipation
• Perceived constipation
• Constipation, Perceived
• Constipation, Risk for
• Constipation, Chronic Functional
• Constipation, Risk for Chronic Functional
• Contamination
• Contamination, Risk for
• Diarrhea
• Gastrointestinal Motility, Dysfunctional
• Gastrointestinal Motility
• Risk for Dysfunctional Gastrointestinal
• Perfusion, Risk for Ineffective
CIRCULATION
• Tissue Perfusion, Ineffective Peripheral
• Tissue Perfusion, Risk for Ineffective Peripheral
• Tissue Perfusion, Risk for Decreased Cardiac
• Tissue Perfusion, Risk for Ineffective Cerebral
• Bleeding, Risk for
• Cardiac Output, Decreased
• Cardiac Output, Risk for Decreased
• Cardiovascular Function, Risk for Impaired
• Shock, Risk for
• Surgical Recovery, Delayed
• Surgical Recovery, Risk for Delayed
• Vascular Trauma, Risk for
FLUID/HYDRATION
• Fluid volume deficit
• High risk for fluid volume deficit
• Fluid volume excess
• Fluid Volume, Risk for Deficient
• Fluid Volume, Risk for Imbalanced
• Fluid Balance, Readiness for Enhanced
• Electrolyte Imbalance, Risk for
ENDOCRINE
• Blood Glucose Level, Risk for Unstable
INFANT FEEDING/BREASTFEEDING PROBLEMS
• Effective breast-feeding
• Ineffective breast-feeding
• Interrupted breast-feeding
• Ineffective infant feeding pattern
•
•
•
•
•
•
•
Insufficient Breast Milk
Readiness for enhanced Breastfeeding,
Liver Function, Risk for Impaired
Jaundice, Neonatal
Jaundice, Risk for Neonatal
Sudden Infant Death Syndrome, Risk for
Suffocation, Risk for
MOBILITY ACTIVITY
• Activity Intolerance
• High risk for activitiy intolerance
• Diversional activity deficit
• High risk for disuse syndrome
• Transfer Ability, Impaired
• Activity Intolerance
• Activity Intolerance, Risk for
• Activity Planning, Ineffective
• Activity Planning, Risk for Ineffective
• Decreased Intracranial Adaptive Capacity
• Lifestyle, Sedentary
• Mobility, Impaired Bed
• Mobility, Impaired Physical
• Mobility, Impaired Wheelchair
• Sitting, Impaired
• Standing, Impaired
• Walking, Impaired
• Wandering
NEUROLOGIC DYSFUNCTION
• Autonomic Dysreflexia
• Autonomic Dysreflexia, Risk for
• Memory, Impaired
• Peripheral Neurovascular Dysfunction, Risk for
NUTRITION/EATING
• Nutrition, Imbalanced: Less than Body
Requirements
• Nutrition, Readiness for Enhanced
• Obesity
• Risk for Overweight
• Overweight
• Nausea
• Swallowing, Impaired
PAIN
•
•
•
•
•
Pain, Acute
Pain, Chronic
Pain Syndrome, Chronic
Pain, Chronic Malignant
Pain, Chronic Nonmalignant
•
PHYSICAL SAFETY/PROTECTION
• Altered protection
• Dysreflexia
• High risk for infection
• High risk for injury
• High risk for poisoning
• High risk for trauma
• Trauma, Risk for
• Sensory/perceptual alterations
• Unilateral neglect
• Infection, Risk for
• Injury, Risk for Corneal
• Falls, Risk for
• Injury, Risk for Perioperative-Positioning
• Injury, Risk for Thermal
• Injury, Risk for Urinary Tract
• Self-Mutilation
• Self-Mutilation, Risk for
• Suicide, Risk for
RESPIRATORY/BREATHING
• Airway Clearance, Ineffective
• Allergy Response, Risk for
• Risk for Aspiration,
• High risk for suffocation
• Inability to sustain spontaneous ventilation
• Dysfunctional ventilatory weaning response
• Ineffective airway clearance
• Ineffective breathing pattern
• Spontaneous Ventilation, Impaired
• Ventilatory Weaning Response, Dysfunctional
REST/SLEEP
• Fatigue
• Sleep, Readiness for Enhanced
• Sleep Deprivation
• Sleep Pattern, Disturbed
• Insomnia
SELF-CARE
• Bathing/Hygiene self-care deficit
• Feeding self-care deficit
• Toileting self-care deficit
• Self-Care, Readiness for Enhanced
• Self-Care Deficit, Bathing
• Self-Care Deficit, Dressing
• Self-Care Deficit, Feeding
• Self-Care Deficit, Toileting
• Self-Concept, Readiness for Enhanced
Self-Neglect
SEX/SEXUALITY
• Altered sexuality patterns
• Sexual dysfunction
• Sexuality Pattern, Ineffective
SKIN/MUCOUS MEMBRANE
• Impaired Oral Mucous Membrane
• Risk for Impaired Oral Mucous Membrane
• High Risk for impaired tissue integrity
• Impaired tissue integrity
• Dry Eye, Risk for
• Skin Integrity, Impaired
• Skin Integrity, Risk for Impaired
• Latex Allergy Response
• Latex Allergy Response, Risk for
• Pressure Ulcer, Risk for
TEMPERATURE
• Body Temperature, Risk for Imbalanced
• High risk for altered body temperature
• Hyperthermia
• Hypothermia
• Hypothermia, Risk for
• Hypothermia, Risk for Perioperative
• Reaction to Iodinated Contrast Media, Risk for
• Protection, Ineffective
• Thermoregulation, Ineffective
URINARY/VOIDING
• Altered urinary elimination
• Reflex incontinence
• Total incontinence
• Urinary retention
• Elimination, Readiness for Enhanced Urinary
• Incontinence, Functional Urinary
• Incontinence, Overflow Urinary
• Incontinence, Reflex Urinary
• Incontinence, Risk for Urge Urinary
• Incontinence, Stress Urinary
• Incontinence, Urge Urinary
• Renal Perfusion, Risk for Ineffective
PSYCHOSOCIAL
COMMUNICATION, THINKING, KNOWLEDGE
• Altered thought processes
• Knowledge/skills deficit
• Knowledge, Deficient
• Knowledge, Readiness for Enhanced
•
•
•
•
•
•
Impaired verbal communication
Comfort, Readiness for Enhanced
Communication, Readiness for Enhanced
Confusion, Acute
Confusion, Chronic
Confusion, Risk for Acute
COPING/ADJUSMENT
• Anxiety
• Defensive coping
• Ineffective individual coping
• Coping, Compromised Family
• Coping, Defensive
• Coping, Disabled Family
• Coping, Ineffective Community
• Coping, Readiness for Enhanced
• Coping, Readiness for Enhanced Community
• Coping, Readiness for Enhanced Family
• Diversional Activity, Deficient
• Decisional conflict
• Fear
• Grieving
• Anticipatory grieving
• Dysfunctional grieving
• Grieving, Complicated
• Grieving, Risk for Complicated
• Hope, Readiness for Enhanced
• Hopelessness
• Human Dignity, Risk for Compromised
• Impaired adjustment
• Ineffective denial
• Power, Readiness for Enhanced
• Powerlessness
• Powerlessness, Risk for
• Stress Overload
• Relocation stress syndrome
• Relocation Stress Syndrome, Risk for
• Spiritual distress
• Social Interaction, Impaired
• Social Isolation
• Sorrow, Chronic
• Spiritual Distress
• Spiritual Distress, Risk for
• Spiritual Well-Being, Readiness for Enhanced
• Religiosity, Impaired
• Religiosity, Readiness for Enhanced
• Religiosity, Risk for Impaired
• Death Anxiety
• Decision-Making, Readiness for Enhanced
• Decisional Conflict
• Denial, Ineffective
•
•
•
•
Emancipated Decision Making, Impaired
Emancipated Decision Making, Readiness for
Enhanced Emancipated Decision Making. Risk
for Impaired
Emotional Control, Labile
Impulse Control, Ineffective
FAMILY & GROWTH/DEVELOPMENT
• Attachment, Risk for Impaired
• Altered family processes
• Family Processes, Dysfunctional
• Family Processes, Interrupted
• Family Processes, Readiness for Enhanced
• Altered growth and development
• Development, Risk for Delayed
• Growth, Risk for Disproportionate
• Altered parenting
• High risk for altered parenting
• Caregiver role strain
• High risk for caregiver role straing
• Family coping: potential for growth
• Ineffective family coping: compromised
• Role Conflict, Parental
• Role Performance, Ineffective
• Role Strain, Caregiver
• Role Strain, Risk for Caregiver
• Parenting, Impaired
• Parenting, Readiness for Enhanced
• Parenting, Risk for Impaired
• Dentition, Impaired
• Frail Elderly Syndrome
• Frail Elderly Syndrome, Risk for
• Resilience, Impaired
• Resilience, Readiness for Enhanced
• Resilience, Risk for Impaired
HEALTH MANAGEMENT
• Altered health maintenance
• Health-seeking behavior
• Impaired home maintenance management
• Ineffective management of therapeutic
regimen
• Noncompliance
• Health, Deficient Community
• Health Behavior, Risk-Prone
• Health Maintenance, Ineffective
• Health Management, Ineffective
• Health Management, Readiness for Enhanced
• Health Management, Ineffective Family
• Home Maintenance, Impaired
INFANT BEHAVIOR
• Behavior, Disorganized Infant Behavior
• Readiness for Enhanced Organized Infant
Behavior,
• Risk for Disorganized Infant
• Mood Regulation, Impaired
• Loneliness, Risk for
• Moral Distress
ROLE/RELATIONSHIP
• Altered role performance
• Impaired social interaction
• Social Isolation
• Relationship, Ineffective
• Relationship, Risk for Ineffective
• Relationship, Readiness for Enhanced
SELF-ESTEEM
• Body image disturbance
• Self-esteem disturbance
• Chronic low self-esteem
• Situational low self-esteem
• Personal Identity, Disturbed
• Personal Identity, Risk for Disturbed
• Self-Esteem, Chronic Low
• Self-Esteem, Risk for Chronic Low
• Self-Esteem, Situational Low
• Self-Esteem, Risk for Situational Low
VIOLENCE
• High risk for self-mutilation
• Self-Directed Violence, Risk For
• Other-Directed Violence, Risk for
• Post-trauma responses
• Rape-trauma syndrome
• Rape-trauma syntdrome: compound reaction
• Post-Trauma Syndrome
• Post-Trauma Syndrome, Risk for
MATERNITY
Childbearing Process, Ineffective
• Childbearing Process, Readiness for Enhanced
• Childbearing Process, Risk for Ineffective
• Comfort, Impaired
• Maternal/Fetal Dyad, Risk for Disturbed
• Pain, Labor
Student :
Date:
Initials
Room:
Patient Data Form Pediatrics
Current Diagnosis / Surgery / Priorities:
AM Report
Adm. Date:
VS / pain assessment (rate 0 – 10)
Frequency:
Time
T
P
R
BP
AGE:
M / F
Weight:
Pain
ALLERGIES:
Teach/psychosocial/
cultural, D/C needs:
Fluids / Nutrition:
Activity
/Restraints /
Isolation :
Diet / Feeding method
Activity
Calming/Pain needs:
GT feeds:
RN
Development needs:
Safety precaut.
CNA
Labs / Diagnostics
MD
IV solution /rate:
Additional notes:
Respiratory
Time O2 L/min
Teaching Needs:
IV site/type:
O2 Sat
Rx
24 hour fluid calc.
INTAKE & OUTPUT
IN – Mntnce.
1X
1.5 X
___ mL/day
___ mL/day
___ mL/hr
___ mL/hr
Treatments / Tests
Parent
present?
Notes:
Y/N
Isolation:
❑ Mask
❑ Gloves
❑ Gown
Cultural/Spiritual:
Wounds/Drains:
Discharge:
I&O During Shift
Intake Output Net
__mL
___mL
+/- mL
Physical Assessment (Head-to-toe)
Off Shift Report:
Gen.:
Skin:
HEENT:
Pulses: (radial / femoral / pedal)
Cardiac:
Resp.:
Abd.:
Neuro:
Extremities (orthopedic: neurovascular assessment):
Wounds (location / drainage / dressing/tubes/drains):
G&D:(eg) Erikson, Piaget, physical, gross/fine motor, language, socialization, cognition, etc):
Safety check: Perform when enter room + check and document when you leave
❑ O2 Sat monitor: Alarms set + Site rotation
LOW sat _______ HIGH sat _______
❑ Apnea monitor: Alarms set LOW RR _______ HIGH RR _________ Apnea time _______________
❑ Cardiac monitor: Alarms set
LOW Heart rate _______ HIGH Heart rate ________ RATE matches apical________
(Update May 2021)
❑ IV fluid / rate – matches order
❑ Infusion device set
❑ IV tubing – dates checked
❑ Oxygen ordered level ______
❑ Suction working
❑ Suction supplies @ bedside
❑ Bag & mask – appropriate size
❑ Face shield
❑ No choking hazards (
Purchase answer to see full
attachment
Please read the following chapter and respond to the following questions.
Manualized Cognitive theraphy for anxiety and depression.pdf( attached)
1-What are the pros and cons of using a CBT treatment manual with adults?
Discuss fidelity with flexibility.
2. What is an automatic negative thought that you “catch” yourself saying to yourself in times of stress?
3. CBT requires collaboration and active participation from the participant. If you are working with a highly anxious adult female patient, what strategies might you use to help her cope with the anxiety using this modality?
4. With the content of the sessions described and the skills taught, what do you think will be the more challenging skills? Please use examples and cite the literature?
Criteria
Meets Criteria
Partially Meets Criteria
Does Not Meet the Criteria
Assessment: Discuss assessment findings and behaviors which meet your DSM-5 criteria; describe further assessment/screening tools which you would recommend to validate the diagnosis
Correctly identifies DSM-5 criteria to correlate with recognized diagnosis/differential diagnosis; screening tools specify and connect with diagnosis.
Identifies the most important findings and misses some minor ones. It doesn’t present results from all sections completed
Identifies some abnormal or pertinent findings but misses significant findings. Results come from only 50% of the sections completed.
Interprets findings correctly, considering pathological, social, lifestyle, and genetic components.
The interpretation is correct. All pertinent details are discussed.
The interpretation is correct. Details consider the most relevant areas.
Interpretation is correct or partially correct. Minimal information is provided. All pertinent areas are not addressed.
Diagnosis: Identify and Discuss your DSM-5 and differential diagnoses (including psychiatric and physical diagnoses).
identifies at least 1 DSM-5 diagnosis and two differential diagnoses, including psychiatric and physical diagnosis
identifies only 1 DSM-5 diagnosis and one differential diagnosis
does not identify a DSM-5 diagnosis or differential diagnosis
Supporting Research: Incorporate at least one scholarly evidence-based article that relates to your identified and differential diagnoses and can guide your treatment plan.
Discusses one scholarly evidence-based article which correlates with diagnosis/differential diagnosis and identifies how to guide the treatment plan
Discusses the article, but the writing is not considered a scholarly evidence-based source.
It does not discuss the scholarly, evidence-based article
Reference: APA format Writing: Sentence structure, spelling, grammar
APA format followed with no errors; correct sentence structure and grammar usage.
APA format followed but with several errors and spelling/grammar errors.
APA format not followed; sentence structure incomplete and numerous grammar errors
Thesis Statement: “Despite numerous advancements in healthcare in the United States, maternal mortality remains an acute health issue in the country, disproportionately affecting minority communities and other disadvantaged populations. This research aims to uncover the primary factors contributing to maternal mortality, assess the impact of socioeconomic disparities on maternal health outcomes, and propose evidence-based interventions to curb maternal mortality rates across diverse populations, promoting equitable access to maternal care.”
Final Paper- (30 points) 30% weight
Thesis statement – See http://owl.english.purdue.edu/owl/resource/545/01/ for examples of types of thesis statements. Your thesis statement should appear in the within the first two paragraphs of your paper.
The paper is limited to 10-15 pages only, not including references, cover page, abstract
Paper Focus: Find a topic of interest to you in public health and develop your paper around a question you have regarding this topic. You may want to analyze a public health intervention or propose your own intervention to a public health problem. For instance, teenage pregnancy has been regarded as a public health problem. Your paper may question whether sex education is more effective, at combating teenage pregnancy, over abstinence only education.
Your paper should cite research in your review of literature. Including a description of the public health problem indicating the burden of disease, such as but not limited to morbidity, mortality, and changes that have occurred in recent years. Describe the course of the disease or condition using the concepts of incidence, prevalence and case-fatality. If these concepts are not relevant to your subject explain what they mean and why they are not relevant. Identify at least one at-risk group (those with an increased probability of developing and/or experiencing bad outcomes). Use the concept of relative risk to describe their probability of developing the condition or specific disease(s) relative to a specific low risk group.
Identify a potential intervention to address the problem. Identify the primary focus in terms of When (Primary, secondary or tertiary prevention), Who (individual, at-risk group, population) and How (education, motivation, obligation, invention).
Critically analyze the topic and intervention. Indicate the advantages and disadvantages of each intervention that you selected and why they would be effective. Indicate methods that you would use to implement the intervention.
Students will select an issue in public health from the Healthy People 2030 10 Leading Health Indicators that you would like to research further. Do some initial research, create a Draft Thesis Statement for instructor’s review (draft will be emailed to instructor on specified date given in class), carry out additional library research, and write a paper using APA 6th Style. See Grading Criteria below for expectations.
Unformatted Attachment Preview
Addressing Maternal Mortality Disparities: A Comprehensive Analysis and Strategy for
Equitable Maternal Healthcare
One of the most compelling health indicators from Healthy People 2030 that I am
particularly interested in and find worthy of further research is “Maternal Mortality.” Maternal
mortality is defined as the death of a woman during pregnancy, during childbirth, or within 42
days of pregnancy termination. It disregards the site or duration of the pregnancy, and evaluates
deaths aggravated or related to the pregnancy and/or its management, with an exception of
incidental or accidental causes of death.
Thesis Statement: “Despite numerous advancements in healthcare in the United States,
maternal mortality remains an acute health issue in the country, disproportionately affecting
minority communities and other disadvantaged populations. This research aims to uncover the
primary factors contributing to maternal mortality, assess the impact of socioeconomic
disparities on maternal health outcomes, and propose evidence-based interventions to curb
maternal mortality rates across diverse populations, promoting equitable access to maternal
care.”
The thesis statement underpins the importance of the issue (maternal mortality/care),
denotes the present disparities, and offers a foundation and direction for the research in
understanding causes and potential interventions to deal with the health issue. Further research
on the issue of maternal mortality is necessary and crucial for the achievement of the Healthy
People 2030 goal of elimination of preventable maternal deaths and the improvement of maternal
health outcomes for all women across different social, ethnic, and economic groups.
Choose a topic from the list provided to you by your course faculty. Apply the concepts of population health and epidemiology to the topic.
Synthesize Course content from Weeks 1-5 according to the following sections:
Introduction: Analysis of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) to include demographic break down that includes age, gender, race, or other at-risk indicators (da ta per demographics should include mortality, morbidity, incidence, and prevalence).
Determinants of Health: Define, identify and synthesize the determinants of health as related to the development of the infection. Utilize HP2020.
Epidemiological Triad: Identify and describe all elements of the epidemiological triad: Host factors, agent factors (presence or absence), and environmental factors. Utilize the demographic break down to further describe the triad.
Role of the NP: Succinctly define the role of the nurse practitioner according to a national nurse practitioner organization ( National Board of Nursing or AANP, for example) and synthesize the role to the management of infectious diseases (surveillance, primary/secondary/tertiary interventions, reporting, data collecting, data analysis, and follow-up). This includes the integration of a model of practice which supports the implementation of an evidence-based practice. Refer to your course textbook for models of practice examples.
Application: Use Microsoft Word™ to create the written assessment.
Length: The paper (excluding the title page and reference page) should be limited to a maximum of four (4) pages. Papers not adhering to the page length may be returned to you for editing to meet the length guidelines.
A minimum of three (3) scholarly research/literature references must be used. CDC or other web sources may be utilized but are not counted towards the three minimum references required. Your course text may be used as an additional resource but is not included in the three minimum scholarly references.
APA format current edition.
Include scholarly in-text references and a reference list.
Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of student created original work for assignments.
Do not write in the first person (such as “me” “I”)
Read the following:“Immunization Information Systems (IIS) Functional Standards”Interactive Activity 7PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action ItemsDescribe one of the functional standards of the Immunization Information Systems and explain its importance thoroughly and completely.Ensure your responses are at least six lines long. make it short
Students in their first graduate level pharmacology course are confused with the recommendations for hypertension (HTN) and treatment choices after ST-elevation myocardial infarction (STEMI) and with heart failure (HF). The drugs used several years ago and still seen commonly on the acute care floors the students work are not the ones now assuming a stronger role in cardiac health issues. For one, the primary order of which meds are selected for an initial level of blood pressure control has seemed to change.Help your fellow students by explaining the following changes.Which classification of drugs has taken the first-choice role in most patients with early hypertension? Is it wrong to select a thiazide diuretic or a beta blocker as was once done?Is there another primary choice for African American patients? Why?
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10/12/23, 12:01 AM
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Case Study Rubric – 20 Pts
Course: NSG6005-Advanced Pharmacology CP03
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Answered
items
completely.
Developed
adequate
responses to
questions. Plan
shows depth
and
application of
course
concepts.
Student did not
submit case
study.
Case study does
not meet
expectations;
plan has no
depth or has
inaccurate
elements listed.
Case study
meets minimal
expectations
with minimal
development of
portions of case
study.
Case study
meets
expectations by
including good
depth for all
elements of plan
but does not
demonstrate
good application
of course
content.
Case study
meets or exceeds
expectations
with creative,
innovative
strategies for
case study.
Identified and
described
pharmacologic
al concepts
and care as
needed.
Student did not
submit case
study.
Case study does
not meet
expectations; no
resources listed.
Case study
meets minimal
expectations
with few
resources listed.
Case study
meets
expectations;
resources listed
are well
developed in all
but a few areas.
/8
Case study
meets or exceeds
expectations
with all resources
well developed
(i.e., textbook,
peer-reviewed
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0
points did not
Student
Emerging
1
point
Numerous
issues
Satisfactory
2
points
Case
study
Proficient
3
pointserrors that
Minor
Exemplary
4
points
Case
study
Criterion
Score
/4
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
Criteria
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
Criterion Score
/8
format.
Total
/ 20
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582502&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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10/12/23, 12:01 AM
Criteria
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
format.
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
articles).
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Criterion Score
No Submission
0 points did not
Student
Emerging
1 point
Numerous
issues
Satisfactory
2 points
Case
study
Proficient
3 pointserrors that
Minor
Exemplary
4 points
Case
study
Score
/Criterion
4
submit case
study.
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
do not distract
from overall case
study.
meets or exceeds
expectations in
all areas of case
study.
Total
/ 20
Overall Score
No Submisssion
Emerging
Satisfactory
Proficient
Exemplary
0 points minimum
12 points minimum
14 points minimum
16 points minimum
18 points minimum
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582502&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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please see annotated paper and make corrections please. Please revise the paper as needed and keep it the 10 page limit (except appendicies and references) (sample is included) I think the title on all should be my picot question. Please see rubric attached, please add 2 background question to the introduction (section 1) and make sure to answer those background questions in the literature review section.Please modify poster as appropriate (attached)
Unformatted Attachment Preview
1
The Impact of Oral Contraceptives and IUDs as Contraceptive Methods for Obese Women
Ages 25-40
AN ASSIGNMENT
SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
DEGREE OF MASTER OF SCIENCE IN NURSING
IN THE GRADUATE SCHOOL OF THE
TEXAS WOMAN’S UNIVERSITY
COLLEGE OF NURSING
BY
DANIELLE MITCHELL
NURS 5695: PRECEPTORSHIP II
DR. JANET WHEAT
OCTOBER 1, 2023
2
The Impact of Oral Contraceptives and IUDs as Contraceptive Methods for Obese
Women Ages 25-40
Although women using contraceptive methods have relatively successful rates, many
develop complications in their adult lives. The debate on the impact of obesity on women using
contraception continues to invoke various options across the board. Understanding the extent to
which hormonal and non-hormonal contraceptive devices contribute to complications in obese
women is integral to developing measures that act as interventions for the most adverse methods.
This paper aims to critically compare the impact of oral contraceptives and IUDs as
contraceptive methods for obese women ages 25-40, assessing which of the two groups is at
higher risk of developing blood clots.
Significance
Researchers widely acknowledge the association between obesity and the excess estrogen
in hormonal contraceptive methods to pose cardiovascular risks. While even moderately healthy
women suffer the risk of being affected by cardiovascular complications, obese women often
have underlying issues that enhance the probability of the risks manifesting much earlier in their
lives (Manrique-Acevedo et al., 2020). This research is necessary to establish the connection
between the oral contraceptive pill and blood clot formation in obese women.
Background
While exploring the connection between contraceptives, obesity, and chronic blood clots,
it is important to understand whether oral contraceptive pills and IUDs are responsible for the
same results. In this case, the major issues are the relationship between contraception in obesity
and the formation of blood clots. In addition, obese women can prevent the cardiovascular risks
associated with contraceptive methods if there is clear evidence of these risks. The purpose of the
Commented [LN1]: This needs to be re-centered
3
study is to establish the etiology of blood clots in obese women who are under specific
contraceptive treatments.
PICOT Question
Are obese women ages 25 to 40 (P) who take oral contraceptives at greater risk (I) for
developing blood clots (O) compared with obese women ages 25 to 40 (P) who use IUDs for
contraception (C) over a 5-year time frame (T)?
ACE Theoretical Model
The ACE theoretical model allows researchers to perform research in five critical stages:
discovery, evidence summary, translation, integration, and evaluation. The evidence-based
project (EBP) would require a qualitative approach to determine whether obese women under
various contraception methods are at risk of having blood clots. In this case, using unstructured
interviews as a qualitative research methodology, women would be assessed to determine the
truth in this hypothesis. Evidence summary would allow the researchers to record all primary
evidence condensing the information into meaningful syntheses (Khialani et al., 2020). The
research would synthesize the raw data on obese women and the contraception indications,
where new findings could be plausible. Translation of the material aims to provide the
practitioners with a document they can implement. Integration requires that practitioners
implement the findings and mitigation procedures they find as they perform the study (Khialani
et al., 2020). The researchers in the study would be inclined to suggest clinical practices that
prevent obese women from experiencing heightened risks in using contraceptive methods meant
to help them. Evaluating the material ensures that the EBP outcomes are desirable, or
implementation can positively change the quality of care and improve patient and provider
satisfaction.
4
Search Strategy and Levels of Evidence
The search strategy started with defining the research question, which was “Are obese
women ages 25 to 40 (P) who take oral contraceptives at greater risk (I) for developing blood
clots (O) compared with obese women ages 25 to 40 (P) who use IUDs for contraception (C)
over a 5-year time frame (T)?” The population included obese women of reproductive age. The
intervention studied was contraceptive use, and the comparison was oral or IUD use. The
outcome was a blood clot, and the study design was either randomized controlled trials,
observational studies, or reports published in English. A search for relevant keywords then
followed this. Keywords used included contraceptive, obesity, blood clot, deep vein thrombosis,
and pulmonary embolism. The search was done in different databases, including MEDLINE,
EMBASE, Cochrane Library, PubMed, CINAHL, Web of Science, and Scopus.
Through an online database search, 21 studies were obtained. It is also important to note
that some of these studies were obtained by searching through the reference lists of the already
obtained studies. After excluding all the duplicates and those not perfectly aligned with the
research topic, 12 studies remained. With further screening, including a full-text review of each
article, 6 studies were finally considered for review in this project (See Appendix). The Johns
Hopkins Nursing Evidence-Based Practice (JHNEBP) rating scale was adopted in evaluating the
references.
Literature Review
Current literature has indicated a connection between formation of blood clots and oral
contraception use. Rambaran and Alzghari (2020) have explored this topic extensively. This
systematic review was carried out by searching PubMed from inception to April 2018 for
relevant articles published in English. The results herein showed that obese women who used
5
oral contraceptives were at a higher risk than nonusers of developing blood clots (Rambaran &
Alzghari, 2020). This study explained the current statistics showing that over 400 women in the
US die every year related to their use of oral contraception (Rambaran & Alzghari, 2020).
The results are similar to findings by Khialani et al. (2020) who explored the relationship
between combined oral contraception and the risk of venous thromboembolism. The study is a
systematic review of 86 articles. The result of this study indicated that even though venous
thromboembolism is a considerably rare condition, the risk of obese women developing it
significantly increases when they use oral contraceptives (Khialani et al., 2020). Nonetheless,
different from other studies, the researchers assert that the benefits of the different oral
contraceptives in preventing pregnancies outweigh the risks for obese women (Khialani et al.,
2020). This study included a review of different studies, and for this reason, it was assigned a
rate of one on the JHNEBP rating scale.
Another study was carried out to update current knowledge on the relationship between
oral contraceptive pills and cerebral venous sinus thrombosis risk. The study also aimed to
examine the impact of other forms of hormonal contraceptives, duration, type, and health
condition of the woman on this relationship (Abdalhabib et al., 2022). This study was a
systematic review and meta-analysis in which a search was performed to identify a series of
published articles on the relationship between the use of hormonal contraceptives and the risk of
blood clots among obese women between 15 and 50 years of age (Abdalhabib et al., 2022). The
researchers reviewed only 11 of the 861 studies identified from the search. The results of this
review show that using oral contraceptive pills significantly increases the risk of obese women of
reproductive age developing cerebral venous sinus thrombosis (Abdalhabib et al., 2022).
However, the researchers quickly note that the available data remains inadequate to draw
6
definitive conclusions regarding how the duration of the use of contraceptives affects this
relationship. On the JHNEBP rating scale, this study was rated one since it extensively reviewed
data from other studies.
LaVasseur et al. (2022) conducted a study to examine the differences in the risk of
thrombosis in different methods of contraception and their interaction with different patientcentered factors. This study was based on the understanding that different methods of
contraception have been closely linked to venous thromboses. This study involved conducting a
narrative review of a series of studies regarding contraceptives and the risk of blood clots
(LaVasseur et al., 2022). The study results indicated that different contraceptive types have
different risk levels of blood clots for obese women. This is based on the idea that these women
have a higher body mass index while alone is a risk factor for blood clots (LaVasseur et al.,
2022). However, the risk even increases because oral contraceptives contain hormones that
increase the risk of blood clots, more so in women with other risk factors such as a family history
of blood clots, smoking, or obesity. Since this study was a systematic review, it was assigned a
score of one on the JHNEBP rating scale.
Analysis of Literature
Abdalhabib, E. K., Jackson, D. E., Alzahrani, B., Elfaki, E., Hamza, A., Alanazi, F., Ali, E.
I., Algarni, A., & Ibrahim, I. (2022). Assessment of risk factors for deep vein
thrombosis associated with natural anticoagulants and fibrinolytic regulatory
proteins. Blood Coagulation & Fibrinolysis, 33(3), 149–152.
https://doi.org/10.1097/mbc.0000000000001116
The article investigates deep vein thrombosis (DVT) as a critical disease in Africa by
investigating its risk factors paying attention to its natural anticoagulants and fibrinolytic
regulatory proteins. The study is designed to understand the specific roles these regulatory
proteins play in the development of the disease among the Sudanese. A case-control study was
utilized which is level II on the JHNEBP rating scale and a suitable design when investigating
7
this kind of problem. The findings presented would have been more convincing if data had been
collected from more than one facility for the indicated year. The researchers also investigated
the right parameters descriptive of deep vein thrombosis in terms of its regulatory proteins. In
this study, 5.5% of the participants were determined to have Protein C deficiency and 8.5% of
participants were victims of protein S deficiency. 3% were diagnosed with antithrombin III
deficiency. The findings also demonstrate that early assessment of risk factors is important in
improving treatment outcomes of DVT. Overall, the article is straightforward and precise in the
way information is presented.
LaVasseur, C., Neukam, S., Kartika, T., Bannow, B. S., Shatzel, J., & DeLoughery, T. G.
(2022). Hormonal therapies and venous thrombosis: Considerations for prevention
and management. Research and Practice in Thrombosis and Haemostasis, 6(6),
e12763. https://doi.org/10.1002/rth2.12763
The article by LaVasseu et al., 2022, seeks to investigate venous thrombosis as one
complication of hormonal therapy. The study pays attention to the risk of developing thrombosis
in persons using hormonal contraceptive agents. The researchers used a narrative review is data
collection which is an ideal method considering that challenges experienced when collecting data
on hormone-related thrombosis risks. The results indicate that thrombosis risk tends to increase
with an increment in oestrogen dosage. Thrombosis rates increase with age in women aged
above 30 years with an incidence rate of 2–3.7 events/10 000 women using oestrogen and
increases 10.2 times in women using third generation contraceptives. However, the study does
not identify effective management of complications of hormone therapy in patients diagnosed
with prothrombotic illnesses. Also, the article is a narrative review, placing it a level V, the
lowest on the JHNEBP rating scale which is very low quality of evidence.
Rambaran, K., & Alzghari, S. K. (2020). Gamer’s thrombosis: A review of published
reports. Ochsner Journal, 20(2), 182–186. https://doi.org/10.31486/toj.19.0058
8
This article investigates thrombosis as a common condition reported in elderly people
that develops in healthy adolescents. Published articles were reviewed to collect relevant data on
the relationship of immobility and increased risk of developing the VT. 12 out of the 26 articles
used in this study revealed instances where immobility led to the development of venous
thromboembolism, where 2 were fatalities reported. 15 patients were also determined to have
recurrent VT. The risk of developing VT was identified to be 2.33 for obesity which represents a
confidence interval of 95%. These results obtained confirm that immobile people are at a high
risk of developing thrombosis. Obesity, use of birth control and cigarette smoking are some risk
factors identified that can easily be modified. The recommendation for screening for venous
thromboembolism in gamers is justifiable owing to the prolonged sitting hours. The main
limitation of the study is that it is a level V evidence literature review, presenting low quality of
evidence.
Rosano, G. M., Rodriguez‐Martinez, M. A., Spoletini, I., & Regidor, P. A. (2022). Obesity
and contraceptive use: Impact on cardiovascular risk. ESC Heart Failure, 9(6),
3761-3767. https://doi.org/10.1002/ehf2.14104
The article considers obesity and contraceptives containing oestrogen as confirmed risk
factors for cardiovascular disease. The study uses a narrative review making it possible to
identify the latest research, current research and contentious issues about overweight and
cardiovascular risk. The results confirm that overweight women using oral contraceptives are 1224 times more likely to have venous thromboembolism comparing them with non-obese women
that are not on contraceptives. Specifically women using combined oral contraceptives with a
BMI index above 25 had the VT risk increased by 12-fold. These findings reveal the importance
of clinicians considering the body weight and BMI indexes of a person when administrating
contraceptives containing estrogen. Overall, the article is specific in its highlight of the dangers
9
of oral contraceptives for obese women but is a narrative review (Level V evidence rating) which
makes it low quality evidence.
Sultanmuratova, G. U., Babadjanova, G. S., Nazarbayev, J. B., & Kerimova, N. M. (2022).
A safe and effective contraceptive method for women with obesity in the postpartum
period. American Journal of Medicine and Medical Sciences 12(8): 836-839.
https://doi.org /10.5923/j.ajmms.20221208.15
This article investigates the safety levels of using drospirenone-containing combined oral
contraceptive in women of reproductive age determined to be overweight. The study used an
appropriate inclusion criterion in selecting sixty five obese women participants on
contraceptives. 39 participants were diagnosed with polycystic ovary syndrome. These are fertile
women who cannot ovulate. 32 people showed clinical signs indicating that they were infertile
while 22 had functional hyperprolactinemia. The study indicates that oral contraceptives pose a
major risk in complications of young women’s reproductive system. This study is a high
evidence rating (level II) as it is a quasi-experimental study.
Khialani, D., Rosendaal, F., & van Hylckama Vlieg, A. (2020, November). Hormonal
contraceptives and the risk of venous thrombosis. In Seminars in Thrombosis and
Hemostasis 46(8), 865-871. https://doi.org/10.1055/s-0040-1715793
The article by Khialani et al. (2020), seeks to reveal how the risk of developing venous
thrombosis (VT) is influenced by the kind of progestogen contained in oral contraceptives. The
study considers that the component ethinyl estradiol has counteracting effects that minimize the
chances of developing VT. The findings create a good understanding of how novel oestrogens
are developed and determined to have a reduced risk of VT. The study succeeds to reveal the
VT risk of combined oral contraceptives but fails to identify the risks associated with other
methods such as injectable contraceptives and vaginal rings. Other risk factors were identified.
Inherited thrombophilia is an underlying condition indicated to increase the susceptibility to VT
in women using combined oral contraceptives. The incidence rate of VT is 0.36% in cases of
10
mild thrombophilia and 0.64% in severe cases. It is unfortunate that the authors did not research
VT risk in women who switch combined oral contraceptives. The article is a narrative review of
the literature and hence a low level (level V) of evidence. In general, the researchers are justified
by suggesting the importance of identifying high-risk women to recommend alternative
contraception methods.
PICO Solution
Current evidence has highlighted a connection between oral contraception and the risk of
blood clots in obese women. All the studies included in the review have reported a statistically
significant correlation between oral contraception and blood clots such as venous
thromboembolism. The most reliable study is by Khialani et al. (2020) who conducted a
systematic review of 86 articles and reported a positive correlation. These findings indicate that
women of child-bearing age who have obesity and use oral contraception are at higher risks of
blood clots and cardiovascular events. Therefore, the evidence confirms the hypothesized
relationship in the PICO question.
The findings indicate the need for clinical changes in how contraception options are
presented to women. The proposed approach is a clinical guideline for contraception in
considering cardiovascular risks. In women seeking contraception assistance, providers should
assess their BMI to determine whether they are overweight or obese. If they fit in that category,
then the provider should advise on using non-hormonal contraception options such as IUDs. The
ultimate decision on the contraception to use will be made by the patients but providers should
provide education on risks associated and provide alternative contraception methods.
In line with the ACE Star model, the proposed solution reflects the translation to practice
and implementation stages. The proposed solution is a clinical practice guideline for providers
11
working with women in reproductive health. Summary of the evidence (step 2) has shown the
importance of prioritizing non-hormonal methods for obese women and this can be translated to
practice as a guideline (step 3) and implemented through patient education and counselling (step
4). The PICO solution and proposed implementation have been reached through a systematic
process for evaluating the evidence and reaching a conclusion for changes in practice. The
proposed solution, therefore, reflects the EBP process in line with the ACE star model.
Conclusion
The risk of cardiovascular events in people with obesity has long been identified but
other factors may aggravate this risk. The EBP project sought to explore the literature on
hormonal oral contraception and cardiovascular risks in women with obesity. To accomplish the
task, the research was based on the ACE star EBP model and a literature review conducted. Six
articles were included in the review focusing on blood clots risks for oral and IUD contraception.
The evidence shows that women experiencing obesity have a higher risk of blood clots if they
use oral hormonal contraceptives compared to IUDs. These findings confirm the hypothesized
relationship of hormonal contraceptives being associated with increased cardiovascular risks.
This project and findings present significant implications for reproductive healthcare.
Providers and nurses in reproductive care should consider the health risks associated with
contraception methods for their patients. Specifically, professionals should assess patients’ BMI
to determine if they are obese and for obese women, recommendations should be made on
appropriate contraception methods. Healthcare professionals have a responsibility to promote
patients’ safety and best health outcomes. Considering potential health effects of contraception
on the patients is important in ensuring this responsibility is met.
12
References
Abdalhabib, E. K., Jackson, D. E., Alzahrani, B., Elfaki, E., Hamza, A., Alanazi, F., Ali, E. I.,
Algarni, A., & Ibrahim, I. (2022). Assessment of risk factors for deep vein thrombosis
associated with natural anticoagulants and fibrinolytic regulatory proteins. Blood
Coagulation & Fibrinolysis, 33(3), 149–152.
https://doi.org/10.1097/mbc.0000000000001116
Khialani, D., Rosendaal, F., & van Hylckama Vlieg, A. (2020, November). Hormonal
contraceptives and the risk of venous thrombosis. In Seminars in Thrombosis and
Hemostasis 46(8), 865-871. https://doi.org/10.1055/s-0040-1715793
LaVasseur, C., Neukam, S., Kartika, T., Bannow, B. S., Shatzel, J., & DeLoughery, T. G. (2022).
Hormonal therapies and venous thrombosis: Considerations for prevention and
management. Research and Practice in Thrombosis and Haemostasis, 6(6), e12763.
https://doi.org/10.1002/rth2.12763
Manrique-Acevedo, C., Chinnakotla, B., Padilla, J., Martinez-Lemus, L. A., & Gozal, D. (2020).
Obesity and cardiovascular disease in women. International Journal of Obesity, 44(6),
1210-1226. https://doi.org/10.1038/s41366-020-0548-0
Rambaran, K., & Alzghari, S. K. (2020). Gamer’s thrombosis: A review of published reports.
Ochsner Journal, 20(2), 182–186. https://doi.org/10.31486/toj.19.0058
Rosano, G. M., Rodriguez‐Martinez, M. A., Spoletini, I., & Regidor, P. A. (2022). Obesity and
contraceptive use: Impact on cardiovascular risk. ESC Heart Failure, 9(6), 3761-3767.
https://doi.org/10.1002/ehf2.14104
Sultanmuratova, G. U., Babadjanova, G. S., Nazarbayev, J. B., & Kerimova, N. M. (2022). A
safe and effective contraceptive method for women with obesity in the postpartum
13
period. American Journal of Medicine and Medical Sciences 12(8): 836-839.
https://doi.org /10.5923/j.ajmms.20221208.15
14
Appendix
Citation of
Objective,
Search
Inclusion/Exc
Data
SR
Aim, Purpose
Strategy
lusion
Criteria
Results
Recommenda
Level of
Extraction
tion/
Evidence
and Analysis
Implication
LaVasseur, C., the differences Large
Thematic
Different
When
Neukam, S.,
in thrombosis
pharmacy
analysis
types of
contemplating
Kartika, T.,
risk of the
databases,
contraceptives
contraception,
Bannow, B.
many
biomarker
have different
clinicians
S., Shatzel, J.,
hormonal
studies,
levels of risk
must factor in
&
preparations
centralized
of blood clots
different
DeLoughery,
available and
hospital
for obese
prothrombotic
T. G. (2022).
their
registries,
women.
risk factors to
Hormonal
interaction
cohort studies,
make more
therapies and
with patient‐
and case-
informed
venous
specific
control studies
decisions
thrombosis:
factors.
Level 1
15
Consideration
s for
prevention
and
management.
Research and
Practice in
Thrombosis
and
Haemostasis,
6(6), e12763
Khialani, D.,
from inception of objectively
Switching
It is important
Rosendaal, F.,
Understanding to April 2018
confirmed
COCs, even
to identify
& van
hormonal
venous
when
women at risk
Hylckama
contraceptives
thrombosis in
switching
of VT and
Vlieg, A.
and the risk of
healthy
from a high-
advise them
Level 1
16
(2020,
venous
women taking
to a low-risk
on alternative
November).
thrombosis
oral
COC,
contraception
contraceptives
increases the
methods.
Hormonal
contraceptives
and the risk of
venous
thrombosis. In
Seminars in
thrombosis
and
hemostasis
(Vol. 46, No.
08, pp. 865871). Thieme
Medical
risk of VT
17
Publishers,
Inc…
Abdalhabib,
To assess the
A search
Factors for
Thematic
The early
Risk factors
E. K.,
roles of
through PMC
deep vein
analysis
assessment of
should be
Jackson, D.
natural
thrombosis
risk factors,
assessed early
E., Alzahrani,
anticoagulants
associated
including the
enough to
B., Elfaki, E.,
and
with natural
measurements
prevent
Hamza, A.,
fibrinolytic
anticoagulants
of natural
occurrence of
Alanazi, F.,
regulatory
inhibitors, can
DVT
Ali, E. I.,
factors in the
predict the
Algarni, A., &
development
occurrence of
Ibrahim, I.
of DVT in
DVT before it
(2022).
Sudanese
is actually
Assessment of
patients.
detected in
risk factors for
patients.
LevelI
18
deep vein
thrombosis
associated
with natural
anticoagulants
and
fibrinolytic
regulatory
proteins.
Blood
Coagulation &
Fibrinolysis,
33(3), 149–
152.
https://doi.org/
10.1097/mbc.
19
00000000000
01116
Rambaran, K.,
To explore the
PubMed,
Thematic
Modifiable
Strongly
& Alzghari, S.
relationship
Scopus, Web
analysis
risk factors
encourage
K. (2020).
between
of Science,
included
screening
Gamer’s
combined oral
and EBSCO
cigarette use,
gamers for
thrombosis: A
contraception
for articles
being
possible VTEs
review of
and the risk of
overweight,
if clinically
published
venous
birth control
warranted.
reports.
thromboembol
use, and
Ochsner
ism
prolonged
Journal, 20(2),
immobility.
182–186.
Anticoagulatio
https://doi.org/
n was the
principal
Level 1
20
10.31486/toj.1
treatment
9.0058
modality in
patients
presenting
with gaming
thrombosis
Rosano, G.
Discuss the
The electronic
Cardiovascula
Exercise
M.,
latest
database
r risks, mainly
caution with
Rodriguez‐
evidence,
search in
VTE risks,
the use of
Martinez, M.
ongoing
PubMed
increase
COCs in
A., Spoletini,
research, and
between 12
patients with
I., & Regidor,
controversial
and 24 times
overweight
P. A. (2022).
issues on the
compared
and obesity,
Obesity and
synergistic
with non-
choosing the
contraceptive
effect of
obese non-
safest
use: impact on
obesity and
COC users.
alternatives
Level II
21
cardiovascular
contraceptive
when
risk. ESC
use in terms of
prescribing
heart failure.
cardiovascular
hormonal
risk
contraception
due to the
rising global
prevalence of
obesity.
Sultanmuratov This study
The electronic
The study
According to
Additional
a, G. U.,
aims to
database
included 65
the study
control should
Babadjanova,
determine the
search in
women of
results, a
be carried out
G. S.,
safety of
PubMed
reproductive
favorable
in patients
Nazarbayev, J. drospirenone-
age who were
effect of low-
with impaired
B., &
containing
prescribed OC
dose OC pills
carbohydrate
Kerimova, N.
combined oral
with 30 µg of
on body
metabolism.
M. (2022). A
contraceptives
ethinyl
weight and
Level II
22
safe and
(OC) in
estradiol and 3 lipid profile
effective
overweight/ob
mg of
was revealed
contraceptive
ese women of
drospirenone
without
method for
reproductive
for 3 months
significant
women with
age.
for therapeutic
changes in
obesity in the
and preventive carbohydrate
postpartum
purposes. The
metabolism. C
period.
main
onclusion. Th
American
parameters
erefore, this
Journal of
evaluated
method of
Medicine and
were lipid and
contraception
Medical
carbohydrate
may be
Sciences
metabolism
recommended
2022, 12(8):
for
836-839.
overweight/ob
https://doi.org
ese patients to
23
/10.5923/j.ajm
control
ms.20221208.
fertility in the
15
postpartum
period.
1
[Insert Title here]
[Insert Names of Author(s) here]
Texas Woman’s University
As a student you are responsible for utilizing the appropriate TWU coversheet, rubric and
current APA edition at the time of your submission. This paper is only a sample and not all
inclusive, but to be used as a guide.
2
[Insert Title here]
This paragraph should be your Introduction. Your introduction follows the title of your
paper (note that title is not bolded). You should start your introduction with a powerful statement
or two to stimulate interest.
You should identify the purpose of your paper and provide a preview of what the paper
will include. Remember that formal papers are in third person. In setting up your paper, you
should introduce the clinical question in PICO or PICOT format. You should define each of
these (Population, Intervention, Comparison, Outcome, Timeframe).
Significance of the Problem (FNP I)
This section should answer the question “why is this important?” You may support this
problem through examples from your own experience and clinical practice. It may be beneficial
to include incidence/prevalence or other appropriate data in order to establish relevance and
urgency. Be sure to add any supportive clinical guidelines or references as appropriate. Review
rubric for specifics.
Theoretical Model (FNP I)
ACE Star Model. See Rubric for a more thorough explanation of what is needed here
Search Strategy and Results (FNP II)
This section should include your search words and terms, the databases used along with
the results in those databases for each word or term, and inclusion and exclusion criteria. The
reason for exclusion of a study that meets your inclusion criteria needs to be explained either by
your exclusion criteria (e.g., English, adults, humans) or your inability to obtain the article
despite your best efforts. You should summarize the final result by identifying the number of
studies in each category (e.g., # of RCTs, # of qualitative studies, # of cohort studies, # of
3
systematic reviews, etc.). This can be achieved through the use of a figure so you can provide a
brief summary and then refer the reader to the figure.
Level of Evidence (FNP II)
Level of evidence hierarchy that is used for this paper.
Literature Review (FNP II)
Evaluate the chosen literature as a whole in relation to your stated problem, grouping
the articles into similar categories and examining the strengths and weaknesses of the literature
review and how it either supports or does not support your stated problem. Keep in mind that
the articles in this section should be research studies or systematic reviews, not summary
articles. This is all about the evidence rather than someone else’s opinion of the evidence. Do
not use secondary sources; you need to get the article, read it, and make your own decision
about quality and applicability to your question even if you did find out about the study in a
systematic review. You will need to define what evidence rating scale you are using (SORT,
Johns Hopkins Nursing Evidence-Based Practice Rating Scale, American Medical Association
(AMA), etc.)
When writing about a study you should include at minimum the study design, setting,
sample, and evidence rating. Do NOT address each study and give a summary. Your summary
table of evidence (Appendix A/B) will do that. Discuss the “high points” in this review. Call out
the most significant data that helped or that you think will help you decide whether or not to
change a practice.
Finally, the studies in this section MUST relate directly to your PICOT question.
Conclude with a summary statement regarding the strength of your evidence. So. . . what is the
answer to your question?
4
Analysis of Literature (FNP III)
Evaluate the chosen literature as a whole in relation to your stated problem. DO NOT
simply restate the information in your table or from the previous review. You should group
articles into similar categories examining overall strength and weakness. This section should
support your conclusion. This is the “So what” part of the paper. Is there enough information
to suggest/enact a change? If not, what can/should be done?
Clinical Implication (PREC II)
Clearly interpret the answer and outcome to your PICO question by utilizing your
research findings. How or in what ways is your PICO and solution relevant in clinical practice?
How will your solution be implemented in clinic (must be specific and integrate theoretical
model you chose)?
Conclusion
The conclusion should start with a statement regarding the intention of the paper and
your achievement toward that intention. Also, it should briefly say what was included in the
paper. The outcome of the literature review and analysis should clearly be linked to the problem.
Discuss how you plan to use the results of this review of literature in relation to your stated
problem. Remember that the introduction is a preview, and this section should contain a
summary. This section should logically “set up” your implementation plan which is part of the
Clinical Project Paper required next semester.
5
References
[Insert Reference List here]
Remember that this is a reference list rather than a bibliography. A bibliography is everything
you read to prepare the paper, but a reference list is only what you cited. If there is not a citation
for a reference, it should not be here.
6
Appendix A (FNP II)
Summary of Primary Sources of Evidence
Citation of
Evidence
Legend:
Study Question or Study Design
Hypothesis
Sample/Setting
Independent and Data Collection & Findings
Dependent
Analysis
Variables & Tools
Used
Recommendation/ Level of
Implications
Evidence
7
Appendix B
Prepare a 10-15 slide PowerPoint presentation, with speaker notes, that examines the significance of an organization’s culture and values. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the Topic Materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning, and an additional slide for References at the end.
Outline the purpose of an organization’s mission, vision, and values.
Explain why an organization’s mission, vision, and values are significant to nurse engagement and patient outcomes.
Explain what factors lead to conflict in professional practice. Describe how organizational values and culture can influence the way conflict is addressed.
Discuss effective strategies for resolving workplace conflict and encouraging interprofessional collaboration.
Discuss how organizational needs and the culture of health care influence organizational outcomes. Describe how these relate to health promotion and disease prevention from a community health perspective.
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.
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. You are required to submit this assignment to LopesWrite.
The answer should be based on close work with the texts assigned before the prompt, rather than your own personal opinions. Substantiate your answers with specific references to the texts and authors assigned.
a) What is the difference (according to Foster) between personalistic and naturalistic etiologies of illness? How does that distinciton correspond with the understanding of witchcraft and illness among the Azande (from the documentary about Evans-Pritchard’s research)? Are there differences between the beliefs about illness in Tzintzuntzan and among the Azande? How does Foster’s model apply (or not) to the possession cosmology of zar participants described by Kenyon?
b) What are the cultural gaps between conceptions of medicine between the Hmong and the American Medical system described by Fadiman in “The Spirit Catches You and You Fall Down”? Do you think there would be a similar gap between curanderos described by De La Portilla and the mainstream medical establishment in San Antonio, Texas, where her fieldwork took place?
*400 WORDS*
*USE TEXTBOOK PROVIDED TO ANSWER THE QUESTIONS AS WELL AS REFERRING TO TEXT*
*TEXTBOOK IS Pamela Moro anthology, “Magic, Witchcraft, and Religion: A Reader in the Anthropology of Religion, 9th Edition READ PAGES 234-288*
*ALSO WATCH THIS VIDEO TO ANSWER QUESTION https://www.youtube.com/watch?v=8q9HyONL_10 *
Attachments area
Preview YouTube video Strange Beliefs: Sir Edward Evans-Pritchard
Understanding the behavioral styles of your team is just as important as the skills they have. Great teams leverage their differences, so they complement each other. This leads to higher performance and better results. Designing highly efficient teams with members that have complimentary personality and leadership styles, using assessment instruments such as the DISC profile, has become increasingly important to organizational success.
In this assignment, students will reflect upon their leadership style through a DISC behavior/personality self-assessment. Note that there is not a “good” style or a “bad” style. Rather, understanding one’s personality and behavioral style will help in understanding how to respond to conflict, what is a motivator, what causes stress, and how you solve problems. In addition, understand one’s DISC profile allows for more targeted selection of teammates that compliment your specific leadership style.
https://www.123test.com/disc-personality-test/
Assignment Instructions:
1)Begin this assignment by identifying an appealing instrument for conducting your leadership self-assessment, such as the DISC assessment posted in Learning Resources.
2)Conduct your self-assessment.
3)Prepare an evaluation that:
a.Identifies the instrument (with citation to either web page or another source).
b.Describes the results of your self-assessment, including areas of strength and challenge.
c.Describes the potential implications of the results on professional leadership and participation as a team member.
d.Includes one figure.
4)In developing the final interesting, informative, and comprehensive manuscript, include the following:
a.Select format elements from APA Style:
i.Double-spacing.
ii.1-inch margins.
iii.Running header.
iv.Times New Roman 12-point font.
v.Title page.
vi.References (including at least two citations).
vii.Figure formatting per APA style.
b.Attention to brevity (concise but complete), as shown by commitment to the length requirement: no more than 5 total pages in length (1 title page, 1 reference page, 1 figure page, ~2 written content pages). I’ve attached a sample paper. also you can can do the personality DISC if it makes the paper easier for you.
Opening and closing sentences and use of topic sentences to organize thoughts into paragraphs. Includes summary paragraph.
Unformatted Attachment Preview
Running head: LEADERSHIP STYLE FOR CHANGE
Leadership Style for Change
Student Student
Stony Brook University
1
LEADERSHIP STYLE FOR CHANGE
2
Leadership Style for Change
In every organization there is a leader. This is the main person to drive policies. Leaders
have their own styles to manage team members. These styles describe the personalities of the
leaders. How to find a leadership style that serves one’s self-awareness, leading to better
communication among staff and improvement of their progress towards successful goals? There
are many behavioral instruments or personality assessments that can come to grips with one’s
own personal style. In this paper, I will use DISC personality assessment to understand my
leadership style in responding to conflict and solving problems.
DISC is a modal that can quickly assess your personally style. It examines four
personality traits: Dominance, Influence, Steadiness and Compliance (123 Test, 2018). DISC
contains 28 groups of four personality statements from which you must chose the one “most like
me” and the one “least like me” (123 Test, 2018)
My DISC assessment results show my personality type as a Dominance personality as
figure 1 described. According to the 123Test website, my score shows that “you have a strong
inner motivation to influence people and circumstances” (2018). A Dominance personality is
described as assertive and fast paced toward goals. The strength of this personality trait,
according to the 123Test website, is these persons like taking action to move straight forward to
their goals (2018). They like to direct people under them and set up goals without team
collaboration. This personality favors goal directed action and dislikes failure or loss of
autonomy (Personality Profile Solutions, 2018). The limitations of this personality trait are that it
is self-directed and uncaring of team collaboration. Such people like to work alone and tend not
to ask others about their opinions because they are impatient to listen to other opinions. They like
LEADERSHIP STYLE FOR CHANGE
3
to make decisions toward achieving goals and are indifferent to people in the team (Personality
Profile Solutions, 2018).
A dominant personality has good potential implications for leadership skills and can
influence team members and overall organization in different ways. With a dominant personality
as a leader, the task assigned will be completed on time or faster. But this leadership style shows
a lack of collaboration skills. This will affect the feelings and attitudes of other team members
(Slowikowski, 2005). While the leader’s only concern is to achieve goals within the time limits,
he or she also depends on the team members for innovative problem solving; this conflict leads a
stress, both for the leader and the team.
In contrast, a dominant personality has a good potential to participate as a solo team
member. This type of personality likes new opportunities and challenges. This can fit with
opportunities for career advancement. They establish their own way to complete the task because
they have a responsibility (Slowikowski, 2005). For example, my community care team was
assigned to do a project on how to establish a system to get information on our veterans from ER
staff to various hospitals. I came up with the initiative of faxing a cover page letter with specific
boxes, including H&P notes, lab data, diagnostic tests and consultation notes from other
physicians. Then, I checked the boxes to inquire about just the information I needed. Moreover, I
would call and find out if they received the fax and how long before they could reply. This
assertive behavior ensured that I would receive the information at a certain time.
In conclusion, there is no right or wrong way for different personalities to work as a
leader or a team member. All the behavioral styles are to drive the team to complete the task. The
relationship between the leader and team members can inspire ideas, prompt the exchange of
LEADERSHIP STYLE FOR CHANGE
information and facilitate brainstorming for success. As the Gregory Nunn’s quote has it: “The
right man, in the right place, at the right time, can steal millions” (Brainy Quote, 2018).
Figure 1. Self-DISC personality result.
4
LEADERSHIP STYLE FOR CHANGE
5
References
123 Test. (2018a). Disc personality test. Retrieved from https://www.123test.com/disc-personality-test/
123 Test. (2018b). Your disc personality report. Retrieved from https://www.123test.com/discpersonality-test/id=fSQWNCXF46LMCZU&version=
Brainy Quote. (2018). Gregory nunn quotes. Retrieved from
https://www.brainyquote.com/quotes/gregory_nunn_159277
Personality Profile Solutions, L. (2018). Disc profiles explained: D is for dominance. Retrieved from
https://www.discprofile.com/what-is-disc/overview/dominance/
Slowikowski, M. K. (2005). Using the DISC behavioral instrument to guide leadership and
communication. Aorn j, 82(5), 835-838, 841-833.
Please describe the topic you have chosen for the Week 8 PowerPoint presentation and discuss why you feel it is important to nursing and healthcare.Cite at least one scholarly source using current APA Style in your response. You are required to participate on at least three (3) days of the week to receive full participation points.+2 peer responses which I will send after initial post
assignment about policy that not applicable in Saudi Arbia why its not? in the future ?prcpactive toward ? I already finish of most of work but i need it to be more orignized and more information under subtitles also new subtitles 1- need of index page 2- need of abstract 3- need of more information under subtitles ( Euthanasia in Saudi Arabia, Perspectives toward Euthanasia , Future Direction to Euthanasia) 4- also new subtitles beside that i mention 5- more in Conclusion 6- follow APA7 style 7- page should not be less then 10 without reference and cover page 8- don’t forgot citation and References
Unformatted Attachment Preview
College of Applied Medical Sciences
Nursing Department
MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
ACADEMIC YEAR 2023-2024 1st Sem
HEALTH POLICY ISSUES
(Euthanasia)
Submitted by:
ID:
Course instructor:
Date:
1 MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
Interdiction:
There are many challenges in life that you must overcome, but some of them are
particularly difficult, such as deciding whether to take your own or another person’s life.
Euthanasia is the intentional taking of a person’s life at their expressed desire, usually to end their
pain or suffering from a terminal condition. Depending on the patient’s consent, it can be classified
as passive euthanasia and active euthanasia be like voluntary, non-voluntary, or involuntary.
(Ezekiel &Emanuel 2016). Voluntary case those in which the patient is mentally competent and
requests euthanasia. Involuntary euthanasia occurs when the patient is mentally competent but did
not request euthanasia( Maas, P 1992). Nonvoluntary euthanasia refers to cases when the patient
is not competent in mental health and could not request euthanasia. passive euthanasia refers to
terminating potentially life-sustaining treatments by withholding or, not administration of a
medical intervention to end a patient’s life (Deliens L 2003) The globe over, passive euthanasia is
widely acceptable. Nearly every nation forbids active involuntary euthanasia. The majority of
nations consider active voluntary euthanasia to be criminal homicide, which carries a 14-year
prison sentence as a penalty. While active involuntary euthanasia is permitted in some nations,
including Belgium, the Netherlands, and Luxembourg (Ebrahimi 2012). Some nations only
provide palliative care to patients beside choose the option to terminate their lives if their illness
cannot be cured and they are in excruciating agony. The patient’s family may also elect to end their
patient’s life if they are in coma or have brain death.
History of Euthanasia
2
MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
Before Christianity, attitudes toward infanticide, active euthanasia, and suicide tended to
be lenient in ancient Greece and Rome. Pagan physicians probably frequently performed abortions
as well as both voluntary and involuntary mercy killings in the ancient Greek and Roman cultures
since many of them lacked a convincingly defined belief in the inherent dignity of every individual
human life. Few ancient Greek or Roman physicians adhered strictly to the Hippocratic Oath,
which forbade doctors from prescribing “a deadly drug to anyone, not even if asked,” or from
advising such a course of action. Many people in classical antiquity preferred quick death to
excruciating pain, and doctors agreed by frequently giving their patients the poisons they wanted.
Euthanasia in Saudi Arabia :
Even for a patient who is terminally sick, ending a person’s life or helping to do so is
prohibited in the Kingdom of Saudi Arabia (KSA). and a minimum of 10 years in prison is the
minimum sentence for violators. The Shari’a law criminalizes euthanasia in any kind (Alqahtani
2018). Saudi Arabia is a Muslim nation, and Islam is practiced there primarily. As a result, the
fundamental principles of Islam serve as the framework for the legal system in use in the nation.
Saudi Arabia’s constitution reflects the predominance of Islamic fundamental principles.
Islam and Euthanasia:
With Islamic ethics and law killing a person who requests to end his life due to suffering
from great pain through euthanasia is forbidden and inconsistent. Euthanasia is a taboo subject as
it is prohibited by the Islamic jurisprudence. the justification of the Qur’an and Sunnah. Islam
teaches that a life is given by Allah and that it cannot be taken without His consent.
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MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
(Aramesh2007). Islamic law fervently defends the sanctity of life, which is evident from numerous
verses (Aayeh) of the Qur’an like ‘‘If you should raise your hand against me to kill me, I shall not
raise my hand against you to kill you. Indeed, I fear Allah, Lord of the worlds’’ [Surah Al-Ma’idah,
5: 28] The Qur’an also mentions that the Muslims would experience ongoing adversity and
difficulties and commands them to have patience during these times. as ‘‘You will surely be tested
in your possessions and in yourselves. And you will surely hear from those who were given the
Scrip- ture before you and from those who associate others with Allah much abuse. But if you are
patient and fear Allah indeed, that is of the matters [worthy] of determination’’ [Surat A’li’Imran,
3: 186]. Also, Prophet Mohammed, peace be upon him (PBUH), said: ‘Whoever kills himself
either by stabbing himself, or ingesting poisonous substances or throwing from the highest, he will
be punished by Allah’ (Hadith: Bukhari 76:90). Islam is a peaceful faith that emphasizes kindness
to the seventh neighbor and compassion for animals before considering human beings. Muslims
ought to take care of their bodies since they are gifts from Allah. Islam respects people’s ability to
think critically about God’s creation and to express gratitude for it, hence it forbids self- or othermurder. Muslims should not give up hope when they fall ill because they believe in Allah’s mercy..
However, in some cases the Islamic code of medical ethics (Code of Conduct 1981), A team of
medical experts or a medical committee involved in the management of such a patient may decide
to stop a patient’s treatment if they are satisfied that continuing the treatment would be futile or
pointless.” Additionally, it adds that individuals whose conditions have been deemed ineffective
by the medical committee “should not begin treatment. (Pasha H 2017). Withholding therapy is
acceptable when it would be fruitless and death would result anyway ( Madadin et al 2020)
Euthanasia, Autonomy and Dignity:
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MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
A person’s capacity to pursue their own values and interests is referred to as autonomy
(Tucker 2014) Autonomies patients have the freedom to decide what kind of medical care they
want to get. This has substantial implications for both the right to knowledge and the right to a
second opinion. Patients have the option to undergo diagnostic procedures or surgical procedures,
as well as the creation of medical advisory boards as necessary under these kinds of conditions.
Patients today in both rich and developing nations have the potential to demand nearly anything
based on their financial situation and social situations (Annas 2016). Patients are allowed to
establish the limits of their own life and death under the accepted idea of autonomy. Even though
these borders are simple, they could also come off as whirred and lacking in focus. Doctors should
respect these borders rather than reject them, so long as they are not badly crossed. The right of
terminally ill patients to end the unbearable suffering they experience in their final phases of life
is compromised and waived when they are unable to consent to euthanasia (Trappe 2017). Patients
who feel as though they are nearing the end of their lives and who endure pain without being able
to alleviate it tend to no longer be worth living for. Living on in such circumstances is no longer
the most important thing for many patients. One of the driving forces behind euthanasia seems to
be a fear of losing control, along with the loss of dignity and the financial burden that goes along
with it (Pardon et al 2012). Dignity is the significance and worth that a somebody possesses and
that inspires others to respect them or inspires them to respect themselves. People frequently argue
that since they have the right to a dignified life, they also have the right to a dignified death. Some
medical illnesses are just so excruciatingly painful and needlessly protracted that the ability of the
medical community to provide palliative care to lessen suffering is exceeded, although the
sufferers lose the majority of their dignity as a result of unrelenting terminal pain. Additionally,
modern medical research and practice can extend human life in ways that have never been done
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MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
before. It might be a prolonging that all too frequently entails a concurrent prolongation of needless
agony. ( Niekerk 2016).
Perspectives toward Euthanasia:
There are several perspectives that are grouped by people, cultures, and nations. Some
people believe that everyone has the right to live their own life and to end their suffering when
they are ill. Some people oppose it. Regardless of the situation, willful homicide is wrong because
every life is sacrosanct. Euthanasia is either legal or illegal in several nations. Euthanasia is
permitted in some countries, including the Netherlands and Belgium, but only under certain
circumstances. It’s still illegal in some places. The societal and governmental perspectives are
reflected in these legal systems. There are various viewpoints held within the medical community
as well. While some medical professionals believe that euthanasia is a compassionate way to end
patients’ suffering, others think it goes against the basic idea of life preservation.
Future Direction to Euthanasia:
the terms of criminal law. Although they differ regarding euthanasia between mitigating
circumstances of punishment and harsher punishment, they outlaw this killing. But as palliative
care progresses, there seems to be a growing call for legislation to permit assisted suicide in some
circumstances. However, it seems obvious that over time, at least passive euthanasia will become
legal in most nations when one considers the developments of the last few decades. The rise of
chronic illnesses, longer life expectancies, and the development of life-saving treatments and
technology will soon present a significant challenge to the health care systems (Phatak 2020).
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MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
Conclusion:
In my opinion, certain nations may consider euthanasia as a plan if they have resource
limitations or population growth. Because they will act with the patient’s agreement, they will
believe that it will be a good option to advance their interests while respecting human dignity and
autonomy. Although palliative care has its place, after a while people in some war-torn and
impoverished nations will turn to euthanasia as a last resort. However, in my home country of
Saudi Arabia, even as the patient’s condition worsens in the future, this strategy won’t be used if
the government adheres to Islamic law.
References
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MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
Sameer, A. S. (2020). Knowledge, awareness and attitude of health profession students of KSAUHS
towards
euthanasia. Ethics,
Medicine
and
Public
Health, 14,
100522.
https://doi.org/10.1016/j.jemep.2020.100522
Phatak, Shantanu & Phatak, Ajay. (2020). Euthanasia: Past, Present and Future. JOURNAL OF CLINICAL
AND DIAGNOSTIC RESEARCH. 14. 10.7860/JCDR/2020/46210.14217.
Alqahtani F. Medical liability law to ban euthanasia, human cloning; 2018 [Accessed on 12th Jan, 2020]
http://www. saudigazette.com.sa/article/526653 .
ordaan DW. Human dignity and the future of the voluntary active euthanasia
debate in South Africa. S Afr Med J. 2017;107(5):383-85.
Chamsi-Pasha H and Albar MA. Withdrawing or with- holding treatment. Int J Hum Health Sci 2017; 1:
59–64
Trappe HJ. Ethics in intensive care and euthanasia : With respect to inactivating defibrillators at the end of
life in terminally ill patients. Med Klin Intensivmed Notfmed. 2017; 112(3): 214-221.
Annas GJ, Mariner WK. (Public) Health and Human Rights in Practice. J Health Polit Policy Law. 2016;
41(1): 129-139.
Annadurai, K., Danasekaran, R., & Mani, G. (2014). ‘Euthanasia: right to die with dignity’. Journal of family
medicine and primary care, 3(4), 477–478. https://doi.org/10.4103/2249-4863.148161
Regional
Review
Committees
for
Physician-Assisted
Death. Annual
Reports
See www.euthanasiecommissie.nl/de-commissie/documenten/
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MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
2002-2014.
Pardon K, Deschepper R, Vander Stichele R, et al. Expressed wishes and incidence of euthanasia in
advanced lung cancer patients. Eur Respir J. 2012; 40(4): 949-956.
Ebrahimi N. The ethics of euthanasia. Aust Med Stud J. 2012;3:73–5.
Aramesh K and Shadi H. An Islamic perspective on euthanasia. Am J Bioeth 2007; 7, W4–6.
Oliver D. A perspective on euthanasia. Br J Cancer. 2006 Oct 23;95(8):953-4. doi: 10.1038/sj.bjc.6603365.
PMID: 17047642; PMCID: PMC2360694.
Deliens, L., & van der Wal, G. (2003). The euthanasia law in Belgium and the Netherlands. Lancet
(London, England), 362(9391), 1239–1240. https://doi-org.sdl.idm.oclc.org/10.1016/S01406736(03)14520-5
Dowbiggin, I. R. (2003). Merciful end: The Euthanasia Movement in modern america. Oxford University
Press.
van der Maas, P. J., van Delden, J. J., & Pijnenborg, L. (1992). Euthanasia and other medical decisions
concerning the end of life. An investigation performed upon request of the Commission of Inquiry
into the Medical Practice concerning Euthanasia. Health policy (Amsterdam, Netherlands), 21(12), vi–262.
Faya. (n.d.). What is autonomy and why does it matter?. I Family. https://www.ifamilystudy.eu/what-isautonomy-and-why-does-it-matter/
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MSN 703: GLOBAL HEALTH, DIVERSITY, & POLITICAL ISSUES
Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
Locating Evidence
Using the Chamberlain University library, search for a recent (published within the last five years) evidence- based article from a scholarly journal that addresses one of the topics listed.
Safety
Delegation
Prioritization
Caring
Include the following sections.
Introduction – 20 points/13%
Clearly establishes the purpose of the paper
Includes key points to be covered
Captures the reader’s interest
Complete, well-developed discussion of key points
Supports the purpose or main idea of the paper
Logical development of ideas with clear and accurate information
Ideas and statements are supported by three or more examples from personal and/or professional experiences
Provides own perspectives on the topic that is reflective, insightful, and original
Conclusion – 30 points/20%
Clear and concise
Summarizes key points discussed in the paper
Leaves a strong impression, message, or idea on the reader
Writing Style – 15 point/10%
Correct use of standard English grammar, paragraph, and sentence structure
No spelling or typographical errors
Organized around required components
APA Format, and References – 25 points/17%
There is correct and appropriate use of margins, spacing, font, and headers
Document setup includes title and reference pages in correct APA format
All information taken from the source, even if summarized, is cited and listed on the Reference page
All sources used are nursing journals published within the last five years
b.Body of Paper – 60 points/40%
h.Information flows in a logical sequence that is easy for the reader to follow
Citation of sources included in the body of the paper uses correct APA format for direct and indirect quotes
•All elements of each reference are included in the correct order
To support your work with evidence bases references. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. In addition you must respond to your professor if applicable. Complete your participation for this assignment by the end of the week.
For this assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
The Aquifer assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases may be present in the quizzes, the midterm exam, and the final exam.
Learn how to access and navigate Aquifer.
This week, complete the Aquifer case titled “Family Medicine 10: 45-year-old man with low back pain”
Apply information from the Aquifer Case Study to answer the following discussion questions:
Discuss the Mr. Payne’s history that would be pertinent to his genitourinary problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.
Describe the physical exam and diagnostic tools to be used for Mr. Payne. Are there any additional you would have liked to be included that were not?
Please list 3 differential diagnoses for Mr. Payne and explain why you chose them. What was your final diagnosis and how did you make the determination?
What plan of care will Mr. Payne be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?
Background: Preparing for a regulatory survey is essential in long term care and complying with these regulations is critical for the success an organization. Over the past several weeks, we have learned a tremendous amount of information on different departments as well as various administrative areas. Now, we will apply your knowledge to creating a proactive plan that assists your team in being prepared should regulatory bodies arrive to conduct a survey or inspection. While we do not have the time to implement and discuss a full mock survey, we will have the time for you to work on a few of the processes for a survey readiness plan.
Your Scenario-Option C: Maryland Skilled Nursing Facilities
Option C: Maryland Skilled Nursing Facilities
SNF Option 2:Chesapeake Shores located in Lexington Park Maryland
SNF Regulation Option 3: Federal CMS SNF Regulation: Food and Nutrition
Services 483.60 o Regulatory Reference: Provided Diet Meets Needs of Each Resident
483.60 o Regulatory Tag:F800
Regulatory Information: Page 2 of the CMS SNF F Tags June 2021 PDF and Pages 564 to 565 of the CMS State Operations Manual Appendix PP for LTC Facilities.
Resources for this Scenario:
How to locate the specific regulations for this scenario: You can you the Control F function on your PC or Command F function on your Mac to search for a specific regulatory reference/tag/rule. Type in the information that you want to search for in the specific document that you are reviewing, using this search function, to locate your information:
CMS SNF F Tags June 2021 PDF
CMS State Operations Manual Appendix PP for LTC Facilities PDF
E-Tags Emergency Preparedness CMS State Operations Manual Appendix Z for All Certified Federal Level Providers PDF
Website link to CMS Provider Compare– Main Page: CMS Provider Compare Search Page
Website link to CMS – Emergency Preparedness Rule Page: CMS Emergency Preparedness Rule Landing Page
****DIRECTIONS***
Creating the PowerPoint Presentation:
Survey Readiness PowerPoint:
Must be no less than 10 slides, excluding the introduction slide(s) and reference page slide(s).
Presenter Notes:
Every slide must have presenter notes except for the reference page(s).
Your presenter notes will be the information that you will be sharing with your team.
Your notes should be detailed and contain APA in-text citations.
References:
Minimum of eight scholarly references, professional publications, and/or academic journals from the last five years.
Include any references from your assigned LTC facility or setting such as the website, company information, facility website, service-level website, etc.
Every reference must have a correlating in-text citation(s).
APA 7th Edition Style:
PowerPoint slides, cover page, and reference page.
The PowerPoint Must Contain the Following Content Aspects for Your Assigned Scenario: Aspect A: Introduction Slide(s)
APA Cover Page – Include the title of the presentation, your name, your instructor’s name, course name, your assigned LTC facility or setting, your assigned regulation, and date submitted.
Provide bulleted points to identify each Content Aspect that will be presented in the presentation.
Aspect B: Regulatory Survey Readiness Analysis Slide(s)
Provide an analysis of the regulatory survey process that includes the importance of survey readiness; a mock survey overview; and an assessment of being survey ready, as a means for creating successful survey outcomes.
Aspect C: Stakeholders Evaluation and Leadership Selection Analyses Slide(s)
Include an evaluation of at least three stakeholders for the regulatory survey process.
You must include the internal stakeholders of the patients and/or residents.
The other stakeholders that you present, as part of your evaluation, may be internal or external.
Include at least two of the applicable items from this list in your evaluation of the stakeholders: (a.) survey awareness; (b.) survey process understanding; (c.) survey engagement; (d.) stakeholder contribution; (e.) stakeholder justification; and/or (f.) importance of the stakeholder.
Identify at least three specific leadership roles that will be involved in the mock survey process and provide an analysis of the assigned facility-level or service-level leaders involved in the mock survey.
You must include the Administrator, Executive Director, or a top leader of the LTC facility or service in your analysis.
The other two leadership roles may be any manager or director-level position at your assigned LTC facility or service for your analysis.
Aspect D: Regulation Assessment Slide(s)
State the regulation that you assigned from your scenario and provide an assessment of this regulation to your assigned LTC facility or setting.
You must include the regulatory standard, condition, rule, and/or tag in the assessment.
Include an evaluation of the mock survey process for the assigned regulation, applying this information to your assigned LTC facility or setting.
Apply your assigned specific regulation for one mock survey step, as this will act as an introduction for your LTC employees to understand the entire mock survey process. (Note – Remember you are only introducing the mock survey process to your staff, so this should be an overview of the potential regulatory mock survey steps.)
Aspect E: Conclusion Slide(s)
Highlight the key takeaways of your presentation and include an explanation to why the information presented in the PowerPoint is essential for the staff to know.
Include one call to action and share with your team any next steps for the upcoming mock survey.
Aspect F: APA Reference Page Slide(s)
Provide the list of all references presented in the PowerPoint, formatted in APA 7th Edition.
EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
I attached THE PREVIOUS PICOT, TO HELP
https://1drv.ms/w/s!AkDtYsV4vV1UjiXXfuK3Mk7Wt8F9
1ST PICOT
https://1drv.ms/p/s!AkDtYsV4vV1UjjohbDfuHbb_JC_rLinks to an external site.
Health Information and Libraries JournalLinks to an external site.
Nursing StandardLinks to an external site.
Keyword searching: Finding articles on your topic: Introduction to keyword searchingLinks to an external site.
Quick Answers: What are filtered and unfiltered resources in nursing?Links to an external site.
Fill out the following document based on the information given and make sure to look at the example given and attachments for help.
Unformatted Attachment Preview
Sample Type / Medical Specialty: Pediatrics – Neonatal
Sample Name: Gagging – 3-year-old
Description: Pediatric Gastroenterology – History of gagging.
(Medical Transcription Sample Report)
HISTORY OF PRESENT ILLNESS: This is a 3-year-old female patient, who was admitted
today with a history of gagging. She was doing well until about 2 days ago, when she
developed gagging. No vomiting. No fever. She has history of constipation. She normally
passes stool every two days after giving an enema. No rectal bleeding. She was brought to
the Hospital with some loose stool. She was found to be dehydrated. She was given IV fluid
bolus, but then she started bleeding from G-tube site. There was some fresh blood coming
out of the G-tube site. She was transferred to PICU. She is hypertensive. Intensivist Dr. X
requested me to come and look at her, and do upper endoscopy to find the site of bleeding.
PAST MEDICAL HISTORY: PEHO syndrome, infantile spasm, right above knee amputation,
developmental delay, G-tube fundoplication.
PAST SURGICAL HISTORY: G-tube fundoplication on 05/25/2007. Right above knee
amputation.
ALLERGIES: None.
DIET: She is NPO now, but at home she is on PediaSure 4 ounces 3 times a day through Gtube, 12 ounces of water per day.
MEDICATIONS: Albuterol, Pulmicort, MiraLax 17 g once a week, carnitine, phenobarbital,
Depakene and Reglan.
FAMILY HISTORY: Positive for cancer.
PAST LABORATORY EVALUATION: On 12/27/2007; WBC 9.3, hemoglobin 7.6,
hematocrit 22.1, platelet 132,000. KUB showed large stool with dilated small and large
bowel loops. Sodium 140, potassium 4.4, chloride 89, CO2 21, BUN 61, creatinine 2, AST 92
increased, ALT 62 increased, albumin 5.3, total bilirubin 0.1. Earlier this morning, she had
hemoglobin of 14.5, hematocrit 41.3, platelets 491,000. PT 58 increased, INR 6.6
increased, PTT 75.9 increased.
PHYSICAL EXAMINATION:
VITAL SIGNS: Temperature 99 degrees Fahrenheit, pulse 142 per minute, respirations 34
per minute, weight 8.6 kg.
GENERAL: She is intubated.
HEENT: Atraumatic. She is intubated.
LUNGS: Good air entry bilaterally. No rales or wheezing.
ABDOMEN: Distended. Decreased bowel sounds.
GENITALIA: Grossly normal female.
CNS: She is sedated.
IMPRESSION: A 3-year-old female patient with history of passage of blood through G-tube
site with coagulopathy. She has a history of G-tube fundoplication, developmental delay,
PEHO syndrome, which is progressive encephalopathy optic atrophy.
PLAN: Plan is to give vitamin K, FFP, blood transfusion. Consider upper endoscopy.
Procedure and informed consent discussed with the family.
NAANDA APPROVED NURSING DIAGNOSES
PHYSICAL PROBLEMS
BOWEL
• Bowel incontinence
• Constipation
• Colonic constipation
• Perceived constipation
• Constipation, Perceived
• Constipation, Risk for
• Constipation, Chronic Functional
• Constipation, Risk for Chronic Functional
• Contamination
• Contamination, Risk for
• Diarrhea
• Gastrointestinal Motility, Dysfunctional
• Gastrointestinal Motility
• Risk for Dysfunctional Gastrointestinal
• Perfusion, Risk for Ineffective
CIRCULATION
• Tissue Perfusion, Ineffective Peripheral
• Tissue Perfusion, Risk for Ineffective Peripheral
• Tissue Perfusion, Risk for Decreased Cardiac
• Tissue Perfusion, Risk for Ineffective Cerebral
• Bleeding, Risk for
• Cardiac Output, Decreased
• Cardiac Output, Risk for Decreased
• Cardiovascular Function, Risk for Impaired
• Shock, Risk for
• Surgical Recovery, Delayed
• Surgical Recovery, Risk for Delayed
• Vascular Trauma, Risk for
FLUID/HYDRATION
• Fluid volume deficit
• High risk for fluid volume deficit
• Fluid volume excess
• Fluid Volume, Risk for Deficient
• Fluid Volume, Risk for Imbalanced
• Fluid Balance, Readiness for Enhanced
• Electrolyte Imbalance, Risk for
ENDOCRINE
• Blood Glucose Level, Risk for Unstable
INFANT FEEDING/BREASTFEEDING PROBLEMS
• Effective breast-feeding
• Ineffective breast-feeding
• Interrupted breast-feeding
• Ineffective infant feeding pattern
•
•
•
•
•
•
•
Insufficient Breast Milk
Readiness for enhanced Breastfeeding,
Liver Function, Risk for Impaired
Jaundice, Neonatal
Jaundice, Risk for Neonatal
Sudden Infant Death Syndrome, Risk for
Suffocation, Risk for
MOBILITY ACTIVITY
• Activity Intolerance
• High risk for activitiy intolerance
• Diversional activity deficit
• High risk for disuse syndrome
• Transfer Ability, Impaired
• Activity Intolerance
• Activity Intolerance, Risk for
• Activity Planning, Ineffective
• Activity Planning, Risk for Ineffective
• Decreased Intracranial Adaptive Capacity
• Lifestyle, Sedentary
• Mobility, Impaired Bed
• Mobility, Impaired Physical
• Mobility, Impaired Wheelchair
• Sitting, Impaired
• Standing, Impaired
• Walking, Impaired
• Wandering
NEUROLOGIC DYSFUNCTION
• Autonomic Dysreflexia
• Autonomic Dysreflexia, Risk for
• Memory, Impaired
• Peripheral Neurovascular Dysfunction, Risk for
NUTRITION/EATING
• Nutrition, Imbalanced: Less than Body
Requirements
• Nutrition, Readiness for Enhanced
• Obesity
• Risk for Overweight
• Overweight
• Nausea
• Swallowing, Impaired
PAIN
•
•
•
•
•
Pain, Acute
Pain, Chronic
Pain Syndrome, Chronic
Pain, Chronic Malignant
Pain, Chronic Nonmalignant
•
PHYSICAL SAFETY/PROTECTION
• Altered protection
• Dysreflexia
• High risk for infection
• High risk for injury
• High risk for poisoning
• High risk for trauma
• Trauma, Risk for
• Sensory/perceptual alterations
• Unilateral neglect
• Infection, Risk for
• Injury, Risk for Corneal
• Falls, Risk for
• Injury, Risk for Perioperative-Positioning
• Injury, Risk for Thermal
• Injury, Risk for Urinary Tract
• Self-Mutilation
• Self-Mutilation, Risk for
• Suicide, Risk for
RESPIRATORY/BREATHING
• Airway Clearance, Ineffective
• Allergy Response, Risk for
• Risk for Aspiration,
• High risk for suffocation
• Inability to sustain spontaneous ventilation
• Dysfunctional ventilatory weaning response
• Ineffective airway clearance
• Ineffective breathing pattern
• Spontaneous Ventilation, Impaired
• Ventilatory Weaning Response, Dysfunctional
REST/SLEEP
• Fatigue
• Sleep, Readiness for Enhanced
• Sleep Deprivation
• Sleep Pattern, Disturbed
• Insomnia
SELF-CARE
• Bathing/Hygiene self-care deficit
• Feeding self-care deficit
• Toileting self-care deficit
• Self-Care, Readiness for Enhanced
• Self-Care Deficit, Bathing
• Self-Care Deficit, Dressing
• Self-Care Deficit, Feeding
• Self-Care Deficit, Toileting
• Self-Concept, Readiness for Enhanced
Self-Neglect
SEX/SEXUALITY
• Altered sexuality patterns
• Sexual dysfunction
• Sexuality Pattern, Ineffective
SKIN/MUCOUS MEMBRANE
• Impaired Oral Mucous Membrane
• Risk for Impaired Oral Mucous Membrane
• High Risk for impaired tissue integrity
• Impaired tissue integrity
• Dry Eye, Risk for
• Skin Integrity, Impaired
• Skin Integrity, Risk for Impaired
• Latex Allergy Response
• Latex Allergy Response, Risk for
• Pressure Ulcer, Risk for
TEMPERATURE
• Body Temperature, Risk for Imbalanced
• High risk for altered body temperature
• Hyperthermia
• Hypothermia
• Hypothermia, Risk for
• Hypothermia, Risk for Perioperative
• Reaction to Iodinated Contrast Media, Risk for
• Protection, Ineffective
• Thermoregulation, Ineffective
URINARY/VOIDING
• Altered urinary elimination
• Reflex incontinence
• Total incontinence
• Urinary retention
• Elimination, Readiness for Enhanced Urinary
• Incontinence, Functional Urinary
• Incontinence, Overflow Urinary
• Incontinence, Reflex Urinary
• Incontinence, Risk for Urge Urinary
• Incontinence, Stress Urinary
• Incontinence, Urge Urinary
• Renal Perfusion, Risk for Ineffective
PSYCHOSOCIAL
COMMUNICATION, THINKING, KNOWLEDGE
• Altered thought processes
• Knowledge/skills deficit
• Knowledge, Deficient
• Knowledge, Readiness for Enhanced
•
•
•
•
•
•
Impaired verbal communication
Comfort, Readiness for Enhanced
Communication, Readiness for Enhanced
Confusion, Acute
Confusion, Chronic
Confusion, Risk for Acute
COPING/ADJUSMENT
• Anxiety
• Defensive coping
• Ineffective individual coping
• Coping, Compromised Family
• Coping, Defensive
• Coping, Disabled Family
• Coping, Ineffective Community
• Coping, Readiness for Enhanced
• Coping, Readiness for Enhanced Community
• Coping, Readiness for Enhanced Family
• Diversional Activity, Deficient
• Decisional conflict
• Fear
• Grieving
• Anticipatory grieving
• Dysfunctional grieving
• Grieving, Complicated
• Grieving, Risk for Complicated
• Hope, Readiness for Enhanced
• Hopelessness
• Human Dignity, Risk for Compromised
• Impaired adjustment
• Ineffective denial
• Power, Readiness for Enhanced
• Powerlessness
• Powerlessness, Risk for
• Stress Overload
• Relocation stress syndrome
• Relocation Stress Syndrome, Risk for
• Spiritual distress
• Social Interaction, Impaired
• Social Isolation
• Sorrow, Chronic
• Spiritual Distress
• Spiritual Distress, Risk for
• Spiritual Well-Being, Readiness for Enhanced
• Religiosity, Impaired
• Religiosity, Readiness for Enhanced
• Religiosity, Risk for Impaired
• Death Anxiety
• Decision-Making, Readiness for Enhanced
• Decisional Conflict
• Denial, Ineffective
•
•
•
•
Emancipated Decision Making, Impaired
Emancipated Decision Making, Readiness for
Enhanced Emancipated Decision Making. Risk
for Impaired
Emotional Control, Labile
Impulse Control, Ineffective
FAMILY & GROWTH/DEVELOPMENT
• Attachment, Risk for Impaired
• Altered family processes
• Family Processes, Dysfunctional
• Family Processes, Interrupted
• Family Processes, Readiness for Enhanced
• Altered growth and development
• Development, Risk for Delayed
• Growth, Risk for Disproportionate
• Altered parenting
• High risk for altered parenting
• Caregiver role strain
• High risk for caregiver role straing
• Family coping: potential for growth
• Ineffective family coping: compromised
• Role Conflict, Parental
• Role Performance, Ineffective
• Role Strain, Caregiver
• Role Strain, Risk for Caregiver
• Parenting, Impaired
• Parenting, Readiness for Enhanced
• Parenting, Risk for Impaired
• Dentition, Impaired
• Frail Elderly Syndrome
• Frail Elderly Syndrome, Risk for
• Resilience, Impaired
• Resilience, Readiness for Enhanced
• Resilience, Risk for Impaired
HEALTH MANAGEMENT
• Altered health maintenance
• Health-seeking behavior
• Impaired home maintenance management
• Ineffective management of therapeutic
regimen
• Noncompliance
• Health, Deficient Community
• Health Behavior, Risk-Prone
• Health Maintenance, Ineffective
• Health Management, Ineffective
• Health Management, Readiness for Enhanced
• Health Management, Ineffective Family
• Home Maintenance, Impaired
INFANT BEHAVIOR
• Behavior, Disorganized Infant Behavior
• Readiness for Enhanced Organized Infant
Behavior,
• Risk for Disorganized Infant
• Mood Regulation, Impaired
• Loneliness, Risk for
• Moral Distress
ROLE/RELATIONSHIP
• Altered role performance
• Impaired social interaction
• Social Isolation
• Relationship, Ineffective
• Relationship, Risk for Ineffective
• Relationship, Readiness for Enhanced
SELF-ESTEEM
• Body image disturbance
• Self-esteem disturbance
• Chronic low self-esteem
• Situational low self-esteem
• Personal Identity, Disturbed
• Personal Identity, Risk for Disturbed
• Self-Esteem, Chronic Low
• Self-Esteem, Risk for Chronic Low
• Self-Esteem, Situational Low
• Self-Esteem, Risk for Situational Low
VIOLENCE
• High risk for self-mutilation
• Self-Directed Violence, Risk For
• Other-Directed Violence, Risk for
• Post-trauma responses
• Rape-trauma syndrome
• Rape-trauma syntdrome: compound reaction
• Post-Trauma Syndrome
• Post-Trauma Syndrome, Risk for
MATERNITY
Childbearing Process, Ineffective
• Childbearing Process, Readiness for Enhanced
• Childbearing Process, Risk for Ineffective
• Comfort, Impaired
• Maternal/Fetal Dyad, Risk for Disturbed
• Pain, Labor
Student :
Date:
Initials
Room:
Patient Data Form Pediatrics
Current Diagnosis / Surgery / Priorities:
AM Report
Adm. Date:
VS / pain assessment (rate 0 – 10)
Frequency:
Time
T
P
R
BP
AGE:
M / F
Weight:
Pain
ALLERGIES:
Teach/psychosocial/
cultural, D/C needs:
Fluids / Nutrition:
Activity
/Restraints /
Isolation :
Diet / Feeding method
Activity
Calming/Pain needs:
GT feeds:
RN
Development needs:
Safety precaut.
CNA
Labs / Diagnostics
MD
IV solution /rate:
Additional notes:
Respiratory
Time O2 L/min
Teaching Needs:
IV site/type:
O2 Sat
Rx
24 hour fluid calc.
INTAKE & OUTPUT
IN – Mntnce.
1X
1.5 X
___ mL/day
___ mL/day
___ mL/hr
___ mL/hr
Treatments / Tests
Parent
present?
Notes:
Y/N
Isolation:
❑ Mask
❑ Gloves
❑ Gown
Cultural/Spiritual:
Wounds/Drains:
Discharge:
I&O During Shift
Intake Output Net
__mL
___mL
+/- mL
Physical Assessment (Head-to-toe)
Off Shift Report:
Gen.:
Skin:
HEENT:
Pulses: (radial / femoral / pedal)
Cardiac:
Resp.:
Abd.:
Neuro:
Extremities (orthopedic: neurovascular assessment):
Wounds (location / drainage / dressing/tubes/drains):
G&D:(eg) Erikson, Piaget, physical, gross/fine motor, language, socialization, cognition, etc):
Safety check: Perform when enter room + check and document when you leave
❑ O2 Sat monitor: Alarms set + Site rotation
LOW sat _______ HIGH sat _______
❑ Apnea monitor: Alarms set LOW RR _______ HIGH RR _________ Apnea time _______________
❑ Cardiac monitor: Alarms set
LOW Heart rate _______ HIGH Heart rate ________ RATE matches apical________
(Update May 2021)
❑ IV fluid / rate – matches order
❑ Infusion device set
❑ IV tubing – dates checked
❑ Oxygen ordered level ______
❑ Suction working
❑ Suction supplies @ bedside
❑ Bag & mask – appropriate size
❑ Face shield
❑ No choking hazards (
Purchase answer to see full
attachment
Racism and Health Inequities, Disparities, and Disease PresentationCreate an 8 to 10-minute presentation on how systemic, structural, and individual racism are causing health inequities, health disparities, and disease, especially in our historically marginalized populations in the U.S. Choose a state and give statistics on 2-3 conditions and compare different races and ethnicities. Your presentation should include at least 8 slides, excluding title and reference slides. Your presentation should have effective visual aids and be engaging. Consider visual design quality, comprehensibility, and organization of subject matter. Your PowerPoint needs to include detailed speaker notes. Submit your .mp4 recording in the assignment area. Note: simple grammar for better understanding and state chosen is Plano, Texas Learning Objectives:1. Analyze how systemic, structural, and individual racism are causing health inequities, health disparities, and disease.2. Compare how different races and ethnicities are affected by systemic, structural, and individual racism.
Week 7 Discussion: Presentation Reflection
and Analysis of power point
Post the following to this discussion thread:
1. Initial Response: Consider what you’ve learned about the topic you presented.
•
•
•
•
How does this topic relate to something you might see in clinical practice?
Which ideas make the most sense and why?
How does this topic to current events?
What might make this problem more treatable?
Use at least one scholarly source besides your textbook to connect your response to
national guidelines and evidence-based research to support your ideas.
MWHC
Reflective Practice
Nurse Residency Program
Medstar Washington Hospital Center
Medstar Washington Hospital Center
1
Objectives
• Describe reflection and reflective practice
• Identify characteristics of reflective thinking and
practice
• Describe what facilitated reflection practice is
• Explain the role of the facilitator in reflection
• Demonstrate effective skills in using facilitated
reflection as a learning strategy
• Engage in professional growth through reflecting
and acting upon job performance feedback
Medstar Washington Hospital Center
2
Rewind to Benner
• Max level of skilled performance that can be
achieved through classroom alone vs. the
context-dependent judgments and skills that can
ONLY be acquired in real situations
(Benner, 2001)
Medstar Washington Hospital Center
3
Reflective Practice
• Reflective practice involves a purposeful analysis
of actions and decisions with the intent of
recognizing problems and successes
• Hypothesizing solutions to the problems
• Applying both recognized successes and new
solutions to future actions and decisions
(Davies, 2012)
Medstar Washington Hospital Center
4
Why Do It?
• There is evidence that engaging in Reflective
Practice is associated with the improvement of
the quality of care, stimulating personal and
professional growth, and closing the gap
between theory and practice
(Davies, 2012)
Medstar Washington Hospital Center
5
Becoming a Reflective Practitioner
• The reflective process has the potential to enable
the beginning health practitioner to learn from
their professional experiences
• Describe and understand their own feelings and
influence in clinical practice
• Link theory to practice gaps
(Johnson, 2013)
Medstar Washington Hospital Center
6
Gibbs’ Reflective Cycle
6 stages
Action Plan
If it arose
again What
would you
do?
Description
What
happened?
Conclusion
What else
could you
have done?
Feelings
What were
you thinking
& feeling?
Analysis
What sense
can you
make of the
situation?
Evaluation
What was
good and
bad about
the
experience?
Medstar Washington Hospital Center
7
Purpose of Gibbs’ Reflective Cycle
• Help one think through the phases of an experience or
activity
• Explore different/new ideas and approaches towards
doing or thinking about things
• Promote self-improvement (by identifying strengths and
weaknesses and taking action to address them)
• Linking practice and theory (by combining doing or
observing with thinking or applying knowledge)
8
(Gibbs, 1988)
Medstar Washington Hospital Center
8
Written Process Example
Stage 1 – Description of the event – What happened?
Stage 2 – Feelings/Reactions
What were you thinking? How did you feel
about the event?
Stage 3 – Evaluation or judgment about the event
Stage 4 – Analysis
Break event down into parts and discuss
Stage 5 – Conclusion – What did you learn?
Stage 6 – Action Plan
What would you do if you encountered again?
(Mind Tools, 2015)
Medstar Washington Hospital Center
9
Benefits?
➢ Increased learning from an experience or situation
➢ Promotion of deep learning
➢ Identification of personal and professional strengths and areas for improvement
➢ Identification of educational needs
➢ Acquisition of new knowledge and skills
➢ Further understanding of ones own beliefs, attitudes and values
➢ Encouragement of self-motivation and self-directed learning
➢ Could act as a source of feedback
➢ Possible improvements of personal and clinical confidence
(Somerville & Keeling, 2004)
Medstar Washington Hospital Center
10
Limitations?
➢ Not all practitioners may understand the reflective process
➢ May feel uncomfortable challenging and evaluating own practice
➢ Could be time consuming
➢ May have confusion as to which situations or experiences to reflect upon
➢ May not be adequate to resolve clinical problems (this could point to a further
learning needs)
(Price, 2004)
Medstar Washington Hospital Center
11
Skills Required – Personal
✓ Self-awareness
✓ Description
✓ Critical analysis
✓ Synthesis
✓ Evaluation
✓ Honesty
✓ Trust
✓ Time commitment
✓ Motivation
✓ Practice
(Atkins and Murphy, 1993)
Medstar Washington Hospital Center
12
Basic Elements
• The what, why, and how of things you do:
– Keeping an open mind
– Being aware
– Questioning
– How do others do
• Generating choices, options and possibilities
• Comparing and contrasting results
• Seeking to understand underlying mechanisms and rationales
• Viewing our activities and results from various perspectives
• Asking “What if …..?”
• Seeking feedback and other people’s ideas and viewpoints
(Roth, 1989)
Medstar Washington Hospital Center
13
Facilitator of Reflective Practice
• Provoke thought and professional development
• Guide discussion
• Talk with v. talk at
(Miraglia, & Asselin, 2015)
Medstar Washington Hospital Center
14
Role of the Facilitator
• Facilitates group discussions and reflective practice
sessions each month, promoting professional reflection
and assisting NTP nurses in developing professional
behaviors
• Acts as a point of contact for the NTP nurses
• Assists NTP nurses in dealing with transition to practice
issues that may arise
• Acts as a guide for the EBP project
Medstar Washington Hospital Center
15
Next Steps
• Each seminar will have opportunity for reflective
practice during Clinical Reflection or Unit Specific
time with your assigned Educator
• You may have a covering Educator depending on
conflicts but the practice will be the same
• Over next 11 months, will complete two reflective
practice prompts (written)
Medstar Washington Hospital Center
16
References
•
•
•
•
•
•
•
•
•
•
Atkins, S., & Murphy, K. (1993). Reflection: A review of the literature. Journal of Advanced Nursing,
18, 1188-1192.
Benner, P.E. (2001). From Novice to Expert. Upper Saddle River, NJ: Prentice Hall Health.
Davies, S. (2012). Embracing reflective practice. Education for Primary Care, 23, 9-12.
Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods, Oxford Centre for
Staff and Learning Development, Oxford Polytechnic. London: Further Education Unit.
Roth, R. (1989). Preparing the reflective practitioner: Transforming the apprenticeship through the
dialectic. Journal of Teacher Education, 44(3), 31-35.
Somerville, D., & Keeling, J. (2004) A practical approach to promote reflective practice within
nursing. Nursing Times, 100(12), 42-45.
Price, A. (2004). Encouraging reflection and critical thinking in practice. Nursing Standard, 18(47),
46-54.
Johnson, J. A. (2013, January/February). Reflective learning, reflective practice, and metacognition.
Journal for Nurses in Professional Development, 29(1), 46-48.
Mind Tools. (2015). Gibbs’ reflective cycle. Retrieved from
https://www.mindtools.com/pages/article/reflective-cycle.htm
Miraglia, R., & Asselin, M. E. (2015 March/April). Reflection as an educational strategy in nursing
professional development. Journal for Nurses in Professional Development, 31(2), 62-72.
Medstar Washington Hospital Center
17
Thank you
Medstar Washington Hospital Center
18
Questions?
Medstar Washington Hospital Center
19
Name:________________________
Unit:________ Date:____________
NEW TO PRACTICE NURSE RESIDENCY PROGRAM
Writing Reflective Narrative: Reflection on Practice Template
Reflective Practice is the “Deliberate process of critically thinking about a clinical experience, which
leads to development of insights for potential practice change.”
Why is reflective practice important?
•
•
•
•
•
It challenges your assumptions.
It supports you in exploring different/new ideas and approaches toward doing or thinking about
things. What can I learn? What can I do to improve my practice? What can I share with others?
It promotes self-improvement (by identifying strengths and weaknesses of your practice,
knowledge and/or skill gaps, and taking action to address them).
It links practice and theory (by combining doing and observing with thinking or applying
knowledge).
It aides in exploring the thoughts and feelings you experienced during a practice situation and
patient care encounter.
Directions:
Choose an event. Some examples of events that you can choose are:
•
•
Clinical situations that occurred on the unit (examples rapid response, patient with uncontrolled pain,
change in patient condition).
Inter-professional: communication with other team members, delegation to support associates, patient
advocate.
Using Gibbs Reflective Model (1988) follow the stages below and reflect on an event, and write about it. The
questions in each box will guide you. You will not need to answer all of them, just those that are relevant to your
event. Use first person when completing the narrative, be specific and concise. When completed, give to you [Nurse
Educator/Residency Coordinator/Residency Facilitator].
Stage 1: Description of the Event – What Happened?
Name:________________________
Unit:________ Date:____________
Stage 2: Feelings/Reaction – What were you thinking? How did you feel about the event/situation?
Stage 3: Evaluation – Evaluate or make a judgment about the event/situation
Stage 4: Analysis – Break the event down into its component parts and explore separately
Stage 5: Conclusion –Focus on learning from the event/situation
Stage 6: Action Plan – Think about encountering the event again and plan what you would do
Name:________________________
Unit:________ Date:____________
Asselin, M.E. & Fain, J.A. (2013). Effect of reflective practice education on self-reflection, insight, and
reflective thinking among experienced nurses. Journal for Nurses in Professional Development, 29(3),
111-119.
Asselin, M.E. & Schwartz-Barcott, D. (2015, May/June). Exploring problems encountered among
experienced nurses using critical reflective inquiry. Journal for Nurses in Professional Development,
31(3), 138-144.
Johnson, J.A. (2013, January/February). Reflective learning, reflective practice, and metacognition.
Journal for Nurses in Professional Development, 29(1), 46 – 48.
Mind Tools. (2015). Gibbs’ Reflective Cycle. Retrieved from
https://www.mindtools.com/pages/article/reflective-cycle.htm
Miraglia, R. & Asselin, M.E. (2015 March/April). Reflection as an educational strategy in nursing
professional development. Journal for Nurses in Professional Development, 31(2), 62-72.
Thompson, N. & Pascal, J. (2012). Developing critically reflective practice. Reflective Practice, 13(2), 311325.
Your written assignment for this module is a worksheet that describes the following:Communication techniques that can be used to promote safety within the healthcare facility.How communication can assist in providing optimal patient care.You should be using complete sentences to answer the questions. Ensure that you are using correct grammar. In addition, support your answers using your textbook, course materials, credible internet resources, and scholarly journals. All citations must be in APA format.1. Identify and describe communication techniques that can be used to promote safetywithin the healthcare facility. (2 Points)2. Describe how communication is used to provide optimal patient care. (2 Points)
Purpose: Students will explore the macro context in which their agency operates. Students will be able to articulate verbally and in writing, the legislative, political, social, and community context in which their field site operates. Students will be able to describe their site’s mission, vision, values, organizational structure(s), and its auspices.
Write a paper identifying the mission, vision, values, goals, and service model/theoretical approach of the practicum site.
Describe the auspices of your agency (i.e. public, private-non-profit, proprietary, etc.)
Discuss (briefly) the history of the agency
Describe the field of practice
Describe the population served by the agency (i.e. socio-economic group, ethnicity, age, etc.)
Describe the agency’s mission, its organizational structure, and the composition of staff. If the program in which the student is working is part of a larger whole, describe the entire agency, and provide the context within the agency of this particular program.
Discuss the agency’s funding base
Discuss your field of practice in an international context (if appropriate).
Students can obtain the above information from agency supervisors, staff, human resources, website, annual report, etc. Please use as many resources as necessary.This paper should be a minimum of three pages, not including the reference page. APA formatting is required, including proper citing of sources. Paper must be uploaded as a Word document to Tk20 AND D2L.
write a reflective journal, on the following questions: 1. In your opinion, what is the most pressing challenge currently facing the further advancement of nursing knowledge? 2. How can we, as a profession, overcome these challenges and barriers, along with promoting collaboration to improve health care delivery?
TikTok Research Project (15 points)-Each student will identify one topic (ex. Ayurveda) discussed in the textbook to research; the topic must be pre-approved by the instructor! After receiving approval, each student will identify five (5) videos on TikTok that discuss information related to the topic. Additionally, students will identify five (5) peer-reviewed journal articles (published within the last 10 years) that also discuss the selected topic. After watching the videos and reading the articles, each student will write a 3-page paper comparing and contrasting the information they learned from the videos with the information in the peerreviewed journal articles. The paper should be written in APA Style (7th edition) and should be double-spaced with 1-inch margins. The font style should be Times New Roman, and the font size should be 12 pt. In-text citations are required! A title page also should be included.
The body of your paper should be 3-4 pages long NOT including the title page and reference page. Papers that are more than 4 pages long will not be accepted
References – incorporate information from the course text plus a minimum of two (2) scholarly references published within the last five (5) years. Textbooks are not to be considered scholarly references.
Use current APA format to style your paper and to cite your sources. Your source(s) should be integrated into the paragraphs. Use internal citations pointing to evidence in the literature and supporting your ideas.
Headings are required.
Discuss all aspects of healthcare coordination in context to the chosen diagnosis.
Your paper must include the following:
Topic – Heart Failure
Description of the health issue chosen
The incidence and prevalence of this condition in the US.
How the condition is diagnosed, monitored, and treated in individuals with this condition?
Description of the interdisciplinary team that will participate in coordinating care. Specifically, define the role of the APRN in management and coordination.
Can care teams use the CCCR model? Think in terms of systems and complexity reflective thinking. If not, name another model to help manage care?
What is the cost of managing this disease in the county you live? Download the CMS Excel to determine the cost of the condition in context to the state and county. Use the CMS link below:
Spending County Level: All Beneficiaries, 2007-2018 (ZIP)Links to an external site.
What resources are available to help manage the costs of care related to this condition?
Identify barriers or challenges that you foresee for patients and care teams. How can barriers be overcome?
ziprasidone – Natalie F.
STUDY GUIDE FOR MEDICATION TREATMENT SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOSIS DISORDERS
Psychosis and schizophrenia greatly impact the brain’s normal processes, which interfere with the ability to think clearly. When symptoms of these disorders are uncontrolled, patients may struggle to function in daily life. However, patients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, you will develop a study guide for an assigned psychotropic agent for treating patients with Schizophrenia Spectrum and Other Psychotic Disorders. You will share your study guide with your colleagues. In sum, these study guides will be a powerful tool in preparing for your course and PMHNP certification exam.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
TO PREPARE FOR THIS ASSIGNMENT:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for treatment of patients with Schizophrenia Spectrum and Other Psychotic Disorders.
Research your assigned psychotropic medication agent using the Walden Library. Then, develop an organizational scheme for the important information about the medication.
Review Learning Resource: Utah State University. (n.d.). Creating study guides. https://www.usu.edu/academic-support/test/creating_study_guidesLinks to an external site.
THE ASSIGNMENT
Create a study guide for your assigned psychotropic medication agents. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the FDA-approved and Evidenced-Based, Clinical Practice Guidelines Research but also supported by at least three other scholarly resources.
Areas of importance you should address, but are not limited to, are:
Title page
Description of the Psychopharmacological medication agent including brand and generic names and appropriate FDA indication uses
Any supporting, valid and reliable research for non-FDA uses
Drug classification
The medication mechanism of action
The medication pharmacokinetics
The medication pharmacodynamics
Mechanism of Action
Appropriate dosing, administration route, and any considerations for dosing alterations
Considerations of use and dosing in specific specialty populations to consider children, adolescents, elderly, pregnancy, suicidal behaviors, etc.
Definition of Half-life, why half-life is important, and the half-life for your assigned medication
Side effects/adverse reaction potentials
Contraindications for use including significant drug to drug interactions
Overdose Considerations
Diagnostics and labs monitoring
Comorbidities considerations
Legal and ethical considerations
Pertinent patient education considerations
Reference Page
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.
Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formattingLinks to an external site..
BY DAY 7
You will need to submit your Assignment to two places: the Week 7 Study Guide discussion forum as an attachment and the Week 7 Assignment submission link. Although no responses are required in the discussion forum, a collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned psychotropic medication agent for study.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK7Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6630_Week7_Assignment_Rubric
NURS_6630_Week7_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCreate a study guide, in outline form with references, for your assigned medication. Incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards.
30 to >26.0 pts
Excellent Point range: 90–100
The response is in a well-organized and detailed outline form. Informative and well-designed visual elements are incorporated. … Followed directions correctly by uploading assignment to Gradebook and submitted to the discussion forum area.
26 to >23.0 pts
Good Point range: 80–89
The response is in an organized and detailed outline form. Appropriate visual elements are incorporated. … Partially followed directions by uploading assignment to Gradebook but did not submit to the discussion forum area.
23 to >20.0 pts
Fair Point range: 70–79
The response is in outline form, with some inaccuracies or details missing. Visual elements are somewhat vague or inaccurate. … Partially followed directions by submitting to the discussion forum area but did not upload assignment to Gradebook.
20 to >0 pts
Poor Point range: 0–69
The response is unorganized, not in outline form, or is missing. Visual elements are inaccurate or missing. … Did not follow directions as did not submit to discussion forum area and did not upload assignment to gradebook per late policy.
30 pts
This criterion is linked to a Learning OutcomeStudy guide completion elements addressed in Week 7 assignment area
50 to >44.0 pts
Excellent Point range: 90–100
The response thoroughly addresses all required content areas.
44 to >39.0 pts
Good Point range: 80–89
The response adequately addresses all required content areas. Minor details may be missing.
39 to >34.0 pts
Fair Point range: 70–79
The response addresses all required content areas, with some inaccuracies or vagueness.
34 to >0 pts
Poor Point range: 0–69
The response vaguely or inaccurately addresses the required content areas. Or, three or more content areas are missing.
50 pts
This criterion is linked to a Learning OutcomeSupport your guide with references and research providing at least five evidence-based, peer-reviewed journal articles or evidenced-based guidelines. Be sure they are current (no more than 5 years old).
10 to >8.0 pts
Excellent Point range: 90–100
The response is supported by the 5 current, evidence-based resources from the literature.
8 to >7.0 pts
Good Point range: 80–89
The response provides at least 4 current, evidence-based resources from the literature that appropriately support the study guide information.
7 to >6.0 pts
Fair Point range: 70–79
3 evidence-based resources are provided to support the study guide, but they may only provide vague or weak justification.
6 to >0 pts
Poor Point range: 0–69
2 or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence-based.
10 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent Point range: 90–100
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.5 pts
Good Point range: 80–89
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
3.5 to >3.0 pts
Fair Point range: 70–79
Contains several (3 or 4) grammar, spelling, and punctuation errors.
3 to >0 pts
Poor Point range: 0–69
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent Point range: 90–100
Uses correct APA format with no errors.
4 to >3.5 pts
Good Point range: 80–89
Contains a few (1 or 2) APA format errors.
3.5 to >3.0 pts
Fair Point range: 70–79
Contains several (3 or 4) APA format errors.
3 to >0 pts
Poor Point range: 0–69
Contains many (≥ 5) APA format errors.
5 pts
Total Points: 100
LEARNING RESOURCES
Required Readings
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.
Chapter 4, “Psychosis, Schizophrenia, and the Neurotransmitter Networks Dopamine, Serotonin, and Glutamate” (pp. 77-158)
Chapter 5, “Targeting Dopamine and Serotonin Receptors for Psychosis, Mood, and Beyond: So-Called “Antipsychotics” (pp. 159-243)
American Psychiatric Association. (2019). Practice guideline for the treatment of patients with schizophreniaLinks to an external site.. https://www.psychiatry.org/File%20Library/Psychiat…
Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapineLinks to an external site.. https://www.clozapinerems.com/CpmgClozapineUI/rems…
Funk, M. C., Beach, S. R., Bostwick, J. R., Celano, C. M., Hasnain, M., Pandurangi, A., Khandai, A., Taylor, A., Levenson, J. L., Riba, M., & Kovacs, R. J. (2018). Resource document on QTc prolongation and psychotropic medicationsLinks to an external site.. American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiat…
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia BulletinLinks to an external site., 13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261
Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. ChestLinks to an external site., 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC43881…
McClellan, J. & Stock. S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent PsychiatryLinks to an external site., 52(9), 976–990. https://www.jaacap.org/article/S0890-8567(09)62600…
Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS DrugsLinks to an external site., 23(8), 649–659. https://doi.org/10.2165/00023210-200923080-00002
Utah State University. (n.d.). Creating study guidesLinks to an external site.. https://www.usu.edu/academic-support/test/creating…on Resources
U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugsLinks to an external site.. https://www.accessdata.fda.gov/scripts/cder/daf/in…
Emmanuel and his mother live in an urban community housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of age and has suffered from asthma for the last 2 years. One evening, his mother poured him some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and coughing. As he gasped for air, he became more and more anxious. His mother ran for his inhaler, but he was too upset and restless to use it. Emmanuel’s skin became moist with sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and waited anxiously for the ambulance to arrive.
Components of the Report
Describe the Disease
Explain the pathophysiology of the disease.
Etiology/Risk/Incidence
Clinical Manifestation
Clinical Management. (Diagnostics/Treatment)
References
Correct use of English, good sentence and paragraph structure, good writing style ,Formatting, spelling, grammar, punctuation.
Emmanuel uses a corticosteroid inhaler for the management of his asthma. What is the mechanism of action of this drug? How is its action different from the β2-agonist inhalants?
Why does someone with severe asthma become physically fatigued during a prolonged attack? What are the physiologic events that occur during an attack?
One of the complications of respiratory fatigue is the development of hypercapnia. How does the body compensate for an increase in CO2? What are the effects of hypercapnia on the central nervous system?
The purpose of this discussion is for you to investigate healthcare privacy breaches and the associated risks and the ethical and legal issues confronted as a DNP-prepared nurse. Privacy breaches are serious offenses that negatively affect the trust between nurses and patients. To maintain this trust, nurses must maintain the privacy and security of patient information.
INSTRUCTIONS
Reflect on the following scenarios related to the protection of health information. Select two of the scenarios to discuss.
Scenario 1: A staff nurse posted the following comment on her social media page: “Can this shift be any longer? It started out with a waiting room full of nagging people who don’t seem to know what ‘emergency’ means. Then, I had to deal with the drama of trying to transfer a 400 lbs. (no joke) intubated chronic obstructive pulmonary disease patient down the hall to the intensive care unit. Those intensive care unit nurses are such divas, and I wasn’t in the mood for their whining. Someone help!”
Analyze the privacy and security issues related to this social media posting.
Scenario 2: A nurse practitioner is preparing a presentation poster for an infectious disease conference. She includes pictures of varying stages of a client’s lesions in the poster.
Analyze the privacy and security issues related to the inclusion of patient information on the poster.
Scenario 3: A clinical instructor is working with nursing students on a medical unit for the day. While rounding to check on students, the instructor discovers a patient’s daughter wants to take a picture of the nursing student and the patient together to post on social media.
Analyze the privacy and security issues and explain the best response for the clinical instructor.
Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:
Link (webpage): Graduate Discussion Grading Guidelines and Rubric
PROGRAM COMPETENCIES
This discussion enables the student to meet the following program competencies:
Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
COURSE OUTCOMES
This discussion enables the student to meet the following course outcomes:
Assess the impact of informatics and information technology on organizational systems, change, and improvement. (PCs 2, 4; PO 6)
Appraise consumer health information sources for accuracy, timeliness, and appropriateness. (PC 4; PO 7)
Resolve ethical and legal issues related to the use of information, communication networks, and information and patient care technology. (PCs 2, 4; PO 6)
Discussion 1 post
One of the five elements of emotional intelligence is self-awareness. Explain why emotional
intelligence is crucial for effective leadership. Discuss what behaviors someone with a high degree
of self-awareness would demonstrate within the context of leading and managing groups. Provide
an example.
Reply to two classmates.
Discussion 2 post
Discuss the purpose of strategic planning in a health care environment. Explain what factors affect
future planning in an organization and what tools can be used for future planning.
Reply to two classmates.
Discussion 3 post
Select a topic for your Topic 3 Executive Summary assignment. Post your idea and basic thoughts
about the topic using the assignment details from Topic 3. You should provide thoughts to your
peers about their topics and ideas that may assist them in completing their projects.
Respond to two classmates.
Effective approach in leadership and management paper
In this assignment, you will be writing a 1,000-1,250 word paper describing the differing
approaches of nursing leaders and managers to issues in practice. To complete this assignment,
do the following:
1.
2.
3.
4.
5.
6.
Select an issue from the following list: bullying, unit closures and restructuring, floating, n urse
turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or
magnet designation.
Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting
in which it occurs.
Discuss how professional standards of practice should be demonstrated in this situation to help
rectify the issue or maintain professional conduct.
Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the
different approaches they take to address the selected issue and promote patient safety and
quality care. Support your rationale by using the theories, principles, skills, and roles of the leader
versus manager described in your readings.
Discuss what additional aspects managers and leaders would need to initiate in order to ensure
professionalism throughout diverse health care settings while addressing the selected issue.
Describe a leadership style that would best address the chosen issue. Explain why this style could
be successful in this setting.
Use at least three peer-reviewed journal articles other than those presented in your text or
provided in the course.
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. A link to the LopesWrite technical
support articles is located in Class Resources if you need assistance.
This benchmark assignment assesses the following programmatic competencies:
RN to BSN
1.1:
Exemplify professionalism in diverse health care settings.
1.3:
Exercise professional nursing leadership and management roles in the promotion of patient safety and
quality care.
3.4:
Demonstrate professional standards of practice.
instructions are in attachment. Write a 6-8 page paper. Use at least 10 references other than your main text. Use APA 7th edition formatting. At least 5 of these need to be within the past 5 years.
Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographiesLinks to an external site.
The Assignment: (4-5 pages not including the title and reference page)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:
Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
Criteria Ratings Pts
This criterion is linked to a Learning Outcome In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following: Properly identify 4 peer-reviewed research articles you reviewed.
20 to >17.0 pts
Excellent
The response identifies 4 peer-reviewed research articles for the Assignment.
17 to >15.0 pts
Good
The response identifies 3 peer-reviewed research articles and one peer-reviewed article for the Assignment.
15 to >13.0 pts
Fair
The response identifies 4 or less peer-reviewed articles
13 to >0 pts
Poor
The response identifies less than 4 peer-reviewed articles or peer-reviewed articles are missing
20 pts
This criterion is linked to a Learning Outcome Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
40 to >35.0 pts
Excellent
The response accurately and thoroughly summarizes in detail each study reviewed, explaining in detail the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described….Specific, accurate, and detailed examples are provided which fully support the response.
35 to >31.0 pts
Good
The response summarizes each study reviewed, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described….Accurate examples are provided which support the response provided.
31 to >27.0 pts
Fair
The response is missing one or two of the required elements or summaries are superficially addressed.
27 to >0 pts
Poor
The response is missing three or more required elements or the summaries are superficially addressed.
40 pts
This criterion is linked to a Learning Outcome Synthesize the findings from the 4 peer-reviewed research articles in a cohesive conclusion.
25 to >22.0 pts
Excellent
Response includes a synthesis of the findings in an exceptionally well-written conclusion.
22 to >19.0 pts
Good
Response includes a synthesis of the findings in a well-written conclusion.
19 to >17.0 pts
Fair
The response is missing a synthesis of the findings or the conclusion is superficial.
17 to >0 pts
Poor
The response is missing a synthesis of the findings and the conclusion is not accurate or is missing.
25 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4 to >3.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3 to >2.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.
2 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains a few (1-2) grammar, spelling, and punctuation errors.
3 to >2.0 pts
Fair
Contains several (3-4) grammar, spelling, and punctuation errors.
2 to >0 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – APA:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Hi there I need help with two separate assignments one is going to be a discussion post that will be based on the second assignment I will post instructions below!
Assignment #1
Choose from one of the following topics ONLY:
Nursing during an epidemic, pandemic or natural disaster across the country or around the globe
The effect of social media on nursing image. How can nurses educate the public and help portray the true image of nursing? How are nurses personally accountable in their use of social media?
The prevalence and impact of substance abuse among nurses (impaired nursing)
Impact of collective bargaining on the nursing profession
Impact of workplace harassment and violence on the nursing profession
You may select from ONE of the following technological advances and discuss its impact on patient outcomes:
Telehealth technology
Health applications
Health-related/electronic wearables
You must use the PowerPoint presentation template provided at the top of this assignment.
You are to create bullet points for each slide, not including the title and reference slides. Every slide must have a speaker note with a minimum of 4-5 sentences addressing the bulleted items on the slide.
Include a minimum of 4-5 peer-reviewed research articles as references in the presentation. All research articles need to have been published within 5 years from today’s date. No blog, chat, other university or Wikipedia information allowed in presentation. The PowerPoint presentation must follow current APA style.
Your presentation should only include the following slides:
Title slide
Why the topic was chosen
How your topic impacts nursing practice
Current relevance of the topic
Clinical Practice Integration
Plan for lobbying: Describe your plan on what and how you would lobby your legislators or local government for funding and support for your chosen issue/trend.
Conclusion
Reference slide
Attached is a powerpoint template on what needs to be done
Assignment # 2
Based off of what topic you pick for the powerpoint, i need a discussion written thats 350 words
Please describe the topic you have chosen for the Week 8 PowerPoint presentation and discuss why you feel it is important to nursing and healthcare.Cite at least one scholarly source using current APA Style in your response.
Surveillance Systems PaperUsing the surveillance systems listed in the learning activities, and other surveillance systems you can locate, identify two data elements relevant to your proposed project or program. Analyze the trends in data over time. Discuss what external factors may be influencing these trends. Reflect on the relevance of your findings to your project/program.This 2-3 page paper should follow current APA guidelines. Provide a minimum of 3 references, with at least 1 reference not included in the course materials.Note: You will include elements of this paper in the M9 Program Presentation and the M10 Final Plan Paper.Learning Objectives:1. Employ surveillance systems to locate data relevant to a specific dental health project and describe the data elements.2. Interpret the data and statistics to determine their relevance to your public health project.
Read the attached article and answer the following questions.1. Do you think it is possible to protect this vulnerable population during a research study? 2. How do the authors apply the four ethical principles when dealing with a vulnerable population such as incarcerated pregnant women?
Unformatted Attachment Preview
Record: 1
Title: Promoting nurses’ and midwives’ ethical responsibilities towards vulnerable people: An alignment of research and clinical practice.
Authors: Baldwin, Adele; 1Capper, Tanya; 2Harvey, Clare; 3Willis, Eileen; 4Ferguson, Bridget; 5Browning, Natalie1
Affiliation: 1School of Nursing, Midwifery and Social Sciences, CQUniversity, Townsville Queensland,, Australia
2School of Nursing, Midwifery and Social Sciences, CQUniversity, Brisbane Queensland,, Australia
3School of Nursing, Massey University, Wellington, New Zealand
4Flinders University, Adelaide South Australia,, Australia
5School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton Queensland,, Australia
Source: Journal of Nursing Management (J NURS MANAGE), Oct2022; 30(7): 2442-2447. (6p)
Publication Type: Journal Article – tables/charts
Language: English
Major Subjects: Health Promotion
Special Populations
Medical Practice
Midwives
Accountability — Ethical Issues
Minor Subjects: Nursing Staff, Hospital
Abstract: Aim: To stimulate discussion and debate about the inclusion of vulnerable populations in primary research to inform practice change and improve health outcomes. Background: Current research
practices to safeguard vulnerable people from potential harms related to power imbalances may in fact limit the generation of evidence‐based practice. Evaluation: The authors draw on their experience
working and researching with a recognized group of vulnerable people, incarcerated pregnant women, to provide insight into the application of ethics in both research and clinical practice. In a novel
approach, the ethical principles are presented in both contexts, articulating the synergies between them. Suggestions are presented for how individuals, managers and organizations may improve
research opportunities for clinical practitioners and enhance the engagement of vulnerable people to contribute to meaningful practice and policy change. Key Issues: Ethical practice guidelines may limit
the ability to create meaningful change for vulnerable populations, who need authentic system change to achieve good health outcomes. Conclusion: Inclusive research and practice are essential to
ensuring a strengths‐based approach to healthcare and addressing health needs of the whole population. Health systems and models of care recognizing the diverse lives and health needs of the
broader population demand practical, sustainable support from clinical managers. Implications for Nursing Management: Practical suggestions for clinical managers to support point of care research is
provided, embedding vulnerable voices in policy, practice development and care provision.
Journal Subset: Core Nursing; Double Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Nursing; Peer Reviewed; UK & Ireland
Special Interest: Nursing Administration
ISSN: 0966-0429
MEDLINE Info: NLM UID: 9306050
Entry Date: 20221212
Revision Date: 20230330
DOI: 10.1111/jonm.13764
Accession Number: 160572023
Database: CINAHL Ultimate
Promoting nurses’ and midwives’ ethical responsibilities towards vulnerable people: An alignment of research and clinical practice
Aim: To stimulate discussion and debate about the inclusion of vulnerable populations in primary research to inform practice change and improve health outcomes. Background: Current research practices to safeguard vulnerable people from
potential harms related to power imbalances may in fact limit the generation of evidence‐based practice. Evaluation: The authors draw on their experience working and researching with a recognized group of vulnerable people, incarcerated
pregnant women, to provide insight into the application of ethics in both research and clinical practice. In a novel approach, the ethical principles are presented in both contexts, articulating the synergies between them. Suggestions are
presented for how individuals, managers and organizations may improve research opportunities for clinical practitioners and enhance the engagement of vulnerable people to contribute to meaningful practice and policy change. Key Issues:
Ethical practice guidelines may limit the ability to create meaningful change for vulnerable populations, who need authentic system change to achieve good health outcomes. Conclusion: Inclusive research and practice are essential to
ensuring a strengths‐based approach to healthcare and addressing health needs of the whole population. Health systems and models of care recognizing the diverse lives and health needs of the broader population demand practical,
sustainable support from clinical managers. Implications for Nursing Management: Practical suggestions for clinical managers to support point of care research is provided, embedding vulnerable voices in policy, practice development and
care provision.
Keywords: case study; ethical nursing practice; research ethics; vulnerable populations
INTRODUCTION
Nursing and midwifery practice is framed by professional codes of conduct, ethics and standards of practice. These frameworks seek to ensure the provision of care meets the expectations of the community, the professions and individuals,
contributing to the best possible health outcomes for the recipient. The International Council of Nurses (ICN) and the International Confederation of Midwives (ICM) provide the overarching ethical frameworks within which all nurses and
midwives must practise. Specifically, the ICN Code of Ethics for Nurses (ICN, [21]) identifies four principal elements for ethical conduct: nurses and patients or other people requiring care or services; nurses and practice; nurses and the
profession; and nurses and global health (p. 3). The ICM ([20]) International Code of Ethics for Midwives bases its core ethical code on the recognition of women’s human rights and the role of the midwife in supporting and advocating for
women. Point 1c of the code states ‘Midwives empower women/families to speak for themselves on issues affecting the health of women and families within their culture/society’ (ICM, [20] p.1).
The concept of advocacy is foregrounded throughout both professional frameworks, explicitly as per Element 1.7 of the ICN Code of Ethics (ICN, [21], p.7) or in a more nuanced manner throughout the International Code of Ethics for Midwives
(ICM, [20]). Accordingly, it is expected that nurses and midwives build trusting relationships with the recipients of care, support them in their healthcare decision making and advocate for change to provide the best possible health outcomes.
People from disadvantaged or vulnerable backgrounds are over‐represented in poor health statistics (Ford et al., [16]) and are often the most frequent seekers of care (Cruwys et al., [15]). For many, engaging with health care providers is
fraught with challenges, including, but not limited to, access to care, understanding of need and adaptability of services (Byrne et al., [13]; Lewis et al., [25]). For many, non‐engagement with healthcare providers is reflective of an overall
disengagement with institutions more broadly and demonstrates a level of structural vulnerability for the individual. Structural vulnerability is a term that describes the complex social determinants that contribute to factors that result in poor
health outcomes (Bourgois et al., [10]). Further Bourgois et al describes structural vulnerability as ‘the outcome of a combination of socioeconomic and demographic attitudes, in conjunction with assumed or attributed status’ (p. 4). Therefore,
the vital role that nurses and midwives play in confronting these factors and in facilitating patient engagement cannot be overstated.
Contemporary healthcare practice is based on evidence‐based knowledge (Boswell & Cannon, [ 9]). However, in order to build an appropriate evidence base, rigorous and credible research that meets a strict ethical criterion is essential. The
fundamental importance of research informing clinical practice is mentioned, albeit briefly, in both aforementioned codes of ethics. Howe
ever, despite this, the role of nursing and midwifery researchers is often overlooked. Whilst there is a strong focus on the ethics of providing quality clinical care, less consideration is given to nurses and midwives involved in research.
Hayes ([19]) clearly links the Code of Ethics requirement that nurses should treat all people as equals, considering individual circumstances to promote inclusivity and addressing ‘hidden coercive influences’ (p. 87). It is therefore imperative
that nurse and midwife researchers contribute to the building of a body of knowledge in order to best advocate for all recipients of care.
The authors draw on their experiences of evaluating a project that included working alongside and conducting research with a vulnerable population of pregnant women in prison (Baldwin et al., [ 5]). Pregnant women in prison are considered
vulnerable by their gender, incarceration, pregnancy, culture and socio‐economic background (Baldwin, Sobolewska, et al., [ 6]). The juxtaposition of clinical practice and the importance of engaging vulnerable populations in primary research
to hear the voices of those who may be silenced by complex social, cultural and political influences is explored. The authors’ new insights demonstrate how practice and research with vulnerable people are aligned, enhancing outcomes for
theoretical understanding and practical application. The need for primary research, centred around the most vulnerable is highlighted, and suggestions will be made for future research involving vulnerable people, without compromising the
research process or compounding the participants vulnerabilities.
BACKGROUND
Ethical practice in research is not a new concept. In the aftermath of WWII, the urgent need to protect the vulnerable resulted in the Nuremberg Code, followed in 1964 by the Helsinki Declaration (Mandal et al., [26]). It is beyond doubt that
the events leading up to the development of these cornerstone documents dictated the need for regulation to prevent further research activity that could result in harm, maim or even kill innocent participants. Since then, formal ethics
committees have become embedded into organizations that engage in research (Brown et al., [12]). Alongside the growth of ethics committees, the definition of vulnerability has evolved to recognize the many layers of vulnerability more
accurately across communities.
Over time, restrictions on vulnerable people participating in research due to concerns about causing them harm have increasingly been called into question, raising issues about the exclusion of vulnerable groups from being represented in
research (Hayes, [19]). For example, non‐participation or exclusion from participating in research may in fact be placing vulnerable populations at a further increased risk of harm (Juritzen et al., [22]). Using healthcare provision in prison as an
example of vulnerability in context, the lack of primary research with offenders is apparent. There is an overall dearth of research about health in prisons, with most of the evidence being drawn from statistical data provided by health services
or research around medical chart audits and reviews. This absence of the person and their lived experience of healthcare delivery within prison indicates a significant gap in knowledge, particularly when considered from the perspective of
person‐centred care.
The complexities of vulnerability are well illustrated in the cases of incarcerated pregnant women, with the recent development of formal recommendations to improve health and well‐being outcomes for this group of mothers and babies
(Baldwin, Capper, et al., [ 4]; Birth Companions, [ 8]). The number of incarcerated women around the world is increasing, many of which are of childbearing age, (Alirezaei & Roudsari, [ 3]; Gibson, [17]), are from poor socio‐economic
backgrounds and have higher levels of emotional and mental health trauma than the general population (World Health Organization, [28]). Often women moving through the criminal justice system lead chaotic lives, involving complex social
issues, resulting in prison sentences related to illicit drugs, violence and robbery (Breuer et al., [11]).
Pregnant women are regarded as a vulnerable population due to a perceived lack of capacity to give informed consent for an unborn child and thereby are seen to pose a greater potential for harm. Because of this classification of
vulnerability, there has been a reluctance to undertake research involving them. Despite this hesitancy, it has been suggested that the exclusion of vulnerable populations may, in fact, cause them more harm as it further suppresses their
voices, thereby contributing further to their marginalization (Aldridge, [ 1]). Incarcerated women have been described as ‘the most vulnerable population of women’ (Hayes, [19], p. 84). Therefore, incarcerated pregnant women may be
categorized as an evenmore vulnerable population.
The paradox of this situation is that pregnancy alone should not be considered the causation of increased vulnerability as it is considered a state of well‐being rather than illness. Therefore, it could be argued that it is in fact unethical not to
undertake research with vulnerable populations, such as pregnant incarcerated women as the need to elicit meaningful findings is paramount with enormous potential benefits (Alexander, [ 2]; Krubiner & Faden, [23]). Further, current evidence
suggests that the prison environment may contribute to improved birthing outcomes and being pregnant whilst ‘inside’ provides the incentive for a woman to transform her life with positive birthing and effective parenting experiences offering
an opportunity to interrupt the cycle of recidivism (Shaw et al., [27]).
DISCUSSION
Our experience foregrounds the often‐avoided topic of doing ethical research with vulnerable people (Gordon, [18]). Recognition of a population such as incarcerated pregnant women as a vulnerable group contributes to the lack of evidence‐
based understanding of their situation, from analysis of primary data rather than the more commonly used data sources of document review or research with people who are not the primary concern. We support the view that it is unethical not
to undertake research with vulnerable populations (Alexander, [ 2]; Krubiner & Faden, [23]) as the need to elicit meaningful findings is paramount to those concerned. In fact, the exclusion of this group may, cause harm as it represses their
voices, further contributing to their isolation (Aldridge, [ 1]). Vulnerability is not static, its levels fluctuate in response to the environment and other physical and emotional factors that are at play at any specific time (Biros, [ 7]).
Usually, there is a distinction made between research ethics and clinical practice ethics. However, our experiences demonstrate the necessary links that nurses and midwives must make between research and practice in order to
operationalize best evidence, contribute to new knowledge, provide high‐quality care and align with ethical clinical practice. Our novel approach to this complex situation is illustrated in the following table. Table 1 shows how our
methodological approach addressed all four basic ethical principles for research and how those concepts may be operationalized in the clinical environment.
1 TABLE Ethical principles in nursing and midwifery research and practice
Ethical principle
Autonomy—Seeks to
Ethical research design
Relationships built between researcher and participantResearchers are not employed by
Ethical clinical practice
The ethical principles for nurse and midwives are visible and embedded into organizational policy and clinical practice
uphold the individual’s right the government or by corrective servicesInformation sheets and consent forms will be
expectationsConsiderations and respect for different ways of knowing and understanding are foregrounded in organizational and clinical
to self‐determination
worded to an agreed literacy levelAll consenting participants will be invited to participate in practiceAll recipients of care are given the option to make informed decisions and if they choose, decline or redefine their careAll clinical
without bias or influence
all aspects of the study
decision making places the recipient of care at the centre and prioritizes their individual choices, empowering them to be active participants,
rather than passive recipientsProfessional relationships between the clinician and the recipient of care are established and nurtured, supported
Justice—Research
outcomes must be fairly
and equally distributed
Findings will not be disseminated without full consent from the participantsTranscripts of
are the collective property of the participants and research team
by nurse and midwife managers and organizational governance processes
Full and accurate explanations of care management options are given, clarified and confirmed with all recipients of careEquity in access to
appropriate services is enhanced by individual and organizational practiceClinicians ensure that current evidence is embedded in practice to
ensure consistent, quality care across settings for all recipients of careNurse and midwife managers, in consultation with all staff, ensure that
adequate resources are available to meet the standard‐of‐care expectations
Non‐maleficence—No harm Fact checking with the participants conducted prior to final publication and dissemination of When providing education, clinicians clarify understandings with the recipient of care, redirecting or explaining where requiredAll recipients of
comes to those who
findingsAll precautions will be taken to protect confidentiality, privacy and identity of
care are offered the opportunity to participate in research and policy development where appropriate. Similarly, all recipients of care can
participate in the research participants with ongoing review during the research processData collection methods
decline or withdraw participation without impact on their careAll nurses and midwives, across all levels of practice, including nurse and midwife
or in the broader
promote the creation of safe spacesResearchers will adopt a reflexive stance
community
Beneficence—Research
The research team are already known to the potential participants and have built
must be conducted with the relationships over a period of timeAll researchers will demonstrate reflexivity in their
intent to do good
managers, engage in reflection and reflexivity as part of their continuing professional development
All healthcare professionals involved in the provision of care establish respectful relationships with recipients of careClinicians at all levels, and
across disciplines, will support each other and provide regular opportunities for debriefing in safe environmentsNurses and midwives, at all
research practices and keep a journal during the studyOpportunities will be provided for
levels, will engage with and contribute to policy development and implementationNurses and midwives, at all levels, will engage with and
participants and researchers (separately) to debriefFindings will be disseminated to the
support the ethical conduct of research to improve health outcomes and reduce risk. This may include actively seeking out opportunities to be
academic community, funding/supporting agencies, and the participants with opportunities involved in researchNurse and midwife managers will create a supportive environment that promotes research as a practice improvement and
to discuss and debrief
continuous professional development opportunity
The application of the ethical principles in both contexts is a novel illustration of how ethics underpins all aspects of nursing and midwifery. Further, it demonstrates the inextricable links beyond that of evidence informing practice. It shows that
the ethical conduct of research could be considered a natural extension of ethical nursing and midwifery practice. There is scope for nursing and midwifery managers to support the conduct of research, involve clinical staff in research and
extend the concept of woman‐centred care by placing vulnerable women at the centre of new understandings as well as at the centre of their care.
Contemporary strategies implemented by all levels of government around the world centre on the concept of inclusivity. It is our assertion that these strategies promote inclusion on multiple levels: one, to actively engage clinicians in research
and two, to design research to uphold the ethical principles allowing for both protection and participation with vulnerable groups. Our insights demonstrate a need for these same organizations to extend inclusion strategies to ensure that all
voices are heard. It seems reasonable that, whilst upholding the ethical principles, nurses and midwives are well positioned to seek out and embed ways of engaging the disenfranchised and marginalized in research studies. Engagement and
inclusion may increase self‐worth and perception of self within the broader community and thereby increase power status for those who have the least. As outlined in Table 1, building relationships is fundamental to creating a research culture
in practice, and these relationships should be across disciplines, contexts, organizations and regions, drawing on the formal and informal networks that nurses and midwives are part of. Adopting a research‐engaged culture and providing
support for clinicians to be actively involved in research are essential elements to increasing nurses’ and midwives’ ownership of the evidence for their practice. Redesigning old strategies such as journal clubs is one way in which
organizations (and managers) may contribute to the shift in clinicians’ thinking (Cooper & Brown, [14]; Leonard et al., [24]).
CONCLUSIONS
The conduct of research with vulnerable populations remains the subject of much debate, despite many now believing that to exclude vulnerable cohorts from research participation contributes to the perception of them as vulnerable and
further perpetuates their sense of powerlessness.
This paper has provided experiential understandings upon which to build and support future practice, policies and procedures in research and clinical practice. It is imperative to conduct robust research to provide the evidence for continual
practice improvement. Whilst serious ethical consideration must be given to support studies that promote the voice of the vulnerable in research and consider the circumstances in context, they should not be excluded on the basis of their
vulnerability. The justification for such considerations by nurses and midwives in practice is apparent when the ethical principles are shown to be embedded in both professions across both research and practice contexts. This highlights that
the divide between building evidence and operationalizing it may not be as wide as previously thought.
IMPLICATIONS FOR NURSING MANAGEMENT
This paper provides a rationale and guidance for nursing and midwifery managers to support research at the point of care ensuring that the voices of the most vulnerable are heard in policy and practice development and care provision.
ETHICS STATEMENT
Ethical approval was gained from the CQUniversity Human Ethics Committee for the project that this commentary was based upon (approval number: 0000021132).
ACKNOWLEDGEMENTS
Open access publishing facilitated by Central Queensland University, as part of the Wiley ‐ Central Queensland University agreement via the Council of Australian University Librarians.
DATA AVAILABILITY STATEMENT
Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
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3 Alirezaei, S., & Roudsari, R. L. (2022). The needs of incarcerated pregnant women: A systematic review of literature. International Journal of Community Based Nursing and Midwifery, 10 (1), 2 – 17.
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6 Baldwin, A., Sobolewska, A., & Capper, T. (2020). Pregnant in prison: An integrative literature review. Women and Birth, 33 (1), 41 – 50. https://doi.org/10.1016/j.wombi.2018.12.004
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9 Boswell, C., & Cannon, S. (2022). Introduction to nursing research: Incorporating evidence‐based practice. Jones & Bartlett Learning.
Bourgois, P., Holmes, S., Sue, K., & Quesada, J. (2017). Structural vulnerability: Operationalizing the concept to address health disparities in clinical care. Academic Medicine, 92 (3), 299 – 307.
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Breuer, E., Remond, M., Lighton, S., Passalaqua, J., Galouzis, J., Stewart, K.‐A., & Sullivan, E. (2021). The needs and experiences of mothers while in prison and post‐release: A rapid review and thematic synthesis. Health & Justice, 9 (31),
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Brown, C., Spiro, J., & Quinton, S. (2020). The role of research ethics committees: Friend or foe in educational research? An exploratory study. British Educational Research Journal, 46 (4), 747 – 769. https://doi.org/10.1002/berj.3654
Byrne, A.‐L., Harvey, C., & Baldwin, A. (2022). Health (il)literacy: Structural vulnerability in the nurse navigator service. Nursing Inquiry, 29, e12439. https://doi.org/10.1111/nin.12439
Cooper, A., & Brown, J. (2018). Journal clubs: Engaging clinical nurses and midwives in research. Journal of Continuing Education in Nursing, 49 (3), 141 – 144. https://doi.org/10.3928/00220124-20180219-09
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Krubiner, C. B., & Faden, R. R. (2017). Pregnant women should not be categorised as a ‘vulnerable population’ in biomedical research studies: Ending a vicious cycle of ‘vulnerability’. Journal of Medical Ethics, 43 (10), 664 – 665.
https://doi.org/10.1136/medethics-2017-104446
Leonard, A., Power, N., Mayet, S., Coetzee, M., & North, N. (2022). Engaging nurses in research awareness using a new style of hospital journal club – A descriptive evaluation. Nurse Education Today, 108, 105123.
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Shaw, J., Downe, S., & Kingdon, C. (2015). Systematic mixed‐methods review of interventions, outcomes and experiences for imprisoned pregnant women. Journal of Advanced Nursing, 71 (7), 1451 – 1463. https://doi.org/10.1111/jan.12605
World Health Organization. (2014). Prisons and health. World Health Organization. Regional Office for Europe.
~~~~~~~~
By Adele Baldwin; Tanya Capper; Clare Harvey; Eileen Willis; Bridget Ferguson and Natalie Browning
Reported by Author; Author; Author; Author; Author; Author
This article is copyrighted. All rights reserved.
Source: Journal of Nursing Management
Im doing a paper on low income individuals I’ve done draft all that needs to be done is add another page or two to make it a final paper and add a few more informations !Conduct a literature review to assess the health and social ecology of a community using scientific data and other information from a variety of academic and public resources.Assess the source and quality of health information and data, as related to individual and community health.Demonstrate understanding of health promotion and disease prevention by analyzing community data, including demographics, health statistics, risk and protective factors, social/environmental context, community design, history, dynamics, current health-related challenges and opportunities.below I have the draft that you can add and edit information to make better into a final
Unformatted Attachment Preview
1
Addressing Health Disparities among Low-Income Hispanic Individuals in Santa Clara
County: A Social Work Perspective on Empowering Change
Sabreen Malhi
San Jose State University
PH 179
Catherine Doyle
September 25, 2023
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Addressing Health Disparities among Low-Income Hispanic Individuals in Santa Clara
County: A Social Work Perspective on Empowering Change
Introduction
Poor health among low-income Hispanics discreetly plagues Santa Clara County’s
diversified and colorful landscape. In this vibrant and culturally rich community, where Silicon
Valley promises, and harsh economic reality clash, healthcare and social services access is
crucial. This exploration seeks to explain inequality and advocate for revolutionary change by
exploring the many facets of this topic. The statement describes personal experiences,
connections, and problems that led to the resolve to address these disparities through social work.
It stresses social justice and equity by examining social work’s critical concepts in removing
structural weaknesses. This exploration upholds social work values of fairness, decency, and
justice for all, regardless of background or socioeconomic situation, and indicates a willingness
to combine knowledge, practical experience, and activism to improve health inequities in Santa
Clara County.
Influences on Pursuing Social Work
Personal experiences, familial background, and different relationships shaped my job
choice in social work. My parents taught me empathy, compassion, and community service.
Growing up in a Hispanic middle-class community in Santa Clara County, I saw the struggles
low-income people experienced. I often saw my neighbors persevere through the challenges of
low money. Thus, after seeing their hardships and inequities, especially in accessing healthcare
and social services, I was inspired to address these concerns. I realized that social work may
change the lives of neglected and underserved people.
3
My schooling was essential to my social work career. My undergraduate sociology
degree helped me grasp systemic inequalities that cause many of our community’s health
disparities. I understood I needed academic understanding and practical experience to make a
permanent change. This revelation led me to work part-time as a community outreach
coordinator, where I met low-income people with health difficulties. These events confirmed my
social work career choice. Volunteering with local charities and community organizations has
shaped my objectives in addition to my schooling and profession. I saw how low-income
Hispanics struggle to receive appropriate healthcare and social support through these volunteer
opportunities. These experiences enhanced my commitment to advocating for underprivileged
groups’ equitable access to resources and services.
My path to higher education and social work has been difficult. I had work-life restraints
that jeopardized my educational goals, like many others. Working and studying, as well as
navigating the education system, were problematic. These obstacles tested my dedication to my
path. My unshakeable belief in social work’s potential for positive change drove me through
these challenges. Job and volunteer stories of tenacity and hope often inspired me. I decided to
address the systemic causes perpetuating health inequalities among low-income Hispanics to
make society more equitable and just. Therefore, I acquired time management to balance work
and school. I also sought community and university mentors who guided and encouraged me
throughout my schooling.
Understanding and Aspirations in Social Work
My view of social work is to improve the lives of individuals, families, and communities
by addressing complex social challenges and achieving social justice. As a future professional
4
social worker, I want a varied career with clear responsibilities that follow the field’s ideals. I
will conduct thorough assessments, collaborate with clients to set achievable goals and execute
evidence-based interventions. Understanding each client’s needs and difficulties allows one to
customize treatments that help people and communities cope with crises, build resilience, and
develop sustainable coping methods (Ayala-Marín et al., 2020). Besides assessment and action,
social workers offer counseling and emotional support. My goal is to provide empathic, clientcentered counseling that values everyone.
Connecting people and communities to resources is crucial. Social workers link people to
services. I want to use my resource expertise to help people get healthcare, housing, education,
jobs, and other essential services. This function involves giving information and lobbying for
resource equity to reduce inequities. Social workers must educate and prevent foreseen and
unforeseen instances (Tartakovsky, 2021). I value community education, prevention, and
resource awareness. I can improve community health and well-being by addressing healthcare
inequities and access among low-income Hispanics. I will continuously operate ethically,
transparently, and professionally with clients and coworkers.
Finally, a diverse world requires cultural knowledge. My priorities include cultural
competence, valuing varied backgrounds and experiences, and customizing solutions to cultural
needs. Cultural biases can be addressed to make my practice sensitive to the particular
viewpoints and issues of the people and communities I serve. I have stressed community service,
social justice, the dignity and worth of every person, human relationships, integrity, and
competence in my volunteer work and personal life. In my future career as a professional social
worker, I will respect these ideals and help people and communities by meeting their needs and
promoting positive change.
5
Choosing ASU and Aligning with Mission
For several convincing reasons, I chose ASU for social work school. First, the ASU
School of Social Work’s mission statement matches my values and career ambitions. The
school’s emphasis on social justice, community empowerment, and diversity matches my goal of
reducing health inequalities among Santa Clara County’s low-income Hispanics. I believe ASU’s
concentration on these ideals will give me the knowledge and abilities to impact my community.
I am thrilled by the redesigned mission statement, which prepares social work practitioners,
researchers, and activists to lead positive change in the Southwest, nationally and worldwide.
This broadened vision emphasizes the school’s responsibility in promoting social justice and
equality. It fits my long-term aim of becoming a social work leader who helps improve
healthcare access and equity. I want to collaborate with groups to reduce health inequities and
improve healthcare access worldwide.
Social Justice and Combating Racism
Social justice is important to social work, and I cherish it. I define social justice as
fairness, equity, and acknowledging all people’s inherent value and dignity, regardless of
background or circumstances. Addressing systemic disparities and aggressively dismantling
barriers to discrimination, oppression, and injustice is vital (Assari et al., 2020). Social justice is
crucial to my problem statement, which addresses health inequities among low-income Hispanics
in Santa Clara County. These discrepancies originate from systematic racism and other
injustices. Social work’s social justice and advocacy ideals can address these social system flaws.
I plan to use a holistic strategy to fight racism and health inequities. This method encompasses
lobbying, education, cultural competence, research, community participation, and policy
6
engagement. My voice and platform will promote racial equity and social justice policies and
practices. This advocacy will include healthcare access, culturally competent services, and
resource allocation that affect Santa Clara County’s Hispanic population’s health.
Education and awareness are vital in fighting racism. I believe in community education
and addressing racism’s health inequities. I organize workshops, seminars, and outreach activities
to raise awareness of this critical topic and start community debates about ending systemic
racism. Cultural competency is another crucial element of my approach. I will constantly
improve my cultural competence to meet diverse populations’ requirements. Self-reflection,
acknowledging and resolving hidden prejudices, and actively listening to underrepresented
communities are part of this. Cultural competence enables respectful, meaningful, and culturally
sensitive interventions (Cheng et al., 2020). By studying Santa Clara County’s low-income
Hispanic health disparities, I seek to find reasons and provide evidence-based solutions. I will
actively seek alliances with community-based groups and grassroots movements fighting racism
and advancing social justice. Finally, local, state and national policy engagement is essential. I
will lobby lawmakers for racism-related health disparities legislation. To stress the necessity of
eliminating systemic racism in our healthcare and social institutions, I will focus on the health
disparities in my issue statement.
Managing Coursework and Internship
I have carefully planned to balance the problematic curriculum, internship, and other
MSW program requirements. I understand that this program requires good time management and
work-life balance. I know time management is critical first. A precise weekly calendar will help
me manage my academics and internship hours. This plan will include classes, internships, and
7
study time to stay on top of homework and assignments. Consistency in following this timetable
will help me balance my workload. I also want to communicate openly with my internship
supervisor and academic advisors. Meeting with my supervisor regularly will help me satisfy
internship obligations and receive assistance and direction. Academic advisors will also help me
balance my school load with my internship. I will evaluate how my additional commitments,
such as part-time work and family, affect my schoolwork and internship management. I will
adapt my work hours or seek additional support to meet MSW program requirements.
Addressing unexpected obstacles requires flexibility and agility. I will prioritize self-care.
Recognizing the importance of physical and mental health, I will schedule rest, exercise, and
recharging activities. Long-term program success requires balancing personal life, academics,
and internships. I will also use university resources and help, such as academic tutoring,
counseling, and time management workshops. These resources will give me tools and ways to
manage various tasks more efficiently.
Conclusion
My mission is to mitigate the health disparities among low-income Hispanic Santa Clara
County residents, focusing on social work. This journey emphasizes cultural competence,
advocacy, and community engagement through personal experiences, background, and
relationships with higher education obstacles. Understanding social work obligations, especially
social justice’s role in tackling structural inadequacies and racism, is essential. The ASU School
of Social Work’s mission is to remove structural barriers, promote fairness, and defend human
dignity. A complete plan for managing coursework, internships, and other life responsibilities
throughout the MSW program will help me align my goal with the institution’s mission.
8
Balanced and sustained academic and professional pursuits require good time management, open
communication, and self-care.
9
References
Assari, S., Mistry, R., Caldwell, C., & Bazargan, M. (2020). Protective effects of parental
education against youth cigarette smoking: diminished returns of blacks and
hispanics
. Adolescent Health Medicine and Therapeutics, Volume 11, 63-71.
https://doi.org/10.2147/ahmt.s238441
Ayala-Marín, A., Iguacel, I., Miguel-Etayo, P., & Moreno, L. (2020). Consideration of social
disadvantages for understanding and preventing obesity in children. Frontiers in Public
Health, 8. https://doi.org/10.3389/fpubh.2020.00423
Cheng, C., Beauchamp, A., Elsworth, G., & Osborne, R. (2020). Applying the electronic health
literacy lens: systematic review of electronic health interventions targeted at socially
disadvantaged groups. Journal of Medical Internet Research, 22(8), e18476.
https://doi.org/10.2196/18476
Tartakovsky, E. (2021). Ethnic minority and majority social workers working with ethnic
minority clients: culture-bound professional interventions and burnout among arab and
jewish israeli social workers. Research on Social Work Practice, 32(2), 215-226.
https://doi.org/10.1177/10497315211049443
Please identify each prompt you answer by number and restate the question in bold letters.Prompt 1: Explain in detail the different types of dementia. Prompt 2: Explain in detail the difference between ischemic vs. hemorrhagic stroke.Prompt 3: Explain the use of tPAs (Tissue Plasminogen Activator).prompt 4: Describe the different types of headacheMust be willing to respond to a peer.
Video presentation Week 7 (Power Point)
The purpose of this assignment is to demonstrate understanding through teaching and explanation.
Begin by choosing one of the topics below, or propose a topic of interest from the assigned readings,
subject to instructor approval. Post your choice to the “Week 5 Student Topics for Week 7 Video
Presentation” discussion thread.
PRO TIP: You may not select a topic a classmate has already chosen. The sooner you choose, the
more options you will have.
You will produce a 4–7 minute audio-video presentation on your chosen topic for this assignment.
In your presentation, include the following:
•
Include at least one type of visual aid in your presentation, such as PowerPoint slides,
diagrams, white board use, etc.
•
You are expected to explain the processes or concepts in your own words using references
to support your explanations. Include a reference list at the end and cite references verbally
or with on-screen citations.
•
Use appropriate master’s level terminology.
•
Include all necessary physiology and/or pathophysiology in your explanation.
•
Use detailed explanations to teach or explain. Your audience is your classmates and
professional colleagues.
•
Reference at least two sources; you may cite your e-text as a source. Use APA format to
style your visual aids and cite your sources. Include a reference page in your video.
•
Your presentation must include both audio and visual components and be professional in
nature
****************************
CHOSEN TOPIC********************************
***Define and describe the pathophysiology of diverticular disease of the
colon.***
You will upload your finished presentation on this page for grading, and you will post a
copy to the Final Video Presentation Upload discussion thread to be shared and
reviewed with your classmates.
Review the rubric for more information on how your assignment will be graded.
Videos can be recorded using any software or tool, but all videos are required to be
uploaded to My Panopto Videos for assignment submission.
You can also use the Panopto Desktop Recording tool to create your video.
Click hereLinks to an external site. for detailed Panopto instructions.
Rubric
NURS_530_DE – Video Presentation Rubric (2)
NURS_530_DE – Video Presentation Rubric (2)
Criteria
Ratings
Pts
This criterion is
linked to a Learning
OutcomeContent
25 to >21.75 pts
Meeting
Expectations
The introduction gets
your attention and
lays out the topic
well. It establishes a
strong framework for
the rest of the
presentation. The
conclusion is
comprehensive and
compelling.
Presentation contains
accurate and complete
information. Ideas,
facts, and information
demonstrate a strong,
confident
understanding of the
material.
21.75 to >18.75 pts
Approaching
Expectations
The introduction
lays out the topic.
It establishes some
framework for the
rest of the
presentation. The
conclusion is clear.
Presentation
contains accurate
and complete
information. Ideas,
facts, and
information
demonstrate an
understanding of
the material.
18.75 to >14.75 pts
Falling Slightly
Below
Expectations
The minimal
introduction
establishes a vague
framework for the
rest of the
presentation. The
conclusion is abrupt
or unclear.
Presentation
contains some
inaccurate and
incomplete
information. Ideas,
facts, and
information
demonstrate little
understanding of
the material.
14.75 to >0 pts
Not Meeting
Expectations
Introduction is
missing. No
framework is
established for the
presentation. The
conclusion is
missing. There
may be multiple
instances of
inaccurate or
incomplete
information. No
understanding is
demonstrated.
25 pt
NURS_530_DE – Video Presentation Rubric (2)
Criteria
Ratings
Pts
This criterion is
linked to a Learning
OutcomeOrganization
15 to >13.05 pts
Meeting
Expectations
Information is
presented in a clear,
logical order with an
apparent beginning,
middle, and end. The
speaker introduces
the topic and
identifies it skillfully.
13.05 to >11.25 pts
Approaching
Expectations
Information is
generally presented
in a clear, logical
order with an
apparent beginning,
middle, and end.
The speaker
introduces the topic.
11.25 to >8.85 pts
Falling Slightly
Below Expectations
Information is
presented in a way
that shows little
organization or
order. The speaker
fails to introduce the
topic or does so in a
way that is
confusing.
8.85 to >0 pts
Not Meeting
Expectations
Information is
not presented in
a logical,
cohesive order.
Topic is unclear.
15 pt
NURS_530_DE – Video Presentation Rubric (2)
Criteria
Ratings
Pts
This criterion is
linked to a Learning
OutcomeNarration
(audio)
15 to >13.05 pts
Meeting
Expectations
The speaker speaks
clearly and
articulately without
a lot of pauses,
“ums,” and “ahs.”
Information is
presented in a
confident, rehearsed
manner. The
speaker presents
with a tone and
manner appropriate
for an academic
audience. Audio is
clear and free from
background noise
distractions. The
length of
presentation is
within the assigned
time limits.
13.05 to >11.25 pts
Approaching
Expectations
The speaker speaks
clearly and
articulately for most
of the presentation
but may lapse
occasionally with
several pauses,
“ums,” and “ahs.”
Information is
presented in a
somewhat confident,
casually rehearsed
manner. The speaker
generally presents
with a tone and
manner appropriate
for an academic
audience. Audio is
generally clear and
free from
background noise
with a few
distractions. The
length of
presentation is
slightly outside the
assigned time limits.
11.25 to >8.85 pts
Falling Slightly
Below
Expectations
There are numerous
lapses in audio or
multiple
background
distractions.
Speaker
demonstrates little
preparation. Tone
may be
inappropriate for
the audience. The
length of
presentation is far
outside the
assigned time
limits. Some audio
is missing or
difficult to hear.
The length of
presentation is well
outside the
assigned time
limits.
8.85 to >0 pts
Not Meeting
Expectations
It is difficult to
follow the speaker
due to many
pauses, starts and
stops, and other
factors suggesting
the speaker is not
practiced or
rehearsed. Little
preparation or
understanding of
the topic is
demonstrated.
There is no audio.
The length of
presentation is far
outside the
assigned time
limits.
15 pt
NURS_530_DE – Video Presentation Rubric (2)
Criteria
This criterion is
linked to a Learning
OutcomeVisual
Aid(s)
Ratings
Pts
10 to >8.7 pts
Meeting
Expectations
Use of visual aids/
images is
appropriate.
Materials are easy
to read, interesting,
and relevant to the
content.
8.7 to >7.5 pts
Approaching
Expectations
Use of visual aids/
images is generally
appropriate. Materials
are generally easy to
read, somewhat
interesting, and
relevant to the
content.
7.5 to >5.9 pts
Falling Slightly
Below Expectations
Use of visual aids/
images is not fully
appropriate.
Materials are
generally not easy to
read. May have
irrelevant visual aids
or images
5.9 to >0 pts
Not Meeting
Expectations
Use of visual
aids/ images is
not appropriate.
Materials are not
easy to read.
5 to >4.35 pts
Meeting
Expectations
The assignment
consistently follows
current APA format
and is free from
errors in formatting,
citation, and
references. No
grammatical,
spelling, or
punctuation errors.
All sources are cited
and referenced
correctly.
4.35 to >3.75 pts
Approaching
Expectations
The assignment
consistently follows
current APA format
with only isolated
and inconsistent
mistakes and/ or has
a few grammatical,
spelling, or
punctuation errors.
Most sources are
cited and referenced
correctly.
3.75 to >2.95 pts
Falling Slightly
Below
Expectations
The assignment
generally follows
current APA format
with several
mistakes and
grammatical,
spelling, or
punctuation errors.
Most sources are
cited and
referenced
incorrectly.
2.95 to >0 pts
Not Meeting
Expectations
The assignment
does not follow
current APA
format and/ or has
many
grammatical,
spelling, or
punctuation
errors. Sources
are missing.
10 pt
This criterion is
linked to a Learning
OutcomeAPA and
Mechanics
Total Points: 70
5 pts
PreviousNext
Week 6 Discussion ForumA theoretical framework provides a rationale for predictions about the relationship among variables. Discuss the variables you will use in your change project and the specific steps that are necessary to implement your change project in your organization.Topic is again: Changing Sexual Behavior
Pediatric Cardiac Disorder Presentation
You will collaborate to create a presentation on Pediatric Cardiac Diseases. You should select one
specific disease to focus on. Your paper should follow the APA format and include at least three reliable
sources. You may choose to present your work in PowerPoint format.
1) Defects with decreased Pulmonary Blood flow
A. Tricuspid atresia
B. Eisenmenger’s syndrome
C. Tetralogy of Fallot
Kindly provide details about the patient’s condition, symptoms, relevant assessment findings, treatment
options, nursing care, nursing diagnosis, and education for the patient and their family. Remember to cite
your sources in-text and include a reference list using APA format. Creativity is encouraged pictures,
videos etc.
SCENARIO: Assume that you are a consultant that has been hired by one of the healthcare organizations from your unit 7 assignment (select one of these organizations to be the basis of your unit 8 assignment). You have been hired to research and present analysis about:
Organizational performance measures and the progress made over the past year
Your recommendations for priorities that the organization should focus on in the next year
The CEO tells you that they have mountains of data, but have difficulty analyzing what are the most important projects to work on in the next fiscal year. They have begun to build analytic capabilities, but are still early in using analytics for operational decision-making. The executive team will be meeting next month for strategic planning and will select the top 3 projects to fund for next fiscal year. Each executive has their own ideas about what are the most important projects.
You have one week to prepare your report that will provide your recommendations for the priorities that the organization should focus on in the next year.
RESEARCH additional information that could be helpful to understanding the strategic priorities of the organization (ex: website, annual reports, community health assessment report). How does this hospital compare to other hospitals in the same geographic area in terms of readmissions, HCAPHS and other data from WhyNotTheBest.org? Based on what you see in these reports, what will the hospital have to measure in order to meet their strategic objectives?
ANALYZE the Quality spreadsheet data provided for the unit 8. The Chief Nursing Officer has provided this spreadsheet with data that her team has collected on several quality and safety metrics over the past year. After looking at the data, what is the best way to include this data and make use of it in your report? Is it feasible to use a pivot table to analyze the data?
Create a table that will use the CNO data in some way so that you can include it in your report.
Create a chart to visualize the data. What does the data reveal? Describe any limitations you see in this data. Highlight the most significant observations. Be sure the charts and all data are properly labeled and titled.
Note: There is no one “correct” answer to this section, it is up to you to decide how to best use this data. This data is not from WhyNotTheBest, but it is a realistic example of additional data that may come to us from a different source.
CNO data_BHIS 540_010418.xlsx
DEVELOP a prototype Performance Analytics Scorecard in an Excel spreadsheet. You have now looked at a variety of data from multiple sources. In unit 7 you began your analysis and developed 3 tables of data from the Hospital Compare database on key performance analytics. How would you incorporate the unit 7 data and the data provided by the CNO into one scorecard so that the organization can have a single source for tracking important metrics? Your prototype should be labeled as a DRAFT. The purpose is to give your clients a start on a tool that organization leaders could use to monitor progress on quality and patient safety organizational performance projects. Look at the example provided in the readings and materials for this unit and design a simple version of a spreadsheet scorecard. It is not required that you include data results in the scorecard. It should include:
1. Key measures to be monitored (2 points)
2.CNO data (1 point)
3. Specification of timeline or time period for measurements (2 points)
4.Effective layout and visualization of data (2 points)
Note: This is an example that may provide you with some ideas for your own scorecard. Performance Dashboard example.xls
Prepare a PowerPoint presentation including slides with all the research and analysis you have done. It should include:
Introduction – description of what you are presenting (2 points)
Key points you want to highlight from the research you have done about the organization (ex: what are their accomplishments related to performance measures, what are their strategic goals, how do they compare to their competition) (2 points)
Data tables showing the results of the performance measures from the past year. (Use the data tables you did for unit 7.) (2 points)
Charts showing the trends of key measures that you want to highlight (2 points)
At least 1 table and/or chart showing the quality and safety data provided by the CNO (2 points)
Your interpretation of the data (2 points)
Your conclusions about the data. (What questions arise after looking at the data? Does the data align with the organizational strategic direction as stated in their annual report or on their website or in other information that you found? Does the data suggest projects that the organization should work on to improve quality or patient safety?) (2 points)
BHIS 540 Unit 8 presentation TEMPLATE.pptx BHIS 540 Unit 8 presentation TEMPLATE.pptx – Alternative Formats
8. By Thursday midnight, post your Performance Analytics Scorecard and PowerPoint to the class discussion board (under My Groups).
9. Discussion: Between Friday and Sunday, provide a substantive comment on 2 other student assignments. (ex: evaluate how they approached their analysis, conclusions, questions raised)
Your deliverables for this assignment are:
DRAFT of a Performance Analytics Scorecard saved as a (PDF or Excel) and upload to Unit 8 Group assignment folder. Include your name on the document. (7 pts.)
PowerPoint slides saved as a PDF and upload to Unit 8 Group assignment folder. Include your name on the document. (14 pts.)
Comment on 2 other student assignments, either the Scorecard or Powerpoint. (6 pts.total)
Chamberlain College of Nursing
NR439: RN Evidence-Based Practice
Week 6: Reading Research Literature Worksheet
Name:
Date:
Complete the required worksheet after reading the assigned article for the session. The NR439
Reading Research Literature Worksheet Rubric must be used to answer each of the graded
criterion for the following:
Purpose of the
Study
Type of Research
& the Design
Sample
Data Collection
NR439_RRL_Worksheet_5.21_ST
1
Chamberlain College of Nursing
NR439: RN Evidence-Based Practice
Data Analysis
Limitations
Findings/Discussion
Reading Research
Literature
NR439_RRL_Worksheet_5.21_ST
2
RESEARCH
“I WAS HERE FIRST, WHY DID THEY GO BEFORE
ME”: EXAMINING PATIENTS’PERCEPTIONS OF
PRIORITY IN A PSYCHOMETRIC STUDY OF
EMERGENCY DEPARTMENT TRIAGE
Authors: Joshua Ray Tanzer, PhD, Marlene Dufault, PhD, RN, Linda Roderick Rioux, BS, RN, Jason Machan, PhD,
Kathy Bergeron, MS, GCNS, RN, and Anthony Napoli, MD, MHL, Providence, Kingston, and Newport, RI
Contribution to Emergency Nursing Practice
What is already known on patient satisfaction is that
there is a significant interplay between patient expectations and perceptions, with patients generally expecting
faster service than is realistic within the emergency
department.
The main finding of this paper is that the Patient Perception of Priority to Be Seen Survey can reliably measure
patient subjective experience, and a verbal explanation
of common triage procedures could standardize patient
expectations.
Recommendations for translation of the findings of this
paper into emergency clinical practice include using the
Patient Perception of Priority to Be Seen Survey in
research, quality improvement projects, and interventions to improve patient-nurse communication in the
emergency department.
Abstract
Introduction: Unrealistic patient expectations for wait times
can lead to poor satisfaction. This study’s dual purpose was: (1)
to address disparities between patients’ perceived priority level
and the Emergency Severity Index (ESI) assigned by emergency
room triage nurses; and (2) to evaluate validity and reliability of
using the Patient Perception of Priority to be Seen Survey
(PPPSS) to investigate patient expectations for emergency
department urgency.
Methods: A two-group pretest-posttest quasi-experimental
approach compared patient urgency opinions to nurse urgency
ratings with and without a scripted educational intervention.
This tested how closely patient perceptions were related to
triage nurse ratings.
Results: Reliability for the PPPSS was acceptable (reliability
¼ 0.75). Patients who were rated lower urgency on the ESI
by triage nurses tended to self-report higher urgency (rho ¼
0.44, P < .01). Attitudes were more consistent in the posttest
patient group who were exposed to the scripted verbal description of emergency department procedures (x2 (1, N ¼ 352) ¼
8.09, P < .01). Patients who disagreed with emergency nurse
scores tended to be younger on average (eg, < 40 years old;
rho ¼ 0.69, P < .01). Male identified patients tended to be rated
both by nurses and themselves as higher urgency (beta ¼ 0.18,
P ¼ .02).
Discussion: We recommend the PPPSS for nurses and re-
searchers to quickly assess patient expectations. Additionally,
promoting patient understanding through a scripted educational
Joshua Ray Tanzer is a Biostatistician, Lifespan Biostatistics, Epidemiology,
Research Design, Informatics Core, Providence, RI.
Department of Emergency Medicine, Newport Hospital Emergency
Department, Newport, RI.
Marlene Dufault is Professor and Nursing Consultant, University of Rhode
Island, Department of Nursing, Kingston, RI.
For correspondence, write: Joshua Ray Tanzer, PhD, Lifespan Biostatistics,
Epidemiology, Research Design, Informatics Core, 130 Plain Street,
Providence, RI 02903; E-mail: jtanzer@lifespan.org
Linda Roderick Rioux is Staff Nurse Newport Hospital Emergency Department,
Department of Emergency Medicine, Newport, RI.
Jason Machan is Director of the Lifespan ClinTECH Center and Lifespan
Biostatistics, Epidemiology, and Research Design Core, Providence, RI.
Kathy Bergeron is Clinical Nurse Educator, Newport Hospital and Adjunct
Faculty, Department of Nursing, Salve Regina University, Newport, RI.
Anthony Napoli is Professor of Emergency Medicine, Department of Emergency
Medicine, Warren Alpert School of Medicine at Brown University and Chair,
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JOURNAL OF EMERGENCY NURSING
J Emerg Nurs 2023;49:294-304.
Available online 24 December 2022
0099-1767
Copyright Ó 2022 Emergency Nurses Association. Published by Elsevier Inc. All
rights reserved.
https://doi.org/10.1016/j.jen.2022.09.017
VOLUME 49 ISSUE 2
March 2023
Tanzer et al/RESEARCH
strategy about the ESI system may also result in improvements
in communication between patients and nurses.
Key words: Emergency department; Triage; Patient perception;
Psychometrics; Educational intervention
Introduction
patient-reported subjective urgency scores with the ESI
scores rated by the triage nurse. In addition, we used a
quasi-experimental approach to see whether or not informing patients of ED triage procedures through a scripted
educational intervention improves patient-reported expectations for wait times. Finally, we use expert knowledge from
more than 35 years’ nursing experience to verify that the patients whom we thought would have unrealistic expectations
for wait times did demonstrate such discrepancies empirically. This provided a multifaceted validation of the Patient
Priority to be Seen Survey and an estimation of reliability.
Discussion is provided of how to interpret individual scores,
possible clinical applications, and how this could be used in
research on patient satisfaction.
PROBLEM DESCRIPTION
Current best practice policies for triaging patients seeking
care in hospital emergency departments are aimed to assure
that emergency nurses, in collaboration with medical staff,
provide triage assessments with a high level of accuracy for
those seeking rapid, emergent treatment.1 The goal of triaging in the emergency department is to assess each patient in
an expedient manner and to prioritize their care. The emergency severity index (ESI) based on joint Emergency Nurses
Association/American College of Emergency Physicians
standards is often used as a tool for facilitating efficient
triage.2 The 5-level emergency triage algorithm provides
clinically relevant prioritization of patients into 5 groups
from 1 (requires immediate intervention) to 5 (least urgent).
Triage nurses are responsible for this assessment using a
rapid, systematic collection of data relevant to the patient’s
chief complaint, age, allergies, and vital signs to obtain sufficient information to determine the ESI level and to be seen
by the emergency provider.3
Although ESI triage procedure provides an efficient algorithm for designating patient urgency, it may not always
be apparent to patients in the waiting room, which risks patient confusion and dissatisfaction. To inform patient provider communication, in 2013, Toloo et al4 developed the
Patient Perception of Priority to Be Seen Survey (PPPSS),
although it has received very little use in research or clinical
settings. The full scale includes 11 questions about patient
health and demographics, including one question directly
asking about how quickly a patient expects to be seen by a
provider. This item seems an intuitive way to calibrate
how realistic patient expectations are for ED efficiency;
however, its lack of use raises concern about its reliability
and validity. The original project that developed the scale
emphasized the face validity of questions. They also did
find positive correlations with pain and seriousness reported
by ambulatory patients, supporting validity of the Patient
Priority to be Seen Survey as a measure of urgency during
a crisis.4 Reliability was not estimated.
In this report, we review some of the challenges in patient communication and psychometric theory and provide
an evaluation of the Patient Priority to be Seen Survey for
use in the emergency department to facilitate nurse-patient
communication. We accomplished this by comparing
March 2023
VOLUME 49 ISSUE 2
AVAILABLE KNOWLEDGE
Emergent patients often perceive their throughput time
more favorably than those with less emergent needs.5 Previous research has found that shorter wait times are positively
associated with patient satisfaction.6-9 Beyond subjective
quality of care, prolonged wait times in the emergency
department also have been associated with increased
morbidity and mortality, especially among critical care
patients.10 Ensuring an efficient emergency department is
important for quality patient care. An evidence summary table of the studies we reviewed is provided in Online
Supplement 1.
Educational interventions have demonstrated some efficacy in raising triage nurses’ understanding regarding priorities to be seen;11 however, less well-studied is the great
misunderstanding in patient’s perception about standard
triage procedures and how this can be ameliorated. Previous
research has shown a discrepancy between patient and practitioner perceptions of priority of need to be seen.12 In addition, triage communication of expected wait time has
demonstrated an association with overall ED satisfaction.8
At this project location, a recent quality improvement survey indicated only 9% agreement between triage nurses’ ratings of urgency and patients’ self-reported perceptions of
priority to be seen.
The balance between patient expectations and what is
realistic was emphasized by Maister13 who conceptualized
what constitutes patient satisfaction. Maister focused on
the discrepancy between patient perceptions and expectations. He goes so far as to suggest that improving the
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RESEARCH/Tanzer et al
experience while waiting for care may decrease the perceptions of wait times and increase satisfaction without an
actual change in the wait time. This is important, because
target ED wait times are often not met, likely because of
contextual factors that are not easy to change.14 If better
patient-nurse communication can improve patient
perceived wait times, this provides a much simpler avenue
to improve patient satisfaction.
RATIONALE
We propose the PPPSS to help to facilitate better research
and quality improvement projects on subjective patient experiences and nurse-patient communication. In addition, if
reliable and valid, this instrument could be used as part of an
intervention during the patient triage process to produce
higher quality, safe, and expedient care that promotes satisfaction both for patients and nurses.
In particular, we used concurrent validity testing
against the validating criterion of urgency scored by trained
triage nurses using the ESI. Thus, the PPPSS was compared
as the extent to which its scores were similar to the “gold
standard” ESI criterion. Previous research has indicated
the ESI provides valid estimates of patient urgency and
has strong inter-rated reliability when used by triage nurses
(reliability estimates ranged from 0.83-0.94),15-17 although
some concerns have been raised that measurement is less
reliable in less developed countries.18 If triage nurse ratings
demonstrate concordance with patient-reported urgency,
this would support the use of the PPPSS as a measure of subjective patient urgency.
In addition, we examine construct validity through the
use of a quasi-experimental design. For the first half of data
collection, a pretest group of patients were simply asked to
report their opinions on the PPPSS in a nonstandardized
way. During the second half of data collection, posttest patients were provided with a brief scripted standardized verbal description of the ESI triage protocol before
completing the questionnaire. If the PPPSS validly measures
patient expectations for when they will be seen, then directly
informing their expectations should result in more standard
scoring.
SPECIFIC AIMS
We aim to better understand patient experiences in the
emergency department, to validate the PPPSS as a tool for
evaluating patient subjective urgency. We hypothesized
that patients who perceived their needs as urgent on the
PPPSS would tend toward lower urgency scores assigned
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JOURNAL OF EMERGENCY NURSING
by triage nurses using the ESI, as has been suggested
previously.4,13 We estimated reliability and validity contextualized by nurse ratings, demographic variables, general
health status, and health care usage behavior. To inform
how to interpret PPPSS scores in research and clinical settings, we estimated the relationships among observed triage
scores, patient health traits, and individual uniqueness.
Finally, we hypothesized that there would be greater agreement between nurse and patient urgency and need to be
seen when patients were provided a verbal description of
ED procedures by the triage nurse.
Methods
SETTING
Data were collected at an emergent care unit situated in a
community magnet-designated hospital in New England.
At capacity, the hospital can care for 40,000 patients annually, although most years there are closer to 33,000. The ED
staff consisted of 43 registered nurses. Of these, 29
(67.44%) were credentialed to perform triage nursing functions using the ESI. This site has used the ESI since 2005
and all triage nurses received updated training following
ESI revisions in 2012. All nurses were required to have at
least a Bachelor of Science in Nursing, and only those nurses
with a year or 2 of emergency nursing experience are trained
to be triage nurses. Training to use the ESI includes a 2-hour
structured didactic course and on-the-job training. In addition, nurses are encouraged to pursue continuing education
opportunities on nursing in general at discounted rates in
collaboration with universities in the area, to maintain familiarity with best practices in nursing.
DATA COLLECTION
DESIGN
AND
QUASI-EXPERIMENTAL
To test the validity of using the PPPSS as a measure of subjective patient urgency, we compared scores with the ESI as
a test of concurrent validity. In addition, we used a quasiexperimental design, with data collected before and after
providing posttest patients with the standardized scripted
verbal description of what to expect. If discrepancies between patient and nurse triage ratings are because patients
have improper expectations for ED procedures, then simply
informing patients of what to expect should standardize
scoring. This tests construct validity, using a script written
by the principal investigator read to patients. If the PPPSS
is a valid measure of patient subjective urgency,
VOLUME 49 ISSUE 2
March 2023
Tanzer et al/RESEARCH
discrepancies between patient- and nurse-reported urgency
will be larger in the pretest nonstandardized group of patients.
The principal investigator was responsible for data
collection using paper and pencil scoring. Patients were oriented to the study when they entered the emergency department after their initial triage assessment. The purpose of the
study was explained and patients verbally consented and
were asked to complete a short survey, the 11-question
PPPSS (Supplementary Appendix A), read to them by the
triage nurse investigator. Patients were not informed as to
the triage nurse assessments. Nurses had pre-existing
ongoing nurse-initiated protocols, which were added to
the list. For the verbal description condition, after more urgent needs were addressed, nurses explained the triage standard of care to patients, script provided in Supplementary
Appendix B. All responses were kept confidential and measures were taken to ensure anonymity of the patients by not
linking patient demographic variables to patient names or
ID numbers. Two independent samples were collected in
the same emergency department. This directly evaluated patient expectations for triage procedures, to compare expectations with ESI triaged urgency, with and without the
scripted verbal description provided.
PARTICIPANTS
Patients were recruited on a walk-in basis over the course of
4 months broken into 2 groups: 2 months of nonstandardized observation (76 patients recruited) and 2 months
with the scripted verbal intervention (100 patients recruited;
total sample 176 patients). Samples were independent of
each other except for the chance possibility that a patient
entered the emergency department twice, with and without
the verbal description. Although patients were allowed to
participate regardless of the time they entered the emergency
department, most patients were enrolled in the morning and
afternoon, when most people visit the emergency department. All patients were English-speaking conscious adults,
at the age of 18 years and older. Exclusion criteria for this
sample were patients with dementia, children, or those unable to answer the short survey. After hearing the study
goals, we asked patients in the emergency department to
participate with no direct benefit to individual patients
provided.
MEASURES
Developed in an earlier study by Toloo et al,4 the PPPSS full
survey includes 11 questions regarding factors that could
explain patients’ perceived urgency such as demographics
March 2023
VOLUME 49 ISSUE 2
(age, sex, ethnicity, socioeconomic status), health beliefs
and preferences (perceived health status, urgency, previous
ED visits), and perceived acuteness including reasons for
seeking care in the emergency department (Supplementary
Appendix A). We focused on the question asking about patient expectations for wait time. Patients were asked by the
triage nurse to rate the urgency of their needs in time they
thought they could wait on a scale from 1 (representing
“within 2 hours”) to 5 (representing “immediately”). We
sought to validate this question on the PPPSS for the purpose of assessing patient expectations for ED procedures
and subjective urgency.
Patient ethnic identity was measured only as Hispanic
and not Hispanic self-reported by patients owing to this
emergency department’s patients being primarily white
and a lack of ethnic diversity within the community. We
had thought Hispanic ethnic identity might be a more
cogent single social group than the inclusion of many underrepresented racial categories. No other race or ethnicity
questions were asked. Although a sample of more diverse respondents would be preferred, this measurement scheme is
consistent with recommendations on how to conceptualize
ethnicity.19
PSYCHOMETRIC THEORY
More detailed discussion of psychometric theory and statistical estimation are included in Online Supplement 2. We
estimated reliability for the PPPSS as internal consistency
from intraclass correlation coefficient for individual patient
traits within a generalizability theory framework and mixed
effects modeling estimation.20-22 Reliability greater than
0.70 is considered acceptable, although values greater than
0.80 are preferred. Reliability at this level would indicate
that repeated use of the PPPSS would tend to produce
similar scores for similar patients at least 70% of the time
depending on the level of reliability.
Previous work has used the PPPSS measure in research
settings; however, its psychometric properties were not the
emphasis of the project.4 This will document the applicability and extend interpretability of this measurement tool
to a clinical setting. By performing a validity analysis, the results can inform how to interpret individual PPPSS scores,
so far as they relate to nurse-rated urgency and other personal health and demographic information. We focus on
concurrent validity relative to the ESI and construct validity
contextualized by the quasi-experimental design and patient
demographic information.
Finally, we incorporated expert opinion into the analysis to ensure face validity, described in detail in Online
Supplement 2. Face validity is the extent to which an
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RESEARCH/Tanzer et al
instrument appears to be an adequate measure, and typically
not considered critical, we believed it could be important if
patients’ resistance to being measured reflects their view that
the scale is of no significance to their problem. Led by the
principal investigator, the research team categorized patients
by how likely they were to agree with the triage nurse and by
how subjectively stressful their symptoms were. This
allowed for consideration within the analysis of those patients for whom there was concern that they may not have
appropriate expectations or patients who may have reasons
to feel that their needs are urgent. If the PPPSS is valid
for understanding subjective patient needs, then patients expected to disagree with the triage nurse or patients with subjectively unpleasant conditions should demonstrate the
largest improvements in concordance between nurse- and
patient-reported ratings when the verbal description is provided.20-22 We tested this empirically.
ANALYSIS PLAN
We determined significance as P < .05. The sample
included 176 individuals (76 nonstandardized pretest and
100 with the scripted verbal description of ED protocol).
For each patient, there were 2 scores, 1 ESI rating and 1
PPPSS patient-reported urgency rating, resulting in a total
sample of 352 observations. First, we examined the correlation matrix and performed discriminant function analysis.23
This helps to understand the characteristics of the expertdetermined patients who may have unrealistic expectations
of ED efficiency, testing concurrent validity.20,21 Observed
discrepancies between patient and nurse triage ratings being
categorized by the expert as likely to disagree with the nurse
would support the validity of the PPPSS. In addition, subjective discomfort of admitting condition is an intuitive
reason patients might disagree with the triage nurse. Finally,
based on the observation while collecting data that younger
patients seemed more likely to disagree, age also was
included in the analysis.
Next we compared PPPSS scores with and without the
verbal description of ED procedures, a direct test of
construct validity. Out of concern that some patients may
have a better intuition for standard triage procedures than
others, a specific comparison was made between participants
categorized as likely agreeing with nurse ratings and those
who would likely disagree. This amounted to a 2 3 2 3
2 repeated measures analysis of variance design with interactions comparing quasi-experimental condition (unstructured pretest or posttest with verbal description of ED
procedures provided), rater of urgency (nurse or patient),
and patient type (agree or disagree with nurse). If the PPPSS
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JOURNAL OF EMERGENCY NURSING
is valid for the purpose of understanding patient experiences, then the interaction between scripted intervention
condition and rater would be significant, indicating that patient ratings were more standard with the verbal description
but not nurse ratings, which should be consistent regardless.
To further assess concurrent validity, the analysis
included a number of covariates, specifically age, gender,
ethnicity, enrollment with a primary care physician, reported knowledge of the ED triage system, use of the emergency department in the past 6 months, patient-reported
health ratings, and categorized rating of how subjectively
stressful the patient’s condition may be. Finally, several
random effects accounted for the known structure to the
data and model sources of variation (eg, heterogeneous variances and correlation between nurse ESI and patient PPPSS
ratings), as is consistent with generalizability theory
methods.21 Estimating power indicated that this analytic
framework could likely detect at least a moderate effect
size demonstrated by the manipulation (see Online
Supplement 2).24-26
ETHICAL CONSIDERATIONS
The hospital’s Human Subjects Safety Committee deemed
the study, which followed a quality improvement project, to
be exempt from review. As stated earlier, responses were
kept confidential and measures were taken to ensure anonymity of the patients by not linking patient demographic
variables to patient names or ID numbers.
Results
Respondents spanned the age range, most between 18 and
60 years old (see Table). All respondents were patients;
none were caregivers. There were similar proportions of
male- (48.86%) and female- (51.14%) identifying respondents. The majority did not identify as Hispanic
(90.91%). Most respondents indicated that they did have
a primary care provider (60.80%) but did not know about
the ED triage system (73.30%) and had not been to the
emergency department recently (68.18%). Rated from 1
(“poor”) to 5 (“excellent”), most respondents indicated
good or very good health, with a mean of 3.88 (SD ¼ 0.73).
There were a wide variety of reasons respondents came
to the emergency department, from allergic reactions to
abnormal laboratory test results. Most patient needs were
rated as moderately stressful (M ¼ 2.07 rated from 1
[“low stress”] to 3 [“high stress”], SD ¼ 0.64). Most respondents thought they should be seen within about 20 minutes,
VOLUME 49 ISSUE 2
March 2023
Tanzer et al/RESEARCH
TABLE
Respondent characteristics (N [ 176)
Variable
Demographic variables
Age
Sex
Ethnicity
Health variables
Do you have a primary care provider?
Do you know about the ED triage system?
Have you used the ED in the last 6 mo?
How is your general health?
Emergency circumstance stress expert
rating
Patient ratings: I should be seen
Nurse triage rating
Predicted agreement with triage nurse
Level
N
%
18-29 y
30-49 y
50þ y
Female
Male
Not Hispanic
Hispanic
73
52
51
90
86
160
16
41.48
29.55
28.98
51.14
48.86
90.91
9.09
No
Yes
No
Yes
No
Yes
Poor
Fair
Good
Very good
Excellent
Low stress
69
107
129
47
120
56
0
3
49
90
34
30
39.20
60.80
73.30
26.70
68.18
31.82
0.00
1.70
27.84
51.14
19.32
17.05
Moderate stress
High stress
Within 2 h
Within 60 min
Within 30 min
Within 10 min
Immediately
Nonurgent
Semiurgent
Urgent
Emergent
Highest priority
Agree
Disagree
104
42
6
26
35
65
44
0
0
0
148
28
81
95
59.09
23.86
3.41
14.77
19.89
36.93
25.00
0.00
0.00
0.00
84.09
15.91
46.02
53.98
ED, emergency department.
March 2023
VOLUME 49 ISSUE 2
WWW.JENONLINE.ORG
299
RESEARCH/Tanzer et al
FIGURE
Differences in triage urgency ratings. Note: Nurse ESI scores were reversed so a higher number represents higher urgency, as is the scoring on the PPPSS. ESI, Emergency Severity
Index; PPPSS, Patient Perception of Priority to Be Seen Survey.
at most an hour (M ¼ 22.61 minutes, SD ¼ 26.97 minutes). Patients were consistently rated as high urgency by
nurses (M ¼ 4.16, SD ¼ 0.35; reverse scored so a larger
value indicates higher urgency).
The discriminant function analysis indicated observed
agreements between nurse and patient urgency ratings
tended to be independently classified as likely agreement
by the expert (lambda ¼ 0.83), supporting concurrent validity of the measurements (Wilks’ lambda ¼ 0.52, F(5,
170) ¼ 32.01, P < .01). Older patients also tended to agree
with the nurse, corroborating the anecdotal observation
(lambda ¼ 1.37). Contrary to expectations, subjective
discomfort operationalizing patient subjective stress had
minimal relationship to agreement or disagreement
(lambda ¼ 0.10).
Figure plots the scoring tendencies with and without
verbal description of ED procedures, comparing between
patients expected to agree with the nurse and patients expected to disagree with the nurse. During the unstructured
pretest, ratings were close between nurses and patients for
the patients expected to agree with the triage nurse (nurse,
M ¼ 4.19, 95% confidence interval [CI] 3.92-4.46; patient,
M ¼ 3.87, 95% CI 3.01-4.74). For patients expected to
disagree with the triage nurse, there was a discrepancy during the unstructured pretest period (nurse, M ¼ 4.06, 95%
CI 3.81-4.31; patient, M ¼ 3.33, 95% CI 2.54-4.11; x2 (1,
N ¼ 352) ¼ 14.61, P < .01).
300
JOURNAL OF EMERGENCY NURSING
However, during the scripted intervention posttest after
rounding, ratings by nurses were identical for agree and
disagree classified patients (nurse, M ¼ 4.16, 95% CI
3.88-4.45), and patient-reported ratings also were very close
(agree, M ¼ 3.62, 95% CI 2.80-4.43; disagree, M ¼ 3.66,
95% CI 2.83-4.48). This is evidence that ratings were more
standard with scripted verbal description of ED procedures,
supporting construct validity of the PPPSS as a measure of
patient expectations (x2 (1, N ¼ 352) ¼ 8.09, P < .01).
Estimating internal consistency reliability, the ratio of
individual variance to total variance for each rater, across
nurse ESI ratings (reliability ¼ 0.73) and patient PPPSS ratings (reliability ¼ 0.75), both demonstrated acceptable reliability (reliability > 0.70). Examining the correlations
between observed ratings and model implied true patient urgency, both rating systems indicated large and nearly identical correlations (nurses, rho ¼ 0.54; patients, rho ¼ 0.55).
That said, the correlation between these 2 rating systems
was moderate to large and negative (rho ¼ 0.38). This
supports the reliability and concurrent validity of the
PPPSS, which demonstrated consistent measurements of
patient urgency. That said, when patients rated themselves
as more urgent, it was likely a nurse would rate them as
less urgent.
Finally, contrary to expectations, only one additional
measure of concurrent validity demonstrated significant association at alpha ¼ 0.05. Patients identified as female
VOLUME 49 ISSUE 2
March 2023
Tanzer et al/RESEARCH
tended to be rated as lower urgency (t(163) ¼ 2.23, P ¼
.02), a small magnitude of difference (beta ¼ 0.18).
Discussion
SUMMARY AND INTERPRETATION
We estimated reliability and considered ways to make valid
interpretations of the PPPSS as a tool for understanding patient subjective experience.13 Using a modern analytic
framework drawing from generalizability theory, reliability
for the measure was acceptable. The quasi-experimental
design targeting patient understandings of triage procedures
supported validity. When patients were explicitly informed
of ED triage procedures, PPPSS scores across patient groups
were nearly identical. This suggests that by directly informing patients of what to expect, this may have standardized
rating systems. By being aware of standard ESI procedures,
all patients received and reported similar ratings of urgency.
This supports the validity of the PPPSS and also demonstrates why clear communications of expectations may
improve ED efficiency.
The concordance between all of patient ratings, triage
nurse ratings, and independent expert ratings supported
convergent concurrent validity. When patients and nurses
gave similar urgency ratings, the expert also tended to indicate that they would likely have agreed. We originally
thought that subjective discomfort may be a primary aspect
of why patients disagree with the triage nurse; however,
there was little evidence of this. Instead, age grouped patients the most. Younger patients tended toward worse expectations for standard ED procedures.
Another finding that was counter to expectations was
that nurses tended to rate patients as higher urgency on
average, which is inconsistent from findings by Toloo
et al.4 This highlights the reasons for performing validity
analysis: to inform how to interpret a measurement for an
intended purpose. There was an inverse relationship between nurse scores and patients scores. As such, no matter
how urgent patients are rated in an absolute sense, to understand patient subjective experiences, PPPSS scores should
only be interpreted relative to standard urgency within a
specific emergency department. For the purpose of triaging
patients, ESI scores are determined based on their ordered
scaling, but the average may differ between emergency departments or by time of day. An example of this scaling
problem is the coronavirus disease 2019 pandemic, wherein
intensive care units were overwhelmed with high urgency
patients.
March 2023
VOLUME 49 ISSUE 2
The issue of scaling complexity is particularly relevant
in the case of the PPPSS, for which discrepancies among patient needs are a likely cause of improper expectations.
Scores should be considered relative to the urgency of
most other patients at the same emergency department
based on what is a typical patient urgency. A low urgency
patient could easily feel like somebody cut in line if they
are not familiar with ESI standards and see other patients
triaged sooner. The severity of this problem may depend
on the unique urgency of the emergency department at a
given moment. Seeking to communicate with these patients
about their likely wait time may improve satisfaction. We
recommend the PPPSS for implementing an intervention
with this target or as a tool for resear
Apply and integrate the concepts and knowledge gained in prior general management and health care administration courses to industry-relevant challenges.
Assess the relevant strategic decision-making and implementation issues within a health care organization.
COVID-19 Pandemic
The COVID-19 pandemic, also known as the coronavirus pandemic, is a pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, China. The World Health Organization declared the outbreak a Public Health Emergency of International Concern in January 2020 and a pandemic in March 2020. As of 14 December 2020, more than 72.5 million cases had been confirmed worldwide, with more than 1.61 million deaths attributed to COVID. As of December 14, 2020, the United States had more than 16, 000,000 positive COVID-19 cases with more than 300,000 deaths; these numbers are continuously updated; please see the STAT COVID-19 Tracker for the most current statistics.
The pandemic has caused global social and economic disruption, including the largest global recession since the Great Depression. COVID-19 has led to the postponement or cancellation of events, widespread supply shortages exacerbated by panic buying, agricultural disruption, and food shortages, and decreased emissions of pollutants and greenhouse gases.
Educational institutions have been partially or fully closed. Misinformation has circulated through social media and mass media. There have been incidents of xenophobia and discrimination against Chinese people and against those perceived as being Chinese or as being from areas with high infection rates.
The pandemic has affected the political systems of multiple countries, causing suspensions of legislative activities, isolations or deaths of multiple politicians, and rescheduling of elections due to fears of spreading the virus. Although they have broad support among epidemiologists, social distancing measures have been politically controversial in many countries. The pandemic has had many impacts on global health beyond those caused by COVID-19 disease.
It has led to a reduction in hospital visits for other reasons. In several countries, there has been a marked reduction in the spread of sexually transmitted infections, including HIV/AIDS, attributable to COVID-19 quarantines, social distancing measures, and recommendations to not engage in casual sex. Similarly, in some places, rates of transmission of influenza and other respiratory viruses significantly decreased during the pandemic. The pandemic has also negatively impacted mental health globally, including increased loneliness resulting from social distancing and depression and domestic violence from lockdowns.
The pandemic has resulted in misinformation and conspiracy theories about the scale of the pandemic and the origin, prevention, diagnosis, and treatment of the disease. Journalists have been arrested for allegedly spreading false information about the pandemic. It has also been propagated by celebrities, politicians, and other prominent public figures.
As of December 14, 2020, in the United States, (a) California, (b) Texas, (c) Florida, and (d) Illinois led the nation in positive COVID-19 cases and deaths.
Your assignment:
You are the CEO/COO of the Regional Hospital in one (choose one) of the above-mentioned states and in 1000-1200 words, please discuss the following about the COVID-19 response as it pertains to the selected state your hospital is located:
What went well with the State’s response?
What were the significant challenges with the State’s response?
In which ways could the State’s response have been improved?
As the Chief Operating Officer (COO) at the Regional Hospital, how would you augment your healthcare facility’s pandemic preparedness and response plan?
During Week One, we discussed Fayol’s Five Functions of Management: (a) Planning, (b) organizing, (c) coordinating, (d) commanding, and (e) controlling. Which ways you would utilize Fayol’s Fifth Function of Management, controlling into enhancing your facilities’ pandemic preparedness and response plan?
Make certain that your assignment is in the APA 7th edition format with a cover page, separating your sections by the appropriate APA Level Headings. Also, make sure you include a reference page and at least five references.
Identify a family issue, research a family therapy approach (locate a relevant peer-reviewed article supporting use of the approach) to address the issue, and construct a single-subject (1 family) research design (SSRD) to evaluate the practice effectiveness of using this design with the family.
The SSRD must be in APA format and include the following headings/sections:
Cover page – in APA format
Introduction – This section should address the family issue (including research showing this issue is a common issue within families) and give a short (1 paragraph) description of the family and what the issue looks like for them.
Approach/Strategy – This section should include an overview of the intervention to be used, including a summary of the empirical article supporting use of the intervention. Details should be provided on how this approach would be used in family sessions, and the intervention should be theory-driven, with a clear discussion of how the intervention is linked with/informed by a theory.
SSRD Plan – This section should discuss the type of research plan you will use to evaluate the effectiveness of the intervention. Be sure to list your research question, hypothesis, independent and dependent variables and the measurement tool utilized (operationalization), design (appropriate phases- AB, ABA, etc), how baseline and post-intervention change in the variable will be measured (data collection), how data will be analyzed (data analysis), and a sample of the graph which would be used to display the data recorded and how that graph would be interpreted (what would the graph need to show for the hypothesis to be supported).
References – APA formatted reference page for all references
Appendix 1 – Brief Treatment Plan (goal, objective, intervention)
Appendix 2 – Measurement Tool to be used
*This assignment should be 3-5 pages in length (not including the cover page, references, and appendices).
The goal is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in this week’s learning materials. Review the SOAP Note Rubric.
Instructions
Choose an abnormal finding related to the content that was covered this week. Examples from this week would include: shortness of breath, cough, wheezing, dyspnea on exertion, etc.
Select “WHEEZING” Diagnosis: ASTHMA ATTACK
Develop a focused SOAP note for the abnormal finding. You do not need to find a patient to match this finding. The point is for you to think about what the HPI would be, what the rest of the history may look like, what the objective findings will be, the potential differential diagnoses, and the plan. In other words, you are creating the patient scenario and documenting it in SOAP format. Please be sure to include all relevant information and not just the system the abnormal finding is in.
Refer to the Grading Rubric to see how your work will be assessed.
Unformatted Attachment Preview
SOAP Note Rubric
[SOAP Note Rubric] – 100 Points
Criteria
Exemplary
Exceeds
Expectations
Advanced
Meets Expectations
Intermediate
Needs
Improvement
Novice
Inadequate
Total
Points
Subjective (25 points)
Patient described in
appropriate detail
Patient described in
appropriate detail
1 detail missed in
patient description
25
Concise and clear
chief complaint as
described by patient
Concise and clear
chief complaint as
described by patient
HPI includes all
components with
appropriate detail
HPI missing minor
detail
Chief complaint as
described by
patient, may not
be concise or clear
>2 details missed
in patient
description
Information about the
patient (3 points)
Name (initials only);
age, and gender
Source of
information; note
relationship to
patient, if relevant
Reliability of
information
Chief Complaint (1 point)
History of Presenting
Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset,
duration,
frequency)
Setting in which it
occurs
Factors that
aggravate or relieve
the symptoms
Associated
manifestations
Review of Focus System(s)
(5 points)
Comprehensive
review of focus
system(s) includes
pertinent negatives
Name, dose, route,
and frequency of
prescribed and over–
the–counter
medications noted,
including
compliance;
Allergies to
medications and
reaction noted
Comprehensive
health history is
appropriate to
reason for visit and
includes pertinent
negatives
Comprehensive
review of focus
system(s)
Name, dose, route,
and frequency of
prescribed and over–
the–counter
medications noted,
including compliance;
Allergies to
medications and
reaction noted
Comprehensive
health history is
appropriate to reason
for visit
Chief complaint
not identified,
concise, or clear
HPI missing 1
component or
significant detail
HPI missing >2
components and
significant detail
Review of focus
system missing 1–
2 components
Review of focus
system(s) missing
>3 components
Medication history
missing 1–2
components
Medication history
missing >3
components
Health history not
appropriate for
reason for visit or
missing 1–2
components
Health history
missing >3
components
17 points
19 points
22 points
25 points
Medications/Allergies (3
points)
History (5 points)
Past Medical
History
Past Surgical
History
Family History
Social History
Health Maintenance
Practices
Objective (30 points)
Physical exam includes
appropriate areas for Chief
Complaint, History of
Presenting Illness, and
Review of Systems (20
points)
Appropriate techniques of
examination used to
identify pertinent findings
(10 points)
Appropriate areas
and systems
included in physical
assessment
Comprehensive
techniques of
observation,
palpation,
percussion, and
auscultation noted
including special
assessments as
appropriate
30 points
Missing 1 expected
area of assessment
Appropriate
techniques of
examination used but
special assessment
technique missed
26 points
Missing 2
expected areas of
assessment
Missing >3
expected areas of
assessment
One basic
technique of
examination
missed
>2 techniques of
examination
missed
23 points
20 points
30
Assessment (20 points)
Differential diagnoses are
supported by subjective
and objective findings (15
points)
Scholarly resources
support differential
diagnoses (5 points)
Three differential
diagnoses are
supported by
findings and include
worst case scenario
Rationale for
differential diagnoses
provided by scholarly
resources
20 points
Plan (15 points)
Comprehensive plan to
address likely differential
diagnosis includes (9
points)
Diagnostic testing
Pharmacologic
intervention
Non–
pharmacologic
intervention
Referrals
Patient education
Follow–up
Comprehensive plan
includes all
components
Appropriate and
current guidelines
cited
15 points
Three differential
diagnoses include
worst case scenario
but one diagnosis
may not be fully
supported by findings
Rationale for
differential diagnoses
provided by scholarly
resources
17 points
Plan missing 1 of the
identified components
Appropriate and
current guidelines
cited
13 points
Differential
diagnoses may or
may not include
worst case
scenario and 2
differential
diagnoses not
supported by
findings
3
of the identified
components
Guidelines are not
current or
appropriate for
identified problem
Guidelines for
plan not cited
20
15
10 points
12 points
Plan is supported by
appropriate and current
practice guidelines (6
points)
Documentation (10 points)
Documentation follows
SOAP template, is logical,
and in correct format (10
points)
Logical and
systematic
organization of data
Logical and
systematic
organization of data
Minor errors in
organization of
data
Correct terminology,
spelling, and
grammar
Terminology, spelling,
grammar or format
errors (1–3)
Scholarly resources
noted in correct APA
format
8 points
Terminology,
spelling, grammar,
or format errors
(4–5)
7 points
Disorganized flow
of data
10
Terminology,
spelling, grammar
or format errors
(>5)
6 points
10 points
Total Points
100
Include subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals.Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms. Plan: Describe your treatment modality and your plan for psychotherapy. Explain the principles of psychotherapy that underline your chosen treatment plan to support your rationale for the chosen psychotherapy framework. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this psychotherapy session?Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.
Draw on readings and research to discuss and critically analyse the application of the Integrated Practice Framework to your practice skills role-play.Think about your areas of strength? and your areas that need improvement? What and where can you improve? what would you do differently? what did you do well?
Unformatted Attachment Preview
MSWPG7102 Assessment Task 3 Rubric
Identify examples of
interpersonal
communication skills
(What did I do?)
Critically reflect on the
application of skills,
highlighting strengths
and weaknesses
(How well did I do?
What worked?)
Identify areas for
improvement
(What do I need to
improve?)
Provide a rationale for
the recommended
improvement
4
Clearly identifies and
explains at least 3
important examples of
interpersonal
communication skills
used in the role play
and their importance
for social workers.
8
Clearly identifies and
assesses more than
one strength and more
than one weakness in
the context of the role
play and the broader
social work profession.
4
Clearly identifies and
explains more than 2
areas of interpersonal
communication for
improvement, with a
clear and explicit link
to the identified
strengths and
weaknesses.
8
Designs a detailed and
well-reasoned plan for
improving key
3
Clearly identifies and
explains at least 3
examples of
interpersonal
communication skills
used in the role play.
2
Identifies 3 examples
of interpersonal
communication skills
used in the role play.
1
Attempts to identify
less than 3 examples of
interpersonal
communication skills
used in the role play.
0
Limited attempt to
identify examples of
interpersonal
communication skills
used in the role play.
6
Clearly identifies and
assesses at least one
strength and at least
one weakness in the
context of the role play
and some links to the
social work profession.
3
Clearly identifies and
explains at least 2
areas of interpersonal
communication for
improvement, with a
basis in the identified
strengths and
weaknesses.
4
Identifies and
describes at least one
strength and one
weakness in the
context of the role
play.
2
Attempts to describe
one strength or
weakness and
attempts to connect
this to the role play.
0
Either not present or
not connected to the
role play.
2
Identifies 2 areas of
interpersonal
communication for
improvement, with
some basis in the
identified strengths
and weaknesses.
0
Limited or no attempt
to identify an area of
interpersonal
communication for
improvement, lacking
in connection to the
identified strengths
and weaknesses.
6
Designs a clear plan for
improving key
interpersonal
4
Outlines a plan for
improving identified
interpersonal
1
An attempt to identify
an area of
interpersonal
communication for
improvement, but
limited connection to
the identified
strengths and
weaknesses.
2
Attempts to develop a
plan for improving
identified
0
Limited or no attempt
to develop a plan for
improving identified
(What should I do next?
What’s my plan?)
Reflection is supported
by reference to
appropriate frameworks
(What evidence do I
have to support my
understanding?)
interpersonal
communication skills,
with a critical analysis
of its importance for
future practice.
2
Synthesises relevant
framework(s) and
evidence to support
the reflection on
interpersonal
communication skills.
communication skills,
with some analysis of
its importance for
future practice.
communication skills,
with some link to their
importance for future
practice.
1
Incorporates a relevant
framework and
evidence to support
the reflection on
interpersonal
communication skills.
interpersonal
communication skills,
with limited links to
their importance for
future practice.
interpersonal
communication skills,
with no link to their
importance for future
practice.
0
Attempts to apply a
relevant framework
and evidence to
support the reflection
of interpersonal
communication skills.
Discuss the importance of using the MMPI-2-RF when assessing the emotional status of a client. Can the MMPI-2-RF be useful in assessing mental status as well? Why or why not? Provide specific examples to support your position. 150 words. 150 word opinion response. What are some strengths and challenges of Beck’s Depression Scale for assessing emotional status? Do you feel that this scale is a good method to assess emotional status? Why or why not? Provide specific examples to support your position.150 words. 150 word opinion response.
Should there be a death penalty for first-degree murder?
1) Define first-degree murder.
2) Define the states that have the death penalty and define the Federal statue for the death penalty.
3) Make an argument that either supports or opposes the use of the death penalty in first-degree murder cases. Be sure to define what is involved with first-degree murder and provide adequate reasoning and support for your argument.
When responding to your classmates’ posts, be sure to identify any fallacies and evaluate whether arguments provide sufficient evidence to support their assertions. You are encouraged to challenge each other, but please remember to use appropriate netiquette when responding to one another. Your response should be respectful and constructive.
Make sure you are using your textbook for intext and reference citations for your initial post.
Assignment Content
Practitioner reflection is more than summarizing thoughts; rather, it is an art of documenting a journey of learning that has occurred through self-inquiry and processing (Johns, 2017).
As an advanced evidence-based practice nurse, it is important that you learn to engage in an open, critical, systematic process in which you intentionally examine your experiences and compare them to your expectations in a way that links learning across time. You will benefit from this practice by learning to advance your ability to identify meaning in your experiences and by critically evaluating where you can improve your effectiveness in responses and future actions.Through reflective journaling, you will apply your curiosity by asking “Why?” and practice your reflexivity by actively analyzing past events. This action is critical to identifying and dismantling barriers as you work toward achieving desirable practice (Johns, 2017).
Write a 350-word (minimum) reflective journal entry that demonstrates your integration of knowledge expansion during this course with your current state of learning and experience.
Explore the following guiding prompts when crafting your reflection.
Part 1
Demonstrate self-awareness by describing your current developmental stage in the advanced evidence-based practice nursing journey.
Connect your current reflection to previous reflections by explaining how this course has promoted growth or change since the last time you engaged in reflective practice.
Apply critical thinking and analysis by evaluating 1 strength and 1 barrier to your current development that you have identified during this course.
Identify possible resources to help you overcome your identified barrier.
Synthesize how you might integrate your current strength into future positive practices.
Summarize 1 takeaway you have gained through this process.
Part 2
Explain how what you have learned through the first seven weeks of this course can be applied to your project.
Describe activities related to this course’s content that you have completed for your project.
Describe activities related to this course’s content that you have or will use for practice hours.
Describe project tasks that you have completed during this course and that you will submit for practice hours.
Explain any other activities related to course topics, such as interviewing health care policy experts that have had an impact on health care regulations that could be used for practice hours.
Discuss how the completion of the practice hours has improved your ability to be a leader in the health care industry and/or with your project.
You may also include questions for the instructor regarding course material that may still be unclear.
Retain these journal entries; they will serve as a log to showcase your evolution as a scholar, practitioner, and leader as you expand your role as an advanced evidence-based practice nurse practitioner.
Format your assignment according to APA guidelines.
Submit your assignment.
ReferenceJohns, C. (Ed.). (2017). Becoming a reflective practitioner (5th ed.). John Wiley & Sons.
Resources
Center for Writing Excellence
Reference and Citation Generator
Grammar Assistance
Submit a 5 page (approx.) template on the adolescent patient. The document attached should be downloaded and saved (see below) to your computer. Fill in all appropriate sections and include 2 references or sources for your information. Bullet points preferred.The Wilkins text has excellent general information about each patient type however the template requires details about each heading area. Students should plan on 4-5 sentences per heading. Students will include at least two peer-reviewed references; typically these are journals and not websites (in addition to your required texts) in APA format, for this assignment.
Exam Content
The Centers for Medicare & Medicaid Services (CMS), along with key stakeholders, developed methodology to calculate and display overall hospital-level quality using a star rating system. The overarching goal of the Overall Hospital Quality Star Rating (Overall Star Rating) is to improve the usability and interpretability of information posted on Hospital Compare, a website designed for consumers to use along with their health care provider to make decisions on where to receive care. The Overall Star Rating provides consumers with a simple overall rating generated by combining multiple dimensions of quality into a single summary score.
Use the Hospital Compare website as a resource for this assignment.
Choose an organization from Hospital Compare.
Review your selected hospital’s quality measures and performance data outlined in the tabs on the Hospital Profile. The available quality measures include:
Mortality
Safety of care
Readmission
Patient experience
Effectiveness of care
Timeliness of care
Efficient use of medical imaging
Select a quality measure as the basis for this assignment.
Create a 12- to 15-slide Microsoft® PowerPoint® presentation to executive leadership in which you advocate for the business side of health care delivery using your selected quality measure. Include the following in your presentation:
Briefly describe your selected quality measure, including all sub-categories.
Apply organizational and systems theories to your chosen quality measure to identify ways to improve organizational performance.
Recommend an evidence-based practice intervention that will improve health outcomes related to your selected quality measure that integrates organizational theory and systems theory concepts.
Evaluate cost-effective measures you would take to balance the cost with the quality of your intervention.
Discuss the methods you could use to evaluate your recommendations to improve the outcomes of the quality measure selected.
Include detailed speaker notes and a minimum of 3 peer-reviewed articles to support your assignment.
Format your assignment according to APA guidelines.
Submit your assignment.
Resources
Center for Writing Excellence
Reference and Citation Generator
Grammar Assistance
Activity 10: Develop an Acquisition Strategy Statement for your proposed IT acquisition project (that you selected in Activity 8 and summarized in your Activity 9 value proposition).A template for preparing the statement, titled Acquisition Strategy Statement, is available in the reference list. Please use this template to prepare your Acquisition Strategy Statement. Keep your responses to the various sections of the Acquisition Strategy Statement as brief as possible, while still communicating your key points. As you likely know from your own experience, executives like brief, to-the-point documents, preferably only a page or two. They usually do not read lengthy acquisition strategy statements.The due date for posting your completed Activity 10 in your Assignments Folder is the end date of Week 7.Please post your final Activity 10 to this link.T10-Strategy Statement.pdf
Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to classmates or your faculty member.Please refer to this week’s learning materials. They are intended to help you engage effectively in this discussion.Due Thursday Read “Readmissions and Costs Among Younger and Older Adults for Targeted Conditions During the Enactment of the Hospital Readmission Reduction Program” from the University Library.The DNP-prepared nurse leader is responsible for ensuring that revenue streams are protected. Hospital readmissions within 30 days of discharge account for a substantial reduction in revenue for Medicare patients. Many of these readmissions are preventable through targeted nursing interventions. Respond to the following in a minimum of 300 words: Choose a common readmission diagnosis and describe an evidence-based nursing intervention that could prevent this occurrence.
andrew: Throughout this course, we have had the opportunity to strengthen our understanding of the systematic approach that is necessary to make evidence-based practice decisions. The evidence-based practice (EBP) process is defined by seven steps, which should be implemented sequentially to accomplish the end goal (Melnyk & Fineout-Overholt, 2023). The first step we honed during this course was creating a clinical question using the PICOT formula. This process makes the rest of the evidence search more applicable to the addressed problem. Conducting the database searches before this class has been nothing more than a Google search. Understanding how to utilize the search functions of the databases makes it possible to narrow down the results for information that is most relevant to the clinical question, which has been extremely useful. Further, knowing how to dig through these results and appraise the data quality using the hierarchy of evidence regarding quantitative research design allows the researcher to evaluate the data for validity and reliability. The final steps of the process include integrating the evidence into practice, evaluating the outcomes, and disseminating the EBP change.
An increased level of EBP understanding and skill has been shown to be a predictive factor of the likelihood that the APRN would implement EBP (Ylimäki et al., 2022). Some experts say practice guidelines should be reassessed every six months to 5 years to provide the most accurate EBP (Kowalski et al., 2021). Being able to answer clinical questions using evidence-based inquiry regularly is necessary for all APRNs to provide patients with the best possible interventions and outcomes.
Kowalski, C. J., Redman, R. W., & Mrdjenovich, A. J. (2021). The transition from inquiry to evidence to actionable clinical knowledge: A proposed roadmap. Journal of Evaluation in Clinical Practice, 27(3), 667–676. https://doi.org/10.1111/jep.13562
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in Nursing & Healthcare: A guide to best practice. Wolters Kluwer.
Ylimäki, S., Oikarinen, A., Kääriäinen, M., Holopainen, A., Oikarainen, A., Pölkki, T., Meriläinen, M., Lukkarila, P., Taam-Ukkonen, M., & Tuomikoski, A.-M. (2022). Advanced practice nurses’ experiences of evidence-based practice: A qualitative study. Nordic Journal of Nursing Research, 42(4), 227–235. https://doi.org/10.1177/20571585221097658
holee: Abu-Baker et al. (2021) stated that integrating evidence-based practice (EBP) could improve patient outcomes and the practice environment. Nurses must aim to standardize practice and build on their body knowledge to improve patient outcomes (Abu-Baker et al., 2021). Healthcare providers striving to provide high-quality, evidence-based care must be able to identify what they want to know (Fineout-Overholt & Stillwell, 2019). Resources such as professional organizations, digital devices, data repositories, libraries, health information databases, and digital applications ensure clinicians can find information when needed. Fineout-Overholt and Johnson (2023) state that finding the correct information can be similar to finding a needle in a haystack. Developing a strong PICOT question guides clinicians in their search and prevents misunderstandings (Fineout-Overholt & Johnson, 2023).
My PICOT question ponders if patients with peripheral artery disease (PAD) are given education on lifestyle modifications compared to the current practice of not providing educational information on lifestyle modifications. Will symptoms improve within six weeks? This question was prompted after noticing a man struggling to walk into the grocery store this past summer. Additionally, I continued to notice that veterans will complain about pain, swelling, and difficulty walking at similar times per day. However, their complaints were rarely addressed. This class has awakened my curiosity to seek evidence-based information on how to serve these patients better. To search for the standard PAD guideline and share this with patients experiencing this phenomenon. As a nurse, I must provide patients with the most up-to-date information on what is happening to them and how they can improve their symptoms.
Care plans should be patient-centered, but how can patients make decisions that are best for them if they do not understand what is happening to them and what they can do to improve their health? It is no longer acceptable to quit smoking, lose weight, and increase physical activity. Health People 2030 has two goals for health literacy: personal health literacy and organizational health literacy. Organizational health literacy acknowledges that healthcare systems have a responsibility to equitably improve the health of individuals by helping them to understand, find, and use information and services to make health-related decisions for themselves. The goal is for people to make informed rather than appropriate decisions (AHRQ, 2020; HRSA, 2022).
Fineout-Overholt, E., Johnson, S. (2023). Asking Compelling Clinical Questions. In Melnyk, B., & Fineout-Overholt (Ed.), Evidence-Based practice in nursing & healthcare (5th). Wolters Kluwer.
For this assignment, create a PowerPoint presentation based on the following case studies:
Read the following two Case Studies and answer the questions presented.
1. Case Scenario: Milagros Amaro located in Chapter 8 on page 149
Questions:
What is the response of the staff to Milagros’s incomplete health records on her children? What assumptions underlie this response?
• How could the N.P best communicate with Reynaldo while preserving his rights to privacy and confidentiality?
• What health-related issues are essential when caring for migrant agricultural workers? Why are these health-related issues important?
• What attributes do nurses working with migrant agricultural workers need to refine to function as effective advocates for their patients?
2. Scenario 4: John located in Chapter 9 on page 172
Questions:
How many interactions have you had with people who identify as LGBTQIA? Would you have known at the time that your patient was LGBTQIA? How might these experiences have prepared you for interactions with patients like John?
• What role do you play as a nurse when John’s family and friends become aware of his gender reassignment plans?
• What are some best practices that organizations can put in place to foster a more welcoming environment for patients who are LGBTQIA? Would you recognize when you need help to approach John’s situation because you are uncomfortable working with someone like him?
• Describe heterosexism, cissexism, homophobia, and transphobia exist? What steps should a nurse take to address these biases?
• What is the most sensitive way to elicit information about health practices that allows the LGBTQIA patient to answer questions honestly and enables the nurse to complete a practical assessment?
Your presentation should be 20 slides (not including title, objectives, and references slides) with detailed notes for each slide. Audio recording is required. Be sure to answer all the questions completely. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with citations throughout your presentation. Make sure to reference the citations using the APA writing style for the presentation. Include a slide for your references at the end.
Follow best practices for PowerPoint presentations by going to the Writing and Resource center, Module 3: Assignments, Microsoft, and utilizing Microsoft Overview and the Creating a Quality PowerPoint video.
Start by reading and following these instructions:
Study the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
Consider the discussion and the any insights you gained from it.
Review the assignment rubric and the specifications below to ensure that your response aligns with all assignment expectations.
Create your assignment submission and be sure to cite your sources, use APA style as required, and check your spelling.
The following specifications are required for this assignment:
Length: At least 20 slides; answers must thoroughly address the questions in a clear, concise manner. Audio is required.
Structure:
Title slide (1 slide)
Content slides (20)
References (1 slide)
References: Use the appropriate APA style in-text citations and references for all resources to answer the questions. Include at least three (3) scholarly sources to support your claims.
Format: Save your assignment as a Microsoft PowerPoint document
RUBRIC—–
Preview Rubric
Graduate PowerPoint Assignment Rubric v1
Print
Criteria Approaches 70% Meets 80% Exceeds 100% Criterion Score
Content/Quality of Information Weight: 40% Topic is inappropriate to assignment, not based on scholarly information (if required), unclear and difficult to understand, no hyperlinks to credible sites; did not include required assignment components; slide notes missing (if required). Topic is mostly covered and appropriate to assignment, but not based on scholarly information (if required); mostly clear and understandable; may contain hyperlinks to non-credible sites; some of required assignment components are present; minimal use of slide notes (if required). Good coverage of topic and appropriate to assignment; sound, research-based (if required) information; clear and understandable; hyperlinks to credible sites; all required assignment components are accurate and present; slide notes used appropriately (if required). In-depth coverage of topic and assignment components; outstanding clarity of information; detailed slide notes ensure all required content is well explained (if required). / 40
Presentation Weight: 20% Unattractive; difficult to interpret; poor color choice and slide contrast; slide presentation unorganized; slide effects detract from the content; missing slide headings or sub-headings (if required for organization purposes); missing title/reference slides. Attractive but somewhat difficult to interpret; somewhat pleasing contrast between text and background, slide presentation may be somewhat disorganized; transitions and slide effects detract from the content; may be missing title or reference slides; included slide headings/sub-headings may detract from presentation. Attractive; easy to interpret, pleasing colors with strong contrast between text and background, slide presentation organized, good use of transitions and slide effects which enhance the presentation; both title and reference slides are present. Slide headings/sub-headings are used appropriately to organize the presentation. Excellent use of transitions and effects that enhance the presentation. Presentation is organized and designed for maximum impact of content. / 20
Use of Multimedia, Graphics, Diagrams, and/or Illustrations Weight: 30% Does not include required multimedia, graphics, diagrams, and/or illustrations or they are irrelevant to topic or detract from slide content or presentation as a whole. Required multimedia, graphics, diagrams, and/or illustrations are generally relevant but some may not appropriately support the slide content. Required multimedia, graphics, diagrams, and/or illustrations are highly relevant and acceptably support the slide content; sized and positioned appropriately. Required multimedia, graphics, diagrams, and/or illustrations add clarity and sophistication to the presentation content; they improve the effectiveness of the presentation. / 30
Writing, Mechanics, and APA Weight: 10% Style is inappropriate or does not address given audience, purpose, etc. Inconsistent grammar, spelling, and punctuation; APA format and style are not evident throughout the presentation. Style is somewhat appropriate to given audience and purpose. Repetitive mechanical errors distract the reader. Inconsistencies in language, sentence structure, and/or word choice are present. There are missing APA elements or some are incorrectly formatted throughout the presentation. Style is appropriate to the given audience and purpose. Word choice is specific and purposeful, and somewhat varied throughout. Minimal mechanical or typographical errors are present, but are not overly distracting. Reference slide and in-text citations have few formatting errors. Style shows originality and creativity. Word choice is dynamic and varied. Free of mechanical and typographical errors. Reference slide and other in-text citations are formatted correctly using APA elements. / 10
TotalScore of Graduate PowerPoint Assignment Rubric v1,/ 100
Overall Score
LEVEL 1
0 points minimum
LEVEL 2
70 points minimum
LEVEL 3
80 points minimum
LEVEL 4
100 points minimum
instructions are in attachment. Basically, post to this discussion question. 250 words or more. Minimum of 2 scholarly resources published within the last 5 years. Must be cited in APA Format 7th edition.
InstructionsIt happens all the time, in personal relationships, at work or any other kind of relationship. Everyone communicates differently. In social work, communication is critical to our work. It helps us understand others, communication to one another, identify what people need to feel seen, heard and supported. In this log, you will explore how you communicate. The log should be no longer than two pages double-spaced, and no shorter than 1 page; at least one paragraph should be devoted to each section of the assignment. You should provide headings for each section of the log so the instructor can clearly tell each section apart. Submit a log that addresses the following:Description: Take a minute to think about how you communicate and share some of your personal communication habits.. What type of body language do you use while talking to a co-worker or friend? How do you react to difficult conversations or negative feedback? What do you need from others in order to feel heard?Reflection: Knowing how you communicate can help you identify areas of communication you are comfortable with and those that make you want to shrink back and hide. What are your communication strengths? What are some areas that might need a little improvement? (For example, let’s say you struggle with having difficult conversations face-to-face..)Next steps: Think about the area(s) where you might need improvement. You might not be able to avoid these types of conversations all together, but you can come up with strategies to make them easier. (For example, for difficult face-to-face conversations you would think about what you want to say beforehand, make a list of points so you feel prepared). Identify 1-2 areas of communication that you want to work on at your internship. What are they? What are some approaches that could help you try to help to improve this area of communication?
Look at the example care plan and with the information given finish filling out the one that is half complete with the information needed.
Information given:A 70-year-old male with a history of chronic obstructive pulmonary disease (COPD), tobacco use, hypertension (HTN), atrial flutter treated with Xarelto, aortic aneurysm, and prior aortic graft repair in 2009 presents with complaints of shortness of breath. The patient attributes his breathing difficulty to the high temperatures in Pasadena and requests a breathing treatment.
The patient, who typically relies on room air for oxygen, is currently experiencing shortness of breath, accompanied by wheezing and a one-day history of cough. This cough is productive of wet sputum and has shown some improvement with the use of Mucinex. The patient denies having a fever or chills and does not report any chest pain. He mentions having persistent leg swelling, which has not been diagnosed by his doctors and for which he is not taking diuretics at home. Frustrated by his ongoing symptoms, he has sought further evaluation in the emergency department with a request for a breathing treatment.
Medical History:
Aortic aneurysm
COPD (chronic obstructive pulmonary disease)
Left inguinal hernia
Hypertension
Surgical History:
Aortic graft repair
Imaging:
A chest X-ray performed on October 7, 2023, revealed the following findings:
A faint left apical pleural line, possibly indicating a minimal apical pneumothorax or bleb rupture in the context of COPD.
Scattered patchy opacities in the lower regions of both lungs, which have shown improvement compared to the findings from August 2023 and are more suggestive of atelectasis than pneumonia.
Mild vascular congestion in the lung fields.
patient with a complex medical history, including COPD and prior aortic graft repair, presents with acute respiratory symptoms and a history of persistent leg swelling. An evaluation of his medications, imaging, and clinical condition is necessary to determine the appropriate treatment and management plan.
Acute Hypoxic Respiratory Failure (Present on Admission)
COPD Exacerbation (Present on Admission)
Trace Left Apical Pneumothorax (Present on Admission)
Pulmonary Edema (Present on Admission)
Assessment: The patient is suspected to be experiencing an acute exacerbation of COPD based on increased shortness of breath and heightened sputum production. There may also be a cardiogenic component contributing to pulmonary edema, though B-type natriuretic peptide (BNP) levels are not significantly elevated. Clinical indicators include bilateral leg edema, acute hypertension, and bibasilar crackles. The following steps are recommended:
Transthoracic Echocardiography (TTE) to assess left ventricular ejection fraction (LVEF).
Computed Tomography (CT) of the chest to further characterize the pneumothorax.
Administer Duonebs (combination nebulizer therapy) four times daily as well as on an as-needed basis.
Continue prednisone at a daily dose of 40mg.
Maintain a low threshold for considering antibiotics but withhold for the time being.
Resume the patient’s home inhalers, specifically Incruse and Arnuity (pharmacy medication reconciliation is appreciated).
Continue intravenous furosemide (Lasix) at a dose of 20mg twice daily.
Monitor daily weight measurements and maintain strict input and output records.
Adjust potassium and magnesium levels to maintain values at 4 and 2, respectively, twice daily.
Administer supplemental oxygen with the goal of maintaining oxygen saturation between 88% and 92%.
Request a pulmonary consultation.
Regarding the issue of Atrial Flutter with Rapid Ventricular Response (Present on Admission), the electrocardiogram (EKG) initially suggests sinus tachycardia, though a query for atrial flutter with fixed block is raised. Management recommendations include:
Administer a one-time dose of Diltiazem 15mg.
Continue the patient’s home Diltiazem XR at a daily dose of 240mg.
Continue the patient’s home Xarelto at a daily dose of 20mg.
Continue the patient’s daily dose of losartan at 50mg.
Maintain the daily dose of diltiazem at 240mg.
Initiate nifedipine at a daily dose of 30mg, discontinuing amlodipine.
Request a medication reconciliation consultation
Hyperlipidemia (HLD): The patient is on atorvastatin 40mg daily.
Gastroesophageal Reflux Disease (GERD): Proton pump inhibitor (PPI) therapy is ongoing.
Dietary management: Implement a 2-gram sodium diet with a fluid restriction of 2000ml.
Deep vein thrombosis (DVT) prophylaxis: The patient requires therapeutic anticoagulation, as previously discussed.a history of COPD, experiencing symptoms of shortness of breath and wheezing. Additionally, the patient exhibited lower extremity edema. To assess for cardiac strain or myocardial infarction, laboratory tests, including B-type natriuretic peptide (BNP) and troponin, were conducted. A chest X-ray was performed, and radiology noted the possibility of an apical bleb or pneumothorax. In order to confirm whether a pneumothorax was present, a CT chest was ordered. The case was discussed with pulmonology, who recommended following the patient in case of decompensation, potentially requiring a chest tube insertion, though at this stage, oxygen therapy was recommended. The patient received continuous nebulizer treatments and intravenous Solu-Medrol. The patient was also noted to be hypertensive and was treated with nitroglycerin paste and intravenous Lasix for diuresis. The patient is scheduled for admission to the hospitalist service for further treatment and management.Regarding the medication administration, acetaminophen was given in both rectal and oral forms, with dosing intervals of 650mg every six hours as needed for fever or mild pain.
Unformatted Attachment Preview
Pt. initials: J.R.
Sex: Male
Admitting diagnosis(s): Chronic
Obstructive Pulmonary Disease (COPD)
exacerbation and Shortness of Breath (SOB)
Age:70 Y.O.
Date(s) Care Given: 10/8/2023
Admission Date: 10/7/2023
Allergies: NKA
CODE Status: Full
Code
History of Present Illness (HPI):
J.R., a 70-year-old male with COPD, hypertension (HTN), and a history of aortic aneurysm repair in 2009, presents with worsening shortness of
breath. He attributes this to the heat in Pasadena and seeks a breathing treatment. He has a one-day history of wheezing and productive cough,
which improves with Mucinex. There are no associated fevers, chills, or chest pain. J.R. also reports persistent unexplained leg swelling and has
come to the Emergency Department for evaluation and a breathing treatment. While he can’t recall all his medications, he identifies his COPD
inhalers and albuterol nebulizers, along with Xarelto, diltiazem, and losartan, as part of his regimen.
.
ASSESSMENT DATA
•
•
•
•
•
•
•
Objective Data
Upon exhalation, bilateral crackles are audible
in lung sounds.
Prescribed diet: Low-fat with restricted sodium
intake (2 grams).
Bilateral edema graded as 1 is present in both
extremities.
The patient relies on auxiliary muscles when
walking to the bathroom.
Experiences dyspnea during exertion.
Oxygen saturation (SpO2) is at 93%.
Respiration rate increases to 24 while walking
to the restroom.
Updated 5/29/18 Rev EC 10/18
•
•
•
•
•
•
Subjective Data
“I have COPD and it is too hot in Pasadena and I can’t breathe. I need a breathing treatment.”
“I am having a hard
Pain 3/10 in lower extremity. Feet while walking
Reports changes in sleep patterns, such as frequent nighttime awakenings due to breathing
difficulties.
Express concern or anxiety about the impact of COPD on their daily life and overall health.
Sates has a “persistent cough, especially in the mornings.”
1
Height:
5’8”
Weight:
215 lbs
BMI: 32.7
Neuro: The patient is alert, fully oriented in all four domains (AOX4), and demonstrates clear speech and cooperation, responding appropriately to
commands. Upon visual inspection, the patient’s head presents as normocephalic with no visible deformities or lesions. Their neck appears symmetrical,
devoid of noticeable masses, scars, or edema, and the trachea is correctly centered. The pupils are positive for equal, round, and reactive to light
(PERRL), and extraocular movements are evident with no signs of nystagmus. Furthermore, the patient’s facial expression maintains symmetry when
they smile, and there is no observed tenderness in the head or neck, suggesting a healthy and unremarkable examination.
Respiratory: Upon inspection chest rise and fall symmetric; respiratory movements are with regular rhythm, and unlabored; RR 18/min, without effort or
use of accessory muscles. Upon palpation of anterior and posterior thorax no pain, tenderness, or masses. Upon auscultation breath sounds are
crackles bilaterally throughout all lobes; wheezes are heard upon inhalation, no rhonchi,or stridor.
Cardiac: : Upon palpation: carotid, radial, brachial, and femoral, pulses present, regular, +2 bilaterally. Dorsalis pedis and posterior tibialis pulses +2
bilaterally. Pulse rate: 90/min; capillary refill < 3 sec. Upon auscultation aortic, pulmonic, Erb’s point, tricuspid, and mitral valve sounds present and
unremarkable; S1/S2 present; no murmurs; no carotid bruits.
GI/GU: Abdomen presents with symmetrical and round contours, devoid of any visible lesions, masses, or scars. There are no indications of inflammation
or herniation. Auscultation reveals normoactive bowel sounds. Gentle palpation of the abdomen elicits no tenderness or pain. The bladder is nonpalpable. The patient is continent.
Musculoskeletal: Upon examining the upper extremities and joints, there are no observed deformities, edema bilateral grade on lower extremities,
scars, or erythema, and both arms appear symmetric. Hand grip strength is measured at 5/5 bilaterally. The spine is symmetric. Muscle tone is within the
normal range upon palpation. Full active range of motion is noted in the upper extremities, but there is limited range of motion in the lower extremities.
Skin (including IV & wounds): During examination, the patient's skin appears appropriate for their racial background. There is mild edema noted
bilaterally, graded as 1. A 20g peripheral IV is in place on the right forearm, with no signs of swelling, redness, or infiltration. Upon palpation, the skin
feels warm and dry, displaying good skin turgor with no tenting.
Psychosocial: Patient displays a sociable and amicable demeanor, responding appropriately when engaged in conversation. He openly shares details
about his life and expresses contentment. He mentions having a girlfriend and a daughter, and currently, he resides in his RV, combining work and travel.
The patient is well-oriented to his current condition and maintains a pleasant disposition throughout the day. He indicates that he is a hands-on learner,
suggesting a preference for learning through practical experience.
Past Medical & Surgical History: COPD (Chronic Obstructive Pulmonary Disease), Left Inguinal Hernia, Hypertension, Aorta Surgery (aortic aneurysm
and dissection s/p graft repair in 2009)
Social History: The patient's current living arrangement involves sharing an RV with his girlfriend. He made the commendable decision to quit smoking a
decade ago, although he occasionally indulges in a cigarette. He had a 36-year history of smoking half a pack a day. The patient no longer consumes
alcohol, but he did engage in occasional drinking and cocaine use during his twenties. He maintains a close connection with his daughter, with frequent
contact. In terms of occupation, he remains active and productive, selling seashells on the beach, as well as working on floats for parades.
Updated 5/29/18 Rev EC 10/18
2
Pathophysiology of Primary Problem(s)
COPD exacerbation is characterized by a sudden worsening of symptoms in individuals with underlying COPD. It is often triggered by various factors,
including respiratory infections (e.g., viral or bacterial), environmental pollutants, or non-compliance with medications. During an exacerbation, there is an
increased inflammatory response in the airways, leading to acute bronchoconstriction and increased mucus production. This results in further airflow
limitation, reduced oxygen exchange, and a subsequent decline in lung function. Patients may experience increased dyspnea (shortness of breath),
increased cough, sputum production, and a decreased ability to perform daily activities. These exacerbations can be severe and require immediate
medical intervention.
Shortness of breath (dyspnea) is a hallmark symptom of COPD and is caused by several underlying pathophysiological processes. In COPD, there is
chronic inflammation in the airways and alveoli, leading to structural changes such as airway narrowing, mucus hypersecretion, and destruction of lung
tissue (emphysema). These changes reduce the elastic recoil of the lung and result in air trapping during exhalation, leading to increased residual
volume. The reduced airflow and inability to expel air effectively result in hyperinflation and impaired gas exchange. Dyspnea occurs when the work of
breathing becomes significantly increased, and patients may feel as though they can't get enough air, especially during physical exertion.
Lab/Diagnostic Test
Normal labs related to patient’s primary diagnosis + all abnormal labs & diagnostic tests
(include rationale and relevant nursing care)
Pt’s value (high/low?)
Rationale for Abnormal
Relevant Nursing Care
MEDICATION LIST: INCLUDE SCHEDULED AND PRN MEDS
Name of
Drug
(Brand &
Generic)
Class &
Mechanism of
Action
Safe Dosage Range
(Med Book &
Calculate Your
Patient's Safe Range)
Dose/ Route/ Frequency
IV Meds (if applicable):
*mLs of diluent/type of diluent
*Length of infusion:
*IV rate mL/Hr:
Reason
Side Effects
RN
Responsibilities/Assessments
acetaminoph
en tab 650
mg
Dose 650 mg
: Oral : Every
6 hours PRN
: Mild Pain
(Pain Scale 13)
Updated 5/29/18 Rev EC 10/18
3
atorvastati
n tab 40
mg
Dose 40
mg : Oral :
Daily
cyclobenz
aprine tab
5 mg
Dose 5
mg : Oral :
Every
night at
bedtime
pratropiu
malbuterol
0.5-2.5
mg/3 mL
inh soln 3
mL
Dose 3
mL :
Nebulizati
on : 3
times daily
Updated 5/29/18 Rev EC 10/18
4
lasix
20mg IV
bid
Fulmer SPICES: An Overall Assessment Tool for Older Adults
ASSESSMENT
Sleep Disorders
Problems with Eating or Feeding
YES/NO and Explanation
No; the patient reports eating 100% of meals. States that his appetite is good. No swallowing problems or
aspiration of food or liquids.
Incontinence
Confusion
Evidence of Falls
Skin Breakdown
No; he has no recent history of falls but does have a history of falls. Since he has full mobility he is at less of a
risk for falls.
No, he does not have any skin breakdown. The only risk is the edema in his bilateral legs due to swelling.
*See https://consultgeri.org/try-this/general-assessment
Gerontological Competency
Communication
Physiological and Psychological Age
Changes
Pain
Functional Status, including ADLS, IADLs
and mobility.
Evidence of Elder Abuse?
Other Geriatric Specific Interventions (Age >65)
Specific Issues Identified
The patient adeptly articulates his needs and engages in extended conversations without any afternoon
confusion. There is no requirement to reorient the patient to his environment.
The patient is mobile and reports feeling short of breath after extended periods of walking around his
room. However, he can ambulate and maintains a positive attitude. His dyspnea during exertion is
relieved by breathing treatments. He has been advised to continue using his incentive spirometer to
prevent atelectasis.
He reports pain in both lower legs bilateral . Legs should remain elevated and he should be assessed for
pain frequently.
It is essential to assess J.R.’s functional status comprehensively, as the exacerbation of his COPD
symptoms and potential complications, such as the leg swelling he’s experiencing, may impact his overall
functional abilities. Additionally, a review of his medications and potential interactions with his current
health status is necessary to optimize his treatment and overall well-being.
No evidence of elder abuse. No bruising present and the patient responded that he feels safe in his life
and living out of his home.
Discharge Planning, including home
environment and social supports
Updated 5/29/18 Rev EC 10/18
5
Updated 5/29/18 Rev EC 10/18
6
Nursing Plan of Care
Nursing Diagnosis
-3 physical, one
psychosocial NANDA dx
-Limit to one “at risk”
NANDA
-For R/T do not use medical
dx
-For AEB, use objective and
subjective data
Goal
What is it you want the
patient to accomplish,
or what do you want to
have happen?
Objective(s)
Measurable with
time frame
Interventions
-What are you going to do
to meet the goals?
-Must have at least 3
interventions per NANDA
-Include assessments,
interventions, pt. teaching,
referrals, discharge
planning, etc.
-Individualize this to your
patient & be specific.
Scientific Rational
Why are you doing
this for this patient?
MUST include
citations.
Evaluation
First, were
goals/objectives met,
not met or partially
met? Second, what
was the patient’s
response to your
interventions?
1. iNFFECTIVE
BREATHING PATTERN
2. Activity Intolerance
Related to:
Imbalance between oxygen
supply and demand
As evidenced by:
Dyspnea
Fatigue
Weakness SOB
3.Acute pain related to
bilater selling
4.Anixety related to
wheather or not this will be
effecting him
References:
Pavord, I. D., Jones, P. W., Burgel, P. R., & Rabe, K. F. (2016). Exacerbations of COPD. International Journal of Chronic Obstructive
Pulmonary Disease, 11(Spec Iss), 21-30. https://doi.org/10.2147/COPD.S85978
Updated 5/29/18 Rev EC 10/18
7
NURSING CARE PLAN
Pt. initials: M.J.P.
Sex: Female
Admitting diagnosis(s):
Left heel pain secondary to osteomyelitis
Age: 92
Date(s) Care Given: 11/09/2020
Admission Date:
11/04/2020
Allergies:
NKDA
CODE Status:
DNR
History of Present Illness (HPI): M.J.P. is a 92 y.o. female admitted on 11/04/20 to the ED for a worsening L heel ulcer with purulent drainage and
pain. She is a poor historian and has a medical history of L toe osteomyelitis, polycythemia, HTN, HLD, PAD, dementia. Pt. had a L total hip
arthroplasty on 8/2020 which was complicated by a periprosthetic femur fracture and an arterial thrombus. This was revealed when the pt. was
recently admitted to St. John’s Hospital from 8/27/20-8/29/20 after the caregiver found her on the floor. She was treated with apixaban 5 mg PO BID.
She first developed the L heel ulcer at the SNF she resides in, but it is not known when it developed. L heel ulcer appears to be related to
osteomyelitis, not a pressure ulcer. Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Shortness of Breathe (SOB)
ASSESSMENT DATA
Objective Data
Deficient fluid volume
• Poor skin turgor with tenting
• BP: 96/56
• Dry mucous membranes
Impaired tissue integrity
• Necrotic/eschar tissue at L heel
• Localized edema/redness/heat to L heel
Frail elderly syndrome
• L heel wound
• Age: 92 y.o
• Sex: female
• Hx of falls
Subjective Data
Deficient fluid volume
• Pt. states, “I am very thirsty.”
Impaired tissue integrity
• 6/10 aching pain at L heel
• Pt. states, “Ouch! My foot hurts.”
Frail elderly syndrome
• Pt. states, “I can’t walk.”
• Pt. states, ”I live alone.”
Decreased diversional activity engagement
• Pt. states, “I can’t walk or do anything.”
• Pt. states, “I don’t have any family.”
Decreased diversional activity engagement
• Prolonged hospitalization per pt. chart
Updated 5/29/18 Rev EC 10/18
1
Height:
1.542 m
Weight:
45.4 kg
BMI: 19.1
Neuro: AOX4, speech clear, cooperative, follows commands and responds appropriately. Upon inspection: head normocephalic; no apparent deformities
or lesions; neck symmetric without visible masses, scars, or edema; trachea midline. Positive PERRL. Extraocular movements present; no nystagmus.
Facial symmetry present upon smiling, No tenderness noted to head or neck.
Respiratory: Upon inspection chest rise and fall symmetric; respiratory movements are with regular rhythm, and unlabored; RR 18/min, without effort or
use of accessory muscles. Upon palpation of anterior and posterior thorax no pain, tenderness, or masses. Upon auscultation breath sounds are clear
bilaterally throughout all lobes; no wheezes, rhonchi, crackles, or stridor.
Cardiac: Upon palpation: carotid, radial, brachial, and femoral, pulses present, regular, +2 bilaterally. Dorsalis pedis and posterior tibialis pulses weak +1
bilaterally. Pulse rate: 84/min; capillary refill < 3 sec. Upon auscultation aortic, pulmonic, Erb’s point, tricuspid, and mitral valve sounds present and
unremarkable; S1/S2 present; no murmurs; no carotid bruits.
GI/GU: Upon inspection, abdomen symmetrical with round contour, no lesions, masses or scars noted; no signs of inflammation or herniation. Upon
auscultation, bowel sounds normoactive. With light palpation, no tenderness or pain noted. Bladder non palpable. Patient has functional incontinence
secondary to limited mobility.
Musculoskeletal: Upon inspection of upper extremities and joints, no deformities, edema, scars or erythema noted; arms are symmetric. Upper
extremity, hand grip 5/5 strength bilaterally. Left heel with eschar, redness, swelling; no drainage or warmth noted. Patient reports 6/10 sharp pain to left
heel. Sensory motor movement intact to both feet. Spine is symmetric; with some lordosis. Upon palpation, muscles have normal tone. Full active ROM in
upper extremities. Limited ROM to lower extremities.
Skin (including IV & wounds): Upon inspection skin is appropriate for race; redness to left forearm that patient states was due to tape. Peripheral IV to
dorsal side of left forearm; no swelling, redness, or infiltration noted. Upon palpation skin is warm and dry; poor skin turgor with tenting.
Psychosocial: Patient is quiet and friendly; answers questions appropriately when asked. Appears content in sharing her life story. She reports having
only one family member, but also a close personal aid. She is oriented to her condition but became confused later on in the afternoon. She states she
can’t do what she used to do due to her limited mobility, and when asked about what she enjoys doing as a diversional activity, she said “I can’t do
anything.” She appeared content and pleasant throughout the day. She learns best by listening.
Past Medical & Surgical History: Acute kidney injury (8/20/20), DVT after hip replacement (8/2020), hyperlipidemia, HTN (essential), memory deficit,
osteoporosis with fracture, polycythemia, osteomyelitis. Surgeries: L knee arthroplasty, mastoidectomy, L rotator cuff repair, L total hip replacement
Social History: Patient lives in a skilled nursing facility. She is a non-smoker and denies ever smoking tobacco or doing illicit drugs. She used to drink
alcohol socially over “40 years ago.” She reports having no children or husband. Her previous careers were being a “postmodern dancer” and pilot.
Updated 5/29/18 Rev EC 10/18
2
Pathophysiology of Primary Problem(s): Osteomyelitis is an infection of the bone that can be caused by a bacteria, virus, parasite, or fungi. The
infection can either enter from outside of the body—such as with an open fracture—or from inside the body—such as through the blood. Often,
osteomyelitis infections occur after total joint replacements (McCance & Huether, 2019). In M.J.P, this most likely occurred with her total hip
replacements. The pathophysiology involves the invasion of the pathogen which the causes an inflammatory response. This leads to edema, vascular
engorgement, and abscess formation. This can cause a disruption in the blood supply to the bone, which then leads to necrosis and an area of dead
bone called sequestrum. Osteoblasts form new bone cells around this area called involucrum, which has openings that allow purulent drainage to leave
the area (McCance & Huether, 2019). Symptoms of osteomyelitis vary with the degree of the infection. They typically include fever, malaise, and weight
loss. At the area of the infection one can see exudate, lymphadenopathy, swelling, and pain (McCance & Huether, 2019).
Lab/Diagnostic Test
WBC
Hgb
Normal labs related to patient’s primary diagnosis + all abnormal labs & diagnostic tests
(include rationale and relevant nursing care)
Pt’s value (high/low?)
Rationale for Abnormal
Relevant Nursing Care
▪ Monitor for s/s of infection or systemic
inflammation (Temp, HR, RR, etc.)
▪ Administer prescribed antibiotics if ordered
8.10 K/uL (4.5-11.0)
N/A
for suspected/confirmed infection
▪ Monitor trends overtime and report
significant changes to provider
▪ Monitor for bleeding and s/s of hypoxia (HR,
BP, RR, cyanosis, etc.)
Hemoglobin may decline after the
▪ Maintain adequate hydration
10.8 g/dL (13.5 to 17.5): Low age of 90 (Meiner & Yeager, 2019).
▪ Monitor trends overtime and report
The patient is 92.
significant changes to provider
Htc
RBC
PLT
Updated 5/29/18 Rev EC 10/18
35.3% (39-52): Low
Hematocrit may decline after the age
of 90 (Meiner & Yeager, 2019). The
patient is 92.
3.24 M/uL (4.4-5.9): Low
Since the patient has an infection of
the bone, there may be a decrease
in hematopoietic tissue in the
marrow of the long bones. This can
lead to a delay in the production of
RBCs (Meiner & Yeager, 2019).
314 k/uL (150-440)
N/A
▪ Monitor for bleeding and s/s of hypoxia (HR,
BP, RR, cyanosis, etc.)
▪ Maintain adequate hydration
▪ Monitor trends overtime and report
significant changes to provide
▪ Monitor for bleeding and s/s of hypoxia (HR,
BP, RR, cyanosis, etc.)
▪ Maintain adequate hydration
▪ Monitor for venous thrombosis
▪ Monitor trends overtime and report
significant changes to provider
▪ Monitor for ecchymosis and bruising.
▪ Monitor for bleeding and ensure IV insertion
sites are not hemorrhaging.
▪ Maintain adequate manual pressure on
bleeding areas.
3
▪ Monitor trends overtime and report
significant changes to provider
Albumin
2.8 g/dL (3.4 to 5.4), Low
Diagnostic Test
MRI of L foot with
contrast
Impression Statement
Large soft tissue defect in heel.
Unstageable ulcer.
Albumin levels decrease with age,
and are associated with chronic
diseases (Meiner & Yeager, 2019).
Diagnostics Test
Rationale for Abnormal
Osteomyelitis
▪ Monitor nutritional status, and ensure
adequate protein intake
▪ Assess for drug toxicity, as low albumin can
lead to toxicity with protein bound drugs
▪ Monitor trends overtime and report
significant changes to provider
Relevant Nursing Care
▪ Assess circulation, sensation, and motor
ability in left foot.
▪ Elevate heel to remove pressure.
▪ Educate about signs and symptoms of
systemic infection.
MEDICATION LIST: INCLUDE SCHEDULED AND PRN MEDS
Name of
Drug
(Brand &
Generic)
Class &
Mechanism of
Action
apixaban
(Eliquis)
Ther. Class:
Anticoagulants
(Davis, n.d.).
Pharm. Class:
factor xa inhibitor
Up to 5 mg PO BID
Dose/ Route/ Frequency
IV Meds (if applicable):
*mLs of diluent/type of diluent
*Length of infusion:
*IV rate mL/Hr:
5 mg PO q BID
80–325 mg PO q day
81 mg PO q daily
Safe Dosage Range
(Med Book &
Calculate Your
Patient's Safe Range)
Side Effects
Prevention of DVT
due to reduced
mobility.
Bleeding, hypersensitivity
reaction (anaphylaxis)
▪ Assess for signs of bleeding
and hemorrhage (bleeding
gums; nosebleed; unusual
bruising; black, tarry stools;
hematuria; fall in hematocrit
or BP)
▪ Assess for DVT and stroke
▪ Explain purpose and method
of administration of
medication. Inform that they
may bruise easily and bleed
longer than usual.
Prevention of MI
Dyspepsia, epigastric distress,
nausea, GI bleeding,
hypersensitivity reactions
(anaphylaxis)
▪ Assess pain severity and
characteristic
▪ Assess fever and associated
signs (tachycardia,
diaphoresis, chills)
▪ Monitor hepatic function
MOA: Acts as
selective factor X
inhibitor that
blocks the active
site of factor Xa,
inactivating the
cascade of
coagulation.
aspirin
(Acurprin)
Ther. Class:
antipyretic,
nonopiod
analgesic
Pharm. Class:
salicylates
Updated 5/29/18 Rev EC 10/18
RN
Responsibilities/Assessments
Reason
4
▪ Monitor for signs of bleeding:
PTT, HTC, Hgb, RBC
(Davis, n.d.)
MOA: Decreases
platelet
aggregation.
Produces
analgesia/
inflammation/
fever by inhibiting
prostaglandins
(Davis, n.d.).
vancomycin
(Vancocin)
Ther. Class: antiinfective
500 mg q 6 hrs or 1 g q
12 hrs up to 4 g/day
300 mg in NaCl 0.9% 100 ml IVPB
q 12 hrs
Osteomyelitis of L
heel
Hypotension, rash, ototoxicity,
N/V, nephrotoxicity, phlebitis,
back and neck pain, anaphylaxis,
chills, fever, red man syndrome
▪ Assess for infection (V/S,
wound appearance, sputum,
urine, stool, WBCs)
▪ Monitor IV site as it may be
irritating to the tissues
▪ Monitor BP throughout
infusion
▪ Monitor for I/Os. Cloudy
urine may indicate
neprotoxicity.
Variable depending on
brand directions/
manufacturer
1 tablet PO daily
Nutritional deficiency
Urine discoloration (vitamin B)
• Educate patient that urine
may change color
• Educated that best source
for vitamins is nutritious
foods from different food
groups
Pharm. Class:
N/A
MOA: Binds to
bacterial cell wall
causing cellular
death.
Multivitamins
Therapeutic:
Vitamins
Pharmacologic:
N/A
(Davis, n.d.)
MOA: Acts as
coenzymes or
catalysts in
metabolic
processes.
Fulmer SPICES: An Overall Assessment Tool for Older Adults
ASSESSMENT
Sleep Disorders
YES/NO and Explanation
No; the patient reports she gets an average of 10 hours of sleep per night. Denied waking up in the middle of
the night or having a difficult time falling asleep.
Problems with Eating or Feeding
No; the patient reports eating 100% of meals. States that her appetite is good. No swallowing problems or
aspiration of food or liquids.
Incontinence
Yes; the patient has functional incontinence due to her limited mobility. The patient wears a diaper; if she is
unable to receive assistance for toileting then she will use her diaper.
Confusion
Updated 5/29/18 Rev EC 10/18
Yes; the patient was able to engage in conversation, but later in the day she was “sundowning” and was not
aware that she lives in a skilled nursing facility.
5
Evidence of Falls
Skin Breakdown
No; she has no recent history of falls but does have a history of falls. Since she has limited mobility she is at
less of a risk for falls.
Yes; she has an open ulcer on her left heel. No pressure ulcers noted to other areas of her body and bony
prominences.
*See https://consultgeri.org/try-this/general-assessment
Communication
Other Geriatric Specific Interventions (Age >65)
Specific Issues Identified
The patient communicates her needs effectively and can maintain longer conversations. Some confusion
was present in the afternoon. Patient needs to be re-oriented to her surroundings periodically.
Physiological and Psychological Age
Changes
Patient is severely limited with her mobility due to her left heel ulcer. Her positions should be changed q 2
hours to avoid pressure injuries. She was dehydrated prior to discharge, so encouraging and reminding
about fluid intake is important even when not thirsty.
Pain
She reports pain to her left heel. Heel should remain elevated and she should be assessed for pain
frequently.
Functional Status, including ADLS, IADLs
and mobility.
Patient can sit but cannot ambulate. She needs assistance with toileting, but her upper extremities allow
her to conduct some ADLs such as brushing her teeth, combing her hair, and washing her face. She
needs assistance with bathing as well.
Evidence of Elder Abuse?
No evidence of elder abuse. No bruising present and the patient responded that she feels safe in her
skilled nursing facility.
Discharge Planning, including home
environment and social supports
The patient will be discharged to a skilled nursing facility with an IV line in place to finish her antibiotic
treatment. She has little family in Los Angeles, but has a personal aid that helps her daily.
Gerontological Competency
Updated 5/29/18 Rev EC 10/18
6
Nursing Plan of Care
Nursing Diagnosis
-3 physical, one
psychosocial NANDA dx
-Limit to one “at risk”
NANDA
-For R/T do not use medical
dx
-For AEB, use objective and
subjective data
Goal
What is it you want the
patient to accomplish,
or what do you want to
have happen?
Objective(s)
Measurable with
time frame
Interventions
-What are you going to do
to meet the goals?
-Must have at least 3
interventions per NANDA
-Include assessments,
interventions, pt. teaching,
referrals, discharge
planning, etc.
-Individualize this to your
patient & be specific.
Scientific Rational
Why are you doing
this for this patient?
MUST include
citations.
Evaluation
First, were
goals/objectives met,
not met or partially
met? Second, what
was the patient’s
response to your
interventions?
1. Deficient fluid volume r/t
insufficient fluid intake AEB:
poor skin turgor with tenting,
BP: 96/56, dry mucous
membranes, pt. states, “I am
very thirsty.”
The patient will achieve
an adequate fluid
volume status.
By the end of the
12-hour shift, the
patient will attain a
systolic BP > 100
mmHg.
1. Monitor VS (pulse,
respirations, BP) q 1
hour until adequate
fluid volume achieved.
1. Deficient fluid
volume results in
tachycardia,
tachypnea, and
hypotension
(Ackley et al.,
2020).
1. Objective met; VS
were taken q 1
hours. VS before
fluid bolus were
BP: 96/56, HR:
84, RR: 20, O2
sat: 95%, T: 98.5.
2. For those with
mild to moderate
fluid deficits, 0.9%
saline can be
used as fluid
replacement
(Ackley et al.,
2020).
2. Objective met;
fluid bolus led to
systolic BP > 100
mmHg. Pt.
tolerated fluid
bolus well.
2. Administer 500 mL
NaCl 0.9% fluid bolus
IV at rate of 500mL/hr.
3. Provide patient
teaching about her
susceptibility to
dehydration due to her
advanced age.
Encourage her to
regularly consume
liquids even when not
thirsty.
Updated 5/29/18 Rev EC 10/18
3. Strategies to
improve fluid
intake in the
elderly include
reminders about
drinking fluids and
encouraging small
amounts of fluid
throughout the
day (Ackley et al.,
2020).
3. Objective partially
met; at time of
teaching pt.
began
“sundowning” and
became
confused.
Teaching had to
be repeated
several times.
7
2. Impaired tissue integrity
r/t infectious process AEB:
necrotic/eschar tissue at L
heel, 6/10 aching pain at L
heel, localized
edema/redness/heat to L
heel, pt. states, “Ouch! My
foot hurts.”
The patient will
maintain an appropriate
wound healing process
(e.g., decrease in size
of wound).
By the end of the
12-hour shift, the
patient will be
provided the
prescribed
treatment
measures for L
heel wound
(protective boot,
antibiotics, pt.
teaching).
1. Assess L heel area for
s/s of worsening
infection (pain,
redness, swelling,
purulent drainage,
heat.).
2. Administer vancomycin
300 mg IVPB q 12
hours.
3. Provide client teaching
on skin and wound
assessments and how
to monitor for
symptoms of infection
and appropriate
healing.
3. Frail elderly syndrome r/t
immobility and social
isolation AEB: pt. states, “I
can’t walk”, ”I live alone,” L
heel wound, age: 92 y.o.,
sex: female, hx of falls.
The patient will perform
activities of daily living
as safely and
independently as
possible.
By the end of the
12-hour shift, the
client will eat,
transfer to a chair,
and toilet with
minimal to no
assistance.
1. Assess the pt.’s degree
of frailty with the Frailty
Index.
2. Encourage and assist
client with activities of
daily living.
3. Discharge the client
with referrals for an
interdisciplinary care
team including physical
therapy.
Updated 5/29/18 Rev EC 10/18
1. An assessment of
ulcers should
include changes
in sensation, a
detailed pain
assessment, and
signs of inection
(Ackley et al.,
2020).
2. Vancomycin is an
anti-infective that
is indicated for
osteomyelitis
infections (Davis,
n.d.).
3. Early assessment
and interventions
of tissue integrity
can aid in
preventing more
serious issues
from developing
(Ackley et al.,
2020).
1. Validated tools
such as the Frailty
Index has
accurate
predicative
reliability and can
help identify frail
older adults
(Ackley et al.,
2020).
2. Elderly client who
remain sedentary
have deteriorating
mobility levels
1. Objective met; L
heel was
assessed during
the shift and
found to be
edematous, red,
and swollen but
with no drainage.
Lower extremity
pedal pulses were
weak.
2. Objective met;
patient received
prescribed dose
of vancomycin.
Pt. tolerated
medication well;
no N/V or rash
noted.
3. Objective not met;
the patient did not
understand the
teaching. Pt. has
limited mobility
and cannot
inspect feet.
1. Objective met; the
pt. was identified
as very frail
according the
Frailty Index
(hypothetical).
2. Objective met: the
client ate
independently,
needed
assistance in
transferring to the
chair and some
8
4.Decreased diversional
activity engagement r/t
impaired mobility,
insufficient opportunities for
diversional activities AEB:
pt. states “I can’t walk or do
anything,” “I don’t have any
family,” prolonged
hospitalization per pt. chart.
The patient will engage
in personally satisfying
recreational activities.
Updated 5/29/18 Rev EC 10/18
By the end of the
12-hour shift, the
client will identify
two diversional
activities she can
comfortably engage
in.
1. Assess the pt.’s motor
skills, hand dexterity,
and vision.
2. Encourage the client to
share feelings about
their interests,
environment, or lack of
opportunities for
recreation. Identify
appropriate activities
that the client can
engage in within their
situation.
3. Refer to occupational
therapy.
(Ackley et al.,
2020).
assistance with
toileting.
3. Care for the frail
elder adult should
not only focus on
medical problems,
but also on
supporting the
client to be
independent
(Ackley at al.,
2020).
1. Diversional
activities need to
be individualized
to the pt.’s
abilities (Ackley et
al., 2020).
2. Sharing feelings
about once’s
perceived sense
of loss can be
therapeutic
(Ackley et al.,
2020).
3. Occupational
therapists assist
clients in
accessing and
conducting
recreational
activities (Ackley
et al., 2020).
3. Objective met;
physical therapy
assessed the
client and
demonstrated
exercises she can
do on her own
(hypothetical).
1. Objective met; the
pt. was found to
have good hand
dexterity, but poor
vision.
2. Objective met; the
pt. shared how
she used to be a
dancer but can’t
do that anymore.
She identified
knitting and board
games as two
activities she
would enjoy
(hypothetical).
3. Objective met; the
patient was
referred to
occupational
therapy at her
SNF
(hypothetical).
9
References:
Ackley, B., Ladwig, G., Makic, M., Kratz, M., & Zanotti, M. (2020). Nursing diagnosis handbook: An evidence-based guide to planning care (12
ed.). Elsevier.
Davis F. A. (n.d.). Davis’s Drug Guide. https://www.drugguide.com/ddo/
McCance, K. L., & In Huether, S
Use your previous assignments to identify a policy related to your chosen health issue and create a Prezi or PowerPoint presentation that focuses on the development, needed change, or implementation related to your health issue. Policy briefs are overviews of issues that are intended to inform policymakers. The presentation should be succinct, colorful, and designed to catch the attention of a busy policymaker. See the attached document below for more information.
The presentation should have the following structure:
Executive Summary
An overview of the problem, why change is needed, and your recommendations for change
Introduction
A clear statement of the problem, its causes, and why it is important
What are the key issues that are relevant to the health issue?
Approaches/policy options
Summarize facts, issues, contexts. Provide facts or examples that support the need for policy to change/impact/solve the issue.
Recommendations
Provide recommendations on development, implementation or changes that need to be considered to solve the health issue. Provide specific steps and reemphasize the importance of this change.
References
Each content component will have one or two slides.
Include a title and references slide
Use bullet points rather than paragraph form. The target audience is a policymaker, not a medical professional, so keep scientific jargon to a minimum.
Please respond to the following:Go to the U.S. National Library of Medicine website and review the Glossary of Frequently Encountered Terms in Health Economics. Focus on terms that define medical care demand including health demand, elasticity, principle, and agent.Discuss whether or not healthcare is elastic or inelastic and share one example to support your argument.Explain how the supply and demand curves can be used by healthcare managers.Provide at least one example of these factors to support your rationale.
The reflection log is designed to encourage self-reflection and self-evaluation. It is a tool for the student to reflect on specific field activities and experiences. The student is challenged to analyze the field learning experience from both a personal and professional perspective. Using a critical thinking model, the student must examine his/her work performance and apply social work knowledge, values and skills to understand and evaluate their performance.
The instructor will provide written feedback to the students. It is at the student’s discretion whether they share their logs with their field site supervisor. In order to protect confidentiality, please do not use any client names in the log. The reflection log is not a substitute for supervision and the students are encouraged to discuss their concerns with their field supervisor.
The logs should be no longer than two pages double-spaced, and no shorter than 1 page; at least one paragraph should be devoted to each section of the assignment. You should provide headings for each section of the log so the instructor can clearly tell each section apart.
Choose one meaningful situation/task/experience to explore critically in your log. This should be an important experience that you can explore in-depth—note that sometimes, very brief interactions can be very meaningful, and that in-depth exploration is possible with even if the situation/task/experience was not lengthy. While this situation doesn’t need to be an ethical dilemma, it should be an experience that has impacted your learning and your development as a professional social worker.
Description: This is the section of the log where you will provide the information about what occurred. Describe in detail the situation/task/experience that happened in the field placement. This should be a significant and/or meaningful experience that you can explore critically. Talk about what occurred and your actions in the situation.
Evaluation/Critical Thinking: This is the section of the log where you will review your actions (or the situation as a whole) and think critically about how the situation/task/experience occurred. Looking back on this situation, how do you feel about how it was resolved? What were you happy about? What would you improve? How would you change your response in the future?
Next Steps: This is the section of the log where you will connect this experience to future interactions, your learning, or the profession as a whole. How could you bring this situation to supervision? How will this situation impact your internship as you move forward? What could you learn/practice in the future to improve in this area?
Unformatted Attachment Preview
Student Name
Reflection Log #X
Date
Description
This week at my internship, we had a new family come in for intake at the shelter. The family
was comprised of a 23-year-old mother and her three children, who ranged in age from 6 months to 4
years. The mother, who I will call “Michelle” for purposes of protecting client confidentiality, was
seeking shelter because she was fleeing domestic violence and did not have any friends or family it
was safe for her to stay with. I was able to sit in and observe the Advocate completing the lengthy
intake packet. I had read through the packet several times, and also read completed forms in client
files, but I had never participated in a live in-person intake interview before. During the meeting,
Michelle shared lots of graphic details about the abuse she has experienced over the course of many
years, including physical and sexual assaults. She cried as she shared feelings of shame, helplessness,
hopelessness, and fear for her own safety and the safety of her children. I did not say anything during
the meeting since the Advocate was in charge of conducting the interview. It was a very emotionally
intense experience, and I had a hard time staying calm. I had to keep reminding myself to take deep
breaths. I noticed that I felt like I could cry and it was all I could do to hold it in. After the client had
left, I asked the Advocate how she managed to stay so calm, and she said, “I’ve been doing this a
really long time. I’m used to the sad stories and they really don’t get to me anymore.”
Evaluation/Critical Thinking:
One of my big learning goals for this semester is to improve my skills with engaging adults
(EPAS 6 –Engage with Individuals, Families, Groups, Organizations, and Communities). Because I
have worked with children for so long, I feel pretty comfortable developing relationships and getting to
know kids. I am less comfortable doing this with adults, and that discomfort felt very clear to me
while I was observing this intake appointment. I was imagining being alone with Michelle, and felt
like I did not know what I would have said or done to help her. The Advocate seemed very natural
while meeting and interviewing Michelle. She did not refer back to the papers too often and asked lots
of follow-up questions that are not on the forms. The Advocate was also very kind and gentle with
Michelle, and it seemed like Michelle was feeling better by the time the intake meeting was over. The
Advocate has a lot of skills that I know I want to develop.
In addition to highlighting things I want to work on, this interaction also made me curious
about the Advocate’s response that sad stories “don’t get to her anymore.” I don’t ever want to be
numb to the sad stories, or to start to normalize domestic violence in my mind in order to survive the
work. I wonder if the Advocate is experiencing burnout or if she meant something different about the
stories not getting to her. I can’t imagine hearing that story and not having it get to me on some level.
Next Steps:
I know I am very interested in working with survivors of domestic violence, so I am going to
ask to sit in on as many intakes as possible so that I continue to learn. My supervisor has told me that
soon, I’ll be doing intakes on my own, but I don’t think I’m ready for that yet; I will ask for my
supervisor or an Advocate to sit with me so that I have support and they can give me feedback before I
do intakes on my own. I am also going to need to talk with my supervisor about what I should do if I
am with a client and feel like I want to cry or feel overwhelmed by her story so that I can build skills in
that area. Since I don’t want to get either burned out or numb, I am also going to keep focusing on
self-care, like we’ve talked about in class, because I can see more than ever how important that is.
I’m not sure if I’m going to talk to the Advocate about her comment about the stories not
getting to her. I’m curious about what she meant, but I don’t want her to think I am criticizing her! I
think I might ask her to talk to me about how she manages the stress of the job, and see if she has any
tips or suggestions that might be helpful to me.
1
Student Name
Reflection Log #X
Date
Description
I shadowed a mental health assessment intake for a DCFS client. The client was recently
transferred to Agency X and has been in therapy for about a year. He is mandated to attend
counseling because he does not have custody of his 1-year-old son and newborn daughter. His
children are currently with their aunt. DCFS got involved because his son cracked his skull a few
months ago.
The intake session was informative and insightful. I learned the process of explaining each
form the client needs to sign. Additionally, I receive insight on probing the assessment questions.
I was not familiar with DCFS and its clients prior to this session, so I went off based on comments
I have heard. For example, I have overheard people say that DCFS clients do not want to be in
counseling, so they are disengaged. However, the client was the opposite. He mentioned he had
been in counseling for about a year, and he liked it because he was able to speak to someone about
things going on in his life. I also learned he has multiple jobs, is certified in his work, and is an
active member of his community’s center.
An instance that caught my attention occurred when the therapist went over the substance
abuse section of the assessment. He asked the client if he smokes marijuana or uses other drugs.
The client said he does not. Before we entered the session, the therapist told me he smelled like
marijuana and I noticed it right away as well when I entered the room. After the client answered
“no”, he went on to explain that he passes his random drug tests at work. He also mentioned he
heavily smokes cigarettes and the smoke leaves him with a bad smell. Since the client has put so
Weekly Log
2
much effort into his job and other responsibilities to get make and income and receive custody of
his children, I believed him.
Evaluation/Critical Thinking:
The session allowed me to check my assumptions about clients, such as mandated ones. I
learned to enter a session with an open mind because every client’s narrative is unique. One of the
Social Work Principles is to individualize each case because every client has distinct experiences.
I was able to observe a case of a father who is engaging in counseling and his community.
Everything he is doing is for his family to come together. Regarding to the client’s answer of not
using substance, I think it is important to believe the clients I will engage with because they are
the experts of their life.
Next Steps:
Previously, I mentioned changing my physical position in sessions to be able to better
observe the therapist and client. I sat across from both members in this session and was able to
pick up non-verbal and body communication. I was able to follow the flow of the session by
looking over each question that was being asked, but I did not write down notes on the assessment
packet. Instead, I wrote personal notes on a sheet of paper. Next time, I would like to write in the
packet to get accustomed with the order of the sections.
I want to learn more about DCFS and its services and programs. I also want to be familiar
with the assessments I will be conducting soon. The session I shadowed provided me with insight
on the process of explaining participant rights, sessions, appointments, and service fees. Now, I
have to incorporate my personality and character because I do not want the session to be
monotonous. Overall, the session also highlighted the importance of creating a flow in the
conversation and maintaining appropriate eye contact as well as body language. f
Describe the health care problem or issue you selected for use in Assessment 2 and provide details about it.
Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
Identify possible causes for the problem or issue.
Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
You may find the applicable Undergraduate Library Research Guide helpful in your search.
Review the Think Critically About Source Quality to help you complete the following:
Assess the credibility of the information sources.
Assess the relevance of the information sources.
Analyze the health care problem or issue.
Describe the setting or context for the problem or issue.
Describe why the problem or issue is important to you.
Identify groups of people affected by the problem or issue.
Provide examples that support your analysis of the problem or issue.
Discuss potential solutions for the health care problem or issue.
Describe what would be required to implement a solution.
Describe potential consequences of ignoring the problem or issue.
Provide the pros and cons for one of the solutions you are proposing.
Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
Describe what would be necessary to implement the proposed solution.
Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
Provide examples from the literature to support the points you are making
The following resources provide information about evidence-based practice:
Macias, C. G., Loveless, J. N., Jackson, A. N., & Srinivasan, S. (2017). Delivering value through evidence-based practice. Clinical Pediatric Emergency Medicine, 18(2), 89–97.
Thomas, S. J. (2016). Does evidence-based health care have room for the self? Journal of Evaluation in Clinical Practice, 22(4), 502–508.
Agency for Healthcare Research and Quality. (n.d.). EPC evidence-based reports. http://www.ahrq.gov/research/findings/evidence-bas…
Value-based healthcare is a healthcare delivery model or a process in which the providers, including hospitals and physicians, are paid based on patient health outcomes. It is one of the alternative models that offer value as well as has the potential to transform and improve healthcare delivery in each and every region. In this care delivery model, the goal is to allow patients and communities to aid themselves and access the best treatment choices available (DelveInsight, 2021). The providers are rewarded for helping patients in improving their health, reducing the effects and incidence of chronic disease, and also assisting them to lead healthier lives in an evidence-based way. Value-based care has a different approach from a fee-for-service where providers are paid based on the number of healthcare services they deliver. Value-based healthcare is a healthcare delivery framework that incentivizes healthcare providers to focus on the quality of services rendered, as opposed to the quantity. Clinicians who actively participate in the value-based care agreements are then rewarded for promoting healthy patient outcomes, helping their patients live healthier lives through evidence-based medicine, and also reducing the chronic disease burden. Value-based healthcare programs are vital to a larger quality strategy to reform how healthcare is delivered and paid for. Also Engen, Bonfrers, Buljac-Samardzic (2022), asserted that Healthcare systems are increasingly moving toward value-based healthcare (VBHC) aiming to further improve quality and performance of care as well as the equitable, sustainable, and transparent use of resources.
Risk Mitigation Strategies to Prevent or Reduce Adverse Health Outcomes
Clinical risk management is the process of investigating sentinel events and other medical errors in a healthcare institution. The risk managers investigate the events and identify root causes otherwise known as root cause analysis. They make recommendations to prevent these errors from happening again. According to Dignity Health (2023), people make mistakes even in the most risk-aware organization. The risk management team, led by a chief risk officer is responsible for mitigating the impact. Depending upon the severity of the error, the repercussions can be significant. An organization with protocols in place to manage adverse events will have a better chance of learning from it and moving beyond it. On the other hand, an organization that is reactive or mismanages a situation can further damage its reputation or be impacted financially.
The University of Scranton (2021) asserted that there are key risk management concepts in healthcare and that there should be main factors of concern when creating a risk management plan. Challenges faced by administrators that should be addressed in a risk assessment plan include:
Patient safety
Mandatory federal regulations
Potential medical error
Existing and future policy
The role of a healthcare manager involves addressing current challenges and preparing for future situations. Neglecting to have comprehensive risk management plans in place can compromise patient care, increase liability risks, and result in financial losses.
References
DelveInsight (2021). Evaluating the Essential Factors Building the Value-Based Healthcare Model. Retrieved from, https://www.delveinsight.com/blog/value-based-heal…
Engen, V. V., Bonfrers, K., Buljac-Samardzic, M (2022). Value-Based Healthcare, From the Perspective of the Healthcare Professional: A Systematic Literature Review. Frontiers in Public Health. 9:800702. doi: 10.3389/fpubh.2021.800702. PMID: 35096748;
Dignity Health (2023). Risk management in healthcare: What it is and why it matters. Retrieved from, https://dhge.org/about-us/blog/risk-management-in-…
The University of Scranton (2021). The Purpose of Risk Management in Healthcare. Retrieved from, https://elearning.scranton.edu/resources/article/p..
gigi:Care Delivery Model
A health care delivery associated with a health outcome within my community would be Team Nursing Method. This method takes advantage of the mix of skills of several members on the nursing teams. It implements a philosophy where a leader leads a group of people. It is a philosophy where all team members are familiar with patients’ needs and or problems. The two fundamental pillars associated with this method are leadership in the planning and evaluation of care delivery to each patient and effective communication to ensure continuity of care. (Parreira P, Santos-Costa P, Neri M, Marques A, Queirós P, Salgueiro-Oliveira A, 2021). A big health outcome in my county would be access to healthcare and mental healthcare services. Great Salt Plains is a federally qualified health center it offers a mobile health clinic to travel to make home visits to those who cant come to the clinic and need to be seen by a providers. This act takes a whole team to be efficient. The provider, nurse, and scheduler all work together to ensure patients are seen. The Physician is the leader that leads the staff in the direction the mobile clinic should go, instructing which patients should be seen first and a protocol to be followed to make sure the best care is given.
Risk Mitigation
Risk mitigation aims to prevent harm and reduce its effects through the assessment of the patient, staff, security, and organizational risk and safety events. It consists of strategies that are enforced in advance, regardless of whether a risk has occurred. (McGowan J, Wojahn A, Nicolini JR, 2023) Many medical errors can occur with a mobile health clinic. It takes the effort of all team members by implementing policies and practices. They must be executed day to day in patient care. In my community and using mobile clinics there must be a protocol when patients must be directed to the Emergency room versus urgent care, and when an ambulance should be called. The physician and the team must work under certain procedures to prevent sentinel events from happening.
McGowan J, Wojahn A, Nicolini JR. Risk Management Event Evaluation and Responsibilities. [Updated 2023 Feb 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559326/
Parreira P, Santos-Costa P, Neri M, Marques A, Queirós P, Salgueiro-Oliveira A. Work Methods for Nursing Care Delivery. Int J Environ Res Public Health. 2021 Feb 21;18(4):2088. doi: 10.3390/ijerph18042088. PMID: 33669955; PMCID: PMC7924841.
Summarize in your own words on a Word Doc:What is the purpose of the X-ray tube?What happens at the cathode? What happens at the anode. citation has to be apa format.
In this assignment, you will review the Bipolar Interactive Case Study patient scenario and analyze the data to determine the health status of the patient.
Select the Patient Subjective Information tab. Within this tab, you will be able to watch a video to gain more insight regarding the patient as well as view important patient details.
For this assignment, you will
Review the Case Study.
Review the Comprehensive Case Study Content Exemplar to understand what is needed within your paper.
Use the Comprehensive Case Study Paper Template to write the assignment in the proper format.
Follow the requirements on the rubric and within the Content Exemplar.
Interactive Comprehensive Case Studies should be 3- to 5-pages in length, excluding the title and reference pages.
Interactive case studies should include a minimum of three evidence-based practice guidelines or articles.
All papers should conform to the most recent APA standards.
Your case study write up should include specific reference to relevant guidelines and other clinical information. The national guidelines should also be considered within treatment plans.
When you have completed viewing the patient information, download the Comprehensive Case Study Paper Template (Word) from the assignment page in Moodle. Use this document to complete the assignment and then submit it to the assignment drop box. Additionally, there is an Exemplar document for review to help guide your case study write up.
Unformatted Attachment Preview
Bipolar Case Study Transcript
Chief Complaint:Mrs. Sylvia Contesta is a 62-year-old Hispanic female with complaint of “sometimes I hear
people talking about me and they stare.” Patient is accompanied by her oldest daughter to the visit.
History of Present Illness:
Onset:For the past 2 months, patient has been up all night cleaning because she cannot sleep.
Location:Headaches on occasion.
Duration:Past 2 months.
Characteristics: Daughter reports that her mother is constantly cleaning out and reorganizing drawers and
closets and is “throwing out things—stating she no longer needs them.” The daughter notes that most things are
not trash or unwanted so she finds this odd behavior.
Patient reports that she is “not tired” even without sleep and “has a lot to do to welcome festivities for her
granddaughter’s new baby arrival next year.” The daughter reports that none of the grandchildren are “having
babies.”
The daughter is worried about her mother’s drastic change of behavior and attitude, which is becoming more
tearful, irritable, and angry when they try to stop her from all the cleaning and organizing.
Aggravating: Increased symptoms with decreased sleeping.
Relieving: Rest, sleep, can be distracted with visits from family.
Temporal: Worse on weekends when she has less visitors.
Severity: I just don’t sleep sometimes but my family is bothered by my cleaning. I just want everything neat and
completed for upcoming events.
Print this page
Patient Comprehensive Assessment Information
Patient Histories
•
•
•
Past Medical History
•
Coronary Artery Disease X 3 years ago
•
Hypertension – X 8 years
•
Osteoarthritis X 2 years ago
• Diabetes X 6 years ago
Surgical
o Cholecystectomy, age 49
Ongoing
o
Coronary Artery Disease
o
Hypertension
o
Osteoarthritis
•
o Diabetes
Psychiatric History
•
Inpatient and Outpatient Psychiatric/Mental Health Care: No previous
psychiatric inpatient care. Has a previous history of taking an SSRI for a short time
several years ago for anxiety and panic related to grief after wife’s passing. Denies
any suicidal ideation or past attempts.
o Past Psych Diagnosis (es): None.
o Treatments: Endorses seeing a therapist after his wife died and meeting in a grief
group at church. Treatments:
❖ Previous Medication Trials: Patient cannot recall: “I think it was something
with a Z for anxiety and depression when my wife passed. I only took it for a
few months to get through.”
❖ Previous Therapy Trials: Reports the therapist assisted him in considering
his new life plan without his wife. Group therapy assisted him with moving
on.
❖ Outcomes of previous treatment: Does not recall.
❖ Current Psychotropic Medications: None.
Developmental History
o
o
o
o
o
Substance Use: Denies any use of nonprescription medication, denies use of
tobacco or ETOH.
o Trauma History: Denies any past history of trauma.
Social History
o
•
Birth History: Unknown
Developmental Delays: Unknown
How were they managed? None identified.
If any delays, what therapies were used, and did they help? N/A
Retired but worked in the corporate world for 40 years. Is used to being very active in
the community and usually spends several hours per week helping out at the local
hospital as a greeter and volunteer. He was unable to go to volunteer work for the
last month due to feeling down. Widowed three years ago, wife passed away from
cancer. They shared 50 years of marriage and have two daughters, aged 30 and 32.
One daughter lives with her family in a house down the street from him and visits
daily. He does not drive anymore but usually visits his daughter daily after a walk
around the block. He enjoys gardening and has a rose garden in memory of his wife.
Denies history of tobacco, ETOH, or drug use.
o Spirituality: None
Family History
o
•
o
o
o
o
o
o
•
Father: Died age 76 (HTN)
Mother: Died age 52 (Stroke)
Brother: Died age 22 (WWII casualty)
Brother: Died age 80 (HTN, asthma, DM)
Daughter 1: alive, age 30
Daughter 2: alive age 32
o Family History of Psychiatric Mental Illness: Unknown
o Family History of Suicide: Denied
Safety
o Regularly wears seatbelt when riding as passenger.
o No weapons in the home
Medications
•
Diclofenac sodium topical 1% gel, apply 4 grams QID to both knees
•
Aspirin 325mg 1 tablet PO daily
•
Valsartan 80 mg 1 tablet PO daily
•
Lipitor 40 mg 1 tablet PO at bedtime
•
Omeprazole 20 mg 1 tablet PO daily before meal
•
Cyanocobalamin 1 mg 1 tablet PO daily
•
Claritin 10 mg 1 tablet PO daily
•
Flonase nasal spray two puffs to each nostril daily
The patient discloses additional medications only when his granddaughter leaves the room, stating,
“They think I may possibly also have a slight case of prostate cancer, so I take these.” He pulls two
pill bottles from his jacket pocket:
•
Flomax 0.8 mg 1 capsule PO at bedtime
•
Finasteride 5 mg 1 tablet PO daily
The patient claims he started this four weeks ago.
Allergies
•
Medication: NKA
•
Food: NKA
•
Environmental: NKA
•
Latex: NKA
Review Of Systems
•
•
General – Reports usual health as “pretty good.” Denies fever, chills, weight changes.
Respiratory
o
•
•
Denies cough, dyspnea, or wheezing.
o Denies past hx of asthma, recurrent infections
Cardiovascular – Denies chest pain, palpitations.
Neuro – Denies coordination problems, numbness, tingling. Endorses some recent weakness
and slight tremors in his hands. Denies seizures or frequent headaches. Not aware of
memory problem. No head injury
Psychiatric Review of Systems
•
•
•
•
•
•
•
•
•
Mood – Denies feelings of depression, but reports feelings of panic and anxiousness
most of the day, with worsening anxiety in late evening. Anxious for the past three years,
with an increase in symptoms over the past three to six months. Affect is full ranging.
Only feels irritable when anxiety worsens; denies feeling easily tearful. Reports difficulty
getting up in the mornings when sleep has been poor
Sleep – Reports difficulty falling asleep almost every night, and some middle-night
awakening.
Interests – No loss of interest or pleasure in activities, although reports he has started to
avoid some social activities that cause him to feel anxious.
Feelings of Guilt – No feelings of hopelessness, helplessness, or hostility; denies any
feelings shame or lack of motivation. Endorses some feelings of guilt that he will need
help with care if his hands get worse from shaking.
Energy – No increased energy; reports feeling fatigued most days, especially when sleep
is poor.
Concentration – Some difficulty concentrating when worrying or with increased anxiety
Appetite – No increased or decreased appetite.
Psychosis – No delusions, hallucinations, feelings of persecution, hearing sounds that
seem to be voices or preoccupation with religion.
Self-harm/Suicide Risk- No self-inflicted injuries; no frequent thoughts of death, lack of
desire to continue living, or suicidal tendencies. No homicidal thoughts.
•
Precipitating Factors- No interpersonal relationship problems, family problems, or legal
problems. Concerned about recent diagnosis and health concerns. Concerned family will
need to take care of him more and will lose independence.
General Appearance
Mr. Bert Colton is an 89-y/o Caucasian male who articulates clearly but softly, ambulates slowly
without difficulty, and is in no acute distress. General appearance is same as stated age, with a
normal level of personal hygiene, no inappropriate clothing, no bizarre personal appearance.
Remainder of physical exam deferred during psychiatric mental health assessment.
Vital Signs – Ht 59in, Wt 172lbs, BP 138/82, Temp 98.6, HR 86, RR 78 irregular
Mental Status Exam
•
•
•
•
•
•
•
•
•
•
•
General – A&Ox4, appearance, behavior, and speech appropriate. Thoughts coherent.
Remote and recent memories intact.
Behavior – Wrings hands when he speaks; no hypervigilance, heightened startle reflex,
abnormal mannerisms, or uncommunicative/disinterested/hostile/inattentive attitude.
Movement- No tremor or tics; normal gait and stance; no involuntary movements.
Speech – No refusal to speak or loosening of association/word salad; not slowed, rapid, or
difficult; normal rhythm of speech, speech tone, and speech volume.
Mood – Not dysthymic or depressed; appears moderately anxious, not dysphoric, euphoric,
angry, elevated, or expansive.
Affect – Full ranging; not blunted or constricted.
Language – No language abnormalities; speech fluent; no dysphonia; no stuttering; language
fluent and intact for naming; normal sentence structure
Cognition – Patient oriented x4, no disorientation, short-term memory impairment, or
reduced abstraction ability; diminished cognitive functioning only when anxiety is intense
Thought Process – No deficiency on evaluation of connectedness; organized.
Thought Content – No thought content impairment; no suicidal ideation, homicidal
ideations, paranoid ideations, poverty of thought, thought insertions, obsessions, irrational
fears, delusions, or hallucinations.
Insight & Judgement – No impaired insight, impaired judgment, or poor problem solving.
Lab Values – No recent labs on file.
Comprehensive Case Study Rubric
Comprehensive Case Study Rubric – 100 Points
Criteria
Exemplary
Exceeds
Expectations
Advanced
Meets
Expectations
Intermediate
Needs
Improvement
Novice
Inadequate
Total
Points
Differential
Diagnoses
All required
differential
diagnoses are
included (including
worst case) and fully
supported by
findings.
Most required
differential
diagnoses are
included (including
worst case); one is
not supported by
findings.
Some required
differential
diagnoses are
included (not
including worst
case); two are not
fully supported by
findings.
Few required
differential
diagnoses are
included; more than
two are not fully
supported by
findings.
10
Rationale for all
differential
diagnoses provided.
Rationale for most
differential
diagnoses provided.
10 points
8 points
Rationale for some
differential
diagnoses provided.
Rationale provided
for few differential
diagnoses.
6 points
7 points
Rationale
Rationale provided
for all answers and
decisions made
regarding patient
care. Rationale is
based on current
evidence, with 0
errors.
Rationale provided
for most answers
and decisions made
regarding patient
care. Rationale is
based on current
evidence, with 1–3
minor errors or 1
major error.
Rationale provided
for some answers
and decisions made
regarding patient
care. Rationale is
based on current
evidence, with 4–6
minor errors or 2
major errors.
Rationale provided
for few answers and
decisions made
regarding patient
care. Rationale is
based on current
evidence, with 6+
minor errors or 2+
major errors.
17 points
15 points
13 points
Plan missing 1 of
the identified
components:
Plan missing 2 of
the identified
components:
Plan missing >3 of
the identified
components and/or
has safety
concerns.
20
20 points
Plan
Comprehensive
plan includes all
components:
Diagnostic
testing
Pharmacologic
intervention
Nonpharmacologic
intervention
Referrals
Patient
education
Follow-up
40 points
Diagnostic
testing
Pharmacologic
intervention
Nonpharmacologic
intervention
Referrals
Patient
education
Follow-up
35 points
Diagnostic
testing
Pharmacologic
intervention
Nonpharmacologic
intervention
Referrals
Patient
education
Follow-up
Diagnostic
testing
Pharmacologic
intervention
Nonpharmacologic
intervention
Referrals
Patient
education
Follow-up
31 points
27 points
40
Approach to
Patient Care
Approach to patient
care is organized,
logical,
patientcentered,
and costeffective,
with 0 errors.
Approach to patient
care is organized,
logical,
patientcentered,
and costeffective,
with 1–3 minor
errors or 1 major
error.
Approach to patient
care is organized,
logical,
patientcentered,
and costeffective,
with 4–6 minor
errors or 2 major
errors.
17 points
15 points
Logical and
systematic
organization of data.
Logical and
systematic
organization of data.
Minor errors in
organization of data.
Disorganized flow of
data.
Correct terminology,
spelling, and
grammar.
Terminology,
spelling or grammar
errors (1–3).
Terminology,
spelling, or grammar
errors (4–6).
Terminology,
spelling, or grammar
errors (>6).
7 points
6 points
10 points
8 points
20 points
Approach to patient
care is organized,
logical,
patientcentered,
and costeffective,
with 6+ minor errors
or 2+ major errors.
20
13 points
Documentation
Total Points
10
100
ASSESSMENTCalculate patient’s BMI, %IBW, %UBW, and % weight loss. Calculate and evaluate the patient’s MCV, MCH, and MCHC. Thoroughly evaluate these and the other abnormal lab values. Investigate potential causes and discuss the causes that are applicable to this patient. (Limit the discussion of abnormal values to those which apply to this patient.)Discuss the issues that are contributing to patient’s problems.Evaluate patient’s intake. Estimate calorie and protein intake based upon her food recall. Consider her intake of vitamins and minerals. Discuss the adequacy of micronutrient and macronutrient intake.Determine patient’s kcal, protein and fluid requirements. Compare her current intake to her estimated needs (from question 5). What percent of her kcal and protein needs is she currently meeting? Is patient’s dietary intake of kcals, protein, and vitamins and minerals adequate? Why or why not? Explain in detail. MCV = Hct * 10/RBC. MCH = Hgb * 10/RBC.MCHC = Hgb * 100/Hct.
Unformatted Attachment Preview
Dietetic Practice Case Study
Objectives:
• Use current information technologies to locate and apply evidence-based guidelines and protocols, such as
the Evidence Analysis Library.
• Describe the governance of nutrition and dietetics practice, such as the Scope of Practice for the Registered
Dietitian Nutritionist and the Code of Ethics for the Profession of Nutrition and Dietetics. (KRDN 2.2)
• Utilize the Nutrition Care Process.
• Demonstrate documentation that follows professional guidelines.
Ms. Espinoza is a 26 YO Hispanic female. She is a graduate student at TCU and works as a graduate assistant in the
English Department. She presented to the Student Health Center after feeling weak and lethargic for the past few
months. Prior to the visit, patient reports fatigue for the past two or more months and worsening in the last two
weeks.
Ms. Espinoza is a vegan and has been for about one year. Her weight has been stable for the past year. Prior to
that time, her weight was approximately 152#. She initially chose a vegan lifestyle for environmental and animal
rights purposes. She has become more committed to the lifestyle for health reasons over the past two years. She
reports that her appetite is fine. She does not consume any meat, poultry, fish, milk or eggs. She consumes
legumes regularly, drinks plain soy milk, and eats soybeans and tofu regularly. She usually consumes legumes
meals and also tries to eat a whole grain at the same time. She does not take any medications or dietary
supplements. She has no food allergies or intolerances. She reports heavy menstrual periods.
Medical Hx: menarche age 14
Social Hx: Lives in an off-campus apartment alone; Denies tobacco or illicit drug use; Does not consume alcohol or
drugs; Sedentary lifestyle with infrequent exercise. She walks about one mile (round trip) from her off-campus
apartment to campus on weekdays. She takes the stairs to her four-story office on campus and her two-story
apartment off-campus. Otherwise, she rarely exercises.
Symptoms: Dizziness, Pallor, Pale gums, Fatigue, Easily fatigued upon physical activity
Medications/Supplement: none
Ht: 5’8”. Wt: 148#.
Patient’s lab values are as follows:
Test
Glucose
BUN
Cr
Ca
Serum Albumin
RBC
Result
85 mg/dL
12 mg/dL
0.7 mg/dL
8.8 mg/dL
3.7 g/dL
4.2
Reference Value
70-110 mg/dL
10-20 mg/dL
0.5-1.1 mg/dL
9.0-10.5 mg/dL
3.5-5.0 g/dL
4.2-5.4
WBC
76000/mm3
5000-10000/mm3
Test
Na
K
Cl
Hgb
Hct
Platelets
Result
142 mEq/L
4.0 mEq/L
102 mEq/L
10.0 g/dl
30%
270,000/mm3
Reference Value
136-145 mEq/L
3.5-5.0 mEq/L
98-106 mEq/L
12-16 g/dl
37%-47%
150.000400,000/mm3
You are an outpatient RD consulting at the student health care center. You received a consult to assess the patient
due to her reports of fatigue and to provide nutrition education regarding a general, healthy diet. She says that she
feels tired and finds it necessary to take a nap almost every evening after she leaves work before she begins
studying. She drinks 2-4 cups of black tea daily to try to stay awake and alert. She states that she has struggled
academically this semester and thinks that her fatigue is to blame.
You obtain a 24 hour recall from the patient. She reports that he usually eats alone. She does not take any dietary
supplements. This menu is fairly representative of her usual intake. Besides the beverages listed in her recall, Ms.
Espinoza drinks water throughout the day.
Breakfast:
2 6 oz cups of black tea
½ cup raw oats
1 T peanut butter
1 cup Silk Original Soymilk*
½ cup blueberries
1 T pumpkin seeds
Lunch:
3 cups of baby spinach
½ cup canned Kroger salted garbanzo beans
1 cup raw broccoli florets
8 Mezzetta pitted Greek Kalmata olives*
20 Wheat Thins* (crackers)
1 8 oz cup black tea
Snack:
½ large banana
1 oz Kroger dry roasted peanuts*
2 6 oz cups of black tea
Dinner:
Tofu tacos (2 Mission corn tortillas*, 3 oz Trader Joe’s Firm Tofu* cooked in 2 tsp olive oil)
2 tsp soy sauce
½ cup canned salted black beans
1 cup butter lettuce
4 Tablespoons of avocado
water
Snack:
1 cup Silk Original Soymilk*
¼ cup blueberries
water
* find precise information for these items rather than using estimates on the exchange list in your Nelms textbook.
ASSESSMENT
1. Calculate patient’s BMI, %IBW, %UBW, and % weight loss.
2. Calculate and evaluate the patient’s MCV, MCH, and MCHC. Thoroughly evaluate these and the other
abnormal lab values. Investigate potential causes and discuss the causes that are applicable to this
patient. (Limit the discussion of abnormal values to those which apply to this patient.)
MCV = Hct * 10/RBC.
MCH = Hgb * 10/RBC.
MCHC = Hgb * 100/Hct.
3. Discuss the issues that are contributing to patient’s problems.
4. Evaluate patient’s intake. Estimate calorie and protein intake based upon her food recall. Consider her
intake of vitamins and minerals. Discuss the adequacy of micronutrient and macronutrient intake.
5. Determine patient’s kcal, protein and fluid requirements.
6.
7.
Compare her current intake to her estimated needs (from question 5). What percent of her kcal and
protein needs is she currently meeting?
Is patient’s dietary intake of kcals, protein, and vitamins and minerals adequate? Why or why not?
Explain in detail.
DIAGNOSIS
8. List three pertinent nutrition diagnoses that apply to patient.
9. Prioritize the nutrition diagnoses from question 8. Write two PES statements for the most pertinent
diagnoses. Which of the two diagnoses is more important and why?
INTERVENTION
10. Brainstorm one or more intervention for each nutrition diagnosis. Use the NCP standardized language
and list your interventions under each nutrition diagnosis. List 1-2 specific goals for each nutrition
diagnosis.
11. Outline a nutrition education session for this patient. Individualize the education session based upon your
assessment.
12. What additional information do you need? Are there others with whom you should coordinate the
patient’s care? Explain and include in your interventions if applicable.
MONITORING/EVALUATION
13. Discuss how you will decide whether your interventions listed above are effective? Use the NCP
standardized language and list the Monitoring/Evaluation criteria that you will use to measure, monitor
and evaluate progress.
DOCUMENTATION
14. Write a chart note in the ADIME format.
OverviewPart of any health administrator’s job is to make decisions about the allocation of resources specifically in terms of Supply and demand to meet patients’ healthcare needs. For this activity, you will be tasked with using economic principles and tools to determine which department – or departments – have the most urgent need for nurses.Complete media activity, Applying Economic Decision Making to Health Transcrip Links to an external site., and make a decision based on the information from Vila Health, and from interviews with various at the hospital. Use this information to write a 250-300 word summary in which you:Identify the departments that have the largest nursing shortages.Analyze the obstacles to recruiting nurses for the identified departmentNote: If sources are used, you must cite them using Strayer Writing Standards (SWS). The library is your home for SWS assistance, including citations and formatting. Please refer to the Library site for all support. Check with your professor for any additional instructions.
identify a patient case to which you can apply your chosen concept. The patient you choose might have multiple co-morbidities. Build your concept map around the concept you chose; this might not necessarily be the patient’s priority concern. Give credit to your references. You do not need a separate ‘Reference Page’, but APA-style references should be identified at the bottom of the assignment.
Unformatted Attachment Preview
NIGHTINGALE COLLEGE
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
NURSING PROCESS TEMPLATE:
Assessment (Recognizing Cues)
Which patient information is relevant? What patient data is most
important? Which patient information is of immediate concern?
Consider signs and symptoms, lab work, patient statements, H & P,
and others. Consider subjective and objective data.
Analysis (Analyzing Cues)
Which patient conditions are consistent with the cues? Do the cues
support a particular patient condition? What cues are a cause for
concern? What other information would help to establish the
significance of a cue?
Analysis (Prioritizing Hypotheses)
What explanations are most likely? What is the most serious
explanation? What is the priority order for safe and effective care?
Planning (Generate Solutions)
What are the desirable outcomes? What interventions can achieve
these outcomes? What should be avoided? (SMART Planning- specific,
measurable, attainable, realistic/relevant, time-restricted- Goal
setting)
Implementation (Take actions)
How should the intervention or combination of interventions be
performed, requested, communicated, taught, etc.? What are the
priority interventions? (Mark with asterisk)
Evaluation (Evaluating Outcomes)
What signs point to improving/declining/unchanged status? What
interventions were effective? Are there other interventions that
could be more effective? Did the patient’s care outlook or status
improve?
Patient Information (SBAR, H&P)
Main Concept
(Should be focus of below map)
CONCEPT MAP TEMPLATE:
Recognizing Cues (S&S)
Disease Process/Pathophysiology/Risk Factors
Analyzing Cues/Concerns
Supporting
Prioritizing Hypotheses
1.
2.
Concerning
3.
Generate Solutions/Outcomes/Interventions
SMART Planning
Taking Action – (How To)
1.
1.
2.
3.
4.
5.
2.
3.
4.
5.
Evaluating Outcomes
1.
2.
3.
4.
5.
Page 2 of 2
NIGHTINGALE COLLEGE
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
NURSING PROCESS TEMPLATE:
Assessment (Recognizing Cues)
Which patient information is relevant? What patient data is most
important? Which patient information is of immediate concern?
Consider signs and symptoms, lab work, patient statements, H & P,
and others. Consider subjective and objective data.
Analysis (Analyzing Cues)
Which patient conditions are consistent with the cues? Do the cues
support a particular patient condition? What cues are a cause for
concern? What other information would help to establish the
significance of a cue?
Analysis (Prioritizing Hypotheses)
What explanations are most likely? What is the most serious
explanation? What is the priority order for safe and effective care?
Planning (Generate Solutions)
What are the desirable outcomes? What interventions can achieve
these outcomes? What should be avoided? (SMART Planning- specific,
measurable, attainable, realistic/relevant, time-restricted- Goal
setting)
Implementation (Take actions)
How should the intervention or combination of interventions be
performed, requested, communicated, taught, etc.? What are the
priority interventions? (Mark with asterisk)
Evaluation (Evaluating Outcomes)
What signs point to improving/declining/unchanged status? What
interventions were effective? Are there other interventions that
could be more effective? Did the patient’s care outlook or status
improve?
Patient Information (SBAR, H&P)
Main Concept
(Should be focus of below map)
CONCEPT MAP TEMPLATE:
Recognizing Cues (S&S)
Disease Process/Pathophysiology/Risk Factors
Analyzing Cues/Concerns
Supporting
Prioritizing Hypotheses
1.
2.
Concerning
3.
Generate Solutions/Outcomes/Interventions
SMART Planning
Taking Action – (How To)
1.
1.
2.
3.
4.
5.
2.
3.
4.
5.
Evaluating Outcomes
1.
2.
3.
4.
5.
Page 2 of 2
Write a 250- to 300-word response to the following: As you reflect on your readings in this week’s learning activities, which specific topic or issue resonates the most with you? Why? What big questions remain unanswered? Include your own experience, as well as 2 citations that align with or contradict your comments as sourced from peer-reviewed academic journals, industry publications, books, and/or other sources. Cite your sources using APA formatting. If you found contradicting information to what your experience tells you, explain why you agree or disagree with the research.https://www.fortherecordmag.com/archives/0317p18.s…
This assignment increases the students’ awareness of the National Patient Safety Goals developed by The Joint Commission. Specifically, this assignment will introduce the Speak Up Initiatives, an award-winning patient safety program designed to help patients promote their own safety by proactively taking charge of their healthcare.
Course outcomes: This assignment enables the student to meet the following course outcomes:
1. Apply the concepts of health promotion and illness prevention in the laboratory setting. (PO #2)
2. Explain the rationale for selected nursing interventions based upon current nursing literature. (PO #8)
Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.
Total points possible: 100 points
Preparing the Assignment
1. Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions. a. Select a Speak Up brochure from The Joint Commission website.
b. Write a short paper reviewing the brochure. Use the Grading Criteria (below) to structure your critique.
c. Include current nursing or healthcare journal article to support your critique.
2. Include the following sections
a. Introduction of brochure (10 points/10%)
i. Includes brochure title
ii. Identifies date published
iii. Describes individuals or groups
iv. Brochure properly cited, included on reference list and submitted with assignment
b. Summary of brochure (20 points/20%) -brochure citation required
i. Review the main topics in the brochure.
ii. Includes information to promote communication between patients and healthcare providers.
iii. Reflects on why this topic is of interest to you?
c. Evaluation of brochure (30 points/30% total (4 points each) (Brochure & nursing article must be cited)
i. Was the information provided in the brochure beneficial? Could you incorporate it in your patient education?
ii. What was done well, and what could have been improved in the brochure?
iii. Was the information presented clearly?
iv. Did current nursing or healthcare related research support the information presented in the brochure?
v. What population or individuals does this brochure apply to (i.e., who will benefit the most from this brochure)?
vi. Who else can use this information?
vii. Will this information increase patient safety?
d. Clarity of Writing (20 points/20%)
i. Information presented in a logical progression.
ii. Section headers used:
iii. Summary of Brochure
iv. Patient Communication
v. Personal Reflection
vi. Evaluation of Brochure
vii. Evidence Review and Application
viii. Conclusion
e. Conclusion (10 points/10%)
i. Restates the purpose of the paper.
ii. Summarizes the main points of the paper.
iii. Summarizes the benefits of following the brochure’s advice to a person at risk.
f. APA style and structure (10 points/10%)
i. Uses appropriate APA format and is free of errors.
ii. Paper is no longer than three (3) pages, excluding title page, reference page, and copy of brochure.
iii. Evidence from a recent (5 years) scholarly nursing journal article was integrated within the Evaluation of Brochure section to support your answers.
iv. Grammar and mechanics are free of errors.
For writing assistance, visit the Writing Center.
Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.
RUA: Safety Goals Grading Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction of Brochure (10 points/10%)1. Includes brochure title
2. Identifies date published
3. Describes individuals or groups
4. Brochure properly cited, included on reference list,
and submitted with assignment
10 pts
Highest Level of Performance
Includes no less than 4 requirements per section.
9 pts
High Level of Performance
Includes no less than 3 requirements per section.
8 pts
Satisfactory Level of Performance
Includes no less than 2 requirements per section.
3 pts
Unsatisfactory Level of Performance
Includes no less than 1 requirement per section.
0 pts
Section not Present
Section not present or includes less than 1 criterion.
10 pts
This criterion is linked to a Learning OutcomeSummary of Brochure (20 points/20%)1. Review the main topics in the brochure.
2. Includes information to promote communication between patients and healthcare providers.
3. Reflects on why this topic is of interest to you?
20 pts
Highest Level of Performance
Includes no less than 1 required criteria.
16 pts
Satisfactory Level of Performance
Includes no less than 2 requirements per section.
8 pts
Unsatisfactory Level of Performance
Includes not less than 1 requirement per section.
0 pts
Section not Present
No requirements for section presented.
20 pts
This criterion is linked to a Learning OutcomeEvaluation of Brochure (30 points/ 30%)1. Was the information provided in the brochure beneficial? Could you incorporate it in your patient education?
2. What was done well, and what could have been improved in the brochure?
3. Was the information presented clearly?
4. Did current nursing or healthcare related research support the information presented in the brochure?
5. What population or individuals does this brochure apply to (i.e., who will benefit the most from this brochure)?
6. Who else can use this information?
7. Will this information increase patient safety?
30 pts
Highest Level of Performance
Includes 7 requirements per section.
26 pts
High Level of Performance
Includes 6 requirements per section.
23 pts
Satisfactory Level of Performance
Includes 5 requirements per section.
11 pts
Unsatisfactory Level of Performance
Includes 4 requirements per section
0 pts
Section not Present
Includes less than 4 requirements per section.
30 pts
This criterion is linked to a Learning OutcomeClarity of Writing (20 points/20%)1. Information presented in a logical progression.
2. Section headers used:
a. Summary of Brochure
b. Patient Communication
c. Personal Reflection
d. Evaluation of Brochure
e. Evidence Review and Application
f. Conclusion
20 pts
Highest Level of Performance
Includes no less than 7 requirements for section.
17 pts
High Level of Performance
Includes no less than 6 requirements for section.
15 pts
Satisfactory Level of Performance
Includes no less than 5 requirements for section.
8 pts
Unsatisfactory Level of Performance
Includes 4 requirements for section.
0 pts
Section not Present
Includes less than 4 requirements per section.
20 pts
This criterion is linked to a Learning OutcomeConclusion (10 points/10%)1. Restates the purpose of the paper.
2. Summarizes the main points of the paper.
3. Summarizes the benefits of following the brochure’s advice to a person at risk.
10 pts
Highest/High Level of Performance
Includes no less than 3 required criteria.
8 pts
Satisfactory Level of Performance
Includes no less than 2 requirements for section.
4 pts
Unsatisfactory Level of Performance
Present, yet includes no required criteria.
0 pts
Section not Present
Section not present.
10 pts
This criterion is linked to a Learning OutcomeAPA Style and Organization (10 points/10%)1. Uses appropriate APA format and is free of errors.
2. Paper is no longer than three (3) pages, excluding title page, reference page, and copy of brochure.
3. Evidence from a recent (5 years) scholarly nursing journal article was integrated within the Evaluation of Brochure section to support your answers.
Read these directions and the rubric criteria and reach out to your instructor if you have any questions before you begin working on this project. Many of the steps below will require you to reference and utilize the work you have done in previous modules of this course. You may use the provided template to complete this project or choose not to use the template and submit a Word document instead.
Part 1: Creating a Research Question: The quality of research often depends on the quality of the question driving it. It is important to understand how personal opinions, perspectives, and historical sources all play a part in developing and examining a research question. Complete the following steps to discuss how you developed a strong research question about your chosen historical event.
Describe how your assumptions, beliefs, and values influenced your choice of topic.
How might your own perspectives and opinions impact the topic you chose and how you may approach studying it?
Discuss the significance of your historical research question in relation to your current event.
State your historical research question and explain the connection between your current event and your question.
Explain how you used sources to finalize your research question.
Identify the specific primary and secondary sources you used.
Discuss how evidence in these primary and secondary sources strengthened or challenged the focus of your question.
Part 2: Building Context to Address Questions: In this part of the project, you will examine the historical context related to your historical event. The context will be like snapshots that capture what was happening in history that affected the development of your current event.
Describe the context of your historical event that influenced your current event.
How does the context of your historical event help tell the story of what was happening at the time? How might this historical event connect or lead to your current event?
Describe a historical figure or group’s participation in your historical event.
This person or people must have directly participated in the event you identified as it was happening, not after it.
Use specific details from your primary and secondary sources to demonstrate how the person or people participated in the event.
Explain the historical figure or group’s motivation to participate in your historical event.
Consider why the person or people were motivated to get involved in the event.
Part 3: Examining How Bias Impacts Narrative: Narrative is how people tell stories based on their own assumptions, beliefs, and values. From a historical perspective, narratives influence who we focus on, what we focus on, and how we discuss events and issues in the past and present. Complete the following steps to explore how the stories about your current event and the historical events leading to it have been told.
Describe a narrative you identified while researching the history of your historical event.
There can be multiple narratives depending on your sources. Pick one or two that you feel have been the most influential.
Articulate how biased perspectives presented in primary and secondary sources influence what is known or unknown about history.
How do potentially biased sources influence knowledge of your historical event and current event?
Support your stance with examples from your primary and secondary sources.
Identify the perspectives that you think are missing from your historical event’s narrative.
Whose stories were not recorded? Whose voices were ignored or silenced?
Part 4: Connecting the Past With the Present: Consider how the work you have done to develop your research question and investigate it can be used to explain connections between the past and present. Complete the following steps to discuss the value of developing historical inquiry skills.
Explain how researching its historical roots helped improve your understanding of your current event.
How did examining your current event from a historical perspective help you better comprehend its origins?
Articulate how questioning your assumptions, beliefs, and values may benefit you as an individual.
Why is it valuable to be aware of your assumptions, beliefs, and values when encountering information in your personal, academic, and professional life?
Discuss how being a more historically informed citizen may help you understand contemporary issues.
Consider how having knowledge of history could influence how you approach current challenges or questions in the world.
Use this template to address the steps in your Project Guidelines and Rubric. Replace the bracketed text with your responses. Ensure that you have considered your instructor’s feedback when revising your work. Proofread the entire document before submitting.
Part 1: Creating a Research Question
1. Describe how your assumptions, beliefs, and values influenced your choice of topic. ·
2. Discuss the significance of your historical research question in relation to your current event. · 3. Explain how you used sources to finalize your research question. ·
Part 2: Building Context to Address Questions
1. Describe the context of your historical event that influenced your current event. · [Insert response here.] 2. Describe a historical figure or group’s participation in your historical event. · [Insert response here.] 3. Explain the historical figure or group’s motivation to participate in your historical event. · [Insert response here.]
Part 3: Examining How Bias Impacts Narrative
1. Describe a narrative you identified while researching the history of your historical event. · [Insert response here.]
2. Articulate how biased perspectives presented in primary and secondary sources influence what is known or unknown about history. · [Insert response here.]
3. Identify the perspectives that you think are missing from your historical event’s narrative. · [Insert response here.]
Part 4: Connecting the Past With the Present
1. Explain how researching its historical roots helped improve your understanding of your current event. · [Insert response here.]
2. Articulate how questioning your assumptions, beliefs, and values may benefit you as an individual. · [Insert response here.]
3. Discuss how being a more historically informed citizen may help you understand contemporary issues. · [Insert response here.]
Unformatted Attachment Preview
HIS 100 Module One Activity Template: Project Topic Exploration
You must pick a topic from the Research Topics Lists in the Library Research Guide. While it is a good
idea to choose your topic early, you may change it until the next module. Replace the bracketed text
below with your responses. Support your responses with specific details and examples.
Identify the topic you chose to explore:
• The Philippine Revolution
Explain what you already know about the chosen topic based on your personal history or experiences.
• The Philippine Revolution started in 1896 when the Spanish authorities discovered an
anticolonial secret organization that had been formed to free the Philippines from the
Spanish colonial power. The Spanish government has been controlling the Philippines
since the sixteenth century. However, their regime nearly ended when they could not
defeat the Filipino rebellion. In 1898, the US declared war against Spain for sinking their
warship near Havana, Cuba, and took action to defeat the Spanish fleet stationed in the
Philippines (Salem Press, Inc., 2017).
Describe the beliefs, assumptions, and values you have related to the topic you chose.
• My opinion about the Philippine Revolution is that the Philippines strongly desired
independence and sovereignty. Their passion to break free and struggle for their freedom
from the Spanish colony was triggered by the mistreatment they received from the
Spanish rule. In my assumption, the Philippine Revolution was a response to the injustice
they were subjected to by the Spanish government, which led to the creation of a secret
society dedicated to liberating the Philippines. Patriotism and historical awareness are the
values related to the Philippine Revolution (Salem Press, Inc., 2017). The sacrifice made
by the Philippines rebels shows love for one’s country and dedication.
Explain why this topic is relevant to current events or to modern society.
• The Philippine Revolution is relevant to modern society because it highlights themes such as
leadership and sacrifice, human rights, self-determination, and nationalism. Furthermore, it
provides historical lessons and valuable insight into contemporary movements and struggles
worldwide.
1
HIS 100 Module Two Activity Template: Historical Research Question
This activity is your last chance to choose a topic. Topic changes may be based on your research
or instructor feedback. Then write a historical research question that addresses an aspect of
your finalized topic. Replace the bracketed text below with your responses.
Non-graded portion:
• List your historical research topic here:
o Philippine Revolution
Graded portion:
• Write a clear, relevant, and focused research question about your finalized topic.
• The research question I have formulated is “How did the Philippine Revolution of 1896 impact
the quest for national independence and sovereignty, and what are the enduring lessons it
offers for contemporary global movements for self-determination, human rights, and
nationalism?”. This question is a comprehensive and multifaceted inquiry into the Philippine
Revolution and its enduring significance. First, the question explores the historical impact of the
Philippine Revolution. This part of the question recognizes the significant contribution the
uprising made to the Philippines’ desire for freedom and democracy. In order to fully
understand how the rebellion changed the trajectory of Philippine history, academics need to
dive into the particular actions, plans, and results of the uprising.
• The inquiry’s second goal is to compare the past and present. The question inquiries about the
enduring lessons that the Philippine Revolution offers to contemporary global movements for
self-determination, human rights, and nationalism. This feature acknowledges how historical
occurrences have influenced contemporary political and social trends and ideas (Zhou, 2023). It
urges academics to investigate how the ideas and lessons of the Philippine Revolution might
guide and motivate today’s conflicts across the world towards equality, liberty, and autonomy.
• This approach of structuring the research question invites a comprehensive investigation of the
subject. Researchers need to consider the social, political, monetary, and social components of
the rebellion and its consequences. They would likewise be provoked to investigate the
verifiable setting of the upset, including colonial dynamics between Spain and the Philippines.
Furthermore, the question invites a comparative analysis between the Philippine Revolution and
other historical and contemporary movements for independence and human rights, facilitating a
broader understanding of global history and politics.
•
•
Explain how another person’s beliefs, assumptions, and values may lead that person to create a
different question than you.
Individuals’ beliefs can significantly influence the questions they pose about historical events. In
the context of the Philippine Revolution, someone with a pro-colonial perspective may believe
that Spanish colonialism positively impacted the Philippines. This belief might stem from the
idea that colonial powers introduced infrastructure, education, and certain aspects of Western
culture. Consequently, their research question may reflect this perspective, asking, “What were
the positive contributions of Spanish colonialism to the Philippines?”. This question is rooted in
the belief that there have been some redeeming qualities to colonial rule, and it seeks to
explore and highlight these potential benefits. The question may lead to research focusing on
•
•
•
•
•
•
aspects such as architecture, language, or legal systems influenced by Spanish colonialism,
aiming to demonstrate its positive impact.
Assumptions
Assumptions play a crucial role in shaping the landscape of research questions, exerting a
substantial influence on the trajectory and scope of inquiry. For instance, consider an individual
who assumes that the United States’ intentions during the Philippine-American War were driven
solely by benevolence. This assumption could give rise to a specific research question like “To
what extent did the intervention of the United States contribute to the modernization and
development of the Philippines?” This question presupposes that the primary outcome of US
intervention was the modernization and development of the Philippines. As a result of this
assumption, the ensuing research may heavily emphasize the economic and infrastructural
transformations ushered in by American rule in the Philippines. However, it may inadvertently
downplay or overlook other significant facets of this historical context, such as the resistance
movements and the formidable challenges faced by Filipinos during that tumultuous period. It is
essential to recognize that assumptions can act as guiding forces in research, shaping the
framing of questions, the selection of methodologies, and the interpretation of findings.
Therefore, researchers need to remain vigilant about the assumptions that underlie their
investigations, acknowledging the potential impact of these assumptions on the depth and
breadth of their scholarly pursuits. This would help researchers strive for a more comprehensive
and balanced understanding of complex historical events and phenomena.
Values
Values play a crucial role in shaping the formulation of research inquiries, as they mirror
personal priorities and ethical beliefs. An individual who deeply appreciates historical narratives
centred on resistance, liberation, and the amplification of oppressed voices may ask, “What
were the pivotal strategies and sacrifices undertaken by Filipino revolutionaries in their
relentless pursuit of independence during the Philippine Revolution?”. This inquiry encapsulates
a profound commitment to acknowledging and commemorating the endeavours of those who
ardently strove for liberty. The question steers the course of research toward a deep exploration
of Filipino revolutionaries’ experiences, motivations, and sacrifices, thereby spotlighting their
invaluable contributions to the nation’s historical tapestry. Such a line of inquiry could lead to indepth investigations into the pivotal roles played by iconic figures such as Andres Bonifacio and
Emilio Aguinaldo in the unfolding of this historic revolution.
In conclusion, the research question is a robust and multifaceted inquiry into the Philippine
Revolution and its enduring significance. This question is designed to encourage a
comprehensive examination of the topic, encompassing its historical importance and relevance
to contemporary global issues. By exploring the historical impact of the Philippine Revolution,
researchers can delve into the specific events, strategies, and outcomes that shaped the
Philippines’ path to independence and sovereignty (Mendez, 2023). This historical analysis
provides a deep understanding of how the revolution altered the course of Philippine history
and challenged colonial dynamics with Spain.
Furthermore, the question invites researchers to draw connections between the past and the
present. It highlights the Philippine Revolution’s enduring lessons to contemporary global
movements for self-determination, human rights, and nationalism. This aspect acknowledges
the relevance of historical events in shaping modern socio-political movements and ideologies.
It encourages researchers to explore how the principles and experiences of the Philippine
Revolution can inform and inspire present-day struggles for freedom, justice, and selfdetermination worldwide.
•
In addition, beliefs, assumptions, and values play significant roles in shaping research questions.
Individuals’ beliefs can lead to questions that reflect their perspectives, assumptions can guide
research direction, and values can influence the choice of topics and emphasis in historical
inquiry. Therefore, researchers need to remain aware of these influences to ensure a balanced
and comprehensive understanding of complex historical events.
•
•
•
References
Mendez, J. R. (2023). Monumentalizing Memories, Memorializing Monuments: Rizal Park and
American Colonial Philippines, 1898-1946 (Doctoral dissertation, Tokyo University of Foreign
Studies).
Zhou, Z. (2023). Producing the Meaning of An Asianist Revolution: Images of Revolutionaries in
the 1899 Sino-Japanese Joint Aid to the Philippine Revolution. The Columbia Journal of Asia,
2(1), 76–91.
o
HIS 100 Module Two Activity Template: Primary and Secondary Sources
Replace the bracketed text below with your responses.
Non-graded portion:
• List your historical research topic here:
o Philippine Revolution
Graded portion:
Distinguish between primary and secondary sources.
• Primary sources are firsthand or original documents, artifacts, or records created during the
event or period under study. They provide direct insight into the subject matter without
interpretation or analysis. Examples include letters, diaries, photographs, and official documents
from the time in question (Renjith et al., 2021). Secondary sources, on the other hand, are
created after the fact and are interpretations or analyses of primary sources or events. They are
typically written by scholars, historians, or researchers and involve interpretation, synthesis, and
analysis. Examples include history books, research articles, and documentaries.
• Primary sources aim to capture and document individuals’ or entities’ immediate experience,
thoughts, and reactions at a specific time. They offer a raw, unfiltered view of historical events.
In contrast, secondary sources seek to analyze, interpret, or provide context to primary sources
or historical events. They often aim to synthesize information, draw conclusions, or present a
broader perspective.
• Primary sources are created contemporaneously with the events they describe. They provide a
snapshot of a specific moment in history, while Secondary sources are produced after the
events they discuss, allowing for hindsight, analysis, and a broader historical context.
• While primary sources can offer a direct perspective, they may also reflect the biases, opinions,
and limitations of the individuals or entities that created them. Secondary sources may be more
objective as they often involve critical analysis and synthesis of multiple primary sources.
However, they can still be influenced by the biases and interpretations of the author.
• In primary sources, examples include personal letters, speeches, newspaper articles from
the time, photographs, original manuscripts, and eyewitness accounts, while in secondary
sources, examples encompass history books, biographies, documentaries, research
articles, and scholarly analysis of historical events.
Explain why it is important to consult a variety of sources when conducting historical research. Include
specific details and examples.
• Consulting a variety of sources is crucial in historical research for several reasons. First, it helps
corroborate information and establish data reliability (García-Milon et al., 2020). For instance,
primary sources like Emilio Aguinaldo’s memoirs can offer personal insights while studying the
Philippine Revolution. However, cross-referencing them with secondary sources like academic
articles can verify the historical accuracy of events and perspectives. Second, a range of sources
allows for a more comprehensive understanding of the topic. In the case of the Philippine
Revolution, using newspapers, photographs, official documents, and oral histories alongside
scholarly analyses provides a multifaceted view of the period. Third, it helps mitigate bias and
subjectivity. The author’s perspective can influence historical accounts, so consulting sources
with differing viewpoints ensures a more balanced interpretation. Ultimately, diverse sources
enrich historical research by providing a holistic, well-rounded perspective on the past.
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Identify one primary source that would help investigate your research question (include the title,
author, and link to the source).
• One primary source that would be valuable for investigating the research question “How did the
Philippine Revolution of 1896 impact the quest for national independence and sovereignty?” is
the book titled “The Philippines: A Past Revisited” by Mente & Valila.
file:///C:/Users/User/Downloads/s41599-023-01911-8.pdf. This book is a comprehensive
examination of Philippine history and provides insights into the historical context and events
surrounding the revolution. It can offer direct information and perspectives from the time
period, aiding in a deeper understanding of the revolution’s impact.
Identify one secondary source that would help investigate your research question (include the title,
author, and link to the source).
• One secondary source that would contribute to the investigation of the research question is the
article titled “Reading Rizal: Wilhelm Tell and texts of revolution in the colonial Philippines” by
Wirth, published in Postcolonial Studies.
https://www.tandfonline.com/doi/full/10.1080/13688790.2021.2018774?scroll=top&needAccess
=true&role=tab. This article delves into the role of literature and texts in the context of the
Philippine Revolution. It offers a scholarly analysis of how revolutionary ideas were
disseminated and discusses the impact of these texts on the revolution. This secondary source
can provide critical insights into the intellectual and ideological aspects of the revolution.
Choose a current event related to the subject of your historical research question and explain how they
are connected.
• A contemporary event linked to the themes of the Philippine Revolution is the ongoing struggle
for self-determination and human rights among marginalized communities in various parts of
the world. For instance, the Indigenous rights movement in Canada, particularly the protests
the construction of pipelines through Indigenous lands, resonates with the historical quest for
autonomy during the Philippine Revolution. Both movements share common goals of asserting
their land, resources, and self-governance rights, challenging historical injustices, and striving for
recognition and equality. The connection lied in the shared pursuit of sovereignty, human rights
and social justice, with the lessons from the Philippine Revolution offering inspiration and
guidance for contemporary global movements advocating for self-determination and equality.
References
García-Milon, A., Juaneda-Ayensa, E., Olarte-Pascual, C., & Pelegrín-Borondo, J. (2020).
Towards the smart tourism destination: Key factors in information source use on the
tourist shopping journey. Tourism management perspectives, 36, 100730.
Mente, T. J. B., & Valila Jr, J. R. (2022). The Philippines: A Past Revisited.
file:///C:/Users/User/Downloads/s41599-023-01911-8.pd
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Renjith, V., Yesodharan, R., Noronha, J. A., Ladd, E., & George, A. (2021). Qualitative methods
in health care research. International journal of preventive medicine, p. 12.
Wirth, C. (2023). Reading Rizal: Wilhelm Tell and texts of revolution in the colonial Philippines.
Postcolonial Studies, 26(2), 259-278.
https://www.tandfonline.com/doi/full/10.1080/13688790.2021.2018774?scroll=top&needAccess
=true&role=tab
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Uncovering Bias in Narratives
Student’s Name
Institution Affiliation
Professor’s Name
Course Name
Date
2
Uncovering Bias in Narratives
Question One
Identifying bias within primary and secondary sources was essential to understanding the
historical event of the Philippine Revolution 1896 and its narratives. One of the strategies I
employed to determine the bias in the sources was assessing the authors’ backgrounds and
affiliations. For example, in Renato Constantino’s article “The Philippines: A Past Revisited,” it
was evident that the author approached the topic from a Filipino nationalist perspective,
emphasizing the struggle for freedom from Spanish colonial rule (Mente & Valila, 2022).
Conversely, Ileto’s article “The Road to 1898: On American Empire and the Philippine
Revolution” presented a contrasting American viewpoint that portrayed the events 1898 as
pivotal for the United States’ global ambitions.
Question Two
Identifying absent voices in historical narratives presented its own set of challenges. One
such challenge was recognizing the marginalized perspectives, particularly those of indigenous
Filipinos, women, and other minority groups. The dominant narratives of leaders like Bonifacio
and Aguinaldo often overshadowed their voices. Identifying these absent voices required crossreferencing with additional sources focusing on indigenous perspectives. Similarly, the role of
women in the revolution was downplayed in several narratives. Female revolutionaries like
Gregoria de Jesus and Melchora Aquino faced oppression and played essential roles, but their
stories were often marginalized (CABALZA, 2019). Recognizing this absence involved
consulting feminist historical works and oral histories that shed light on the contributions of
women.
Question Three
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Despite the richness of the sources, there are still missing perspectives in the narrative
about the Philippine Revolution 1896. One notable absence is the perspective of women in the
revolution. While the sources mention key male figures and their roles, they basically overlook
the contributions and experiences of Filipino women who played crucial roles in supporting the
revolution through various means, including nursing, espionage, and activism. Another missing
perspective is indigenous communities and their interactions with the revolution. The sources
primarily focus on urban and educated elites, but indigenous groups had unique experiences and
responses to colonial rule and the revolution.
In conclusion, the brainstorming process for identifying bias in sources involved
assessing author backgrounds and perspectives. Identifying absent voices required critically
examining the sources to ensure diverse perspectives were considered. Furthermore, the missing
perspectives in the narrative may include the voices of women and indigenous communities.
Recognizing these gaps is essential for a more inclusive and well-rounded understanding of the
Philippine Revolution 1896 and its relevance to contemporary global movements for selfdetermination, human rights, and nationalism.
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References
CABALZA, C. B. (2019). When The Last Men Standing are Women: An Exploratory Anthology
Laying the Foundation for a Leni Robredo-Sara Duterte-Carpio 2022 Election Win.
Mente, T. J. B., & Valila Jr, J. R. (2022). The Philippines: A Past Revisited.
file:///C:/Users/User/Downloads/s41599-023-01911-8.pd
Complete the “State’s Rules Review Worksheet.”While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines,
Learning Goal: I’m working on a nursing question and need a sample draft to help me learn.
Develop a hypothetical health promotion plan, 3-4 pages in length, addressing a specific health concern for an individual or a group living in the community that you identified from the topic list provided.
Immunization.
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Introduction
The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to plan a hypothetical clinical learning experience focused on health promotion associated with a specific community health concern or health need. Such a plan defines the critical elements of who, what, when, where, and why that establish the foundation for an effective clinical learning experience for the participants. Completing this assessment will strengthen your understanding of how to plan and negotiate individual or group participation. This assessment is the foundation for the implementation of your health promotion educational plan (Assessment 4).
Note: Assessment 1 must be completed first before you are able to submit Assessment 4. Complete the assessments in this course in the order in which they are presented.
Preparation
You will need to satisfactorily pass Assessment 1 (Health Promotion Plan) before working on your last assessment (Assessment 4).
To prepare for the assessment, consider a various health concern or health need that you would like to be the focus of your plan from the topic list provided, the populations potentially affected by that concern or health need, and hypothetical individuals or groups living in the community. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.
As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Effective Interpersonal Communications activity. The information gained from completing this activity will help you succeed with the assessment. Completing activities is also a way to demonstrate engagement.
For this assessment, you will propose a hypothetical health promotion plan addressing a particular health concern or health need affecting a fictitious individual or group living in the community. The hypothetical individual or group of your choice must be living in the community; not in a hospital, assistant living, nursing home, or other facility. You may choose any health issues or need from the list provided in the instructions.
In the Assessment 4, you will simulate a face-to-face presentation of this plan to the individual or group that you have identified.
Please choose one of the topics below:
Bullying.
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Immunizations.
Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (MUST address all tobacco products).
In addition, you are encouraged to:
Complete the Vila Health: Effective Interpersonal Communications simulation.
Review the health promotion plan assessment and scoring guide to ensure that you understand the work you will be asked to complete.
Review the MacLeod article, “Making SMART Goals Smarter.”
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Note: Assessment 1 must be completed first before you are able to submit Assessment 4.
HEALTH PROMOTION PLAN
Choose a specific health concern or health need as the focus of your hypothetical health promotion plan. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.
Bullying.
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Immunizations.
Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (MUST address all tobacco products).
Create a scenario as if this project was being completed face-to-face.
Identify the chosen population and include demographic data (location, lifestyle, age, race, ethnicity, gender, marital status, income, education, employment).
Describe in detail the characteristics of your chosen hypothetical individual or group for this activity and how they are relevant to this targeted population.
Discuss why your chosen population is predisposed to this health concern or health need and why they can benefit from a health promotion educational plan.
Based on the health concern for your hypothetical individual or group, discuss what you would include in the development of a sociogram. Take into consideration possible social, economic, cultural, genetic, and/or lifestyle behaviors that may have an impact on health as you develop your educational plan in your first assessment. You will take this information into consideration when you develop your educational plan in your fourth assessment.
Identify their potential learning needs. Collaborate with the individual or group on SMART goals that will be used to evaluate the educational session (Assessment 4).
Identify the individual or group’s current behaviors and outline clear expectations for this educational session and offer suggestions for how the individual or group needs can be met.
Health promotion goals need to be clear, measurable, and appropriate for this activity. Consider goals that will foster behavior changes and lead to the desired outcomes.
DOCUMENT FORMAT AND LENGTH
Your health promotion plan should be 3-4 pages in length.
SUPPORTING EVIDENCE
Support your health promotion plan with peer-reviewed articles, course study resources, and Healthy People 2030 resources. Cite at least three credible sources published within the past five years, using APA format.
GRADED REQUIREMENTS
The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Analyze the health concern that is the focus of your health promotion plan.
Consider underlying assumptions and points of uncertainty in your analysis.
Explain why a health concern is important for health promotion within a specific population.
Examine current population health data.
Consider the factors that contribute to health, health disparities, and access to services.
Explain the importance of establishing agreed-upon health goals in collaboration with hypothetical participants.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Write with a specific purpose and audience in mind.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
Before submitting your assessment for grading, proofread it to minimize errors that could distract readers and make it difficult for them to focus on the substance of your plan.
Context
Historically, nurses have made significant contributions to community and public health with regard to health promotion, disease prevention, and environmental and public safety. They have also been instrumental in shaping public health policy. Today, community and public health nurses have a key role in identifying and developing plans of care to address local, national, and international health issues. The goal of community and public health nursing is to optimize the health of individuals and families, taking into consideration cultural, racial, ethnic groups, communities, and populations. Caring for a population involves identifying the factors that place the population’s health at risk and developing specific interventions to address those factors. The community/public health nurse uses epidemiology as a tool to customize disease prevention and health promotion strategies disseminated to a specific population. Epidemiology is the branch of medicine that investigates causes of various diseases in a specific population (CDC, 2012; Healthy People 2030, n.d.).
As an advocate and educator, the community/public health nurse is instrumental in providing individuals, groups, and aggregates with the tools that are essential for health promotion and disease prevention. There is a connection between one’s quality of life and their health literacy. Health literacy is related to the knowledge, comprehension, and understanding of one’s condition along with the ability to find resources that will treat, prevent, maintain, or cure their condition. Health literacy is impacted by the individual’s learning style, reading level, and the ability understand and retain the information being provided. The individual’s technology aptitude and proficiency in navigating available resources is an essential component to making informed decisions and to the teaching learning process (CDC, 2012; Healthy People 2030, n.d.).
It is essential to develop trust and rapport with community members to accurately identify health needs and help them adopt health promotion, health maintenance, and disease prevention strategies. Cultural, socio-economical, and educational biases need to be taken into consideration when communicating and developing an individualized treatment and educational plan. Social, economic, cultural, and lifestyle behaviors can have an impact on an individual’s health and the health of a community. These behaviors may pose health risks, which may be mitigated through lifestyle/behaviorally-based education. The environment, housing conditions, employment factors, diet, cultural beliefs, and family/support system structure play a role in a person’s levels of risk and resulting health. Assessment, evaluation, and inclusion of these factors provide a basis for the development of an individualized plan. The health professional may use a genogram or sociogram in this process.
What is a genogram? A genogram, similar to a family tree, is used to gather detailed information about the quality of relationships and interactions between family members over generations as opposed to lineage. Gender, family relationships, emotional relationships, lifespan, and genetic predisposition to certain health conditions are components of a genogram. A genogram, for instance, may identify a pattern of martial issues perhaps rooted in anger or explain why a person has green eyes.
What is a sociogram? A sociogram helps the health professional to develop a greater understanding of these factors by seeing inter-relationships, social links between people or other entities, as well as patterns to identify vulnerable populations and the flow of information within the community.
REFERENCES
Centers for Disease Control and Prevention. (2012). Lesson 1: Introduction to epidemiology. In Principles of Epidemiology in Public Health Practice (3rd ed.). https://www.cdc.gov/csels/dsepd/ss1978/lesson1/sec…
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2030. https://health.gov/healthypeople
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Analyze health risks and health care needs among distinct populations.
Analyze a community health concern or need that is the focus of a health promotion plan.
Competency 2: Propose health promotion strategies to improve the health of populations.
Explain why a health concern or need is important for health promotion within a specific population.
Establish agreed-upon health goals in collaboration with hypothetical participants.
Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Health Promotion Plan Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Analyze a community health concern or need that is the focus of a health promotion plan. Does not identify a community health concern or need that is the focus of a health promotion plan. Identifies a community health concern or need that is the focus of a health promotion plan. Analyzes a community health concern or need that is the focus of a health promotion plan. Provides an in-depth analysis of a community health concern or need that is the focus of the health promotion plan, and articulates underlying assumptions and points of uncertainty in the analysis.
Explain why a health concern or need is important for health promotion within a specific population. Does not describe a health concern or need that is important for health promotion within a specific population. Describes a health concern or need that is important for health promotion within a specific population. Explains why a health concern or need is important for health promotion within a specific population. Conclusions are not supported by relevant or current health data. Explains why a health concern or need is important for health promotion within a specific population. Conclusions are well supported by current and relevant population health and demographic data and based on a perceptive analysis of the factors that contribute to health, health disparities, and access to services.
Establish agreed-upon health goals in collaboration with hypothetical participants. Does not establish agreed-upon health goals in collaboration with hypothetical participants. Establishes health goals without hypothetical participant collaboration. Establishes agreed-upon health goals in collaboration with hypothetical participants. Establishes agreed-upon health goals in collaboration with hypothetical participants. Goals are realistic, measurable, and attainable.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Does not organize content for ideas. Lacks logical flow and smooth transitions. Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling. Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly. Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes, and/or paraphrasing. Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly.
Hi , Thank you for your work on this assessment #1. This assessment provided you with an opportunity to plan a hypothetical health promotion plan focused on a specific health concern in your community for a hypothetical individual or group who live in your community, not a facility. Goods start addressing the scoring guide criteria. Thank you for allowing me to evaluate the assessment. look forward to working with you throughout the course! Dr. Goozee
-Denys Goozee
Scoring Guide
Competency 1
Analyze health risks and health care needs among distinct populations.
Criterion
Analyze a community health concern or need that is the focus of a health promotion plan.
Your Result:DISTINGUISHED
Provides an in-depth analysis of a community health concern or need that is the focus of the health promotion plan, and articulates underlying assumptions and points of uncertainty in the analysis.
Faculty Comments:You did a great job describing a health concern that you chose from the list provided in the assessment guidelines for your hypothetical population living in your community, not in a facility. This is a growing concern in our health care system, especially for the community.
Show all Performance Ratings
Competency 2
Propose health promotion strategies to improve the health of populations.
Criterion
Explain why a health concern or need is important for health promotion within a specific population.
Your Result:DISTINGUISHED
Explains why a health concern or need is important for health promotion within a specific population. Conclusions are well supported by current and relevant population health and demographic data and based on a perceptive analysis of the factors that contribute to health, health disparities, and access to services.
Faculty Comments:Nice work explaining why the health concern you identified is important for health promotion within your hypothetical population. Your conclusions were well supported by current and relevant health data.
Show all Performance Ratings
Criterion
Establish agreed-upon health goals in collaboration with hypothetical participants.
Your Result:NON_PERFORMANCE
Does not establish agreed-upon health goals in collaboration with hypothetical participants.
Faculty Comments:Please be sure to identify SMART goals with a bold heading, clear goals, what are SMART goals, and what does the literature say about this. Be sure to establish measurable, and attainable SMART health goals for your hypothetical participants with sources cited to show research was done. This will help you to further develop, present, and evaluate your final #4 assessment which is the implementation of this plan.
Show all Performance Ratings
Competency 5
Apply professional, scholarly communication strategies to lead health promotion and improve population health.
Criterion
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Your Result:BASIC
Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling.
Faculty Comments:I hope you will use the Essay Example I provided in the Announcements! I like that your writing was clear and logical but there were just a few errors noted: Missing the appropriate introduction heading and the entire Introduction paragraph (about 4-5 sentences to clearly outline the main points the paper will discuss). Missing the bold Conclusion heading and the entire Conclusion paragraph (4-5 sentences) to summarize each main point in the essay. Also please be sure each bold heading matches each answer in the order asked (use a few of the same words from each question/ point) to be very clear as to what you are addressing. Be sure each bold heading meets capitalization rules. Please be sure all content on the title page is centered. I hope you will use the Essay Example I provided in the Announcements or the Academic writer website: https://academicwriter-apa-org.library.capella.edu… to help you with this. You have the potential to be an excellent writer.
Show all Performance Ratings
Criterion
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Your Result:PROFICIENT
Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Faculty Comments:Great start with citations and references but please be sure to cite sources in each paragraph to show research was done, strengthen the assignment, and avoid (unintentional plagiarism). I hope you will use the Essay Example I provided to you in my Announcements! and http://www.apastyle.org/learn/tutorials/basics-tut… to help you with this. You have the potential to be an excellent writer.
Unformatted Attachment Preview
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Health Promotion Plan: Immunization
Youssef Tawfik
Capella University
Professor Denys Goozee
NURS-FPX4060 – Summer 2023 – Section 33
Sep 18th, 2023
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Health Promotion Plan: Immunization
Analyze the health concern that is the focus of your health promotion plan
Medical researchers have contributed to knowledge on the value of immunizations to
protect populations from certain infectious diseases over centuries. The CDC (2022) defines
immunization as administering a vaccine to protect an individual from acquiring an infection.
Vaccines are a particular category of pharmaceutical products inoculated into the body to
stimulate its immune response against a pathogen (CDC, 2022). UNICEF and the WHO
acknowledge that vaccination is the most cost-effective intervention to promote public health and
consider it a right for all children (Crescitelli et al., 2020). Prevention against disease is the
primary benefit of administering a vaccine.
Nevertheless, vaccine refusal and outright refusal still linger even in developed societies.
A recent Pew Research study established that 88% of Americans support childhood vaccines
against measles, mumps, and rubella (MMR) (Funk et al., 2023). Failure to urgently address
vaccine hesitancy thwarts any efforts to eradicate some diseases, achieve herd immunity, and
manage the healthcare costs associated with their care. Vaccine hesitancy is fueled by the
assumption that the risks of vaccines outweigh their benefits.
The current analysis is premised on the assumption that the benefits of childhood
vaccines in preventing the incidence of known communicable diseases are clearly understood.
The benefits of childhood vaccines are extensively covered in literature, and the information is
readily available for anyone interested in learning about the subject. The primary point of
uncertainty is the extent to which individuals are willing to promote community health. The
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general assumption is that individuals understand that community health is a personal
responsibility.
Why immunization is important for health promotion within a specific population
Statistics on the prevalence of parental vaccine hesitancy and refusal vary. According to
Salazar et al. (2022), different US studies have reported a wide range of prevalence figures
ranging from 3.5% to 8%. 60% of US pediatric health providers encounter at least one refusal
per month, with higher rates among rural and suburban compared to urban parents (Salazar et al.,
2022). Kempe et al. (2020) established that 70% of parents are confident about childhood
vaccines, while 40% have concerns regarding their safety. A 2012 study reported that 80% of
parents in the US embraced all childhood vaccines, while the remaining 20% had varying
degrees of hesitancy (Salazar et al., 2022). The literature on intentional parental vaccine
hesitancy or refusal in African-American communities is limited.
Importance of establishing agreed-upon health goals in collaboration with hypothetical
participants
Agreed-upon health goals provide a structure to guide the health promotion education
plan. The absence of a consensual goal means parents and healthcare practitioners have no
shared goal, rendering the process futile. An agreed-upon health goal also means both parties are
equally invested in promoting children’s health and ensuring they enjoy their right to good health
as envisioned by UNICEF. Parents have the final decision regarding whether or not to immunize
their children. Despite their best interest in promoting children’s health, health practitioners can
only achieve so much without parental involvement.
Population definition
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Parents and guardians are expected to make an objective choice regarding their children’s
health or those under their care. UNICEF categorizes childhood vaccines as every child’s
fundamental right (Crescitelli et al., 2020). From this perspective, coupled with the inherent
benefits of vaccines, one would expect all parents and guardians to embrace childhood vaccines
to protect their children, or those under their care, from preventable diseases. Unfortunately, this
is not the case. The available data shows a predilection for childhood vaccine refusal among
White, college-educated, married women with relatively high family income (Thornton & Reich,
2022). A third category of children, unvaccinated, exists. Undervaccination is beyond the scope
of the current article because it is primarily associated with a lack of access to childhood
vaccines rather than individual parental choice. According to Thornton and Reich (2022), undervaccinated children are predominantly from lower-income families whose mothers lack a college
education and are likely to be of color. The current article focuses on intentional refusal or
hesitancy to immunize children against vaccine-preventable diseases.
In the post-COVID-19 era, political affiliation is also a significant predictor of parental
vaccine refusal or hesitancy. Republican and Republican-leaning parents are six times more
likely to refuse childhood vaccines than Democrats or Democrat-leaning parents (Panchalingam
& Shi, 2022). Parental vaccine refusal and hesitancy are more prevalent in non-Hispanic Black
parents due to institutional mistrust fueled by racial inequalities in the healthcare system
(Panchalingam & Shi, 2022). The age of the child also determines the parents’ likelihood of
refusal. Szilagyi et al. (2021) posit that a child’s age is inversely proportional to the parents’
likelihood to accept vaccination, particularly against COVID-19.
Characteristics of children for this activity and how they are relevant to the targeted
population
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Children are the selected group for this activity. Globally, parents and guardians are
legally entrusted to make decisions that promote health and a standard quality of life for their
children. From when a child is conceived to when they attain a legal age, their parents are
required and expected to make decisions on their behalf, especially on health and safety matters.
A parent or guardian’s choices directly determine the child’s quality of life. Some choices, such
as immunization against vaccine-preventable illnesses, may have more far-reaching
consequences on the child’s health and quality of life than others.
Why parents are predisposed to immunization and why they can benefit from a health
promotion educational plan
Parents are entrusted to make informed and objective choices for their children. Such
decisions include whether or not to accept routine childhood immunizations against vaccinepreventable diseases. Parents’ choices are inspired by their religious beliefs, personal philosophy,
and political affiliations. As long as parents are entrusted to make vaccination decisions for their
children, refusal and hesitancy in routine childhood vaccines will continue to linger.
Fear, mistrust, and misinformation often inform personal beliefs and philosophy.
According to Crescitelli et al. (2020), parental mistrust of the government and healthcare
institutions, healthcare practitioners, and the accuracy of official communication often culminate
in vaccine hesitancy or refusal. Some parents believe that immunizations are an unwelcome
interference with the body’s immune response to disease and are, therefore, opposed to
immunizing their children (Crescitelli et al., 2020). Misconceptions on the perceived risk of
vaccines also fuel hesitancy and refusal. Crescitelli et al. (2020) note that some vaccine-hesitant
parents believe vaccines contain toxic ingredients that expose their children to illness. A health
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promotion education plan could address some of these concerns, instilling trust in health
practitioners and institutions and eliminating doubt about vaccine safety.
Elements of a sociogram
A parent’s level of education, socioeconomic status, and religious and political affiliations
influence their decision whether to embrace routine childhood vaccinations for their children.
Integrating these parameters in a sociogram would significantly contribute to understanding the
profile of parents who are likely to resist or hesitate to vaccinate their children. Besides, these
elements will offer insight into the role of a community in shaping parents’ perspectives on
childhood vaccines.
Potential learning needs
The three cardinal learning needs for this exercise are the safety of vaccines, vis-à-vis
their perceived risk, the health benefits of vaccines, and health care practitioners. Some parents’
choice to deny their children the right to routine vaccines is inspired by misinformed notions
about the safety of vaccines. Vaccine safety has been extensively researched and chronicled. Any
interested party can, with a simple Google search, access a myriad of reputable research
publications on the safety of vaccines in promoting children’s health.
Notions on vaccine perceived risk are often founded on misinformation, devoid of
empirical research findings. Addressing these concerns could be beneficial for health promotion.
Health practitioners are legally and professionally bound to the ethical principle of nonmaleficence. The practitioner cannot knowingly harm the patient child and is instead obligated to
pursue interventions in their best interest.
Expectations for the educational session and how the individual or group needs can be met
7
The proposed educational session would enlighten the target population on crucial
aspects of immunization to impart knowledge, expel fear, and offer guidance on accessing
reliable evidence to clarify any concerns. The target population’s educational needs can be met
by ensuring presentations are persuasive, evidence-based, and presented by authority figures in
the respective areas.
8
References
Díaz Crescitelli, M., Ghirotto, L., Sisson, H., Sarli, L., Artioli, G., Bassi, M., Appicciutoli, G., &
Hayter, M. (2020). A meta-synthesis study of the key elements involved in childhood
vaccine hesitancy. Public Health, 180, 38-45. https://doi.org/10.1016/j.puhe.2019.10.027
Funk, C., Tyson, A., Kennedy, B., & Pasquini, G. (2023, May 16). Americans’ largely positive
views of childhood vaccines hold steady. Pew Research Center Science &
Society. https://www.pewresearch.org/science/2023/05/16/americans-largely-positiveviews-of-childhood-vaccines-hold-steady
Immunization basics | CDC. (2022, April 6). Centers for Disease Control and
Prevention. https://www.cdc.gov/vaccines/vac-gen/imz-basics.htm
Kempe, A., Saville, A. W., Albertin, C., Zimet, G., Breck, A., Helmkamp, L., Vangala, S.,
Dickinson, L. M., Rand, C., Humiston, S., & Szilagyi, P. G. (2020). Parental hesitancy
about routine childhood and influenza vaccinations: A national
survey. Pediatrics, 146(1). https://doi.org/10.1542/peds.2019-3852
Panchalingam, T., & Shi, Y. (2022). Parental refusal and hesitancy of vaccinating children
against COVID-19: Findings from a nationally representative sample of parents in the
U.S. Preventive Medicine, 164, 107288. https://doi.org/10.1016/j.ypmed.2022.107288
Szilagyi, P. G., Shah, M. D., Delgado, J. R., Thomas, K., Vizueta, N., Cui, Y., Vangala, S.,
Shetgiri, R., & Kapteyn, A. (2021). Parents’ intentions and perceptions about COVID-19
vaccination for Their Children: Results from a national
survey. Pediatrics, 148(4). https://doi.org/10.1542/peds.2021-052335
9
Thornton, C., & Reich, J. A. (2022). Black mothers and vaccine refusal: Gendered racism,
healthcare, and the state. Gender & Society, 36(4), 525551. https://doi.org/10.1177/08912432221102150
Please attached is the assignment information and the interview information for the paper please do step by step of everything and less than five years references
Teen Depression and Suicide – “Out of the Darkness” – A WRAL DocumentaryLinks to an external site.
Each week I will be posting a mini podcast/video/ mini lecture. You are required to view the weekly videos that I post and submit a 250 word reflection. You are to reflect on any specific questions that I may ask as well as the content of the video itself. It is important that you integrate evidence and information from the textbook and readings to support the ideas in your reflection. Reflections are due every Sunday evening by 11:59 p.m. Late submissions will be deducted by half. You will be graded based on the quality of your reflection, including appropriate content, proper grammar and spelling and thoughtful consideration of the ideas and concepts.
Rubric
Some Rubric (1)
Some Rubric (1)
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeQuality ReflectionStudent submits a reflection that reflects thoroughly on the content that was posted for the week. Reflections should not be mere summaries of the content. Rather, they should raise thought provoking questions or discuss personal insight that you have gained through watching the videos. (2 points). Reflections should integrate evidence and information from the textbook and readings to support the ideas in the reflection (1 point). References should be cited using APA formatted in-text citations (1 point)
4 pts
Exceptional
3 pts
Average
2 pts
Fair
1 pts
Poor
0 pts
No Marks
4 pts
This criterion is linked to a Learning OutcomeTimely submissionStudent submits reflection by the due date
2 pts
On time
1 pts
Late
2 pts
This criterion is linked to a Learning OutcomeWord CountSubmissions should be at least 250 words in length
2 pts
250 words or greater
0 pts
Less than 250 words
2 pts
This criterion is linked to a Learning OutcomeSpelling & GrammarStudent’s submission is mostly free of grammatical and spelling mistakes
2 pts
Full Marks
1 pts
Poor
There are numerous grammar and spelling mistakes, but these do not impede the reader from understanding the ideas that are being communicated.
0 pts
Unsatisfactory
Numerous spelling and/or grammatical mistakes significantly reduce the reader’s ability to understand what the writer is trying to communicate
READ CAREFULLY: This video/PowerPoint is all about you and how kinesiology impacts your life. I want you to be creative. You can add music or special effects. Whatever you would like. If doing the video, you can film yourself showing off how you use your component of fitness, or you can film someone else but I want you to think outside of the box. If you just sit in front of the camera with nothing added and just talk you will lose 20 points automatically. If doing the PowerPoint you must not submit a PDF it needs to have special effects, music, a video Etc… You must check the video in your PowerPoint before submitting. You will lose 20 points if there are no added affects. When doing a PowerPoint you must have at least 5 slides. Make this fun! do not go over or under the time limit of 3-5 minutes. There is a rubric for your reference. **If you submit your video/PowerPoint after the due date you will automatically lose 50 points**
Directions: You are to make a 2-5 minute video or a PowerPoint about a component of fitness and how it applies to your daily life. In the video/PowerPoint you will need:
1) What is the definition of the word kinesiology (use a dictionary definition)
2) What does kinesiology look like in your life
3) Choose ONE component of fitness; muscular strength, muscular endurance, body composition, flexibility, and cardiovascular fitness.
4) Define the component.
5) Show us how you use the component of fitness in your daily life.
6) How can other people use this component as well. 7) Be creative. Add music edit your video make is assignment all about you!
Please contact me before the due date if you have any questions.
Rubric
VIDEO
VIDEO
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDescription of criterionDirections: You are to make a 3-5 minute video about a component of fitness and how it applies to your daily life. In the video you will need: 1) what is definition of the word kinesiology 2) What does kinesiology look like in your life 3) choose ONE component of fitness; muscular strength, muscular endurance, body composition, flexibility, and cardiovascular fitness. 4) Define the component. 3) Show us how you use the component of fitness in your daily life. 5) How can other people use this component as well. 6) be creative.
200 pts
Full marks
If the student’s video is 3-5 minutes long and has all seven requirements.
33.33 pts
Missing 1 of the 7 topics
If the student is missing any of the 6 topics he or she will lose 25 points
32.33 pts
Staying in the time frame
Students will lose 25 points if they go either below or over the 3-5 minute time limit.
20 pts
Creativity
Students will lose 15 points if the student does not add some form of creativity to the video
Activity 9: Write a value proposition for the alternative you selected. An explanation of how to write a value proposition is provided in the reading titled Value Proposition, which also gives two examples of value propositions. You can model your value proposition after the examples. The reading and examples are available in the reference list.The due date for posting your completed Activity 9 in your Assignments Folder is the end date of Week 7.Please post your final Activity 9 to this link.T9-Value Proposition.pdf
You and your supervisor will be working together to complete your Learning Agreement for the year. Your Learning Agreement is an important road map for what you’ll accomplish in the year ahead! This log will help you explore what some of your goals and hopes are. The log should be no longer than two pages double-spaced, and no shorter than 1 page; at least one paragraph should be devoted to each section of the assignment. You should provide headings for each section of the log so the instructor can clearly tell each section apart. Submit a log that addresses the following:
Description: This is the section of the log where you will provide the information about your goals. What are you most hoping to accomplish in the year ahead? Consider the following prompts:
“I’ll know I had an effective learning experience if…”
“Some goals for myself include…”
“I chose this internship hoping to be able to learn…”
Reflection: This is the section of the log where you will review your hopes and goals and think critically about them. Why do you have these goals (because of personal experience, what you’re hoping to do after you graduate, what you’ve heard from past interns, what you learned during the interview process, etc.)? Why are these goals significant to you?
Next Steps: This is the section of the log where you will connect this to next steps. Identify steps that you will take when discussing your goals and hopes with your supervisor. What might you do if your supervisor has very different goals than you do? How might you feel if some of your goals will not be possible? How are you going to challenge yourself to make the most of your internship experience and all the learning opportunities available to you?
Unformatted Attachment Preview
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM 2018-2019
EPAS Competency and Practice
Behavior(s)
Competency 1: 1. Make ethical decisions by
applying the standards of the
Demonstrate
NASW Code of Ethics, relevant
laws and regulations, models for
Ethical and
ethical decision-making, ethical
Professional
conduct of research; and
additional codes of ethics as
Behavior.
Objective(s)/Goal(s)
Competency 2:
Engage
Diversity and
Difference in
Practice.
1. Apply critical
thinking issues of
diversity and antioppressive
practice
2. Demonstrate
sensitivity to
diversity in the
classroom.
Competency 3:
Advance
Human Rights
and Social,
Economic, and
Environmental
Justice
appropriate to context.
2. Use reflection and selfregulation to manage personal
values and maintain
professionalism in practice
situations.
3. Demonstrate professional
demeanor in behavior;
appearance; and oral, written,
and electronic communication
4. Use technology ethically and
appropriately to facilitate
practice outcomes
1. Make ethical decisions by
applying the standards of the
NASW Code of Ethics, relevant
laws and regulations, models for
ethical decision-making, ethical
conduct of research; and
additional codes of ethics as
appropriate to context.
2. Use reflection and selfregulation to manage personal
values and maintain
professionalism in practice
situations.
3. Demonstrate professional
demeanor in behavior;
appearance; and oral, written,
and electronic communication
4. Use technology ethically and
appropriately to facilitate
practice outcomes
5. Use supervision and
consultation to guide
professional judgment and
behavior.
1. Apply their understanding of
social, economic, and
environmental justice to
advocate for human rights at the
individual and system levels
2. Engage in practices that
advance social, economic, and
environmental justice.
1. Conduct
myself
ethically
2. Recognize
personal
biases
1. Fulfill
agency’s
mission,
goals, and
vision
2. Advocate for
rights and
human justice
Assignments/Tasks
1. Be on time
2. Dressing
appropriate
3. Utilize supervision
time to talk about
biases and how the
internship is going.
Time Frame
1st semester
In process
How will work be monitored and
evaluated?
Physically and verbally: I will be
monitored in person and evaluated
based on my performance.
1. Implement a
strengths and
perspective
approach
2. Be mindful
during
presentations
1st semester
In process
Physically and verbally: I will be
monitored during presentations on
how I interact with a diverse
population of students.
1. Understand
mission, goal,
and vision of Zcenter
2. Represent Zcenter
appropriately.
1st semester
In process
Physically and verbally: I will be
monitored by my performance on
agency’s mission, goal, and vision. I
will be supervised if I represent Zcenter everywhere I go during
internship tasks.
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM 2018-2019
EPAS Competency and Practice
Behavior(s)
Competency 4: 1. Use practice experience and
theory to inform scientific inquiry
Engage in
and research.
2. Apply critical thinking to
Practiceengage in analysis of
informed
quantitative and qualitative
research methods and research
Research and
findings.
Research3. Use and translate research
informed
evidence to inform and improve
practice, policy and service
Practice.
Objective(s)/Goal(s)
1. Use research
and evidencebased practice
approaches
delivery.
Competency 5:
Engage in
Policy Practice
1. Assess how social welfare
and economic policies impact
the delivery of and access to
social services.
2. Apply critical thinking to
analyze, formulate, and
advocate for policies that
advance human rights
Competency 6:
Engage with
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks to engage with
clients and constituencies.
2. Use empathy, reflection, and
interpersonal skills to effectively
engage diverse clients and
constituencies
1. Ablity to
engage with
clients in the
field through
supervision
Competency 7:
Assess
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Collect and organize data,
and apply critical thinking to
interpret information from clients
and constituencies.
2. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks in the analysis of
assessment data from clients
and constituencies.
3. Develop mutually agreed-on
intervention goals and
objectives based on the critical
assessment of strengths, needs,
and challenges within clients
and constituencies.
4. Select appropriate
intervention strategies based on
the assessment, research
knowledge, and values and
preferences of clients and
constituencies.
1.Use multi-dimensionl
bio-psycho-socialspiritual assessment
tools
1. Demonstrate
knowledge of field
agency policies while
delivering services.
Assignments/Tasks
1. Research more
about Erin’s
Law
2. Research all the
programs
offered for
schools due to
Erin’s law
1. Understand the
policies in place
that allows Zcenter to give
their services
1. Medical
advocacy
2. Support line
3. Prevention
education
program
1. Work with
Kylene (Intake
Manager) and
assess clients
readiness for
change
2. Go over coping
strategies for
survivors
Time Frame
1st semester
In process
How will work be monitored and
evaluated?
Verbally: I will be monitored by
completing my research and providing
my findings to my supervisor.
1st semester
In process
Physically: This will be monitored in
person and based on my level of
understanding for policies within my
agency.
1st semester
In process
Physically and verbally: I will be
monitored by how many times I
interact with survivors during medical
calls and how they choose to evaluate
our services.
1st semester
In process
Physically and verbally: I will be
monitored by the number of times I
met with Kylene to discuss the client’s
satisfaction and improvements.
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM 2018-2019
EPAS Competency and Practice
Behavior(s)
Competency 8: 1. Critically choose and
implement interventions to
Intervene with
achieve practice goals and
enhance capacities of clients
Individuals,
and constituencies.
Families,
2. Apply knowledge of human
behavior and the social
Groups,
person-inOrganizations, environment,
environment, and other
and
multidisciplinary theoretical
frameworks in interventions with
Communities.
Objective(s)/Goal(s)
1. Ability to
intervene with
clients
2. Provide
services
effectively
clients and constituencies.
3. Use inter-professional
collaboration as appropriate to
achieve beneficial practice
outcomes.
4. Negotiate, mediate, and
advocate with and on behalf of
diverse clients and
constituencies.
5. Facilitate effective transitions
and endings that advance
mutually agreed-on goals.
Competency 9:
Evaluate
Practice with
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Select and use appropriate
methods for evaluation of
outcomes.
2. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks in the evaluation of
outcomes.
3.Critically analyze, monitor, and
evaluate intervention and
program processes and
outcomes.
4. Apply evaluation findings to
improve practice effectiveness
at the micro, mezzo, and macro
levels.
1. I will utilize
feedback from client,
workers, field
supervisor to evaluate
myself
2. Effectively evaluate
my practice in the field
setting with supervisor
Assignments/Tasks
1. Medical
Advocacy
2. Hotline support
– Giving out the
resources they
need as well as
finding the right
ones.
1. 1 on 1 with Kyle go
over what is going on
2. Also taken into
account my partners
feedback in
presentations
Time Frame
1st semester
In process
1st Semester
In process
How will work be monitored and
evaluated?
Verbally: This will be monitored by the
shifts I pick up on better impact.
Verbally and physically: This will be
evaluated by meeting with my
supervisor and talking over all of the
improvements made over time as well
as what can further be improved.
Student
Printed Name
Signature
Date
Signature
Date
Field Supervisor
Printed Name
Discussion Board #42525 unread replies.2525 replies.Recent studies indicate that children of depressed parents are more likely to experience depression themselves than children with non-depressed parents. Do you think this is because of genetic or environmental factors? What other factors could there be? If it is true that children with depressed parents are more likely to be depressed, what preventative actions, if any, do you feel should be taken? [For an article on this issue, see Wagner, K. D. (2002). Children of Depressed Parents. Psychiatric Times.].It is required that you post at least 2 times per discussion (initial post and response to at least 1 peer) over the two week period (on two different days) to encourage a lively discussion. Your first post must be submitted during the first week that the question is posted. Your initial response must contain an in-text citation, referencing material from your textbook and/or other academic sources. Your second response, which is your follow-up response to another student, can be posted during either the first or second week that the discussion board is open. Your initial response needs to use in-text citations and must contain an academic reference at the end of your post. This is an upper-level psychology course, so APA style is mandated for the discussion board. Failure to use proper APA style in-text citations and references will result in point loss. Please consult Purdue’s OWL Resources (Links to an external site.)Links to an external site. for APA format.Each of your required two responses should be a minimum of 225 words and should meet the content requirements stated in the syllabus. However, your initial response will probably be longer. Two postings per discussion module (a two week period) is the minimum number of postings per discussion and will yield a minimum grade. Proper grammar and spelling are required and points will be deducted for errors.
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
Analyze the impact of health care technology on the patient, family, or population problem.
Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.
Determine whether the evidence is consistent with technology use you see in your nursing practice.
Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem.
Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.
Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.
Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.
Identify barriers to the use of care coordination and community resources in the context of this problem.
Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources.
Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
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Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations Scoring Guide
Assessing the Problem: Technology, Care Coordination, and Community
Resources Considerations Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Analyze the impact
of health care
technology on a
patient, family, or
population problem.
Does not describe
the impact of health
care technology on a
patient, family, or
population problem.
Describes the impact
of health care
technology on a
patient, family, or
population problem.
Analyzes the impact
of health care
technology on a
patient, family, or
population problem.
Conducts an astute
analysis of the impact of
health care technology
on a patient, family, or
population problem.
Cites credible and
balanced evidence of
the advantages and
disadvantages of
specific technologies.
Provides clear insight
into current technology
use in professional
practice, as well as
potential barriers and
costs.
Explain how care
coordination and the
utilization of
community
resources can be
used to address a
patient, family, or
population problem.
Does not describe
the value of care
coordination and the
utilization of
community resources
in addressing health
care challenges.
Attempts to describe
the value of care
coordination and the
utilization of
community resources
in addressing health
care challenges.
Explains how care
coordination and the
utilization of
community resources
can be used to
address a patient,
family, or population
problem.
Provides a convincing
explanation of how care
coordination and the
utilization of community
resources can be used
to address a patient,
family, or population
problem. Cites credible
and balanced evidence
of the benefits of care
coordination and the
use of community
resources. Provides
clear insight into current
use in professional
practice, as well as
potential barriers.
Analyze state board Does not describe
Attempts to describe
Analyzes state board Conducts an astute
nursing practice
state board nursing
state board nursing
nursing practice
analysis of state board
standards and/or
practice standards
practice standards
standards and/or
nursing practice
organizational or
and/or organizational and/or organizational organizational or
standards and/or
governmental
or governmental
or governmental
governmental policies organizational or
policies associated
policies associated
policies associated
associated with
governmental policies
with health
with health
with health
health technology,
associated with health
technology, care
technology, care
technology, care
care coordination,
technology, care
coordination, and
coordination, and
coordination, and
and community
coordination, and
community
community
community resources, resources
community resources.
resources
resources, and does and/or does not
and documents the
Clearly articulates the
and document the
not document
document practicum
practicum hours
implications for ethical
practicum hours
practicum hours in
hours in Capella
spent with these
professional practice of
spent with these
Capella Academic
Academic Portal
individuals or group
applying standards
individuals or group Portal Volunteer
Volunteer Experience in the Capella
and/or policy guidance
in the Capella
Experience Form.
Form.
Academic Portal
or legislative
Academic Portal
Volunteer Experience requirements to the
Volunteer
Form.
problem. Documents
Experience
Form.
the practicum hours
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spent with these
10/11/23, 3:08 PM
CRITERIA
Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations Scoring Guide
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Portal Volunteer
Experience Form
Support main
points, assertions,
arguments,
conclusions, or
recommendations
with relevant and
credible evidence.
Does not support
main points,
assertions,
arguments,
conclusions, or
recommendations
with relevant and
credible evidence.
Sources lack
relevance or
credibility, or the
evidence is not
persuasive or
explicitly supportive of
main points,
assertions,
arguments,
conclusions, or
recommendations.
Supports main points,
assertions,
arguments,
conclusions, or
recommendations
with relevant and
credible evidence.
Supports main points,
assertions, arguments,
conclusions, or
recommendations with
relevant, credible, and
convincing evidence.
Skillfully combines
virtually error-free
source citations with a
perceptive and coherent
synthesis of the
evidence.
Apply APA style and
formatting to
scholarly writing.
Does not apply APA
style and formatting
to scholarly writing.
Applies APA style and Applies APA style and
formatting to scholarly formatting to
writing incorrectly
scholarly writing.
and/or inconsistently,
detracting noticeably
from good
scholarship.
Applies APA style and
formatting to scholarly
writing. Exhibits strict
and nearly flawless
adherence to stylistic
conventions, document
structure, and source
attributions.
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What is the issue/topic?What is the history/background of this issue? Who is this issue most relevant to? (ie. Government, schools, hospitals, global, local, etc.) Why is this topic considered an issue?Is there a “for “and “against”? What are the potential outcomes of the issue? Who would benefit from a deeper understanding of this issue? How does this issue tie to some of the dimensions of health?
For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:
Select one of the case studies presented in the Assessment 03 Supplement: Applying Ethical Principles [PDF] resource.
Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
Summarize the facts in the selected case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
Identify who is involved or affected by the ethical problem or issue.
Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
Apply the three components outlined in the Ethical Decision-Making Model media.
Analyze the factors that contributed to the ethical problem or issue identified in the case study.
Describe the factors that contributed to the problem or issue and explain how they contributed.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
Review the Think Critically About Source Quality resource.
Assess the credibility of the information source.
Assess the relevance of the information source.
Discuss the effectiveness of the communication approaches present in a case study.
Describe how the health care professional in the case study communicated with others.
Assess instances where the professional communicated effectively or ineffectively.
Explain which communication approaches should be used and which ones should be avoided.
Describe the consequences of using effective and non-effective communication approaches.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
Discuss the key lessons this case provides for health care professionals.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Describe the proposed solution.
Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
Discuss how likely it is the proposed solution will foster professional collaboration.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Apply the principles of effective composition.
Determine the proper application of the rules of grammar and mechanics.
Write using APA style for in-text citations, quotes, and references.
Determine the proper application of APA formatting requirements and scholarly writing standards.
Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
The following links provide information about the codes of ethics of professional associations, government entities, and other organizations:
American College of Healthcare Executives. (2019). ACHE code of ethics. https://www.ache.org/about-ache/our-story/our-comm…
American Nurses Association. (n.d.). Ethics topics and articles. https://www.nursingworld.org/practice-policy/nursi…
Centers for Disease Control and Prevention. (n.d.). Public health ethics resources. https://www.cdc.gov/od/science/integrity/phethics/…
Ennis-O-Connor, M., & Mannion, R. (2020). Social media networks and leadership ethics in healthcare. Healthcare Management Forum, 33(3), 145–148.
Levitt, D. (2014). Ethical decision-making in a caring environment: The four principles and LEADS. Healthcare Management Forum, 27(2), 105–107.
Moradi, K., Najarkolai, A. R., & Keshmiri, F. (2016). Interprofessional teamwork education: Moving toward the patient-centered approach. The Journal of Continuing Education in Nursing, 47(10), 449–460.
Raus, K., Mortier, E., & Eeckloo, K. (2018). The patient perspective in health care networks. BMC Medical Ethics, 19(1), 52.
Sanders, S., Wisse, B., Van Yperen, N. W., & Rus, D. (2018). On ethically solvent leaders: The roles of pride and moral identity in predicting leader ethical behavior. Journal of Business Ethics, 150(3), 631–645.
HCM 520
Critical Thinking Assignment
Medical Errors – Policy and Procedures (100 points)
Reporting errors in healthcare is an essential component of patient safety.
For this assignment, you will assume that you are a healthcare administrator at a healthcare
facility (Hospital, long term care facility, clinic, etc.).
You are tasked with creating a process for reporting errors and reducing adverse events at your
facility. Your submission will demonstrate your knowledge of healthcare error reporting to
create your process. Be sure to include at least one QI tool and discuss the process involved.
Describe how your process aligns with current practices in KSA. Include current data of medical
errors in healthcare settings within KSA and describe what the current gaps are. Your process
should address these gaps that are published in the literature.
Your process should include the following:
•
•
•
•
An identification of the most prevalent and common medical errors in your facility
Risks associated with those medical errors.
All individuals (staff, groups, agencies) will be involved in the reporting process.
Design a reporting template and be sure to include any workflow processes or tools that
can be used in the process.
• Provide a brief evaluation of departments responsible for following up on errors and
events.
Your report should meet the following structural requirements:
•
•
•
•
Be five to six pages in length, not including the title or reference pages.
Be formatted according to APA 7th edition Saudi Electronic University writing
guidelines.
Provide support for your statements with in-text citations from a minimum of six
scholarly articles. Two of these sources may be from the class readings, textbook, or
lectures, but four must be external.
Utilize headings to organize the content of your work.
There will be two parts to this assignment. Part A and Part B. You will need to reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews or (other filtered high- level evidence) you selected in Module 3. Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources. Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3. Part 3B: Critical Appraisal of Research Based on your appraisal, in a 2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research. Please make sure to use the rubric and make sure that you have included all of the info required by the rubric. You will not need a title page or a ref page. Your table will serve as a ref page as your refs will be listed there. The 2-page appraisal will be an addition to the table/template for the assignment. Make sure to cite and give credit appropriately throughout the table and the 2-page appraisal. 1. Please write the 2 page research after the table, also add the references that you will use at the end of the paper in the same page that there is already exist. 2. A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria. 3. Use 3 outside resources and 3 course-specific resources that fully support the responses provided (that have DOI) 4. Use the same topic and the articles that you previously used in the matrix worksheet that I already attached Course references Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing. 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. American Journal of Nursing. 110(7), 47-52 Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence.American Journal of Nursing., 110(11), 43-51. doi:10.1097/01.NAJ.0000390523.99066.b5 Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association. 15(3), 202–207. doi:10.1177/1078390309338733
Hello,Please fill this out with the patients information listed. i will send both pdf’s thank you. just fill out and try to fill out as much and long information as possible about this patient. use initials for this patient like i provided.
Unformatted Attachment Preview
Course: NURS 223L
PSYCHIATRIC NURSING PROCESS WORKSHEET: Daily Charting 1
Psychiatric Mental Health Nursing
NURS 223L
Student Name:
Date:
Patient Identification:
Name (initials):______ Age: _____ Gender: _____ Unit: _____
Current Legal Status (Vol., 5150, 5250, Conservatorship, T-Con):
Description of Hold:
Psychiatric Diagnosis:
Medical Diagnosis (If any):
AllergiesVital Signs Presenting Problem
Chief Compliant: (Patient’s own words):
Past Psychiatric History:
Prior Hospitalizations:
Prior Suicide Attempts:
Family History:
Substance Use
Substance
Amount /
Frequency
Duration
Last Used
ETOH:
Tobacco:
Illicit Drugs:
Other:
Psychosocial and Environmental Problems:
(problems with primary support group, education, occupational, housing, economic, access to health care)
Page 1 of 5
Course: NURS 223L
PSYCHIATRIC NURSING PROCESS WORKSHEET: Daily Charting 2
Mental Status Examination
Appearance (grooming, hygiene, disheveled etc.):
Motor Activity: (balance, coordination, gait, tremors, tics etc.):
Cognition (orientation, memory recall):
Speech (normal rate, rhythm & tone, delayed, vague, clanging, rapid, pressured, loud, spontaneous, slurred,
other):
Affect (flat, guarded, blunted, labile, restricted, other):
Attitude (cooperative, uncooperative, friendly, hostile, guarded, suspicious, etc. ):
Mood (Irritable, euthymic, anxious, expansive, euphoric, apathetic, depressed, elevated, other):
Thought Content:
Suicide Ideation (plan and/or intent):
Homicidal Ideation (plan and/or intent):
Hallucinations (auditory, visual, olfactory, gustatory, tactile):
Delusions (bizarre, somatic, paranoid, grandiose, religious):
Perception (ideas of reference, thought insertion, thought broadcasting, depersonalization, phobias, illusions,
other):
Thought Process (flight of ideas, logical, coherent, goal directed, circumstantial, tangential, loose association,
preservation, rumination, confabulations, other):
Insight/Judgement:
Goals (Long/short term):
Nursing Interventions (Patient education):
Example: Provided patient education on the importance of medication compliance
Page 2 of 5
Course: NURS 223L
PSYCHIATRIC NURSING PROCESS WORKSHEET: Daily Charting 3
MEDICATION LIST
Medication
(Generic / Trade)
Dose / Route / Frequency /
Range
Side Effects
Food and Drug Interaction
Purpose / Rationale for the
Patient
Medication
(Generic / Trade)
Dose / Route / Frequency /
Range
Side Effects
Food and Drug Interaction
Purpose / Rationale for the
Patient
Medication
(Generic / Trade)
Dose / Route / Frequency /
Range
Side Effects
Food and Drug Interaction
Purpose / Rationale for the
Patient
Complete charts below using two disorders that patient has been diagnosed with. If patient only has one
diagnosis, choose a disorder that interests you.
Disorder:
Risk Factor:
Etiology:
Page 3 of 5
Course: NURS 223L
PSYCHIATRIC NURSING PROCESS WORKSHEET: Daily Charting 4
Expected Findings:
Patient Education:
Disorder:
Risk Factor:
Etiology:
Expected Findings:
Page 4 of 5
Course: NURS 223L
PSYCHIATRIC NURSING PROCESS WORKSHEET: Daily Charting 5
Patient Education:
Page 5 of 5
In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:
The purpose of the quality improvement initiative.
The target population or audience.
The benefits of the quality improvement initiative.
The interprofessional collaboration that would be required to implement the quality improvement initiative.
The cost or budget justification.
The basis upon which the quality improvement initiative will be evaluated.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Unformatted Attachment Preview
Collapse All
Executive Summary – Rubric
Purpose of the Quality Improvement Initiative
21 points
Criteria Description
Purpose of the Quality Improvement Initiative
5. Excellent
21 points
The purpose of the quality improvement initiative meets all criteria for the
assignment, as indicated in the assignment instructions, is provided in detail, and
demonstrates higher level thinking by incorporating prior learning or reflective
thought.
4. Good
18.69 points
The purpose of the quality improvement initiative meets all criteria for the
assignment, as indicated in the assignment instructions, and is provided in detail.
3. Satisfactory
16.59 points
The purpose of the quality improvement initiative is provided and meets the basic
criteria for the assignment as indicated in the assignment instructions.
2. Less Than Satisfactory
15.75 points
The purpose of the quality improvement initiative is incomplete, missing relevant
information.
1. Unsatisfactory
0 points
The purpose of the quality improvement initiative is not provided.
Target Population or Audience
18.2 points
Criteria Description
Target Population or Audience
5. Excellent
18.2 points
The target population or audience meets all criteria for the assignment, as indicated
in the assignment instructions, and is provided in detail, while demonstrating
higher level thinking by incorporating prior learning or reflective thought.
4. Good
16.2 points
The target population or audience meets all criteria for the assignment, as indicated
in the assignment instructions, and is provided in detail.
3. Satisfactory
14.38 points
The target population or audience is provided and meet the basic criteria for the
assignment as indicated in the assignment instructions.
2. Less Than Satisfactory
13.65 points
The target population or audience is incomplete, missing relevant information.
1. Unsatisfactory
0 points
The target population or audience is not addressed.
Benefits of Quality Improvement Initiative
18.2 points
Criteria Description
Benefits of Quality Improvement Initiative
5. Excellent
18.2 points
The benefit of the quality improvement initiative meet all criteria for the
assignment, as indicated in the assignment instructions, and is provided in detail,
while demonstrating higher level thinking by incorporating prior learning or
reflective thought.
4. Good
16.2 points
The benefit of the quality improvement initiative meets all criteria for the
assignment, as indicated in the assignment instructions, and is provided in detail.
3. Satisfactory
14.38 points
The benefits of the quality improvement initiative are provided and meet the basic
criteria for the assignment as indicated in the assignment instructions.
2. Less Than Satisfactory
13.65 points
The benefits of the quality improvement initiative are incomplete, missing relevant
information.
1. Unsatisfactory
0 points
The benefits of the quality improvement initiative are not provided.
Interprofessional Collaboration Required to Implement the Quality
Improvement Initiative
18.2 points
Criteria Description
Interprofessional Collaboration Required to Implement the Quality Improvement
Initiative
5. Excellent
18.2 points
The interprofessional collaboration that would be required to implement the quality
improvement initiative is clearly discussed and meets all criteria for the assignment,
as indicated in the assignment instructions, and is provided in detail, while
demonstrating higher level thinking by incorporating prior learning or reflective
thought.
4. Good
16.2 points
The interprofessional collaboration that would be required to implement the quality
improvement is discussed and meets all criteria for the assignment, as indicated in
the assignment instructions, and is provided in detail.
3. Satisfactory
14.38 points
The interprofessional collaboration that would be required to implement the quality
improvement is discussed and meets the basic criteria for the assignment as
indicated in the assignment instructions
2. Less Than Satisfactory
13.65 points
The interprofessional collaboration that would be required to implement the quality
improvement initiative is incomplete, missing relevant information.
1. Unsatisfactory
0 points
The interprofessional collaboration that would be required to implement the quality
improvement initiative is not discussed.
Cost or Budget Justification
Criteria Description
Cost or Budget Justification
18.2 points
5. Excellent
18.2 points
The cost or budget justification issue meets all criteria for the assignment, as
indicated by the assignment instructions, and is provided in detail, while
demonstrating higher level thinking by incorporating prior learning or reflective
thought.
4. Good
16.2 points
The cost or budget justification issue meets all criteria for the assignment, as
indicated in the assignment instructions, and is provided in detail.
3. Satisfactory
14.38 points
The cost or budget justification is provided and meets the basic criteria for the
assignment as indicated in the assignment instructions.
2. Less Than Satisfactory
13.65 points
The cost or budget justification is incomplete, missing relevant information.
1. Unsatisfactory
0 points
The cost or budget justification is not provided.
Basis Upon Which the Program or Project Will Be Evaluated
18.2 points
Criteria Description
Basis Upon Which the Program or Project Will Be Evaluated
5. Excellent
18.2 points
The basis, upon which the quality improvement initiative will be evaluated as
indicated by the assignment instructions, is provided in detail, while demonstrating
higher level thinking by incorporating prior learning or reflective thought.
4. Good
16.2 points
The basis upon which the quality improvement initiative will be evaluated is
provided in detail.
3. Satisfactory
14.38 points
The basis upon which the quality improvement initiative will be evaluated meets the
basic criteria for the assignment as indicated in the assignment instructions.
2. Less Than Satisfactory
13.65 points
The basis upon which the quality improvement initiative will be evaluated is
incomplete, missing relevant information.
1. Unsatisfactory
0 points
The basis upon which the quality improvement initiative will be evaluated is not
provided.
Thesis Development and Purpose
7 points
Criteria Description
Thesis Development and Purpose
5. Excellent
7 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement
makes the purpose of the paper clear.
4. Good
6.23 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and
reflective of the arguments and appropriate to the purpose.
3. Satisfactory
5.53 points
Thesis is apparent and appropriate to purpose.
2. Less Than Satisfactory
5.25 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Paragraph Development and Transitions
7 points
Criteria Description
Paragraph Development and Transitions
5. Excellent
7 points
There is a sophisticated construction of paragraphs and transitions. Ideas progress
and relate to each other. Paragraph and transition construction guide the reader.
Paragraph structure is seamless.
4. Good
6.23 points
A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit
a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are
appropriate to purpose.
3. Satisfactory
5.53 points
Paragraphs are generally competent, but ideas may show some inconsistency in
organization and/or in their relationships to each other.
2. Less Than Satisfactory
5.25 points
Some paragraphs and transitions may lack logical progression of ideas, unity,
coherence, and/or cohesiveness. Some degree of organization is evident.
1. Unsatisfactory
0 points
Paragraphs and transitions consistently lack unity and coherence. No apparent
connections between paragraphs are established. Transitions are inappropriate to
purpose and scope. Organization is disjointed.
Mechanics of Writing (includes spelling, punctuation, grammar, language
use)
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
7 points
Writer is clearly in command of standard, written, academic English.
4. Good
6.23 points
Prose is largely free of mechanical errors, although a few may be present. The
writer uses a variety of effective sentence structures and figures of speech.
3. Satisfactory
5.53 points
7 points
Some mechanical errors or typos are present, but they are not overly distracting to
the reader. Correct and varied sentence structure and audience-appropriate
language are employed.
2. Less Than Satisfactory
5.25 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in
language choice (register) or word choice are present. Sentence structure is correct
but not varied.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning.
Inappropriate word choice or sentence construction is used.
Paper Format (use of appropriate style for the major and assignment)
2.8 points
Criteria Description
Paper Format (use of appropriate style for the major and assignment)
5. Excellent
2.8 points
All format elements are correct.
4. Good
2.49 points
Appropriate template is fully used. There are virtually no errors in formatting style.
3. Satisfactory
2.21 points
Appropriate template is used. Formatting is correct, although some minor errors
may be present.
2. Less Than Satisfactory
2.1 points
Appropriate template is used, but some elements are missing or mistaken. A lack of
control with formatting is apparent.
1. Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed
correctly.
Documentation of Sources
Criteria Description
4.2 points
Documentation of Sources (citations, footnotes, references, bibliography, etc., as
appropriate to assignment and style)
5. Excellent
4.2 points
Sources are completely and correctly documented, as appropriate to assignment
and style, and format is free of error.
4. Good
3.74 points
Sources are documented, as appropriate to assignment and style, and format is
mostly correct.
3. Satisfactory
3.32 points
Sources are documented, as appropriate to assignment and style, although some
formatting errors may be present.
2. Less Than Satisfactory
3.15 points
Documentation of sources is inconsistent or incorrect, as appropriate to
assignment and style, with numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
Total 140 points
Executive Summary Feedback Form
Student Name:__________________
Date of Interview:________________
Section & Faculty Name:_________________________________
Provider Information
Employee Name :
Last
Credentials:
First
M.I.
Title:
(I.e. MS, RN, etc.)
Organization:
Phone Number:
E-mail Address:
Feedback Section
The RN to BSN program at Grand Canyon University meets the requirements for clinical
competencies as defined by CCNE and AACN using non-traditional experiences for practicing
nurses. These experiences come in the form of direct and indirect care experiences in which
licensed nursing students engage in learning within the context of their hospital organization,
their specific care discipline and their local communities.
This activity is intended to foster demonstration of skills related to leadership and management.
Share your written proposal with your manager, supervisor or other colleague in a formal
leadership position within a health care organization. Request their feedback using the following
questions as prompts:
1.
2.
Do you believe the proposal would be approved if formally proposed?
What are some strengths and weaknesses of the proposal?
_______________________________
_________________
Signature of Individual Providing Feedback
Date Signed
NOTE:
Acknowledgement form is to be returned to the student for electronic submission to the faculty member
via the learning management system (LoudCloud).
What is HIPAA and HITECH and their relevance to the informed consent process? 150 response and 150 opinion response Define Informed Consent. How would you describe informed consent to a client? What does it include? What additional information would need to be in the informed consent when providing distance counseling? Refer to section H.2.a of the ACA Code of Ethics. 150 response and 150 opinion response
For this case study, you will create an engaging, 20-minute recorded presentation on condition management, that encompasses pharmacological and non-pharmacological utilizing evidence-based guidelines within the last five years. Pick one of the following cases:
Sherri is 48-year-old African American female with hypertension on Lisinopril 40mg with reports of the systolic blood pressure consistently over 160 in the last three weeks. Today in the clinic, the patient is 162/90 and she reports taking her medication daily. Her Heart rate is 72, Temperature 98.4, Respirations 16 and Oxygen Saturation 98%. She comes to the office because she has had a sore throat for several days and stuffy nose, which was found to be strep negative. She has no fever or cough. What should you recommend for her sore throat and stuffy nose and why? What precautions should you give her regarding over-the-counter medication because of her medical history and why? Discuss the medications that you will prescribe and/or recommend. Include patient education for the visit, as well. Include diagnostics and work-up, as deemed appropriate for the clinical guidelines.
Hailey, a 32-year-old Hispanic female has a 13-year history of asthma. For the past two-months, she has been using albuterol every day. Previously, she had been using the inhaler every 3 to 4 months. She is in the office for a refill. What further information is needed to treat this patient and why? What is her asthma classification? Which clinical guidelines should you refer to for her medication management and why? Discuss the medications that you will prescribe and/or recommend. Include patient education for the visit, as well. Include diagnostics and work-up, as deemed appropriate for the clinical guidelines.
Shaon is a 41-year-old African American male with a history of hypertension and hypertriglyceridemia. Current medications include: ezetimibe 10 mg daily, niacin SR 1,000 mg at bedtime and HCTZ/lisinopril 25/20 mg daily. He complains of lack of energy, core weight gain, and a decrease in erections. Labs reveal: testosterone 180 ng/dL (193–836 ng/dL) with normal TSH/thyroxine, FSH, LH, and PSA. Is this patient a candidate for testosterone therapy? Why or why not? Which, if any, of his medications are contributing to his symptoms? Discuss the medications that you will prescribe and/or recommend. Include patient education for the visit, as well. Include diagnostics and work-up, as deemed appropriate for the clinical guidelines.
The presentation should include an overview of the health problem identified, an in-depth review of the associated epidemiology, anatomy and physiology, clinical manifestations/symptoms, diagnostics/work-up, and an overview of treatment methodologies, including pharmacological and non-pharmacological management; in addition, include patient education. If your scenario has specific questions. You can use a slide in your presentation to address the questions.
Your presentation should be prepared in PowerPoint and recorded with voice over narration (.PPT or .PPTX file) and in APA Format. The PowerPoint should have a conclusion slide to summarize the points of the presentation, title slide and reference slide. Illustrations should be used. A minimum of 4 scholarly references are required.
Expectations
Format: Microsoft PowerPoint, APA Format
References: A minimum of 4 scholarly references are required.
Please include script in each slides (separate word document with in text-citation)
For this case study, you will create an engaging, 20-minute recorded presentation on condition management, that encompasses pharmacological and non-pharmacological utilizing evidence-based guidelines within the last five years. Pick one of the following cases:
Sherri is 48-year-old African American female with hypertension on Lisinopril 40mg with reports of the systolic blood pressure consistently over 160 in the last three weeks. Today in the clinic, the patient is 162/90 and she reports taking her medication daily. Her Heart rate is 72, Temperature 98.4, Respirations 16 and Oxygen Saturation 98%. She comes to the office because she has had a sore throat for several days and stuffy nose, which was found to be strep negative. She has no fever or cough. What should you recommend for her sore throat and stuffy nose and why? What precautions should you give her regarding over-the-counter medication because of her medical history and why? Discuss the medications that you will prescribe and/or recommend. Include patient education for the visit, as well. Include diagnostics and work-up, as deemed appropriate for the clinical guidelines.
Hailey, a 32-year-old Hispanic female has a 13-year history of asthma. For the past two-months, she has been using albuterol every day. Previously, she had been using the inhaler every 3 to 4 months. She is in the office for a refill. What further information is needed to treat this patient and why? What is her asthma classification? Which clinical guidelines should you refer to for her medication management and why? Discuss the medications that you will prescribe and/or recommend. Include patient education for the visit, as well. Include diagnostics and work-up, as deemed appropriate for the clinical guidelines.
Shaon is a 41-year-old African American male with a history of hypertension and hypertriglyceridemia. Current medications include: ezetimibe 10 mg daily, niacin SR 1,000 mg at bedtime and HCTZ/lisinopril 25/20 mg daily. He complains of lack of energy, core weight gain, and a decrease in erections. Labs reveal: testosterone 180 ng/dL (193–836 ng/dL) with normal TSH/thyroxine, FSH, LH, and PSA. Is this patient a candidate for testosterone therapy? Why or why not? Which, if any, of his medications are contributing to his symptoms? Discuss the medications that you will prescribe and/or recommend. Include patient education for the visit, as well. Include diagnostics and work-up, as deemed appropriate for the clinical guidelines.
The presentation should include an overview of the health problem identified, an in-depth review of the associated epidemiology, anatomy and physiology, clinical manifestations/symptoms, diagnostics/work-up, and an overview of treatment methodologies, including pharmacological and non-pharmacological management; in addition, include patient education. If your scenario has specific questions. You can use a slide in your presentation to address the questions.
Your presentation should be prepared in PowerPoint and recorded with voice over narration (.PPT or .PPTX file) and in APA Format. The PowerPoint should have a conclusion slide to summarize the points of the presentation, title slide and reference slide. Illustrations should be used. A minimum of 4 scholarly references are required.
Expectations
Format: Microsoft PowerPoint, APA Format
References: A minimum of 4 scholarly references are required.
Please include script in each slides (separate word document with in text-citation)
It is important to identify both internal and external stakeholders for your sustainability initiative. It is through identification of and communication with these stakeholders that you will understand what partnerships might benefit the initiative. These can include community leaders, organizations, and even patients, their families, and friends.
The top leadership of your selected organization has requested that you prepare a stakeholder engagement analysis and strategy for your sustainability initiative.
Part I: Stakeholder identification analysis
Prepare a 350- to 400-word identification and analysis of the key internal and external stakeholders essential to your initiative’s success. Include thefollowing:
Identify key internal and external stakeholders who are essential to the success of your initiative. Provide evidence for your choices.
Identify partnerships that can be formed between organizations to foster collaboration or healthy competition. Provide evidence for your choices,
Identify community leaders who can use power and influence to further the initiative on your behalf. Provide evidence for your choices.
Part II: Patient engagement strategy
Develop a 350- to 400-word strategy for how you will engage patients and their friends or family to participate in your initiative (directly or indirectly)III: Promotional media strategy
Develop a 350- to 400-word promotional media strategy and promotional elements for your sustainability initiative that will be used to reach your identified stakeholders. Include the following:
A 90- to 175-word script for a 30- to 60-second online advertisement that promotes your sustainability initiative, advocates for sustainable health care practices, and invites the community to action
A storyboard that outlines the advertisement. Complete the Script and Storyboard Template for this part of the assignment.
Four social media posts in the platform of your choosing that promotes your initiative and invites the community to get involved
CASE 2
A 23-year-old female patient was complaining of joint pain throughout her body. The
patient also presented with a rash on their face. Fluorescent antinuclear antibody
(FANA) testing indicated positive fluorescence with a speckled pattern. Anti-rheumatoid
factor and anti-CCP testing both came back negative for the patient. It was later
confirmed by multiplex fluorescent microbead testing that the patient contained anti-Sm,
anti-DNP and anti-RNP antibodies.
1. Which autoimmune disease the patient most likely have? (1 pt)
2. What type of hypersensitivity can this disease induce? Briefly explain your
answer (2 pts)
3. Which specific HLA allele is commonly associated in patients with this disease?
(1 pt)
4. Could the FANA testing results ALONE be enough to CONFIRM this disease you
answered in question #11? Explain your answer regarding the sensitivity and
specificity of FANA testing. (3 pts)
5. Explain the principle of multiplexed fluorescent microbead (microsphere multiplex
immunoassay (MIA)) test (i.e what is the analyte, how does this assay detect the
analyte). (3 pts)
CASE 1
A 7-year old male was stung by a bee at school during recess. Minutes later he had a hard time
breathing, and presented with rapid swelling of the throat are. They immediately got him to the school
nurse, where his blood pressure was well below normal. The nurse immediately injected a shot of
epinephrine, and symptoms started to subside.
1. What type of hypersensitivity (1,2,3 or 4) BEST describes this case? (1 pt)
2. Which immunoglobulin isotype AND cell are involved in this type of
hypersensitivity? (2 pts)
3. Name 2 compounds (mediators) that are immediately released from Mast cells
that induce this type of hypersensitivity. (2 pts)
4. Indicate 1 compound (mediator) that is synthesized by mast cells during the late
phase of this hypersensitivity reaction. (1 pt)
5. Explain the action mechanism of epinephrine. ( 2 pts)
6. Which 2 WBC’s may be increased during this allergic reaction? (2 pts)
Assignment:HealhyPeople 2020:Environmental Health Investigation
(Group activity)
·Background:
o Students should familiarize themselves with HealthyPeople 2020’s EnvironmentallHealth objectives, which focus on 6 themes: I) outdoor air quality; 2) surface andground water quahity, 3) toxie substances and hazardous wastes; 4) homes andcommunities, 5) infrastructure and surveillance, and 6) global environmental health.Students ean aecess https://www.healihypeople.gov/2020/topiesobjective… for more information.
Instructions:
§ Students should choose one of the HealthyPeople 2020’s Environmental Healththemes to investigate and explore how their community (town, city, county, or state)is aflecied and impacted by this theme, as well as what is being done to address thisenvironmental health theme to safeguard or improve societal and environmentalhealth. Students should search relevant public/governmental agency websites andmedia/newspaper publications to help understand the situation from historieal,present, and future oriented perspectives, The EPA’s My Environment website(https://www3.epa.gov/enviro/myenviro/)may also be helpful.
§ Students should addresses the following:
1. Briefly deseribe the selected environmental health theme.
2.Discuss how the community is affected/impacted by this environmental healththeme.
3.Explore the selected environmental health situation from historical, present,andfuture-oriented perspectives.
4. Discuss any strategies that are planned or have been implemented to address thisenvironmental health theme to safeguard or improve societal and environmentalhealth. Consider the barriers and facihtators for success of these strategies. Proposestrategies if none are found.
5. Consider and address population health concepts such as “social justuce” and “thegreater good.”
§ Student should utilize and appropriately cite relevant public/governmental agencywebsites and media/newspaper publications to substantiate their writing.
§ Students should submit the completed paper as directed by the instructor.
HQS-520: Risk Management and Patient Safty ( 3 assignments):
From the perspective of a learning organization, identify the SMART aim, the Key
Drivers of the initiative you are proposing as a healthcare area as a transformation
project.
Discuss the following
1.
2.
3.
4.
5.
System approach
Resource allocation you identify as important
Identify the executive sponsor
Identify the stakeholders and steering committee members
Environment for local team leaders to collaborate, and 6) governance of the
metrics.
6. The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
•
•
•
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing
standards
Provide support for your statements with in-text citations from a minimum of four
scholarly articles. Two of these sources may be from the class readings, textbook,
or lectures, but the other two must be external. The Saudi Digital Library is a
good place to find these references.
HQS-525: Technology and Health Informat (3 assignments)
Research a peer-reviewed article in the SEU library regarding workflow analysis in
healthcare. Discuss the following aspects:
•
•
•
•
•
•
Strengths
Weaknesses
Opportunities
Threats
Risks that are identified in the workflow described.
What changes are recommended and provide additional recommendations you
would make to improve the efficiency and effectiveness of this process.
Your paper should meet the following structural requirements:
•
•
•
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing
standards
Provide support for your statements with in-text citations from a minimum of four
scholarly articles. Two of these sources may be from the class readings, textbook,
or lectures, but the other two must be external. The Saudi Digital Library is a
good place to find these references.
HQS-530: Human Factors and Ergonomics (2 assignments)
The Ergonomic Challenge in Healthcare
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and
healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
•
•
•
•
Background facts about the Ergonomic challenge including incidence and
prevalence
The impact of the Ergonomic challenge on the Healthcare worker
The impact of the Ergonomic challenge on the patient
Your recommendations to improve this Ergonomic challenge based on evidence
from the literature
Your paper should meet the following structural requirements:
•
•
•
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing
standards
Provide support for your statements with in-text citations from a minimum of four
scholarly articles. Two of these sources may be from the class readings, textbook,
or lectures, but the other two must be external. The Saudi Digital Library is a
good place to find these references.
EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
Generate strategies to form strategic alliances with internal and external stakeholders in the health care industry.
Reflection
Reflect on the following in a minimum of 350 words:
Who are the stakeholders at your organization in relation to your role, and why?
What metrics or strategies should you use to determine which stakeholders are most useful to engage with?
What strategies are most effective when interacting with stakeholders?
Submit your reflection.
Competency 2
Synthesize health sector best practice in facilitation and negotiation.
Reflection
What strategies would you use to develop professional relationships?
Under what conditions would you sever a networking relationship? Explain your answer. How would you handle any possible ramifications of this action?
Cite any sources to support your assignment.
Format your citations according to APA guidelines.
Competency 3
Analyze the connection between personal professional development and relationships with others.
Reflection
Read the following articles:
“What’s your Leadership Signature?” from Heidrick and Struggles
“The Leadership Continuum” from Mind Tools in the University Library.
Then take the My Leadership Style questionnaire from Mind Tools in the University Library to acquire feedback about your top 3 leadership styles.
Reflect on the following in a minimum of 500 words:
Your top 3 leadership styles
Potential blind spots of your personality that you were not aware influenced your leadership style
How your personality typology makes you a better leader
Organizational environments in which you are likely to thrive and struggle
SMART goals that focus on self-improvement
What leadership skills you possess to make you an effective facilitator and negotiator in the workplace
Future leadership skills that you may not currently possess to make you an effective facilitator and negotiator in the workplace
Cite any sources that support your assignment.
Format your citations according to APA guidelines.
Florida National University
NUR3805
Course Reflection
Guidelines
PURPOSE
The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN
competencies acquired through the NUR3805 course.
COURSE OUTCOMES
This assignment provides documentation of student ability to meet the following course outcomes:
–
–
–
The students will be able to identify the evolution and history of the nursing profession (ACCN
Essential I, II, V, VII; QSEN: safety, evidence-based practice, teamwork and collaboration, and
patient centered care).
The student will identify the scope of the nursing practice (ACCN Essential I, II, V, VII; QSEN: safety,
evidence-based practice, teamwork and collaboration, and patient centered care).
The student will identify the importance of the evidence-based practice in the nursing profession and
its impact on the healthcare guidelines (ACCN Essential I, II, V, VII; QSEN: safety, evidence-based
practice, teamwork and collaboration, and patient centered care).
The student will be able to identify the different roles in the nursing profession (ACCN Essential I, II,
V, VII; QSEN: safety, evidence-based practice, teamwork and collaboration, and patient centered
care).
POINTS
This assignment is worth a total of 100 points (10%).
DUE DATE
Submit your completed assignment under the Assignment tab by Sunday 11:59 p.m. EST of Week 7 as
directed.
REQUIREMENTS
1. The Course Reflection is worth 100 points (10%) and will be graded on quality of selfassessment, use of citations, use of Standard English grammar, sentence structure, and overall
organization based on the required components as summarized in the directions and grading
criteria/rubric.
2. Follow the directions and grading criteria closely. Any questions about your essay may be posted
under the Q & A forum under the Discussions tab.
3. The length of the reflection is to be within three to six pages excluding title page and
reference pages.
4. APA format is required with both a title page and reference page. Use the required components
of the review as Level 1 headers (upper and lower case, centered):
Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with
the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).
a. Course Reflection
b. Conclusion
PREPARING YOUR REFLECTION
The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for
the BSN-prepared nurse. Reflect on the NUR3805 course readings, discussion threads, and applications
you have completed across this course and write a reflective essay regarding the extent to which you feel
you are now prepared to: Only use three goals to reflect in your paper
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1. “Demonstrate skills in using patient care technologies, information systems, and communication devices
that support safe nursing practice.
2. Use telecommunication technologies to assist in effective communication in a variety of
healthcare settings.
3. Apply safeguards and decision-making support tools embedded in patient care technologies
and information systems to support a safe practice environment for both patients and healthcare workers.
4. Understand the use of CIS systems to document interventions related to
achieving nurse sensitive outcomes.
5. Use standardized terminology in a care environment that reflects nursing’s unique contribution to patient
outcomes.
6. Evaluate data from all relevant sources, including technology, to inform the delivery of care.
7. Recognize the role of information technology in improving patient care outcomes
and creating a safe care environment.
8. Uphold ethical standards related to data security, regulatory requirements, confidentiality, and clients’
right to privacy.
9. Apply patientcare technologies as appropriate to address the needs of a diverse patient population.
10. Advocate for the use of new patient care technologies for safe, quality care.
11. Recognize that redesign of workflow and care processes should precede implementation of
care technology to facilitate nursing practice.
12. Participate in evaluation of information systems in practice settings through
policy and procedure development.
13. Conduct comprehensive and focused physical, behavioral, psychological, spiritual,
socioeconomic, and environmental assessments of health and illness parameters in patients,
using developmentally and culturally appropriate approaches.
14. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics,
prognostics, selection of treatment, and monitoring of treatment effectiveness,
using a constructed pedigree from collected family history information as well as standardized symbols
and terminology.
15. Implement holistic, patient centered care that reflects an understanding of human growth
and development, pathophysiology, pharmacology, medical management,
and nursing management across the health illness continuum, across the lifespan, and in all
healthcare settings.
16. Communicate effectively with all members of the healthcare team, including the patient and the patient’s
support network.
17. Deliver compassionate, patient centered, evidence-based care that respects patient and family
preferences.
18. Implement patient and family care around resolution of end of life and palliative care issues, such as
symptom management, support of rituals, and respect for patient and family preferences.
19. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient
preferences, and health literacy considerations to foster patient engagement in their care.
20. Implement evidence-based nursing interventions as appropriate for
managing the acute and chronic care of patients and promoting health across the lifespan.
21. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions.
22. Facilitate patient centered transitions of care, including discharge planning and ensuring the caregiver’s
knowledge of care requirements to promote safe care.
23. Provide nursing care based on evidence that contributes to safe and high-quality patient outcomes within
healthcare microsystems.
24. Create a safe care environment that results in high quality patient outcomes.
25. Revise the plan of care based on an ongoing evaluation of patient outcomes.
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26. Demonstrate clinical judgment and accountability for patient outcomes
when delegating to and supervising other members of the healthcare team.
27. Manage care to maximize health, independence, and quality of life for a group of individuals that
approximates a beginning practitioner’s workload
28. Demonstrate the application of psychomotor skills for the efficient, safe, and compassionate delivery of
patient care.
29. Develop a beginning understanding of complementary and alternative modalities and their role in health
care.
30. Develop an awareness of patients as well as healthcare professionals’ spiritual beliefs and values
and how those beliefs and values impact health care.
31. Manage the interaction of multiple functional problems affecting patients across the lifespan,
including common geriatric syndromes.
32. Understand one’s role and participation in emergency preparedness and disaster response with an
awareness of environmental factors and the risks they pose to self and patients
33. Engage in caring and healing techniques that promote a therapeutic nurse patient relationship.
34. Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on
the healthcare system as related to nursing practice.” (pp. 18-19, 31-32).
Reference:
American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education
for professional nursing practice. Washington, DC: Author.
DIRECTIONS AND GRADING CRITERIA
Category
Points
%
Description
(Introduction
– see note
under
requirement
#4 above)
8
8
Introduces the purpose of the reflection and addresses BSN Essentials
(AACN, 2008) pertinent to healthcare policy and advocacy.
You Decide
Reflection
80
80
Include a self-assessment regarding learning that you believe
represents your skills, knowledge, and integrative abilities to meet the
pertinent BSN Essential and sub-competencies (AACN, 2008) as a
result of active learning throughout this course. Be sure to use
examples from selected readings, threaded discussions, and/or
applications to support your assertions to address each of the following
sub-competencies:
(a) “Demonstrate skills in using patient care technologies,
information systems, and communication devices that support
safe nursing practice.
(b) Use telecommunication technologies to assist in
effective communication in a variety of healthcare settings.
(c) Apply safeguards and decision-making support tools
embedded in patient care technologies and information
systems to support a safe practice environment for
both patients and healthcare workers.
(d) Understand the use of CIS systems to document interventions
related to achieving nurse sensitive outcomes.
(e) Use standardized terminology in a care environment that
reflects nursing’s unique contribution to patient outcomes.
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(f) Evaluate data from all relevant sources, including technology,
to inform the delivery of care.
(g) Recognize the role of information technology in
improving patient care outcomes
and creating a safe care environment.
(h) Uphold ethical standards related to data security, regulatory
requirements, confidentiality, and clients’ right to privacy.
(i) Apply patientcare technologies as appropriate to address
the needs of a diverse patient population.
(j) Advocate for the use of new patient care technologies for safe,
quality care.
(k) Recognize that redesign of workflow and care processes
should precede implementation of care technology
to facilitate nursing practice.
(l) Participate in evaluation of information systems in practice
settings through policy and procedure development.
(m) Conduct comprehensive and focused physical, behavioral,
psychological, spiritual, socioeconomic, and environmental
assessments of health and illness parameters in patients,
using developmentally and culturally appropriate approaches.
(n) Recognize the relationship of genetics and genomics to health,
prevention, screening, diagnostics, prognostics, selection of
treatment, and monitoring of treatment effectiveness,
using a constructed pedigree from collected family history
information as well as standardized symbols and terminology.
(o) Implement holistic, patient centered care that reflects an
understanding of human growth and development,
pathophysiology, pharmacology, medical management,
and nursing management across the health illness continuum,
across the lifespan, and in all healthcare settings.
(p) Communicate effectively with all members of
the healthcare team, including the patient and the patient’s
support network.
(q) Deliver compassionate, patient centered, evidencebased care that respects patient and family preferences.
(r) Implement patient and family care around resolution of end of
life and palliative care issues, such as symptom management,
support of rituals, and respect for patient and family
preferences.
(s) Provide appropriate patient teaching that reflects
developmental stage, age, culture, spirituality, patient
preferences, and health literacy considerations to foster patient
engagement in their care.
(t) Implement evidence-based nursing interventions as
appropriate for managing the acute and chronic care of
patients and promoting health across the lifespan.
(u) Monitor client outcomes to evaluate the effectiveness of
psychobiological interventions.
(v) Facilitate patient centered transitions of
care, including discharge planning and ensuring the caregiver’s
knowledge of care requirements to promote safe care.
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(w) Provide nursing care based on evidence that contributes
to safe and high-quality patient outcomes within
healthcare microsystems.
(x) Create a safe care environment that results in high quality
patient outcomes.
(y) Revise the plan of care based on an ongoing evaluation of
patient outcomes.
(z) Demonstrate clinical judgment and accountability for patient
outcomes when delegating to and supervising other members
of the healthcare team.
(aa) Develop a beginning understanding of complementary
and alternative modalities and their role in health care.
(bb) Develop an awareness of patients as well as
healthcare professionals’ spiritual beliefs and values
and how those beliefs and values impact health care.
(cc) Manage the interaction of multiple functional problems
affecting patients across the lifespan, including common
geriatric syndromes.
(dd) Understand one’s role and participation in emergency
preparedness and disaster response with an awareness of
environmental factors and the risks they pose to self
and patients
(ee) Engage in caring and healing techniques that promote a
therapeutic nurse patient relationship.
(ff) Demonstrate tolerance for the ambiguity and unpredictability of
the world and its effect on the healthcare system as related to
nursing practice.” (pp. 18-19, 31-32).
Conclusion
4
4
An effective conclusion identifies the main ideas and major conclusions
from the body of your essay. Minor details are left out. Summarize the
benefits of the pertinent BSN Essential and sub-competencies (AACN,
2008) pertaining to scholarship for evidence-based practice.
Clarity of
writing
6
6
Use of standard English grammar and sentence structure. No spelling
errors or typographical errors. Organized around the required
components using appropriate headers. Writing should demonstrate
original thought without an over-reliance on the works of others.
APA format
2
2
All information taken from another source, even if summarized, must
be appropriately cited in the manuscript and listed in the references
using APA (6th ed.) format:
1. Document setup
2. Title and reference pages
3. Citations in the text and references.
100
100
A quality essay will meet or exceed all of the above requirements.
Total:
GRADING RUBRIC
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Assignment
Criteria
Meets Criteria
Partially Meets Criteria
Does Not Meet Criteria
(Introduction –
see note under
requirement #4
above)
Short introduction of
selected BSN subcompetencies (AACN,
2008) pertinent to
scholarship for evidencebased practice. Rationale
is well presented, and
purpose fully developed.
Basic understanding
and/or limited use of
original explanation and/or
inappropriate emphasis on
an area.
Little or very general
introduction of selected
BSN sub-competencies
(AACN, 2008). Little to no
original explanation;
inappropriate emphasis on
an area.
(8 pts)
7 – 8 points
5 – 6 points
0 – 4 points
You Decide
Reflection
Excellent self-assessment
of skills, knowledge, and
integrative abilities
pertinent to healthcare
policy and advocacy.
Reflection on pertinent
BSN sub-competencies
(AACN, 2008) supported
with examples.
Basic self-assessment of
skills, knowledge, and
integrative abilities
pertinent to healthcare
policy and advocacy.
Reflection on pertinent
BSN sub-competencies
(AACN, 2008) not
supported with examples.
Little or very general selfassessment of skills,
knowledge, and
integrative abilities
pertinent to healthcare
policy and advocacy. Little
or no reflection on
pertinent BSN subcompetencies (AACN,
2008) or reflection not
supported with examples.
(80 pts)
70 – 80 points
59 – 69 points
0 – 58 points
Conclusion
Excellent understanding of
pertinent BSN subcompetencies (AACN,
2008). Conclusions are
well evidenced and fully
developed.
Basic understanding
and/or limited use of
original explanation and/or
inappropriate emphasis on
an area.
Little understanding of
pertinent BSN subcompetencies (AACN,
2008). Little to no original
explanation; inappropriate
emphasis on an area.
(4 pts)
3 – 4 points
Clarity of writing
Excellent use of standard
English showing original
thought with minimal
reliance on the works of
others. No spelling or
grammar errors. Well
organized with proper flow
of meaning.
Some evidence of own
expression and competent
use of language. No more
than three spelling or
grammar errors. Well
organized thoughts and
concepts.
Language needs
development or there is
an over-reliance on the
works of others. Four or
more spelling and/or
grammar errors. Poorly
organized thoughts and
concepts.
(6 pts)
5 – 6 points
3 – 4 points
0 – 2 points
APA format
APA format correct with
no more than 1-2 minor
errors.
3-5 errors in APA format
and/or 1-2 citations are
missing.
APA formatting contains
multiple errors and/or
several citations are
missing.
(2 pts)
2 points
1 point
0 points
2 points
0 – 1 point
Total Points Possible = 100 points
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To complete the Case 1 clinical assignment follow these steps:
Go to the following website: https://games.de.torontomu.ca/hospital/
Select “Enter”
You are now in the virtual hospital. Please select “Pediatrics”.
There are TWO scenarios here. You need to complete scenario “1”. To go to this scenario click on the “1” at the bottom of the screen.
You are now at the starting page for the “Pediatric Patient with an Acute Injury and Post-operative Event”. You should see the summary for a 17 year old young man who has had a surgical repair of a lacerated liver. Click on “Play Game”.
You are now on the scenario menu page. You should do the following BEFORE starting a new game:
Review the learning objectives (what you should learn from this scenario) by clicking on “Learning Objectives”. Click on “Close” when you are done reading these.
Review how this scenario process works by clicking on “How to Play”. Click on “Close” when you are done reading the instructions.
Click on “New Game” to begin the scenario.
You will work through multiple videos and questions that ask you what to do next at many points throughout the scenario. If you make an error you will be brought back to the question last asked to allow you to think about your clinical reasoning and prioritization. Please select a different option. Keep going until you complete the scenario.
Once you complete the scenario you should click on the Contents menu button at the top of the end page on the left-hand side.
Click on the link for “Reflection Questions.” Copy and paste these seven (7) questions into a Word document. Answer ALL of the questions on this document. Save the document with YOUR name.
Develop a plan of care for this client at the end the Word document saved in step 10 above. Upload your reflection questions answers and plan of care to the same drop box. Remember that your plan of care MUST meet the needs of both the patient and the family. Remember to prioritize your nursing diagnoses.
Upload the document for completion of this alternative clinical assignment, due not later tha
To review the Pre-Predictor Exam Summary Report: APEA OTC.
Expand all categories by clicking “Expand All” to see all categories under the topic areas.
Create a Word Document with headings that correlate with the missed Knowledge Area, Question Topic, and Domain on the Pre-Predictor Exam Summary Report. (See Diagram 1 below).
Use resources such as your textbook, or a reputable standard of care website, such as the American College of Cardiology, etc. to remediate. Summarize the missed content topic in 2-3 paragraphs and include a hyperlink to the reference.
All missed questions must be addressed to earn all points.
Summarize the missed content topic in 2-3 paragraphs and include a hyperlink to the reference.
She also posted the following announcement
You are required to address each section missed with 2-3 paragraphs of no less than 6 sentences per paragraph.
You must address every section missed even if it is a duplicate (each section requires its own 2-3 paragraphs with a minimum of 6 sentences in each paragraph). EX: You missed AP skills for depression four times. You would need to write about AP Skills four different times (each in a different section with at least 2-3 paragraphs in each section.)
We need to address every section missed. There are times when the report is not very specific and will note that you have missed a certain section multiple times. For instance, you missed depression assessment four times. You must create four sections and target this area at a different angle for each section. So you could speak about depression assessment from the PHNP for the first section, the next section you could speak about depression assessment in primary care environment, and then depression assessment in public schools. So each area must be addressed. Also, be sure that each paragraph has at least 6 sentences.
Wk 5 – Summative Assessment: The Smooth Muscle Lab Report [due Mon]Exam ContentThe final step for this assessment is to complete the lab report. As you work through the lab, compile the pieces of your report. To make the experience more interesting, complete the Hypothesis section prior to diving into the lab. When you are satisfied with your report, please complete it, and submit your lab report. ResourcesCenter for Writing ExcellenceReference and Citation GeneratorGrammar Assistance
Unformatted Attachment Preview
BIO/290 v3
Lab Reporting Worksheet – The Smooth
Muscle Lab
In science, reporting what has been done in a laboratory setting is incredibly important for
communicating, replicating, and validating findings. However, writing scientific reports can be a little
overwhelming. There are a set of agreed upon components that the scientific community requires when
reporting scientific experimentation. Answer the following questions to describe what occurred during the
lab you conducted in Labster. Be sure to use complete sentences and descriptions that fully represent
what you experienced. Writing a lab report is less about being correct or incorrect, than it is accurately
reporting what happened and why. So, do not worry about reporting data that might seem counterintuitive
or unexpected. Focus on clearly communicating what you did and what you observed.
TITLE:
What was the title of the lab you completed?
Click or tap here to enter text.
PROBLEM:
What was the problem you were trying to resolve in the Lab?
Click or tap here to enter text.
HYPOTHESIS:
What information from the textbook and classroom is relevant for the problem you were trying to resolve
in the lab? Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
During the lab, what information from the THEORY section provided additional background information
about the problem? (To review the theory section, launch the Lab and click the “Theory” tab on the top of
the data pad). Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
Most scientific experimentation involves examining variables and their relationships. A variable is a
construct that can be changed and studied. Examples of variables are a condition or measurable quantity.
What are the variables you examined in the lab? Which one were you controlling and changing? Which
one were you observing was impacted by your change?
Click or tap here to enter text.
Developing a hypothesis requires understanding relevant background knowledge. Now that you have
described relevant background information, it is time to develop a hypothesis. A hypothesis is a simple
statement (not a question), grounded in previous research, that predicts the relationship between the
variables being studied. Please make a statement that predicts the relationship between the variables
being studied.
Click or tap here to enter text.
Copyright 2021 by University of Phoenix. All rights reserved.
The Smooth Muscle Lab
BIO/290 v3
Page 2 of 3
METHOD:
Describing what you did during a lab supports other scientists in replicating your work. It is through this
consistent replication that scientists are able to see repeating patterns and develop ideas that help move
science forward. When you discuss your data, in a later section, you will have to describe what choices
you made, why you made them, and any concerns about things that occurred that were unexpected. In
order to have enough information to do this, you need to keep very detailed notes. What doesn’t seem
important in the moment may end up being something that explains your findings later. A benefit of
conducting virtual labs when learning science, is that many potential errors are controlled for you. The
virtual lab environment often will alert you if something is not going the way it should. This does not occur
non-virtual settings. The virtual lab setting can be very helpful to learners for this reason. However, we still
have to practice documenting so that those skills are practiced for the lab experiences when technology
will not be there as a coach.
You have already, identify the variables that you studied in the lab in the previous section. Now, take
some time to fully define and describe what each variable is and how it was changed throughout the lab.
Click or tap here to enter text.
In 3-5 sentences summarize what you did during the lab not including your process of logging into the
system. This section would be much more robust for a non-virtual lab. For this virtual lab, a short, highlevel summary will suffice.
Click or tap here to enter text.
Describe some of the observations you made. What numbers did you write down or keep track of? What
did each of your senses observe during the lab process? What did you see (ex: changes in colors,
movement, shapes, sizes, patterns)? What did you hear (ex: sounds from reactions, collisions, error
messages)? What did you lab character touch? Did you notice anything that seemed unexpected? Did
you notice anything that you did expect to observe?
Click or tap here to enter text.
Which parts of the lab required you to think more than others and required more time? Which parts were
simple and completed easily?
Click or tap here to enter text.
DATA & RESULTS:
Many lessons learned as a result of scientific experiment come from the reporting and analysis of data.
This part of scientific reporting requires detailed descriptions of technical information and quantities as
well as high-level synthesis of information. High-level synthesis requires a mastery of foundational
content in the related scientific field and a complimentary mastery in some field of quantitative and/or
qualitative analysis. For this report, let’s focus on big picture patterns.
What relationships did you notice between the variables you examined? When you changed the
variable(s), how did the other(s) change?
Click or tap here to enter text.
Did you notice any patterns in your data? Any patterns between the variables?
Click or tap here to enter text.
DISCUSSION:
The discussion section is used to explain why things might have happened the way that they did in your
experiment. Here, scientists describe any potential anomalies or mistakes and why they think they may
have occurred.
Copyright 2021 by University of Phoenix. All rights reserved.
The Smooth Muscle Lab
BIO/290 v3
Page 3 of 3
During your lab, what happened that might have impacted the accuracy of your data? Did the simulation
alert you that an error was occurring? If so, how did you resolve it?
Click or tap here to enter text.
CONCLUSION:
The conclusion section of a lab report describes how the learnings from the lab experimentation fit in to
prior scientific knowledge. This is done by comparing new information to previously known information
that was identified in the section of your report that discusses background information.
Review the hypothesis section of your report from above and describe how the results of your lab
compare to the background information that you discussed before.
Click or tap here to enter text.
Once scientists have identified how the new knowledge fits into the old knowledge, they discuss the
implications of the new information for moving forward. In this class, the purpose of study is to learn some
foundational science ideas represented by the course student learning outcomes. Review the course
student learning outcome aligned to this lab in the assignment directions in Blackboard. How is the
information from this lab related to the course student learning outcome? What knowledge has the lab
supported you with learning that is related to this course student learning outcome?
Click or tap here to enter text.
Following scientific experimentation, scientists usually come up with new questions that result from what
they learned. These new questions often end up leading to new experiments in the future. What
additional scientific things do you wonder about after completing and writing about your lab experience?
Click or tap here to enter text.
Copyright 2021 by University of Phoenix. All rights reserved.
Activity 8: In this activity, you will perform a comparative value-risk analysis of the two alternatives, using Template 8 (IT Investment Assessment Rating Form). The template is in the reading from IT Economic Corp. titled Comparative Analysis of Acquisition Alternatives. It is available in the reference list.Use the criteria categories and weights provided in the template to rate your two alternative solutions. Based on the results of your assessments, select the best alternative. In other words, you conclude that it is the best solution to the performance problem because it has the best balance of value and risk for your organization.The due date for posting your completed Activity 8 in your Assignments Folder is the end date of Week 7.Please post your final Activity 8 to this link.T8-Analysis Alternatives.pdf
Mann, T, Tomiyama, AJ, Ward, A. (2015). Promoting Public Health in the Context of the “Obesity Epidemic”: False Starts and Promising New Directions. Perspect Psychol Sci, 10(6):706-10. READ ARTICLE AND COME UP WITH 3 DISCUSSION QUESTIONS REGARDING THE ARTICLE
Florida National University
NUR3165
Course Reflection
Guidelines
PURPOSE
The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN
competencies acquired through the NUR3165 course.
COURSE OUTCOMES
This assignment provides documentation of student ability to meet the following course outcomes:
–
The student will be able to produce a complete research paper.
The student will identify the research methods, sources and application in nursing practice.
POINTS
This assignment is worth a total of 100 points (10%).
DUE DATE
Submit your completed assignment under the Assignment tab by Sunday 11:59 p.m. EST of Week 15 as
directed.
REQUIREMENTS
1. The Course Reflection is worth 100 points (10%) and will be graded on quality of selfassessment, use of citations, use of Standard English grammar, sentence structure, and overall
organization based on the required components as summarized in the directions and grading
criteria/rubric.
2. Follow the directions and grading criteria closely. Any questions about your essay may be posted
under the Q & A forum under the Discussions tab.
3. The length of the reflection is to be within three to six pages excluding title page and
reference pages.
4. APA format is required with both a title page and reference page. Use the required components
of the review as Level 1 headers (upper and lower case, centered):
Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with
the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).
a. Course Reflection
b. Conclusion
PREPARING YOUR REFLECTION
The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for
the BSN-prepared nurse. Reflect on the NUR3165 course readings, discussion threads, and applications
you have completed across this course and write a reflective essay regarding the extent to which you feel
you are now prepared to:
1. “Explain the interrelationships among theory, practice, and research.
2. Demonstrate an understanding of the basic elements of the research process and models for
applying evidence to clinical practice.
3. Advocate for the protection of human subjects in the conduct of research.
4. Evaluate the credibility of sources of information, including but not limited to databases and Internet
resources.
5. Participate in the process of retrieval, appraisal, and synthesis of evidence in collaboration with
other members of the healthcare team to improve patient outcomes.
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6. Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in
planning, implementing, and evaluating outcomes of care.
7. Collaborate in the collection, documentation, and dissemination of evidence.
8. Acquire an understanding of the process for how nursing and related healthcare quality and safety
measures are developed, validated, and endorsed.
9. Describe mechanisms to resolve identified practice discrepancies between identified standards
and practice that may adversely impact patient outcomes.” (p. 16).
Reference:
American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education
for professional nursing practice. Washington, DC: Author.
DIRECTIONS AND GRADING CRITERIA
Category
Points
%
Description
(Introduction –
see note
under
requirement
#4 above)
8
8
Introduces the purpose of the reflection and addresses BSN
Essentials (AACN, 2008) pertinent to healthcare policy and
advocacy.
You Decide
Reflection
80
80
Include a self-assessment regarding learning that you believe
represents your skills, knowledge, and integrative abilities to meet
the pertinent BSN Essential and sub-competencies (AACN, 2008)
as a result of active learning throughout this course. Be sure to use
examples from selected readings, threaded discussions, and/or
applications to support your assertions to address each of the
following sub-competencies:
(a) “Explain the interrelationships among theory, practice,
and research.
(b) Demonstrate an understanding of the basic elements of
the research process and models for applying evidence
to clinical practice.
(c) Advocate for the protection of human subjects in
the conduct of research.
(d) Evaluate the credibility of sources of information,
including but not limited to databases and Internet
resources.
(e) Participate in the process of retrieval, appraisal,
and synthesis of evidence in collaboration with
other members of the healthcare team to improve patient
outcomes.
(f) Integrate evidence, clinical judgment, interprofessional
perspectives, and patient preferences in planning,
implementing, and evaluating outcomes of care.
(g) Collaborate in the collection, documentation,
and dissemination of evidence.
(h) Acquire an understanding of the process for
how nursing and related healthcare quality and safety
measures are developed, validated, and endorsed.
(i) Describe mechanisms to resolve identified practice
discrepancies between identified standards and practice
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NUR3165
that may adversely impact patient outcomes.” (AACN,
2008, p. 16).
An effective conclusion identifies the main ideas and major
conclusions from the body of your essay. Minor details are left out.
Summarize the benefits of the pertinent BSN Essential and subcompetencies (AACN, 2008) pertaining to scholarship for evidencebased practice.
Conclusion
4
4
Clarity of
writing
6
6
Use of standard English grammar and sentence structure. No
spelling errors or typographical errors. Organized around the
required components using appropriate headers. Writing should
demonstrate original thought without an over-reliance on the works
of others.
APA format
2
2
All information taken from another source, even if summarized,
must be appropriately cited in the manuscript and listed in the
references using APA (6th ed.) format:
1. Document setup
2. Title and reference pages
3. Citations in the text and references.
Total:
100
100
A quality essay will meet or exceed all of the above requirements.
GRADING RUBRIC
Assignment
Criteria
Meets Criteria
Partially Meets Criteria
Does Not Meet Criteria
(Introduction –
see note under
requirement #4
above)
Short introduction of
selected BSN subcompetencies (AACN,
2008) pertinent to
scholarship for evidencebased practice. Rationale
is well presented, and
purpose fully developed.
Basic understanding
and/or limited use of
original explanation and/or
inappropriate emphasis on
an area.
Little or very general
introduction of selected
BSN sub-competencies
(AACN, 2008). Little to no
original explanation;
inappropriate emphasis on
an area.
(8 pts)
7 – 8 points
5 – 6 points
0 – 4 points
You Decide
Reflection
Excellent self-assessment
of skills, knowledge, and
integrative abilities
pertinent to healthcare
policy and advocacy.
Reflection on pertinent
BSN sub-competencies
(AACN, 2008) supported
with examples.
Basic self-assessment of
skills, knowledge, and
integrative abilities
pertinent to healthcare
policy and advocacy.
Reflection on pertinent
BSN sub-competencies
(AACN, 2008) not
supported with examples.
Little or very general selfassessment of skills,
knowledge, and
integrative abilities
pertinent to healthcare
policy and advocacy. Little
or no reflection on
pertinent BSN subcompetencies (AACN,
2008) or reflection not
supported with examples.
(80 pts)
70 – 80 points
59 – 69 points
0 – 58 points
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NUR3165
Conclusion
Excellent understanding of
pertinent BSN subcompetencies (AACN,
2008). Conclusions are
well evidenced and fully
developed.
Basic understanding
and/or limited use of
original explanation and/or
inappropriate emphasis on
an area.
Little understanding of
pertinent BSN subcompetencies (AACN,
2008). Little to no original
explanation; inappropriate
emphasis on an area.
(4 pts)
3 – 4 points
Clarity of writing
Excellent use of standard
English showing original
thought with minimal
reliance on the works of
others. No spelling or
grammar errors. Well
organized with proper flow
of meaning.
Some evidence of own
expression and competent
use of language. No more
than three spelling or
grammar errors. Well
organized thoughts and
concepts.
Language needs
development or there is
an over-reliance on the
works of others. Four or
more spelling and/or
grammar errors. Poorly
organized thoughts and
concepts.
(6 pts)
5 – 6 points
3 – 4 points
0 – 2 points
APA format
APA format correct with
no more than 1-2 minor
errors.
3-5 errors in APA format
and/or 1-2 citations are
missing.
APA formatting contains
multiple errors and/or
several citations are
missing.
(2 pts)
2 points
1 point
0 points
2 points
0 – 1 point
Total Points Possible = 100 points
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In your healthcare career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then, you can analyze the problem and the people and systems it affects. You can also examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem.
First review the assessment Scoring Guide. This will make organization and content a much more comprehensive process. This is the rubric that is used to review the submission. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.
Write a 4–6-page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.
Instructions
Describe the healthcare problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it.
Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
Identify possible causes for the problem or issue.
Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
You may find the How Do I Find Peer Reviewed Articles?Links to an external site. library guide helpful in locating appropriate references.
You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
You may find the applicable Undergraduate Library Research Guide helpful in your search. Review the Think Critically About Source Quality to help you complete the following:
Assess the credibility of the information sources.
Assess the relevance of the information sources.
Analyze the health care problem or issue.
Describe the setting or context for the problem or issue.
Describe why the problem or issue is important to you.
Identify groups of people affected by the problem or issue.
Provide examples that support your analysis of the problem or issue.
Discuss potential solutions for the health care problem or issue.
Describe what would be required to implement a solution.
Describe the potential consequences of ignoring the problem or issue.
Provide the pros and cons of one of the solutions you are proposing.
Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
Describe what would be necessary to implement the proposed solution.
Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented
Review the humanistic-existential psychotherapy videos in this week’s Learning Resources.Reflect on humanistic-existential psychotherapeutic approaches.Then, select another psychotherapeutic approach to compare with humanistic-existential psychotherapy. The approach you choose may be one you previously explored in the course or one you are familiar with and especially interested in.
I want you to pick any clinical quality problem and apply either an experimental or quasi-experimental design for quality improvement. Which design would you use and why? What are the strengths and weakness of this chosen design method? (Make sure when you answer, you tell me what quality problem you are trying to improve –CAUTI, CLABSI, FALL’s, are some examples)
Q2- Nowadays, obesity has become a serious health problem among university students. What are the factors that
contribute to obesity among university students? In your opinion what is the best strategies to reduce or prevent obesity among university students
:Instructions for Completing the Discussion Questions
Please post your original response by Wednesday at •
11:59 pm. Your response should be a minimum of five sentences but should not exceed 250 words.
Appropriately cite any of the references that you use to fully answer the questions
Respond to at least one of your classmates
Q3-Is 3D Printing Technologies necessary in healthcare? Give some examples of this technology in the healthcare industry?
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 5
Course name:
HCM
Course number:
101
CRN
•
•
Assignment title or task:
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
College of Health Sciences
Department of Public Health
Guidelines:
•
•
•
•
•
•
•
Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
Hi there, I need help writing a nursing portfolio. Attached are two documents: one is the NMBA standards, and the other one is the document to work on. Please avoid using AI since I will be run through an AI detector.
The instructions are in the word document.
You can make up the reflections and the scenarios; just take into account that I am a student registered nurse and my placements were:
surgical ward placement- surgical abdominal where I Shadowed experienced nurses to acquire new skills. Finished a 4-week clinical placement where I administered oral, IV, and intramuscular medications under supervision, while also monitoring patient responses. Utilized the nursing process to evaluate the needs of patients and families. Maintained accurate documentation of patient care, treatments, procedures, and observations in medical records. Engaged in evidence-based practice projects, nursing competency development, and nursing simulation activities. Kept a close watch on patient vital signs and promptly reported any changes to experienced nursing staff.
Acute ward placement – Infectious diseases
Worked alongside experienced nursing professionals to learn new procedures. Completed 6 weeks of clinical placement. Under supervision, administered medications via oral, IV, and intramuscular injections and monitored responses. Assessed care needs of patients and families utilising nursing process. Utilised Electronic Medical Records (EMR) systems to record patient data. Monitored patient vital signs, reporting any changes to experienced nursing staff. Practice proper hygiene and infection control measures to protect both themselves and their patients. Perform head-to-toe assessments and focused assessments.
Mental health placement. I performed mental health examinations on patients with OCD, depression and bipolar disorder. Writing their notes and administering medications.
Unformatted Attachment Preview
1
Table of Contents
Professional Portfolio ……………………………………………………………………………………………………………. 2
Professional Nursing Portfolio of ………. ………………………………………………………………………………… 2
My Philosophy (approximately 500-700 words) …………………………………………………………………….. 2
Portfolio Purpose ……………………………………………………………………………………………………………….. 2
Standard Element or Competency Domain ……………………………………………………………………………. 2
Appendices …………………………………………………………………………………………………………………………… 5
Appendix 1: Curriculum Vitae ……………………………………………………………………………………………… 5
Appendix 2: *Give the appendix an appropriate name* ……………………………………………………….. 5
Appendix 3: *Give the appendix an appropriate name* ……………………………………………………….. 6
Appendix 4: *Give the appendix an appropriate name* ………………………………………………………. 6
Appendix 5: *Give the appendix an appropriate name* ………………………………………………………. 7
Appendix 6: *Give the appendix an appropriate name* ………………………………………………………. 7
Appendix 7: *Give the appendix an appropriate name* ………………………………………………………. 8
Appendix 8: *Give the appendix an appropriate name* ………………………………………………………. 8
Appendix 9 (and on): Additional documents ……………………………………………………………………….. 9
PROFESSIONAL PORTFOLIO
2
Professional Portfolio
Professional Nursing Portfolio of ……….
Personal Details
Don’t worry about this part, I will populate it with my details.
Why I chose nursing
I am an Aeronautical engineer who found a passion for nursing during COVID working
as a support worker and I am transitioning from engineering to nursing.
Provide a summary of why you chose nursing as a career.
My Philosophy (approximately 500-700 words)
WRITE the introduction to your portfolio, including why you chose nursing, and your
personal nursing philosophy.
There is no need to reference within this.
My personal nursing
philosophy
Outline you own personal nursing philosophy
A philosophy of nursing is a statement that outlines a nurse’s values, ethics, and beliefs, as well
as their motivation for being part of the profession. A philosophy of nursing helps you identify
the beliefs and theories that shape the choices you make on the job every day. ..
Consider the following when writing your philosophy:
1.
2.
3.
4.
5.
What is nursing?
Why is it important to me?
What does a nurse bring to society?
Why do I make a great nurse?
What qualities and skills are important for me to bring to my
role as a nurse?
6. Which values do I bring to my role as a nurse?
7. What am I passionate about?
Overall, your introduction to yourself, including why you chose nursing, and your
nursing philosophy should be approximately for 500-700 words.
When considering why you chose nursing and your philosophy, your emphasis
should be on the philosophy. There is no need to reference within this.
Portfolio Purpose
Summary statement
Here you can summarise the purpose of this portfolio. Make sure to provide a brief of
how you plan to achieve this
Standard Element or Competency Domain
Standard Element or
Competency Domain
RN Standard 1: Thinks critically and analyses nursing practice.
Evidence statement
Read Standard 1 in the NMBA Registered Nurse
Standards for Practice. Now with reference to the
NMBA standards, write a 200-word summary
Student ID number
Appendix number: 2
PROFESSIONAL PORTFOLIO
3
explaining how your reflection is evidence of your
NMBA Standard 1 in your clinical practice.
Standard Element or
Competency Domain
RN Standard 4: Comprehensively conducts assessments
Evidence statement
Read Standard 4 in the NMBA Registered Nurse
Standards for Practice. Now with reference to the
NMBA standards, write a 200-word summary
explaining how your reflection is evidence of your
NMBA Standard 4 in your clinical practice.
Standard Element or
Competency Domain
RN Standard 6: Provides safe, appropriate and
responsive quality nursing practice
Evidence statement
Read Standard 6 in the NMBA Registered Nurse
Standards for Practice. Now with reference to the
NMBA standards, write a 200-word summary
explaining how your reflection is evidence of your
NMBA Standard 6 in your clinical practice.
Standard Element or
Competency Domain
RN Standard 2: Engages in therapeutic and
professional relationships
Evidence statement
Now with reference to the NMBA standards, write a
200-word summary explaining how your reflection is
evidence of your NMBA Standard 2 in your clinical
practice
Standard Element or
Competency Domain
RN Standard 3: Maintains the capability for practice.
Evidence statement
Now with reference to the NMBA standards, write a
200-word summary explaining how your reflection is
evidence of your NMBA Standard 3 in your clinical
practice.
Standard Element or
Competency Domain
RN Standard 5: Develops a plan for nursing practice
Evidence statement
Now with reference to the NMBA standards, write a
200-word summary explaining how your reflection is
evidence of your NMBA Standard 5 in your clinical
practice
Standard Element or
Competency Domain
RN Standard 7: Evaluates outcomes to inform nursing Practice
Evidence statement
Now with reference to the NMBA standards, write a
200-word summary explaining how your reflection is
Student ID number
Appendix number: 3
Appendix number: 4
Appendix number: 5
Appendix number: 6
Appendix number: 7
Appendix number: 8
PROFESSIONAL PORTFOLIO
evidence of your NMBA Standard 7 in your clinical
practice.
Student ID number
4
PROFESSIONAL PORTFOLIO
5
Appendices
*start each appendix on a new page*
Appendix 1: Curriculum Vitae – I’ll do this appendix.
———————————————————
Each appendix should have 500-700 words and have at least
two references to support the reflections on evidence with intext citations. The references can go below each reflection.
Each reflection has prompts to help you write the reflection,
but it must be paragraph formatted.
Keep in mind that for each reflection you write, in the above
table you need to write a 200-word summary explaining how
each reflection is evidence of each NMBA Standard in the
clinical practice.
Appendix 2: *Give the appendix an appropriate name* Standard 1
Describe an occasion in which you experienced or observed the theory-practice gap in your
clinical practice. Were you directly involved or an observer?
How did the experience make you feel? Were you confused? Frustrated? Perhaps you felt like
you had been taught the wrong thing? Maybe you were worried about the impact on the
patient.
How do you evaluate the experience now? What was good about it? What was bad? How was
the patient impacted? Was it valuable to your learning or clinical practice in some way?
Analyse the situation. What was the impact on patient outcomes? Health service outcomes? The
nurses, students, or other health professionals? What was the impact on you? What factors do
you think contributed to that theory-practice gap? Were there valid reasons for it? What
sources of evidence were being used in that situation? Are there other/better sources of evidence
that could have been used?
Draw some conclusions. What have you learned from this experience? What could you have
done differently?
What Actions will you take to deal with a similar situation in the future? More generally, what
changes will you make in your nursing practice to try and bridge the theory-practice gap and
use evidence to support your nursing practice?.
Reference list for Appendix 2
Student ID number
PROFESSIONAL PORTFOLIO
Appendix 3: *Give the appendix an appropriate name* Standard 4
Think about a patient assessment you undertook while on placement. Describe the assessment
you completed, including some details about the practice setting and context, as well as the
approach you took to your assessment (primary survey, body systems, focused etc.)
How did you feel about the patient assessment at the time? Did you feel comfortable with what
you needed to do? Did you think about what data you were collecting and why, or did you just
follow the steps of assessment?
Now think about a patient assessment you have observed a “specialist” nurse complete. What
was different about that nurses’ assessment to your own assessment? What would you do
differently now? What deficits in your knowledge or skills do you feel that you still need to
address?
If there is a specialty area that you are thinking of practicing in, think about the knowledge and
skills you will need for patient assessment in that area – identify those that you already have, and
also those that you will need to develop.
I want to work as ICU nurse
Draw some conclusions. Are your assessment skills and knowledge good, great, developing,
underdeveloped?
What Actions will you take to continue to develop your ability to comprehensively conduct patient
assessments?
Reference list for Appendix 3
Appendix 4: *Give the appendix an appropriate name* Standard 6
Think about a clinical decision you have witnessed or been a part of during your clinical
placement experiences. You may have recorded details in a PEP essay. Describe the decision,
including some details about the practice setting and context, as well as who made the decision
How did you feel about the decision at the time? Did you feel comfortable with that it was the
correct decision? Did you think that the decision was the best way to support safe, appropriate
and responsive patient care?
With hindsight, and given what you have learned since this event, are you confident that the
correct decision was made? Did the correct member of the team end up providing care to the
patient, or would another member of the team have been more appropriate? Did all members of
the team adhere to their scope of practice?
Briefly analyse the clinical decision with reference to the national decision-making tool, codes of
professional and ethical conduct, legislation, and current literature. What factors influenced the
decision?
Draw some conclusions. Was the correct clinical decision made, in the best interests of safe,
appropriate patient care?
What Actions will you take to improve your future clinical decision-making?
Student ID number
6
PROFESSIONAL PORTFOLIO
Reference list for Appendix 4
Appendix 5: *Give the appendix an appropriate name* Standard 2
Think about an experience of challenging communication you have encountered during your
clinical placement experiences. It may be with a patient or client, family member, registered
nurse, or other clinician. You may have recorded details in a PEP essay. Describe the
communication encounter, including some details about the practice setting and context.
How did you feel about the communication encounter at the time? Did you feel like you were
listened to? Did you feel that you were able to listen effectively to the other person?
What were the good aspects of the communication encounter? What worked well for you, or for
the other person from a communication perspective? What were the bad aspects? What didn’t
really work? Were there any positive or negative impacts, outcomes or consequences?
With reference to the resources you have regarding communication (with patients, families or
clinicians) undertake a brief analysis of the communication encounter. Were you able to
communicate in a way that was consistent with or reflective of the evidence?
Draw some conclusions. What could you have done differently?
What Actions will you take to improve your future communication, especially when faced with
a similar situation?
Reference list for Appendix 5
Appendix 6: *Give the appendix an appropriate name* Standard 3
Think about an experience of receiving feedback. It may be during a clinical placement, on an
assessment task, or informal feedback at university. You may have recorded details in a PEP
essay. Describe the feedback encounter, including some details about the context and
content of the feedback.
Receiving feedback can be very confronting for a number of reasons and can really challenge
our self-confidence. How did you feel about receiving feedback at the time? Did you feel
angry, worried, upset, confused or something else? At the time, did you feel that the
feedback was justified? How did you feel about how the feedback was delivered?
Student ID number
7
PROFESSIONAL PORTFOLIO
What were the good aspects of the way you received the feedback? What did you do well?
What were the bad aspects? What did you not do well during that initial experience of
receiving feedback? Were there any positive or negative impacts, outcomes or
consequences?
With reference to any relevant resources undertake a brief analysis of your experience of
receiving feedback and of your reactions and responses, with a focus on how you have been
able to use the feedback to improve your clinical practice.
Draw some conclusions. In the initial experience of receiving feedback, what could you have
done differently?
What Actions will you take to improve your capacity to seek out and receive feedback and use
it to improve your clinical practice in future?
Reference list for Appendix 6
Appendix 7: *Give the appendix an appropriate name* Standard 5
Think about a plan of care you developed for a patient in one of your clinical placements
experiences. Describe the care plan using the nursing process: your assessment, problem
statement(s), SMART goal(s), planned interventions and planned evaluation criteria. Include
some details about the practice setting and context
How did you feel about the plan of care at the time? Were you confident that you had identified
the problem(s)? How did you feel about your SMART goals? Did you think that the
interventions were appropriate and achievable?
With hindsight, evaluate, the care planning process you enagegd in at that time? What was good
about it? What went well? What was not good about it? What role (good or bad) did the patient
or other members of the healthcare team play in your care planning?
Now analyse the care plan. Ask yourself why did things go well/not go well? What knowledge
did I have that helped? What knowledge did I need that I didn’t have? What rsources (eg texts,
literature) can I use to understand the situation better?
Draw some conclusions. What did you learn from this care planning process? What would you
do differently now? What skills or knowledge do you need in order to be a better nurse in that
situation?
What Actions will you take to improve your future care planning?
Reference list for Appendix 7
Appendix 8: *Give the appendix an appropriate name* Standard 7
Think about the care outcomes for a patient you have looked after on one of your professional
placement experiences. It can be any outcome – e.g. the patient went home, the patient went to
ICU, the patient went to theatre, the patient died, the patient got better, the patient was
Student ID number
8
PROFESSIONAL PORTFOLIO
9
satisfied, the patient was dissatisfied – anything. Describe the outcome(s), the nursing care, the
treatment, and the goals of care. Include some details about the practice setting and context.
How did you feel about the outcome(s) for the patient at the time? Were you happy, sad, angry,
disappointed, upset? Did you have any thoughts about the patients’ outcome(s) either before or
after? Did your thoughts or feelings change?
With hindsight, evaluate, the outcome(s). What was good about it? What went well? What was
not good about it? What role (good or bad) did the patient or other members of the healthcare
team play in the care outcome(s)?
Now analyse the outcome(s). Ask yourself why did things go well/not go well? What knowledge
did I have that helped? What knowledge did I need that I didn’t have? What resources (e.g.
texts, literature) can I use to understand the situation better?
Draw some conclusions. What did you learn from this experience? What would you do
differently now? What skills or knowledge do you need in order to be a better nurse in that
situation?
What Actions will you take to improve your future nursing care?
Reference list for Appendix 8
Appendix 9 (and on): Additional documents – I’ll do this appendix.
Student ID number
Nursing and Midwifery Board of Australia
REGISTERED NURSE
STANDARDS FOR PRACTICE
1 June 2016
NMP00011
REGISTERED NURSE
STANDARDS FOR PRACTICE
Orienting statements
Registered nurse (RN) practice is person-centred and
evidence-based with preventative, curative, formative,
supportive, restorative and palliative elements. RNs
work in therapeutic and professional relationships
with individuals, as well as with families, groups and
communities. These people may be healthy and with
a range of abilities, or have health issues related to
physical or mental illness and/or health challenges.
These challenges may be posed by physical, psychiatric,
developmental and/or intellectual disabilities.
The Australian community has a rich mixture of cultural
and linguistic diversity, and the Registered nurse
standards for practice are to be read in this context.
RNs recognise the importance of history and culture to
health and wellbeing. This practice reflects particular
understanding of the impact of colonisation on the
cultural, social and spiritual lives of Aboriginal and
Torres Strait Islander peoples, which has contributed to
significant health inequity in Australia.
As regulated health professionals, RNs are responsible
and accountable to the Nursing and Midwifery Board
of Australia. These are the national Registered nurse
standards for practice for all RNs. Together with the
Nursing and Midwifery Board of Australia standards,
codes and guidelines, these Registered nurse standards
for practice should be evident in current practice, and
inform the development of the scopes of practice and
aspirations of RNs.
RN practice, as a professional endeavour, requires
continuous thinking and analysis in the context of
thoughtful development and maintenance of constructive
relationships. To engage in this work, RNs need to
continue to develop professionally and maintain their
capability for professional practice. RNs determine,
coordinate and provide safe, quality nursing. This
practice includes comprehensive assessment,
development of a plan, implementation and evaluation
of outcomes. As part of practice, RNs are responsible
and accountable for supervision and the delegation of
nursing activity to enrolled nurses (ENs) and others.
unpaid role where the nurse uses their nursing skills
and knowledge. This practice includes working in a
direct non-clinical relationship with clients, working
in management, administration, education, research,
advisory, regulatory, policy development roles or other
roles that impact on safe, effective delivery of services
in the profession and/or use of the nurse’s professional
skills. RNs are responsible for autonomous practice
within dynamic systems, and in relationships with other
health care professionals.
How to use these standards for
practice
The Registered nurse standards for practice consist of the
following seven standards:
1. Thinks critically and analyses nursing practice.
2. Engages in therapeutic and professional
relationships.
3. Maintains the capability for practice.
4. Comprehensively conducts assessments.
5. Develops a plan for nursing practice.
6. Provides safe, appropriate and responsive quality
nursing practice.
7. Evaluates outcomes to inform nursing practice.
The above standards are all interconnected (see Figure
1). Standards one, two and three relate to each other, as
well as to each dimension of practice in standards four,
five, six and seven.
Practice is not restricted to the provision of direct
clinical care. Nursing practice extends to any paid or
2 Registered nurse standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
REGISTERED NURSE
STANDARDS FOR PRACTICE
Figure 1: RN standards
Standard 5
Standard 6
Standard 7
Develops a plan for nursing practice
Provides safe, appopriate and responsive
quality nursing practice
Evaluates outcomes to inform nursing
practice
Standard 4
Standard 1
Standard 2
Engages in therapeutic and
professional relationships
Standard 3
Maintains the capability for
practice
Comprehensively conducts assessments
Thinks critically and analyses
nursing practice
Each standard has criteria that specify how that standard
is demonstrated. The criteria are to be interpreted in
the context of each RN’s practice. For example, all RNs
will, at various times, work in partnerships and delegate
responsibilities, however, not every RN will delegate
clinical practice to enrolled nurses. The criteria are not
exhaustive and enable rather than limit the development
of individual RN scopes of practice.
The Registered nurse standards for practice are for all
RNs across all areas of practice. They are to be read
in conjunction with the applicable NMBA companion
documents such as the standards, codes and guidelines,
including the Code of conduct for nurses, National
framework for the development of decision-making
tools for nursing and midwifery practice, Supervision
guidelines for nursing and midwifery, and Guidelines for
mandatory notifications. The glossary is also important
for understanding how key terms are used in these
standards.
RN standards for practice
Standard 1: Thinks critically and analyses nursing
practice
RNs use a variety of thinking strategies and the best
available evidence in making decisions and providing
safe, quality nursing practice within person-centred and
evidence-based frameworks.
The RN:
1.1 accesses, analyses, and uses the best available
evidence, that includes research findings for safe
quality practice
1.2 develops practice through reflection on experiences,
knowledge, actions, feelings and beliefs to identify
how these shape practice
1.3 respects all cultures and experiences, which
includes responding to the role of family and
community that underpin the health of Aboriginal
3 Registered nurse standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
REGISTERED NURSE
STANDARDS FOR PRACTICE
and Torres Strait Islander peoples and people of
other cultures
and others, to share knowledge and practice that
supports person-centred care
1.4 complies with legislation, common law, policies,
guidelines and other standards or requirements
relevant to the context of practice when making
decisions
2.8 participates in and/or leads collaborative practice,
and
1.5 uses ethical frameworks when making decisions
1.6 maintains accurate, comprehensive and timely
documentation of assessments, planning, decisionmaking, actions and evaluations, and
1.7 contributes to quality improvement and relevant
research.
Standard 2: Engages in therapeutic and
professional relationships
RN practice is based on purposefully engaging in
effective therapeutic and professional relationships. This
includes collegial generosity in the context of mutual
trust and respect in professional relationships.
The RN:
2.1 establishes, sustains and concludes relationships
in a way that differentiates the boundaries between
professional and personal relationships
2.9 reports notifiable conduct of health professionals,
health workers and others.
Standard 3: Maintains the capability for practice
RNs, as regulated health professionals, are responsible
and accountable for ensuring they are safe, and have
the capability for practice. This includes ongoing selfmanagement and responding when there is concern
about other health professionals’ capability for practice.
RNs are responsible for their professional development
and contribute to the development of others. They are
also responsible for providing information and education
to enable people to make decisions and take action in
relation to their health.
The RN:
3.1 considers and responds in a timely manner to the
health and well being of self and others in relation to
the capability for practice
3.2 provides the information and education required to
enhance people’s control over health
2.2 communicates effectively, and is respectful of a
person’s dignity, culture, values, beliefs and rights
3.3 uses a lifelong learning approach for continuing
professional development of self and others
2.3 recognises that people are the experts in the
experience of their life
3.4 accepts accountability for decisions, actions,
behaviours and responsibilities inherent in their
role, and for the actions of others to whom they have
delegated responsibilities
2.4 provides support and directs people to resources to
optimise health related decisions
2.5 advocates on behalf of people in a manner that
respects the person’s autonomy and legal capacity
2.6 uses delegation, supervision, coordination,
consultation and referrals in professional
relationships to achieve improved health outcomes
3.5 seeks and responds to practice review and feedback
3.6 actively engages with the profession, and
3.7 identifies and promotes the integral role of nursing
practice and the profession in influencing better
health outcomes for people.
2.7 actively fosters a culture of safety and learning
that includes engaging with health professionals
4 Registered nurse standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
REGISTERED NURSE
STANDARDS FOR PRACTICE
Standard 4: Comprehensively conducts
assessments
Standard 6: Provides safe, appropriate and
responsive quality nursing practice
RNs accurately conduct comprehensive and systematic
assessments. They analyse information and data and
communicate outcomes as the basis for practice.
RNs provide and may delegate, quality and ethical goaldirected actions. These are based on comprehensive and
systematic assessment, and the best available evidence
to achieve planned and agreed outcomes.
The RN:
4.1 conducts assessments that are holistic as well as
culturally appropriate
4.2 uses a range of assessment techniques to
systematically collect relevant and accurate
information and data to inform practice
The RN:
6.1 provides comprehensive safe, quality practice
to achieve agreed goals and outcomes that are
responsive to the nursing needs of people
6.2 practises within their scope of practice
4.3 works in partnership to determine factors that affect,
or potentially affect, the health and well being of
people and populations to determine priorities for
action and/or for referral, and
6.3 appropriately delegates aspects of practice to
enrolled nurses and others, according to enrolled
nurse’s scope of practice or others’ clinical or nonclinical roles
4.4 assesses the resources available to inform planning.
6.4 provides effective timely direction and supervision to
ensure that delegated practice is safe and correct
Standard 5: Develops a plan for nursing practice
RNs are responsible for the planning and communication
of nursing practice. Agreed plans are developed in
partnership. They are based on the RNs appraisal of
comprehensive, relevant information, and evidence that
is documented and communicated.
The RN:
6.5 practises in accordance with relevant nursing
and health guidelines, standards, regulations and
legislation, and
6.6 uses the appropriate processes to identify and report
potential and actual risk related system issues
and where practice may be below the expected
standards.
5.1 uses assessment data and best available evidence to
develop a plan
Standard 7: Evaluates outcomes to inform nursing
practice
5.2 collaboratively constructs nursing practice plans
until contingencies, options priorities, goals, actions,
outcomes and timeframes are agreed with the
relevant persons
RNs take responsibility for the evaluation of practice
based on agreed priorities, goals, plans and outcomes
and revises practice accordingly.
5.3 documents, evaluates and modifies plans accordingly
to facilitate the agreed outcomes
5.4 plans and negotiates how practice will be evaluated
and the time frame of engagement, and
5.5 coordinates resources effectively and efficiently for
planned actions.
The RN:
7.1 evaluates and monitors progress towards the
expected goals and outcomes
7.2 revises the plan based on the evaluation, and
7.3 determines, documents and communicates further
priorities, goals and outcomes with the relevant
persons.
5 Registered nurse standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
REGISTERED NURSE
STANDARDS FOR PRACTICE
Glossary
These definitions relate to the use of terms in the
Registered nurse standards for practice.
Accountability means that nurses answer to the people
in their care, the nursing regulatory authority, their
employers and the public. Nurses are accountable
for their decisions, actions, behaviours and the
responsibilities that are inherent in their nursing
roles including documentation. Accountability cannot
be delegated. The RN who delegates activities to be
undertaken by another person remains accountable
for the decision to delegate, for monitoring the level of
performance by the other person, and for evaluating
the outcomes of what has been delegated (Nursing and
Midwifery Board of Australia 2013). See below for the
related definition of Delegation.
Criteria in this document means the actions and
behaviours of the RN that demonstrate these Standards
for practice.
Delegation is the relationship that exists when a RN
delegates aspects of their nursing practice to another
person such as an enrolled nurse, a student nurse or
a person who is not a nurse. Delegations are made to
meet peoples’ needs and to enable access to health
care services, that is, the right person is available at
the right time to provide the right service. The RN who
is delegating retains accountability for the decision to
delegate. They are also accountable for monitoring of the
communication of the delegation to the relevant persons
and for the practice outcomes. Both parties share the
responsibility of making the delegation decision, which
includes assessment of the risks and capabilities. In
some instances delegation may be preceded by teaching
and competence assessment. For further details see
the NMBA’s National framework for the development of
decision-making tools for nursing and midwifery practice
(2013).
Enrolled nurse is a person who provides nursing
care under the direct or indirect supervision of a
RN. They have completed the prescribed education
preparation, and demonstrate competence to practise
under the Health Practitioner Regulation National
Law as an enrolled nurse in Australia. Enrolled nurses
are accountable for their own practice and remain
responsible to a RN for the delegated care.
Evidence-based practice is accessing and making
judgements to translate the best available evidence,
which includes the most current, valid, and available
research findings into practice.
Person or people is used in these Standards to refer to
those individuals who have entered into a therapeutic
and/or professional relationship with a RN. These
individuals will sometimes be health care consumers,
at other times they may be colleagues or students, this
will vary depending on who is the focus of practice at
the time. Therefore, the words person or people include
all the patients, clients, consumers, families, carers,
groups and/or communities that are within the RN
scope and context of practice. The RN has professional
relationships in health care related teams.
Person-centred practice is collaborative and respectful
partnership built on mutual trust and understanding
through good communication. Each person is
treated as an individual with the aim of respecting
people’s ownership of their health information, rights
and preferences while protecting their dignity and
empowering choice. Person-centred practice recognises
the role of family and community with respect to cultural
and religious diversity.
Registered nurse is a person who has completed
the prescribed education preparation, demonstrates
competence to practise and is registered under the
Health Practitioner Regulation National Law as a RN in
Australia.
Scope of practice is that in which nurses are educated,
competent to perform and permitted by law. T
This assignment will allow students to utilize the basic tools of public health inquiry to identify and describe the distribution of diseases and/or health-related outcomes.
CEPH CONTENT COMPETENCIES
Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health (3)
List major causes and trends of morbidity and mortality in the US or other community relevant to the school or program (4)
Instructions
Purpose
This assignment will allow students to utilize the basic tools of public health inquiry to identify and describe the distribution of diseases and/or health-related outcomes.
CEPH Content Competencies
Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health (3)
List major causes and trends of morbidity and mortality in the US or other community relevant to the school or program (4)
Instructions
You have already completed an Exercise where you learned about the quantitative (numerical) information that is available from the Center for Disease Control and Prevention’s, Behavioral Risk Factor Surveillance System (BRFSS). That site is not working so we have found another similar site for you to use to complete this assignment, the CDC’s United Cancer Statistics Data Visualizations site. You will explore the distribution of mortality from one type of cancer by sex and race/ethnicity across two states.
From this “Cancer Statistics at a Glance” page, make selections from the drop-down menus as follows:
Area: Choose any state; you will do a second state afterwards to compare.
New Cases (Incidence) or Deaths (Mortality): Choose “Rate of Cancer Deaths”.
Sex: Start with male or female; you will come back to the other.
Cancer Type: Choose one cancer that occurs in both women and men (not corpus and uterus, cervix, ovary, prostate, breast, testis).
Year: Choose 2016-2020.
Race and Ethnicity: Start with ALL Races and Ethnicities. You will come back for the others.
Using this “Cancer Statistics at a Glance” site (and other reputable internet sources), write a 2-page essay that addresses the following:
Explain why you selected the states you chose. Use internet sources to find information that allows you to briefly describe the states you selected, including demographics and other important features.
Explain why you selected the cancer you chose. Use internet sources to write one paragraph about this cancer including risk factors, prevention strategies, treatments, how common it is, how deadly it is and/or any other information you think is valuable.
Use the drop down menu options to find the mortality rates (not the number of cases) for your selected cancer in each of the two states for each race/ethnicity for males and females. Hover your mouse over the state to see the rates. Organize this information in a table you create and put in after your references as an Appendix.
Discuss the distribution of this disease/health indicator by state, sex, and race/ethnicity. Who is most at risk of death from this cancer? Who is least at risk? Did anything surprise you?
Discuss why it is important to have this evidence and suggest how a public health expert might use this numerical information.
Grading Criteria
See Attached Rubric.
GUIDELINES FOR ALL WRITING ASSIGNMENTS:
As per UNLV second-year seminar requirements, this course has a heavy writing component. There are fourmajor essays (2 pages), two reflection papers about two non-fiction books (4 pages), and a final research paper (4 pages). You are expected to complete every one of these larger assignments and may receive a failing grade if more than 1 is not completed.
Use ESSAY format. No sub-headers or numbered paragraphs.
Use FORMAL writing, not casual as if you are chatting with a friend. No SLANG or Idioms.
Include a DISTINCT Introductory paragraph that tells the purpose of the paper and previews topics to be covered and a Concluding paragraph that summarizes.
DOUBLE SPACE, indent paragraphs 0.5inches, don’t leave extra space between paragraphs, 1 inch margins, size 12 font, either Times New Roman or Arial.
NO title page or Running Header required.
HEADER: 3 lines only, SINGLE-SPACED: Name, Date, Assignment title. Must show on every page; Use “insert header” in Word.
MEET or EXCEED minimum page length requirement. Consider going 1-2 lines onto the next page to be sure you do not lose points.
REFERENCES: Required. Must include all websites required for an assignment and any others you use, Must be academic. Separate page at the end. See APA Module.
IN-TEXT CITATIONS: Required in most paragraphs. NO quotations permitted for this class; Use paraphrasing with citation. See APA Module.
CHECK your Turnitin Similarity score, which should be 20% or less.
EDITING: Spelling, mechanics, word selection (correct use of words), and grammar count. Please proofread your paper carefully.
IF THESE REQUIREMENTS ARE NOT MET, PAPER MAY BE RETURNED TO YOU WITH A ZERO GRADE UNTIL YOU REDO IT. LATE PENALTIES WILL APPLY.
Resources:A minimum of 3 published sources of information must be used (i.e., JADA, CDA Journal, PUB MED, ADHA Journal, Access, CDHA Journal). Product package inserts are also allowed as well as testimony from dental professionals who currently use a product. Internet sources are acceptable but may not be substituted for the 3 published sources, unless they reflect material from a reputable journal that is “on line.”Format: The Literature Review should be approximately 3-4 pages in length, typed in 12 font Times New Roman and double-spaced, with references cited in the body of the text and an appropriate reference page attached using an APA format. Please give a brief history of the product/procedure, current technology, weaknesses, limitations, advantages, and disadvantages.
Module 6
HCM 500
1Reimbursement practices in both Saudi Arabia (SA) and United States (US) healthcare
are complex and vary depending on the type of provider and payer. In SA the government
provides free healthcare to all citizens and expatriates. This is done through a network of public
hospitals and clinics.(Alasiri & Mohammed, 2022) The Saudi government is the main payer for
healthcare in SA. In 2023, Saudi Arabia allocated a budget of 50.4 billion USD (SAR 189 bn) for
health sectors.(Budget Statemennt 2023) while in the US the government pays for certain groups
of the population through Medicare and Medicaid. Medicare is a health insurance program for
people aged 65 and older, as well as people with certain disabilities. Medicaid is a joint federalstate program that provides health insurance to low-income individuals and families.(United
States, 2020)
Private healthcare providers in Saudi Arabia are reimbursed by a variety of payers,
including commercial health insurance companies, the government, and patients themselves.
Commercial health insurance companies are becoming increasingly important payers in the
Saudi healthcare system, as the government is gradually shifting to a mandatory health insurance
system for all citizens and residents.(AlRuthia et al., 2020)
The most common reimbursement model in both SA and US is fee-for-service (FFS).
Under FFS, healthcare providers are reimbursed for each service they provide to patients. This
model has been criticized for incentivizing providers to over-treat patients and for contributing to
the rising cost of healthcare.(AlRuthia et al., 2020; Trends and Challenges in the U.S.
Healthcare Payment System, n.d.)
FFS is a relatively simple reimbursement model to understand and implement. It also
gives providers the flexibility to choose how they treat their patients and to set their own prices.
allows them to maintain their autonomy and make decisions about their practices without
interference from payers. It is a transparent reimbursement model, meaning that patients can
easily see how much they are being charged for each service.(Wang et al., 2021)
On the other hand, FFS can incentivize providers to overtreat patients in order to generate
more revenue. This can lead to unnecessary tests and procedures, which can increase the cost of
healthcare and potentially harm patients. It is a relatively expensive reimbursement model. This
is because providers are often paid more for more expensive services, even if those services are
not necessary. FFS does not incentivize providers to focus on prevention. This is because
providers are not paid for preventive services such as screenings and immunizations. This type of
reimbursement can be inequitable for patients with low incomes or chronic health conditions.
This is because these patients may need more services, which can be expensive under
FFS.(Wang et al., 2021)
References:
Alasiri, A. A., & Mohammed, V. (2022). Healthcare Transformation in Saudi Arabia: An
Overview Since the Launch of Vision 2030. Health Services Insights, 15,
11786329221121214. https://doi.org/10.1177/11786329221121214
AlRuthia, Y., Abdulaziz Bin Aydan, N., Sulaiman Alorf, N., & Asiri, Y. (2020). How can Saudi
Arabia reform its public hospital payment models? A narrative review. Saudi Pharmaceutical
Journal, 28(12), 1520–1525. https://doi.org/10.1016/j.jsps.2020.09.020
Budget Statemennt 2023. (n.d.). Retrieved October 8, 2023, from
https://www.mof.gov.sa/en/budget/2023/Documents/Bud-En%202023MoF.pdf
Trends and challenges in the U.S. healthcare payment system. (n.d.). Retrieved October 9, 2023,
from https://dhge.org/about-us/blog/healthcare-payment-system-trends-and-challenges
United States. (2020, June 5). https://www.commonwealthfund.org/international-health-policycenter/countries/united-states
Wang, Y., Hou, W., Wang, X., Zhang, H., & Wang, J. (2021). Bad to All? A Novel Way to
Analyze the Effects of Fee-for-Service on Multiple Grades Hospitals Operation
Outcomes. International Journal of Environmental Research and Public Health, 18(23),
12723. https://doi.org/10.3390/ijerph182312723
2-
Description of current reimbursement formats in Saudi Arabia and the United States
In Saudi Arabia, the healthcare reimbursement system is primarily funded by the government
through the Ministry of Health (MOH). The MOH provides and funds a significant portion of
healthcare services, covering 57% of services through hospitals and primary healthcare centers
(Al-Hanawi et al., 2018). The government also oversees and supervises private sector services
and other government healthcare sectors. The funding model in Saudi Arabia is mainly based on
a tax-funded system, where healthcare services are provided free of charge to all Saudi citizens
(Hazazi et al., 2022). Private health insurance is also available, but its implementation is still in
progress.
In the United States, the healthcare reimbursement system is a mix of public and private
funding. The government provides healthcare coverage through programs like Medicare for the
elderly and Medicaid for low-income individuals and families. These programs reimburse
healthcare providers based on predetermined rates and fee schedules. Private health insurance,
either through employers or individual plans, is another significant source of healthcare
reimbursement in the United States. Private insurance companies negotiate reimbursement rates
with healthcare providers, and individuals pay premiums to access these services.
Pros and cons of the current reimbursement model in Saudi Arabia and the United States
Saudi Arabia
Pros:
1. Universal access: The tax-funded system in Saudi Arabia ensures that all citizens have access
to healthcare services without financial barriers.
2. Government control: The government’s oversight and funding of healthcare services allow for
centralized planning and coordination.
3. Cost control: The government’s control over healthcare funding enables cost control measures
and allocation of resources based on population needs.
Cons:
1. Financial sustainability: The reliance on government funding raises concerns about the longterm financial sustainability of the healthcare system, especially with rising healthcare costs and
population growth.
2. Limited private sector involvement: The limited implementation of private health insurance
restricts competition and innovation in the healthcare sector.
3. Potential strain on resources: The free healthcare services provided by the government may
lead to increased demand and strain on healthcare resources.
United States
Pros:
1. Choice and competition: The presence of private health insurance allows individuals to choose
their healthcare providers and plans based on their needs and preferences.
2. Innovation: The involvement of private insurance companies encourages innovation in
healthcare delivery and payment models.
3. Financial sustainability: The mix of public and private funding helps distribute the financial
burden of healthcare across different stakeholders.
Cons:
1. Access disparities: The reliance on private insurance can lead to disparities in access to
healthcare, as not all individuals can afford or qualify for private insurance.
2. Administrative complexity: The multiple reimbursement systems and insurance plans in the
United States can result in administrative complexities for healthcare providers and patients.
3. Affordability: The high cost of private health insurance premiums and out-of-pocket expenses
can make healthcare unaffordable for some individuals and families.
References:
Al-Hanawi, M. K., Alsharqi, O., Almazrou, S., & Vaidya, K. (2018). Healthcare Finance in the
Kingdom of Saudi Arabia: A Qualitative Study of Householders’ Attitudes. Applied health
economics and health policy, 16(1), 55–64. https://doi.org/10.1007/s40258-017-0353-7
Hazazi, A., Wilson, A., & Larkin, S. (2022). Reform of the Health Insurance Funding Model to
Improve the Care of Noncommunicable Diseases Patients in Saudi Arabia. Healthcare, 10(11),
2294. MDPI AG. Retrieved from http://dx.doi.org/10.3390/healthcare10112294
Module 6
HCM 520
First one:
King Abdualaziz Medical City Mission and Vision statements
COLLAPSE
A vision statement sets an organization’s ultimate goals and focuses on the future while a mission
statement focuses on the present and the actions taken by an organization to fulfill it. A mission
statement outlines an organization’s core functions, serving and accomplishing its goals. It serves
as a roadmap for the future, while a vision statement outlines the organization’s long-term
aspirations. Together, these statements coordinate stakeholders’ actions, establishing a clear
sense of direction and purpose, and helping to coordinate the actions of the organization. (Barr,
2020)
The mission and vision statements for King Abdualaziz Medical City will be discussed below.
King Abdualaziz Medical City’s (KAMC) goal is to offer high-quality, individualized care to
those in Saudi Arabia’s Western Region who have cancer and blood problems. They promote
education and research while also enhancing cancer care through evidence-based methods,
research, and quality improvement. They also work to advance the prevention and treatment of
cancer and blood disorders by developing novel therapies and doing laboratory research. With an
emphasis on excellence, safety, and satisfaction, their mission is to provide complete, highstandard, and holistic cancer patient treatment on a national and worldwide level. To stay at the
leading edge of cancer management, they place a strong emphasis on teaching, research, and
technology. By carefully examining the mission statement, it becomes evident that the current
goal of KAMC is to provide excellent, patient-centered care for cancer and blood disorders in the
Western Region of Saudi Arabia. They also place a strong emphasis on education, research, and
innovation as essential elements of their purpose. With regard to the vision statement, it shows
their goals for the future. The goal of KAMC is to provide comprehensive, top-notch cancer care
and establish itself as a leader both domestically and globally. They place a strong emphasis on
the value of innovation, safety, and excellence. Both phrases emphasize patient-centered care,
excellence, and innovation in similar ways. They demonstrate a dedication to improving
healthcare and cancer management, with a strong emphasis on teaching and research, not just for
the benefit of their patients but also for greater national and global contributions to the field of
cancer care. (Mission and Vision, n.d.)
King Abdualaziz Medical City (KAMC)’s mission and vision align with Saudi Vision 2030’s
goals. KAMC focuses on providing high-quality, patient-centered care and advancing healthcare
through research and innovation, aligning with the kingdom’s goal of enhancing healthcare
services. Its dedication to education, collaboration, and international leadership aligns with Saudi
Arabia’s vision of becoming a global leader. KAMC’s emphasis on cutting-edge technology in
cancer management reflects the nation’s drive for technological advancement and innovation.
(Health Sector Transformation Program, n.d.)
References:
Barr, E. (2020, February 4). The Difference Between Mission and Vision Statements •
SpriggHR. SpriggHR. https://sprigghr.com/blog/alignment-direction/the-difference-betweenmission-and-vision-statements/
Health Sector Transformation Program. (n.d.). Retrieved October 9, 2023, from
http://www.vision2030.gov.sa/en/vision-2030/vrp/health-sector-transformation-program/
Mission and Vision. (n.d.). Retrieved October 9, 2023, from
https://ngha.med.sa/English/MedicalCities/Jeddah/MedDepartments/PNOC/Pages/MV.aspx
Second one:
Vision and mission
COLLAPSE
All organizations must have a vision and mission that will help to achieve their goals. In
addition, focus and a clear definition of mission and vision will lead the hospital to a unique
development. (JOSSO 2 by Atricore, n.d.) Vision and mission statements differ on some points.
The vision statement is a statement that an organization’s leadership wants to achieve in the
future, and it includes critical characteristics. Also, the vision represents the hospital’s overall
direction. On the other hand, the mission statement is a short statement that describes the
hospital’s overall objectives and purposes. Also, the mission statement addresses the purpose and
directs the employee to achieve the vision. (Qin et al., 2023)
National Guard Health Affairs Hospital is one of the main hospitals in Saudi
Arabia. NGHA’s vision is to be an internationally recognized hospital in excellence and to
promote public and individual health status. The mission of NGHA is to give the Saudi Arabia
National Guard individuals, their dependents, and other eligible patient the optimum healthcare
services. Also, NGHA’s mission is to give a good academic opportunity, conduct research, and
participate in community and industry service programs in the health field. (Mission, Vision &
Core Values, n.d.)
As a part of Saudi Vision 2023, the health sector transformational program aims to improve
healthcare accessibility, increase the quality of healthcare services, and prevent any health
threats. (Health Sector Transformation Program, n.d.). This aligned with NGHA’s vision by both
of them prioritizing the well-being of the individuals and aiming to develop healthcare outcomes.
According to NGHA, the development of healthcare outcomes aligned with the Saudi Vision of
being an internationally excellent hospital.
Reference:
HealthSectorTransformationProgram.(n.d.c).https://www.vision2030.gov.sa/en/vision2030/vrp/h
ealth-sector-transformation-program/
JOSSO 2 by Atricore. (n.d.). https://www.shrm.org/resourcesandtools/tools-and-samples/hrqa/pages/mission-vision-values-statements.aspx
Mission, Vision & core values. (n.d).
https://ngha.med.sa/English/aboutnghanew/Pages/missionvisionvalues.aspx
Qin, X., Wang, B., Zhao, J., Wu, P., & Liu, T. (2023). Learn from the best hospitals:
a
comparison of the mission, vision and values. BMC Health Services Research,
23(1). https://doi.org/10.1186/s12913-023-09699-8
Apply information from the Aquifer Case Study to answer the following discussion questions:Discuss the Mrs. Gomez’s history that would be pertinent to her difficulty sleeping. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.Describe the physical exam and diagnostic tools to be used for Mrs. Gomez. Are there any additional you would have liked to be included that were not? Please list 3 differential diagnoses for Mrs. Gomez and explain why you chose them. What was your final diagnosis and how did you make the determination?What plan of care will Mrs. Gomez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up
http://www.cdc.gov/vaccines/programs/iis/func-stds…PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action ItemsDescribe one of the functional standards of the Immunization Information Systems and explain its importance thoroughly and completely.
pls check the below attachment for the work I need done urgently
Unformatted Attachment Preview
Psychiatric Mental Health Assessment of a
Child/Adolescent
Instructions
You will complete a comprehensive psychiatric mental health assessment of a
child/adolescent.
This should NOT be a patient you have encountered in your work but, instead, should be
a family member or friend (who gives consent) or preferably a patient in clinical. You
should note that all information will be confidential and that their private information will
NOT be shared as part of this assignment.
Requirements
•
•
•
•
•
•
Your assessment should be comprehensive, and you should refer to course texts to
inform items for inclusion in your assessment.
Keep in mind that you will be responsible for covering those areas addressed in the
reading assignments up to this point.
The documentation should remain HIPAA-compliant even though this is not a real
patient.
DO NOT USE REAL PATIENT IDENTIFIERS.
Be sure to include birth and developmental information as well as school and
behavior information for the child.
Consider cultural, gender, ethnicity, spiritual, and social competencies needed to
formulate the best care plan for the patient.
The patient will be referred to as Jane Doe or Jack Doe.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59
pm CT.
Estimated time to complete: 4 hours
Rubric
NU674 Unit 5 Assignment – Case Study Rubric
NU674 Unit 5 Assignment – Case Study Rubric
Criteria
This criterion is
linked to a Learning
OutcomeSubjective
Data
This criterion is
linked to a Learning
OutcomeObjective
Data
This criterion is
linked to a Learning
OutcomeAssessment
Ratings
10 pts
Level 5
Includes all relevant subjective
data necessary for differentiation
of the client’s problem. Data is
presented in a systematic,
organized manner consistently.
10 pts
Level 5
Objective data is complete
and consistently presented in
an organized manner.
7 pts
Level 3
Includes most subjective data
with omission of two minor
details or one major detail.
Most data is presented in a
systematic, organized manner.
7 pts
Level 3
Objective data is complete
and presented in an organized
manner most of the time.
10 pts
Level 5
Assessment, including differential
and/or diagnosis (if appropriate), is
complete and appropriate to client.
Diagnostics are complete and
appropriate to clients.
7 pts
Level 3
Assessment, including
differential and/or diagnosis
(if appropriate), is complete
but some may not be
appropriate for clients.
4 pts
Level 1
Includes subjective data but
omits four minor details or
two major details. Some data
is presented in a systematic,
organized manner.
4 pts
Level 1
Objective data is not
complete or is not presented in
an organized manner.
4 pts
Level 1
Assessment, including
differential and/or
diagnosis (if appropriate),
is not complete but is
appropriate.
NU674 Unit 5 Assignment – Case Study Rubric
Criteria
This criterion is
linked to a Learning
OutcomePlan
This criterion is
linked to a Learning
OutcomeProfessional
Application
This criterion is
linked to a Learning
OutcomeCollegelevel academic
writing
Total Points: 60
Ratings
10 pts
Level 5
Plan includes all relevant measures
95% to 100%. Pharmacologic
Non-pharmacologic Education
Referral Follow-up
10 pts
Level 5
Case incorporates four
evidence-based practice
articles.
10 pts
Level 5
Includes no more than three
grammatical, spelling, or
punctuation errors that do not
interfere with the readability.
Meets the assignment length
requirements.
7 pts
Level 3
Plan includes all relevant measures
89% to 94% Pharmacologic NonPharmacologic Education Referral
Follow-up.
7 pts
Level 3
Case incorporates three
evidence-based practice
articles.
4 pts
Level 1
Plan includes four of
the five relevant
measures, but the four
are complete.
4 pts
Level 1
Does not include an evidence-based
practice article but has two or more
advanced practice articles.
7 pts
Level 3
Includes no more than
four grammatical, spelling, or
punctuation errors that do not
interfere with the readability.
Meets the length requirements.
4 pts
Level 1
Includes five or more
grammatical, spelling, and
punctuation errors make
understanding parts of
assignment difficult but does not
interfere with readability. Meets
the length requirements.
0
L
D
m
S
Research a peer-reviewed article in the SEU library regarding workflow analysis in healthcare. Discuss the following aspects:StrengthsWeaknessesOpportunitiesThreatsRisks that are identified in the workflow described. What changes are recommended and provide additional recommendations you would make to improve the efficiency and effectiveness of this process. Your paper should meet the following structural requirements:Five pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition and Saudi Electronic University writing standardsProvide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
Select a healthcare organization in KSA and review the organization’s mission and vision statements.
State what organization you selected to review and briefly summarize the organization’s mission and vision statements.
Discuss the difference between a vision and mission statement.
Discuss the difference between a vision and mission statement.
Analyze the selected organization’s mission and vision statement.
Describe how the vision statement aligns with Saudi Vision 2030.
Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
You are required to reply to at least two peer discussion question post answers to this weekly discussion question and/or your instructor’s response to your posting. These post replies need to be substantial and constructive in nature. They should add to the content of the post and evaluate/analyze that post’s answer. Normal course dialogue doesn’t fulfill these two peer replies but is expected throughout the course. Answering all course questions is also required.
dis 2
: In this discussion board, you will compare healthcare reimbursement methodologies in Saudi Arabia with the United States. Research and evaluate the need for more public and private funding of healthcare in Saudi Arabia.
Your response should address the following:
Description of current reimbursement formats in Saudi Arabia and the United States.
Pros and cons of the current reimbursement model in Saudi Arabia and the United States.
Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
Objective: The Literature Review assignment is designed to encourage students to become aware of current professional literature published on topics pertaining to the new and forever evolving field of dental materials. Given that the field of dental materials is changing so rapidly, it is important that the dental hygienist develop their abilities to evaluate new products and explore a topic presented in class in greater detail. Topic Selection: Each student will choose any applicable topic related to the field of dental materials. The list below is an example of potential topics and is not to be considered your only choices. Please pick a topic that you are interested in learning more detail than can be presented in lecture. Please email a topic idea by week 3 as the due date will be on week 14 so I have time to read and grade them before grades are due into the collegeResources:A minimum of 3 published sources of information must be used (i.e., JADA, CDA Journal, PUB MED, ADHA Journal, Access, CDHA Journal). Product package inserts are also allowed as well as testimony from dental professionals who currently use a product. Internet sources are acceptable but may not be substituted for the 3 published sources, unless they reflect material from a reputable journal that is “on line.”Format: The Literature Review should be approximately 3-4 pages in length, typed in 12 font Times New Roman and double-spaced, with references cited in the body of the text and an appropriate reference page attached using an APA format. Please give a brief history of the product/procedure, current technology, weaknesses, limitations, advantages, and disadvantages.
In this current clinical I see many medical issues that are being treated. One was from a person having DVT that progressed to PE’s as well. This patient is very obese and not very active. Patient works from home which does not require patient to move much. Patient presented with shortness of breath. Slightly diaphoretic, bp and heart rate was slightly elevated and oxygen saturation would only go up to 92% even after breathing treatment. When the patient arrived oxygen saturation was around eighty-eight with exertion. Patient never stated left leg hurt and not other real complications noted. Pt had breathing treatments at home but did not really use them correctly. Through Telehealth messaging nothing stuck out as being severe enough to be send patient to hospital. Since the issue has been going on for several days, we brought him in to assess patient. Lungs clear at time of assessment. Vitals did not red flag other than the oxygen sat when first coming in. We are unable to complete a chest x ray or CT in the clinic. Lab values would take some time. It was not until the patient stated something about the leg being discomfort behind the knee and calf. Patients’ legs were already swollen, no redness noted. Due to obesity, shortness of breath with very little activity along with the discomfort to left leg gave enough suspicion to send pt in further testing. Such as a U/S and x ray of chest if warned. Due to the inability to get an outpatient U/S of leg and the possibility of decline not to mention the stress and strain that it would have put on the patient the patient refused EMS and was instructed to head straight to the ER. The guideline that would have been used was a treatment for 3 months. This guideline state there is no one way to treat the patient. VTE treatment needs to be given promptly. Other things to consider are age and the patients’ ability to afford the medication. Thrombolytic therapy is necessary to treat patients with pulmonary embolism especially if unstable and having symptoms. Anticoagulant therapy is a secondary prevention at this point. Depending on the reason for DVT will determine the need to continue medication and for how long. Thrombolytic and anticoagulant therapy require monitoring of the patient. Clots do not go away in weeks they can take months. IVC filter may be needed for the protection of the patient (Ortel et al., 2020).
How can the NP balance shared decision making and the patient’s culture and/or preferences with safe clinical practice?
With shared decision making, there must be optimized organization among the team. There must be understanding, and trust built. Prompting the patient and family with the topic of discussion can help at times by allowing the topic or condition to be discussed and absorbed before coming into the clinic. It also allows them to brainstorm. To better understand if a patient or family member understands what was taught the teach back method is an effective way to gather that data. Document and write down the education and reason for the decisions being made (Raleigh et al., 2022). When allowing a patient and at times the family to make decisions based on the possible outcome of the health of the patient can bring unity and trust towards the health care team. This also allows the health care team the ability to understand culturally or logically how the patient feels. In shared decision making you must have communication, relationship building, and a shared decision of the direction the treatment will go. It really is a team approach (Truglio-Londrigan & Slyer, 2018).
References
Ortel, T. L., Neumann, I., Ageno, W., Beyth, R., Clark, N. P., Cuker, A., Hutten, B. A., Jaff, M. R., Manja, V., Schulman, S., Thurston, C., Vedantham, S., Verhamme, P., Witt, D. M., D. Florez, I., Izcovich, A., Nieuwlaat, R., Ross, S., J. Schünemann, H., … Zhang, Y. (2020, October 2). American Society of Hematology 2020 Guidelines for management of venous thromboembolism: Treatment of deep vein thrombosis and pulmonary embolism. American Society of Hematology. https://ashpublications.org/bloodadvances/article/4/19/4693/463998/American-Society-of-Hematology-2020-guidelines-for
Raleigh, M. F., Nelson, M. D., & Nguyen, D. R. (2022, July 31). Shared decision-making: Guidelines from the National Institute for Health and Care Excellence. American Family Physician. https://www.aafp.org/pubs/afp/issues/2022/0800/practice-guidelines-shared-decision-making.html
Truglio-Londrigan, M., & Slyer, J. T. (2018, January 22). Shared decision-making for nursing practice: An integrative review. The open nursing journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC58062…
When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.
In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.To Prepare:
Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
Review the health policy you identified and reflect on the background and development of this health policy.
Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.
Here are the resources provided by the teacher
American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advoc…
Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a…
Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.
Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.
Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.
Please make sure to incorporate APA writing and include references and in text citations. Thank you!
One of your challenges as a leader in the HIM profession will be preparing stakeholders for change and implementing change. Review the following resource, located in the module Reading and Resources area: Change Management in EHR Implementation.Then, for your initial post, respond to the following scenario:You have decided to hold a town hall to announce the HIE plan.Using the concepts discussed in the resource above, discuss the change management strategies you would use to help address resistance from various stakeholders who attend the town hall. What stakeholders should be involved in collaboration on the information governance initiatives and why?In response to at least two of your peers, compare and contrast the change management strategies they chose with those in your initial post. Try to choose to respond to students who chose different strategies than you whenever possible.
All healthcare organizations need capital to acquire the facilities, equipment, and other assets needed to run the business. They can finance their ongoing activities and future operations in a variety of ways, including equity or debt financing, or even a combination of both. Each approach has merits and shortfalls.
Address the following requirements:
Describe different types of debt financing.
Describe how credit rating can influence debt financing.
Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
You are required to reply to at least two peer discussion question post answers to this weekly discussion question and/or your instructor’s response to your posting. These post replies need to be substantial and constructive in nature. They should add to the content of the post and evaluate/analyze that post’s answer. Normal course dialogue doesn’t fulfill these two peer replies but is expected throughout the course. Answering all course questions is also required.
Discuss the project management considerations that healthcare leaders need so that HIS implementations are delivered successfully. Discuss the involvement of the end-users needed in the planning and implementation of these systems to achieve functionality and usability.In developing your initial response, be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, you are encouraged to examine their opinions, offering supporting and/or opposing views. You are required to reply to at least two of your peers’ answers to this weekly discussion question and/or your instructor’s response to your posting. These post replies need to be substantial and constructive in nature. They should add to the content of the post and evaluate/analyze that post’s answer. Normal course dialogue doesn’t fulfill these two peer replies but is expected throughout the course. Answering all course questions is also required.
This discussion gives you an opportunity to solidify your understanding of benchmarking tools, other approaches commonly used to address performance improvement, and teamwork in promoting quality care and safety.
Compare and contrast various benchmarking tools and determine how they promote quality in healthcare organizations.
Select two of the following topics and assess how they address performance improvement:
Lean
Six Sigma
Baldrige Quality Award
Outcomes measurement
Examine the importance of effective teams and how they contribute to the organization’s high-quality care and culture safety.
Access these websites for more information: Fact Sheet: The 340B Drug Pricing Program and 340B Drug Pricing Program. Access this part of the website and enter the name of your state and city or town, and see a list of contracted 340b pharmacies. If you live in a small town and there are no 340b pharmacies, choose a town in a surrounding area. For those of you who live in metro areas, look at the number of 340b pharmacies available. Then, select 2-3 small rural towns and see if there are any 340b pharmacies there.The point of this is to see where the closest 340b pharmacy is in rural areas and to learn about 340b pharmacies.
Access Letter to Sec. Becerra Urging Him to Stop Six Drug Companies That Are Denying 340B Discounts and HHS Moves to nix 340B insulin, EpiPen Discount Rule, Cites Health Center Burdento read the information regarding infighting between Big Pharma and hospitals over 340b pricing. Both of these articles highlight the importance of staying abreast of what is happening with trying to put the brakes on drug pricing and maintaining this valuable program.
When the term “community health center is used in these articles, it refers to an entity defined by HRSA to serve under- and uninsured populations. These are federally-qualified health centers (FQHCs) such as Great Salt Plains or Mary Mahoney down around OKC.
In your discussion, answer the following questions:
What did you learn from the question post links that you did not know?
Did you find any 340b pharmacies around your home?
Do you know anyone who accesses 340b drugs?
What are some other ways that can help patients save money on prescriptions?
List two websites where you can find drug pricing or help patients receive discount drug pricing at the pharmacy.
Expectation
Length: A minimum of 300 words, not including references
Citations: At least two high-level scholarly reference in APA from within the last 5 years
Assignment guidelines: Assignment must be submitted with properly filled cover sheet (Name, ID, Submission date) in word document, Pdf is not accepted.It must Avoid plagiarism. It is not acceptable. Marks will cut if plagiarism available.Word count- Maximum 500 words for each answer.Font should be 12 Time New Roman. Color should be black.Line spacing should be 1.5.Don’t use bold or Italic or underline in your answer.References should be in APA style format only.
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
Assignment Cover Sheet
Course name:
GLOBAL HEALTH
Course number:
PHC 311
CRN
Assignment title or task:
What are the different types of Aids which are delivered by
wealthy countries to poor countries? (10 marks)
Student Name:
Students ID Number:
Submission Date:
Instructor name:
Turki Alsabhan
Grade:
Out of 10
College of Health Sciences
Department of Public Health
Assignment Instructions (Week 5):
Dear Students,
The Assignment is available in Course materials and activities under Week 5 by name Week 5 –
Assignment.
This activity will comprise for 10 marks in the Total course work.
The Assignment is available from Release date 26/09/2023.
Assignment guidelines:
•
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, Submission date)
in word document, Pdf is not accepted.
It must Avoid plagiarism. It is not acceptable. Marks will cut if plagiarism available.
Word count- Maximum 500 words for each answer.
Font should be 12 Time New Roman.
Color should be black.
Line spacing should be 1.5.
Don’t use bold or Italic or underline in your answer.
References should be in APA style format only.
Attached is the document with the patient scenario and instructions.Word count: 2500 words. Please avoid using AI since it will be run through an AI detector.Use APA 7th edition format.
Unformatted Attachment Preview
Patient scenario
Elena T. (she/her) is a 53-year-old primary school teacher of Greek background with a past
medical history of social anxiety disorder, hypertension, and osteoarthritis. Her medications
include Zoloft (sertraline 50 mg orally, mane), Olsetan (olmesartan medoxomil 20 mg orally,
once daily), Panadol Osteo (paracetamol 665 mg-controlled release orally, two tablets BD),
and Nurofen (ibuprofen 200 mg orally, TDS PRN). Elena is overweight (BMI = 30) and has a
history of smoking one pack of cigarettes per day for 25 years (31 pack years). She had
elevated blood sugar and cholesterol levels 12 months ago but did not follow up with a
clinical diagnostic work-up. Until recently, Elena has felt fine. Today, she presents to the
general practitioner (GP), Dr. Lee, complaining that her left foot has been weak and numb for
nearly two weeks, and that the foot is difficult to flex. Furthermore, she reports that she has
been very thirsty lately and gets up more often at night to urinate.
Elena’s physical examination including random plasma glucose level revealed the following:
blood pressure of 160/105 mmHg, pulse rate of 96 bpm, and random plasma glucose of 13.1
mmol/L. Dr. Lee suspects type 2-diabetes, and orders additional tests that need to be done
after an overnight fast. Some of Elena’s results of additional tests are presented in the table
below.
Blood test results
BGL: 8.8 mmol/L
HbA1c = 7.5
Total cholesterol: 6.9
mmol/L
HDL: 1.2 mmol/L
Urinalysis
Ketones: negative
Protein: negative
Glucose: positive
Microscopy: negative for
microbes, red blood
cells and white blood
cells.
LDL: 4.7 mmol/L
Dr. Lee initiates pharmacological therapy consisting of Caduet (amlodipine 10 mg and
atorvastatin 20 mg orally, once daily), Diabex XR (metformin 500 mg-controlled release
orally, once daily) and cessation of olmesartan medoxomil. Elena is now referred for
education in relation to her medication management.
A complete response will:
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•
•
•
•
•
Include a clear introduction, essay body divided into sections, and a
conclusion.
o Introduction sets the context and diverse perspectives. It
outlines the findings of the patient scenario and clearly and
succinctly describes the structure and purpose of the assignment
focusing on the pharmacology, Quality Use of Medicines (QUM)
Framework, education and medication management.
o Body critically analyses the patient scenario in relation to
pharmacology and the QUM Framework. Applies the principles
of the QUM to develop an education session that covers
medication management aspect for the patient. Utilises the
relevant evidence to the patient scenario, applies theoretical
perspectives to practice and makes clear recommendations for
further research. Examines the patient scenario findings in a
unified and structured manner and considers the quality of the
evidence and similarity of patients studied compared to the
patient scenario given. The body needs to be divided into
sections with headings and subheadings where appropriate. The
ideas expressed in the body of the assignment should follow a
logical progression. A structured approach using subheadings for
the areas discussed can be helpful for the author (to order your
thoughts) and for the reader (they serve as signposts for the
direction of the content). A logical, rational argument also
depends on appropriate sentence and paragraph construction.
Paraphrase previous work wherever possible rather than using
direct quotes. However, direct quotes can be used to emphasise
key issues. Avoid long quotes as they interrupt the flow of your
discussion.
o Conclusion provides a comprehensive summary of the patient
scenario, reiterates the paper’s main findings and outlines
limitations.
Provide a sophisticated and highly accurate explanation of
pharmacodynamics & pharmacokinetics and how the medications apply to
the patient.
Shows how the scenario relates to QUM principles and provide an
evidence-based rationale and explanation for patient’s education and
medication management
A concise and highly systematic synthesis, interpretation and analysis of
research evidence; identifies and analyses patterns or trends in the
literature and provides well-constructed evidence for further research,
with careful consideration to what research has already been undertaken.
Use double spacing and avoid single or triple spacing between paragraphs.
Use a minimum of eight different references (peer-review articles, textbooks, clinical guidelines, policies, professional websites) in APA 7th
This assignment is a video using a Power Point presentation. Videos can be recorded using any software or tool, but all videos are required to be uploaded to My Panopto Videos for assignment submission. Again save as an MP4 file.
Ethical Issues Debate Question: When a patient is in the end-of-life decision, should food or water be withheld?
Position: Against that statement. You need to convince your audience of your point and position.
Once you receive your topic and position, prepare to create a video that will be due in Week 5. Save as an MP4 file otherwise, I will not be able to open it.
The video should be 4-5 minutes long and address the topic and viewpoint you were assigned.
You may not be personally in support or opposition of the topic, however it is your job to convince your peers of your position. Include evidence that supports the viewpoint.
Include an introduction to the issue, your stance, the rationale for the stance, the ethical principals involved, theories and evidence supporting your position, and your proposed resolution. Review the rubric in this forum for complete grading criteria.
Your video should include both audio and visual components such a graphics or charts. You can choose to do a PowerPoint, yourself on video with a poster or visual aids, or anything that supports and convinces your peers of your stance.
Get creative! Be succinct but convincing. If you go over the time limit, you will only be graded on the first 5 minutes.
Assignment Rubric DetailsCloseRubricNURS_510_DE – Ethical Issues Debate Project
NURS_510_DE – Ethical Issues Debate Project
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeWeek 5 Video Overall Presentation
20 to >16.4 ptsAccomplished (80-100%)Presentation is well organized and approximately 4-5 minutes in length. Audio is clear and reasonably paced. Visual component compliments audio component. Discussion reflects an atmosphere of mutual respect. 16.4 to >15.0 ptsEmerging (60-79%)Presentation is fairly organized, but there are several areas of improvement. Presentation is less than 4-5 minutes in length and some areas are not addressed. Audio needs some improvements. Visual component needs work. Discussion reflects an atmosphere of mutual respect. 15 to >0 ptsUnsatisfactory (0-59%)Presentation is unorganized and lacks structure. Presentation is extremely limited. Audio is absent or needs significant improvements. Visual component is absent or severely lacking.
20 pts
This criterion is linked to a Learning OutcomeWeek 5 Video: Ethical Issues, Concern, & Proposed Resolution
60 to >49.2 ptsAccomplished (80-100%)There is a clear description of the ethical issue including a proposed resolution. The issue topic is a current issue of debate and related to health care. The issue has a clearly defined dilemma with more than one resolution. Ethical principles and theories involved with the ethical issue are clearly identified and explained. 49.2 to >45.0 ptsEmerging (60-79%)Description of the ethical issue, the dilemma, and/or proposed resolution is lacking some details and relevant information. 45 to >0 ptsUnsatisfactory (0-59%)Description of the ethical issue, the dilemma, and/or proposed resolution is absent or severely lacking.
60 pts
This criterion is linked to a Learning OutcomeWeek 5 Video: Supporting Argument/Stance
40 to >32.8 ptsAccomplished (80-100%)Supporting argument is well developed either for or against the issue. Factors supporting the stance are well identified. Ethical principles and theories involved with the ethical issue are clearly identified and explained and in alignment with the viewpoint. 32.8 to >30.0 ptsEmerging (60-79%)Proposed resolution supporting your argument is not well defined. Key stakeholders and factors supporting your resolution are not clearly identified. 30 to >0 ptsUnsatisfactory (0-59%)Proposed resolution supporting your argument is absent or ill defined. Key stakeholders and factors supporting your resolution are absent or poorly identified.
40 pts
This criterion is linked to a Learning OutcomeWeek 6 Rebuttal
40 to >32.8 ptsAccomplished (80-100%)Rebuttal to classmate’s post is complete and includes key points including stakeholders, essential factors, and important facts supporting the resolution. The rebuttal reflected an atmosphere of mutual respect. Policy drivers and ethical principles involved are clearly identified and explained in support or opposition of the resolution. 32.8 to >30.0 ptsEmerging (60-79%)Rebuttal to classmate’s post is incomplete and missing some key points regarding stakeholders, essential factors, and important facts supporting the resolution. Policy drivers and ethical principles involved are not clearly identified and explained in support or opposition of the resolution. 30 to >0 ptsUnsatisfactory (0-59%)Rebuttal to classmates’ post is absent or largely incomplete. Key points regarding stakeholders, essential factors, and important facts supporting the resolution are absent or severely lacking. Policy drivers and ethical principles involved and in support or opposition of the resolution are absent or severely lacking.
40 pts
This criterion is linked to a Learning OutcomeWeek 6 Rebuttal: Participation
40 to >32.8 ptsAccomplished (80-100%)The minimum number of postings were met. The student followed netiquette in addition to the posting timeframe to contribute throughout the week. 32.8 to >30.0 ptsEmerging (60-79%)Less than the minimum number of postings were evident. The student mostly followed netiquette and met most of the posting timeframe to contribute throughout the week. 30 to >0 ptsUnsatisfactory (0-59%)There was a severe deficit in contribution. Less than the minimum number of postings were evident. The student did not follow netiquette and did not meet the participation requirements.
40 pts
Hello there, i hope you doing great. When you writing the assignment, copying from artificial intelligence or Internet sources is not allowed ** Please use your own words **
Unformatted Attachment Preview
Written Assignments
Core Concepts Paper
Purpose: The purpose of this assignment is to facilitate thinking about your
personal beliefs in relation/comparison to the core concepts of Communication,
Compassionate Care, Diversity, equality and inclusion, Ethics, Evidence-Based
Practice, Health Policy, and social determinants of Health in nursing practice as
outlined and defined by the AACN . As a senior level nursing student you may be
asked to revisit this assignment so please keep your work.
Before you begin to write this paper:
Read the American Association of Colleges of Nursing (AACN) “2021 THE
ESSENTIALS: CORE COMPETENCIES FOR PROFESSIONAL NURSING
EDUCATION” description of the above core concepts – Look closely at pages 1114. (https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essential
s-2021.pdf Reflect within your paper on at least 5 out of the 8 core concepts and
how they
o 1) relate to nursing
o 2) how they compare to your own thoughts and feelings on these
concepts. Provide examples from nursing literature, your work or life
experiences.
This paper can be thought of as a comparison and introspection of your own
beliefs and values compared to Rockford University’s Nursing Department values
of the discipline of nursing rising from the AACN Essentials.
Directions:
Students are expected to use the Publication Manual of the American
Psychological Association (7th edition) to guide the formatting of this paper. One
third of the points received for this paper stem from APA formatting, see
rubric below.
5-6 pages (not including title, reference and rubric page) typed, doublespaced, one-sided, 12-point font paper. Required typeface throughout- Times
New Roman.
Minimum of four different reference citations (Four Different resources)
All papers submitted should be at an acceptable college level of writing.
The following grading rubric will be used: Please attach a copy of this rubric as
the final page of your paper, after reference page.(One will be available on
Canvas)
Core Concept Paper Grading Rubric
Grading Rubric
Points
AACN Core Concepts (Student to pick 5 out of the 8 of their choice)
Concept 1:
2
Concept 2:
2
Concept 3:
2
Concept 4:
2
Concept 5:
2
Mechanics:
Clarity and effectiveness of writing
2
Lack of spelling errors
1
APA Format:
Appropriate formatting of paper using APA 6th Edition guidelines
3
• Title page
• Page headers
• Page numbers
• Headings
• Page margins
• No Use of First Person
Appropriate in-text citation of sources using APA formatting
2
• Match reference page
• Quotations cited correctly
Complete reference page that includes all sources cited in text
2
• APA format of citation
• Citations congruent with the text
• Citations accurate and complete including punctuation
TOTAL
20
Your Score
