Category: Nursing

Nursing Research Paper

Write a five to seven page paper. The paper should include basic information about the research article you have chosen to investigate.

Format your paper consistent with APA guidelines. Within your paper, please include a minimum of three references (your text may be used as a reference).

Identification of the research study: independent and dependent variables

Identification of the research study: sample characteristics

Identification of the data collection procedures

Discuss the results of the study. What was the statistical significance? Were the results meaningful?

Identify the study implications. What are the implications of this study for nursing practice, education, or administration? What further questions were raised by this study?

Include your own evaluation of the study. In your opinion, was this study done well, and was this an important study for nursing? How could the study have been improved? What are the implications of this study for your practice area? Please give your rationale for your opinion.

Your recommendations on this topic for further nursing research: include a new research hypothesis with identified variables

Your conclusions, summary, or ending statements on nursing research

APN Role in Teaching

An advanced practice nurse (APN) serves a critical role in today’s health care sector by educating patients, students, staff and other learners. Patient education is an important part of managing patient care to achieve optimal outcome. Patients gain an understanding of their health status, disease processes, treatments, dietary/lifestyle modifications and health promoting behaviors. This enables patients to be an active participant in their health care decisions. In addition, APN’s educate or teach staff by assisting them in developing the knowledge and skills essential for providing care, keeping them up to date with advances in clinical practice, and mentoring/precepting nurses in the practice setting-improving the quality of patient care (Joel, 2013). This role of APN’s also extends to nursing students as they teach and guide their learning in the practice setting.

APN’s should be well versed with the concepts of learning and teaching in order to teach patients, staff, students and others. This helps APN’s in making educational decisions. Teaching process includes assessment of learning needs, planning, implementation and evaluation (Joel, 2013). However, the process is not always linear. APN’s should possess predominant qualities of effective learning like expert knowledge, clinical competence, teaching skills, positive relationships and personal characteristics. APN’s should be able to decipher not just the learning needs, but also the learner’s readiness to learn. This is achieved through questionnaires, pretests and observations. Assessment phase is the most crucial phase as it defines the course of action the APN has to take. Once assessment is complete, different teaching mechanisms can be inherited to impart the knowledge. The group sizeis an important factor. When educating patients or staff/students, an APN has to be innovative in determining the teaching method. The teaching method can include lecture, discussion, clinical conference, case study, multimedia, self-directed instructional methods, demonstrations, and simulations. After teaching evaluating whether the learner has comprehended the knowledge imparted is important as well.

APN’s have an important role in educating patients, staff and students. Nurses in advanced practice are well prepared for their role as an educator with their extensive knowledge base, expert clinical skills, and strong communication skills (Joel, 2013).

References

American Association of Colleges of Nursing (2011). The essentials of master’s education in nursing. Retrieved from http://www.aacn.nche.edu/education-resources/MastersEssentials11.pdf

Joel, L.A., (2013) Advanced practice nursing: Essential for role development. (3rd Ed.). Philadelphia: F.A. Davis. Pp 327-346

Penn, B., Wilson, L., Rosseter, R., (2008) Transitioning From Nursing Practice to a Teaching Role.OJIN: The Online Journal of Issues in Nursing; Vol (13/ 3). Doi:10.3912/OJIN.Vol13No03Man03

Your peer has written the following on Nursing theory, please respond …

For me, the nursing theories topic was a highlight for me in this course. The topic shed so much light on the nursing practice and it enlightened me. The topic provided the basics of nursing practice, helped to generate additional knowledge and point out in which way nursing is supposed to develop in the coming days. The theories have described, predicted and explained the experience of nursing. The topic helped me to decide what I know and what I need to know. The topic also helped to differentiate what should form the base of practice by openly describing nursing practice.

The nursing theory that I believe will be most relevant to your current practice and future career as an advanced practice nurse is self-care deficit nursing theory by Dorothea Orem which specifies that as nurses, it is very important to think about the health status of us and also that of the relatives they have. A lot of the nurses do not consider this as they are paying attention to providing healthcare services to other patients and therefore forget to offer themselves better care (Masters, 2015). As a lover of nursing, I am quite sure that my service to patients will come naturally without a lot of strife and therefore I will practice them without a problem. However, the self-care deficit theory stood out for me since I thought that I would fall into the trap of concentrating too much on the patients and forgetting about myself and my relatives and friends.

References

Masters, K. (2015). Nursing Theories: A Framework for Professional Practice. (2nd Ed.). Burlington, Massachusetts. Jones & Bartlett Learning

Write a quantitative research article about how to decrease pain using routine pain meds versus PRN pain medication with cognitive impairment patients

Approach to care of cancer

Write a paper describing the approach to care of cancer. In addition, include the following in your paper:

Describe the diagnosis and staging of cancer.

Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the

rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

RUBRICS

30.0 % Explanation of the Diagnosis and Staging of Cancers is Provided.

An explanation of the diagnosis and staging of cancers is not provided.

An explanation of the diagnosis and staging of cancers is provided but is missing relevant information.

An explanation of the diagnosis and staging of cancers is provided that meets the assignment criteria.

An explanation of the diagnosis and staging of cancers is provided that is offered in a detailed manner.

An explanation of the diagnosis and staging of cancers is provided that is offered in a detailed manner, while demonstrating higher level or critical thinking.

20.0 % At Least Three Complications of Cancer are Identified With Comprehensive Discussion of Available Treatments.

Less than three complications of cancer are identified.

At least three complications of cancer are identified but lacking a comprehensive discussion of available treatments.

At least three complications of cancer are identified with a comprehensive discussion of available treatments.

More than three complications of cancer are identified with a comprehensive discussion of available treatments.

More than three complications of cancer are identified with a comprehensive discussion of available treatments, while demonstrating higher level or critical thinking.

30.0 % Provides Recommendations to Address Physiological and Psychological Side Effects of Care.

Recommendations to address physiological and psychological side effects of care are lacking.

Recommendations to address physiological and psychological side effects of care are missing relevant information.

Recommendations to address physiological and psychological side effects of care meet the assignment criteria.

Recommendations to address physiological and psychological side effects of care are offered in a detailed manner.

Recommendations to address physiological and psychological side effects of care are offered in a detailed manner, while demonstrating higher level or critical thinking.

15.0 %Organization and Effectiveness

5.0 % Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.

Thesis and/or main claim are apparent and appropriate to purpose.

Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

5.0 % Paragraph Development and Transitions

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.

Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.

Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

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.

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.

5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

5.0 %Format

2.0 % Paper Format (1- inch margins; 12-point-font; double-spaced; Times New Roman, Arial, or Courier)

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

3.0 % Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

No reference page is included. No citations are used.

Reference page is present. Citations are inconsistently used.

Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.

Reference page is present and fully inclusive of all cited sources.

Heath care organization

Overview

Review the performance dashboard for a health care organization, as well as relevant local, state, and federal laws and policies. Then, write a 3-4 page report for senior leaders in the organization that communicates your analysis and evaluation of the current state of organizational performance, including a recommended metric to target for improvement.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

In the era of health care reform, many of the laws and policies set by government at the local, state, and federal levels have specific performance benchmarks related to care delivery outcomes that organizations must achieve. It is critical for organizational success that the interprofessional care team is able to understand reports and dashboards that display the metrics related to performance and compliance benchmarks. This assessment offers an opportunity for you to demonstrate and sharpen your ability to analyze, interpret, and evaluate performance dashboard metrics.

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

Competency 1: Analyze the effects of health care policies, laws, and regulations on organizations, interprofessional teams, and personal practice.

Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization or an interprofessional team.

Competency 3: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.

Advocate for ethical action in addressing a benchmark underperformance, directed toward an appropriate group of stakeholders.

Competency 4: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, for health care policies and law for patients, organizations, and populations.

Evaluate dashboard metrics with regard to benchmarks set by local, state, or federal health care policies or laws.

Evaluate a benchmark underperformance in a heath care organization or an interprofessional team that has the potential for greatly improving overall quality or performance.

Competency 6: Apply various methods of communicating with policy makers, stakeholders, colleagues, and patients to ensure that communication in a given situation is professional, clear, efficient, and effective.

Influence an idea for change into a law

As you have discovered through this course, nurses are influential members of the community and the political system. Therefore, for the purposes of this assignment you will identify a problem or concern in your community, organization, etc. that has the capacity to be legislated. You will conduct research and state a proposal. Through the legislative process, your proposal for the problem or concern may influence an idea for change into a law.

First, refer to the “How a Bill Becomes a Law” media.

Then, view the “Bill to Law Process” to watch the scenario.

After viewing the scenario, refer to the “Legislative Assignment.” You will need to save the document first in order to use it.

Submit the assignment to the instructor. You also reserve the right to submit your completed proposal to the respective government official. However, this is optional. If you select to submit your proposal as a part of the legislative process, refer to “Find Your Representative” or research the contact information on your own.

APA format is not required, but solid academic writing is expected.

You are not required to submit this assignment to Turnitin.

Critical Incident Stress Debriefing (CIS)

Working in the health care industry often puts health care professionals in the line of danger from ill patients, stressed families, overburdened health care facilities, and the many situations and locations in which each individual works. The Critical Incident Stress Debriefing (CIS) Management Tool has been designed to decrease the stress levels of those that experienced or witnessed violence or trauma. You will read the article “Workplace violence: Differences in perceptions of nursing work between those exposed and those not exposed: A cross-sector analysis” to complete your assignment.

Write a 1,250-1,500-word paper describing the CIS. Be sure to specifically address:

What are the physical, cognitive, emotional, and behavioral reactions to stress?

Can you name at least three professions that are at risk and would have utilized the tool?

What is the purpose of using the tool?

What is the expected outcome from utilizing this stress management tool?

Do you believe the tool to be useful in decreasing stress and coping with violence in the workplace? Why or why not?

How a Bill Becomes a Law

Introduction (Setting the Stage)

You are working in the emergency room of a local hospital. Two children are rushed in with multiple

injuries including broken bones and lacerations to the head. You learn that the children were riding on

the front row of a school bus when a car made an illegal turn in front of the bus causing the bus driver to

brake suddenly.

You decide to research similar incidents and notice this is a common occurrence both in the state and

nationally. You are also aware of a legislative bill in your state last year to have seatbelts placed on all school buses, but it did not pass; in fact, the bill never progressed past the House Transportation

Committee which meant that the bill “died in committee.”

Here is an example of the path a bill has to take to become a law in the state of Indiana. The process is

very similar in other states. Notice how easy it is for a bill to die along the way.

http://www.in.gov/gov/files/BillintoLaw.pdf

How a Bill Becomes a Law, Your Idea:

As a constituent of your state and a concerned health care provider, you find yourself troubled that such

an important bill focused on child safety would not even pass through its first committee. You decide

that if the recommendations to the bill were changed to require seatbelts for those only sitting in the

front seats of the bus, the bill might have a better chance of passing. So you discuss the idea with

several colleagues and they agree that it would be worth perusing. You do not know how to move this

initiative forward so you start exploring. You find out that the idea for a bill can begin with a legislator

(elected government official), state agency, business, lobbyist, state-nursing association, or a citizen like you! You find out that Mr. Thomas Jones is your representative to the state legislature, and you realize that he is a parent in your school district.

How a Bill Becomes a Law, Putting Your Plan Into Action:

Mr. Jones has been very active in the community. He has three young children who ride the school bus.

You see him at a PTA meeting and decide to mention your idea to him. Mr. Jones tells you he is

interested in your idea but needs to know more information; how many people feel the same way and

how much background information can you give him. He informs you that he will consider supporting

the idea if you obtain 1,500 names on a petition from the district and fill out his legislative worksheet for new ideas. You get your friends to canvas the neighborhood where the incident occurred. Within days,

you have more than 2,000 signatures of registered voters who support this initiative.

You visit Mr. Jones in his office in the State Capitol and present him with the signatures and the

completed legislative worksheet. He discusses this initiative with his colleagues in the house and gets

three representatives to agree to sponsor the bill with him. They introduce the bill and it starts its

journey through the legislative process. The members of the committee discuss the merits of the bill and

then vote on it. If approved, the bill goes to the full House. They will examine the merits of the bill,

debate as needed, and vote. If the House does not approve the bill, it may either send it back to the

committee it came from or abandon it. If more than half of members approve it, the bill is sent to the

other house (in this case, the Senate).

In the Senate, the process is repeated. If passed, it then goes to the governor to sign into law. The

governor reserves the right to veto the bill and send it back to Congress. Both houses of Congress then

have three choices:

1. They can change the bill so it is more to the governor’s liking; or

2. They can agree that the bill will never be passed and let it go; or

3. They can vote to override the governor’s veto.

In order for Congress to override the governor’s signature, they need to have two-thirds of the members

of both houses vote to override.

Good news for you: The Senate passed your bill, and the governor has signed it. Your bill is now a law!

Nursing Questions and Answers

Question 1

When a provider receives a fixed amount to provide only the care that an individual needs from the provider, this is known as a _____________ payment.

capitation

fixed

premium

sub-capitation

4 points Save Answer

Question 2

The healthcare industry is heavily regulated by ____ and ____ legislation.

city; local

state; city

county; state

federal; state

4 points Save Answer

Question 3

When a patient signs a release of medical information at a physician’s office, that release is generally considered to be valid

for six months

for a single visit to the physician

for one year from the date entered on the form

until the patient changes insurance companies

4 points Save Answer

Question 4

When the provider is required to receive as payment in full whatever amount the insurance reimburses for services, the provider is agreeing to

accept assignment

assignment of benefits

authorize services

coordination of benefits

4 points Save Answer

Question 5

Which document is used to guarantee the patient’s financial and medical record?

encounter form

patient insurance form

patient ledger

patient registration form

4 points Save Answer

Question 6

The person responsible for paying the charges for services rendered by the provider is the

beneficiary

guarantor

guardian

subscriber

4 points Save Answer

Question 7

Which federal legislation was enacted in1995 to restrict the referral of patients to organizations in which providers have a financial interest?

Federal Anti-Kickback Law

Hill-Burton Act

HIPAA

Stark II laws

4 points Save Answer

Question 8

The recognized difference between fraud and abuse is the

cost

intent

payer

timing

4 points Save Answer

Question 9

The specified amount of annual out-of-pocket expenses for covered health care services that the insured must pay annually for health care is called the

coinsurance

copayment

deductible

premium

4 points Save Answer

Question 10

Which three components constitute the RBRVS payment system?

fee schedule, practice expense, and malpractice expense

physician work, practice expense, and geographical location

physician work, practice expense, and malpractice insurance espense

practice expense, malpractice insurance expense, and liability insurance expense

4 points Save Answer

Question 11

Mandates are

directives

laws

regulations

standards

4 points Save Answer

Question 12

Which type of HMO offers subscribers health care services by physicians who remain in their individual office setting?

closed panel

independent practice association

network model

staff model

4 points Save Answer

Question 13

HIPAA requires payers to implement rules called electronic __________, which result in a uniform language for electronic data interchange.

data interchanges

health records

medical records

transaction standards

4 points Save Answer

Question 14

The ambulatory payment classification prospective payment system is used to reimburse claims for what services?

inpatient

nursing facility

outpatient

rehabilitation

4 points Save Answer

Question 15

Breach of confidentiality can result from

discussing patient health care information with unauthorized sources

discussing the patient’s case in the business office

sending medical information to non-health care entities with the patient’s consent

sending patient health care information to the patient’s insurance company

4 points Save Answer

Question 16

When a patient elects to receive care from a non-PAR, the patient will accrue _____.

higher copays

higher out-of-pocket expenses

lower premiums

lower copays

4 points Save Answer

Question 17

When a number of people are grouped for insurance purposes, this is known as a(n)

adverse selection

insurance pool

member group

risk pool

4 points Save Answer

Question 18

Because the diagnosis and procedure codes reported affect the DRG selected (and resultant payment), some hospitals engaged in a practice called __________, which is the assignment of an ICD-10-CM diagnosis code that does not match patient record documentation, for the purpose of illegally increasing reimbursement.

downcoding

jamming

unbundling

upcoding

4 points Save Answer

Question 19

The problem-oriented record (POR) is a systematic method of documentation that consists of

a database.

progress notes.

an initial plan.

all of the above.

4 points Save Answer

Question 20

Which of the following is an example of fraud?

billing noncovered services as covered services

falsifying certificates of medical necessity plans of treatment

reporting duplicative charges on an insurance claim

submitting claims for services not medically necessary

4 points Save Answer

Question 21

Care rendered to a patient that was not properly approved (e.g., preapproved) by the insurance company is known as

medical necessity

noncovered benefits

unapproved services

unauthorized services

4 points Save Answer

Question 22

A risk contract is defined as an arrangement among health care providers

stating that the HMO can provide services to Medicare beneficiaries only

that allows higher payments to the HMO if they treat Medicare beneficiaries

to make available capitated health care services to Medicare beneficiaries

to offer fee-for-service health care services to Medicare beneficiaries

4 points Save Answer

Question 23

Which of the following is an example of abuse?

billing noncovered services/procedures as covered services/procedures

falsifying health care certificates of medical necessity plans of treatment

misrepresenting ICD-10-CM and CPT/HCPCS codes to justify payment

submitting claims for services and procedures knowingly not provided

4 points Save Answer

Question 24

Preventive services

may result in the early detection of health problems.

are required by most insurance companies.

allow treatment options that are less dramatic and less expensive.

both a and c.

4 points Save Answer

Question 25

Drew Baker is referred to a health care provider by an employer for treatment of a fracture that occurred during a fall at work. The physician billed Medicare and did not indicate on the claim that the injury was work related. Medicare benefits were paid to the provider for services rendered. This resulted in Medicare contacting the provider, who is liable for the __________ because of the provider’s failure to disclose that the injury was work-related.

adjudication

mediation

overpayment

unbundling