Category: Nursing

  • Utilitarianism Ethical Principle Theory and Bentham’s Felicific Calculus Essay

    Utilitarianism Ethical Principle Theory and Bentham’s Felicific Calculus Essay

    Choose a contemporary moral issue in our society and apply the ethical principle of Utilitarianism to approve and be in favor of this moral issue. You must pick a moral issue that you strongly agree with and apply the utilitarian claims to back up your arguments. In addition, you must apply Bentham’s Felicific Calculus.

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    The paper must be done in MLA format with a minimum of 500 words (quotes are not included in the word count). You must read Chapter 2 and watch the Week 3 Lectures before you do this paper. You must use at least 3 sources from LIRN, in our library. This assignment is due on January 21st, NO LATER than at 11:59 pm. Not applying Utilitarianism or the Felicific Calculus results in an automatic F. Utilitarianism is the ethical theory that the moral worth of an action is only determined by its contribution to overall utility . It is thus a form of consequentialism , meaning that the moral worth of an action is determined by its outcome-the ends justifies the means.

    Utilitarianism Ethical Principle Theory and Bentham’s Felicific Calculus Essay

  • NURS 6053 – Interprofessional Organizational and Systems Leadership

    NURS 6053 – Interprofessional Organizational and Systems Leadership

    Students in this course prepare to exercise leadership through which they can help to ensure their organization is able to adapt and flourish in the ever-changing world of healthcare. Students explore the impact of healthcare system changes on transforming the nursing profession. They examine and discuss theories related to leadership and management and learn about empowerment strategies that assist master’s-prepared nurses to assume and succeed in leadership roles. Students engage in course assignments that focus on real-world nursing practice applications of theory.

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    NURS 6053 – Interprofessional Organizational and Systems Leadership Required Course Readings

    The links are for required readings found in the Walden databases 
    ONLY
    . For all other readings, see your course resources.

    Enter your myWalden user name and password at the prompt.

    Adams, S. L., & Anantatmula, V. (2010). Social and behavioral influences on team process. 
    Project Management Journal, 41
    (4), 89–98.

    Allmark, P., Baxter, S., Goyder, E., Guillaume, L. and Crofton-Martin, G. (2013), Assessing the health benefits of advice services: using research evidence and logic model methods to explore complex pathways. 
    Health & Social Care in the Community
    , 21, pp. 59–68. NURS 6053 – Interprofessional Organizational and Systems Leadership

    Azaare, J., & Gross, J. (2011). The nature of leadership style in nursing management. 
    British Journal of Nursing, 20
    (11), 672–676, 678–680.

    Benoliela, P.  &  Somecha, A. (2014). The health and performance effects of participative leadership: Exploring the moderating role of the Big Five personality dimensions. 
    European Journal of Work and Organizational Psychology
    , 23(2), 277-294.

    Brunettoa Y., Shacklockb K., et al. (2012). Comparing the impact of leader–member exchange, psychological empowerment and affective commitment upon Australian public and private sector nurses: implications for retention. The International Journal of Human Resource Management, 23(11), 2238-2255.

    Chun, J. S., & Choi, J. N. (2014). Members’ needs, intragroup conflict, and group performance. 
    The Journal Of Applied Psychology
    , 99(3), 437-450.

    Cianci, A. M., Hannah, S. T., Roberts, R. P., & Tsakumis, G. T. (2014). The effects of authentic leadership on followers’ ethical decision-making in the face of temptation: An experimental study
    . The Leadership Quarterly
    , 25(3), 581-594.

    Collins, J. C., & Porras, J. I. (1996). Building your company’s vision. 
    Harvard Business Review, 74
    (5), 65–77.

    Disch, J. (2014). Using Evidence-Based Advocacy to Improve the Nation’s Health
    . Nurse Leade
    r, 12(4), 28-31.

    Downey, M., Parslow, S., & Smart, M. (2011). The hidden treasure in nursing leadership: Informal leaders. 
    Journal of Nursing Management, 19
    (4), 517–521.

    Eagar, S. C., Cowin, L. S., Gregory, L., & Firtko, A. (2010). Scope of practice conflict in nursing: A new war or just the same battle? 
    Contemporary Nurse, 36
    (1/2), 86–95.

    Gifu, D., Dima, I. C., & Teodorescu, M. (2014). New communication approaches vs. traditional communication. 
    International Letters of Social and Humanistic Sciences
    , (20), 46-55.

    Graham, S., & Melnyk, B. M. (2014). The Birth of a Healthcare Leadership Academy: Lessons Learned From The Ohio State University. 
    Nurse Leader,
     12(2), 55-74. NURS 6053 – Interprofessional Organizational and Systems Leadership

    Haynes, J., & Strickler, J. (2014). TeamSTEPPS makes strides for better communication. 
    Nursing
    , 44(1), 62-63.

    Hogg, M. A., Van Knippenberg, D., & Rast, D. E., III. (2012). Intergroup leadership in organizations: Leading across group and organizational boundaries. 
    Academy of Management Review, 37
    (2), 232–255.

    Jennings, B. M., Scalzi, C. C., Rodgers, J. D., & Keane, A. (2007). Differentiating nursing leadership and management competencies. 
    Nursing Outlook, 55
    (4), 169–175.

    Johansen, M. L. (2012). Performance potential. Keeping the peace: Conflict management strategies for nurse managers.
    Nursing Management, 43
    (2), 50–54.

    Johansson, C., Miller, V. D., Hamrin, S. (2014) Conceptualizing communicative leadership: A framework for analyzing and developing leaders’ communication competence. 
    Corporate Communications: An International Journal
    , 19 (2), 147 – 165.

    Kaufman, B. (2012). Anatomy of dysfunctional working relationships. 
    Business Strategy Series, 13
    (2), 102–106.

    Keys, Y. (2014). Looking ahead to our next generation of nurse leaders: Generation X Nurse Managers. 
    Journal of nursing management,
     22(1), 97-105.

    Leach, L. S., & McFarland, P. (2014). Assessing the Professional Development Needs of Experienced Nurse Executive Leaders.
     Journal of Nursing Administration
    , 44(1), 51-62. NURS 6053 – Interprofessional Organizational and Systems Leadership

    Manley, K., O’Keefe, H., Jackson, C., Pearce, J., & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: Organisational transformation using practice development methodology.
     FoNS 2014 International Practice Development Journal
     4 (1) [2].

    Manojlovich, M., & Ketefian, S. (2016). The effects of organizational culture on nursing professionalism: Implications for health resource planning. Canadian Journal of Nursing Research Archive, 33(4).

    Manojlovich, M., Harrod, M., Holtz, B., Hofer, T., Kuhn, L., & Krein, S. L. (2015). The Use of Multiple Qualitative Methods to Characterize Communication Events Between Physicians and Nurses. 
    Health communication
    , 30(1), 61-69.

    Marker, D. (2010). Leadership or management? 
    Management Quarterly, 51
    (2), 31–34.

    Martin, M. B. (2014). Transcultural Advocacy and Policy in the Workplace: Implications for Nurses in Professional Development.
     Journal for nurses in professional development
    , 30(1), 29-33.

    McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P. Brown, C.,  Baumgart, A.,  Nyström, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change.
    Quality Management in Health Care
    , 23(4), 254-267

    Meyer, R. M., & O’Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. 
    Journal of Advanced Nursing, 66
    (12), 2828–2838. NURS 6053 – Interprofessional Organizational and Systems Leadership

    Mitchell, G. (2013). Selecting the best theory to implement planned change. 
    Nursing Management – UK
    , 20(1), 32-37.

    Nelson, W. A., & Gardent, P. B. (2011). Organizational values statements. 
    Healthcare Executive, 26
    (2), 56–59.

    Ortega, A., Sánchez-Manzanares, M., Gil, F., & Rico, R. (2013). Enhancing team learning in nursing teams through beliefs about interpersonal context. Journal Of Advanced Nursing, 69(1), 102-111.

    Plath, D. (2013). Organizational processes supporting evidence-based practice
    . Administration in Social Work,
     37(2), 171-188.

    Rai, G. S. (2013). Job satisfaction among long-term care staff: Bureaucracy isn’t always bad
    . Administration in Social Work
    , 37(1), 90-99.

    Rao, A. (2012). The contemporary construction of nurse empowerment.
     Journal of Nursing Scholarship,
     44(4), 396-402.

    Ross, E. J., Fitzpatrick, J. J., Click, E. R., Krouse, H. J., & Clavelle, J. T. (2014). Transformational leadership practices of nurse leaders in professional nursing associations. 
    Journal of Nursing Administration
    , 44(4), 201-206.

    Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. 
    The Journal of Nursing Administration,
     43(2), 69-72.

    Seyranian, V. (2014). Social Identity Framing communication strategies for mobilizing social change. 
    The Leadership Quarterly
    , 25(3), 468-486. NURS 6053 – Interprofessional Organizational and Systems Leadership

    Spence Laschinger, H. K., & Fida, R. (2014). New nurses burnout and workplace wellbeing: The influence of authentic leadership and psychological capital
    . Burnout Research, 
    1(1), 19-28.

    Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., & Charns, M. P. (2014). Leadership for Evidence-Based Practice: Strategic and Functional Behaviors for Institutionalizing EBP. 
    Worldviews on Evidence-Based Nursing
    , 11(4), 219-226.

    Stoddart, K., Bugge, C., Shepherd, A., & Farquharson, B. (2014). The new clinical leadership role of senior charge nurses: a mixed methods study of their views and experience. 
    Journal of Nursing Management
    , 22(1), 49-59.DOI: 10.1111/jonm.12008

    Tost, L. P. (2015). When, why, and how do powerholders “feel the power”? Examining the links between structural and psychological power and reviving the connection between power and responsibility. Research in organizational behavior, 35, 29-56. NURS 6053 – Interprofessional Organizational and Systems Leadership

    Van Keer, R. V., Deschepper, R. D., Huyghens, L. H., Distelmans, W. D., & Bilsen, J. B. (2014). Dealing with cultural diversity during the process of communication and decision-making in the ICU: a literature review.
     Critical Care
    , 18(Suppl 1), P24.

    Woods, M. (2014). Beyond moral distress preserving the ethical integrity of nurses. Nursing Ethics, 21(2), 127-128.

    Zydziunaite, V, & Suominen, T. Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences.
    Contemporary Nurse
    , 48(2):150-16. NURS 6053 – Interprofessional Organizational and Systems Leadership

  • NURS521 Virtue Ethics Essay

    NURS521 Virtue Ethics Essay

    Respond to one of the following three “news clippings” related to virtue ethics from your Pozgar text. Write a 1- 2 page essay addressing the discussion questions posed for the one you selected. Be sure to clearly identify the news clipping you selected.

    Adhere to APA formatting and cite all sources. Review the rubric for further information on how your assignment will be graded.

    Due: Sunday, 11:59 p.m. (Pacific time)

    Points: 40

    Watch the following 3 videos and choose one to address for your assignment.

    #1. Wrong-Operation Doctor

    Download Script

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    Find Out More: You may use these and other outside sources to frame your discussion.

    The Pain of Wrong Site Surgery

    Judgment Upheld in Arkansas Brain Surgery Lawsuit

    National Quality Forum

    Assignment Discussion Questions

    1. Discuss the issues of integrity in this case.

    2. Should criminal charges be considered in this case, if accurately reported? Discuss your answer.

    3. Why did you choose to respond to this story?

    4. How is integrity displayed in your clinical setting?

    #2. Cheney’s Staff Cuts Testimony on Warming

    Download Script

    Find Out More: You may use these and other outside sources to frame your discussion.

    The full story Cheney’s Staff Cut Testimony On Warming

    CDC on Air Quality

    NURS521 Virtue Ethics Essay Assignment Discussion Questions

    1. Discuss how headlines such as this affect your opinion of politicians.

    2. At the end of our days, the most basic principles of life–trust and survival–are on trial. What is your verdict, if you believe there was a cover-up?.

    3. Why did you choose to respond to this story?

    4. How are government and political trust displayed in your clinical setting?

    #3. Surgeon Uses Ministry in Medical Practice

    Download Script

    Find Out More: You may use these and other outside sources to frame your discussion.

    The full story: Praying with patients: A Dallas surgeon finds a way to put ministry into practice

    Should Your Doctor Pray With You?

    South Korean Hospitals Shut Over MERS Fears; 11th Person Dies

    Note the picture in this article

    NURS521 Virtue Ethics Essay Assignment Discussion Questions

    1. Discuss the pressure, if any, placed on the patient to responding to the suggestion of prayer prior to surgery.

    2. Describe how you, as the surgeon, or nurse, would address a patient’s religious or spiritual needs if the risks of a complex surgical procedure appear to be threatening.

    3. Why did you choose to respond to this story?

    4. How is religion or faith displayed in your clinical setting?

    NURS521 Virtue Ethics Essay

  • Family Health – Primary Care : NSG6440

    Family Health – Primary Care : NSG6440

    Week 1 – Assignment 2 Discussion

    You are a family nurse practitioner working in a community health center. The patient you are about to see is a 3 month old natal female infant for a well-baby check. The child has just been adopted. The mother stays at home with the baby and the father works outside the home. They are covered by private health insurance through the father’s work. The parents own their own home in a suburban area, neither smoke, and they have one dog. Answer the following questions using course resources (texts) and two other evidence based sources (current guidelines and/or scholarly articles that are within a 3-5 year time frame).

    What are the components of a well-child check for this 3-month old infant?

    Write an educational intervention plan for the parents. What are you going to teach the parents about their baby?

    When completing a physical exam for this baby, what would be of particular focus and why?

    Week 2 – Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    SOAP Note

    Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

    SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline,or currently published peer reviwed journal article. Family Health – Primary Care : NSG6440

    Submission Details:

    Enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

    Include the reference number from eMedley in your document.

    Submit your SOAP note into the discussion area below by Sunday, October 15, 2017 along with clinical insights about your case.

    Respond to two peers with a substantial response that includes supportive references by Wednesday, October 18, 2017.

    Week 3 – Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    Assignment 1: SOAP Note

    Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

    SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline, or currently published peer reviewed journal article.

    Submission Details:

    Enter your patient encounters into eMedley and complete at least one SOAP note in the template provided. Family Health – Primary Care : NSG6440

    Include the reference number from eMedley in your document.

    Submit your SOAP note into the discussion area below by Sunday, October 22, 2017 along with clinical insights about your case.

    Respond to two peers with a substantial response that includes supportive references by Wednesday, October 25, 2017.

    Name:

    Pt. Encounter Number:

    Date:

    Age:

    Sex:

    SUBJECTIVE

    CC:

    Reason given by the patient for seeking medical care “in quotes”

    HPI:

    Describe the course of the patient’s illness, including when it began, character of symptoms, location where the symptoms began, aggravating or alleviating factors, pertinent positives and negatives, other related diseases, past illnesses, and surgeries or past diagnostic testing related to the present illness.

    Medications:
    (List with reason for med )

    PMH

    Allergies:

    Medication Intolerances:

    Chronic Illnesses/Major traumas

    Hospitalizations/Surgeries

    “Have you ever been told that you have diabetes, HTN, peptic ulcer disease, asthma, lung disease, heart disease, cancer, TB, thyroid problems, kidney problems, or psychiatric diagnosis?”

    Family History

    Does your mother, father, or siblings have any medical or psychiatric illnesses? Is anyone diagnosed with: lung disease, heart disease, HTN, cancer, TB, DM, or kidney disease? Family Health – Primary Care : NSG6440

    Social History

    Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, and marijuana. Safety status

    ROS

    General

    Weight change, fatigue, fever, chills, night sweats, and energy level

    Cardiovascular

    Chest pain, palpitations, PND, orthopnea, and edema

    Skin

    Delayed healing, rashes, bruising, bleeding or skin discolorations, and any changes in lesions or moles

    Respiratory

    Cough, wheezing, hemoptysis, dyspnea, pneumonia hx, and TB

    Eyes

    Corrective lenses, blurring, and visual changes of any kind

    Gastrointestinal

    Abdominal pain, N/V/D, constipation, hepatitis, hemorrhoids, eating disorders, ulcers, and black, tarry stools. Family Health – Primary Care : NSG6440

    Ears

    Ear pain, hearing loss, ringing in ears, and discharge

    Genitourinary/Gynecological

    Urgency, frequency burning, change in color of urine.

    Contraception, sexual activity, STDs

    Female: last pap, breast, mammo, menstrual complaints, vaginal discharge, pregnancy hx

    Male: prostate, PSA, urinary complaints

    Nose/Mouth/Throat

    Sinus problems, dysphagia, nose bleeds or discharge, dental disease, hoarseness, and throat pain

    Musculoskeletal

    Back pain, joint swelling, stiffness or pain, fracture hx, and osteoporosis

    Breast

    SBE, lumps, bumps, or changes

    Neurological

    Syncope, seizures, transient paralysis, weakness, paresthesias, and black-out spells

    Heme/Lymph/Endo

    HIV status, bruising, blood transfusion hx, night sweats, swollen glands, increase thirst, increase hunger, and cold or heat intolerance. Family Health – Primary Care : NSG6440

    Psychiatric

    Depression, anxiety, sleeping difficulties, suicidal ideation/attempts, and previous dx

    OBJECTIVE

    Weight BMI

    Temp

    BP

    Height

    Pulse

    Resp

    General Appearance

    Healthy-appearing adult female in no acute distress. Alert and oriented; answers questions appropriately. Slightly somber affect at first and then brighter later.

    Skin

    Skin is brown, warm, dry, clean, and intact. No rashes or lesions noted.

    HEENT

    Head is normocephalic, atraumatic, and without lesions; hair evenly distributed. Eyes: PERRLA. EOMs intact. No conjunctival or scleral injection. Ears: Canals patent. Bilateral TMs pearly gray with positive light reflex; landmarks easily visualized. Nose: Nasal mucosa pink; normal turbinates. No septal deviation. Neck: Supple. Full ROM; no cervical lymphadenopathy; no occipital nodes. No thyromegaly or nodules. Oral mucosa, pink and moist. Pharynx is nonerythematous and without exudate. Teeth are in good repair
    .

    Cardiovascular

    S1, S2 with regular rate and rhythm. No extra sounds, clicks, rubs, or murmurs. Capillary refills two seconds. Pulses 3+ throughout. No edema.

    Respiratory

    Symmetric chest wall. Respirations regular and easy; lungs clear to auscultation bilaterally
    .

    Gastrointestinal

    Abdomen obese; BS active in all the four quadrants. Abdomen soft, nontender. No hepatosplenomegaly
    .

    Breast

    Breast is free from masses or tenderness, no discharge, no dimpling, wrinkling, or discoloration of the skin
    .

    Genitourinary

    Bladder is nondistended; no CVA tenderness. External genitalia reveals coarse pubic hair in normal distribution; skin color is consistent with general pigmentation. No vulvar lesions noted. Well estrogenized. A small speculum was inserted; vaginal walls are pink and well rugated; no lesions noted. Cervix is pink and nulliparous. Scant clear to cloudy drainage present. On bimanual exam, cervix is firm. No CMT. Uterus is antevert and positioned behind a slightly distended bladder; no fullness, masses, or tenderness. No adnexal masses or tenderness. Ovaries are nonpalpable. Family Health – Primary Care : NSG6440

    (Male: Both testes are palpable, no masses or lesions, no hernia, and no uretheral discharge.)

    (Rectal as appropriate: No evidence of hemorrhoids, fissures, bleeding, or masses—Males: Prostrate is smooth, nontender, and free from nodules, is of normal size, and sphincter tone is firm).

    Musculoskeletal

    Full ROM seen in all four extremities as the patient moved about the exam room.

    Neurological

    Speech clear. Good tone. Posture erect. Balance stable; gait normal.

    Psychiatric

    Alert and oriented. Dressed in clean slacks, shirt, and coat. Maintains eye contact. Speech is soft, though clear and of normal rate and cadence; answers questions appropriately.

    Lab Tests

    Urinalysis—pending

    Urine culture—pending

    Wet prep—pending

    Special Tests

    Diagnosis

    Include at least three differential diagnosis

    Final diagnosis

    Evidence for final diagnosis should be
    documented
    in your Subjective and Objective exams. Family Health – Primary Care : NSG6440

    PLAN including education

    Plan:

    Further testing

    Medication

    Education

    Nonmedication treatments

    Follow-up

    Week 4 – Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    Assignment 1: Grand Rounds

    As a major project in this course, you will deliver a Grand Rounds presentation.

    The health care topic for this presentation will be decided by your course faculty based on the results of the APEA Pre-Predictor Exam in Week 1. Your presentation will consist of a patient scenario that you experienced in your clinical setting. The format of your presentation can be Microsoft PowerPoint. APA format is also expected, and references should be cited. Include references at the bottom of the slides and a final reference list on the last slide.

    Your goal is to:

    Provide a case study to go with the diagnosis.

    Utilize research articles or other materials to support your findings.

    Identify any practice barriers, issues, or problems (including cultural diversity and healthcare literacy).

    Discuss best practices for optimal outcomes.

    In addition to submitting your presentation, you will also be expected to lead a discussion throughout the week. You will want to keep the presentation interesting, professional, and focused to the topic.

    When the week is over, you will update, revise, and complete your presentation on the basis of student comments and instructor feedback.

    In Week 1, the instructor will divide the class into groups and assign you a week in which you will be expected to present your case. Some of you will present in Week 4, some will present in Week 7, and the remainder will present in Week 9. Family Health – Primary Care : NSG6440

    Those who are not presenting in a given wee – k are responsible for participating in at least two presentations.

    For additional details, please see the Grand Rounds assignment page in the week in which you are assigned to present.

    Submission Details:

    Name your document SU_NSG6440_W4_A1_LastName_FirstInitial.doc.

    Week 5 -Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    Assignment 1: Discussion

    As a family nurse practitioner, you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes in complaining of having difficulty concentrating in school. On exam, you also note that the patient is very thin and frail in appearance and is asking you for diet pills.

    What are some initial areas for concern? What screening tools can help lead you closer to your diagnosis?

    Describe 1 health promotion strategy you can discuss with the patient.

    Be sure to address the following in your plan of care: pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referral/s.

    Your work should integrate course resources (text/s) as well as a minimum of two (2) other evidence-based guidelines and/or articles published within 3–5 years.

    Submission Details:

    Name your document SU_NSG6440_W5_A1_LastName_FirstInitial.doc.

    Submit by Saturday, November 4, 2017.

    Week 6 -Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    Assignment 1: SOAP Note

    Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

    SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline, or currently published peer reviewed journal article.

    Submission Details:

    Enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

    Include the reference number from eMedley in your document.

    Submit your SOAP note into the discussion area below by Sunday, November 12, 2017 along with clinical insights about your case.

    Respond to two peers with a substantial response that includes supportive references

    Week 7 -Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    Assignment 1: Grand Rounds

    As a major project in this course, you will deliver a Grand Rounds presentation.

    The health care topic for this presentation will be decided by your course faculty based on the results of the APEA Pre-Predictor Exam in Week 1. Your presentation will consist of a patient scenario that you experienced in your clinical setting. The format of your presentation can be Microsoft PowerPoint. APA format is also expected, and references should be cited. Include references at the bottom of the slides and a final reference list on the last slide.

    Your goal is to:

    Provide a case study to go with the diagnosis.

    Utilize research articles or other materials to support your findings.

    Identify any practice barriers, issues, or problems (including cultural diversity and healthcare literacy).

    Discuss best practices for optimal outcomes. Family Health – Primary Care : NSG6440

    In addition to submitting your presentation, you will also be expected to lead a discussion throughout the week. You will want to keep the presentation interesting, professional, and focused to the topic.

    When the week is over, you will update, revise, and complete your presentation on the basis of student comments and instructor feedback.

    In Week 1, the instructor will divide the class into groups and assign you a week in which you will be expected to present your case. Some of you will present in Week 4, some will present in Week 7, and the remainder will present in Week 9.

    Those who are not presenting in a given week are responsible for participating in at least two presentations.

    For additional details, please see the Grand Rounds assignment page in the week in which you are assigned to present.

    Submission Details:

    Name your document SU_NSG6440_W7_A1_LastName_FirstInitial.doc.

    Submit by Saturday, November 18, 2017.

    Week 8 – Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    Assignment 1: SOAP Note

    Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

    SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline, or currently published peer reviewed journal article.

    Submission Details:

    By Wednesday, November 29, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

    Include the reference number from eMedley in your document.

    Submit your SOAP note into the discussion area below by Sunday, November 26, 2017 along with clinical insights about your case.

    Respond to two peers with a substantial response that includes supportive references by Wednesday, November 29, 2017.

    Week 9 -Assignment 1 Discussion – Family Health – Primary Care : NSG6440

    Assignment 1: Grand Rounds

    This week continues the Grand Rounds presentations as assigned by the instructor.

    Those who are not presenting this week are responsible for participating in at least two presentations.

    Keep in mind the following guidelines while taking part in this assignment:

    For those who are presenting, post your presentation to this Discussion Area by Saturday, December 2, 2017. Begin facilitating the discussion and continue to lead it throughout the week.

    For those who are participants this week, begin participating on Saturday, December 2, 2017, and continue until the end of the week.

    For the presenters:

    The Grand Rounds presentation should consist of a patient scenario that you experienced in your clinical setting or a diagnosis that has been covered within the course material prior to this week. This may be presented in Microsoft PowerPoint or Microsoft Word format

    Your goal is to:

    Provide a case study to go with the diagnosis.

    Utilize research articles or other materials to support your findings.

    Identify any practice barriers, issues, or problems (including cultural diversity and healthcare literacy).

    Discuss best practices for optimal outcomes.

    In addition to submitting your presentation, you will also need to lead a discussion. Here are some guidelines:

    To prepare for your presentation, rehearse the key points and findings of your research and think about points you can make to initiate the discussion and keep it going.

    Develop questions you can ask to initiate the discussion and keep it going.

    As you approach the end of the discussion period, ask participants to:

    Summarize the discussion.

    Draw conclusions from the collective group discussion.

    Keep the presentation interesting, professional, and focused to the topic. APA format is expected and references should be cited. If you are presenting on Microsoft PowerPoint, include references at the bottom of the slide(s) and a final reference list on the last slide.

    When the week is over, update/revise/complete your presentation based on students’ comments and instructor’s feedback.

    For the participants:

    Those who are not assigned to present this week should review at least two presentations and participate in the discussion. Here are some guidelines for participation:

    Prepare for the discussion by reading the presenter’s submission.

    Keep your participation at the level of critical thinking—analyzing, synthesizing, and evaluation. Make connections between what you are learning in this course and what you already know.

    Make comparisons, note contrasts, and challenge points of view. Interact with both presenters and other students.

    Add to the experience what you might have read about the topic or experienced personally.

    Be prepared to substantiate your points of view.

    At the end of the week, be prepared to summarize or draw conclusions from the presentation experience.

    Week 10 – Assignment 1 Discussion -Family Health – Primary Care : NSG6440

    Assignment 1: Evidence-Based Clinical Intervention

    By Friday, December 8, 2017, submit your Evidence-Based Clinical Intervention to the Discussion Area.

    Your Evidence-Based Clinical Intervention should be submitted in a Microsoft Word document following APA style and should include the following:

    The medical problem/diagnosis/disease.

    Typical presenting signs and symptoms including:

    Onset, Characteristics, Location, Radiation, Timing, Setting, Aggravating factors, Alleviating factors, Associated symptoms, Course since onset, Usual age group affected

    Concomitant disease states associated with the diagnosis

    The pathophysiology of the problem.

    Three differential diagnoses and the usual presenting signs and symptoms in priority sequence with rationales.

    Reference to at least two current journal articles that show evidence-based practice as how to best treat this disorder related to the primary differential.

    The expected outcomes of the intervention.

    Algorithms if available.

    A typical clinical note in SOAP format.

    Respond to at least two of your classmates’ Evidence-Based Clinical Interventions using the lessons and vocabulary found in the reading. Support your answers with examples and research. Your responses should clarify your understanding of the topic. They should be your own, original, and free from plagiarism. Follow the APA format for writing style, spelling and grammar, and citation of sources.

    Week 10 -Assignment 2 Discussion – Family Health – Primary Care : NSG6440

    Assignment 2: Reflection

    Reflect on the course and what you have learned over the last ten weeks. Write up a brief summary of how you meet each course objective. Include examples from both the course and practicum experiences.

    Post your response to the Discussion Area. Include references to support your work. Respond to at least two of your peers providing substantial feedback supported with references. Family Health – Primary Care : NSG6440

  • NR507 Advanced Pathophysiology Quiz -Exam Questions and Answers

    NR507 Advanced Pathophysiology Quiz -Exam Questions and Answers

    PAR
    T 1:

    You are contacted by an attorney representing a client who has been charged with child abuse and whom faces loss of her child and 15 years in prison. The record indicated that the child was 4 years old and presented to the ER room with a broken arm and a broken leg. There also appeared to be multiple previous fractures. Now, you examine the child and find blue sclera, a sunken chest wall, severe scoliosis, and you observe a triangular face and prominent forehead. You confirm that there have been multiple previous fractures by evaluating the previous X-rays. This is a genetic disorder.

    What is the most likely genetic disease that this presents and why?

    What is the molecular basis of this disease?

    Before, calling the police what should the initial clinician have done?

    ORDER A PLAGIARISM-FREE PAPER NOW

    The presenting genetic disease is most likely osteogenesis imperfecta (OI), also known as brittle bone disease. OI consists of a diverse group of symptoms related to genetic mutations found in type 1 collagen biosynthesis (Golshani, Ludwig, Cohn, & Kruse, 2016). The Sillence classification system delineates OI based on the severity of the disease. Types II and III are the most severe, are characterized by autosomal recessive inheritance, can cause severe deformity in the neonate, stillbirth, and these patients have a short life expectancy (McCance, Huether, Brashers, & Rote, 2013). Types I and IV are considered less severe forms, are characterized by inherited autosomal dominant trait, and the onset varies in age from childhood to adulthood (McCance et al., 2013). The main characteristics of OI include low bone mass and elevated bone fragility that leads to fractures and deformities (Golshani et al., 2016). The classic manifestations associated with OI are osteoporosis like and include an increased incidence of fractures, triangular facies, possible bony deformations, poor dentition, possible blue sclera, and possible vascular weaknesses (McCance et al., 2013).

    To fully understand the disease process, it is important to know what happens at the molecular level in regards to the biosynthesis of type 1 collagen. First, procollagen is created via rough endoplasmic reticulum as triple helix that form two collagen chains, a1(I) and a2(I), which are encoded by the COLIA1 and COILA2 genes (Golshani et al., 2016). Both chains have C and N terminal peptides (Golshani et al., 2016). These chains also have domains with repetitive amino acid sequence that contain glycine by every third amino acid, which permits the triple helix arrangement (Golshani et al., 2016). Once post-translational modifications and folding occurs, the procollagen molecule is carried to the extracellular matrix, cleavage of the terminal propeptides takes place, and the collagen molecule forms (Golshani et al., 2016). When the collagen molecule forms, it forms fibrils via covalent bonding inside and in the middle of triple helix molecules (Golshani et al., 2016). Additionally, the fibrils formed will accumulate and produce type 1 collagen fibers (Golshani et al., 2016).

    Upon examination, medical professionals may find evidence of bone fractures in various stages of healing, including fractures of the skull, metaphysis bones, and ribs, leading to the suspicion of child abuse (Golshani et al., 2016). While OI is rare, it should still be included in ones differential diagnosis (Golshani et al., 2016). Evaluation and treatment of OI is established by the presence of clinical manifestations, therefore it is very important clinicians are able to recognize them (McCance et al., 2013). In all types of the disease process, serum alkaline phosphate levels will be elevated (McCance et al., 2013). Another way to evaluate OI is by culturing skin fibroblast collagen via electrophoresis; 95 percent of people tested who have OI show a decreased amount of collagen (McCance et al., 2013). The initial clinician should have questioned the child’s symptoms; diagnosis of OI is distinct when some key elements exist including blue sclera, scoliosis, wormian bones, and a family history (Golshani et al., 2016). Without these features, diagnosis can be difficult (Golshani et al., 2016).

     

     

     

    Golshani, K.R., Ludwig, M.R., Cohn, P.L., & Kruse, R. (2016). Osteogenesis Imperfecta.
    Delaware Medical Journal, 88
    (6), 178-185. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=27506061&site=eds-live&scope=site

     

    McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). 
    Pathophysiology: The biologic basis for disease in adults and children
     (7th ed.). St. Louis, MO: Mosby.

     

     

    PART:

    Johnny is a 5-year-old Asian boy who is brought to a family practice office with a “runny” nose that started about 1 week ago but has not resolved.  He has been blowing his nose quite frequently and “sores” have developed around his nose.  His mother states, “The sores started as ‘big blisters’ that rupture; sometimes, a scab forms with a crust that looks like “dried maple syrup” but continues to seep and drain.”  She is worried because the lesions are now also on his forearm.  Johnny’s past medical and family histories are normal.  He has been febrile but is otherwise asymptomatic.  The physical examination was unremarkable except for moderate, purulent rhinorrhea and 0.5- to 1-cm diameter weeping lesions around the nose and mouth and on the radial surface of the right forearm.  There is no regional lymphadenopathy.

    Write a differential of at least three (3) possible diagnoses and explain how each may be a possible answer to the clinical presentation above. Remember, to list the differential in the order of most likely to less likely.

    Based upon what you have at the top of the differentials how would you treat this patient?

    When would you allow the student back to school? Elaborate on your reasoning?

     

    Impetigo is a bacterial skin infection seen in infants and children and is more commonly seen in mid to late summer, especially in climates that are hot and humid(McCance, Huether, Brashers, & Rote, 2013). Impetigo is prevalent in settings like daycare or in crowded areas with poor sanitary conditions (McCance et al., 2013). Impetigo pustules or vesicles may be seen anywhere however, the face and extremities are the more common sites (Allmon, Deane, & Martin, 2015). Predisposing factors for impetigo include anemia and malnutrition however, healthy children are also affected (McCance et al., 2013).

    Bullous impetigo
     – Bullous impetigo is a highly contagious bacterial infection caused by
    Staphylococcus aureus
    and is carried in the anterior nares, the fingernails, and the perineal area (McCance et al., 2013). The pathogen is transmitted via contact with an infected individual or by non-direct contact, such as equipment that is contaminated (McCance et al., 2013). A person becomes infected because the
    Staphylococcus aureus
    produces exfoliative toxins (ETs) that inoculate into the dermis and epidermis causing blisters to form (McCance et al., 2013). The blisters are usually located around the patient’s nose or mouth however, the hands and other exposed regions such as the extremities can also be affected (McCance et al., 2013). The blisters can amalgamate, forming superficial bullae that can be localized or spread over different areas of the skin (McCance et al., 2013). When the bullae break open, a honey colored crust will form around the area; this crust is a hallmark sign of impetigo (McCance et al., 2013). In bullous impetigo, regional lymphadenopathy is uncommon (McCance et al., 2013).

    The treatment of choice for impetigo is antibiotics, either topical or systemic. Topical antibiotics, such as mupirocin or fusidic acid, are recommended for localized areas of impetigo (Watkins, 2013). Topical antibiotics need to be rubbed on the lesions and the skin area around the lesion 3 times a day for 7 to days or until the lesions are healed (Watkins, 2013). If a patient has an allergy to mupirocin or fusidic acid, an alternative antiseptic such as hydrogen peroxide, chlorhexidine, or iodine may be used (Watkins, 2013). If topical antibiotics are ineffective, the lesion should be swabbed to determine the causative pathogen and the pathogens sensitivity to antibiotics (Watkins, 2013). Systemic antibiotics may be needed for severe cases or for those that did not respond to topical antibiotics (Watkins, 2013). Systemic antibiotic options include flucloxacillin and clarithromycin, if the patient is allergic to penicillin (Watkins, 2013). Phenoxymethylpenicillin should be added to the treatment if erysipelas is present (Watkins, 2013). Patients with MRSA or glomerulonephritis need to be referred to a specialist for care (Watkins, 2013). Education should include proper hand hygiene and seclusion of the child’s items that could spread the infection such as wash cloths, linens, towels, clothes, and utensils and glasses used for eating and drinking (McCance et al., 2013). Children should not return to school or daycare until the lesions are completely crusted over and healed, or for at least 48 hours after beginning antibiotics because antibiotics reduce the infection period (Watkins, 2013).

    Johnny fits the presentation for impetigo, most likely bullous impetigo, based on his clinical manifestations, especially the lack of lymphadenopathy. However, a diagnosis of nonbullous is also conceivable. I  would start Johnny on topical antibiotics and advise his mother to keep him home until the lesions have healed or for at least 48 hours after starting the antibiotic treatment. I would also educate her on hygiene precautions so the infection does not spread to others. Also, she must thoroughly bathe him with soap and water, carefully removing any crust around the lesions (Watkins, 2013).

    Nonbullous impetigo
    – Nonbullous impetigo, the more common of the types, is also a highly contagious bacterial infection caused by
    Staphylococcus aureus
    or group A
    Streptococcus pyogenes
    . A person can become infected with either pathogen via direct physical contact or via insect bites (McCance et al., 2013). Nonbullous impetigo forms superficial, acute, vesicles with honey like serum; when the vesicle ruptures, yellow to white-brown crust will form (McCance et al., 2013). These lesions can look similar to herpes simplex lesions and therefore a distinction should be made (McCance et al., 2013). Unlike bullous impetigo, it is common to see regional lymphadenopathy in nonbullous (McCance et al., 2013). Treatment and education are the same for both types of impetigo (McCance et al., 2013).

    Even though nonbullous is the more common of the two types, based on clinical manifestations, nonbullous does not completely fit the presentation. However, the presentation between the two types is so similar it cannot be fully ruled out.

    Herpes simplex virus
    – Herpes simplex virus (HSV) are usually caused by two different strains of the virus, HSV 1 and HSV 2 and can occur all over the body (McCance et al., 2013). The only way to distinguish between the two is laboratory testing. HSV type 1 is transmitted via infected saliva (McCance et al., 2013). The first infection is referred to as the primary infection where the virus travels to the dorsal ganglion root and remains latent (McCance et al., 2013). In the secondary phase, reactivation of the virus occurs and the virus travels via peripheral nerves to the original site of infection, where it sheds (McCance et al., 2013). Reactivation of the virus can occur related to stress, skin irritation, fatigue, ultraviolet light, and fever (McCance et al., 2013). HSV-1 lesions present as inflamed, painful vesicles in rash like patterns or clusters and in children are typically located on the lips, in and/or around the nose, on the tongue, and within the mouth (McCance et al., 2013). When the vesicle ruptures, a crust will form over the area (McCance et al., 2013). Lesions can last up to 6 weeks if left untreated (McCance et al., 2013). Generally, topical antivirals can help resolve the lesions in 2 weeks (McCance et al., 2013). Additionally, oral antivirals can be given for acute infections or for daily use as a suppressive therapy (McCance et al., 2013).

    Impetigo can be mistaken for herpes simplex virus because their lesions can look similar. However, HSV does not fit the presentation. I do not believe Johnny has HSV.

     

    Allmon, A., Deane, K., & Martin, K.L. (2015). Common skin rashes in children.
    American Family Physician, 92
    (3), 211-216.  http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=26280141&site=eds-live&scope=site

    McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). 
    Pathophysiology: The biologic basis for disease in adults and children
     (7th ed.). St. Louis, MO: Mosby.

     

    Watkins, J. (2013). Bullous and non-bullous impetigo.
    Practice Nursing, 24
    (2), 95-96.  http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=108026722&site=eds-live&scope=site

     

    PART 3:

    Keisha, a 13-year-old female, has come into your urgent care center. She has red conjunctiva, a cough and a fever of about 104 F, She also has a rash on her face a possibly the beginning of a rash on her arms. About 10 days ago she was around another student who had similar symptoms. 

    Write three (3) differential diagnoses?

    What are some of the complications of this disease, assume that the top of your differential is the definitive?

    Assume that the second item you place on your differential is the definitive diagnosis. What are some complications of that disease?

     

    Rubeola
    – Rubeola is an acute, viral disease seen in children that is very contagious (McCance, Huether, Brashers, & Rote, 2013). A specific RNA virus containing the paramyxovirus causes rubeola, it is transmitted via droplets from individuals already infected with the virus (McCance et al., 2013). This means Rubeola can be spread via sneezing, breathing, and coughing (Grif Alspach, 2015). The virus can remain on surfaces and in the air for up to 2 hours (Grif Alspach, 2015). Rubeola has an incubation period that lasts 7 to 12 days; during this time, the infected person will not have any symptoms (McCance et al., 2013). The virus is introduced via the respiratory tract where it latches onto alveolar macrophages and dendritic cells, the virus increases in size in the lymphatic tissue, and then advances to systemic disease (McCance et al., 2013). Early symptoms include high fevers (up to 105 degrees), skin rash, koplik spots, conjunctivitis, cough, malaise, and coryza (Grif Alspach, 2015). Approximately 1 to 4 days after being exposed to the virus, a maculopapular rash will appear, it begins on the forehead and spreads to the trunk, extremities, hands, feet and even the palms and soles of the hands and feet (Grif Alspach, 2015). It is important to know that patients are contagious 4 days prior to the development of the rash and 4 days after it begins (Grif Alspach, 2015). Immunocompromised patients may not develop a rash so providers should be able to recognize symptoms without the rash development (Grif Alspach, 2015). The rash will gradually begin to fade, beginning from the head down, and will typically resolve on it’s own within 7 to 10 days (Grif Alspach, 2015). One way to distinguish Rubeola from Rubella is conjunctivitis is present in Rubeola but not in Rubella (Grif Alspach, 2015). Confirmation via lab work can be achieved by serum or swabbing of nasal cavity or oropharyngeal cavity (Grif Alspach, 2015).  Even though most people will resolve the disease on their own, some people can have serious complications such as encephalitis and pneumonia (Grif Alspach, 2015). The best way to prevent Rubeola is through the MMR vaccine (Grif Alspach, 2015). Additionally, hand hygiene is essential in helping to decrease the spread of disease.

    Rubella
    – Rubella is a communicable disease seen in children and young adults, it is caused by an RNA virus that enters via the respiratory tract and invades the bloodstream (McCance et al., 2013). Rubella is contracted via droplets, maternal-fetus transmission, or contact with nasopharyngeal secretions (Chan, MacFadden, & Leis, 2016). The virus has an incubation period of 14 to 23 days; patients are thought to be contagious one week prior to the onset of the rash and 4 days after the rash begins (Chan et al., 2016). Early symptoms include a low grade fever (which usually presents 1 to 5 days before the rash), possible enlarged postauricular and cervical lymph nodes, sore throat, headaches, cough, and runny nose (McCance et al., 2013). Other clinical manifestations may include arthritis, arthralgias, and cold symptoms (Chan et al., 2016). When the rash develops, it is characterized by pinpoint pink macules; the rash will begin on the head and spread down to the trunk and extremities in 24 hours (Chan et al., 2016). The rash with Rubella is absent on the palms and soles on the hands and feet (McCance et al., 2013). Once someone contracts the disease, a lifelong immunity develops against the disease (McCance et al., 2013). The diagnosis is typically made via lab work (Chan et al., 2016). Preventative treatment for Rubella is vaccination (Chan et al., 2016). Treatment for Rubella is supportive and includes using a vaporizer, fluids, and rest (McCance et al., 2013). Some patients may develop mild encephalitis or peripheral neuritis (McCance et al., 2013). Significant mortality occurs in people who do not vaccinate against Rubella with encephalitis, pneumonia, and croup causing the largest number of deaths related to the disease (McCance et al., 2013).

    Chickenpox
    – Chickenpox affects most patients in the first decade of their life (McCance et al., 2013). It is spread via airborne droplets and contact with an infected person (McCance et al., 2013). Patients are contagious at least one day prior to the development of lesions and about 5 to 6 days after the lesions appear (McCance et al., 2013). Prodromal symptoms include itching, then vesicles will begin to appear (McCance et al., 2013). Fever may be present, up to 104 degrees and typically lasts 2 to 3 days (McCance et al., 2013). The vesicles usually appear on the face, scalp, or trunk first then will spread to the extremities later (McCance et al., 2013). In chickenpox, the lesions will characteristically heal in various stages therefore macules, papules, and vesicles can all be seen; there can be anywhere from 100 to 300 lesions present and all in different stages of development and healing (McCance et al., 2013). On occasion, vesicles may appear in the mouth, on the palms of hands, soles of feet, pharynx, and conjunctiva (McCance et al., 2013). Complications are unusual in children and more common in adults, complications can include epistaxis, hematuria, varicella pneumonia, and laryngeal edema (McCance et al., 2013). Once someone contracts the virus, immunity is developed (McCance et al., 2013). There is a vaccine to help prevent chickenpox (McCance et al., 2013). For uncomplicated cases, supportive care includes wet dressings, baths, and oral antihistamines (McCance et al., 2013). Oral antiviral medications can be given to reduce symptoms, especially in immunocompromised patients (McCance et al., 2013).

     

    Chan, T., MacFadden, D.R., & Leis, J.A. (2016). Rubella in a returned traveller.
    CMAJ: Canadian Medical Association Journal = Journal De L’association Medicale Canadienne, 188
    (5), 363-366. doi: 10.1503/cmaj.150574  http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=26622002&site=eds-live&scope=site

    Grif Alspach, J. (2015). Measles: Eliminated but not eradicated.
    Critical Care Nurse, 35
    (4), 9-13. doi: 10.4037/ccn2015629.  http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=109826168&site=eds-live&scope=site

    McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). 
    Pathophysiology: The biologic basis for disease in adults and children
     (7th ed.). St. Louis, MO: Mosby

     

     

    INSTRUCTOR:

    Whitney,

    Thank you for your discussion.  The good (maybe) thing about this condition is that as the child grown, the fractures tend to decrease in severity.  Why might a thorough hearing examination be helpful in its diagnosis?

    Dr. Winters7382

     

    Hi Dr. Winters,

    Thank you! One of my article does address the auditory issues that can arise, as well as our text, and I completely missed it! Per Swinnen, De Leenheer, Goemaere, Cremers, Coucke, and Dhooge (2012), skeletal conditions related to OI can improve when the patient enters into adulthood, unfortunately about 50 percent of these patients develop hearing loss sometime during adulthood. Hearing impairment is related to disease of the soft tissue in the ear as well as the middle ear bone (Golshani, Ludwig, Cohn, & Kruse, 2016). Hearing exams should begin in the teen years and continue regularly into adulthood (Golshani et al., 2016). Hearing impairment is usually related to a conductive hearing problem at first and typically advances to mixed hearing loss later; some patients may develop pure sensorineural hearing loss (SNHL) (Swinnen et al., 2012). Conductive hearing loss is usually related to otosclerosis-like lesions, which produce a fixed and thickened stapes footplate (Swinnen et al., 2012). Additionally, conductive hearing loss can also be related to ossicular discontinuity, particularly by atrophied or fractured stapes crura and replaced with fibrous threads (Swinnen et al., 2012). If or when the disease advances to a mixed hearing loss, a CT scan will show pericochlear demineralization (Swinnen et al., 2012). A thorough hearing exam could show middle ear abnormalities and/or conductive hearing loss, which could help lead to the diagnosis of OI.

     

    Golshani, K.R., Ludwig, M.R., Cohn, P.L., & Kruse, R. (2016). Osteogenesis Imperfecta.
    Delaware Medical Journal, 88
    (6), 178-185. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=27506061&site=eds-live&scope=site

    Swinnen, F.R., De Leenheer, E.R., Goemaere, S., Cremers, C.J., Coucke, P.J., & Dhooge, I.M. (2012). Association between bone mineral density and hearing loss in osteogenesis imperfecta.
    The Laryngoscope, 122
    (2), 401-408. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=22252604&site=eds-live&scope=site

     

    PEER:

    Hi Amber,

    Thank you for your post! I also had a hard time distinguishing between bullous and non-bullous impetigo. Ultimately, I went with bullous because the patient did not show any regional lymphadenopathy. However, the clinical manifestations are so similar I was not 100 percent sure I chose the correct type. According to Lewis (2016), bullous is less contagious than nonbullous and its lesions are more likely to affect the face, extremities, the trunk, axillae, and perianal areas. Bullous differs from nonbullous in two ways, bullous can affect buccal mucous membranes but rarely causes regional lymphadenopathy (Lewis, 2016). In the clinical setting, a bacterial culture may be obtained from fresh exudate (found under the scab) or a gram stain and culture of blister fluid may be performed (Lewis, 2016). The gram stain will show gram-positive cocci in clusters for
    Staphylococcus aureus
    and gram-positive cocci in chains for
    Streptococcus pyogenes
    (Lewis, 2016). The good news, per McCance, Huether, Brashers, and Rote (2013), is that the treatment for both is the same. Therefore, antibiotic therapies chosen have to provide coverage against
    Staphylococcus aureus
    and
    Streptococcus pyogenes
    (Lewis, 2016).

     

    Lewis, L. (2016). Impetigo.
    Medscape.
    Retrieved from http://emedicine.medscape.com/article/965254-overview

     

    McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). 
    Pathophysiology: The biologic basis for disease in adults and children
     (7th ed.). St. Louis, MO: Mosby.

     

    QUIZ:

    Considering the pathophysiology of osteoporosis, which cytokines and hormones decrease receptor activator of RANKL expression?(Points : 2)

    IL-4 and transforming growth factor-beta (TGF-ß)

    IL-1 and tumor necrosis factor-alpha (TNF-)

    IL-11 and glucocorticoids

    IL-17 and parathyroid hormone (PTH)

     

    Rhabdomyolysis is characterized by (Points : 2)

    paralysis of skeletal muscles resulting from impaired nerve supply.

    smooth muscle degeneration resulting from ischemia.

    lysis of skeletal muscle cells through the initiation of the complement cascade.

    release of myoglobin from damaged striated muscle cells.

     

    Which type of osteoporosis would a person develop after having the left leg in a cast for 8 weeks to treat a compound displaced fracture of the tibia and fibula? (Points : 2)

    Iatrogenic

    Regional

    Idiopathic

    Osteoblastic

     

    Considering the pathophysiology of osteoporosis, what are the effects of extracellular signal regulated kinases (ERKs) and receptor activator of RANKL on osteoblasts and osteoclasts? (Points : 2)

    ERKs increase the life span of osteoclasts and RANKL decreases the life span of osteoblasts.

    ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts.

    ERKs and RANKL increase the life span of osteoblasts and decrease the life span of osteoclasts.

    ERKs increase the life span of osteoblasts and RANKL decreases the life span of osteoclasts.

     

    What is the diagnosis of a person who has tennis elbow characterized by tissue degeneration or irritation of the extensor carpi brevis tendon? (Points : 2)

    Lateral epicondylitis

    Medial tendinitis

    Bursitis

    Lateral tendinitis

     

     

     

     

    Which statement is false about giant cell tumors? (Points : 2)

    They are an overexpression of genes including osteoprotegerin ligand (OPGL).

    They are malignant, solitary, irregularly shaped tumors.

    They are typically located in the epiphysis in the femur, tibia, radius, and humerus.

    They are slow-growing tumors that extend over the articular cartilage.

     

    What pattern of bone destruction is described as not well defined and not easily separated from normal bone? (Points : 2)

    Moth-eaten

    Permeative

    Geographic

    Porous

     

    The pain experienced in Legg-Calvé-Perthes disease is referred to as involving (Points : 2)

    elbows and upper and lower arms that is aggravated by activity and relieved by rest.

    knees, inner thighs, and groin and is described as a continuous ache and relieved by anti-inflammatory drugs.

    knees, inner thighs, and groin that is aggravated by activity and relieved by rest.

    elbows and upper and lower arms and is described as a continuous ache and relieved by anti-inflammatory drugs.

     

    In osteomyelitis, bacteria gain access to the subperiosteal space in the metaphysis, which is considered the “path of least resistance.” What factor makes this route for bacteria the path of least resistance? (Points : 2)

    Cortex of the bone in this area is porous or maze-like.

    Blood supply to the metaphysis is easily compromised.

    Macrophages and lymphocytes have limited access to the subperiosteal space.

    Bacteria usually spread down the medullary cavity of the bone.

     

    Molecular analysis has demonstrated that osteosarcoma is associated with (Points : 2)

    TP53.

    src.

    myc.

    TSC2.

     

    Ewing sarcoma arises from (Points : 2)

    bone marrow.

    bone-producing mesenchymal cells.

    metadiaphysis of long bones.

    embryonal osteocytes.

     

    Which serum laboratory test is elevated in all forms of osteogenesis imperfecta? (Points : 2)

    Phosphorus

    Calcium

    Alkaline phosphatase

    Total protein

     

     

     

     

     

     

    The _____ is cartilage that retains the ability to form and calcify new cartilage and deposit bone until the skeleton matures. (Points : 2)

    epiphyseal line

    physeal plate VIA ENDOCHONDRAL OSSIFICATION

    epiphyseal cartilage

    metaphyseal plate

     

    Osteochondrosis is caused by a(n) (Points : 2)

    imbalance between calcitonin and parathyroid hormone.

    nutritional deficiency of calcium and phosphorus.

    bacterial infection of the bone.

    vascular impairment and trauma to bone.

     

    An insufficient dietary intake of vitamin _____ can lead to rickets in children. (Points : 2)

    C

    B
    12

    B
    6

    D

     

    In latex allergies, which immunoglobulin is associated with an immediate reaction? (Points : 2)

    A

    E

    G

    M

     

    Chickenpox may be followed years later by (Points : 2)

    erysipelas.

    cytomegalovirus.

    warts (verrucae).

    herpes zoster.

     

    Cutaneous vasculitis develops from the deposit of _____ in small blood vessels as a toxic response allergen. (Points : 2)

    immune complexes

    IgE

    complement

    T lymphocytes

     

    Which malignancy is characterized by slow-growing lesions that usually have depressed centers and rolled borders and are frequently located on the face and neck? (Points : 2)

    Squamous cell carcinoma

    Kaposi sarcoma

    Malignant melanoma

    Basal cell carcinoma

     

    Scleroderma is more common in women and is associated with a(n) (Points : 2)

    X-linked recessive gene.

    X-linked dominant gene.

    virus.

    autoantibodies.

     

     

    Thrush is a superficial infection that commonly occurs in children and is caused by (Points : 2)

    Staphylococcus.

    Streptococcus.

    herpesvirus.

    Candida albicans

     

    What is the cause of chickenpox? (Points : 2)

    Poxvirus

    Varicella-zoster virus (VZV)

    Adenovirus

    Human papillomavirus

     

    Which vascular anomaly is a congenital malformation of dermal capillaries that does not fade with age? (Points : 2)

    Cutaneous hemangioma

    Port-wine (nevus flammeus) stain

    Strawberry hemangioma

    Cavernous hemangioma

     

    What is a common source of tinea corporis? (Points : 2)

    Mites

    Kittens

    Fleas

    Ticks

     

    Which contagious disease creates a primary skin lesion that is a pinpointed macule, papule, or wheal with hemorrhagic puncture site?(Points : 2)

    Pediculosis

    Tinea capitis

    Scabies

    Rubeola

     

     

     

     

     

     

     

     

     

     

     

     

     

    NR507 Advanced Pathophysiology Quiz -Exam Questions and Answers

  • Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Week 1 -Assignment 2 Discussion

    Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

    Identify a problem or issue from within your specialty area that you feel needs to be improved upon. The Doctor of Nursing Practice site (http://www.doctorsofnursingpractice.org/resources/dnp-scholarly-projects/) provides many examples of these projects. The list below may help focus your thoughts.

    Educational program

    Evidence-based healthcare policy change

    Evidence-based clinical issue or protocol for specific disease/condition

    Discuss the relevance of the issue from your perspective (not the literature at this juncture) in relation to your selected advanced role option.

    What piqued your interest about this issue or problem?

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    How does it relate to your area of specialization?

    What gave you the idea that evidence exists to support this change? See “note” below.

    Provide a rationale as to why this will be an evidence-based project to improve outcomes and not generate new evidence (research).

    Please remember that the project will not be implemented during this course and no data will be collected. The outcome of this course is to complete a project proposal only. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Week 2 – Assignment 1 Discussion

    Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

    Briefly describe the problem or issue that you have decided to be the topic for your project proposal in order to orient your classmates and faculty

    Indicate how it relates to your area of specialization

    State your PICOT question. Indicate in parentheses after each segment, what part of PICOT the preceding words represent. For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T).

    Discuss which process model resonates with you and will help keep you focused during the project. Process models included in your text (Melnyk & Fineout-Overholt, 2011) are:

    Clinical scholar model

    Stetler model of evidence-based practice

    Iowa model of evidence-based practice to promote quality care

    Model for evidence-based practice change by Rosswurm and Larrabee

    Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model

    Provide feedback to your classmates that focuses on:

    The use of correct PICOT format for the question to guide the literature search.

    Does the question reflect a clinical research question or one appropriate for an evidence-based practice project?

    Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing – South University

    Week 3 – Assignment 1 Discussion

    In this discussion, you will share your search strategies that you have employed to find evidence for your study. For this discussion:

    State your PICOT question. Did using the terms used in this question lead you to useful research studies?

    What MESH terms have you tried? Did they help you find additional studies? Are you finding MESH terms useful to expand or delimit your search?

    Are you finding relevant articles? If not, how did you modify your search to increase productivity?

    Indicate which databases you used—those you found useful and those that were not.

    What levels of evidence do the studies you are finding represent?

    Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

    Use the Search Tracker to keep track of search terms.

    Using the appropriate Rapid Clinical Appraisal (RCA) Tools, appraise one or two articles and add the information to your Evaluation Table to receive feedback from faculty. At this juncture, your table is a work in progress. You will complete it in Week 4. The RCA Tools and Evaluation Table in Word for you to complete can be found in the Week 3 Overview section. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Week 4 – Assignment 1 Discussion

    Discuss your experience completing the rapid critical appraisal process.

    Was it really “rapid” or was it more of a laborious process?

    Did reading the abstract help you make quick decisions about including or excluding the study?

    What worked best for you in terms of the approach you decided to use to complete the appraisal and Evaluation Table? What didn’t work?

    Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

    Week 5 – Assignment 1 Discussion

    This week the discussion focuses on creating a Synthesis Table(s) as a means to summarize and organize the body of evidence from the Evaluation Table. The Synthesis tables will be included in your formal proposal in the Appendix. In the body of the paper, you will describe the “keeper” studies in narrative format.

    For this discussion, include the following:

    Share your approach to synthesizing the evidence. What were the variables of interest you identified?

    Learning to write in a scholarly fashion requires that you are able to succinctly summarize an article in a sentence or two and cite it appropriately using APA format. In this discussion, practice summarizing 2 articles you have identified from the Synthesis Table as pertinent to your proposal. Include the level of evidence, study design, and evidence of rigor. Use appropriate APA citation in text and references. Incorporate feedback from peers and faculty in your Dropbox assignment for this week. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    In addition to research studies, patient preference and clinical expertise should also be considered. Discuss how you will incorporate these important perspectives into your project proposal.

    Week 6 – Assignment 1 Discussion

    For this week’s discussion, please address the following:

    Briefly describe the clinical issue or problem for your project, the setting, and population of interest to orient classmates and faculty

    Write your clinical question

    Describe the intervention you plan to test

    What type of study will you conduct? Will it be experimental? Quasi-experimental? Provide a rationale for your answer.

    Provide feedback on the clinical questions of your colleagues

    Week 7 – Assignment 1 Discussion

    This discussion will focus on the measurement tools you will use to evaluate change from the intervention. The purpose of this discussion is to fine-tune your thinking about evaluation by receiving feedback from colleagues and faculty. Include in your discussion:

    Write a brief description of your project that starts by stating your clinical question and succinctly explaining your planned intervention in order to orient everyone.

    Will you need to develop your own evaluation tools or are valid and reliable tools available?

    If you create your own tools, what are your thoughts on pilot testing them? How will you go about this?

    Will you gather baseline data? Will you use pre- and posttests? How will you measure change?

    How will you identify the participants for your study? How does the sampling method chosen further define the type of study you will be doing? Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    How will you ensure confidentiality of study participants?

    Week 8 – Assignment 1 Discussion

    The discussion for this week will revolve around the analysis phase of your project. Include the following points in your discussion:

    Begin with a brief description of your project that includes your clinical question, your planned intervention, the type of study you will conduct and how you plan to evaluate the outcomes.

    What type of statistical analysis will be done?

    What is a reasonable timeline for your project?

    What expenses should be considered? Include both obvious expenses, such as materials, as well as those that are hidden, such as time, which equates to part of your salary.

    Will you need to consider a funding source for your project?

    Week 9 – Assignment 1 Discussion

    Although you will not implement your project during this course, it is important that you understand the various steps that are necessary to do so. As you begin to formulate your strategic plan for implementing your change project, discuss the following specific to your proposed project:

    Who are the stakeholders? Please identify them by role or job within the organization, not by name. Can you identify any “champions” or people within your organization that you can convert to champions? Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    What potential barriers do you foresee and what strategies do you envision to prevent or overcome these barriers?

    What change theory will you use to guide you?

    Week 10 – Assignment 1 Discussion

    For this discussion question, you are asked to review the student learning outcomes for this course and discuss how you met these outcomes. The intention here is to provide you an opportunity to “reflect” on the learning achieved during this term and how you successfully met these learning outcomes. If you do not feel you successfully met the objective, discuss your plans to successfully complete the objective in the future.

    By the end of the course, the student should be able to:

    Demonstrate synthesis of the knowledge and skills acquired in preceding graduate nursing core and specialty curriculum content.

    Evaluate current health policy and legal and ethical considerations in addressing the health promotion and disease prevention of a target population.

    Integrate this synthesis in the creation of a scholarly project of either an evidenced-based practice proposal or a research proposal that generates new nursing knowledge. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Disseminate significant components of the project through a written paper and oral presentation.

    Week 1 assignment 3

    Evidence-Based Project Proposal

    Project Overview:

    Title: Evidence Based Project-Proposal

    Description:

    As the course progresses over the 11 weeks, learners will develop a scholarly project that demonstrates an application of evidence to practice for substantive change. This project emphasizes critical appraisal and application of evidence-based research, scholarly writing, and critical thinking. The scholarly project will be submitted as a written paper in APA format/style. In addition, learners will present a summary of the final project orally or by creating a PowerPoint presentation.

    Learners will select one of the following types of projects related to their specific advanced role specialization and target population:

    Educational program

    Evidence-based healthcare policy change

    Evidence-based clinical issue or protocol

    Overview of the Evidence Based Project (EBP):

    In Week 1 of the course, students will identify an area of inquiry as a basis for practice change, and in Week 2, write their clinical question in PICOT format that will drive the literature search.

    Following approval of the practice change idea and the PICOT question by course faculty, in Week 3 students will begin their literature search and rapid critical appraisal (RCA) using the RCA checklists available in Appendix D of the course text (Melynk & Fineout-Overholt, 2011) and in Word format. The Search Tracker may be useful in organizing and tracking your search. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Your evidence review will be completed in Week 4, resulting in a finished Evaluation Table containing only the “keeper” studies.

    In Week 5 you will synthesize the evidence to determine best evidence for your project. Faculty will continue to serve in the role of mentor as the student progresses through the remaining steps of the project.

    Weekly submissions will be used to monitor progress in the development of your proposal. It is recommended that upon receiving feedback from faculty on each section, you revise your work and add that section to build your final paper. Doing so as you proceed through the course will avoid last-minute work. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    When you began your study of evidence-based practice it was contrasted with the research process. The underlying goal of EBP is to appraise research and study its application to specific patient populations in order to identify best practices. In order to accomplish this, what must be included within your project is a research study. You will most likely compare pre-intervention data with post-intervention results. In come cases, statistical analysis will be necessary. Your proposal will include plans for this study.

    EBP Project Criteria

    Students will prepare a formal project proposal using APA format. Below is an outline for the final paper with the weeks where this content will be covered. Each week you will turn in parts of this outline as Dropbox assignments. The week each part will be due is indicated in the outline. After receiving feedback from faculty on each part submitted, it is recommended that you begin building your paper, adding the pieces where they belong. Since you will not be implementing this project, the results section has been omitted. This outline is consistent with the format used for journal articles when reporting results of evidence-based practice projects. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Criteria and organization of final paper

    Abstract

    Part 1

    Introduction – Week 2

    Practice issue

    Summarize the practice issue in need of change providing background information about the organization (setting) and the perceived significance and severity of the problem

    Describe the specific aims of the project – what improved outcomes do you hope to achieve

    PICOT question – State your question in PICOT format, labeling each part with P-I-C-O-T in parentheses

    Significance – what is the significance of the issue in terms of poor outcomes, cost, etc.

    Part 2 – Week 3. 4, & 5

    Evidence review and synthesis

    List the names of the databases you searched and if limited to a span of time, i.e., less than 5 years old

    Summarize “keeper” studies

    Summarize the synthesis of the body of evidence. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Part 3 – Week 6

    Purpose of the project – include intervention

    Theoretical framework

    Clinical questions

    Part 4 – Week 7

    Study design

    Setting/sample

    Confidentiality

    Procedure/intervention

    Instruments/scales and measurement of outcomes

    Data collection

    Part 5 – Weeks 8 & 9

    Data analysis

    Outcomes expected

    Aligning stakeholders

    Appendices

    Evaluation Table – turned in Weeks 3 & 4

    Synthesis Table – turned in Week 5

    The paper provides evidence of synthesis of coursework, professional writing, and graduate level scholarship.

    Oral or Poster Presentation

    In addition to the written paper, students will present a summary of their project by submitting a professional Microsoft PowerPoint presentation. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Criteria:

    Organize the presentation to include all required criteria of the EBP project proposal.

    Quality of presentation is professional and provides evidence of graduate level scholarship.

    This week’s Dropbox Assignment

    Keep in mind that this proposal will be developed piece by piece during the course. The Dropbox assignment this week provides you an opportunity to identify the problem or issue within your specialization that is in need of improvement and receive feedback from faculty.

    Review the grading criteria listed below as you begin this assignment. Note that you must pass all elements in order to move forward with your proposal development. Faculty will provide feedback either approving or asking that you resubmit prior to further development of your project. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    For this week’s assignment discuss the following:

    State your idea for your evidence-based project proposal including the rationale as to how it reflects an EBP project vs. a research project

    Very briefly describe the issue you will address, the intervention that you feel has research evidence (this may change later after you complete the literature search), and the expected outcomes

    Discuss how this project is relevant to your role specialization

    Week 2 assignment 2

    Evidence Based Project Proposal

    For this week’s Dropbox assignment, you will submit Part 1 of the project proposal in a one-page APA formatted paper (excluding the cover page and reference page). Be sure to reflect on feedback from faculty and classmates from this week’s discussion. Include:

    Part 1: Introduction

    Summarize the practice issue in need of change providing background information and the perceived significance of the problem. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Describe the specific aims of the project – what improved outcomes do you hope to achieve

    State your question in PICOT format, labeling each part with P-I-C-O-T in parentheses

    Discuss the significance of the issue in terms of poor outcomes, cost, etc

    Week 3 assignment 2

    Evidence Based Project Proposal

    This week you will begin the submission of Part 2 of the project proposal written in APA format. In a one-page APA paper, write a narrative that describes your search of the literature for evidence, which includes:

    List of the names of the databases you searched

    If limited to a span of time, i.e., less than 5 years old

    Using the appropriate Rapid Clinical Appraisal Tools, appraise one or two articles and add the information to your Evaluation Table to receive feedback from faculty. At this juncture, your table is a work in progress. You will complete it in Week 4.

    You will also turn in the Evaluation Table with two studies appraised (see below) and the Search Tracker for feedback on your search strategies.

    After receiving feedback from faculty, add what you have completed this week to Part 1 to begin to build your project proposal paper. Keep this in mind when completing this assignment, using a professional writing style in your narrative

    Week 4 assignment 2

    Evidence Based Project Proposal

    This week you will submit the completed Evaluation Table that includes only your “keeper” studies. This will be added to your final paper as an Appendix. You will also turn in the Search Tracker so faculty can see the steps you took to locate the evidence. This will not become a part of your paper, but it is for feedback only should faculty deem that necessary. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Week 5 assignment 2

    Evidence Based Project Proposal

    For this week’s Dropbox assignment, you will complete Part 2 of your project proposal, the evidence review and synthesis section. This section consists of narrative descriptions of each study that forms the body of evidence. The length of this section will vary based on the number of studies that you include. The paper should be written in a scholarly fashion using APA format. For each article include in the narrative:

    Authors’ names, date of publication (included in the citation).

    Quality and level of evidence

    How significant (or not) the evidence is and why you think so. How are these articles relevant to change practice or policy for your specific practice site and population? If a study is not significant and you have included it, mention how your clinical expertise was involved in this decision.

    Your summary the synthesis section should clearly indicate the intervention you plan to use in your project proposal. You will discuss this in greater detail in the next section, but do leave the reader with the understanding of the intervention you chose. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    You will also turn in your completed Synthesis Table(s) that will become part of your Appendix in your final paper.

    Week 6 assignment 2

    Evidence Based Project Proposal

    For your Dropbox assignment this week, you will write Part 3 of your project proposal. In a one- to two-page paper in APA format, include:

    Your clinical question

    How the clinical question indicates the type of study that will be done (quasi-experimental vs. experimental). Describe the type of study. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Theoretical framework(s) chosen including a rationale for your choice

    Week 7 assignment 2

    Evidence Based Project Proposal

    For your Dropbox assignment this week, you will write Part 4, the Methods section of your project proposal that consists of plans for conducting the study of the intervention and methods of evaluation. Use the titles of each bullet point in your paper.

    In a two- to three-page APA formatted paper:

    Study design: Briefly describe the study design indicated by the question (experimental, quasi-experimental, descriptive).

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    Setting/sample: Briefly describe the setting for the study, who your study participants will be, and how these participants will be chosen. Will random sampling or a sample of convenience be used?

    Confidentiality: How will you protect the confidentiality of your participants?

    Procedures/intervention: Discuss the intervention you will implement and the procedures you will use in enough detail that others could replicate the study.

    Instruments/scales and measurement of outcomes: Describe the instruments you will use to measure changes and whether they are quantitative, qualitative, or of a mixed design. If they have been tested previously, include reliability and validity data. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Data collection: Explain plans for data collection including:

    Methods of collection, i.e., interviews, paper and pencil testing, etc.

    Testing frequency. Will you gather baseline data prior to the intervention? Will you employ repeated measures such as pre- and posttests?

    Week 8 assignment 2

    Statistical Analysis

    For this week’s Dropbox assignment, you will begin to develop Part 5 of your project proposal: Analyzing change. In your discussion, include the following points:

    State your clinical question.

    Briefly state the intervention you will implement. While these two items are not typically included in Part 5, doing so will help orient faculty so appropriate feedback can be provided.

    What outcomes will be analyzed and how they will be analyzed?

    Describe the statistical analysis you will do relating this to the data collection tools you plan to use.

    Indicate the types of demographic data you plan to report on your participants as well.

    Briefly discuss the outcomes expected should this project be implemented.

    After receiving feedback from faculty, incorporate the appropriate content into your project proposal.

    Week 9 assignment 2

    Evidence Based Project Proposal

    For your Dropbox assignment, you will write another part of your Methods section (Part 4) that you began in Week 7. In a paragraph or two in APA format include the following:

    Identify your stakeholders by job title and how their participation was key to the project.

    Briefly discuss potential barriers to project implementation that stakeholders may present. Include strategies to prevent or address these barriers.

    After receiving feedback from faculty, incorporate this paragraph into the Methods section of your paper after the “Procedures/intervention” section and before the “Instruments/scales and measurement of outcomes” section.

    Week 10 assignment 2

    Evidence-Based Project

    Overview/Description:

    Learners will develop a scholarly project that will demonstrate an application of evidence to practice for a substantive change. This project emphasizes application of evidence-based methodology, scholarly writing, and critical thinking. The scholarly project will be submitted as a written paper in APA format/style. In addition, learners will present a summary of the final project orally and/or with a PowerPoint presentation.

    Learners will select one of the following projects related to their specific advanced role specialization that addresses a health promotion and disease prevention of a target population: Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Educational program

    Evidence-based healthcare policy change

    Evidence-based clinical issue or protocol

    Criteria for scholarly EBP project proposal

    Over the past 11 weeks, students have developed a proposal for an evidence-based project in their area of specialization. This final paper is the culmination of this scholarly activity. All papers must be written using APA format and a professional writing style. The proposal should include the following sections and content.

    Abstract

    Part 1 – Introduction – Week 2

    Introduction

    Practice issue

    Summarize the practice issue in need of change providing background information about the organization (setting) and the perceived significance and severity of the problem. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Describe the specific aims of the project – what improved outcomes do you hope to achieve

    PICOT question – State your question in PICOT format, labeling each part with P-I-C-O-T in parentheses

    Significance – what is the significance of the issue in terms of poor outcomes, cost, etc.

    Part 2 – Evidence review and synthesis – Week 3, 4, & 5

    List the names of the databases you searched and if limited to a span of time, i.e., less than 5 years old

    Summarize “keeper” studies

    Summarize the synthesis of the body of evidence

    Part 3 – Purpose of the project – Week 6

    Purpose of the project – include intervention

    Theoretical framework

    Clinical questions

    Part 4 – Methods – Week 7

    Study design

    Setting/sample

    Confidentiality

    Procedure/intervention

    Aligning stakeholders

    Instruments/scales and measurement of outcomes

    Data collection

    Part 5 – Data analysis – Weeks 8 & 9

    Outcomes to be analyzed and how they will be analyzed

    Outcomes expected (hypothesized)

    Appendices

    Evaluation Table – turned in Weeks 3 & 4

    Synthesis Table – turned in Week 5

    Oral and/or PowerPoint Presentation

    Students will present a summary of their project using Microsoft PowerPoint.

    The presentation for onground campus students will be done orally in a 20-minute presentation

    Online campus students will include speaker notes in their PowerPoint slides and will defend their presentation in a discussion board. Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

    Criteria:

    Assemble the presentation to present all required criteria sections of the EBP project.

    Quality of presentation is professional and provides evidence of graduate level scholarship.

    Evidence Based Project (EBP) & PICOT Question: NSG6999 Graduate Project in Nursing

  • Walden nurs6052 all week discussions

    Walden nurs6052 all week discussions

    Week 1 discussion

    Nursing Research and Evidence-Based Practice

    In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.

    Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

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    To prepare:

    Consider a recent clinical experience in which you were providing care for a patient.

    Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?

    What questions have you thought about in a particular area of care such as a procedure or policy?

    Review Chapter 2, pages 36—39 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.

    Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.

    Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.

    By Day 3

    Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional strategies for addressing barriers to EBP based on readings and evidence.

    Week 2 discussion

    Literature Searches

    An important step in the EBP process is reviewing the current body of literature to better understand the subject or topic in which you are interested. By conducting a review of the literature, you are building foundational knowledge about the topic; later, you can use this background to build new insights. Developing a strong grasp of a topic can only be garnered by taking the time to thoroughly search for relevant information and resources.

    For this Discussion, you will practice searching the literature to find evidence on a specific topic.

    To prepare:

    Choose a simple search term(s) relating to a topic of your PICOT question.

    Review the information on the evidence hierarchy discussed in Chapter 2 of the course text, in the article, “Facilitating Access to Pre-Processed Research Evidence in Public Health,” and in the multimedia presentation “Hierarchy of Evidence Pyramid,” found in this week’s Learning Resources.

    Review the information on the Walden Library’s website, “Levels of evidence.” Take a few minutes to explore the different types of databases available for each level of evidence and focus on the meaning of filtered and non-filtered resources.

    Conduct a literature search in the Walden Library on your selected topic using the databases that you reviewed. Use at least one database for each of the three levels of filtered information and at least one unfiltered database. Record the number of hits that you find at each level of the hierarchy of evidence.

    Select one article from the results at each level of the hierarchy. Compare the articles based on the quality and depth of information. What would be the value of each resource if you were determining an evidence-based practice?

    By Day 3

    Post a summary of your search. Describe what topic you selected, the search term(s) that you used, and the number of results found at each level of the hierarchy. Compare the types of information found in the articles from different levels and the value of the information from each level. Highlight a useful tip that you could share with your colleagues about conducting an effective literature search.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings, or after synthesizing multiple postings.

    Week 3 discussion

    Theory, Research, and Evidence-Based Practice

    As they explore the world around them, young children often want to know the “why” and “how” of the things they observe. This is similar to what researchers do when they approach a new problem. Researchers develop new theories or build on old ones to explain the “why” of the world around them. They use models and conceptual frameworks to help explain “how” the processes and events they observe occur. Together, theories and models provide an understanding of the world and allow researchers to explore it in meaningful ways.

    Virtually all research questions can benefit from the use of an existing theory or model. Researchers should consider their research questions and select the most suitable theory or model, which then serves as a foundation for the research design. The selection of a theory or model is an important part of the research process.

    In this Discussion, you focus on the role of theory and models in research and evidence-based practice.

    To prepare:

    Review the information in Chapter 6 of the course text. Focus on the various conceptual theories and models that are currently used in nursing research.

    Select one of the theories or models described that is of interest to you.

    Using the Walden Library, search for and identify a research article that uses the theory or model you selected.

    Reflect on how the theory or model provides structure to the research study described in the article.

    Now, think about an issue in your practice area that you would be interested in exploring through research.

    Review this week’s media presentation and consider strategies for locating and identifying a relevant theory or model for a research study.

    By Day 3

    Post a summary of the article that you located and explain how the theory or model that you selected was used in the research study. Assess the value of basing research on an established theory or model.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Week 4 discussion

    Ethical Dimensions of Research Studies

    In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval.

    This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research.

    To prepare:

    Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)

    As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified?

    By Day 3

    Post a description of the case that you selected and the ethical issues involved. Analyze the ethical principles that were breached by the researchers or organizations in your selected case as well as the possible cause of the breach(es). Suggest how the research might have been conducted differently to avoid or minimize the ethical problems. Discuss how research can be done on sensitive issues while still protecting the rights of the research subjects.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Week 5 discussion

    Quantitative Research Designs

    In order to find the best information on a topic, not only should you develop a question and search for resources, but you should also know how to analyze the value of the resources that you identify. There are different ways to evaluate resources, such as using the hierarchy of evidence, which you explored in Week 4 of this course. Another way to evaluate resources is to consider the appropriateness of the research design. Understanding how research designs contribute to the quality of a study is essential for being able to analyze resources when conducting a literature review or locating evidence for practice.

    In this Discussion, you consider the different research designs and evaluate how these designs have been used to research a specific topic. You also consider strategies for selecting an appropriate research design.

    To prepare:

    Review the information in the course texton quantitative research designs. Focus on the information in Box 9.1, “Guidelines for Critiquing Research Designs in Quantitative Studies” located on page 230 of the course text.

    Select a topic from the list below and search the Walden Library to find two different quantitative research studies addressing that issue:

    Caregiver stress

    Anxiety in children

    Sleep apnea

    Depression in college freshmen

    Rural health care issues

    Post-traumatic stress syndrome

    Traumatic brain injury in veterans

    Health effects of environmental contaminants

    Bipolar disorder

    End-of-life ethical issues

    Alternative medicine

    For each of the sources that you select, identify the type of quantitative research design used, and evaluate whether it is the most appropriate approach to the research.

    Consider the ramifications of choosing an inappropriate design for a research study.

    By Day 3

    Post the topic you selected, references for the two sources you identified, and the quantitative research design used in each. Critique the appropriateness of the design used and justify your comments with information from the Learning Resources. Discuss the ramifications of choosing an inappropriate design for a research study.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days in one or more of the following ways:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Week 6 discussion

    Validity in Quantitative Research Designs

    Validity in research refers to the extent researchers can be confident that the cause and effect they identify in their research are in fact causal relationships. If there is low validity in a study, it usually means that the research design is flawed and the results will be of little or no value. Four different aspects of validity should be considered when reviewing a research design: statistical conclusion validity, internal validity, construct validity, and external validity. In this Discussion, you consider the importance of each of these aspects in judging the validity of quantitative research.

    To prepare:

    Review the information in Chapter 10 of the course text on rigor and validity.

    Read the method section of one of the following quasi-experimental studies (also located in this week’s Learning Resources). Identify at least one potential concern that could be raised about the study’s internal validity.

    Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.

    Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.

    Yuan, S., Chou, M., Hwu, L., Chang, Y., Hsu, W., & Kuo, H. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.

    Consider strategies that could be used to strengthen the study’s internal validity and how this would impact the three other types of validity.

    Think about the consequences of an advanced practice nurse neglecting to consider the validity of a research study when reviewing the research for potential use in developing an evidence-based practice.

    By Day 3

    Post the title of the study that you selected and your analysis of the potential concerns that could be raised about the study’s internal validity. Propose recommendations to strengthen the internal validity and assess the effect your changes could have with regard to the other three types of validity. Discuss the dangers of failing to consider the validity of a research study.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues in one or more of the following ways:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 7 discussion

    Qualitative Research Designs

    For the past 2 weeks, you have focused on the features and considerations of quantitative research designs. However, quantitative designs are not appropriate for all research questions. Perhaps you are concerned with how patients react when confronted with negative test results, or you wish to study how views on a certain health topic change over time. In each of these cases, the emphasis is more on understanding the thinking and experiences of an individual or group than on numerical measurements. For these types of questions, a qualitative or mixed methods research design is the most appropriate.

    For this Discussion, you focus on the different types of qualitative research designs, when they are used, and why they are important.

    To prepare:

    Reflect on the comments made by Dr. Mauk in this week’s media presentation on the value of qualitative research in nursing.

    Locate the journal Qualitative Health Research in the Sage Premier database in the Walden Library.

    From this journal, select an article of interest to you that was published within the last 3 years.

    Review the information on different qualitative research designs in Chapter 21 of your course text.

    Determine what qualitative research design was used in your selected article and evaluate whether it was the best choice.

    Consider ethical issues involved in the study and how the researchers addressed them.

    Think about how using a quantitative design would have affected the type of data gathered.

    By Day 3

    Post an APA citation for the article that you selected and provide a brief summary of the content and the qualitative research design used. Evaluate the appropriateness of the design, and explain how ethical issues in the study were addressed. Analyze how the study would have been different if a quantitative design had been used.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 8 discussion

    Planning for Data Collection

    Data collection is an important part of both quantitative and qualitative research. Although the actual approach to gathering information may vary, for either research design, researchers need to plan in advance how the data will be gathered, reported, and stored, and they need to ensure that their methods are both reliable and valid. As nurses review research when considering a new evidence-based practice, it is important to be familiar with sound collection practices in order to ascertain the credibility of the data presented.

    Consider the following scenario:

    Nurses and other health care professionals are often interested in assessing patient satisfaction with health care services. Imagine that you are a nurse working in a suburban primary care setting that serves 10,000 patients annually. Your organization is very interested in understanding the patient’s point of view to help determine areas of care that can be improved. With this focus in mind, consider how you would create a survey to assess patient satisfaction with the services your organization provides. You may wish to consider variables such as the ease of accessing care, patient wait time, friendliness of the staff, or the likelihood that a patient would recommend your organization to others.

    For this Discussion, you generate questions and an overall plan for data collection that would be appropriate for a patient satisfaction survey in relation to the above scenario.

    To prepare:

    Consider the guidelines for generating questions presented in this week’s Learning Resources.

    Review the scenario and formulate at least five questions that you could use to evaluate patient satisfaction.

    Reflect on the different methods or instruments that can be used for gathering data described in Chapter 13 and Chapter 22 of the course text. Which methods or instruments would work well for the scenario?

    Determine an appropriate sample size for the scenario.

    By Day 3

    Post the questions that you created for gathering information about patient satisfaction based on the above scenario. Explain which method or instrument you would use to gather data. Describe the sample size appropriate for the population and how you would select participants. Provide a rationale for your choices, and explain how you can ensure high standard of reliability and validity.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from the readings or after synthesizing multiple postings.

    Week 9 discussion

    Data Analysis—Small Group Discussion

    As a nurse engaged in evidence-based practice, it is important to recognize how statistics and other data analysis tools are used to generate and assess evidence. Most nurses need only a foundational understanding of statistical tools and terminology to understand the majority of research studies. As a nurse, you should be able to recognize the most commonly used statistical tests, how and when they are used, and how significance is determined.

    In this Discussion, you examine different types of statistics and statistical tests, when and why these particular tests would be selected for use, and, most importantly, what the results indicate. To this end, you will be assigned to a group by Day 1 of this week. Each group will be assigned one of the five chapters listed in this week’s Learning Resources and will develop a study sheet on their chapter that will be shared with the other groups.

    To prepare:

    Review the information in your assigned chapter.

    As a group, develop a 1-page study sheet that includes the following:

    The key concepts of the chapter: Focus on the basic concepts that are important for nurses to understand as they review research studies.

    A description of the statistical methods covered in the chapter, what they measure, and under what circumstances they are used. Identify examples of how the statistical methods have been used in research studies.

    An explanation of the key statistical tests and how they measure significance (if applicable).

    Note: This should be a collaborative effort, with each member of the group making contributions to the design and content of the study sheet. Use the Groups link on the left navigation bar to collaborate with your group. When you have developed your 1-page study sheet, select one member to post it to the Week 9 Discussion Forum so that the rest of your colleagues can access it.

    By Day 5

    Post your group’s study sheet. Discuss why it is important for nurses to understand the basics of these statistical methods.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two other groups on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Week 10 discussion

    Weighing the Evidence

    When conducting original research, the final step researchers must complete is weighing the evidence and interpreting the meanings of their data, statistics, and analyses. This is the culmination of the research process in which all of the research methods and designs can be synthesized into a meaningful conclusion. In this stage, researchers should formulate explanations for what their data indicates, determine whether the data answers their initial research question, identify areas of uncertainty, and consider directions for further research.

    In this Discussion, you focus on one of the research articles that you identified for Part 2 of the Course Project (Literature Review). You then explore the process of how the researchers generated conclusions based on their data, consider other possible interpretations of their data, and formulate ideas for further research.

    To prepare:

    Review this week’s Learning Resources, focusing on how researchers find meaning in their data and generate sound conclusions. Pay particular attention to Table 2 in the article, “Study Design in Medical Research.”

    Revisit the 5 articles that you identified in Part 2 of the Course Project. Select one to consider for the purpose of this Discussion.

    Read sections of the chosen article where the data is presented, analyzed, and interpreted for meaning. What reasoning process did the researchers use to formulate their conclusions? What explanation did they give to support their conclusions? Were there any weaknesses in their analysis or conclusions?

    Consider possible alternate conclusions that the researchers could have drawn based on their data.

    Examine the findings that the article presents and consider how well they addressed the researcher’s initial question(s). What additional research could be done to build on these findings and gain a fuller understanding of the question?

    By Day 3

    Post an APA citation and brief summary of the research article that you selected. Describe the data and the results of any statistical tests or analyses presented in the article. Explain how the researchers formulated their conclusion, any weaknesses in their analysis or conclusions, and offer at least one alternate interpretation of their data. Propose at least one additional research study that could be done to further investigate this research topic.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 11 discussion

    Creating a Culture of Evidence-Based Practice

    An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.

    In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.

    To prepare:

    Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.

    Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?

    Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.

    Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?

    Reflect on how nurses can disseminate findings from evidence-based practice research.

    By Day 3

    Post an evaluation of your organization’s use of EBP and how it is furthered or hindered by organizational culture and policies. Describe how you could disseminate the findings. Propose a strategy for strengthening the culture of EBP within the organization. Discuss a nurse’s responsibility to further the use of EBP, providing a rationale supported by specific information from the Learning Resources.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Walden nurs6052 all week discussions

  • NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Week 1 discussion

    The Effects of “To Err Is Human” in Nursing Practice

    The 1999 landmark study titled “To Err Is Human: Building a Safer Health System” highlighted the unacceptably high incidence of U.S. medical errors and put forth recommendations to improve patient safety. Since its publication, the recommendations in “To Err Is Human’” have guided significant changes in nursing practice in the United States.

    In this Discussion, you will review these recommendations and consider the role of health information technology in helping address concerns presented in the report.

    To prepare:

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    Review the summary of “To Err Is Human” presented in the Plawecki and Amrhein article found in this week’s Learning Resources. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Consider the following statement:

    “The most significant barrier to improving patient safety identified in “To Err Is Human”is a “lack of awareness of the extent to which errors occur daily in all health care settings and organizations (Wakefield, 2008).”

    Review “The Quality Chasm Series: Implications for Nursing” focusing on Table 3: “Simple Rules for the 21st Century Health Care System.” Consider your current organization or one with which you are familiar. Reflect on one of the rules where the “current rule” is still in operation in the organization and consider another instance in which the organization has effectively transitioned to the new rule.

    By Day 3

    Post your thoughts on how the development of information technology has helped address the concerns about patient safety raised in the “To Err Is Human” report. Summarize how informatics has assisted in improving health care safety in your organization and areas where growth is still needed.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 2 discussion

    Nursing Informatics Competencies

    Today’s fast-paced health care environment demands nurses to be skilled not only in their clinical practice or specialty area but in the use of technology tools that improve practice and lead to better patient care. Basic and advanced technology competencies are required and expected as technology increasingly touches and changes the job of every nurse. Numerous organizations, including the American Nurses Association (ANA), the American Medical Informatics Association (AMIA), and Healthcare Information and Management Systems Society (HIMSS), have developed nurse-specific technology competencies. The challenge for nurses is to identify both needs and training opportunities.

    In this Discussion, you identify the role informatics plays in your professional responsibilities. You pinpoint personal gaps in skills and knowledge and then develop a plan for self-improvement. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    To prepare:

    Review Nursing Informatics: Scope and Standards of Practice in this week’s Learning Resources, focusing on the different functional areas it describes. Consider which areas relate to your current nursing responsibilities or to a position you held in the past. For this Discussion, identify one or two of the most relevant functional areas.

    Review the list of competencies recommended by the TIGER Initiative. Identify at least one skill in each of the main areas (basic computer competencies, information literacy competencies, and information management competencies) that is pertinent to your functional area(s) and in which you need to strengthen your abilities. Consider how you could improve your skills in these areas and the resources within your organization that might provide training and support.

    By Day 3

    Post the key functional area(s) of nursing informatics relevant to your current position or to a position you recently held, and briefly describe why this area(s) is relevant. Identify the TIGER competencies you selected as essential to your functional area(s) in which you need improvement. Describe why these competencies are necessary and outline a plan for developing these competencies. Include any resources that are available to you within your organization and the ways you might access those resources. Assess how developing nursing informatics competencies would increase your effectiveness as a nurse.NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using the following approach: Assume the role of a consultant. Respond to your colleagues as someone who can offer advice on improving their skills on the competencies they identified as needing improvement. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Week 3 discussion

    Standardized Coding Systems

    As a result of the fragmented nature of the health care system, professionals in various specialty areas of medicine have developed their own unique sets of terminology to communicate within that specialty. In the past, limited attention has been given to codifying practices in order for them to be understood and utilized across disciplines or through different information technology systems. The implementation of a federally mandated electronic medical records system, therefore, poses a challenge to nursing professionals and others who must be prepared to utilize standardized codes for the new system. Why are coding standards important for promoting consistent, high-quality care?

    According to Rutherford (2008, para. 15), “Improved communication with other nurses, health care professionals, and administrators of the institution in which nurses work is a key benefit of using a standardized nursing language.” In this Discussion you consider the reasoning behind and the value of standardized codification. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    To prepare:

    Review the information in Nursing Informatics: Scope and Standards of Practice. Determine which set of terminologies are appropriate for your specialty or area of expertise.

    Reflect on the importance of continuity in terminology and coding systems.

    In the article, “Standardized Nursing Language: What Does It Mean for Nursing Practice?” the author recounts a visit to a local hospital to view its implementation of a new coding system. One of the nurses commented to her, “We document our care using standardized nursing languages but we don’t fully understand why we do” (Rutherford, 2008, para. 1). Consider how you would inform this nurse (and others like her) of the importance of standardized nursing terminologies.

    Reflect on the value of using a standard language in nursing practice. Consider if standardization can be limited to a specialty area or if one standard language is needed across all nursing practice. Then, identify examples of standardization in your own specialty or area of expertise. Conduct additional research using the Walden Library that supports your thoughts on standardization of nursing terminology.

    By Day 3

    Post an explanation of why nurses need to document care using standardized nursing languages and whether this standardization can be limited to specialty areas or if it should be across all nursing practice. Support your response using specific examples from your own specialty or area of expertise and using at least one additional resource from the Walden Library. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 4 discussion

    Current Information and Communication Technologies

    With so much attention focused on health care reform, it is important that nurses be given the opportunity to use high-quality technology tools. These tools can increase access to vital medical information, promote effective communication among health care professionals, and improve the patient experience. By actively seeking out and adopting these tools, nurses can greatly enhance the quality and safety of care that they provide. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    This Discussion focuses on identifying quality technology tools that increase the ability of nurses to provide safe, effective care.

    To prepare:

    Review the various technology tools described in this week’s Learning Resources.

    Identify a recently adopted information, education, or communication technology tool in your specialty area. Reflect on how it is used and how its use impacts the quality of care.

    Consider how your identified technology tool might impact nursing practice if it were more widely used. What are some barriers preventing increased usage? How could wider implementation be facilitated?

    By Day 3

    Post a description of a current or new information, education, or communication technology tool that is being used in your specialty area and assess its impact on the quality of care. Highlight the effect that increased use of this technology would have on nursing practice and discuss the barriers that are slowing or hindering its adoption. Summarize how adoption of the technology tool could be facilitated.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 5 discussion

    Electronic Health Records

    Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.

    To Prepare:

    Review the Learning Resources focusing on the implementation of EHRs in an organization. Reflect on the various approaches used.

    If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?

    Reflect on the reactions of others during the implementation process. Were concerns handled effectively?

    If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.

    Search the Walden Library for examples of effective and poor implementation of EHRs.

    By Day 3

    Post an overview of at least three challenges in the implementation of electronic health records and provide an example of each challenge. Develop strategies for addressing each challenge based on what has been demonstrated to be successful. Cite your resources. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    Week 6 discussion

    Successful Implementation of Electronic Health Information Technology

    Since the inception of the HITECH Act, health organizations have faced increased pressure to update their health information technology (HIT) resources. As discussed last week, many believe that the increased use of electronic health records and the quick and efficient communication afforded by HIT can lead to improved quality of patient care. Yet there are significant costs associated with implementing such systems. What can organizations do to ensure that the correct system is selected and that the system will be appropriate for those required to use it? Who should be involved in those decisions?

    This week introduces the systems development life cycle and discusses how it can guide an organization through the complexities of adopting a new HIT system. In this Discussion, you are asked to consider the role of nurses in the SDLC process.

    To prepare:

    Review the steps of the systems development life cycle.

    Think about your own organization, or one with which you are familiar, and the steps the organization goes through when purchasing and implementing a new HIT system.

    Consider what a nurse could contribute to decisions made at each stage when planning for new health information technology. What might be the consequences of not involving nurses?

    Reflect on your own experiences with your organization selecting and implementing new technology. As an end user, do you feel you had any input in the selection or and planning of the new HIT system? NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    By Day 3

    Post an analysis of the ramifications of an organization not involving nurses in each stage of the systems development life cycle when purchasing and implementing a new HIT system. Give specific examples of potential issues at each stage and how the inclusion of nurses could help avoid such issues.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight fro NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papersm having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 7 discussion

    Understanding Workflow Design

    As you explored last week, the implementation of a new technology can dramatically affect the workflow of an organization. Newly implemented technologies can initially limit the productivity of users as they adjust to their new tools. Such implementations tend to be so significant that they often require workflows to be redesigned in order to achieve improvements in safety and patient outcomes. However, before workflows can be redesigned, they must first be analyzed. This analysis includes each step in completing a certain process. Some systems duplicate efforts or contain unnecessary steps that waste time and money and could even jeopardize patient health care. By reviewing and modifying the workflow, you enable greater productivity. This drive to implement new technologies has elevated the demand for nurses who can perform workflow analysis.

    In this Discussion you explore resources that have been designed to help guide you through the process of workflow assessment. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    To prepare:

    Take a few minutes and peruse the information found in the article “Workflow Assessment for Health IT Toolkit” listed in this week’s Learning Resources.

    As you check out the information located on the different tabs, identify key concepts that you could use to improve a workflow in your own organization and consider how you could use them.

    Go the Research tab and identify and read one article that is of interest to you and relates to your specialty area.

    By Day 3

    Post a summary of three different concepts you found in “Workflow Assessment for Health IT Toolkit” that would help in redesigning a workflow in the organization in which you work (or one with which you are familiar) and describe how you would apply them. Next, summarize the article you selected and assess how you could use the information to improve workflow within your organization. Finally, evaluate the importance of monitoring the effect of technology on workflow. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Read a selection of your colleagues’ responses. Focus particularly on questions raised for which you can add comments based on your experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions. Review the Learning Resources for any clarification needed before responding.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    Week 8 discussion

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

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

    To prepare:

    Read the following scenario from the text (McGonigle & Mastrian, 2011, p. 482):

    Twelve-hour shifts are problematic for patient and nurse safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004, the Institute of Medicine (Board on Health Care Services & Institute of Medicine, 2004) published a report that referred to studies as early as 1988 that discussed the negative effects of rotating shifts on intervention accuracy. Workers with 12-hour shifts realized more fatigue than workers on 8-hour shifts. In another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu, and Aygun (2006), factors relating to increased risk for injury were age of 24 or less, less than 4 years of nursing experience, working in the surgical intensive care units, and working for more than 8 hours. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

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

    Select an issue in your practice that is of concern to you. Using health information technology, locate at least three evidence-based practice resources that address your concern and that could possibly inform further action.

    By Day 3

    Post a description of your practice concern. Outline how you used health information technology to locate evidence-based practices that address this concern. Cite and include insights from the resources. Analyze how health information technology supports evidence-based practice. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Read a selection of your colleagues’ responses. Focus particularly on those questions raised to which you can add comments based on shared experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions. Review the Learning Resources for any clarification needed before responding.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Week 9 discussion

    HITECH Legislation

    In order for organizations to receive the incentives offered through the HITECH legislation, they must be able to demonstrate that they are using the technology in meaningful ways. The following criteria for meaningful use must be evident to qualify for EHR incentives (U.S. Department of Health & Human Services, 2012). The technology must:

    Improve quality, safety, and efficiency, and reduce health disparities

    Engage patients and families

    Improve care coordination

    Improve population and public health

    Ensure adequate privacy and security protections for personal health information

    For this Discussion you consider the impact of the meaningful use criteria of the HITECH legislation on the adoption of health information technology. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    To prepare:

    Review the Learning Resources on the HITECH legislation and its primary goals.

    Reflect on the positive and negative impact this legislation has had on your organization or one with which you are familiar.

    Consider the incentives to encourage the use of EHRs. Focus on the definition of meaningful use and how it is measured.

    Reflect on how the incentives and meaningful use impact the quality of patient care.

    Find an article in the Walden Library dealing with one of the criteria to qualify for meaningful use and how it has been successfully met.

    By Day 3

    Post a description of how HITECH legislation has positively or negatively impacted your organization. Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care. Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Week 10 discussion

    Security of Health Care Records

    With the increase of health information technology used to store and access patient information, the likelihood of security breaches has also risen. In fact, according to the Canadian Medical Association Journal (CMAJ):

    In the United States, there was a whopping 97% increase in the number of health records breached from 2010 to 2011… The number of patient records accessed in each breach has also increased substantially, from 26,968 (in 2010) to 49,394 (in 2011). Since August 2009, when the US government regulated that any breach affecting more than 500 patients be publicly disclosed, a total of 385 breaches, involving more than 19 million records, have been reported to the Department of Health and Human Services.

    A large portion of those breaches, 39%, occurred because of a lost, stolen, or otherwise compromised portable electronic device—a problem that will likely only get worse as iPads, smartphones, and other gadgets become more common in hospitals. (CMAJ, 2012, p. E215).

    Consider your own experiences. Does your organization use portable electronic devices? What safeguards are in place to ensure the security of data and patient information? For this Discussion you consider ethical and security issues surrounding the protection of digital health information. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    To prepare:

    Review the Learning Resources dealing with the security of digital health care information. Reflect on your own organization or one with which you are familiar, and think about how health information stored electronically is protected.

    Consider the nurse’s responsibility to ensure the protection of patient information. What strategies can you use?

    Reflect on ethical issues that are likely to arise with the increased access to newer, smaller, and more powerful technology tools.

    Consider strategies that can be implemented to ensure that the use of HIT contributes to an overall culture of safety.

    By Day 3

    Post an analysis of the nurse’s responsibility to protect patient information and the extent that HIT has made it easier or more difficult to protect patient privacy. Comment on any security or ethical issues related to the use of portable devices to store information. Assess the strategies your organization uses to safeguard patient information and how these promote a culture of safety. Describe an area where improvement is needed and one strategy that could address the situation.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 11 discussion

    Health Literacy

    In order to effectively manage their own health, individuals need to have competencies in two areas—basic literacy and basic health literacy. What is the difference? Basic literacy refers to the ability to read, even simple language. Health literacy is defined as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (National Coalition for Literacy, 2009). Unfortunately, according to a Department of Education report on health literacy, only 12% of adults aged 16 and older are considered to have a proficient level of health literacy (U.S. Department of Education, 2006). Acquiring health literacy skills has become more complicated with the explosion of online health information, some credible and some misleading.

    In this Discussion, you focus on how to help individuals find credible information on the Internet and develop strategies nurses can use to increase the health literacy of their patients.

    To prepare:

    Think about the nurse’s role in improving the health literacy of patients.

    Consider the many ways patients access health information, including blogs, social media, patient portals, websites, etc.

    Reflect on experiences you have had with patients who self-diagnose using online medical sources.

    Using the Internet, the Walden Library, or other trustworthy sources, identify a resource that you could introduce to patients to help them evaluate the credibility of health information found online. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    What are some strategies you could employ to improve the health literacy of patients?

    By Day 3

    Post your assessment of the nurse’s role in improving the health literacy of patients. Then, identify the resource you would recommend to patients for evaluating online health information and why it would be beneficial. Describe additional strategies for assisting patients in becoming informed consumers of online health information.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 4 assignment

    Using the Data/Information/Knowledge/Wisdom Continuum

    Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom—knowledge applied in meaningful ways.

    Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom.

    To prepare:

    Review the information in Figure 6–2 in Nursing Informatics and the Foundation of Knowledge.

    Develop a clinical question related to your area of practice that you would like to explore.

    Consider what you currently know about this topic. What additional information would you need to answer the question?

    Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.

    Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.

    Once you have identified useful databases, how would you go about finding the most relevant articles and information?

    Consider how you would extract the relevant information from the articles.

    How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom?

    By Day 7 of Week 4

    Write a 3- to 4-page paper that addresses the following:

    Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.

    Identify the databases and search words you would use.

    Relate how you would take the information gleaned and turn it into useable knowledge.

    Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Your paper must also include a title page, an introduction, a summary, and a reference page

    Week 6 assignment

    Assignment: Application: Adoption of New Technology Systems

    As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.

    Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:

    Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.

    Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.

    Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.

    Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.

    Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.

    Note: You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.

    For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    To prepare

    Review the Learning Resources this week about successful implementations of EHRs.

    Consider how you would present the new EHR system to the nurses to win their approval.

    Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success?

    By Day 7 of Week 6

    Write a 3- to 5-page paper which includes the following:

    Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.

    Analyze the role of nurses as change agents in facilitating the adoption of new technology.

    Week 8 assignment

    Assignment: Creating a Flowchart

    Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining.

    In this Assignment, you select a common event that occurs regularly in your organization and create a flowchart representing the workflow. You analyze the process you have diagrammed and propose changes for improvement.

    To prepare:

    Identify a common, simple event that frequently occurs in your organization that you would like to evaluate.

    Consider how you would design a flowchart to represent the current workflow.

    Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste.

    To complete:

    Write a 3- to 5-page paper which includes the following:

    Create a simple flowchart of the activity you selected. (Review the Sample Workflow of Answering a Telephone in an Office document found in this week’s Learning Resources for an example.). NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    Next, in your paper:

    Explain the process you have diagrammed.

    For each step or decision point in the process, identify the following:

    Who does this step? (It can be several people.)

    What technology is used?

    What policies and rules are involved in determining how, when, why, or where the step is executed?

    What information is needed for the execution of this step?

    Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

    Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow.

    Summarize why it is important to be aware of the flow of an activity.

    Remember to include a cover page, introduction, and summary for your paper

    Week 11 assignment

    Assignment: Health Information Patient Handout

    One of the pivotal goals of consumer health literacy efforts is to design educational materials that attract as well as educate users. In this Assignment, you design a health information document on a topic that is of interest to you.

    To prepare:

    Select a health issue of interest to you.

    Identify the audience or population that you seek to educate about this issue.

    Search the Internet to find credible sites containing information about your selected topic.

    Review the two health literacy websites listed in this week’s Learning Resources. Focus on strategies for presenting information. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

    To complete:

    Design an educational handout on the health issue you selected.

    Include a cover page.

    Include an introduction that provides:

    An explanation of your issue and why you selected it

    A description of the audience you are addressing

    In the handout itself:

    Develop your handout in such a way that it attracts the attention of the intended audience.

    Include a description of the health issue and additional content that will enhance your message (i.e., key terms and definitions, graphics, illustrations, etc.).

    Recommend four or five sites that provide clear, valuable, and reliable information on the topic.

    Note: Remember to keep the information in your health handout and its design at the appropriate level for the audience you are seeking to inform. Submit your Assignment as a Word document.

    By Day 5

    Submit the Assignment.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.

    Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.

    Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.

    If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

    Click on the Submit button to complete your submission. URS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

  • Rasmussen nur2058 – Balancing School and Life – My Quality of Life Self-Care Plan

    Rasmussen nur2058 – Balancing School and Life – My Quality of Life Self-Care Plan

    Balancing School and Life – My Quality of Life Self-Care Plan. The purpose of developing this Plan is to set a framework and a plan to maintain wellness and to stay motivated and engaged throughout your Program. Doing this will help you achieve success during your coursework and as a professional nurse.

    The goal of the Project is to help you become self-aware and reflective as a means of identifying personal self-care strategies that will increase your energy and help you manage your stress. The Project will give you a chance to learn how this is accomplished as you will be doing similar work with clients during the Program and as a professional nurse to assist them in the same way.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Use the Quality of Life Self-Care Wheel to assess your current state. After you determine your scores, in a 2-3 page paper complete the following:

    Discuss those areas that are strengths (higher scores) and those areas that need further development (lower scores).

    Identify two strategies you can use to maintain or maximize each identified strength.

    Identify two strategies you can use to strengthen each area needing development. Explain how you will put these strategies into action. Be specific. For example, instead of stating, “I need to exercise,” your action should state “I will begin to walk 20 minutes a day, 3 days a week.” The action should be SMART- Specific, Measurable, Attainable, Realistic, Timeframe

    Also attach your completed form

    Minimum length 2-3 pages not including cover or referencing. APA formatting

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

    rasmussen nur2058 – Balancing School and Life – My Quality of Life Self-Care Plan

  • Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Week 1 -Assignment 2 Discussion

    Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

    Identify a problem or issue from within your specialty area that you feel needs to be improved upon. The Doctor of Nursing Practice site (http://www.doctorsofnursingpractice.org/resources/dnp-scholarly-projects/) provides many examples of these projects. The list below may help focus your thoughts.

    Educational program

    Evidence-based healthcare policy change

    Evidence-based clinical issue or protocol for specific disease/condition

    Discuss the relevance of the issue from your perspective (not the literature at this juncture) in relation to your selected advanced role option.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    What piqued your interest about this issue or problem?

    How does it relate to your area of specialization?

    What gave you the idea that evidence exists to support this change? See “note” below.

    Provide a rationale as to why this will be an evidence-based project to improve outcomes and not generate new evidence (research). Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Please remember that the project will not be implemented during this course and no data will be collected. The outcome of this course is to complete a project proposal only.

    Week 2 – Assignment 1 Discussion

    Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

    Briefly describe the problem or issue that you have decided to be the topic for your project proposal in order to orient your classmates and faculty

    Indicate how it relates to your area of specialization

    State your PICOT question. Indicate in parentheses after each segment, what part of PICOT the preceding words represent. For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T). Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Discuss which process model resonates with you and will help keep you focused during the project. Process models included in your text (Melnyk & Fineout-Overholt, 2011) are:

    Clinical scholar model

    Stetler model of evidence-based practice

    Iowa model of evidence-based practice to promote quality care

    Model for evidence-based practice change by Rosswurm and Larrabee

    Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model

    Provide feedback to your classmates that focuses on:

    The use of correct PICOT format for the question to guide the literature search.

    Does the question reflect a clinical research question or one appropriate for an evidence-based practice project?

    Week 3 – Assignment 1 Discussion

    In this discussion, you will share your search strategies that you have employed to find evidence for your study. For this discussion:

    State your PICOT question. Did using the terms used in this question lead you to useful research studies?

    What MESH terms have you tried? Did they help you find additional studies? Are you finding MESH terms useful to expand or delimit your search?

    Are you finding relevant articles? If not, how did you modify your search to increase productivity?

    Indicate which databases you used—those you found useful and those that were not.

    What levels of evidence do the studies you are finding represent?

    Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

    Use the Search Tracker to keep track of search terms. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Using the appropriate Rapid Clinical Appraisal (RCA) Tools, appraise one or two articles and add the information to your Evaluation Table to receive feedback from faculty. At this juncture, your table is a work in progress. You will complete it in Week 4. The RCA Tools and Evaluation Table in Word for you to complete can be found in the Week 3 Overview section.

    Week 4 – Assignment 1 Discussion

    Discuss your experience completing the rapid critical appraisal process.

    Was it really “rapid” or was it more of a laborious process?

    Did reading the abstract help you make quick decisions about including or excluding the study?

    What worked best for you in terms of the approach you decided to use to complete the appraisal and Evaluation Table? What didn’t work?

    Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

    Week 5 – Assignment 1 Discussion

    This week the discussion focuses on creating a Synthesis Table(s) as a means to summarize and organize the body of evidence from the Evaluation Table. The Synthesis tables will be included in your formal proposal in the Appendix. In the body of the paper, you will describe the “keeper” studies in narrative format.

    For this discussion, include the following:

    Share your approach to synthesizing the evidence. What were the variables of interest you identified?

    Learning to write in a scholarly fashion requires that you are able to succinctly summarize an article in a sentence or two and cite it appropriately using APA format. In this discussion, practice summarizing 2 articles you have identified from the Synthesis Table as pertinent to your proposal. Include the level of evidence, study design, and evidence of rigor. Use appropriate APA citation in text and references. Incorporate feedback from peers and faculty in your Dropbox assignment for this week.Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    In addition to research studies, patient preference and clinical expertise should also be considered. Discuss how you will incorporate these important perspectives into your project proposal.

    Week 6 – Assignment 1 Discussion

    For this week’s discussion, please address the following:

    Briefly describe the clinical issue or problem for your project, the setting, and population of interest to orient classmates and faculty

    Write your clinical question

    Describe the intervention you plan to test

    What type of study will you conduct? Will it be experimental? Quasi-experimental? Provide a rationale for your answer.

    Provide feedback on the clinical questions of your colleagues

    Week 7 – Assignment 1 Discussion

    This discussion will focus on the measurement tools you will use to evaluate change from the intervention. The purpose of this discussion is to fine-tune your thinking about evaluation by receiving feedback from colleagues and faculty. Include in your discussion:

    Write a brief description of your project that starts by stating your clinical question and succinctly explaining your planned intervention in order to orient everyone.

    Will you need to develop your own evaluation tools or are valid and reliable tools available?

    If you create your own tools, what are your thoughts on pilot testing them? How will you go about this? Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Will you gather baseline data? Will you use pre- and posttests? How will you measure change?

    How will you identify the participants for your study? How does the sampling method chosen further define the type of study you will be doing?

    How will you ensure confidentiality of study participants?

    Week 8 – Assignment 1 Discussion

    The discussion for this week will revolve around the analysis phase of your project. Include the following points in your discussion:

    Begin with a brief description of your project that includes your clinical question, your planned intervention, the type of study you will conduct and how you plan to evaluate the outcomes. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    What type of statistical analysis will be done?

    What is a reasonable timeline for your project?

    What expenses should be considered? Include both obvious expenses, such as materials, as well as those that are hidden, such as time, which equates to part of your salary.

    Will you need to consider a funding source for your project?

    Week 9 – Assignment 1 Discussion

    Although you will not implement your project during this course, it is important that you understand the various steps that are necessary to do so. As you begin to formulate your strategic plan for implementing your change project, discuss the following specific to your proposed project:

    Who are the stakeholders? Please identify them by role or job within the organization, not by name. Can you identify any “champions” or people within your organization that you can convert to champions?

    What potential barriers do you foresee and what strategies do you envision to prevent or overcome these barriers?

    What change theory will you use to guide you?

    Week 10 – Assignment 1 Discussion

    For this discussion question, you are asked to review the student learning outcomes for this course and discuss how you met these outcomes. The intention here is to provide you an opportunity to “reflect” on the learning achieved during this term and how you successfully met these learning outcomes. If you do not feel you successfully met the objective, discuss your plans to successfully complete the objective in the future.

    By the end of the course, the student should be able to:

    Demonstrate synthesis of the knowledge and skills acquired in preceding graduate nursing core and specialty curriculum content. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Evaluate current health policy and legal and ethical considerations in addressing the health promotion and disease prevention of a target population.

    Integrate this synthesis in the creation of a scholarly project of either an evidenced-based practice proposal or a research proposal that generates new nursing knowledge. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

    Disseminate significant components of the project through a written paper and oral presentation.

    Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools.