IDENTIFYING A PROBLEM OR CONCERN IN AN ORGANIZATION


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

Through the legislative process, your proposal for the problem or concern may influence an idea for change into a law.

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

http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs440v_how-a-bill-becomes-a-law-v2.1.php/.

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

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

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

 ( 600-700 words. Find a topic that actually can be legislated (made into a law). It could be a health issue in your community. An example of a problem that troubles me is why restaurant food that is left over is thrown out each night instead of saving and offering it to soup kitchens when 25% of our population has “food insecurity”. Such a topic could be developed into a proposal following the steps on the form. 

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

Legislative Worksheet (SBAR Format) – 

How a Bill Becomes a Law

SITUATION: IS THIS SOMETHING THAN CAN BE LEGISLATED?

  • Identify      the problem/concern:     
  • State      your proposal/idea.    

     

BACKGROUND: DO YOUR RESEARCH

  • Include      studies, reports, personal experience, or anecdotal stories related to      your proposal.    
  • Has      there been similar legislation introduced and/or passed in other states?      If so, include it.    
     

ASSESSMENT: FINANCES AND STAKEHOLDERS 

  • Identify      financial impact if any (e.g., added costs, cost savings, increased      revenue):   
  • Identify      stakeholder groups that would support this bill:   
  • Identify      people/groups that would oppose this bill:   

     

RECOMMENDATION

Make an appointment with your legislator to discuss your proposal.

Benchmark – Curriculum Design And Program Evaluation

Benchmark – Curriculum Design And Program Evaluation

Curriculum design is an essential part of a program design and it guides stakeholders to achieve overall desired course and program outcomes. Program evaluation is a routine assessment of various parts of a program and a measure of intended goals. Program evaluation is done for a variety of purposes, including evaluating program implementation, determining program effectiveness, providing direction, and guiding improvements. The purpose of this assignment is to become familiar with the program evaluation process. Benchmark – Curriculum Design And Program Evaluation

Use the program outcomes on the example lesson plan in Chapter 10 of the Teaching in Nursing: A Guide for Faculty textbook. Create a hypothetical course framework that includes a course description and learning outcomes. Provide a rationale for how your course fits within the program and aligns to program outcomes. Your course outcomes should be different from the ones in the example lesson plan. Include a detailed explanation of how you plan to evaluate the course’s success within the program.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Benchmark – Curriculum Design And Program Evaluation.

Rubic Print Format

Course Code Class Code Assignment Title Total Points
NUR-648E NUR-648E-O500 Benchmark – Curriculum Design and Program Evaluation 120.0
Criteria Percentage Unsatisfactory 0-75% (0.00%) Less Than Satisfactory (80.00%) Satisfactory 81-88% (88.00%) Good 89-92% (92.00%) Excellent 93-100% (100.00%) Comments Points Earned
Criteria 100.0%
Participate in Curriculum Design and Evaluate Program Outcomes (6.3, MSN, 1.3 Post- MSN) 30.0% Student does not participate in curriculum development through an evaluation of program outcomes related to the course objectives. Student participates in curriculum development through an evaluation of program outcomes related to the course objectives, but the evaluation lacks details or is incomplete. Student participates in curriculum development through an evaluation of program outcomes related to the course objectives. Student participates in curriculum development through an evaluation of program outcomes related to the course objectives, and the evaluation is well developed. Student participates in curriculum development through an evaluation of program outcomes related to the course objectives, and the evaluation is thoroughly developed.
Course Framework 20.0% Course framework is not present. Course framework is present, but lacks detail or is incomplete. Course framework is present. Course framework is present and well developed. Course framework is thoroughly developed with supporting details.
Rationale 20.0% Rationale for how the course fits within the program and aligns to program outcomes is present. Rationale for how the course fits within the program and aligns to program outcomes is present, but lacks detail or is incomplete. Rationale for how the course fits within the program and aligns to program outcomes is present. Rationale for how the course fits within the program and aligns to program outcomes is present and well developed. Rationale for how the course fits within the program and aligns to program outcomes is thoroughly developed.
Evaluation of Success 20.0% An explanation of how to evaluate the success of the course within the program is present. An explanation of how to evaluate the success of the course within the program is present, but lacks detail or is incomplete. An explanation of how to evaluate the success of the course within the program is present. An explanation of how to evaluate the success of the course within the program is present and well developed. An explanation of how to evaluate the success of the course within the program is thoroughly developed.
Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage 100%

 

Engagement Survey And Action Work Plan

Engagement Survey And Action Work Plan

Assignment Content

  1. Resource: Employee Engagement Survey Results

    Imagine your health care organization conducted an employee engagement survey and received the results.

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    Create a 3- to 4-page annual Action Work Plan. Your plan should: Engagement Survey And Action Work Plan

    • Define SMART goals, objectives, and strategies.
    • Identify desired results.
    • Define how success will be measured.
    • Identify, analyze, and delegate tasks.
    • List the tactics that will be used.
    • Create a timeline of events.
    • List expenses and create a budget.
    • Your plan is not limited to the above list.

      Cite at least 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

      Format your assignment according to APA guidelines Engagement Survey And Action Work Plan.

PSYCHIATRIC NURSING

  I want this assignment asap -PLAGIARISM MUST BE LESS THAN 10% 

sychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.

Learning Objectives

Students will:
  • Assess client factors and history to develop personalized plans of antipsychotic therapy for clients
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy
  • Evaluate efficacy of treatment plans
  • Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan

To prepare for this Assignment:

  • Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

The Assignment

Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Improving Medication Adherence in Diabetic Patients in Home Health Care

Improving Medication Adherence in Diabetic Patients in Home Health Care

Once IRB approval for your proposal is obtained, learners will commence the implementation phase of the DPI Project. For the remainder of the course, learners are required to develop working drafts of Chapters 4 and 5 of the final DPI Project. These chapters will undergo further revision in DNP-965 with the requirement that the entire DPI Project will be submitted to the DPI Committee at the end of DNP-965.

General Requirements:

TOPIC: Improving Medication Adherence in Diabetic Patients in Home Health Care Settings

This Paper should be about 25 pages long including the reference pages

Student should use Credible and Verifiable Academic Resources

Please use the Criterion in the Manuscript attached to Complete the assignment

Criterion must be attached with each stage or heading criteria

Please start the Project with a 1 page introduction that Summarizes the Chapter

Use the following information to ensure successful completion of the assignment: Improving Medication Adherence in Diabetic Patients in Home Health Care

· Remember to use the appropriate forms and templates (if required) for completing this assignment. These are available on the PI Workspace of the DC Network.

· Doctoral learners are required to use APA style for their writing assignments.

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

· You are required to submit this assignment to LopesWrite.

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Directions:

Submission of the completed DPI Project – Working Draft Chapter 5 is the recommended deliverable to progress through the DPI Project implementation phase. Locate the “Final DPI Project Template” in the PI Workspace area of the DC Network and utilize it to develop and submit initial and ongoing working versions of Chapter 5 of your DPI Project.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. Improving Medication Adherence in Diabetic Patients in Home Health Care

QUALITY IMPROVEMENT PROJECT 2

 

Improving Medical Adherence in Diabetic Patients in Home Health Care Settings

Submitted by

Bola Odusola-Stephen

Direct Practice Improvement Project Proposal

Doctor of Nursing Practice

Grand Canyon University

Phoenix, Arizona

February 15, 2021.

 

Chapter 4

Introduction

Quality improvement in nursing is entailed in facilitating important strategies that can be used in enhancing outcomes in a healthcare setting. The chapter begins by introducing the descriptive data and offering visual representation for the collected data for enhanced understanding. The results section offer an evidence based as well as safety and quality improvement type of report for future reference and improvement. Tools to use for effectiveness in quality improvement are also offered to enhance success in future nursing practices.

 

Criterion Learner Score (0, 1, 2, or 3) Chairperson Score (0, 1, 2, or 3) Comments or Feedback
INTRODUCTION (TOTHE CHAPTER)

This section of Chapter 4 briefly restates the problem statement, the methodology, the clinical question(s) or phenomena, and offers a statement about what will be covered in this chapter.

     
Re-introduces the purpose of the practice project.      
Briefly describes the project methodology and/or clinical question(s) tested.      
Provides an orienting statement about what will be covered in the chapter.      
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.      
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for review, please remove all of these assessment tables from this document.

Score 0 (not present); 1(unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).

 

 

Descriptive Data

Table 1. Socio-demographic characteristics of patients (n=114)
Variables Frequency Percent
Age (years)

30-40

41-50

51-60

61-70

Above 70

 

8

17

31

28

30

 

7.0

14.9

27.2

24.6

26.3

Sex

Male

Female

 

51

63

 

44.7

55.3

Occupation

Artisans

Unemployed

Civil servant

Professionals

Trading Retiree

 

6

10

11

28

29

30

 

5.3

8.8

9.6

24.6

25.4

26.3

Educational qualification

No formal education

Primary

Secondary Tertiary

 

11

22

32

49

 

9.6

19.3

28.1

43.0

Marital status

Single

Married

Widowed Divorced

 

5

89

17 3

 

4.4

78.1

14.9

2.6

Studies reveal that diabetic patients have an issue with taking their medications at home which has caused a lot of issues in their health. The table below shows data collected from different people with different status in the sample population used for this research study. When looked at the age factor it is evident that those as people grow older, they usually become less adhering to their medications while at home. The issue of age may be associated with the various side effects of aging that may be present in people. As people grow older their memory may be weak and cases of forgetting crucial issues are common. To handle the issue of forgetfulness and loss of memory as people age there is the need for the healthcare practitioners to keep a close monitoring of the identified patients.

The females are considered to be highly likely to forget to take their medications or adhere to taking their medications while at home because of the many activities they indulge in during their daily operations from work activities to household activities. When looked at from the employedt vs unemployed status, the unemployed have a higher level of adherence to medication while at home as compared to the employed people who have lost adherence to medications while at home. This may be associated to the many activities that the employed people indulge in during their day as compared to the unemployed who have enough time relaxing and managing their schedules Improving Medication Adherence in Diabetic Patients in Home Health Care.

Table 4. Association between socio-demographic characteristics and opinion on costs of medication as the reason for medication non-adherence.

Costs as reason (Rank) (n=96)

Variables Number Mean rank Kruskal-Wallis (p-value)
Age (year)

30- 40 41-50

51-60

61-70

Above 70

 

7

16

27

25

21

 

46.21

50.16

55.13

38.60

51.26

 

 

 

0.246

Sex Males

Females

 

43

53

 

45.63

50.83

 

 

0.343

Occupation Artisan

Civil servant

Unemployed

Retiree

Trading

Professional

 

4

8

9

23

26

26

 

24.75

79.81

45.56

34.67

45.13

59.13

 

 

 

 

0.000*

Educational qualification

No formal education

Primary

Secondary Tertiary

 

9

19

23

45

 

54.17

54.97

40.30

48.82

 

 

0.297

 

 

Marital status

Single

Married

Widowed Divorced

 

4

78

11 3

 

29.50

49.76

55.05

17.0

 

 

 

0.071

Level of significance p< 0.05, * = Significant difference

Alongside the socio-demographic factors that have been discussed above in an attempt to explain the key reasons as to why there is the issue of lack adherence to the diabetic medications that people have been given is that one regarding the costs of medication. Most of the individuals revealed that they have an issue with adhering to medications because of the cost associated with the given medications. Diabetic medications can be quite costly making people to be less adhering to the medications especially due to the many combinations that the patients are required to take for full recovery.

 

Criterion Learner Score (0, 1, 2, or 3) Chairperson Score (0, 1, 2, or 3) Comments or Feedback
DESCRIPTIVE DATA

This section of Chapter 4 provides a narrative summary of the population or sample characteristics and demographics of the participants in the project. It establishes the number of subjects, gender, age, level (if appropriate), organization, or setting (if appropriate). The use of graphic organizers, such as tables, charts and graphs to provide further clarification and promote readability, is encouraged.

     
Provides a narrative summary of the population or sample characteristics and demographics.      
Graphic organizers are used as appropriate to organize and present coded data, as well as descriptive data such as tables, histograms, graphs, and/or charts.      
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.      
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for review, please remove all of these assessment tables from this document.

Score 0 (not present); 1(unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).

Data Analysis Procedures

This QI project uses the mobilize as well as the assess, plan, implement and Track process type of approach to arrive at the research outcomes indicated in this chapter. The sample entailed adult patients with T2DM who had at least a single oral diabetic type of medication prescribed to them. 194 patients met the identified criteria for inclusion in the sample. This project took place over 12 weeks. Initially, the identified recruitment regarding participants in the study was planned to take place for ten weeks but it was eventually extended to two more weeks so as to facilitate the enlisting of more participants for enhanced feasibility as well as efficacy of the study (Steinberg & Miller, 2015). At the start of the project associated implementation, there was carrying out of individual as well as group education types of meetings with the identified medical assistants as well as providers so as to train them on the manner in which to implement the given interventions. The project began with the adjusting of the given techniques in the implementation of the identified Interventions through the utility of the run charts. Prelusion of the data collection and data analysis materials happened next.

To analyze the given data tally sheets were utilized in counting the daily number regarding the patients who have been involved in the completion of the LON pre survey as well as there was recording the scores in the same type of document. There was the summarizing of the demographic data through computing the identified frequency as well as mean, the standard deviation and the identified percentages so as to effectively describe the given participants. There was thereafter a generation of a run chart so as to come up with an analysis of whether or not the 80% regarding the eligible parents received the identified DAEP. There were three categories regarding the LON scores which included the low from 0-1 as well as medium ones from 2-7 and the high ones from 8-36 ( Steinberg & Miller, 2015)Improving Medication Adherence in Diabetic Patients in Home Health Care.

The differences that existed between the identified LON scores pre as well as the post intervention distinctions were analyzing through the use of the identified sign test as well as the Mann Whitney U test. Nonetheless, there was summarization or the identified adherence rate regarding the given participants through the calculation of the identified mean as well as standard deviation and the median. These analysis were essential in offering increased knowledge on the adherence rate among the individuals and come up with an average of the identified figures for use for future references and in coming up with the right set of interventions. Finally, the analysis practice ended with the analysis of the identified relationship that exists between the identified adherence associated rates post Interventions Lon scores through the utility of the Pearson correlation coefficient.

Through out the collection and the Analysis Procedures, there was effective ensuring of the maintenance of privacy as well as confidentiality during the identified chart associated audit through the de-identification of the Pearson information by the participants using the codes. Nonetheless, it is important to note that printed data along with information were secured at the identified organiztaion in a locked file cabinet within a secured office. All the identified electronic data was stores on a password protected and an encrypted computer. To ensure there is effective sustainability regarding the identified aspect of practice change, the identified providers will go on addressing the outcomes from the identified adherence estimator regarding the medium to high score regarding the LON to medications. They will as well be following up on the identified adherence rate that was reported from the identified analysis during the assessment of the responses given for every participant. Implementation of the various interventions presented by different scholars along with researchers will be vital in the extension of the identified patients who have other chronic illnesses like hyperlipidemia along with hypertension so as to address the issue of inappropriate medical adherence among the patients ( Steinberg & Miller, 2015)Improving Medication Adherence in Diabetic Patients in Home Health Care.

NURSING CASES STUDY

I- Case Study: Care of the Child in Inpatient and Outpatient Settings

Jordan is 9-year-old male who is a direct admit for observation. He has a history of vomiting and diarrhea for 48 hours.

Subjective Data

  • Nausea and vomiting for 24 hours
  • Has not voided today
  • Unable to tolerate oral fluids

Objective Data

  • Vital signs: T 37.8° C, P 120, R24, BP 110/60
  • Weight: 34 kg
  • Hyperactive bowel sounds to auscultation

1. Question 1

When should the discharge teaching begin for Jordan and his family?

2. Question 2

What is the best way to approach Jordan regarding the IV that has been ordered.

3. Question 3

What would be good distractions for a child of Jordan’s age?

II- Case Study: Pediatric Cancer

Mario is a 7-year-old male who presents with a 1-week history of body aches and pallor. He has a 2-day history of fever to 103° F and a 1-day history of bruising and lethargy.

Subjective Data

  • Complains of hurting all over
  • States he feels very tired
  • States he feels dizzy when he stands up

Objective Data

  • Weight 26.1 kg
  • Vital signs: T 38.9° C, P 140, R 40, BP 108/54, O2 sat 100%
  • Purpural rash on extremities
  • WBC 0.7
  • HGB 3.1
  • Hct 8.5
  • Plt .08
  • ANC 0.1

4. Question 1

Which of Mario’s presenting symptoms must be treated and stabilized before chemotherapy induction?

5. Question 2

What testing is required for a definitive diagnosis of meningitis?

6. Question 3

What should the nurse do in this clinical situation? Prioritize actions.

III-  Case Study: Pediatric Respiratory System

Will is a 4-month-old infant born at 34 weeks of gestation. Will’s mother states that he has not been able to go to day care because he has been coughing with a fever for the past 3 days. She states today he is unable to feed well from the bottle because of nasal secretions.

Subjective Data

  • Mother complains that infant has had cough for 3 days
  • Mother states that infant is having trouble sleeping
  • Not voided in past 6 hours

Objective Data

  • Birth Weight: 1.9 kg
  • Today’s Weight: 5.5 kg
  • Vital Signs: T 38° C, P 186, R 60, BP 90/52, Pulse Oximetry 93%
  • Thick yellow nasal secretions
  • Nasal flaring with moderate intercostal retractions
  • Breath sounds decreased with crackles bilaterally to auscultation

7. Question 1

What risk factors does Will have for contracting bronchiolitis?

8. Question 2

What is the first priority for Will’s treatment?

9. Question 3

What should the nurse do in this clinical situation? Prioritize actions.

IV-  Case Study: Pediatric Gastrointestinal System

Lucy is a 44-day-old formula-fed infant who presents with a 4-day history of vomiting.

Subjective Data

  1. Mother states infant has been vomiting undigested formula after feedings
  2. Mother states that infant has not had fever or diarrhea
  3. Mother states that infant has had 8 wet diapers in the past 24 hours

Objective Data

  1. Weight 4.8 kg (birth weight 3.5 kg)
  2. Vital signs: T 37.1° C (rectal), P 130, R 30, BP 92/52
  3. Mucous membranes moist, anterior fontanel flat and soft
  4. Awake and alert, lusty cry
  5. Good muscle tone
  6. Olive-sized mass palpated at epigastrium

10. Question 1

What test will be used to diagnose pyloric stenosis?

11. Question 2

What should the nurse do in this clinical situation? Using the case study above, the first prioritization step the nurse would take is ____.

12. Question 3

The second prioritization step the nurse would take is ____.

13. Question 4

The third prioritization step the nurse would take is ____.

14. Question 5

The fourth prioritization step the nurse would take is ____.

15. Question 6

The fifth prioritization step the nurse would take is ____.

16. Question 7

The sixth prioritization step the nurse would take is ____.

17. Question 8

The seventh prioritization step the nurse would take is ____.

18. Question 9

The eighth prioritization step the nurse would take is ____.

V- Case Study: Pediatric Cardiovascular System

Michael is a 7-week-old breastfed infant who presents with a 2-day history of irritability and poor feeding.

Subjective Data

  • Mom states patient has been “fussy” for past 2 days
  • Only feeds for a “few” minutes at a time
  • Breathing heavily and fast for 2 days

Objective Data

  • Weight: 4.8 kg
  • Vital Signs: T 36.8° C, P 250, R 65, BP 84/58
  • Breath sounds clear to auscultation
  • Oxygen Saturation 95%
  • Central capillary refill 4 sec

19. Question 1

What is the treatment for an unstable patient with SVT?

20. Question 2

Decreased cardiac output from prolonged SVT will produce what complication?

21. Question 3

In this clinical situation what should the nurse do? Prioritize actions.

VI-  Case Study: Hematologic System

Liam is an 8-year-old male with a history of hemophilia. Liam presents today with a 1-day history of right elbow pain.

Subjective Data

  • Right elbow pain for 1 day
  • Patient states he hit his right elbow on desk yesterday
  • Patient complains that he cannot move his elbow

Objective Data

  • Weight 31.6 kg
  • Vital sighs: T 37.4° C, P 82, R 20, BP 108/68
  • Rates pain 6 on scale of 10

22. Question 1

How should the nurse respond when Liam’s father explains that they watched and waited to see if Liam needed treatment after his injury?

23. Question 2

Why are neuro checks an important part of Liam’s physical exam?

24. Question 3

What should the nurse do in this clinical situation? Prioritize actions.

VII- Case Study: Common Disorders of the Red Blood Cells

Susan is a 26-year-old G1P0 at 6 weeks of gestation with type 2 diabetes. Her BMI is 32. Her hemoglobin A1C is 9. She uses glyburide 10 mg PO daily. The physician has switched her to insulin at this time.

1. Question 1

What is the nursing priority at this time?

2. Question 2

What should Susan be taught about insulin needs during pregnancy?

3. Question 3

What additional risk factor does Susan have?

4. Question 4

How should Susan be counseled regarding weight gain in pregnancy?

5. Question 5

What advice can be given to Susan regarding exercise?

VIII-  Case Study: Pediatric Genitourinary System

Lilly is a 3-year-old female who presents with complaints of abdominal pain and fever since yesterday.

Subjective Data

  • Complains of lower abdominal pain
  • Fever for 24 hours
  • Lilly has ‘wet her pants’ despite being recently potty trained

Objective Data

  • Vital signs: T38.5° C, P 114, R 32, BP 104/62
  • Urine positive for WBCs, nitrites, blood

6. Question 1

What risk factors does Lilly have for UTI?

7. Question 2

What might prevent Lilly from a recurring UTI?

8. Question 3

What should the nurse do in this situation? Prioritize actions.

IX-  Case Study: Pediatric Neurologic System

Abby is a 1-year-old female who presents after a reported seizure at day care.

Subjective Data

  • Fever for 1 hour
  • Eating and drinking normally per mother

Objective Data

  • Vital signs: T 40° C, HR 160, R 44, BP 104/68
  • Awake and alert
  • Skin hot to touch, otherwise normal physical examination

9. Question 1

How should the nurse respond to Abby’s mother when she asks if Abby has epilepsy?

10. Question 2

How should the nurse respond to Abby’s mothers question about brain damage?

11. Question 3

In this clinical situation what should the nurse do?

Curriculum Models In Nursing Education

Curriculum Models In Nursing Education

There are many established and emerging curriculum design models. In a 10-15 slide PowerPoint presentation, address the following:

  1. Describe three curriculum design models.
  2. Identify the level of nursing education for which each model would be most appropriate.
  3. Describe advantages and disadvantages of each model for the learner.
  4. Describe advantages and disadvantages of each model for the educator Curriculum Models In Nursing Education  Curriculum Models In Nursing Education

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Present your findings in a professional PowerPoint presentation that would be helpful to a nursing school curriculum committee in revising their curriculum model.

Each slide should include speaker notes.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Curriculum Models In Nursing Education Curriculum Models In Nursing Education.

Rubic Print Format

Course Code Class Code Assignment Title Total Points
NUR-648E NUR-648E-O500 Curriculum Models in Nursing Education 80.0
Criteria Percentage 1: Unsatisfactory (0.00%) 2: Less Than Satisfactory (80.00%) 3: Satisfactory (88.00%) 4: Good (92.00%) 5: Excellent (100.00%) Comments Points Earned
Criteria 100.0%
Three Curriculum Design Models 10.0% A description of three curriculum design models is not present. A description of three curriculum design models is present but lacks detail or is incomplete. A description of three curriculum design models is present. A description of three curriculum design models is well developed. A description of three curriculum design models is thoroughly developed with supporting details.
Level of Nursing Education 10.0% The level of nursing education appropriate for each model is not present. The level of nursing education appropriate for each model is present but is inaccurately identified. NA NA The level of nursing education appropriate for each model is correctly identified.
Advantages and Disadvantages of Each Model for the Learner 10.0% Advantages and disadvantages of each model for the learner are not present. Advantages and disadvantages of each model for the learner are present but lack detail or are incomplete. Advantages and disadvantages of each model for the learner are present. Advantages and disadvantages of each model for the learner are well developed. Advantages and disadvantages of each model for the learner are thoroughly developed with supporting details.
Advantages and Disadvantages of Each Model for the Educator 10.0% Advantages and disadvantages of each model for the educator are not present. Advantages and disadvantages of each model for the educator are present but lack detail or are incomplete. Advantages and disadvantages of each model for the educator are present. Advantages and disadvantages of each model for the educator are well developed. Advantages and disadvantages of each model for the educator are thoroughly developed with supporting details.
Presentation of Content 20.0% The content lacks a clear point of view and logical sequence of information. Includes little persuasive information. Sequencing of ideas is unclear. The content is vague in conveying a point of view and does not create a strong sense of purpose. Includes some persuasive information. The presentation slides are generally competent, but ideas may show some inconsistency in organization or in their relationships to each other. The content is written with a logical progression of ideas and supporting information exhibiting a unity, coherence, and cohesiveness. Includes persuasive information from reliable sources. The content is written clearly and concisely. Ideas universally progress and relate to each other. The project includes motivating questions and advanced organizers. The project gives the audience a clear sense of the main idea.
Layout 15.0% The layout is cluttered, confusing, and does not use spacing, headings, and subheadings to enhance the readability. The text is extremely difficult to read with long blocks of text, small point size for fonts, and inappropriate contrasting colors. Poor use of headings, subheadings, indentations, or bold formatting is evident. The layout shows some structure, but appears cluttered and busy or distracting with large gaps of white space or a distracting background. Overall readability is difficult due to lengthy paragraphs, too many different fonts, dark or busy background, overuse of bold, or lack of appropriate indentations of text. The layout uses horizontal and vertical white space appropriately. Sometimes the fonts are easy to read, but in a few places the use of fonts, italics, bold, long paragraphs, color, or busy background detracts and does not enhance readability. The layout background and text complement each other and enable the content to be easily read. The fonts are easy to read and point size varies appropriately for headings and text. The layout is visually pleasing and contributes to the overall message with appropriate use of headings, subheadings, and white space. Text is appropriate in length for the target audience and to the point. The background and colors enhance the readability of the text.
Speaker notes 5.0% Speaker notes are not present. Speaker notes are present but lack detail or are incomplete. Speaker notes are present. Speaker notes are present and well developed. Speaker notes are thoroughly developed with supporting details.
Mechanics of Writing (includes spelling, punctuation, grammar, language use) 10.0% Slide errors are pervasive enough that they impede communication of meaning. Frequent and repetitive mechanical errors distract the reader. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Slides are largely free of mechanical errors, although a few may be present. Writer is clearly in control of standard, written, academic English.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 10.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage 100%

GOVERNMENT ROLE IN Health Care System

The Role of Government in the U.S. Health Care System

The health care enterprise is one of the most important parts of the U.S. social system and of our economic system as well however, with millions of citizens uninsured, rising costs, massive health disparities, and the need to improve quality and access, many view health care as a broken system. As such, it continues to be a significant political issue in the United States. Most agree that something needs to be done to fix the health care system, but the methods and solutions for addressing problems vary greatly, particularly with respect to the role government should play. Proponents of varying approaches often have strong, emotional opinions, making compromise difficult.

In this Discussion, you will consider the role of government in health care, and you will examine the impact of a social, economic, technological, ethical, or legal issue on health care delivery.

To prepare:

·         Is health care a right or a privilege?

Focus on the role of the government in health care including Affordable Care Act.

·         Pinpoint a social, economic, technological, ethical, or legal issue that could, or has, affected health care delivery in the United States.

·         Locate a current article from the popular press (within the past 6 months) related to the health care issue you identified. How does this article inform your understanding of the influence of your selected issue in the health care debate?

Post your position on whether health care in the United States is a right or a privilege, and explain what you believe to be the proper role of government in health care. Justify your position. Explain how the social, economic, technological, ethical, or legal issue you selected is impacting health care delivery and whether this issue should be addressed by the government or by private entities. Identify the article you selected, and explain how this article informs your stance.

Informatics Competencies And Advanced Nursing Practice

Informatics Competencies And Advanced Nursing Practice

Instructions: These are 2 separate questions, so they are 2 separate papers.

At least 2 pages each: APA format. At least 2 references– Must NOT be over 5 years old.

1.  Informatics Competencies and Advanced Nursing Practice

According to the AACN (2006) Essentials of Doctoral Education for Advanced Nursing Practice, DNP graduates are distinguished by their abilities to use information systems/technology to support and improve patient care and healthcare systems and provide leadership within healthcare systems and/or academic settings” (p. 12).

Reflect on the AACN DNP “Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care” and your own technology experience and answer the following.

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·  What were your initial thoughts on reading the AACN Information Systems/Technology Essentials for the DNP graduate? Informatics Competencies And Advanced Nursing Practice

·  Did you find any of the essentials surprising? Why or Why not?

·  Describe the changes you have seen in your practice setting over the past five years that have been brought about by the use of technology and evidence-based practice.

·  Describe the changes you expect to see in your practice setting over the next five years based on technology.

·  How have these changes affected nursing practice in your setting?

Supplemental reading: Informatics Competencies And Advanced Nursing Practice

McBride, S., & Tietze, M. (2018). Nursing informatics for the advanced practice nurse: Patient safety, quality, outcomes, and interprofessionalism. (2nd ed.). Springer Publishing.

·  Chapter 1: Introduction to Health Information Technology in a Policy and Regulatory Environment (p. 3-18)

·  Chapter 2: Advanced Practice Roles in Interprofessional Teams (p. 19-38)

·  Chapter 24: Developing Competencies in Nursing for an Electronic Age of Healthcare (p. 587-608)

Articles:

Choi, J., & Zucker, D. M. (2013). Self-assessment of nursing informatics competencies for Doctor of Nursing Practice students (Links to an external site.). Journal of Professional Nursing, 29(6), 381-387. https://doi.org/10.1016/j.profnurs.2012.05.014  (Links to an external site.)

Kinnunen, U. M., Heponiemi, T., Rajalahti, E., Ahonen, O., Korhonen, T., & Hyppönen, H. (2019). Factors related to health informatics competencies for nurses—results of a national electronic health record Survey (Links to an external site.). CIN: Computers, Informatics, Nursing, 37(8), 420-429. https://doi.org/10.1097/CIN.0000000000000511 

2. Clinical Information Systems

1.

Conduct an online search for two different EHR Software Solutions (e.g., eClinicalWorks, McKesson, Cerner, Allscripts, Athena Health, GE Healthcare, Epic, Care360, practice fusion, OPTUMInsight, NEXTGEN, etc.)Informatics Competencies And Advanced Nursing Practice.

·  Briefly describe the selected EHR software solutions. Include three features of each software in the description.

·  Compare and contrast the benefits of the two selected EHR software solutions.

·  Select an EHR software solution that is best suited for your workplace environment. Identify the workplace environment (hospital, stand-alone private practice, etc.) and provide your rationale for the selected software.

Supplemental reading:

McBride, S., & Tietze, M. (2018). Nursing informatics for the advanced practice nurse: Patient safety, quality, outcomes, and interprofessionalism. (2nd ed.). Springer Publishing.

·  Chapter7: Electronic Health Records and Point of Care Technology. (p. 143 -174)

·  Chapter 9: Workflow Redesign in a Quality-Improvement Modality (p. 207-226)

·  Chapter 11: Electronic Health Records and Health Information Exchanges (p. 249-270)

Articles:

Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health information technology in healthcare quality and patient safety: Literature review. (Links to an external site.) JMIR medical informatics6(2), e10264. https://doi.org/10.2196/10264

Kruse, C. S., & Beane, A. (2018). Health information technology continues to show positive effect on medical outcomes: Systematic review (Links to an external site.). Journal of Medical Internet Research20(2). https://doi.org/10.2196/jmir.8793 Informatics Competencies And Advanced Nursing Practice

Psychopharmacologic Approaches To Treatment Of Psychopathology

Psychopharmacologic Approaches To Treatment Of Psychopathology

Introduction to Neuroanatomy

Introduction to Neuroanatomy and Adherence

When building a house, contractors and architects rely on a blueprint to help determine what features and structures are needed to support the house and provide those features sought after by potential buyers. If a potential error occurs in the construction of a support beam, for example, it is likely that the house will sustain damage and, possibly, crumble.

In much the same way, the features and structures of your brain provide a blueprint that help to support your body and provide the mechanisms with which to sustain your well-being. Individuals who suffer from mental illness, according to the fundamental premise of psychiatric neuroscience, are a result of abnormal brain function. Yet, as advancements in neuroimaging and genetics emerge, a whole new understanding of how to address mental illness remains for the psychiatric nurse practitioner (PNP). Neuroimaging and genetic techniques help provide insights, such as a blueprint of the brain, for detailing how the brain’s structure and wiring is functioning. Psychopharmacologic Approaches To Treatment Of Psychopathology

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By determining what functions and structures of the brain or central nervous system are implicated in psychopathologies observed PNPs are able to synthesize biological explanations into treatment protocols for sustained, positive patient outcomes. A solid foundation and understanding of the functions and structures of the central nervous system is the first pillar of solidifying your understanding of psychopharmacology.

 

The human brain is organized into the cerebral cortex, brainstem, subcortical structures, and the cerebellum. These anatomical structures are made of inter-connected elements that create distributed and highly inter-connected circuits. It is in these circuits where cognition, behavior, and affect are processed.

—Camprodon, J. A., & Roffman, J. L. (2016, p. 6)

By using a combination of psychotherapy and medication therapy, psychiatric nurse practitioners (PNP) are positioned to provide a very unique type of care to patients with psychiatric disorders. To be successful in this role, you must have a strong theoretical foundation in pathophysiology, psychopharmacology, and neuroscience. This foundation will help you assess, diagnose, and treat patients as you relate presenting symptoms to theoretical neuronal functioning.

As you study psychopharmacology, you will explore the basic functional unit of the nervous system, the neuron. You will review the structure of the neuron and you will examine the anatomy of the central nervous system and consider the functionality of the different structure and outward (phenotypic) expression of their activities. You will analyze these concepts as you complete your short answer assessment.

 

· Describe the functions and structures of the central nervous system

· Describe the different structures that make up the neuron

· Explain the function of neurons in intracellular communication

 

Assignment: Short Answer Assessment

As a psychiatric nurse practitioner, before you can recommend potential pharmacotherapeutics to address a patient’s condition or disorder, you must understand the basic function and structure of the neuron and central nervous system. For this Assignment, you will review and apply your understanding of neuroanatomy by addressing a set of short answer prompts.

To Prepare: Psychopharmacologic Approaches To Treatment Of Psychopathology

· Review the Learning Resources for this week in preparation to complete this Assignment.

· Reflect on the basic function and structure of the neuron in relation to the central nervous system.

· Reflect on the inter-connectedness between neurons and the central nervous system, including the pathway and distribution of electrical impulses.

· Reflect on how neurons communicate with each other and review the concept of neuroplasticity.

 

To complete:

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

1. In 4 or 5 sentences, describe the anatomy of the basic unit of the nervous system, the neuron. Include each part of the neuron and a general overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse. Be specific and provide examples.

2. Answer the following (listing is acceptable for these questions):

· What are the major components that make up the subcortical structures?

· Which component plays a role in learning, memory, and addiction?

· What are the two key neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control?

3. In 3 or 4 sentences, explain how glia cells function in the central nervous system. Be specific and provide examples.

4. The synapse is an area between two neurons that allows for chemical communication. In 3 or 4 sentences, explain what part of the neurons are communicating with each other and in which direction does this communication occur? Be specific.

5. In 3–5 sentences, explain the concept of “neuroplasticity.” Be specific and provide examples Psychopharmacologic Approaches To Treatment Of Psychopathology.

Short Answer Assessment

1. Axon consists of elongated fibers that extend from the cell body to the terminal endings and aids in transmitting signals. Some axons have a fatty substance called myelin, which acts as an insulator and can transmit signals much faster than other neurons. Axon elongated fibers connect with other cells in the body through the synapses (Stern, Fava, Wilens, & Rosenbaum, 2016)

2.The major components that make up the subcortical structures include the cerebellum, basal ganglia, and the thalamus, hypothalamus, pituitary, and brainstem.

The frontal lobe is involved in functions such as planning, attention, problem-solving, judgment, and initiative. The following components play a role in learning, memory, and addiction.

The cerebellum is responsible for motor coordination and learning. The ventral striatum plays a vital role in emotion and learning via connections with the hippocampus, amygdala, and prefrontal cortex.

The two critical neurotransmitters located in the nigra striatal region of the brain that plays a significant role in motor control is Dopamine and GABAergic neurons (Sonne, 2020)

3.Glia cells are non-neuronal cells in the central nervous system and do not produce electrical impulses. Glia cells maintain homeostasis, form myelin, and provide support and protection for neurons. Glia cells are divided into two groups, microglia cells and macroglia cells; Macroglia cells can be further divided into astrocytes and oligodendrocytes. Microglia cells act as a primary immune defense of the central nervous system, travel and remove damaged substances, pathogens, or other foreign substances. Glia cells also play a role in neurotransmission and synaptic connections and the physiological processes of breathing. Astrocytes are star-shaped glia cells with many functions, including providing nutrient support to the neurons, helping repair damaged nervous system tissue, regulating communication between neurons, and maintaining blood-brain barriers. Oligodendrocytes are responsible for axonal regulation and the generation and maintenance of the myelin sheath that surrounds axons (Hooper & Pocock, 2020) Psychopharmacologic Approaches To Treatment Of Psychopathology

4. A neuron, referred to as the pre-synaptic cell, releases a neurotransmitter or other neurochemical from special pouches clustered near the cell membrane called synaptic vesicles into space between cells. Those molecules will then be taken up by membrane receptors on the post-synaptic or neighboring, cell hence changing the cell’s behavior. Chemicals from the pre-synaptic neuron may excite the post-synaptic cell, for example, telling it to slow down signaling or stop it altogether. Synapses offer the possibility of bi-directional communication; as such, post-synaptic cells can send back their messages to pre-synaptic cells, telling them to change how much or how often a neurotransmitter is released (Penttila, 2019).

5. Neuroplasticity is the brain’s ability to recognize itself by forming new neural connections throughout. Neuroplasticity allows neurons in the brain to compensate for injury and disease and adjust their activities to respond to new situations or changes in their environment. For example, if one hemisphere of the brain is damaged, the intact hemisphere takes over some of its functions hence compensating for the damaged hemisphere (William C. Shiel Jr., 2017) Psychopharmacologic Approaches To Treatment Of Psychopathology

References

Hooper, C., & Pocock, J. M. (2020, November 25). The functions of glia in the CNS. Retrieved December 06, 2020, from https://www.abcam.com/neuroscience/the-functions-of-glia-in-the-cns

Penttila, N. (2019, August 26). What Happens at The Synapse? Retrieved December 06, 2020, from https://www.dana.org/article/qa-neurotransmission-the-synapse/

Sonne, J. (2020, November 08). Neuroanatomy, Substantia Nigra. Retrieved December 06, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK536995/

Stern, T. A., Fava, M., Wilens, T. E., & Rosenbaum, J. F. (2016). Chapter 1. In Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 13-316). London: Elsevier.

William C. Shiel Jr., M. (2017, January 24). Definition of Neuroplasticity. Retrieved December 06, 2020, from https://www.medicinenet.com/neuroplasticity/definition.htm Psychopharmacologic Approaches To Treatment Of Psychopathology