Part one: 

Discussion Question:

Henderson believed nurses have the responsibility to assess the needs of the individual patient, help individuals meet their health needs, and provide an environment in which the individual can perform activities unaided. What is an opportunity in your nursing practice that would benefit from application of Henderson’s theory? How does this align with the ANA’s definition of nursing? Provide at least one evidenced-based research article to support this recommendation.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length. 

Part two: 

Assignment:

This week you will create a two-part Power Point to discuss the following:

Part one:

Peplau was the first nursing theorist to identify the nurse–patient relationship as being central to all nursing care. Peplau valued knowledge, believing that the nurse must possess extensive knowledge about the potential problems that emerge during a nurse–patient interaction. Peplau’s theoretical work on the nurse–patient relationship continues to be essential to nursing practice.

• Describe the phases of the Nurse-Patient relationship as defined by Peplau. Align your presentation regarding the use of Peplau’s theory with a current practice example. 

Part two:

Provide a discussion of Orem’s Self-Care Deficit Theory. Identify and explain the three related parts? Identify a current nursing practice example where Orem’s theory would be relevant. Use at least one evidenced-based research article to support your practice example. The PowerPoint should include at least 3 outside references and the textbook. It should include title and reference slides and be 14-20 slides.

ITS IMPORTAT TO MEET THE COMPETENCES. THATS HOW I GET EVALUATED.

Create an 8–10-slide mobilization plan PowerPoint presentation (with detailed speaker’s notes) for a mobilization plan by your health care organization to commit 20 nurses to participate in a 4-month-long multinational effort to treat patients exposed to a highly contagious virus in a hot zone in Africa.

Nursing leaders must incorporate approaches that are inclusive and respectful of all stakeholders in the health care workforce, patient population, and the larger community that is served by the organization. Communication among members of teams, between departments and service lines, within large networks, with strategic business partners, and with patients, families, or support persons requires awareness of various facets of effective communication and cultural competence. 

A mobilization plan for an international medical mission requires careful planning of organizational structure roles, power distribution, and team member empowerment.

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

• (IMPORTANT) Competency 1: Identify nursing leadership priorities, using a systems perspective.       
  • -Apply systems thinking to determine a) the impact of the mobilization effort on hospital staffing and b) the actions needed to assure safe, quality care for the mission patients and personnel. 
• (IMPORTANT) Competency 2: Apply systems theory and systems thinking to facilitate health care delivery and patient outcomes.       
  • -Identify the major stakeholders within the health care system that would be affected by the mobilization plan.
• (IMPORTANT) Competency 3: Analyze the role of multiculturalism and diversity in organizational and systems structure and leadership.       
  • -Examine potential multicultural and diversity issues that mission personnel may encounter.
• (IMPORTANT) Competency 4: Evaluate how power relates to health care organizational structure, behavior, and leadership.       
  • -Describe the medical mission team’s organizational structure and assess how this structure empowers team members. 
• (IMPORTANT) Competency 5: Communicate in a manner that is consistent with the expectations of a nursing professional.       
  • Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

Assessment Instructions 

Preparation

Use the Capella library and the Internet to help you complete this assessment. For help using PowerPoint, refer to the Microsoft Tutorials and other resources located in the Suggested Resources and left navigation menu of the courseroom.

This assessment is based upon the scenario below. The scenario is very limited in detail; where more detail is needed, incorporate any assumptions you make to flesh out the scenario. It is intended to assess your ability to communicate your approach to a challenge by evaluating issues of organization, leadership, safety, quality improvement, multiculturalism and diversity.

Your approach should be very conceptual and high-level.

Scenario
Your health care organization has recently committed 20 nurses to participate in a 4-month-long multinational effort to treat patients exposed to a highly contagious virus in a “hot zone” in Africa. The director of your organization has asked you, because of your previous medical mission experience, to outline nursing-related plans for preparing for the mobilization and present this information at an upcoming staff meeting.

Deliverable: Mobilization Plan PowerPoint Presentation

Create an 8–10-slide PowerPoint presentation (with detailed speaker’s notes) of your mobilization plan. It should be targeted toward members of the hospital’s administrative staff, nurses, and the physicians who will also participate in this medical mission.

• Use bullet points and phrases on the slides.
• The narrative, or explanation for each slide, should be in the speaker’s notes section.

The mobilization plan should address the following:

• Identify the major stakeholders within the health care system that would be affected by the mobilization plan.
• Analyze how the mobilization effort will impact staffing patterns and nursing care at the hospital.
• Describe the medical mission team’s organizational structure of the mission team and how power is distributed.
   
  • Include one slide of an organizational diagram for the mission.        
    • Describe the roles (in the speaker’s notes).
• Assess how the organizational structure empowers team members.      
  • Provide 1–2 examples of how team members will have power.
• Identify key actions needed to assure quality of care and safety for mission patients and personnel.
• Evaluate potential power issues that may arise when dealing with a multinational contingent.      
  • (Be generic; that is, do not address individual nationalities, races, et cetera.)
  • Consider interactions with health care personnel from other countries.
• Examine potential multicultural and diversity issues that mission personnel may encounter.      
  • Consider that the indigenous population may be hostile to treatment.
  • Outline possible training requirements to improve cultural competencies of the personnel.

Additional Requirements

• Written communication: Written communication should be free of errors that detract from the overall message.
• APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
• Length: Presentation should be 8–10 slides. Include speaker’s notes on each content slide.
• References: Include a minimum of three peer-reviewed resources on the final slide (in APA format).
• General formatting: Choose an appropriate theme if using a template.

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.

2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).

3. The PICOT question will provide a framework for your capstone project. 

4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Solid academic writing is expected, and documentation of sources should be presented using APA formatting guideline. See the attached sheets along with the above questions.

PICOT Statement and Literature Search

Clinical Issue Summary

Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.

PICOT Statement

In mechanically ventilated patients in the ICU, does the utilization of a custom oral care protocol with chlorhexidine compared to a routine oral care protocol reduce the incidence of ventilator-associated pneumonia (VAP) during the length of stay in the ICU.

Literature Search

Cutler, L. R., & Sluman, P. (2014). Reducing ventilator associated pneumonia in adult patients through high standards of oral care: A historical control study. Intensive & Critical Care Nursing, 30(2), 61-68. http://dx.doi.org/10.1016/j.iccn.2013.08.005

Objectives: Implement and evaluate the impact of oral hygiene measures (teeth brushing, 1% oral chlorhexidine and oropharyngeal suction) on the incidence of ventilator-associated pneumonia (VAP) and the costs of prevention and treatment.

Design: A historical control study of all 1087 patients, mechanically ventilated for at least 48hours in a general adult critical care unit, between July 2009 and December 2011. The incidence of VAP in 528 patients before a practice change was compared with the incidence in 559 patients after a practice change. The clinical audit cycle was used to review compliance with existing standards and implement a regime of enhanced oral hygiene. The costs of changing the oral care regime and the treatment of VAP with antibiotics was calculated.

Setting: 22 bed combined intensive care and high dependency unit in England.

Main outcome measures: (1) Compliance with standards for oral care. (2) The incidence of VAP before and after the change.

Results: 91% (95% CI 90–93%) compliance with the standards for oral care was achieved throughout the 30 months of the study with very little difference before (90%, 95% CI 88–93%) and after (92%, 95% CI 90–95%) the changes in oral care standards were introduced. Of 528 patients mechanically ventilated for at least 48hours before the change, 47 developed VAP. The mean incidence of VAP was 0.09 (8.9%) (95% CI 0.07–0.12). The mean VAP per 1000 ventilator days was 13.6 (95% CI 13.1–14.0). After the change 24 of 559 patients developed VAP. The mean incidence of VAP after the change was 0.04 (4.1%) (95% CI 0.03–0.06). The mean VAP per 1000 ventilator days was 6.9 (95% CI 6.5–7.1). There was a £6319 ($10,112, €7518) cost saving on preventing and treating VAP following the practice change. A statistically significant difference (p<0.01) was seen between the incidence of VAP expected and that observed after the change in oral care. This represents a relative risk reduction of 0.53 (95% CI 0.25–0.71) and number needed to treat (NNT) of 21.

Conclusion: An enhanced oral care bundle, incorporating 1% Chlorhexidine Gluconate, was associated with a significant reduction in VAP and the costs of treating VAP. Limitations of the study relate to analysis of other variables, in particular severity of illness, between the two groups and the lack of agreement in the literature on VAP criteria, which limits generalisation of these findings.

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.  Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: 

1.Background 

2.Problem statement 

3.Purpose of the change proposal

4.PICOT 

5.Literature search strategy employed 

6.Evaluation of the literature 

7.Applicable change or nursing theory utilized 

8.Proposed implementation plan with outcome measures 

9.Identification of potential barriers to plan implementation, and a discussion of how these could be overcome 

10.Appendix section, if tables, graphs, surveys, educational materials, etc. are created  

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.  

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

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

You are required to submit this assignment to Turnitin.