NURS 6051: Transforming Nursing And Healthcare Through Technology

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NURS 6051: Transforming Nursing And Healthcare Through Technology

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate. NURS 6051: Transforming Nursing And Healthcare Through Technology

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To Prepare:

  • Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
  • Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
  • Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following: NURS 6051: Transforming Nursing And Healthcare Through Technology

  • Briefly and generally explain the policy or regulation you selected.
  • Address the impact of the policy or regulation you selected on system implementation.
  • Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
  • Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific NURS 6051: Transforming Nursing And Healthcare Through Technology.

Global Health Comparison Matrix

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Global Health Comparison Matrix

If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?

You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country. Global Health Comparison Matrix

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To Prepare:

  • Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
  • Select at least one additional country to compare to the U.S. for this Assignment.
  • Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
  • Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following: Global Health Comparison Matrix

  • Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
  • Explain the strengths and weaknesses of each policy.
  • Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
  • Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
  • Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
  • Explain how the health policy you selected might impact the role of the nurse in each country.
  • Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

  • Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples Global Health Comparison Matrix

Health Assessment Discussion Paper

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Health Assessment Discussion Paper

Prior to class, and after reading/viewing the module assignment, select one of the following and conduct an assessment.

  • Eyes
  • Ears
  • Nose
  • Mouth

You may conduct the assessment on a fellow student, friend, or family member. Remember to secure their permission.

Collect both subjective and objective data using the process described in the textbook. Health Assessment Discussion Paper

Then, document your findings and bring them to class.

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Your instructor may ask that you submit your documentation. If so,

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

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.)

ASSESSMENT AND HISTORY OF THE EYES, EARS, NOSE, MOUTH, AND THROAT
FACULTY: This is for the review and discussion of history and assessment of eyes, ears, nose, mouth, and
throat. This is also the format the students should follow later in the class when they are assessing the eyes,
ears, nose, mouth, and throat on their partner. Note, however, the portions that are part of the General Head
to Toe Assessment. The remainder of the assessments are for more comprehensive assessments and should
be used based on findings from the review of systems. The “other tests” may be discussed if time is available.
For your health history/review of systems, remember to use the following prompts:
• Have you ever experienced…
• Do you have a history of…
• Do you have a family history of…
I. Eyes
a. History (from Review of Systems):
i. Decreased acuity, blurring, blind spots, eye pain, diplopia, redness or swelling, watering
or discharge, glaucoma, cataracts
ii. Wears glasses or contacts, last eye exam or glaucoma test, how coping with loss of
vision if any
b. Inspection: Health Assessment Discussion Paper
i. Eyebrows, eyelids, and eyelashes for abnormalities
ii. Sclera and conjunctiva for color, swelling, or lesions
iii. Pupils (equal, round, reactive to light and accommodation)*
iv. Eye movement (extraocular muscles)*
c. Other tests:
i. Snellen eye chart
ii. Confrontation test (peripheral vision)
II. Ears
a. History (from Review of Systems):
i. Earaches, infections, discharge and characteristics, tinnitus, vertigo
ii. Hearing loss, hearing aid use, how hearing loss affects daily life
b. Inspection:
i. Size and shape
ii. External auditory meatus for size, swelling, redness, or discharge
c. Palpation:
i. Pinna and tragus for tenderness
d. Other tests:
i. Whispered voice test
III. Nose and Sinuses
a. History (from Review of Systems): Health Assessment Discussion Paper
i. Discharge (characteristics), unusually frequent or severe colds, sinus pain, nasal
obstruction, nosebleeds, allergies or hay fever, change in sense of smell
b. Inspection:
i. Symmetry and deformity
c. Palpation:
i. Nasal patency
ii. Frontal and maxillary sinuses for tenderness
Rev. 01/2017 Page 5 of 11
IV. Mouth and Throat
a. History (from Review of Systems):

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i. Mouth pain, frequent sore throat, bleeding gums, toothache, lesion in mouth or on
tongue, dysphagia, hoarseness or voice change, tonsillectomy, altered taste
ii. Pattern of daily dental care, use of dentures, bridges, last dental checkup
b. Inspection:
i. Lips for color, moisture, cracking, or lesions
ii. Teeth and gums for abnormalities
iii. Tongue for color, surface characteristics, look under tongue for lesions, and assess
moisture
iv. Using a wooden tongue blade and a good light source, inspect the inside of the patients
mouth including the buccal folds and under the tongue. Note any ulcers, white patches
(leucoplakia), or other lesions. If abnormalities are discovered, use a gloved finger to
palpate the anterior structures and floor of the mouth.
v. Inspect the posterior oropharynx by depressing the tongue and asking the patient to say
“Ah.” Note any tonsilar enlargement, redness, or discharge.
vi. Buccal mucosa for color, moisture, nodules, and lesions*
vii. Tonsils for size, color, and surface characteristics
c. Palpation:
i. Instruct the students to don gloves, take a gauze pad and ask the partner to stick out
their tongue. As the student holds the tongue with the gauze pad they palpate (by
sliding their finger) along the sides of the tongue for any signs of cancer-lesions. They
should also do a finger sweep of the oral mucosa assessing for any papules Health Assessment Discussion Paper

Risk management programs for health care facilities or organizations

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For this assignment, you will research risk management programs for health care facilities or organizations. Review the criteria below in order to select an exemplar that applies to your current or anticipated professional arena. (Note: Select an example plan with sufficient data to be able to complete the assignment successfully.)

In a 1,000-1,250 word paper, provide an analysis that includes the following:

  1. Brief summary description of the type of risk management plan you selected (new employee, specific audience, community-focused, etc.) and your rationale for selecting that example.
  2. Description of the recommended administrative steps and processes in a typical health care organization risk management program contrasted with the administrative steps and processes you can identify in your selected example plan. (Note: Select an example plan with sufficient data to be able to complete the assignment successfully.)
  3. Analyze the key agencies and organizations that regulate the administration of safe health care and the roles each play in the risk management oversight process.
  4. Evaluation of the selected exemplar risk management plan regarding compliance with the American Society of Healthcare Risk Management (ASHRM) standards relevant to privacy, health care worker safety, and patient safety.
  5. Proposed recommendations or changes you would make to your selected risk management program example to enhance, improve, or to secure compliance standards.

In addition to your textbook, you are required to support your analysis with a minimum of three peer-reviewed references.

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

Leadership And Group Collaboration

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Leadership And Group Collaboration

Write a 3–4 page letter in which you analyze your leadership skills and how you would use them to lead a project requiring group collaboration.

Assessments 1 and 2 are scenario-based, so you must complete them in the order in which they are presented.

Leadership is an integral element in any job, regardless of the work title. However, it is important to recognize that leadership is not just one single skill; instead, success in leadership depends on a broad range of skills, among them decision making, collaboration, and communication. Leadership And Group Collaboration

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

  • Competency 1: Apply qualities, skills and practices used by effective healthcare leaders.
    • Describe the leadership qualities desirable for the proposed project.
    • Compare one’s own leadership skills against those of a chosen health care leader.
    • Explain one’s role as project leader, using approaches from a selected leadership model.
  • Competency 2: Apply practices that facilitate effective interprofessional collaboration.
    • Describe an approach to effectively facilitate collaboration among a professional team.
  • Competency 4: Produce clear, coherent, and professional written work, in accordance with Capella’s writing standards.
    • Address assignment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences. Leadership And Group Collaboration

 

Preparation

Read the Assessment 1 Scenario found in the Resources. Information in your assessment should be based on information from the scenario.

Instructions

Develop a professional response to the supervisor using the template provided. The letter will have two main components:

  1. Identify the qualities of a successful leader and compare them to your own leadership characteristics.
  2. Make recommendations on how to lead and foster teamwork.

Please refer to the scoring guide for details on how you your assessment will be evaluated.

Submission Requirements

  • Your letter should be 3–4 double-spaced pages in length.
  • Apply correct APA formatting to all in-text citations and references.
  • Use Times New Roman, 12-point font.
  • Express your main points, arguments, and conclusions coherently.
  • Use correct grammar and mechanics.
  • Support your claims, arguments, and conclusions with credible evidence from 2–3 current, scholarly or professional sources.
  • Proofread your writing. Leadership And Group Collaboration

Grading Rubric:

1- Describe leadership qualities desirable for the proposed project.

Passing Grade:  Describes in detail desirable leadership qualities that are specifically appropriate for the proposed project.

2-  Compare one’s own leadership skills against those of a chosen health care leader.

Passing Grade:  Compares one’s own leadership skills against those of a chosen health care leader, using specific examples or actions that illustrate the similarities and differences.

3-  Explain one’s role as project leader, using approaches from a selected leadership model.

Passing Grade:  Explains one’s role as project leader in detail, referencing approaches from a selected leadership model with support from academic resources.

4-  Describe an approach to effectively facilitate collaboration among a professional team.

Passing Grade:  Describes multiple approaches to effectively facilitate collaboration among a professional team.

5-  Address assignment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences.

Passing Grade:  Presents a focused purpose through strong organizational skills. Presents evidence through strong paraphrasing/summarizing and appropriate tone and sentence structure Leadership And Group Collaboration

Evidence-Based Change Proposal

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Evidence-Based Change Proposal

Describe one internal and one external method for the dissemination of your evidence-based change proposal. For example, an internal method may be the hospital board, and an external method may be a professional nursing organization. Discuss why it is important to report your change proposal to both of these groups. How will your communication strategies change for each group?

Internal and external method for dissemination of an EBP project results

please respond to the main DQ1 and DQ2. Also respond to the peer discussions 1-6

DQ1

Describe one internal and one external method for the dissemination of your EBP project results. For example, an internal method may be the hospital board, and an external method may be a professional nursing organization. Discuss why it is important to report your results to both of these groups. How will your communication strategies change for each group? Evidence-Based Change Proposal

DQ2

In order to evaluate an evidence-based practice project, it is important to be able to determine the effectiveness of your change. Discuss one way you will be able to evaluate whether your project made a difference in practice

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Peer DQ1

Internal and external method for dissemination of an EBP project results.

An internal method is the use of hospital board. An external method is use of a professional nursing organization.A good technique must be used in order to identify the individual or organization that need to be included in the programs. In order to identify the suitable method, the following process is used. First identify the internal and external stakeholders, then assess the nature of each stakeholder’s influence and importance in the organization. Follow this by construction of a matrix that identifies stakeholder influence and importance. Finally monitor and manage stakeholder relationships.

It is important to report the results to both groups. This will enable the outcome of the research of the project to be perfect and hence more informative.

The communication strategies for each group will change. This is where a good communications strategy is helpful. An internal method is approached different with the external methods.

In the internal method, you cross all the information whereas in the external method one need to have the limit of the information you give out Evidence-Based Change Proposal.

References:

1. Stetler, C. B., & Caramanica, L. (December 01, 2007). Evaluation of an Evidence-Based Practice Initiative: Outcomes, Strengths and Limitations of a Retrospective, Conceptually-Based Approach. Worldviews on Evidence-Based Nursing, 4, 4, 187-199.

2. Aarons, G. A., Green, A. E., Trott, E., Willging, C. E., Torres, E. M., Ehrhart, M. G., & Roesch, S. C. (November 01, 2016). The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study. Administration and Policy in Mental Health and Mental Health Services Research, 43, 6, 991-1008.

3. Komendzi??ski, T., Dreszer-Drogor??b, J., Miko??ajewska, E., Miko??ajewski, D., & Ba??aj, B. (January 01, 2016). Science and Innovative Thinking for Technical and Organizational Development

Peer DQ2

The process of disseminating the findings of the EBP can be done using external and internal methods.Internal methods may include sharing the findings with the hospital board while the external may involve sharing information with a professional nursing firm. Dissemination of the EBP findings helps in creating awareness of what projects have been established and their success (Myers & Barnes, 2004). As such, it acts a tool for establishing a profile for the project provided to the people. It helps stakeholders to understand the processes that have been undertaken and the results obtained to allow them to take the lessons learned on board when making a decision. Decision-making process requires having a clear understanding of the program developed to ensure making an informed decision that will improve the health care outcomes of the people, the credibility and effectiveness of the health delivery system (McCormack et al., 2013)Evidence-Based Change Proposal.

When sharing the findings with the internal and external stakeholders different communication strategies can be utilized. For example, formal reports can be used to share information with the hospital board. The formal reports provide tailored message to board members on what has been achieved and future recommendations that can be followed to establish effective EBP projects (McCormack et al., 2013). This is because the board members are interested in making a conclusion on the effectiveness of the project in meeting its desired goals in the internal environment. On the other hand, conferences can be used to share the findings with the professional nursing firm. The conferences will help share the results obtained with a wider audience to impact the policymaking for bets practice. It will help the external parties to evaluate the outcomes and cost-effectiveness of the project that can guide the entire nursing organization in making decisions. Additionally, nursing organizations conferences provide a platform where stakeholders can share their views and identify opportunities that are provided by the EBP projects (McCormack et al., 2013).

References

Myers, P., & Barnes, J. (2004). Sharing Evaluation Findings.

McCormack, L., Sheridan, S., Lewis, M., Boudewyns, V., Melvin, C. L., Kistler, C., … & Lohr, K. N. (2013). Communication and dissemination strategies to facilitate the use of health-related evidence

Peer DQ3

Dissemination of project findings, results and outcomes is highly critical in healthcare sector. It is therefore paramount for communication aspects ought to be carefully and critically evaluated to ensure that relevant information is disseminated to all pertinent stakeholders (Becker et al., 2017). In one way or another, the stakeholders contribute to the project design, development and implementation and thus have a right to be informed on the project outcomes. Result dissemination takes into account two methods; the internal and the external (Pandi-Perumal et al., 2015). The internal methods include outcome dissemination to the internal stakeholders such the healthcare leadership, the physicians, and the nursing staff. In this project of stem cell therapy, the internal stakeholders will be communicated to through presentations in a staff meeting. The hospital board will equally be communicated to through interactive board meetings and outcome presentation through projections.

During the presentations, the internal stakeholders will have an opportunity to provide insights, ask questions and even respond and discuss the projects results. Reporting to the internal stakeholders is essential for making them understand the project results, building a sense of ownership and trust, and establishing the desire to advocate and support future evidence based projects. In disseminating the results to the external groups, the American nursing organization will be the key recipient of the project outcomes following its function as a bridge between the government and the nursing practice, as can easily pass information between the government and the healthcare sector and advocate for government support in light of EBPs in healthcare practice. More so, the project will be published for everyone’s access.

References

Becker, C. B., Perez, M., Kilpela, L. S., Diedrichs, P. C., Trujillo, E., & Stice, E. (2017). Engaging stakeholder communities as body image intervention partners: The Body Project as a case example. Eating behaviors, 25, 62-67. doi: 10.1016/j.eatbeh.2016.03.015

Pandi-Perumal, S. R., Akhter, S., Zizi, F., Jean-Louis, G., Ramasubramanian, C., Edward Freeman, R., & Narasimhan, M. (2015). Project stakeholder management in the clinical research environment: how to do it right. Frontiers in psychiatry, 6, 71. doi: 10.3389/fpsyt.2015.00071 Evidence-Based Change Proposal

Peer DQ4

In this present era, EBP is a problem-solving approach to clinical decision-making within a health care organization. In this approach, clinicians use theory-derived, research-based knowledge to inform their decisions about care delivery. EBP considers internal and external influences on practice and encourages critical thinking in the judicious application of such evidence to the care of individual patients, or a patient population, replacing erstwhile sources of evidence such as authority and tradition (Salinas, 2017).
As regards my change project, I would use the framing communication strategy in a structured format (co signed by clinical and academic authorities), to disseminate information about my change project to the management board of the health care facility; while I would use the narrative strategy to disseminate information to the local chapter of my state nursing association. This is informed by the drive of the health organization to be cautious in its approach to innovation and the quest to mitigate against loss and risk. Following this, my project must be framed as an initiative that improves the bottom line and cuts losses. In the other scenario, a more informal approach (the narrative strategy), would pique the interest of my colleagues and galvanize support for my initiative, which the nurse can propose to their respective managements (McCormack et al, 2013). Internal and external method for dissemination of an EBP project results

References
Salinas, A. (2017). Why evidence-based practice matters to students. Retrieved October 2018 from https://www.nurse.com/blog/2017/02/22/why-evidence-based-practice-matters-to-students-alexanders-student-blog/
McCormack L, Sheridan S, Lewis M, et al. (2013). Communication and Dissemination Strategies to Facilitate the Use of Health-Related Evidence. Retrieved October 2018 from https://www.ncbi.nlm.nih.gov/books/NBK179090/?repo…_

Peer DQ5

According to Brigham Research Institute, creating a comprehensive dissemination strategy for my EBP project will increase the awareness of my research and thereby take full advantage of the research done to increase the health outcomes of those patients with alcohol use disorder (2015). On my unit we have Unit-Based Council (UBC) that is where we start the process of incorporating an EPB and policy changes the nursing staff presents for best practice. I have utilized this process for my internal dissemination of increasing knowledge of CIWA-ar protocol. The communication strategy that I utilized was personal and professional in the narrative style. I utilized the personal style in part due to these are nurses I work with, attend UBC meetings with, and have a personal relationship with. Utilizing the professional strategy of communication to add validity to my EBP proposal, I needed them to understand the research placed behind my proposal and the importance of increasing nurses understanding of alcohol withdraw including treatment significance.

For the external dissemination, after discussion with my mentor, will be to write my PICOT paper for publication in our state’s quarterly newspaper. Articles may be sent in for publication that is sent to all registered nurse practitioners throughout our state. The format will be slightly change from my capstone paper in effort to explain the information and capture our state’s nurses attention to the increasing population of patients with alcohol use disorder. I will include my information to respond if so desired.

Reference

Brigham Research Institute, (2015), Retrieved from http://bwhresearch.org/wp-content/uploads/2015/10/…

Mazurek Melnyk, Bernadette, RN, PhD, CPNP/PMHNP, FNAP, FAANP, FAAN, Gallagher‐Ford, Lynn, RN, PhD, DPFNAP, NE‐BC, English Long, Lisa, RN, MSN, CNS, Fineout‐Overholt, Ellen, RN, PhD, FAAN, (2014), The Establishment of Evidence‐Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real‐World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs, World Views on Evidence-Based Nursing Linking Evidence to Action, 11(1), 5-15. Retrieved from https://sigmapubs.onlinelibrary.wiley.com/doi/full…

Novins, D. K., Green, A. E., Legha, R. K., & Aarons, G. A. (2013). Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review. Journal of the American Academy of Child and Adolescent Psychiatry, 52(10), 1009-1025.e18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC39228 Evidence-Based Change Proposal

Peer DQ6

The results of my evidence-based practice project will be important to disseminate in more than one way to reach the most people possible. An internal method for spreading the information would be to first consult with the organization’s higher management to explain the project and learn about their internal dissemination process. According to Harris et al., having a close partnership between the researcher and the organization is helpful to create a sense of ownership of the process (2013). A mutually beneficial collaborative partnership is the goal to be sure that both have the same goals when attempting to distribute the information (Harris et al., 2013). Internal and external method for dissemination of an EBP project results

External methods for spreading information about the evidence-based practice project results may include a professional nursing organization such as the National Association of Bariatric Nurses (NABN) whose goal is to dedicate resources, knowledge, and research towards improving the life and nursing care of people suffering from obesity. They are found through American Nurses Association. They would be great to help disseminate research results for evidence-based practice but may only receive a narrow viewing population. Another, less professional option is simply using social media. Utilizing such a broad and wide-spreading platform will ensure that the information is seen by all different types of people who may be affected by the topic, in this case obesity. Social media is used by nearly 80% of the United States population in 2018 according to statistics gathered by a company called Statista (www.statista.com). This would seem to be an appropriate platform to reach the overweight and obese population in the United States Evidence-Based Change Proposal

Factors that could increase the likelihood of a certain health problem occurring within a specific population

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Measures of Effect

One important application of epidemiology is to identify factors that could increase the likelihood of a certain health problem occurring within a specific population. Epidemiologists use measures of effect to examine the association or linkage in the relationship between risk factors and emergence of disease or ill health. For instance, they may use measures of effect to better understand the relationships between poverty and lead poisoning in children, smoking and heart disease, or low birth weight and future motor skills.

What is the significance of measures of effect for nursing practice? In this Discussion, you will consider this pivotal question.

To prepare:

  • With      the Learning Resources in mind, consider how measures of effect strengthen      and support nursing practice.
  • What      would be the risk of not using measures of effect in nursing practice?
  • Conduct      additional research in the Walden Library and other credible resources and      locate two examples in the scholarly literature that support your      insights.

By tomorrow 04/11/2018 3pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive scholarly response that addresses the following:

  • Analyze      how measures of effect strengthen and support nursing practice. PROVIDE AT LEAST TWO SPECIFICS      EXAMPLES from the literature to substantiate your insights.
  • Assess      dangers of not using measures of effect in nursing      practice.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones &smp; Bartlett.

Review Chapter 3, “Measures of Morbidity and Mortality Used in Epidemiology”

Chapter 9, “Measures of Effect”

Chapter 9 extends the discussion that began with Chapter 6 (which looked at ecologic, cross-sectional, and case-control study designs) by introducing additional measures that are useful in evaluating the potential implications of an exposure-disease association.

Tripepi, G. Jager, K. J., Dekker, F. W. & Zoccali, C. (2010). Measures of effect in epidemiological research. Nephron Clinical Practice, 115(2), c91–c93.

As noted by the authors of this article (2010), “Measuring the strength of observed associations between a given risk factor (e.g., blood pressure) and a given outcome (e.g., stroke) is an important goal in epidemiological and clinical research” (p. c91). This article provides an accessible overview of the terminology and various methods used to measure associations in research.

Optional Resources

Krethong, P., Jirapaet, V., Jitpanya, C., & Sloan, R. (2008). A causal model of health-related quality of life in Thai patients with heart-failure. Journal of Nursing Scholarship, 40(3), 254–260.

Ibrahim, M., Alexander, L., Shy, C., & Deming, S. (2001). Common measures and statistics in epidemiological literature. ERIC Notebook, 17, 1–6. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_17.pdf

Schmidt, C. O., & Kohlmann, T. (2008). When to use the odd ratio or the relative risk? International Journal of Public Health, 53(3), 165–167.

Vineis, P., & Kriebel, D. (2006). Causal models in epidemiology: Past inheritance and genetic future. Environmental Health: A Global Access Science Source, 5, p. 21.

Family Structures Discussion

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Family Structures Discussion

Abstract

“Family structure” is a term that describes the members of a household who are linked by marriage or bloodline and is typically used in reference to at least one child residing in the home under the age of 18. Today these structures are identified as two-parent, one-parent, and “living with neither parent” (e.g., adoptive families, grandparent families or other relatives, foster care families, institutionalized children). However, since the mid-1940s other changes in family life have resulted in more complicated designations of family structure, including blended families, single-parent plus partner families (cohabiting couples, both opposite sex and same sex), multigenerational families, and binuclear families). This entry outline the various common definitions of different family structures, identifies changes in family structure over time, and discusses their increasing complexity Family Structures Discussion.

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Definitions of Family Structure

Family structure reflects relationships at the juncture of biological relatedness, marital and partnership status, and living arrangements. There are several sources of data available that provide information on family structure (see US Census Bureau 2009). The longest established data source is the Decennial Census, first taken in 1790. Current Population Surveys (CPS) began in 1947 and were followed by the National Survey of Family Growth (NSFG) in 1973, the Survey of Income and Program Participation (SIPP) in 1978, and the American Community Survey in 2005. The strengths and weaknesses of these sources of data vary as do their estimates on family structure. Some surveys are better for estimating the prevalence of children living with unmarried parents (e.g., CPS), whereas others provide better estimates of complex families and living arrangements of children tracked over time (e.g., SIPP). In addition, the NSFG was undertaken to provide additional information on fertility, relationship status, and children. For example, from 1973 to 1995 the NSFG focused only on women; both men and women were surveyed in 2002; and in 2006–11 and 2011–15 data collection of large samples of both men and women were obtained. These surveys provide the best estimates of past and emerging family structures, such as those families where multiple partner fertility occurs (a father or mother with biological children from at least one prior partner).

Prior to the availability of these data sources, the Decennial Census provided most of the available information regarding family structure. Interestingly, from 1790 to 1940, “family” (those related by marriage, blood, or adoption) was not distinguished from “household” (which could contain more than one family). Most of the early censuses (1790–1880) focused on race, nativity, parentage, occupation, and dwelling. It was not until 1880 that enumeration of “relationships between household members (e.g., father, son, cousin, grandmother) and “civil condition” (marital status) were included. Since then, additional information has been added that allows the differentiation between family structures, and this has resulted in key definitions that are commonly accepted across data sources and are reflected in the reporting of family structure.

Key definitions that are used in discussions of family structure include the following (see US Census Bureau 2013b)Family Structures Discussion.

  • Household: one or more people living in a housing unit; a householder is one of the people who owns or rents the residence.
  • Family household: at least two members related by birth, marriage, or adoption, one of whom is the householder; maintained by married couples or by a man or woman living with other relatives – children may or may not be present.
  • Nuclear family: a family in which a child lives with two married biological parents and with only full siblings, if siblings are present.
  • Cohabiting families: those in which the child’s parent is living with at least one opposite-sex, nonrelated adult. This additional adult may or may not be the biological parent of the child.
  • Same-sex cohabiting/married families: those in which the child’s parent is living with at least one same-sex, nonrelated adult. The additional adult may or may not be the biological parent of the child.
  • Stepfamilies and blended families (terms used interchangeably): formed when remarriages occur or when children living in a household share one or no parents. The presence of a stepparent, stepsibling, or half-sibling designates a family as blended.

Several definitions regarding children are important to understanding family structure. However, unless otherwise noted, “children” always refers to only those under 18 years of age and residing in the household regardless of age or marital status. In some studies, reference is made to “own children” which includes only the biological, adopted, and stepchildren of the householder. Foster children are not included in either category. Also, “related children” is used with reference to a householder’s own children and to all other children under 18 years of age in the household who are related to the householder by birth, marriage, or adoption. “Stepchildren” refers to children who co-reside with a biological parent and stepparent, although the adults may not be married. “Stepsiblings” are children who share a parent, but that parent is the biological parent of one child and the stepparent of the other child. Last, “half-siblings” are children who share one biological parent; some may also have stepsiblings Family Structures Discussion.

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Historical Changes in Family Structure

Historically, family structure has changed. These notable changes are influenced by other changes in the population: fewer and later marriages, marriages of shorter duration, more divorce followed by repartnering or remarriage, more nonmarital unions (cohabitation), more children born outside marriage, and more women employed outside the home even with very young children (see Cherlin 2010). For example, since 1950 the number of children residing with a married couple has decreased from slightly over 90 percent to about 74 percent. Concomitantly, the number of both mother-only and father-only families increased during this period, with mother-only families being more prevalent. Family structure is linked with race such that black children are much less likely to reside with two parents compared to all other children, with estimates in 2010 of around 50 percent. Moreover, of all children living in mother-only families, about half of the mothers had never married, and about 30 percent were with divorced mothers.

Another example of family structure changes over time shows that divorce was uncommon prior to the 1900s, so stepfamilies were commonly formed following the death of a spouse. Such newly formed stepfamilies did not experience the complication of a living nonresident parent, so children were not expected to transition between the separate homes of their parents as in the case of access agreements. The term “binuclear family” was coined in the 1970s to represent families of divorce where children belonged to two households. Yet another example of family structure change results from the delay in marriage and increase in divorce. We have witnessed an increase in nonmarital unions, and it is not uncommon that such unions also involve children. Thus, the simple designation of one- and two-parent families does not communicate the complexity inherent in these two categories which include the intersection of number of parents present and marital/partnership status. Included in one-parent families are distinctions between never married parents and divorced parents, as well as a cohabiting parent (both never married and divorced) and a current partner. Similarly, two-parent families can be used to refer to two-parent biological families (married or not) or some form of stepfamily (married or not).

A typical reporting of children’s living arrangements via CPS data provides a good deal of information about both the child and her/his living context, whether living with both parents and their marital status, living with mother only and her marital status, living with father only and his marital status, or living with no parent present (see US Census Bureau 2013a)Family Structures Discussion. For example, information is provided on: the child’s sex, age, and race (white alone, black alone, Asian alone, and all other combinations); the presence and number of siblings; the presence of a parent’s unmarried partner; parents’ highest level of education; the nativity of both child and parents; the presence of grandparents; the presence of other adults; child support receipt; a stay-at-home parent; the labor force involvement of child and parents; family income; health insurance coverage; and poverty. The most recent data from 2012 (US Census Bureau 2013c) reveal that 68.1 percent of children under the age of 18 were living with two parents (biological and/or stepparent) and that almost all of these couples were married. Of children living with a parent, 94.7 percent resided with at least one biological parent (28.3 percent were with one parent and 61.8 percent were with both parents), 5.8 percent lived with a stepparent (4.1 percent of the 5.8 percent were stepfather families), 1.5 percent lived with at least one adoptive parent, and 3.6 percent lived with no parent present. Unfortunately, the data do not allow us to know whether the children who live with single mothers also live part of the time with their father, who may be remarried or repartnered, nor is information available on the father’s household and his marital status in such cases. Children in these households are designated as living with a single parent, when they are also a member of a stepmother family. Also, if there are adult stepchildren in the home, these are not included in any estimates. Children living with no parent present include several categories: grandparent only, other relative only, nonrelatives only, and other arrangementsFamily Structures Discussion.

There is also information on multigenerational households that include grandparents, and this information differentiates between children living with both parents, one parent, and no parents, whether the parents are married, cohabiting, or single. Also, information is available on whether the household includes both a grandmother and grandfather or only the grandmother or grandfather. For example, recent estimates from the United States Census Bureau show that, in 2012, 3.7 percent of children under 18 lived with both a grandmother and a grandfather, whereas 5 percent lived with a grandmother only, and 0.9 percent lived with a grandfather only (Lofquist et al. 2012)Family Structures Discussion. Other information shows that children living with at least one grandparent is less common if they are also living with both parents rather than living with only a mother, only a father, or with neither parent.

Similar patterns can be seen in family structures globally. While there is a decrease in two-parent families, they remain the majority structure around the world. They are more common in Asia and the Middle East compared to the Americas, Europe, Oceania, and sub-Saharan Africa. Cohabitation is more common in Europe, North American Oceania, and especially South America. Childbearing outside marriage is most common in South America and Europe, and least common in Asia and the Middle East. Extended families are most common in South Africa (70 percent of children) and other regions (sub-Saharan Africa and part of South America).

Limitations in Family Structure Measurement

There are several limitations with the sources of data currently available. These data typically capture family structure at one point. Unfortunately, the data do not capture structural change or the more nuanced family structures of today. As mentioned, most reports do not recognize that children may be members of multiple households (e.g., single-mother household and remarried or repartnered father/stepmother household). This becomes critical in the case of unmarried families, because partnership status is often unclear. While the parents may be cohabiting at one point, at a later point it cannot always be determined with confidence that the cohabiting partner is the parent reported earlier. Also, some couples may be dating, but live together only some of the time. Further, because many of the data represent the household, the following two households will look identical: (1) a married couple and their two children in the household, and (2) the same couple but the father also has a child from a prior partner who lives elsewhere. Clearly, future data collection must allow for greater specificity in designating the diversity of family structure in contemporary families while retaining adequately broad categories to allow for meaningful comparisons with the past Family Structures Discussion.

History And Process Of Nursing Research, Evidence-Based Nursing Practice, And Quantitative And Qualitative Research Process

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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 (see attached document).

1. Select a nursing practice problem of interest to use as the focus of your research (Infection control). Start with the patient population (Hospital, medical surgical unit) and identify a clinical problem or issue that arises from the patient population (nosocomial infections). 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.  Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources (minimum 6) should be presented using APA formatting guidelines. 

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

Conditions associated with positive and negative nitrogen balance

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Chapter 6 1.  List at least four of the functions of body proteins. 2.  What is meant by nitrogen balance?  Give examples of conditions associated with positive and negative nitrogen balance. 3.  What are complementary proteins?  List three examples of food combinations that contain complementary proteins. 4. What potential health effects can occur over time from consuming too much protein? 5. Proteins that use energy and convert it into some form of mechanical work are ________ ________. They are active in processes such as cell division, muscle contraction, and sperm movement. 6. ________ _________a disease that involves an inability to digest gluten, a protein found in wheat, rye, oats, and barley. If untreated, it causes flattening of the villi in the intestine, leading to severe malabsorption of nutrients. Symptoms include diarrhea, fatty stools, swollen belly, and extreme fatigue. 7. ________ _________ is an inherited disorder that causes widespread dysfunction of the exocrine glands, resulting in chronic lung disease, abnormally high levels of electrolytes (e.g., sodium, potassium, chloride) in sweat, and deficiency of pancreatic enzymes needed for digestion.Metabolism (Fill in the blank): The term ______________ describes a series of chemical reactions that either break down a large compound (catabolism) or build more complex molecules (anabolism). Cells are known as the “work centers” of metabolism. The basic animal cell is divided into two parts: the ____________and the _____________, which is filled with a fluid called cystosol. The ______________ are power generators that contain many important energy-producing pathways. ____________and their cofactors speed up chemical reactions in metabolic pathways.