In clinical settings, pediatric patients often present with hematologic and metabolic disorders such as anemia and diabetes. Many of these disorders are manageable with drug therapy and lifestyle changes, but they can pose serious complications for patients if left untreated. In your role as the advanced practice nurse, you must identify patients at risk of hematologic and metabolic disorders and provide the appropriate education for them and their families. Consider potential treatment, management, and education strategies for the patients in the following case studies.

Case Study 1

You see a 1-week-old Asian infant for a weight check. The infant is back to his birth weight and is breastfeeding for 10 minutes every 2 hours with one 3-hour stretch a day. He is alert, has bowel movements with each feeding, and wets 8–10 diapers a day. His blood type is A+ and his mother’s blood type is A+. Coombs’ testing at birth was negative. You note slight scleral and skin jaundice.

Case Study 2

Jimmy is a 3-year-old “picky” eater according to his mother. He refuses to eat anything but waffles for breakfast and macaroni and cheese or chicken nuggets for lunch and dinner. He will eat apples and bananas but refuses all vegetables except corn. After a normal physical examination, you obtained blood testing that revealed the hemoglobin is 11.4 mg/dl and his hematocrit is 30% (both obtained by venipuncture). The CBC revealed microcytic hypochromic RBCs.

Case Study 3

Melissa is a 13-year-old who presents to your office for a well-child check. Physical examination reveals a thin child who is short of stature. Breast Tanner stage is II and pubic hair development is Tanner I. Neurologic, skin, heart, lung, abdominal, and HEENT examinations are normal.

To prepare:

Review “Endocrine and Metabolic Disorders” and “Hematologic Disorders” in the Burns et al. text.

Review and select one of the three provided case studies. Analyze the patient information.

Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.

Consider strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

100 points

Introduce yourself to your classmates and to me. Write using first person, such as—Hello class, my name is ME, and I want to tell you a little bit about myself and why I am interested in healthcare administration…

Within the context of your intro, share your perspective on the importance of “finding balance” between the roles of healthcare delivery providers, such as nurses and assorted clinicians in a hospital environment next to the business/financial component that drives variables such as costs, length of stay, discharge protocols, admit/surgical denials, and any others. Further consider that there is (or should be) a synergy among/between patient care providers and bean counters, yet it requires money to keep the beds open and salaries paid—just as it takes the care provided by trained professionals on the units. How effective is writing “policy” on matters such as these?

This first assignment should be at least two pages in length, double spaced, 12 points font, and the title page is not part of the page count. If you cite, be sure to include your sources within the essay, and at the end in a separate Reference List. However, because this assignment is more of an opportunity to opine, sources are not mandatory.

Evaluation Criteria

You will be evaluated on your ability to complete the following tasks according to points designated:

Introduce yourself…………………………………………………………………………………………………………………………….10 points

Identify and analyze a problem………………………………………………………………..………………………… 20 points

Outline and analyze proposed solutions……………………………………………………………………………………20 points

Explain the background of the issue including its history and previous attempts to address the problem…………….20 points

Name any inherent values that need to be assessed…………………………………………………… …………………..10 points

Determine the resources, both financial and human, needed to bring the issue forward and to reach a resolution…10 points

Describe a plan of action or policy based on your conclusions…………………………………………………………. 10 points

Practicum: Planning Learning Objectives

The practicum experience allows you to develop and expand your advanced nursing knowledge and skills at the aggregate, organizational, or policy level. During week 1 you will submit two to three individual learning objectives that you wish to achieve during this practicum experience. You should prepare a set of measurable learning objectives, using Bloom’s Taxonomy (See attached file). Your practicum objectives should reflect your interest in expanding knowledge. They are not to include activities related to your DNP project. These objectives will be identified during your mentoring course (NURS 8700P, 8700, 8701). Practice experiences should be designed achieve specific learning objectives related to the DNP Essentials and specialty competencies (AACN, 2006).

Your practicum objectives should include the following:

1) Three learning objectives using Bloom’s Taxonomy.

2) Description of how these objectives will expand your advanced nursing knowledge and skills at the aggregate, organizational, or policy level.

3) Relationship of the learning objectives to the DNP Essentials.

NOTE: Learning objectives must be submitted using APA style. Points may be deducted for lack of references, writing style, and APA format. Refer to the sample attached in the file area (See attached file >> very important)

Please, kindly cover all aspects of the questions (No Plagiarism)

Topic: Making the Case for Evidence-Based Practice

Evidence-Based Practice Proposal – Section A: Organizational Culture and Readiness Assessment

Details:

Before making a case for an evidence-based project, it is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.

1. Develop an analysis of 250 words from the results, addressing your organization’s readiness level, possible project barriers and facilitators, as well as how to integrate clinical inquiry.
2. Make sure to include the rationale for the survey categories scores that were significantly high and low, incorporating details and/or examples. Also explain how to integrate clinical inquiry into the organization, providing strategies that strengthen the organizations weaker areas.
3. Submit a summary of your results. The actual survey results do not need to be included.

Prepare this assignment according to the APA guidelines found in the APA Style Guide. An abstract is not required.

You are required to submit this assignment to Turnitin.

Upon receiving feedback from the instructor, revise “Section A: Organizational Culture and Readiness Assessment” for your final paper submission. This will be a continuous process throughout the course for each section.

Evidence-Based Practice Proposal – Section B: Problem Description

Details:

Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:

1. Describe the background of the problem. Tell the story of the issue and why it deserves attention.
2. Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.
3. Use the feedback from the Topic 2 main forum post and refine your PICOT question. Make sure that the question fits with your graduate degree specialization.
4. State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes.
5. 5) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.
6. Develop an initial reference list to assure that there is adequate literature to support your evidence-based practice project. Follow the “Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use “NUR-699 Search Method Example” to assist you.
7. 7) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.
8. Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted.

Prepare this assignment according to the APA guidelines found in the APA Style Guide. An abstract is not required.

You are required to submit this assignment to Turnitin.

Upon receiving feedback from the instructor, refine “Section B: Problem Description” for your final submission. This will be a continuous process throughout the course for each section.

Assignment: Disaster Planning for Public Health

By Day 7 of Week 5

Select a potential natural or man-made disaster that could happen in your community. Then, write a 3- to 4-page paper about the disaster from the community nurse’s perspective.

Section 1: The Disaster, Man-Made or Natural

What disasters may strike your community and why? For example, do you live in “Tornado Alley,” or has climate change resulted in unusual cold weather snaps or blizzards in your community? Are you located in a flood plain? Include possible diseases that may result from a natural disaster, such as tetanus or cholera.

Section 2: The Nursing Response

Formulate responses to the disaster, considering systems and community levels of intervention.

Review websites where a disaster plan may be available for the public, or if one is not currently available, call public health department to see if a disaster plan exists for your community and what the plan contains.

In addition to reviewing websites for information about your local disaster plan, you will need to locate best practice/evidence-based practice guidelines in professional literature to determine whether your community’s disaster plan is as sound as it might be or if there is room for improvement.

Section 3: Is My Community Prepared for a Disaster?

What conclusions can you draw about your community’s preparedness plan from having completed this evaluation?

Week 4: Evidence-Based Practice in Disaster Planning: Nurses as Leaders

Public health surveillance is one way that public health officials target intervention strategies (Turlock, 2016). Often, it is through prompt recognition of and reporting of incidents of communicable disease that a disaster can be averted (Turlock, 2016). Surveillance activities often prompt questions such as, What is causing the disease? How is it spreading? And who is at risk (Turlock, 2016)? While it is true that preparedness planning cannot eliminate all traces of threat to a community, planning assures that medical services and treatment are deployed in an effective, efficient, and rapid manner (Turlock, 2016). Public health plays a vital role in coordination of providers, assurance of supplies particularly when the Strategic National Stockpile pharmaceuticals and supplies are required, and mobilization of state and national response systems. Public health officials may also provide health care services when required (Turlock, 2016).

Stanhope (2016) noted that evidence-based practice (EBP) has become more important in health care for many reasons: increased expectations of consumers, increased availability of information through the Internet, increased accountability for results, health care economic changes, and growing numbers of lawsuits, among other reasons. EBP is a lifelong problem-solving approach that regularly produces excellent results and often provides the theoretical underpinnings for programs to mitigate problems in the community. Once programs are in place, evaluation of their effectiveness should be conducted to determine whether they are worth the continued expenditure of resources. Use of EBP is vital to assure safe outcomes for populations during disasters, such as massive communicable disease outbreaks, and should be the foundation of disaster-planning strategies.

Required Readings

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

Chapter 15, “Evidence-Based Practice” (pp. 342–354)

Chapter 23, “Public Health Nursing Practice and the Disaster Management Cycle” (pp. 503–528)

Chapter 24, “Public Health Surveillance and Outbreak Investigation” (pp. 529–544)

Chapter 25, “Program Management” (pp. 545–567)

Required Media

Laureate Education (Producer). (2009a). Family, community and population-based care: Emergency preparedness and disaster response in community health nursing [Video file]. Baltimore, MD: Author.

TED. (2012). How to step up in the face of disaster [Video file]. w_to_step_up_in_the_face_of_disaster

This Ted Talk describes the actions of two sisters who step up as leaders during a tornado disaster in their community.