PICOT

The first step of the EBP process is to develop a question from the nursing practice problem of interest.

Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

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

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.

Suggestions for locating qualitative and quantitative research articles from credible sources:

1. Use a library database such as CINAHL Complete for your search.
2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

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

P.S I already formulate the PICOT question and started on the paper. I just won’t have time to finish it

P- Bedside report among nurses and patient

I-Giving handoff in patient’s rooms

C-Bedside shift report vs report at nurses station

O-To involve patient in their plan of care, and to effectively provide patient with safe and quality of care.

T-During patient stay in the hospital.

Question what is the effect of bedside shift report on patient care compare to traditional report outside patient room?

Laws, D., & Amato, S. (2010). Incorporating bedside reporting into change-of-shift report.

Rehabilitation Nursing, 35 (2), 70-74. doi:10.1002/j2048-7940.2010.tb00034.x

Background: Conventionally patients and their family/caregivers were not involved in the process of change of shift report. In the past, shift report has been held in each units conference room with all the nurses listening to report on every patient in the unit (Tidwell et al, 2011, p. E2). Now days, change of shift handoff is done in the patient room, usually at the computer in front of the EMR. Bedside nursing report allows the patient and nurse the opportunity to share information, ask questions, and plan individualized interventions. Methods: implementation of moving changes od shift report to the bedside. Implementing the change of report started with a pre-implementation survey to all the nurses. Nurses were provided with survey question, consisted 6 statement, and they were asked to circle all the statement they found to be true (Laws & Amato, 2010., p. 70-74). The questions were: (1) Bedside report can improve patient safety. (2) bedside report provides an opportunity for patient to discuss their plan of care (3) Bedside report violate patients confidentiality (4)Bedside report holds off going staff more accountable than taped report (5) Bedside report takes longer than taped report (6)Bedside report reassure patient that staff work as a team (Laws & Amato, 2010, p. 72). After bedside report was initiated the result showed that most of the nurses felt that bedside report had improved patient safety and satisfaction (70%) and gives patient opportunity to discuss their plan (78%) (Laws & Amato, 2010, p. 70-74). In addition, it showed less issues with inaccurate or missing information, because it includes actual patient visualization. Recommendation: the patient satisfaction was improved once reporting was done with the patient in the room. Moving the report to the bedside allows accurate information to be exchanged. It was found that bedside reporting works best at the start of the day and evening shift (Laws & Amato, p. 73).

Comparison of APN PracticeInterviews of Two APNs The work for this paper entails interviewing in person (not by telephone or e-mail), TWO different categories of advanced practice nurses (APNs). One

Comparison of APN Practice

Interviews of Two APNs 

The work for this paper entails interviewing in person (not by telephone or e-mail), TWO different categories of advanced practice nurses (APNs). One APN has to be a primary care nurse practitioner (e.g., family NP, adult NP, pediatric NP); that is, the NP cannot be one who is an acute care NP. Furthermore, the NP must work in a primary care setting such as a “doctor’s office” or community health center—that is, in a setting the buzz-word for which is now medical home. An NP who works in a retail clinic or free-standing urgent care center would also be acceptable (but NOT an emergency department). Yes, there are many APNs who are prepared as FNPs or adult NPs who take jobs in non-primary care settings (e.g., as hospitalists and as providers in nursing homes). But a common premise with health care reform and the Affordable Care Act is that there already is and will be a huge need for primary care providers, thus paving the way for even greater opportunities for NPs in this area. It is important that you get a firm grasp of how NPs are prepared for primary care, and thus why NP organizations assert an important solution to the primary care provider shortage is educating more NPs which is why every state should allow full independent practice authority for APNs, especially NPs. 

The other APN may be your choice of one of the following: a certified nurse midwife (CNM) or a certified nurse anesthetist (CRNA) ora clinical nurse specialist (CNS). There is no limitation regarding the types of settings these APNs might work. Be sure to indicate the state(s) where the APNs practice.

Although the information gathered from these APNs will be acquired via an interview, the paper should be written in summary format (i.e., it should not look like a dialogue between you and the APN). Information on both interviews should be in a single document. It is not necessary to provide the APNs’ full names. Most elements of APA format should be used, including a title page and abstract. Most students’ papers that address all of these questions for both APN are about five double-spaced pages, without counting the title page or abstract (be sure to read your APA manual regarding what an abstract should look like!). An exception to the APA format requirement is that a reference list is not required, since all of the information will be derived from two sources (the APNs whom you interviewed). Although you have free range to discuss other topics about advanced practice nursing, you must address the following issues with each APN (please follow the order of list below):

1. Reason for their choosing their specific APN specialty.

2. Descriptions of: (a) the type of setting where they work (e.g., community hospital, major medical center, private primary care practice, clinic for the underserved, etc.), and (b) a “typical” day as they render care. 

3. Level of satisfaction with their role in general, and specifically within the system where they are currently employed.

4. The type of APN certification that they hold, including identifying the accurate name of the certifying body with which they are certified (Note: Review your textbooks for the correct names of these certifying bodies. Also note there are several different certifying bodies for NPs).

5. Whether they have prescriptive authority and whether they prescribe controlled substances. If they do prescribe controlled substances, you must indicate from which schedules of controlled substances they are allowed prescribe.

6. Whether they must practice according to an agreement with a physician. If so, is the relationship supervisory or collaborative?

7. Are they credentialed and privileged by a hospital or health system?  If the answer is “yes,” ask them to explain what the credentialing and privileging process entails at their organization (e.g., are the documents reviewed by only the human resources department, the nursing department, or the medical staff office, a combination of all three, etc.).

8. Whether they belong to a professional organization(s) that specifically addresses APN issues. If so, which one (s)? If not, why not?

9. Their understanding about the DNP degree (i.e., have them actually explain what they know about the degree) and whether they have this degree already or intend to pursue it. Be sure to probe to see if they have positive or negative feelings about the DNP—and why.

10. Final grading criterion: Paper’s adherence to APA format (with the exception that references are not required for this particular paper), including grammar, spelling, punctuation, sentence structure, etc. 

Total points for this assignment is 100; each question above is worth 10 points.

Nurses Working to Prevent Disease at Home

Week 4: Public Health Threats, Emergencies, and Disasters

Public health threats, emergencies, and disasters are as diverse as they are devastating to a population. Infections such as pandemic influenza outbreaks cause severe illness and often death in susceptible populations like the very young or old. Disasters such as these require rapid response to vaccinate susceptible populations and educate the public on how to protect themselves from contracting the disease.

Natural disasters like tsunamis, hurricanes, sudden heavy snowstorms or blizzards, and flooding also jeopardize health. These types of disasters create environmental health concerns through the spread of toxic waste, increased water-borne infections and insect-borne disease, as well as loss of power or the inability to navigate roadways during floods or blizzards. In addition, natural disasters create environmental concerns such as low food supply, destruction of crops and livestock, and lack of clean water. Natural catastrophes like these are predicted to increase in frequency and severity as long as climate change with increasing global temperatures continues unchecked through slow reaction or frank inaction by governments.

Organizations across the globe are developing strategies for decreasing their carbon footprint in order to reduce pollution that contributes to climate change. Because no one is immune from this hazard, nurses must have a grasp of the growing concern for the impact of climate change and its associated implications for public health worldwide. It is important for nurses to learn how to increase their leadership capabilities to affect local, state, and national outcomes.

This week, you will consider the role of the nurse in preventing illnesses due to environmental issues. Additionally, you will discuss the role of nurses in developing health promotion and health protection strategies to address global climate change health concerns.

Learning Objectives

Students will:

• Analyze the role of the nurse in preventing illnesses due to environmental issues
• Analyze the implications of global climate change on health*

*The Assignment related to this Learning Objective is introduced this week and submitted in Week 5.

Photo Credit: Photograph by Michael Rieger taken on 09/01/2005 in Louisiana – 15091. FEMA.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Holtz, C. (2013). Global health care: Issues and policies (2nd ed.). Burlington, MA: Jones & Bartlett.

• Chapter 14, “Global Perspectives on Nutrition” (pp. 355–384)
• Chapter 16, “Global Perspectives on Environmental Health” (pp. 409–427)

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

• Chapter 10, “Environmental Health” (pp. 217–241)

Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, N., Couig, M. P., … Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to action. Journal of Nursing Scholarship, 48(2), 187–200.

Retrieved from the Walden Library databases.

Required Media

Laureate Education. (Producer). (2010a). Public and global health: Global emergencies and disasters [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 9 minutes.

Accessible player–Downloads–Download Video w/CCDownload AudioDownload Transcript

TED. (2015a). Why climate change is a threat to human rights. Retrieved from https://www.ted.com/talks/mary_robinson_why_climate_change_is_a_threat_to_human_rights

Note: The approximate length of this media piece is 22 minutes.

Former President of Ireland, Mary Robinson, talks about the effects of climate change on human rights in poorer populations where some islands or lowlands are beginning to submerge as sea waters rise.

TED. (2016b). The case for optimism on climate change. Retrieved from https://www.ted.com/talks/al_gore_the_case_for_optimism_on_climate_change

Note: The approximate length of this media piece is 25 minutes.

Former Vice President Al Gore speaks practically about global warming and offers some reasons we should feel optimistic about recent developments and changes in outcomes. His message is that people are changing their attitudes about global warming into action to stop the warming trend.

Writing Resources and Program Success Tools

Document: AWE Checklist (4000) (Word document)

This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved May 20, 2016, from http://academicguides.waldenu.edu/ld.php?content_id=7980455

Dr. Mary Bassett (Health Commissioner of New York City) discusses why physicians, nurses, and other health care professionals should not keep silent about health care disparities, based on her insights from her work in Zimbabwe.

Discussion: Nurses Working to Prevent Disease at Home

According to the Centers for Disease Control and Prevention (CDC) (2016), a vaccination has not been found to prevent the Zika virus, a disease that has been transmitted to humans through mosquito bites from mosquitoes that are most active during the day. Zika has been found in many countries around the globe, and its range is expanding. The symptoms of Zika are generally mild, last about a week, and include fever, rash, joint pain, and/or conjunctivitis. Symptoms are generally so mild that many victims will not know they have been infected, but about 20% of those individuals who are bitten will develop Zika. The most concerning symptom of Zika affects pregnant women, whose babies may develop microcephaly. In general, the CDC (2016) has recommended that people wear long-sleeved shirts and long pants when outside and apply insect repellant beforehand to avoid getting bitten. People who possibly have been infected with the Zika virus are urged to use a condom during sexual contact to avoid spreading the virus to others. In fact, some countries, such as El Salvador, have recommended that women avoid pregnancy for the next two years (The New York Times, 1/25/16). The CDC has also recommended that any vessels or containers of open water be protected from access to mosquitoes so that breeding cycles are disrupted. Brazil has begun a massive campaign to stop mosquitoes from accessing breeding grounds by closing their access to water collection systems and other sources of standing or still water. Could something like the Zika virus begin in your neighborhood?

In this Discussion, you will examine your neighborhood through the eyes of the public health nurse or a nurse epidemiologist.

To prepare for this Discussion:

• Walk around a two-block radius near where you live or work.
• Look to see if you can spot any areas where mosquitoes may reproduce. These sites may include abandoned tires, rainwater collection systems that have been installed at homes, parks or golf courses, low sections at roadsides or near sidewalks, and the like. You may include pictures of sites that you find to enhance your discussion thread.
• Note any positive or negative findings that you observe. Have steps been taken to prevent mosquito breeding?
• Find out what your community health department does for mosquito abatement.
• Discover who in your community you would contact to report deficiencies/negative findings.
• Determine what you can do, as a PHN, to change policy to reduce mosquito breeding grounds in your neighborhood.

By Day 3

Post your findings regarding mosquito breeding grounds in a two-block radius near where you live or work. Include any preventative strategies you can see that are already in place. Report on the role your local health department plays in mosquito abatement and to whom you would report negative findings. Then, describe your role as a BSN in changing policy to ensure a healthier climate (reduced mosquito breeding grounds) in your neighborhood.

Support your response with references from the professional nursing literature.

Note Initial Post: A 3-paragraph (at least 250–350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

Walden University nurs6512 week 2 quiz latest 2017

QuestionWeek2 quizQuestion 1 When percussing, a dull tone is expected to be heard over:Question 2 Which technique should be used to stabilize the stethoscope during auscultation?Question 3 The degree of percussion tone is determined by the density of the medium through which the sound waves travel. Which statement is true regarding the relationship between density of the medium and percussion tone?Question 4 Which of the following describes a physical, not a cultural, differentiator?Question 5 Your new patient is a 40-year-old Middle Eastern man with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to:Question 6 Which statement is true regarding the impoverished?Question 7 To perform a deep tendon reflex measurement, you should:Question 8 In terms of cultural communication differences, Americans are more likely to _____ than are other groups of patients.Question 9 Underestimation of blood pressure will occur if the blood pressure cuff s bladder:Question 10 Guidelines for Standard Precautions indicate that mask and eye protection or a face mask should be worn while performing:Question 11 A patient in the emergency department has a concussion to the head. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this  patient. Which aperture of the ophthalmoscope is most appropriate for this patient?Question 12 A nonambulatory 80-year-old male patient tells the female nurse that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?Question 13 For a woman with a small vaginal opening, the examiner should use a _____ speculum.Question 14 Which statement is true regarding the relationship of physical characteristics and culture?Question 15 You are performing a vaginal examination for a patient with a history of spina bifida. As you insert the metal speculum, the patient suddenly feels nauseated and is sweating, and her skin turns blotchy. What is your most immediate reaction to this situation?Question 16 The infant should be placed in which position to have his or her height or length measured?Question 17 Which question has the most potential for exploring a patient s cultural beliefs related to a health problem?Question 18 Expected normal percussion tones include:Question 19 A naturalistic or holistic approach to health care often assumes:Question 20 Because of common cultural food preferences, avoidance of monosodium glutamate (MSG) is likely to be most problematic for the hypertensive patient of which group?