In this Discussion, you creatively and critically explore the evolution of nursing education and thus the evolving role of the nurse educator.

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MSN degree need initial discussion to the assignment below 1-2 pages4 References one from Walden University LibraryDue tonight by 10 pm EST.  Will pay 15.00$What were the skills required of nurse e

 MSN degree need initial discussion to the assignment below 1-2 pages

4 References one from Walden University Library

Due tonight by 10 pm EST.  Will pay 15.00$

What were the skills required of nurse educators yesterday, what are they today, and what will they be tomorrow?

Though nursing has long been a forward-thinking profession, there is much value in looking to the past to better build for the future. Examining societal, political, and global trends allows nurse educators to develop programs that will meet the needs of their future learners. In addition, taking time to consider the volatility of the economic landscape, as well as the swift changes brought on by technology and medical informatics, nurse educators can better prepare themselves to teach students, staff, and patients.

In this Discussion, you creatively and critically explore the evolution of nursing education and thus the evolving role of the nurse educator.

To prepare:

  • Review Chapter 1, “Best-Laid Plans: A Century of Nursing Curricula” in the Keating course text. How has the nursing profession evolved in response to societal, economic, political, and technological factors? How has this evolution directly impacted the role of the nurse educator?
  • Review Chapter 17, “Issues and Challenges for Nurse Educators” also in the Keating text. Consider how the issues and challenges of today’s nurse educators differ from those of past nursing educators. Then, imagine the issues and challenges that might arise for tomorrow’s nurse educators in both clinical and academic settings.
  • Explore the website “Creative Writing Now” to review the parameters for writing a haiku. With this information in mind, write a haiku using the following questions as a guide:
    • If the first line of the haiku represented the roles of past nurse educators, what five-syllable description would you create?
    • If the second line represented the roles of today’s nurse educators, what seven-syllable description would you create?
    • If the third line represented the roles of tomorrow’s nurse educators, what five-syllable description would you create?

Correct differential and medical diagnosis.

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Soap note to presents GYN problem or OB case and subjective data

please attach files to complete paper

Presentation of Case and Subjective Data

Clearly and thoroughly presents GYN problem or OB case and subjective data.

Objective Data

Clearly and thoroughly presents objective data. All of the relevant systems addressed based on the CC and HPI.

Assessment

Correct differential and medical diagnosis.

Plan

Correct plan of care for each issue. Thoroughly addressed (diagnostic studies, meds, education social and personal responses, health promotion/screening by age, ethical and cultural considerations, follow up, referrals). All components addressed.

Organization and Writing.

SOAP note/plan of care was thoroughly organized and well-written. All ideas were stated clearly and logically.

Writes relevant content.

Project was thoroughly on topic and relevant.

Formatting, spelling and grammar.

All formatting guidelines followed and template was used. No spelling or grammatical errors.

SOAP NOTE TEMPLATE

Please include a heart exam and lung exam on all clients regardless of the reason for seeking care. So, if someone presented with vaginal discharge, you would examine the General appearance, Heart and Lungs, abdomen and pelvis for a focused/episodic exam. The pertinent positive and negative findings should be relevant to the chief complaint and health history data. This template is a great example of information documented in a real chart in clinical practice. The only section that will not be included in a real chart is differential diagnosis. The term âRule Outâ¦â cannot be used as a diagnosis.

Subjective Data (20 pts.)

Chief Complaint (CC):

History of Present Illness (HPI):

Last Menstrual Period (LMP)

Allergies:

Past Medical History:

Family History:

Surgery History:

Obstetrical/GYN History:

Social History (alcohol, drug, or tobacco use):

Current medications:

Review of Systems (Remember to inquire about body systems relevant to the chief complaint and HPI)

Objective Data (25 pts.)

Please remember to include an assessment of all relevant systems based on the CC and HPI.

Vital Signs/ Height/Weight:

General Appearance:

Assessment (20 pts.)

A: Differential Diagnosis

Please rule out all differential diagnosis with subjective and objective data and/or lab-work. Provide references.

1.

2.

3.

B: Medical Diagnosis

Rule in diagnosis with subjective and objective data and lab-work. Please explain how you arrived at the diagnosis. Provide references.

1.

PLAN (25 pts.)

A: Orders

1.Prescriptions with dosage, route, duration, amount prescribed, and if refills are provided

2.Diagnostic testing needed

3.Problem oriented education

4.Interpersonal/Social support/communication

5.Age appropriate Health Promotion/Maintenance/Screening Needs

6.Referrals and follow up with rationales

Cultural Diversity: What cultural considerations would you suggest for this patient?

Patient/Family Education: If patient is currently on any medications, please address if you want them to discontinue or continue. You always want this to be clear at the end of the visit.

B: Follow-Up Plans (When will you schedule a follow-up appointment and what will you address in the subsequent visit —F/U in 2 weeks; Plan to check annual labs on RTC (return to clinic) with rationales

APA Format (10 pts.)

Include a title page and references with all of your papers. There should be at least four references from textbooks, journal articles, CDC or NIH that are not older than 5 years. Please do not use Wikipedia, WebMD, dictionaries, or any websites that are not evidence based.

In this paper you will select a nursing concept from the list provided below.

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chronic illness – stigma

In this paper you will select a nursing concept from the list provided below.

Caring

Comfort

Coping

Empathy

Empowerment and powerlessness

Hardiness and resilience

Dignity

Empathy

Facilitation

Fatigue

Recovery

Grief

Diversity

Humour

Loneliness

Shame

Suffering

Trust

Vulnerability

Body Image

Chronic Illness: Stigma

Life span issues of the nurse

Palliative care: children/ adolescents/ older adults

  • You will apply the pertinent theoretical concepts to a clinical situation from your past or present nursing experience (notpersonal life experiences). This paper offers you the opportunity to analyze a practice issue in light of enhanced knowledge and personal awareness. The paper must follow APA format. Marks will be deducted for improper APA format.
  • Should you wish to present on a topic not on the above list please consult with your instructor.
  • Should there be any issues within the group membership it is an expectation that these issues will be brought to the attention of the course instructors and will be addressed with the members and course instructor.

The application paper should include:

  1. an introduction to the scope of the paper and a conclusion that captures the essence of your discussion.
  2. a description of the clinical situation to be analyzed.
  3. the identification of the relevance of the topic/clinical situation to you both personally and professionally.
  4. the identification, discussion, and analysis of 2 issues of the concept within the clinical situation.
  5. discussion of how theory related to the concept (from the scholarly sources/ articles) facilitates your understanding/interpretation of issues/aspects of the clinical situation.
  6. how your analysis of the clinical situation utilizing theory related to the concept will influence your future nursing practice.
  7. conclusion/ summary
  8. theoretical content that must be clearly related to the situation you are discussing
  9. headings.

N.B. “Theory” identified in 6. does not refer to Nursing Theory or Theorists (e.g. Watson, Roy and their models). It refers to the scientific information contained in the scholarly readings – those in all readings listed with the class concept and/or any scholarly material related to the concept you have chosen.

Length of paper: 5-6 typewritten pages (excluding title page and reference pages).

Due date of paper: Week 9.

Provided below is a detailed explanation of the requirements of each of the above sections (# 1-9). Should you have any questions about your paper please be sure that you contact your instructor and ask your questions.

Detailed Requirements for Paper

The following provides you with a detailed explanation of the requirements for the paper. Consider this to be the recipe for success in the writing of your paper. I encourage you to print the details included below and follow them carefully as you construct your paper.

Step 1

You will need to select 1 concept from the list of concepts that are provided above. In consideration of your choice of concept you are encourage to think about one clinical situation you will be presenting/ exploring/ discussing in your paper and ensure that the two are compatible, if they are not

  • consider exploring and presenting a different clinical situation.or
  • consider exploring another concept that is relevant to the situation.

Step 2- Description of Clinical Situation

Write a description of the clinical situation that you are going to present in the paper. This description should not be more than 1/2 page in length. Within this description you should provide an overview of the situation so that the reader has a brief but clear understanding of what occurred in the situation.

Once you have done this, reflect on what you have written and make sure that your description includes the two issues that you are going to talk about latter so that your instructor can clearly see that they existed in the situation.

For example if your paper was about the concept of Music Therapy (note: this is not a concept being covered this year in this course) three issues that might be part of the clinical situation may be: 1) the client experienced a decrease in pain with the use of music therapy; 2) a sense of empowerment with the ability to choose his music and 3) the physiological impact on his blood pressure and pulse from his listening to music.

It is important to remember that sometimes a “conceptâ can become an issue in another concept. For example “stigmaâ maybe an issue in the concept of “body imageâ just as “powerlessness â maybe an issue in chronic illness.

It is important that the two issues of the concept you are exploring are present in the paper. Remember, this is an application paper, you will be exploring the two issues of the concept through how they presented in the clinical situation not how they present in general within society.

Please note that a definition of a clinical situation for this paper is: the events of 1 client within 1 time frame. This means that you will be talking about 1 person’s experiences during 1 episode/ event of their life.

There are a few clinical situations that have been received in some papers in the past that were not acceptable clinical situations and thus this was reflected in the students’ grades. These included but were not limited to:

  • presenting the clinical situation as being: a unit at work, a hospital, a country.
  • rather than talking about 1 client presenting more then 1 client in the clinical situation.
  • presenting a clinical situation that is not about a client you cared for: rather it is a family member’s experience.
  • using yourself as a client in any of the topics not identified as being acceptable to do so.

Remember that this is an application paper you are exploring the concept through the lens of your experience as a nurse and your interactions with a client. This section should not be longer then 1 page in length.

Step 3- Relevance of topic/ situation to Me Personally and Professionally

This step is reflective in nature. We are asking you to reflect on and identify why you chose this concept/ clinical situation to talk about. There was something that stood out above all the other concepts/ experiences that you have had during your professional life and I am interested in hearing about this.

We are interested in hearing about the professional relevance. For example, how will this exploration allow you to grow professionally or what impact did the situation have on you professionally?

We are also interested in hearing how the situation impacted on you as a person. This section in your paper should be no longer than 1/2 page in length.

Step 4

You have previously identified your concept and the 2 issues of the 1 concept that you will be exploring, discussing and analyzing in the clinical situation. It is at this point I recommend that you carry out a review of the literature. Please do not use the words “I carried out research on the topicâ in your paper, this is not a correct statement to make or to include in your paper. Should you wish, you could say “I reviewed the available literature on the topicâ.

I suggest that you gather the articles that are relevant to the 1 concept and each of the two issues and make 2 piles: one pile of articles for each of the issues. As you go through each article in each pile take 2 colored highlighters and mark the content that is relevant to issue 1 (highlight in red) and the content that is relevant to issue 2 (highlight in blue). Once you have done this you have easy color-coded access to content that is relevant to each issue.

The articles that you use/ include in your paper should be within 5 published years unless they are seminal and then they can be older.

Step 5 – Identification, discussion and analysis of the two issues

During this step you will do the following:

  1. with issue one, describe the issue as it presented in the clinical situation. This should be 1-1/2 pages in length.
  2. with issue two repeat the above process- describe the issue as it presented in the clinical situation .This should be 1 page in length.

Once you have done this for each of the issues, go back to the one page documents and add the relevant theory/ content from the articles you have selected. It is important that the content that you include be relevant to the issue as it has been presented in the clinical situation. For example if the issue in your clinical situation is about a 9 year old who is experiencing stigma from friends it would not be appropriate to include content that discusses stigma that older adults experience from their friends.

Each of the two issues (within the clinical situation) should be identified/ presented and discussed and analyzed. During the analysis process, the theory/content from relevant articles (6 sources) is integrated into the analysis- to provide you and the reader with greater understanding of the issue within the situation.

For example you might want to talk about how a specific excerpt of content from an article:

  • increases your understanding/ interpretation of issues/ aspects of clinical situation.
  • supports the actions that you took in the situation.
  • how the content/ position in an article is opposite from your experiences in the situation.

The theoretical content must be clearly related/ linked back to the situation you are discussing. For example if you are talking about an issue of family support and yet the theory you are presenting is talking about support from distant friends although this theory maybe interesting and informative it is not relevant to the issue.

We always encourage students (including ourselves when writing papers) to look back at what theory (content) that we have included and to ensure that it is relevant for the issues being discussed and if it has nothing to do and does not support my analysis and discussion of that issue we remove it and look for more relevant theory that is specific to what we are wanting to discus.

We encourage you to go back and ensure that you link each piece of theory (discuss it within the context of the issue) as you present in the paper to show the relevance/ your understanding.

This section should be about 2 pages in length.

Step 6 – Discussion/ analysis of how future practice may be influenced

In this section you will discuss how your analysis of the clinical situation and theory presented in the paper may influence your future nursing practice. I encourage you to bring examples from your analysis section (the previous section). This section should be about 3/4 pages in length.

Step 7 – Conclusion or summary

In this section you need to first make the decision to write either 1) a conclusion for your paper or 2) a summary. Your decision should be reflected in the heading you use. So if you are choosing to write a summary the heading used should be: “Summaryâ and if you are writing a conclusion then the heading should be: “Conclusionâ.

The two are very distinct. A summary provides the reader with an overview of some of the key elements in the paper. A conclusion is an afterthought, sometimes reflective in nature providing the reader with insight to your final ” ahaâ of the paper. Both are considered acceptable and receive the same weight in the grading process.

This section should be about 1/2 page in length.

Step 8 – Introduction

You maybe asking why we have suggested that you wait to write the introduction until after you have written the paper? The reason for this is that your introduction should provide an overview of what will be in the paper and what the reader has to look forward to. Some would say you really cannot say what will be in your paper until you write it.

Your introduction should include the following:

  • Identify the concept that you will be presenting
  • Identify the 2 issues of the concept that you will be exploring
  • Identify what the reader will read about in the paper in a sequential order. For example:Within this paper I will explore the xxxx concept and yyy and, zzz, issues. A clinical situation will be presented in which I will explore each of the above issues. As well, I will discuss briefly both professionally and personally why I have chosen to present this situation. I will discuss and analyze each of the above issues as they presented in the situation and after this I will discuss how my future practice may be influenced by the contents of the paper. Finally, I will present a brief summary of the paper.
  • The introduction should be a paragraph in length

Some additional considerations for the paper

  • Headings must be used. We have provided you with all the headings that are APA formatted
  • Keep the grading sheet near you as you complete your paper and before you submit your paper go through it to ensure you have met each of the criteria.
  • Prior to your submitting your paper, review your paper using the student self-feedback sheet. If during your review you check off “somewhatâ or “noâ in any section please ensure you go back to this section in your paper and make any additions/ changes that may need to be made.
  • The length of the paper is 8-10 pages including the title and reference pages.

Headings:

The following headings should be used in your paper.

Introduction

Description of Clinical Situation

Discussion of Relevance of Clinical Situation/ Topic to Student Both Personally & Professionally

Identification, Discussion, and Analysis of 2 Issues of the Concept Within the Clinical Situation

Issue 1:

Issue 2:

Discussion/ Analysis of How My Future Practice May be Influenced

Conclusion/ Summary

feedback sheet for the paper

The grading/ feedback sheet that will be utilized is provided below.

Introduction:

Yes

No

Provides an overview of paper

Identifies concept to be addressed in paper

Identifies issues of the concept in the clinical situation

Clearly states

Concisely states

Description of clinical situation:

Yes

No

Provides sufficient detail

Clearly states

Discussion of relevance of clinical situation/ topic to student both personally & professionally:

Yes

No

Discusses relevance of clinical situation/ topic to student personally

Discusses of relevance of clinical situation/ topic to student professionally

Identification, Discussion and Analysis of the Issues

Identification, discussion, and analysis of 2 issues of the concept within the context of the clinical situation that was presented:

Integration of ideas and theory from different scholarly references in the discussion and analysis of the issue:

Instructor’s notes/ course note provided by any instructors in class /on line are excluded]There is an expectation that the literature that is included will be linked back and discussed within the context of the issue as it is presented in the situation

Minimum of 6 scholarly references are included: articles and chapters from published books

Issue 1:

Issue 1:

Exceptional

Exceptional

Excellent

Excellent

Good

Good

Satisfactory

Satisfactory

Minimal

Minimal

Absence

Absence

Issue 2:

Issue 2:

Exceptional

Exceptional

Excellent

Excellent

Good

Good

Satisfactory

Satisfactory

Minimal

Minimal

Absence

Absence

Discussion/ analysis of how future practice may be influenced:

Yes

No

Identifies and discusses how analysis of the issues and theory may influence

future practice

Provides sufficiently details

Clearly states

Conclusion/ Summary:

Yes

No

Captures the essence of paper

Overview of content presented and discussed in paper:

Grasp of subject matter:

Comprehensive grasp

Good grasp

Satisfactory grasp

Minimal treatment of the subject matter

Superficial treatment of the subject matter

Demonstration of ability to organize and present ideas logically and fluently:

Superior

Excellent

Good

Satisfactory

Minimal

Absence of

Demonstration of originality, creativity, and critical thinking

Exceptional

Good

Satisfactory

Minimal

Absence of

Originality

Creativity

Critical thinking

Format of paper:

Yes

No

Title page:

Name/ student number, course number, University, teacher’s name, date due

Length: 10-12 pages

Use of headings

APA format:

Correct

Essentially correct

Occasional minor errors

Multiple errors

Does not utilize guidelines correctly

Font 12

Direct quotes

Indirect quotes

References

Pagination

GRADE __

Expected method of submission:

The paper can be submitted anytime up to the last day of class during week 12 of the course. The paper is to be submitted to your instructor. Details of how the paper is to be submitted will be posted by your instructor.

Student self-feedback/ grading tool for application paper:

After you have written your paper we recommend that you carry out a self-evaluation/ self grading of your paper using the tool provided below. This will assist you in identifying the strengths of your paper and areas in your paper that need additional consideration (attention/ work) before you submit it.

All sections that have a “yesâ; “somewhatâ and “noâ box. If you select “somewhatâ or “noâ this states that your paper could benefit with further attention. After you have been successful in achieving a “YESâ with each row in each section I suggest that you are ready to submit your paper for review and grading by your instructor.

Yes

Somewhat

No

Title page

I have included the following:

Title of paper

My name/student number

Name of university

Name of course and section

Date and year of submit

Introduction

  1. I have included a heading in this section.
  2. I have provided an overview of the paper including: identified the concept, the issues to be discussed
  3. I have identified in sequence what will be provided in the paper e.g. in this paper the following will be presented and discussed…
  4. This section is well written- sentence structure, grammar, paragraph minimum of 3 sentences.
  5. This section is clear and concise.
  6. This section is 1 paragraph in length

Description of the clinical situation

  1. I have included a heading in this section.
  2. I clearly provided enough details about the clinical situation so that the reader will gain an understanding of the situationThis section well written- sentence structure, grammar, all paragraphs should have at least 3 sentences in each.
  3. This section is about 3/4 of a page in length.

* With the following concepts: horizontal violence, life span issues of the nurse and self care- I may have used myself as the client- please note in all other topics (concepts) the clinical situation needs to be that of a client.

* The word “Iâ can be used throughout my paper.

The identification of the topic/ clinical situation to me both personally/professionally

  1. I have included a heading in this section
  2. Within this section, I have spoken about the personal relevance of the topic (concept) and/or the clinical situation e.g. to personal growth, reflection on one’s own life.
  3. Within this section, I have spoken about the professional relevance of the topic (concept) and/or the clinical situation e.g. to professional growth and development, reflection.
  4. This section is well written- sentence structure, grammar, the paragraph should contain at least 3 sentences.
  5. This section is about 1/2 page in length.

Identification, discussion and analysis of the 2 issues

Issue #1:

  1. I have identified, discussed and analysed the issue as it presents in the clinical situation.
  2. I have integrated theory into the analysis & discussion of the issue.
  3. Each piece of theory that I have included is clearly linked back to/discussed within the context of the situation.
  4. This section is well written- sentence structure, grammar, the paragraphs should contain at least 3 sentences.

Issue #2:

  1. I have identified, discussed and analysed the issue as it presents in the clinical situation.
  2. I have integrated theory into the analysis & discussion of the issue.
  3. Each piece of theory that I have included is clearly linked back to/discussed within the context of the situation.
  4. This section is well written- sentence structure, grammar, the paragraphs should contain at least 3 sentences.

Overall in 1 & 2:

  1. I have included headings in each section.
  2. I have always discussed both issues and all the theory included within the context of the situation.
  3. This section is about 6 pages in length.
  4. Within this section, 6 different references (articles) have been included/sourced throughout.

Discussion and analysis of how future practice may be influenced by my review of the concept, situation and theory

  1. I have spoken to how my review of: the concept, issues, theory could influence my future practice.
  2. This section is well written- sentence structure, grammar, the paragraphs should contain at least 3 sentences.
  3. This section is about 3/4 of a page in length.

Conclusion or summary

  1. I have included a heading in this section.
  2. I have included either a conclusion or summary -not both and the heading and content included reflects the choice.
  3. This section well written- sentence structure, grammar, the paragraphs should contain at least 3 sentences.
  4. This section is about 1/2 page in length.

Reference page

  1. I have 5th edition, APA formatted each of my references.
  2. Each of the sources cited in the paper have been included in the reference list.

Complete the following throughout the paper

  1. I have ensured that all theory: direct and indirect quotes have been sourced.

Highlight all direct quotes in your paper pink and highlight all indirect quotes in your paper yellow. This allows me the opportunity to see what theory I have included in the paper.

  1. I have reflected on the balance of direct quotes versus indirect quotes included throughout the paper and there appears to be very few, no direct quotes.
  2. I have changed all possible direct quotes to indirect quotes-by rewording ideas and key points in my own words.
  3. I have identified all sources of theory have been identified and APA formatted these throughout the paper.
  4. I have ensured that no “back to backâ quotes or “cut and pasteâ quotes are present in my paper.
  5. I have reflected on the number of quotes versus my comments, thoughts and ideas throughout the paper and there appears to be good balance.
  6. The margins

Respond by offering additional thoughts regarding the examples shared, Systems Development Life Cycle SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues. Initial Post

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Respond by offering additional thoughts regarding the  examples shared, Systems Development Life Cycle SDLC-related issues, and  ideas on how the inclusion of nurses might have impacted the exampl

Consequences of a Healthcare Organization not Involving Nurses

Nurses are the backbone of healthcare and when they are not involved in the design and decision-making processes of the Systems Development Life Cycle the results can be catastrophic. According to the authors Powell-Cope & Nelson (2008), nurses are the frontline and chief users of electronic health record (EHR) systems, it only makes sense they’d have a major say in EHR design and upgrades. Unfortunately, however, in many facilities, EHR design is left primarily to IT and only minor input is taken into consideration from the nursing staff. When subject matter experts, such as nurses, don’t have autonomy and responsibility within the design process, implementing and utilizing an EHR can take longer because providers are distanced from the outcomes (Powell-Cope & Nelson, 2008). 

Inclusion of Nurses in EHR Design

When nurses are included in technology design, it enables and enhances safety (Hamer & Cipriano, 2013). A study was done in 2009 on early nursing involvement during the implementation of a Bar Code Medication Administration (BCMA) system. The authors of this study describe how nurses participated in the early design, planning, implementation, and evaluation phases of the BCMA. The study found that the benefits of early nursing involvement in each phase of BCMA technology greatly outweigh the problems that can arise from early nursing involvement (Weckman & Jansen, 2009). This study found that in order to find success when implementing new technologies, it is essential that nurses be involved throughout all phases of the process. Comments and feedback from nurses provide the necessary clues that are needed to resolve underlying systemic issues and can offer possible resolutions.   

My Personal Input

My current healthcare facility is changing its EHR system to Epic. They have selected a specific team of nurses and nurse informaticists that are currently part of their healthcare team, to design and adapt the Epic program to meet the institution’s requirements. My facility has named their adaptation of the Epic EHR to Elle. The entire healthcare team has been invited to monthly townhouse meetings which involve disclosing the most recent updates made to Elle and team members are also encouraged to provide input on any modifications they would like to add to Elle. As critical nurses, we are excited that we will finally have a charting system that downloads our vital signs electronically. Before Elle, we had to write our vital signs every 15 minutes on each of our two patients. It might not seem like a big deal, but writing vital signs for two patients can take up a considerable amount of time, especially when a patient is unstable and on multiple drips. If nurses were not involved in the EHR design, downloading vital signs might be something that was overlooked again. 

ReferencesHamer, S., & Cipriano, P. (2013). Involving nurses in developing new technology. Nursing Times,     109(47). Powell-Cope, G., Nelson, A. L., & Patterson, E. S. (2008). Patient Care Technology and Safety.     Retrieved April 22, 2019, from https://www.ncbi.nlm.nih.gov/books/NBK2686/ Weckman, H. N., & Jansen, S. K. (2009). The Critical Nature of Early Nursing Involvement for     Introducing New Technologies. The Online Journal of Nursing Issues, 14(2).

For this assignment, you will be further defining your Phenomenon of Interest within a theoretical and ethical framework.

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I need a 8 page paper. This paper is related to my previous paper and I will provide the paper once you accept this paper. The paper needs to be written in APA format. For this assignment, you will b

I need a 8 page paper. This paper is related to my previous paper and I will provide the paper once you accept this paper. The paper needs to be written in APA format. 

For this assignment, you will be further defining your Phenomenon of  Interest within a theoretical and ethical framework.  The same  Phenomenon of Interest (POI) identified in your first written paper  should also be used for this assignment.  You will begin this paper by  providing a concise description of your POI, this information should be a  short summary of information your presented in your first paper.  

Next, you will  discuss the Fawcett’s Meta-paradigm of Nursing and  relate the paradigm directly to your POI. How do the four concepts  within the meta-paradigm relate to your POI? Is one more important? Do  all four have the same level of importance?  You should support this  section with peer reviewed references as appropriate.  Specifically  identify the components of the meta-paradigm within your discussion. Be  sure to reference the meta-paradigm with the primary source.  

Then, you will select both a Grand nursing theory as well as a Middle  range nursing theory.  Take time to review several examples of each type  of theory as the selected theories need to “fit” your POI…and work  well together.  

Grand  nursing theory discussion:  identify and discuss the  inter-related concepts from your selected theory.  What aspects of the  nursing meta-paradigm are addressed by your grand theory?  Then provide  information about how you will view your POI through the lens of the  grand theory.  How does the theory guide your assessment of the POI?   How does the theoretical framework chosen categorize or define your POI?  How does the theoretical framework effect your perception of the POI? 

Middle range nursing theory discussion: identify and discuss the  inter-related concepts within the middle range theory.  What aspects of  the nursing meta-paradigm are addressed in the mid-range theory? How  will this theory guide your assessment/perception of the POI?  How does  this mid range theory relate to your grand theory?  

Complexity science: how does complexity science relate to your POI?   Depending on the nature of your POI, this conversation may have  different foci for different students.  For example, if your POI is  glycemic management of the peri-operative patient, this discussion would  center on the complex responses of the human body as a Complex Adaptive  System.  If your POI is focused on a policy change issue, the focus may  be on organizational complexities with communication, change, etc.  Identify a specific Complex Adaptive System that is related to your  chosen POI and discuss how complexity science impacts this portion of  your POI.  

Ethical framework:  you should discuss your specific POI in the context  of ethical principles.  Basic principles include autonomy, justice,  beneficence, and non-maleficence. Is your POI in violation of a core  ethical principle?  Is it possible it may be in violation?  What ethical  principles do you need to be sure to safeguard?  You should also  identify a specific Ethical Framework that will guide your  practice…Virtue ethics, Utilitarianism, the ANA Code of Ethics, are  examples of an ethical framework. 

Conclusion:  this section should not contain any new information but  should only provide a summary of what what discussed in the paper. 

1. What demographic variables were measured at the nominal level of measurement in the Oh et al. (2014) study? Provide a rationale for your answer.

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Please see below and contact

Statistical Technique in Review

Most research reports describe the subjects or participants who comprise the study sample. This description of the sample is called the sample characteristics, which may be presented in a table and/or the narrative of the article. The sample characteristics are often presented for each of the groups in a study (i.e., intervention and control groups). Descriptive statistics are calculated to generate sample characteristics, and the type of statistic conducted depends on the level of measurement of the demographic variables included in a study (Grove, Burns, & Gray, 2013). For example, data collected on gender is nominal level and can be described using frequencies, percentages, and mode. Measuring educational level usually produces ordinal data that can be described using frequencies, percentages, mode, median, and range. Obtaining each subject’s specific age is an example of ratio data that can be described using mean, range, and standard deviation. Interval and ratio data are analyzed with the same statistical techniques and are sometimes referred to as interval/ratio-level data in this text.

Research Article

Source

Oh, E. G., Yoo, J. Y., Lee, J. E., Hyun, S. S., Ko, I. S., & Chu, S. H. (2014). Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: A randomized controlled trial. Research in Nursing & Health, 37(4), 292–301.

Introduction

Oh and colleagues (2014) conducted a randomized controlled trial (RCT) to examine the effects of a therapeutic lifestyle modification (TLM) intervention on the knowledge, self-efficacy, and behaviors related to bone health in postmenopausal women in a rural community. The study was conducted using a pretest-posttest control group design with a sample of 41 women randomly assigned to either the intervention (n = 21) or control group (n = 20). “The intervention group completed a 12-week, 24-session TLM program of individualized health monitoring, group health education, exercise, and calcium–vitamin D supplementation. Compared with the control group, the intervention group showed significant increases in knowledge and self-efficacy and improvement in diet and exercise after 12 weeks, providing evidence that a comprehensive TLM program can be effective in improving health behaviors to maintain bone health in women at high risk of osteoporosis” (Oh et al., 2014, p. 292).

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Relevant Study Results

“Bone mineral density (BMD; g/cm2) was measured by dual energy x-ray absorptiometry (DXA) with the use of a DEXXUM T machine . . . . A daily calibration inspection was performed. The error rate for these scans is less than 1%. Based on the BMD data, the participants were classified into three groups: osteoporosis (a BMD T-score less than −2.5); osteopenia (a BMD T-score between −2.5 and −1.0); and normal bone density (a BMD T-score higher than −1.0)” (Oh et al. 2014, p. 295).

“Characteristics of Participants

The study participants were 51–83 years old, and the mean age was 66.2 years (SD = 8.2). The mean BMI was 23.8 kg/m2 (SD = 3.2). Most participants did not consume alcoholic drinks, and all were nonsmokers. Antihypertensives and analgesics such as aspirin and acetaminophen were the most common medications taken by the participants. Less than 20% of participants had a regular routine of exercise at least three times per week. Daily calcium- and vitamin D-rich food intake (e.g., dairy products, fish oil, meat, and eggs) was low. Seventy-five percent (n = 31) of the participants had osteoporosis or osteopenia. There were no differences in the baseline characteristics of the groups (Table 2). The adherence rate to the TLM program was 99.6%” (Oh et al., 2014, p. 296).

TABLE 2

BASELINE CHARACTERISTICS AND HOMOGENEITY OF THE TREATMENT AND CONTROL GROUPS

Intervention (n = 21)Control (n = 20)CharacteristicMean ± SD Mean ± SD t or χ2 a 

Anthropometric Age (years)65.95 ± 8.5966.35 ± 7.940.154 Height (cm)152.33 ± 6.53150.57 ± 6.010.896 Weight (kg)57.90 ± 10.8554.66 ± 9.481.016 BMI (kg/m2)24.17 ± 3.1423.38 ± 3.320.782Lifestyle Years since menopause20.21 ± 10.4417.5 ± 11.050.767 Calcium-rich food intake (times/week)27.3 ± 11.423.8 ± 8.81.110 Vitamin D-rich food intake (times/week)2.4 ± 2.53.1 ± 3.10.705Intervention (n = 21) Control (n = 20) Characteristic n  %  n  % t or χ2  a    History of fracture8385251.026 Regular exercise (≥3 times/week)4194200.006 Non-drinker (alcohol)2095201000.024 Non-smoker21100201000.024Bone statusb   Normal (T ≥ −1.0)6294201.995 Osteopenia (−1.0 > T > −2.5)8381260 Osteoporosis (T ≤ −2.5)733420Intervention (n = 21) Control (n = 20) Characteristic Mean ± SD  Mean ± SD  t or χ2  a   BMD Lumbar 2–40.83 ± 0.120.85 ± 0.200.526 Femur neck0.67 ± 0.150.67 ± 0.130.055Bone biomarkers Serum osteocalcin (ng/ml)13.97 ± 4.9015.85 ± 5.641.135 Serum calcium (mg/dl)9.47 ± 0.409.54 ± 0.590.405 Serum phosphorus (mg/dl)3.68 ± 0.443.70 ± 0.500.165 Serum alkaline phosphatase (IU/L)68.43 ± 21.5266.70 ± 13.240.308 Serum 25-OH-Vitamin D (ng/ml)14.03 ± 4.3412.38 ± 4.651.177 Urine deoxypyridinoline (nM/mM creatinine)5.70 ± 1.705.95 ± 1.120.555

image

a All group differences p > 0.05.

b Defined from T-score of femur neck site based on World Health Organization criteria.

Note. SD, standard deviation; BMD, bone mineral density (g/cm2).

Oh, E. G., Yoo, J. Y., Lee, J. E., Hyun, S. S., Ko, I. S., & Chu, S. H. (2014). Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: A randomized controlled trial. Research in Nursing & Health, 37(4), p. 297.

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Study Questions

1.  What demographic variables were described in this study?

2.  Which variable was measured at the ordinal level? Provide a rationale for your answer.

3.  What level of measurement is the data for history of fracture? Provide a rationale for your answer.

4.  What statistics were calculated to describe history of fracture? Were these appropriate? Provide a rationale for your answer.

5.  Could a mean be calculated on the history of fracture data? Provide a rationale for your answer.

6.  What statistics were calculated to describe the regular exercise (≥3 times per week) for the intervention and control groups? Calculate the frequency and percentage of the total sample who exercised regularly. Round your answer to the nearest tenth of a percent.

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7.  What statistics were calculated to describe age in this study? Were these appropriate? Provide a rationale for your answer.

8.  Were the intervention and control groups significantly different for age? Provide a rationale for your answer.

9.  What was the mode for bone status for the total sample (N = 41)? Determine the frequency and percentage for the bone status mode for the sample. Round your answer to the nearest whole percent. Why is this clinically important?

10.  Based on the bone status of the study participants, discuss the clinical importance of this study. Document your response.

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Answers to Study Questions

1.  Demographic variables described in the study were age, height, weight, body mass index (BMI), lifestyle (years since menopause, calcium-rich food intake, vitamin D-rich food intake), history of fracture, regular exercise, alcohol consumption, and smoking. You might have identified the bone status, bone mineral density (BMD), and bone biomarkers but these are dependent variables for this study (Grove et al., 2013).

2.  The variable bone status provided ordinal-level data. The researchers classified the participants into three groups, normal (T-score higher than −1.0), osteopenia (T-score between −1.0 and −2.5), and osteoporosis (T-score less than −2.5), based on their BMD scores. These categories are exhaustive, mutually exclusive, and can be ranked from greatest or normal BMD to osteoporosis or least BMD.

3.  The data collected for history of fracture are nominal level, including the two categories of no history of fracture and yes history of fracture. These categories are exhaustive and mutually exclusive, since all study participants will fit into only one category. These yes and no categories of history of fracture cannot be ranked so the data are nominal versus ordinal level (see Exercise 1).

4.  Frequencies and percentages were used to describe history of fracture for the intervention and control groups. Since the data are nominal, frequencies and percentages were appropriate. The researchers might have also identified the mode, which was no history of fracture since 13 participants had a history of fracture and 28 had no history of fracture.

5.  No, a mean cannot be calculated on the history of fracture data, which are nominal-level data that can only be organized into categories (see Exercise 1). A mean can only be calculated on interval- and ratio-level data that are continuous and have numerically equal distances between intervals.

6.  Regular exercise was described for both the intervention and control groups using frequencies and percentages. A total of 8 or 19.5% of the participants exercised regularly. Eight of the participants (4 in the intervention and 4 in the control groups) were involved in regular exercise of the sample (N = 41). Percentage = (8 ÷ 41) × 100% = 0.1951 × 100% = 19.51% = 19.5%. Researchers also indicated in the narrative that less than 20% of the participants were involved in regular exercise, supporting the importance of providing these individuals with an exercise program.

7.  Age was described with means and SDs for the intervention and control groups (see Table 2). In the narrative, the range of ages for the participants was identified as 51–83 years, and the mean age for the total sample was 66.2 years (SD = 8.2). The statistics were appropriate since age was measured in years, which are ratio-level data that are analyzed with mean, SD, and range (Grove et al., 2013).

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8.  No, the groups were not significantly different for age. The results from the t-test (t = 0.154) indicated that the groups were not significantly different for age. In addition, the bottom of Table 2 states that all group differences were p > 0.05. The level of significance (alpha) in nursing studies is usually set at α = 0.05, and since all differences were p > 0.05, then no significant differences were found for the baseline characteristics between the intervention and control groups.

9.  The mode was osteopenia for the intervention and the control groups. The number and percentage of participants with osteopenia for the sample was (8 + 12) ÷ 41 × 100% = (20 ÷ 41) × 100% = 0.488 × 100% = 48.8% = 49%. It is clinically important that 49% of the women in the study had osteopenia or thinning bones and needed assistance in managing their bone health problem. Also 11 participants had osteoporosis or holes in their bones, an even more serious condition, requiring immediate and aggressive management to prevent fractures.

10.  Oh et al. (2014) indicated that 75% (n = 31) of the study participants had osteopenia or osteoporosis. So it is important for these individuals to have their bone health problem diagnosed and managed. The TLM program is multifaceted and has the potential to reduce these women’s bone health problems (osteopenia and osteoporosis). Additional research is needed to determine the effect of this intervention with larger samples and over extended time periods. National guidelines and important information about the assessment, diagnosis, and management of osteoporosis and osteopenia might be found at the following website: http://www.guideline.gov/search/search.aspx?term=osteoporosis or the National Osteoporosis Foundation (NOF) website at http://www.nof.org. You might use a variety of resources for documentation including research articles, websites, and textbooks.

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EXERCISE 10 Questions to Be Graded          (NEED THESE QUESTIONS ANSWERED)

Follow your instructor’s directions to submit your answers to the following questions for grading. Your instructor may ask you to write your answers below and submit them as a hard copy for grading. Alternatively, your instructor may ask you to use the space below for notes and submit your answers online at http://evolve.elsevier.com/Grove/statistics/ under “Questions to Be Graded.”

Name: _______________________________________________________ Class: _____________________

Date: ___________________________________________________________________________________

1.  What demographic variables were measured at the nominal level of measurement in the Oh et al. (2014) study? Provide a rationale for your answer.

2.  What statistics were calculated to describe body mass index (BMI) in this study? Were these appropriate? Provide a rationale for your answer.

3.  Were the distributions of scores for BMI similar for the intervention and control groups? Provide a rationale for your answer.

4.  Was there a significant difference in BMI between the intervention and control groups? Provide a rationale for your answer.

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5.  Based on the sample size of N = 41, what frequency and percentage of the sample smoked? What frequency and percentage of the sample were non-drinkers (alcohol)? Show your calculations and round to the nearest whole percent.

6.  What measurement method was used to measure the bone mineral density (BMD) for the study participants? Discuss the quality of this measurement method and document your response.

7.  What statistic was calculated to determine differences between the intervention and control groups for the lumbar and femur neck BMDs? Were the groups significantly different for BMDs?

8.  The researchers stated that there were no significant differences in the baseline characteristics of the intervention and control groups (see Table 2). Are these groups heterogeneous or homogeneous at the beginning of the study? Why is this important in testing the effectiveness of the therapeutic lifestyle modification (TLM) program?

9.  Oh et al. (2014, p. 296) stated that “the adherence rate to the TLM program was 99.6%.” Discuss the importance of intervention adherence, and document your response.

10.  Was the sample for this study adequately described? Provide a rationale for your answer.

2. To practice medicine, in most states, a physician must complete all of the following except:

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HCA200 UNIT 2 EXAM (ANSWER 100%)

Question

1. Understanding the musculoskeletal system and employing a holistic approach describes _________ medicine.

a. alternative

b. allopathic

c. osteopathic

d. homeopathic

2. To practice medicine, in most states, a physician must complete all of the following except:

a. complete paid on-the-job training.

b. graduate from a formal educational program.

c. pass a licensing exam.

d. serve as a health aide.

3. According to the text, all of the following are issues for the medical profession except:

a. quality of care.

b. access to care.

c. managed care.

d. oversupply of physicians.

4. According to the 2007 physician characteristics data, approximately _________.

a. 91% are men and 8% are women.

b. 49% are men and 50% are women.

c. 71% are men and 29% are women.

d. 55% are men and 44% are women.

5. Gastroenterologists specialize in the diagnosis and treatment of _________.

a. diseases and disorders of the stomach and intestine

b. diseases and disorders of the mind

c. acute illness or injury

d. changes in organs, tissues, and cells

6. Psychiatrists specialize in the diagnosis and treatment of _________.

a. diseases and disorders of the stomach and intestine

b. diseases and disorders of the mind

c. changes in organs, tissues, and cells

d. acute illness or injury

7. Before a surgeon can begin open heart surgery, which physician specialist must assure that the

patient doesn’t feel anything?

a. Anesthesiologist

b. Cardiovascular physician

c. Radiologist

d. Orthopedist

8. Which nursing professional performs many duties similar to a physician?

a. RN

b. CNA

c. LPN

d. NP

9. RNs can have any of the following as minimal education in order to practice except:

a. certificate.

b. associate’s degree.

c. bachelor of science.

d. hospital diploma program.

10. The average salary of an RN is _________.

a. $40,000

b. $50,000

c. $60,000

d. $70,000

11. Nurse Practice Acts _________.

a. contain the states’ requirements for practice

b. specify what educational, clinical, and licensure requirements are necessary to practice in a state

c. are the same in all 50 states

d. are waived in long-term care

12. Medical school tuition and fees have increased by ________% in public schools since 1984.

a. 50

b. 100

c. 133

d. 66

13. Health administration is concerned about all of the following except:

a. patient care.

b. profitability.

c. the local EMS system.

d. marketing.

14. A CT _________.

a. uses radiation to produce images

b. takes a cross-sectional view of a patient’s body

c. resulted in the passage of the Consumer-Patient Health and Safety Act

d. uses radio waves to produce images

15. Tests using sound waves may be performed by _________.

a. EKG technicians

b. vascular technologists

c. cardiology technologists

d. nuclear medicine technologists

16. Medical technicians usually have a(n) _________.

a. associate’s degree

b. 1-year certi? cate

c. master’s degree

d. bachelor’s degree

17. Coders would least likely be found in _________.

a. private billing practices

b. government agencies

c. medical clinics

d. occupational therapy

18. Activities of daily living therapy is in the domain of the _________.

a. pharmacist

b. occupational therapist

c. physical therapist

d. speech-language pathologist

19. Which pharmacy professional typically counts tablets and labels bottles?

a. Pharmacy technician

b. Pharmacy aide

c. Pharmacist

d. Pharmacy technologist

20. Which of the following occupations does not require a bachelor’s degree?

a. Respiratory therapist

b. Occupational therapist

c. Optometrist

d. Recreational therapist

21. The practice of a chiropractor is focused on _________.

a. the spine

b. the foot

c. the eyes

d. the teeth

22. All of the following are true of optometrists except:

a. they provide primary care.

b. they prescribe corrective lenses.

c. they perform eye surgery.

d. they manage macular degeneration.

23. Ultrasonography uses sound waves to generate an image to assess and diagnose medical conditions. The professionals who performs such tests are called __________.

a. imaging technologists

b. nuclear technologists

c. medical sonographers

d. phlebotomists

24. All of the following may be areas of practice for the professional in information technology except:

a. coding of services.

b. risk management.

c. data analysis.

d. website management.

25. Medical transcriptionists can be found in all of the following settings except:

a. hospitals.

b. physicians’ offices.

c. home businesses.

d. cardiovascular labs.

13. Characteristics of home 14. Characteristics of neighborhood and larger community

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Family Assessment

Hi Ultimate Writer,

Can you help me with my homework. 

5 pages, APA, use Rubric 1-6 and Friedman Family Assessment-1-17 short answers, and choose 1 from family structure and  1 from family function. Family theorist is Murary Bowen or one you choose. Thanks.

Toni

Friedman Family Assessment—Short form

Identifying Data

1. Family name 

2. Address and phone  3. Family composition 4. Type of family form 5. Cultural (ethnic) background  6. Religious identification 7. Social class status 8. Family’s recreational or leisure-time activities 

Developmental Stage and History of Family

9. Family’s present developmental stage 10. Extent of family developmental tasks fulfillment

11. Nuclear family history 12. History of family of origin of both parents

Environmental Data

13. Characteristics of home 14. Characteristics of neighborhood and larger community

15. Family’s geographic mobility 16. Family’s associations and transactions with community

17. Family’s social support system or network

Family Structure

18. Communication patterns       Extent of functional and dysfunctional communication       (types of recurring patterns)       Extent of emotional (affective) messages and how expressed Characteristics of               

            communication within family subsystems Extent of congruent and incongruent messages             Types of dysfunctional communication processes seen in family Areas of open and      

            closed communication             Familial and contextual variables affecting communication

19. Power structure Power outcomes

      Decision-making process       Power bases       Variables affecting family power       Overall family system and subsystem power (Family power continuum placement)

20. Role structure       Formal role structure       Informal role structure      Analysis of role models (optional) Variables affecting role structure

21. Family values       Compare the family to American or family’s reference group values and/or identify     

            important family values and their importance (priority) in family.             Congruence between the family’s values and the family’s reference group or wider      

            community

      Congruence between the family’s values and family member’s values Variables     

      influencing family values       Values consciously or unconsciously held       Presence of value conflicts in family

      Effect of the above values and value conflicts on health status of family

Family Functions

22. Affective function       Family’s need–response patterns       Mutual nurturance, closeness, and identification Separateness and connectedness

23. Socialization function       Family child-rearing practices       Adaptability of child-rearing practices for family form and family’s situation       Who is (are) socializing agent(s) for child(ren)?       Value of children in family       Cultural beliefs that influence family’s child-rearing patterns       Social class influence on child-rearing patterns       Estimation about whether family is at risk for child-rearing problems and if so, indication       

            of high risk factors             Adequacy of home environment for children’s need to play

24. Health care function       Family’s health beliefs, values, and behavior       Family’s definitions of health–illness and their level of knowledge Family’s perceived         

      health status and illness susceptibility       Family’s dietary practices      Adequacy of family diet (recommended 3-day food history record) Function of mealtimes       

      and attitudes toward food and mealtimes Shopping (and its planning) practices       Person(s) responsible for planning, shopping, and preparation of meals Sleep and rest       

      habits       Physical activity and recreation practices (not covered earlier)       Family’s drug habits       Family’s role in self-care practices       Medically based preventive measures (physicals, eye and hearing       tests, and immunizations)       Dental health practices       Family health history (both general and specific diseases— environmentally and      

      genetically related)       Health care services received       Feelings and perceptions regarding health services       Emergency health services       Source of payments for health and other services       Logistics of receiving care

Family Stress and Coping

25. Short- and long-term familial stressors and strengths

26. Extent of family’s ability to respond, based on objective

      appraisal of stress-producing situations

      Coping strategies utilized (present/past)

      Differences in family members’ ways of coping Family’s inner coping strategies       Family’s external coping strategies

      Dysfunctional adaptive strategies utilized (present/past; extent of usage)

Name (last, first)

1.     (Father)

2.     (Mother)

3.     (Oldest child)

4. 5. 6. 7. 8.

Friedman, M. M., Bowden, V. R., & Jones, E. G. (2003).  Family nursing:  Research,

theory and practice (5th ed.).  Upper Saddle River, NJ:  Prentice Hall/Pearson Education.

Structure & Function—Family Theory/Friedman (2003):

STRUCTURE:  Refers to how family is organized, and how they relate to each other & to the whole.  Four interactive & interrelated dimensions: 

1.     Role systems

2.     Value Systems

3.     Communication networks

4.     Power Structure

FUNCTION:  Refers to how families go about meeting needs of individuals and broader society.  Family functions are what a family does.  Five family function dimensions:

1.     Affective

2.     Socialization

3.     Reproductive

4.     Health care

5.     Economic

Additionally….  How a family deals with stress, coping, adaptation, and SPIRITUALITY are all important in our assessments of families.

Identify organizational factors that impact the situation using a SWOT analysis.

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org assmt 3

Required Resources

The following resources are required to complete the assessment.

Resources

Click the link provided to view the following resource:

.

Suggested Resources

The following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom.

Multimedia

Click the links provided below to view the following multimedia pieces:

Systems Theory and the Fifth Discipline | Transcript.

Riverbend City: Getting Started | Transcript.

Riverbend City: Decision Mission | Transcript. Consider the elements that needed to be taken into consideration as the nurse leader made her decision.

Riverbend City: Needs Priorities Mission | Transcript.

Library Resources

The following e-books or articles from the Library are linked directly in this course:

Grossman, S. C., & Valiga, T. M. (2013). Chapter 1: The nature of leadership: Distinguishing leadership from management. In New leadership challenge: Creating the future of nursing (4th ed., pp. 1–7). Philadelphia, PA: F. A. Davis.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32–37.

Clancy, T. R., Effken, J. A., & Pesut, D. (2008). Applications of complex systems theory in nursing education, research, and practice. Nursing Outlook, 56(5), 248–256.

Salmela, S., Eriksson, K., & Fagerström, L. (2013). Nurse leaders’ perceptions of an approaching organizational change. Qualitative Health Research, 23(5), 689–699.

Painter, K., Reid, S., & Fuss, E. P. (2013). The evolution of nursing shared governance at a community hospital. Nursing Management, 44(8), 10–14.

Martin, D., Godfrey, N., & Walker, M. (2015). The baccalaureate big 5: What Magnet® hospitals should expect from a baccalaureate generalist nurse. The Journal of Nursing Administration, 45(3), 121–123.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32–37.

Bamford-Wade, A., & Moss, C. (2010). Transformational leadership and shared governance: An action study. Journal of Nursing Management, 18(7), 815–821.

Azaare, J., & Gross, J. (2011). The nature of leadership style in nursing management. British Journal of Nursing, 20(11), 672–680.

Tomlinson, J. (2012). Exploration of transformational and distributed leadership. Nursing Management, 19(4), 30–34.

Internet Resources

Access the following resources by clicking the links provided. Please note that URLs change frequently. Permissions for the following links have been either granted or deemed appropriate for educational use at the time of course publication.

MindTools. (n.d.). SWOT analysis: Discover new opportunities, manage and eliminate threats. Retrieved from https://www.mindtools.com/pages/article/newTMC_05.htm

Agency for Healthcare Research and Quality. (n.d.). AHRQ. Retrieved from http://www.ahrq.gov

American Organization of Nurse Executives. (n.d.). AONE. Retrieved from http://www.aone.org

AONE. (n.d.). Toolkit for the role of the nurse in future patient care delivery. Retrieved from http://www.aone.org/resources/caredeliverypuzzle.shtml

Sherman, R., & Pross, E. (2010). Growing future nurse leaders to build and sustain healthy work environments at the unit level. The Online Journal of Issues in Nursing, 15(1). Retrieved from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol152010/No1Jan2010/Growing-Nurse-Leaders.html

Institute for Healthcare Improvement. (n.d.). Retrieved from http://www.ihi.org/Pages/default.aspx

National Academy of Medicine. (n.d.). Retrieved from http://nam.edu

Institute of Medicine of the National Academies. (n.d.). The future of nursing: Leading change, advancing health. Retrieved from https://iom.nationalacademies.org/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

Bookstore Resources

The resources listed below are relevant to the topics and assessments in this course and are not required. Unless noted otherwise, these materials are available for purchase from the When searching the bookstore, be sure to look for the Course ID with the specific –FP (FlexPath) course designation.

Huber, D. L. (2010). Leadership and nursing care management (5th ed.). Maryland Heights, MO: W. B. Saunders.

Chapter 1–4.

Chapter 9.

Chapter 14.

Chapter 17–18.

Preparation

Use the Suggested Resources for this assessment to study systems theory, SWOT analysis, and shared governance teams, as background for an Impact Report to Senior Leadership. The report includes a SWOT analysis. The SWOT Analysis Template is linked in Required Resources.

Study a facility in your area and examine its Web site and any available public documents to aid you in completing this assessment. You may wish to examine an organization where you work, where you have worked in the past, or where you did your clinical work.

Do not name the organization in your report; instead, identify the type of facility and location. Example: A rehabilitation center in a mid-size Midwestern city.

Use the following scenario as the basis for your report:

Scenario

The unit-based Shared Governance Council of the organization where you work has identified a major nursing-related challenge (patient/staff safety, confidentiality, management/staff conflict, poor patient satisfaction survey scores, or nursing staff shortages) within your health care organization.

In an unusual move, your system administrator is considering creating a new nurse leadership position that would have the responsibility and authority to address this specific issue. As a member of the shared governance council’s subcommittee, you have been asked to write the committee’s final report.

Deliverable: Impact Report to Senior Leadership

Write a 4–5-page Impact Report to senior leadership that identifies the challenge, analyzes how it affects the organization from a nursing perspective, and details the new position.

Use systems thinking and leadership theory as tools to approach this problem.

Construct the report with the following headings:

The Nursing Challenge:

Identify the nursing challenge and its impact from a nursing perspective. Choose from:

Patient/staff safety, confidentiality, management/staff conflict, poor patient satisfaction survey scores, or nursing staff shortages.

The System/Organization:

Explain how the nursing challenge creates a gap or conflict between the organization’s statements and practice.

Identify the organization type, that is, specialty hospital, teaching hospital, major health care system, et cetera, and summarize the organizational structure, its mission, vision, and philosophy statements.

Use systems theory and systems thinking to explain the gap or conflict.

SWOT Analysis:

Use the SWOT Analysis Template linked in Required Resources and include the SWOT analysis table in your paper.

Identify organizational factors that impact the situation using a SWOT analysis.

For example, a budget cut may cause short staffing, which relates directly to the problem.

What factors within the system may facilitate a solution for this problem?

The Position:

Assess how the new nurse leader position will have power and influence and impact patient outcomes.

How will this position affect change within the organization?

Identify key leadership skills, knowledge, or abilities required for the position.

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: The report should be 4–5 pages in content length. Include a separate title page and a separate reference page.

Font and font size: Times New Roman, 12 point, double-spaced.

Number of resources: Use a minimum of three peer-reviewed resources

PLEASE USR PROPER APA FORMAT AND INCORPORATE SWOT ANALYSIS AS NEEDED AND NO MORE THAN 5 PAGES PLEASE

Discuss nurse-specific challenges in influencing change in quality improvement.

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Discussion: Promoting Safety and Quality

Week 6: Accountability for Clinical Outcomes and Promoting Safety and Quality

Introduction

Throughout your education, patient safety and improving the quality of patient care have been examined. Through numerous readings and media pieces, you have heard about Never Events. These are serious and costly medical errors that are preventable, such as wrong-side surgery, medication errors, and hospital-acquired infections. Each of these types of medical errors is preventable. The consequences of such errors are now financial as well as legal and emotional. The Centers for Medicare & Medicaid Services no longer reimburse for medical errors classified as Never Events.

As a nurse, how can you help to prevent these types of medical errors? What is your accountability for clinical outcomes? There are standards and core measures in place that guide nursing practice. In addition, the National Database of Nursing Quality Indicators (NDNQI) examines those components of clinical care that are specific to nursing. The NDNQI quantifies, or assesses, these nurse-sensitive components and provides specific feedback on how well nursing practice is being executed in those areas related to patient care.

This week, you will consider a series of articles that focus on strategies for ensuring safety and quality care for patients. You will also explore how successful, efficient teamwork between nurses, nursing leaders, physicians, and other medical personnel can help prevent many of the Never Events from occurring and decrease the likelihood of such events in the future.

Learning Objectives

Students will:

  • Analyze the core measures and standards for nursing practice that promote patient safety and quality of care outcomes
  • Analyze the impact of the nurse’s role in clinical outcomes for organizations
  • Analyze nurse-specific challenges for influencing change in quality improvement
  • Analyze the role of the nurse in supporting the organization’s strategic agenda in improving clinical outcomes

Photo Credit: PhotoAlto/Odilon Dimier / PhotoAlto Agency RF Collections / Getty Images

Learning Resources

Prior Knowledge

It is not uncommon for students to be required to complete group projects or to work as part of a team. While obtaining your RN credentials, or at some time in your work career, you have more than likely at some point been part of a unit or a collaborative team. Reflect on that experience of working with others to achieve a common goal. How did the actions of your team members impact your success as a team? Consider how this same philosophy applies within an organization. How might the actions of the individuals influence the success of the organization?

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

Amin, A. N., Hofmann, H., Owen, M. M., Tran, H., Tucker, S., & Kaplan, S. H. (2014). Reduce readmissions with service-based care management. Professional Case Management, 19(6), 255–262. doi: 10.1097/NCM.0000000000000051

Note: You will access this article from the Walden Library databases.

Forster, A. J., Dervin, G., Martin, C., & Papp, S. (2012). Improving patient safety through the systematic evaluation of patient outcomes. Canadian Journal of Surgery, 55(6), 419–425. doi: 10.1503/cjs.007811

Note: You will access this article from the Walden Library databases.

Johansen, M. L. (2014). Conflicting priorities: Emergency nurses perceived disconnect between patient satisfaction and the delivery of quality patient care. Journal of Emergency Nursing, 40(1), 13–19. doi: 10.1016/j.jen.2012.04.013

Note: You will access this article from the Walden Library databases.

McDowell, D. S., & McComb, S. A. (2014). Safety checklist briefings: A systematic review of the literature. AORN, 99(1), 125–137. doi: 10.1016/j.orn.2013.11.015

Note: You will access this article from the Walden Library databases.

Payne, D. (2014). Elderly care: Reflecting on that ultimate ‘never event.’ British Journal of Nursing, 23(13), 702. doi: 10.12968/bjon.2014.23.13.702

Note: You will access this article from the Walden Library databases.

Thornlow, D. K., & Merwin, E. (2009). Managing to improve quality: The relationship between accreditation standards, safety practices, and patient outcomes. Health Care Management Review, 34(3), 262–272. doi: 10.1097/HMR.0b013e3181a16bce

Note: You will access this article from the Walden Library databases.

American Hospital Association. (2016). Retrieved from http://www.aha.org/

Explore the American Hospital Association’s website. Focus on the information on improving patient safety and quality of care.

American Organization of Nurse Executives. (2016). Retrieved from http://www.aone.org

“Since 1967, the American Organization of Nurse Executives (AONE) has provided leadership, professional development, advocacy and research to advance nursing practice and patient care, promote nursing leadership excellence and shape public policy for health care nationwide. AONE is a subsidiary of the American Hospital Association” (AONE, 2016).

Centers for Medicare & Medicaid Services. (n.d.). Quality of care center. Retrieved August 11, 2016, from http://www.cms.gov/Center/Special-Topic/Quality-of-Care-Center.html?redirect=/center/quality.asp

Most health care organizations receive some amount of reimbursement from the Centers for Medicare & Medicaid Services (CMS). Reimbursement continues to be jeopardized and reduced by pay for performance standards. Health care organizations are being held to higher standards by CMS. Explore the standards set to improve patient safety and the quality of care. Consider how they affect acute care providers and nursing practice.

The National Academies of Sciences, Engineering, and Medicine. (2016). Health and Medicine Division. Retrieved from http://www.nationalacademies.org/hmd/

The Health and Medicine Division (HMD) promotes policies and best practices in an effort to improve patient safety and delivery of quality care. Review a few of the publications available at this site.

The Joint Commission. (2016). National Quality Forum (NQF) endorsed nursing-sensitive care performance measures. Retrieved from http://www.jointcommission.org/national_quality_forum_nqf_endorsed_nursing-sensitive_care_performance_measures/

The Joint Commission (TJC) also accredits health care organizations. Through funding provided by the Robert Wood Johnson Foundation, the Joint Commission developed the Implementation Guide for the National Quality Forum (NQF) Endorsed Nursing-Sensitive Care Performance Measures. Review this guide as you consider how core measures and national guidelines improve nursing practice.

Required Media

Laureate Education. (Producer). (2009b). Topics in clinical nursing: Accountability for clinical outcomes and promoting safety and quality [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 15 minutes.

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

Discussion: Promoting Safety and Quality

In the article “Managing to Improve Quality: The Relationship Between Accreditation Standards, Safety Practices, and Patient Outcomes,” the authors discuss the growing trend by medical insurance companies to eliminate reimbursement for Never Events. As these types of mistakes should be easily preventable, hospitals have developed protocols to lessen or extinguish the occurrence of these events. In addition, The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) have developed core measures to guide health care providers’ efforts in improving patient safety and the quality of care delivered.

Health care organizations have developed strategic agendas to help meet these standards and reduce the incidence of Never Events. Nurses significantly influence the overall quality of health care provided and play a pivotal role in improving patient outcomes.

For this Discussion, you will consider the standards that are in place for nurses and how they can be used to improve quality of care.

To prepare for this Discussion:

  • Review the information at the Joint Commission and Centers for Medicare & Medicaid Services websites on the core measures and standards presented in this week’s Learning Resources.
  • Consider the nurse’s role in supporting the organization’s strategic agenda as it relates to improving clinical outcomes.
  • Conduct an Internet search for either a Never Event or a core measure, and select one to address in your post.

By Day 3

Respond to the following:

  • How has the emphasis on quality of care, patient safety, and clinical care outcomes been impacted by specific standards emanating from TJC and/or CMS? Cite your selected core measure or Never Event in your response.
  • What is the impact of the nurse’s role in clinical outcomes for the organization?
  • Discuss nurse-specific challenges in influencing change in quality improvement.
  • How does this influence the ability of the organization to achieve its strategic agenda?

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).

Read two or more of your colleagues’ postings from the Discussion question (support with evidence if indicated).