Respond to the post bellow (positive comment), using one or more of the following approaches:Ask a probing question, substantiated with additional background information, and evidence.Share an insight

Respond to the post bellow (positive comment), using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

                                                          Main post

In order to improve patient outcomes and ensure appropriate decision making, it is essential that evidence-based practice (EBP) be incorporated into patient clinical experiences (Polit & Beck, 2017). EBP should be a priority in this current day and age of healthcare. Patient healthcare decisions should be designed according to the most up to date available clinical evidence. This clinical evidence should be focused on safe and efficient patient care. In many facilities, my own included, EBP is encouraged to be incorporated into daily clinical practice. Unfortunately, the practical process and resources that are necessary for achieving EBP are frequently not available or successful (Aitken et al., 2011). In order to improve and increase EBP utilization in healthcare, nurse-led EBP programs have been put in place. My current institution is currently trialing a nurse-led EBP in the ICU. This program consists of 3 nurses that complete daily rounds in the ICU to evaluate the efficacy of specific protocols or products such as oral care on ventilated patients being completed every 2 hours. 

According to Cullen & Adams (2012), nurse-led research is increasingly recognized as an essential pathway to effective and practical was of improving patient outcomes. The dissemination of EBP should be a top priority. Effective dissemination strategies provide a pathway for knowledge to be shared and inspire further innovations. In order to disseminate EBP findings, my institution uses its website to post the most current and up to date clinical findings. The healthcare staff members are expected to review newly posted information on a weekly basis. When it comes to instituting an excellence-focused culture in healthcare, nursing research and EBP are required along with the integration of a professional practice model (Aitken et al., 2011). In order to achieve this great feat, nurses and all healthcare staff alike need to be encouraged to participate in scholarly activities (Aitken et al., 2011). Healthcare institutions should also have readily available resources for nurses and staff members to investigate the most current EBP methods.  

Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence-based practice: A developmental process. Australian Critical Care, 24(4), 244–254.

Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230.

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

ary is a 35 years old electrical engineer who presents to the office for evaluation of a rash on her face that has been present for 1 week. She denies new soaps, detergents, lotions, environmental ex

Mary is a 35 years old electrical engineer who presents to the office for evaluation of a rash on her face that has been present for 1 week. She denies new soaps, detergents, lotions, environmental exposures, medications, and foods. The rash is across her face and the bridge of her nose. She states that she first noticed it after spending a week hiking and camping in the Appalachians. The lesions itch and are painful. She has not tried anything to make it better, but she has noticed that going outdoors makes it worse. She denies any spread of the rash to other areas. She has never had this rash before.

She has noticed some increased fatigue, fever, and weight loss. She denies headache, sore throat, ear pain, nasal or sinus congestion, chest pain, shortness of breath, cough, abdominal pain, and pain with urination, constipation, or diarrhea. She does have mouth soreness. She has noticed some increased muscle aches and pains, which are worse in the hand and wrist. She denies early morning joint stiffness or difficulty with being able to move in the morning. She denies temperature intolerance, polyuria, polydipsia, or polyphagia.

She had a tonsillectomy at age 9 for chronic strep throat infections. She has been healthy as an adult. She has never had children. She has never been hospitalized for any reason.

Her family history is significant for a mother with rheumatoid arthritis. Her father is healthy.

She does not smoke; she drinks a glass of wine nearly every night with her dinner; she denies illicit drug use. She completed a master’s degree in engineering. She has lived with her boyfriend for the past 5 years.

Patient is an alert young woman, sitting comfortably on the examination table. BP 112/66 mm Hg; HR 62 BPM and regular; respiratory rate 12 breaths/min; temperature 100.3°F. Several erythematous plaques scattered over the cheeks and the bridge of nose, sparing the nasolabial folds. Normocephalic, atraumatic. Sclera white, conjunctivae clear; pupils constrict from 4 mm to 2 mm and equal, round, and reactive to light and accommodation. Oropharynx moist with erythema in the posterior pharyngeal wall; no exudates; shallow ulcers in the buccal mucosa bilaterally. Neck supple without cervical lymphadenopathy or thyromegaly. Full range of motion; no swelling or deformity; muscles with normal bulk and tone.

Instructions:

Make a whole history and physical examination in a comprehensive manner with all its elements included: CC, HPI, PMH, FH, SH, MEDICATIONS, ALLERGIES, ROS PER APPARATUS OR SYSTEMNS, HEAD TO TOE PHYSIACL EXAMINATION PER SYSTEMS ( write your presentation in H&P format no paragraph format).

           Based on this information, what is your presumptive nursing diagnosis? All nursing diagnosis that apply to the case written in NANDA format related to … and evidence by…., NO MEDICAL DIAGNOSIS.

   Teaching plan and nursing care plan per each nursing diagnosis on this case.

Requirements.

           1- All written assignment and documentations must be  in APA 6th edition format.

           2- Double spaces, minimum 4 pages long , minimum 3 up to date bibliography. (UP to date means last 3 years.), Note: you can use your test book as bibliography too, bibliography have to be written in APA format.

Class 1 Unit 4 DISCUSSION (DQ)

Purpose

DISCUSSION: 

Opinion Leader Perspectives

Consider some of the situations that motivated you to return to graduate school. Describe one in which you were (or wished you could have been) an opinion leader. What are the characteristics of opinion leaders? In what ways do you see yourself being an opinion leader?

1. Textbook Readings

Advanced Practice Nursing: An Integrative Approach

•Chapter 11: “Leadership”

1. THINGS TO REMEMBER: 

• Discussion post is at least 200 words. 
• Answers all questions with opinions/ideas creatively and clearly. Supports post using several   outside, peer-reviewed sources. 
• 3 References, try to find resources that are 5 years or less
• No errors with APA format.

 Describe at least four factors that can be associated in a complex inheritance health issue.B. Compare two genomic tests used for screening, diagnosis, and management of a disease. Describe whether

A. Describe at least four factors that can be associated in a complex inheritance health issue.

B. Compare two genomic tests used for screening, diagnosis, and management of a disease. Describe whether outcome data exists related to the utility of these tests and what the data shows, if available.

C. Contrast two models used for multigenerational family health histories. Which do you prefer and why?

D. Describe the importance of a comprehensive health and physical assessment that includes information on environment, and genomic influences. Frame this answer through your current role, whether as an Advanced Registered Nurse Practitioner (ARNP) with a practice, or a nurse executive overseeing nursing practice in an organization.

Respond to the post bellow in one or more of the following ways:Ask a probing question, substantiated with additional background information, and evidence.Share an insight from having read your collea

Respond to the post bellow in one or more of the following ways:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from  the classroom or from your own review of the literature in the Walden  Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

                                                    Main Post

                             Effect of a Nurse-Driven Mobility Protocol

The  title of the study that I have chosen is “the effect of a nurse-driven  mobility protocol.” The population that this study focuses on is that of  older adults. The participants who took part in the study were only 50.  The purpose of the study was to find out if patients had a better  outcome of functional mobility and a decline in the length of stay after  discharge in case a nurse-driven mobility model was employed. The  nurse-driven mobility protocol that was used in the study was the  Geriatric Friendly Environmental through Nursing Evaluation and Specific  Interventions for Successful Healing. Thus nurse-driven agility was  used before the study was conducted and this gave the nurses an  opportunity to train before the study. This protocol allows the nurses  to walk patients two to three times a day for meals or to the washrooms  (Padula, Hughes, &Baumhover, 2009). 

Potential Concerns

Validity  means the degree of credibility and accuracy of information provided  during a study. Internal validity is the liberated variable being the  reason for the results as opposed to several other factors. In this  study, the internal validity is at risk from the reality that most of  the research participants in the treatment group are at a lesser risk  for falls than those from the control group (Metheny, Davis-Jackson,  & Stewart, 2010). This can have an effect on the validity of  information during the research study. This is because if the treatment  group were at a lower risk for falls, the group would be more  self-sufficient before the study which can affect the outcomes of the  research. 

 Another  concern could also be seen where the staff may seem reluctant to walk  their patients for long distances in case the patient is at risk for  falls. Another problem of validity that can be encountered is the fact  that there is no distinct definition of the exact number of times that a  patient should be walked through and the distance to be covered by the  control group. Lack of data showing the exact number of patients who  were in the control and the treatment groups could also harm the  internal validity. Another concern that may affect the validity of  information may arise where patients from a nursing home may not  participate actively as compared to those new from home. 

 Recommendations to Reinforce Internal Validity

To  reinforce the internal validity in this case, the management of nursing  care should implement clear and concise principles to guide the control  group. The assessment of how often patients are ambulated and put on a  chair for feeding should be done before the study to reinforce the  internal validity of the data. In this research, the patients should  have come from a similar environment before the admission. Using the  data for all patients in the control group could also make the data  clear thus strengthening the internal validity. They should also have  similar statuses to enhance internal validity. Before being admitted, it  is also essential for all patients to use or not use an assistive  device for uniformity purposes. Ensuring similarity between these groups  would have prevented issues of internal validity (Yuan et al. 2009).

Effects my Changes Could Have Regarding the Three Types of Validity

The  changes regarding the three types of validity will lead to  strengthening internal validity. By ensuring that all the participants  of this study come from one environment and using the same assistive  device, this will improve the validity of data during the study. Having  clear guidelines for the control group will enhance validity by  providing the best evidence.

  Dangers of Failing to Be Considering the Validity of the Research Study.

During  any research study, backing up your data through evidence-based  practices improves the decision-making process and enhances validity.  Failing to consider validity leads to weak and unreliable results which  may harm the study subjects. Therefore, it is imperative to ensure that  validity is maintained as this would lead to certain outcomes.

References

Metheny,  N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of  an aspiration risk reduction protocol. Nursing Research, 59(1), 18–25.

Padula,  C. A., Hughes, C., &Baumhover, L. (2009). Impact of a nurse-driven  mobility protocol on functional decline in hospitalized older adults.  Journal

of Nursing Care Quality, 24(4), 325 331.

Yuan,  S., Chou, M., Hwu, L., Chang, Y., Hsu, W., &Kuo, H. (2009). An  intervention programs to promote health-related physical fitness in  nurses.

Journal of Clinical Nursing, 18(10), 1,4041,411.