What sources of internal evidence will you use in providing data to demonstrate improvement in outcomes?

Nursing Clinical Problem—-  cical problem that you have identified in your area of nursing practice (as identified in Module 1). Critically appraise the research and summarize the knowledge availabl

Nursing Clinical Problem—- 

cical problem that you have identified in your area of nursing practice (as identified in Module 1). Critically appraise the research and summarize the knowledge available on the clinical problem (minimum requirement of 6 scholarly journal articles reviewed and appraised for application to practice problem). Outline a strategic plan for implementation of a practice change in your clinical practice environment based upon your findings. Describe how you intend to operationalize the practice change in your practice environment. What theoretical model will you use and how will you overcome barriers to implementation? What sources of internal evidence will you use in providing data to demonstrate improvement in outcomes? Describe evaluation methods of implementation clearly. Are there any ethical considerations? Refe

Wk 10 Discussion Application Of FEMA

Wk 10 Discussion Application Of FEMA

Failure modes and effects analysis (FMEA) is an outstanding tool for evaluating potential sources of failure, the possible effects of failure, and mitigation actions that would reduce the consequences of failure for a given process. As a current or future health care administration leader, FMEA is a necessary tool to help your aim in reducing errors in health care delivery. Wk 10 Discussion Application Of FEMA

For this Discussion, review the ASQ article and the application of FMEA discussed in the article. Then download the free FMEA template. Using this template as a mental guide, think about a process in your health services organization, or an organization with which you are familiar, that might fail.

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FMEA template

By Day 3

Post a description of a process in your organization, or an organization with which you are familiar, that might be subject to failure. Explain the potential failure modes and effects as well as the criticality associated with failures. Also, suggest mitigation techniques that will address the failure. Be specific and provide examples. Calculate risk priority numbers for various failure elements of this process using your own assessment of severity, likelihood of occurrence, and detectability. From your analysis, do you believe your organization is prepared for this process to fail? Why, or why not? Wk 10 Discussion Application Of FEMA

Resource

http://asq.org/learn-about-quality/process-analysis-tools/overview/fmea.html

Nursing homework help

Alcohol has been used by humans for everything from social gatherings to social ceremonies. Alcohol consumption is interwoven with many traditions and moderate use of alcohol can enhance celebrations or special events. Tobacco use is the single most preventable cause of death. Tobacco is known to cause about 20 diseases and nearly half of all smokers die of smoking-related diseases. Using approximately 100 words each and APA 7th edition citations and referencing as appropriate, refer to Chapter 9 of the textbook, Health, The Basics, and answer the following questions regarding alcohol and tobacco use:

  1. Would a person be more intoxicated after having four gin and tonics instead of four beers? Why or why not.?  Nursing homework help
  2. At what point in life should you start worrying about the long-term effects of alcohol abuse or misuse?
  3. When it comes to drinking alcohol, how much is too much? How can you avoid drinking amounts that will affect your judgement? If you see a friend having too many drinks at a party, what actions could you take?

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  4. What are some of the most common negative consequences college students experience as a result of drinking? What negative impacts do students experience as a result of other students’ excessing drinking?
  5. What tactics do tobacco companies use to target different groups of people?
  6. What are some of the main reasons college students choose to use tobacco?
  7. Discuss the various ways in which tobacco is used. Is any method less addictive or less hazardous to health than another?
  8. Discuss health hazards associated with tobacco. Who should be responsible for the medical expenses of smokers? Insurance companies? Smokers themselves?
  9. Describe the various methods of tobacco cessation. Which method would be most effective for you (if you were a smoker and wanted to quit)? Why? Nursing homework help

Evidence-Based Project, Part 3: Critical Appraisal Of Research

Evidence-Based Project, Part 3: Critical Appraisal Of Research

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts. Evidence-Based Project, Part 3: Critical Appraisal Of Research

To Prepare:

  • Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
  • Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
  • Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

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The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented. Evidence-Based Project, Part 3: Critical Appraisal Of Research

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

Effective Approaches In Leadership And Management

Effective Approaches In Leadership And Management

In this assignment, 1,000-1,250  describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

  1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
  2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs. Effective Approaches In Leadership And Management
  3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.

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  4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.

  5. Discuss what additional aspects managers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
  6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course. Effective Approaches In Leadership And Management

Case Study: Fetal Abnormality

Case Study: Fetal Abnormality

Based on “Case Study: Fetal Abnormality” and the required topic Resources, write a 750-1,000-word reflection that answers the following questions:

  1. What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
  2. Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected? Case Study: Fetal Abnormality
  3. How does the theory determine or influence each of their recommendations for action?
  4. What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Remember to support your responses with the topic Resources.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant. Case Study: Fetal Abnormality

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

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Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears. Case Study: Fetal Abnormality

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother

Some references:

Human Dignity: A First Principle “Human Dignity: A First Principle,” by Mitchell, from Ethics & Medicine (2014).https://search-proquest-com.lopes.idm.oclc.org/docview/1610748447/fulltextPDF/FC4B7FE8C99D4F60PQ/3?accountid=7374

Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care (1st Edition)

https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/2 Case Study: Fetal Abnormality

Explain at least three specific ways in which the nursing conceptual model could be used to improve nursing practice. Elaborate, explain, or defend each point mentioned.

elect a Nursing Conceptual Model from Topic 2, and prepare a 12-slide PowerPoint presentation about the model. Include:

Select a Nursing Conceptual Model from Topic 2, and prepare a 12-slide PowerPoint presentation about the model. Include:

  1. A brief overview of the nursing conceptual model selected.
  2. Explanation of how the nursing conceptual model incorporates the four metaparadigm concepts.
  3. Explain at least three specific ways in which the nursing conceptual model could be used to improve nursing practice. Elaborate, explain, or defend each point mentioned.
  4. Provide current reliable sources to establish credibility for the presentation.

Requirements for PowerPoint are as follows:

  1. 10 slides for content.
  2. 1 slide for references.
  3. 1 slide for the title, which includes: (a) title of the presentation, (b) names of the CLC group members, and (c) date
  4. Accompanying speaker notes elaborating on the information contained in each slide.
  5. One member of the CLC group will submit the presentation, speaker notes, and the completed “CLC Group Project Agreement” to the instructor.

While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

Mandatory Vaccination Assignment

Mandatory Vaccination Assignment

Week 7 Assignment: Course Project Milestone – Final Paper

Required Resources

  • Read/ Textbook: Chapter 12
  • Lesson
  • Minimum of 5 scholarly sources (This includes the sources from the annotated bibliography. Additional sources may be included as appropriate.)

Instructions
Return to the topic you chose in the week three assignment. Articulate a specific dilemma in a situation faced by a particular person based on that topic. The situation can be real or fictional.

  • Summarize the dilemma.
  • Define any needed key terms associated with the dilemma.
  • Analyze the conflicts or controversies involved in the dilemma.

Revise and rewrite based on any feedback you received in your previous draft (week three). Reference and discuss any professional code of ethics relevant to your topic such as the AMA code for doctors, the ANA code for nurses, etc.  State whether and how your chosen topic involves any conflicts between professional and familial duties or conflicts between loyalty to self and loyalty to a community or nation. Mandatory Vaccination Assignment

What in your view is the most moral thing for that person to do in that dilemma? Why is that the most moral thing? Use moral values and logical reasoning to justify your answer

Next, apply the following:

  • Aristotle’s Golden Mean to the dilemma
  • Utilitarianism to the dilemma
  • Natural Law ethics to the dilemma

Which of those three theories works best ethically speaking? Why that one?

Why do the other two not work or not work as well?

Is it the same as what you said is the most moral thing earlier? Why or why not?

Use the 5 articles from your annotated bibliography to support your answers. (Additional academic scholarly research from the past 5 years can be included as well.)

Include a reference page at the end of your paper in APA format that includes your bibliography with the annotations removed and any other sources used in your final paper.

Writing Requirements (APA format)

  • Length: 4-5 pages (not including title page or references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (minimum of 5 scholarly sources) Mandatory Vaccination Assignment

Annotated Bibliography on Mandatory Vaccination

Jones, L. (2019). Mandatory Vaccination. The American Journal of Nursing110(3), 13–  13.

According to Jones (2019), taking advantage of the population in fear of an infection or a disease outbreak to try and sway them for a vaccine that is approximately 50% is not appropriate. Vaccination is important to people’s lifestyles and choices but it should not be mandatory because that would be interfering with the people’s rights and freedom. The government needs to roll out the vaccination processes with a good initiative to get numerous people to voluntarily accept the program but not a compulsory process. Jones explained that the fact that there is “interference with people’s rights and freedom it is not right to take part in a program that would deny people the mandatory vaccination” (2019). The inaccuracy of the vaccines and the fact that there is no clear understanding of the negative consequences and reactions of the vaccines makes it a major threat. The concept makes it a major problem because people will not willingly jeopardize their health instead, they do need a healthy standard which will make it easier to change their interactions which is important towards their practice.

Offit, P. A., & Salisbury, D. M. (2021). Childhood vaccination: should it be             mandatory? BMJ: British Medical Journal344(7858), 18–19.

Offit explained that childhood vaccination should be mandatory because it helps protect people from infections (2021). However, Salisbury thinks that “mandatory issuing of vaccines is not an option instead there are alternative approaches that the government can easily utilize” to help make sure that there is a higher uptake of the vaccinations (2021). It is evident that the government might have the best interests for its people but the research and the effects of the vaccinations are usually not clear and this is what makes numerous people skeptical. The mandatory sense of the vaccine will help get rid of a disease or an outbreak within a short duration and help save millions of lives which is vital for the way that they do advance the health protocols and principles that would shape and change the way that they embrace the concept of vaccinations. The general belief of the most of the public is that the government needs to be forthright with the consequences of the vaccines and all the possible effects. The clear understanding of such impacts will help make it easier to change and improve the appreciation by the public towards the vaccinations.

Lambert, S. B. (2020). Patient Care Drives Mandatory Vaccination. BMJ: British             Medical Journal337(7680), 1188–1188.

According to Lambert (2020), patient care demands for mandatory vaccination because it seeks to increase its beneficiary of the service. The program runs to make sure that there is a vaccination program that sees them “cut the costs on medical procedures and approaches which is vital for the way that they do achieve their interests (Lambert, 2020)”. It is important to understand that health standards will help make sure that they achieve the best principles and outcomes that would see a conclusive health program. Lambert explained that mandatory vaccination will help cut back on the level of people needing patient care and the rate of illnesses and disease outbreaks that will help improve and change the way that they do connect (2020). It is important to understand that the health principles in the society are to make sure that the population remains healthy and thus it is important to understand the mandatory vaccines will help improve their outcomes. The organization works towards achieving their right outcomes for the majority of its population which is important for the way that they do conduct their goals but it is not the right approach. There is need for democracy in health thus it is important to give people their right to choose which is vital for allowing people to choose to get vaccines or to deter which should be a personal choice. Mandatory Vaccination Assignment

Cave, E. (2017). Debating the future of mandatory vaccination. BMJ: British Medical          Journal358.

According to Cave (2017), future vaccination is an important prospect that would help make sure that they do change or improve the health standards across the world. The rate at which there is an increase in the medical risks makes it a major threat thus its mandatory vaccination becoming an important principle. For instance, the recent Covid-19 outbreak that got the entire world on its knees would suffice within a short time with mandatory vaccination. “The previous Spanish flu disease outbreak led to death of millions and vaccinations helped put an end to the disease thus it was a tough lesson (Cave, 2017)”. The possibility of the vaccinations being mandatory is high but it might start with specific directives such as those travelling outside of the country or to certain parts of the country, or healthcare providers, or those working in the public service. The concept will help make sure that there is a minimization of the repeat of the events that threaten the larger population. It is important to acknowledge that the future is seeing the introduction of new principles and laws but it is also a new approach and understanding of the world which influences the democracy level in the country which changes the way that they can improve their interactions and outcomes. Most people will decline mandatory vaccinations with the basis that interferes with their rights which is not appropriate thus it is important to find what works for all the people.

Killmond, M. (2017). Why Is Vaccination Different? A Comparative Analysis of             Religious Exemptions. Columbia Law Review117(4), 913–952.

Killmond explained that the approach to vaccination is a problem because it is a major political heated topic which makes it integral in all the decision-making processes within the state and country (2017). The vaccination concept is a problem that even led to the Supreme Court to intervene which proves that some people argue on the subject in relation to their religious beliefs. Some religions and denominations have certain demands and directives when it comes to vaccinations and thus it is important to acknowledge and respect such freedoms. People do not need to force the religious beliefs onto the people but instead try to make sure that they do accommodate the interests of the people to help salvage the case. Vaccination is a sensitive topic because it is a political influencing issue and this changes the narrative of numerous people thus it is important to come up with the right prospects to avoid causing numerous issues (Killmond, 2017). Religious exemptions are influential and it is a strong arguing point because it influences a large number of people, because similarly to abortion some religions disagree while other approve which results to a major difference in opinions. It is important to understand that religious background is influential since they do change and have a major influence to the people’s choices and decisions in the society.

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References

Cave, E. (2017). Debating the future of mandatory vaccination. BMJ: British Medical             Journal358.

Jones, L. (2019). Mandatory Vaccination. The American Journal of Nursing110(3), 13–13.

Killmond, M. (2017). Why Is Vaccination Different? A Comparative Analysis of Religious        Exemptions. Columbia Law Review117(4), 913–952.

Lambert, S. B. (2020). Patient Care Drives Mandatory Vaccination. BMJ: British Medical           Journal337(7680), 1188–1188.

Offit, P. A., & Salisbury, D. M. (2021). Childhood vaccination: should it be             mandatory? BMJ: British Medical Journal344(7858), 18–19. Mandatory Vaccination Assignment

Mandatory Vaccination 

Topic: Mandatory Vaccination

Mandatory vaccination is an ancient practice that has remained a controversial issue due to variance in beliefs, attitudes, and knowledge. Since vaccines were introduced in 1796, there have been people in support of the practice while there have also been other against vaccines. The case has only gotten worse with the government making some vaccines mandatory as the determined compelled those against vaccines to feel like their feelings and rights have been violated by the government. at the same time, the government leaving people exposed and vulnerable to contagious diseases has led to massive negative effects a situation that has compelled the government to go against the wish and desires of some people. There are a lot of reasons shared by both parties and the challenging thing is that all arguments are valid hence creating an intense ethical or moral dilemma on the issue.

The supporters of mandatory vaccinations claims that vaccines save lives since infectious diseases are leading killers for instance polio, tetanus, chickenpox, measles, and the recent corona virus among others (Orient, 2019). Secondly, the supporters claims that vaccines boosts the body’s immune system and this makes the body able to handle even other underlying conditions that could have affected overall wellbeing of the person.

On the other hand, the opposers of mandatory vaccinations claim that vaccines have string side effects and there are many instances they have weakened the body’s natural immune system. This is because the body is created in a manner it has a natural method of fighting diseases and hence vaccines only compromises the original body version (Giubilini, 2021). The second reason shared by those opposing vaccines is that vaccines are made from chemicals and it is for this reason that some people have still suffered other complications to the point of suffering death despite having been vaccinated.

According to MacDonald, et al., (2018); Ethical Egoist is a person that makes a moral decision guided by pure self-interest. On the case of Ethical Egoist, such a person is likely to support the perspective that he/she would feel would suit personal interests on the matter. In the case the ethical egoist would have a direct link and benefit from the act of having people vaccinated, he/she would support the idea not because it is good but because he/she is benefiting. On the other hand, it he/she is not benefiting in any way, he/she is likely to go against the mandatory vaccinations claiming they violate human rights. The reason for this is that ethical egoist are always in support of things they would benefit and can highly all benefits while shadowing negative effects and always talks ill of things they feel are not of any importance to them even though they have a general benefit to others (MacDonald, et al., 2018). Whenever there is no benefit, ethical egoists are more focused on negativity of the issues than the positivity of an issue. Mandatory Vaccination Assignment

Looking at the mandatory vaccinations moral controversy issue; it is evident there is a conflict between loyalty to self and to community. A majority of the people are more focused on loyalty to self by looking at the gains they would have as individuals as compared to community benefits. As a long as people feel they do not have any direct benefit as individuals, they tend to argue against vaccines overlooking the general benefit the society is having (Orient, 2019). At the same time, many people make use of the knowledge they have, personal beliefs, and attitudes towards an issue to make a decision that would affect a community. Nevertheless, the fact that vaccines affects the society, loyalty to self should be overlooked and people applying good interest for others to make a general decision. This being the case, vaccines should be viewed from the perspective of how they have benefited the society and not a few people as this is the morally acceptable perspective.

Social contract ethicists are people that claim people live together in society in accordance with an agreement that established political and moral rules of behaviors. On the case of mandatory vaccines, the social contract ethicists would support vaccinations since they have proven to have more benefits than challenges a situation that communicates morally and interest of the majority (Giubilini, 2021). The more reason is that social contract ethicists are more focused on morals than self-interests and this means it is the well-being of the society that takes center stage. From this perspective, it is evident there is a collision between personal obligations and national ones. This is because social contract ethicists are nationalists that focus on taking care of national obligations overshadowing their personal obligations despite the desire to have their attitudes and feelings on the issue taken into consideration. This is the action that best suits the situation where personal interests should be left aside while national interests uplifted for the wellbeing of the majority (Orient, 2019). The more reason is that when the interest of the majority is considered, mandatory vaccines would be supported or opposed from morally acceptable arguments and not because a single or few people like or do not like them.

 

References

Giubilini, A. (2021). Vaccination ethics. British medical bulletin137(1), 4-12.

MacDonald, N. E., Harmon, S., Dube, E., Steenbeek, A., Crowcroft, N., Opel, D. J., … & Butler, R. (2018). Mandatory infant & childhood immunization: Rationales, issues and knowledge gaps. Vaccine36(39), 5811-5818.

Orient, J. M. (2019). Vaccine Controversies: the Case for Freedom and Informed Consent. Journal of American Physicians and Surgeons24(3). Mandatory Vaccination Assignment

 

 

 

 

 

 

 

 

 

Describe how you would use each process (e.g. EBP, QI, and research) to address the selected quality indicator in Ambulatory Care.

REPOST/QUICK TURN AROUND NEEDED – 2-3 page research paper on Nursing Turnover within the Ambulatory Care Setting

Evidence-Based Practice  [provide definitions for a) evidence-based practice, b) quality improvement, and c) research.  Please include references using APA format.]

Describe how you would use each process (e.g. EBP, QI, and research) to address the selected quality indicator in Ambulatory Care. 

A.     Description of Clinical Problem/Situation: Nursing Turnover within the Ambulatory Care (ACS) Setting

B.     PICO Question

The following PICO question has been devised to guide this exploration of the scientific literature and other essential forms of evidence.

PICO Question Components:

      P:  [patient, population, or problem] Nurse Retention within the Ambulatory Care Setting

      I: [intervention or treatment] Factors that may positively influence retention rate

      C:  [comparison with other treatments, when warranted] Factors that may negatively influence retention rate

      O:  [outcome]  ?

Question:  What factors may positively (I) or negatively (C) impact nursing retention within the Ambulatory Care Nursing setting (P), (O)?

C.     Sources of Evidence & References [types of evidence – published, expert opions, patient preferences, etc.]

Article 1 –

Article 2 –

D.     Critical Appraisal of the Evidence [briefly describe how this was done – used the Johns Hopkins Nursing EBP criteria, provider an evidence rating for each article/evidence source used [e.g. 1A, 3C etc.]

[ex:  Each article was critically appraised using the Johns Hopkins Nursing Evidenced-based Practice Research criteria.  As an example, the article ……

Questions to consider – should we implement the practice recommendations? Would this change improve nurse retention outcomes? Would it improve overall unit/pavilion operations e.g. costs, workload, culture? Can the evidence be translated inn other ways e.g. policy/procedure development?

E.     Translation [would you put the evidence you appraised into practice? How would that be done? Should we implement the practice recommendations? Would this change improve our nurse retention outcomes? Would it improve overall unit/pavilion operations (e.g. costs, workload, and culture)? Can the evidence be translated in other ways (e.g. policy/procedure development)?

Caste Study: Diabetic drug adherence

Caste Study: Diabetic drug adherence

Case Study’s

Case Study: Type 2 diabetes

 

Fatimah Aswad is a 55-year-old married woman of Middle Easter origin. She lives with her husband. Her two daughters are married and live nearby. Her mother (deceased) had type 2 diabetes. Her father is well. She has a body mass index of 32. She seldom smokes and does not drink alcohol. She denies taking any recreational drugs. She buys St John’s Wort over the counter, as she feels anxious and depressed at times. She has no allergies. Her past medical history reveals that she has had two caesarean sections. She presents with oral thrush, a second occurrence in three weeks. On questioning she reports thirst, lethargy and that her vision has deteriorated. Her blood pressure is 150/90. Caste Study: Diabetic drug adherence

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  1. List Mrs. Aswad’s risk factors for a possible diagnosis of type 2 diabetes.
  2. What tests would you order for Mrs. Aswad in order to confirm a diagnosis of type 2 diabetes.
  3. Draw on your knowledge of the complications of type 2 diabetes and consider what mutually agreed goals you could set to minimize progression of any diabetes-related complications.

 

Caste Study: Diabetic drug adherence

 

Mr. Edmund Wilson is a 77-year-old retired post office worker. He has never been married and lives alone with a social support from neighbors and family. He is a past smoker and likes a beer each evening. He denies taking any recreational drugs and does not use any over-the-counter (OTC) remedies. He reports no allergies. He is not overweight. His father died of a heart attack aged 65. Past medical history includes hypertension diagnosed over twenty years ago and a myocardial infarction two years ago. He was diagnosed with type 2 diabetes ten years ago. Current medication includes metformin, glipizide, simvastatin and captopril. At the most recent review, HbA1C was 6%. Caste Study: Diabetic drug adherence

 

On closer questioning, it would seem that Mr. Wilson stopped taking his anti-diabetic drugs several weeks ago, as he reported feeling generally unwell.

  1. Based on his current medications what do you see as problematic?
  2. In view of the low HbA1c test-revise his treatment plan -using your guidelines and knowledge of anti-diabetic drugs. State rationale for each medication you prescribe.
  3. What would your goal be for Mr. Wilson’s HBA1c? Caste Study: Diabetic drug adherence

 

NO citation required, NO reference required, original work please.