Nursing homework help

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Nursing homework help

Manuel Garcia Periu

 

Nursing informatics has integrated information and knowledge to support learning in my APRN education. McGonigle & Mastrian (2018) state that nursing informatics facilitates learning. This idea is accurate because, in my experience, I have had a learning experience using nursing informatics. Specifically, I have used the virtual simulation whereby there was the use of non-existent patients on the online platform to learn various aspects such as diagnosis, treatment, and the other elements of patient management. Therefore, technology played an excellent role by eliminating the need for having practical experience in the patient units. Besides, it also reduced the adverse risk of having students learn using actual patients, as the possibility of errors and other mistakes is high. The advantage is that it made learning logistics easy, thus enhancing the class experience. Nursing homework help

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In my APRN education, learning informatics was not only a means of studying but an end in itself. Harerimana et al. (2021) state that nursing informatics is a competence that medical care workers must have as part of their qualifications. A nurse without the skills may appear less qualified. Therefore, in my APRN education, the skills for using information technology in practice were a significant consideration and part of the syllabus. Specifically, we learned how to operate the system that comprises tablets, and wearable technology, among others. Consequently, we learned how to use informatics and even did some tests on it to evaluate our competence. Furthermore, during our practical lessons in the hospital setting, informatics was applied in a real hospital context when we treated patients with the aid of that technology. Apart from the in-class education, I also consider my work and practice an opportunity for continuous learning and education. Therefore, since I worked full time as I studied, I used this technology in the hospital setting, and the knowledge I gained there was to be part of individual or personal studies. Through this learning and testing, informatics is primarily applied in education. Nursing homework help

References

Harerimana, A., Wicking, K., Biedermann, N., et al. (2021). Integrating nursing informatics into undergraduate nursing education in Africa: A scoping review. International Nursing Review, 68(3), 420–433. https://doi.org/10.1111/inr.12618

McGonigle, D., & Mastrian K.G. (2018). Nursing Informatics and the Foundation of Knowledge (4th e.d). Jones & Bartlett Learning, LLC.

 

 

 

Ivon Hernandez

 

According to Iyengar et al. (2018), healthcare informatics is the integration of healthcare science with other analytical and information disciplines to acquire, store, share, and manage data, knowledge, and information that is applicable in healthcare. It encompasses various components, including information management systems, use of the Internet, and online networking (McGonigle & Mastrian, 2021). Healthcare Informatics has been applied in my Advanced Practice Registered Nurse (APRN) education through computer-mediated communication (CMC), computer-assisted instructions (CAI), and interdisciplinary collaboration.

CMC entails different forms of human communication aided by the computer network. Some of the components that have been used in the program include telephone conversations, audio, videos, and electronic mail. Also, coursework and other study materials have been made available through various electronic and digital mechanisms such as web links and e-mails. Besides sharing educative YouTube videos, the instructors have also organized and invited APRNs to attend video conferences. The discipline of computer science is largely incorporated to aid the learning process.

CAI is a technique in which instructional materials are presented in electronic form. The APRN program has incorporated online chats, electronic mailing list groups, instant messaging, and discussion forums through which instructions are presented. A platform for learners has been created through which they can share their thoughts, ideas, and experiences on different healthcare topics. Direct messaging and online chats are also used among peers as well as with the instructors to seek clarifications. Instructors also use online tutorials to guide students on how to complete certain assignments or activities. The program implements a blended instructional method.

The modules have applied a holistic approach to healthcare. Faculty and instructors, partner and collaborate with other institutions and experts to help APRNs learn different skills such as analytical, critical thinking, and research that are essential in the modern healthcare sector. For example, the IT department welcomes the opportunity to help APRNs understand the use of various systems and software, such as electronic health records, when providing telemedicine or telehealth.

Reference

Iyengar, A., Kundu, A., &Pallis, G. (2018). Healthcare Informatics and Privacy. IEEE Internet Computing, 22(2), 29–31. https://doi.org/10.1109/mic.2018.022021660

McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.

 

Cira Perez Miranda

28 minutes ago, at 9:40 PM

 

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Diabetes is a common and most prevalent non-communicable chronic condition associated with increased mortality, morbidity, and economic burden. The disease is costly to treat and manage, posing a tremendous financial burden on healthcare systems and affected people due to associated severe micro and macro-vascular complications and longevity of the disease. According to the CDC, type 2 diabetes is avoidable with lifestyle modifications, such as physical activity and weight control (CDC, 2021).

Three main challenges could hinder preventive intervention for diabetes, including family and friends, economic factors, and limited knowledge. Friends and family can become facilitating factors and barriers to preventative intervention. At times, family and friends could act supportively towards diabetes promotion or obstruct it. Diabetes preventive interventions require dietary habits that members or friends might not be willing to change. If the family decides to stick to family traditions in preparing meals, it might hinder the effectiveness of the promotion being (Breuing et al., 2020).

Economic barriers are associated with preventive initiatives, such as travel or fitness costs and nutrition changes. Likewise, lack of insurance cover constitutes financial barriers, hindering access to quality care. Limited knowledge could delay the effective implementation of diabetes health promotion, particularly in implementing information, such as diet guidelines that require knowledge on cooking and food to improve well-being (Breuing et al., 2020).

Effective intervention requires comprehensive prediabetic management, particularly intervention that focuses on lifestyle interventions of exercise and diet. Therefore effective navigation of these challenges, such as friends and family, limited knowledge, and economic factors to achieve lifestyle modifications, is required. Effective implementation of diabetes promotion requires cultural competencies in the targeted population. Involving diverse interprofessional teams in diabetes health promotion can improve an organization’s cultural competence, enhancing patient outcomes. Likewise, creating awareness among the patients, families, and friends to embrace healthy living through community mobilization could reduce challenges to diabetes health promotion.

References

Breuing, J., Pieper, D., Neuhaus, A. L., Heß, S., Lütkemeier, L., Haas, F., … & Graf, C. (2020). Barriers and facilitating factors in the prevention of diabetes type 2 and gestational diabetes in vulnerable groups: a scoping review. PloS one, 15(5), e0232250. https://doi.org/10.1371/journal.pone.0232250

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Mayra Oliva Rivero

43 minutes ago, at 9:25 PM

 

NEW

Top of Form

Health promotion is the cornerstone in the public health sector from how it facilitates improved quality of life and overall reduction of premature deaths. At the same time, diabetes is a chronic disease listed among the leading burdens in public health, and this calls for a need for health promotion. According to Heath (2020), health promotion is a complex and challenging healthcare approach, especially when the issue addressed affects large numbers of people. This research explores challenges associated with the implementation of health promotion for cases of diabetes.

Challenges of diabetes health promotion

The world is characterized by multiculturalism. The population comprises people from different socioeconomic statuses, ages, cultural diversity, and education. In understanding diabetes epidemiology, the health issue is a nationwide issue and a burden for the United States and the world as a whole. For this case, therefore, the issue affects all people regardless of their needs and demographic characteristics. In understanding the concept of multiculturalism, major challenges affecting health promotion practices are; language barriers, religious issues, especially in strategizing diet plans, and unfamiliarity with the concept, especially from illiterate people.

Another key challenge is the varying patient needs, making it hard to address all needs through health promotion. According to Leyns et al. (2021), type 2 diabetes affects people differently, and among the issues associated are mental, social, and physical needs, all of which need to be addressed. Meeting these needs across millions of people globally is a costly and near-impossible approach. This extensiveness of disease pattern and association with commodity makes the disease complex to be understood. The population regarding disease patterns is also shaped by environmental, social, and economic factors whose extensiveness makes understanding diabetes complex (Galea, 2017). War, insecurity issues, and economic fluctuations are also historical issues that may affect health promotion’s effectiveness and successful implementation.

Diabetes is one of the common chronic health issues affecting millions of people across the globe. The fact that it is a disease burden associated with the high cost of healthcare to management and comorbidity is enough to mandate the implementation of health promotion approaches. The process is, however, complex and demanding. High cost of care, cultural barriers such as communication, historical issues like was wars, and economic fluctuations are some of the challenges preventing this health promotion process from taking place and should thus be considered during planning.

 

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Ivon Hernandez

an hour ago, at 9:08 PM

 

 

Top of Form

 

Whether public or private, every organization is interested in the well-being of its workforce. A healthy workforce is more productive and poses minimal health burdens to the organization. However, effective management requires a holistic approach that addresses the health concerns at the grassroots or community level (Nash et al., 2016). In this regard, multi-sector partnerships and collaborations are essential to increase the capacity of the community to shape outcomes. Public and private organizations can work together better to achieve goals of mutual interest in healthcare through shared goals, joint community healthcare programs, and setting common healthcare policies and standards.

Public and private entities can establish shared healthcare values, objectives, policies, and standards to attain goals of mutual interest in healthcare. According to Nash et al. (2016), an organization should go beyond the international and national healthcare policies to address the specific healthcare concerns of its staff and the community they serve. Therefore, both public and private companies can set the same internal policies and put in place measures to address healthcare needs and demands.

Public and private organizations can plan and implement joint community programs aimed at promoting healthy living. Instead of each sector organizing its initiative, the sectors can collaborate to advance similar programs. Furthermore, these organizations can mobilize funds and other resources to oversee community or population-based health initiatives. The arrangement enables the entities to reach out to many people and save on resources.

Partnership and collaboration between public and private entities can be facilitated through ongoing, structured communication. Sharing information across sectors allows interested organizations to create a mutual understanding regarding the capacity of each entity (Nash et al., 2016). Through collaboration, each firm can focus on a specific area of concern depending on its strengths, thereby avoiding duplication of healthcare services or programs in a community.

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Taymir Torres

Transformative change is taking place in the government’s health sector. As a result of the public healthcare society’s adoption of a “health in all measures” strategy, several different technologies and projects are emerging across the country. Aggregation of insurance firms into massive corporations, value-based payment solutions, and a rising merging of inpatient and outpatient services into huge hospital systems, both charitable and shareholder, are just a few of the key changes occurring in healthcare provision and funding (Protasov&Morozova, 2021). One of the most encouraging aspects of this shift is the growing recognition of the importance of improved communication and increased public-private cooperation.

A large number of innovative and promising cross-sectoral efforts are now underway. Nevertheless, there is still a lot of work to be done. Cooperation between public health agencies and non-profit health care providers, and other community representatives are often lacking across the country (Filho, 2019). We need to disseminate the knowledge we’ve gleaned through effective cooperative partnerships. If you’re a healthcare, clinical, or public health group at the state and national level and you’re interested in providing training, government initiatives, and practical assistance to current and prospective public-private partnerships, there’s a lot of potentials there.

With the help of groups like the IOM, Academy Health, foundations with an interest in promoting public health, and universities—along with institutions such as these—the effectiveness of public-private partnership on the healthcare system and costs may be studied in a methodical manner (Collyer, 2019). Future public-private collaborations will benefit greatly from clearer documentation of the success or failure of current collaborations in terms of both economic and non-economic outcomes.

References.

Collyer, F. (2019). Chapter thirteen: Navigating private and public healthcare. Navigating Private and Public Healthcare, 271-294. https://doi.org/10.1007/978-981-32-9208-6_13

Filho, P. O. (2019). Social organizations in health. Advances in Healthcare Information Systems and Administration, 228-246. https://doi.org/10.4018/978-1-5225-6133-0.ch011

Protasov, M., &Morozova, T. (2021). Risk accounting in a public-private partnership for the creation of infrastructure facilities for healthcare organizations. Buhuchet v zdravoohranenii (Accounting in Healthcare), (6), 40-46. https://doi.org/10.33920/med-17-2106-04

 

 

 

Synthesis of the Literature

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Synthesis of the Literature

Synthesis of the Literature

Synthesize your final primary quantitative research studies and/or systematic reviews; do not include summary articles such as a review of the literature, a clinical article, or a clinical practice guidelines. This section is all about the scientific evidence rather than someone else’s opinion of the evidence. Refer the reader to your evidence table(s).  See Table 1 and 2. Do not use secondary sources; you need to get the article, read it, and make your own decision about quality and applicability to your question even if you did find out about the study in a review of the literature. The studies that you cite in this section must relate directly to your PICOT question. This is a synthesis(Table 3) rather than a study-by-study review. Address the similarities, differences, and controversies in the body of evidence.

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Practice Recommendations

So. . . using available best evidence, what is the answer to your question? This section is for you to summarize the strength of the body of evidence (quality, quantity, and consistency), make a synthesis statement, and, based on your conclusions drawn from your review of the body of evidence related to your clinical question, give a recommendation for practice change. This would logically be the intervention of your PICOT question. You might want to design an algorithm and include it in as a figure. Perhaps you found substantiation for usual practice, and you recommend reinforcement and education regarding this best practice.Using Johns Hopkins, identify whether this recommendation be graded A, B, or C based on the strength of the evidence. Synthesis of the Literature

 

References

Remember that this is a reference list rather than a bibliography. A bibliography is everything you read to prepare the paper but a reference list is only what you cited. If there is not a citation for a reference, it should not be here. PLEASE make sure that your references and your citations throughout the paper are in APA format. You can go from an A paper to a B paper on APA errors alone. Take the time to make sure that they are correct. We have already formatted the paper for you with this template.

 

Table 1

Primary Quantitative Research Evidence (this table may be single space and 10-point font; ONLY primary quantitative research articles should be in this table)Example provided. Synthesis of the Literature

Source Study design

 

JH Level of Evidence

 Population/

Sample

 

Age
Race/ Ethnicity

Setting/
Location

% dropout

 Intervention (IV)

 

Details

Action

Duration
Fidelity

Comparison/ Control (IV)

Details

Action

Duration

Fidelity

 Outcome (DV) &Time

Intervention vs comparison

(statistical test, value, p value)

 

 

 Grading of evidence

JH Quality Rating

 Author’s conclusions

———–

Other outcomes of interest

 Your Conclusions

Limitations

 Fit/Useful
Abel, 2020 RCT

 

Level I

 

 196  inter-city

Age 36.4 (8.9) [Range 24 – 49]

55% Male,

40% Black,

62% Latino

 

73% Medicaid, annual income <$25,000

Setting: Outpatient

Location: Boston, MA

Baseline pain score 6.4 avg on both groups

Dropout: 15/200, 7.5%

 Weekly chiropractic adjustment

Assessed &tx

10 weeks

100% of visits over 10weeks

Average total 180 mins

 

 Massage

Medical massage

50 min/wk

100% for 10 weeks

 

 

 At 10 weeks,

avg pain score

 

Tx = 3.6

Control = 5.2

(X2 = 7.3; p<.05):

 

 

Latino males

Tx = 2.8

Control = 5.7

(X2 = 8.3; p<.001):

 

 

Latino women

Tx =6.0

C = 2.8

(X2 = 9.2; p<.001):

 

 

 

 

  Quality A

 

 

 Pain scores

30% lower w/ wkly chiro compared to 50 mins/wk medical massage

 

Tx more effective in Latino males

 

C more effective in Latino women

———

Massage would cost 30% more out of pocket

 Tx. Better than control

 

Chiropractic adjustments effective in general and in Latino males but not in Latino women

 

Limitations =

-not equal time in tx

-not include high income

 

 Yes/Yes but only if cost covered by Medicaid in my state
                   
                   
                   
                   

 

Legend:(all abbreviations and acronyms used in the table should be listed here such as: )

 

Table 2

Evidence Summaries (this table may be single space and 10 point font; ONLY systematic reviews should be in this table)(Example provided)

 

Source Study design

 

JH Level of Evidence

 Population/

Sample

 

Search strategy

Inclusion

Exclusion

 

N articles addressing your PICOT

 

Other descriptions

 

 Intervention (IV)

 

Details

Action

Duration
Fidelity

Comparison/  Control (IV)

Details

Action

Duration

Fidelity

 Outcome (DV)

& Time

 

Mean differences

Intervention vs comparison

Effect size

Heterogeneity

 

(statistical test, value, p value)

 

 

 Grading of evidence

JH Quality Rating

 Author’s conclusions

 

 

——

Other outcomes of interest

 Your Conclusions

Limitations

 Fit/Useful
Brown, 2018 Meta-analysis

 

Level I

 

 Medline

OVID

CINAHL

2000-2017

 

RCTs, conducted in the US, high-quality (>21/25 points on CONSORT), comparing regular chiropractic adjustment vs regular medical massage for chronic pain measured using a 0-10 scale

10 RCTs of low back pain

Exclusions

Studies of phantom pain

 

Total participants N=867

Avg age 59 (6)

Avg baseline pain scores 3.2 (3.4)

Avg Dropout:

8% (4)  Only completers included in this analysis

 Chiropractic adjustment in office

 

Most weekly

(2/10 allowed 2x wk)

 

Fidelity

All  > 80%

 

 

 Massage

45-60 mins

 

 

Most weekly

(2/10 allowed 2x wk)

 

Fidelity

All >86%

 

 

 At 8 weeks

N=4

 

Tx = 3.6

Control = 5.2

(RR for 2 point pain reduction= 1.6 (1.1-2.3); p=.04):

 

I2= 10%

 

At 12 weeks

N=6

 

 Tx = 3.2

Control = 4.8

(RR for 2 point pain reduction= 1.7 (1.4-2.4); p=.04):

 

I2= 13%

 

 

 

 Quality B due to no ITT

 

 

 wkly chiropractic adjustment was more effective than weekly massage for reducing chronic pain based on the data from these studies

—none

 

 Tx. Better than control

 

High dropout rate and not analyzed with ITT

 Partially- my population is much younger on average

Partially- my population has a variety of pain sources

Useful- yes
Add more                  
                   
                   
 

 

 

 

                  

 

Legend:(all abbreviations and acronyms used in the table should be listed here)

 

 

Table 3.

Synthesis Matrix(identify the trends; this table may be single space and 10 point font; ONLY primary quantitative research articles or systematic reviews should be in this table; use only the highest level and quality of evidence; if the evidence is of mixed level or mixed quality, sort the trends using the Johns Hopkins Appendix H; trends must be related to the outcome) (example provided regarding effective pain management which may or may not be within your scope of practice- make sure your PICOT is within your scope of practice.)

 

Main ideas Albright (2020) Reference 2 Reference 3 Reference 4 Reference 5 Add columns as necessary
Weekly chiropractic adjustment equally effective as weekly massage            
Biweekly chiropractic adjustment associated with 30% lower pain scores compared to weekly massage in those with back pain            
In those with a mean age under 50, weekly massage associated with 20% lower pain scores compare to chiropractic adjustments            
Add more as needed            

 

Figure 1

Results of Search for Research

Use http://prisma.thetacollaborative.ca/ to generate a diagram describing the results of your search. Paste it here.

 

 

 

 

 

 

 

 

Obesity In Children

 

 

Obesity in Children

An apple does not fall far from the tree. A saying that has beenreferenced in conversations involving children who have acquired specific traits from their parents. Among these traits is obesity, both genetic and lifestyle-related obesity. A child is classified as obese when his or her weight is well above the normal for their age and height (CDC, 2021).

One of the tools widely used to gauge obesity is the body mass index(BMI). The BMI needs to be compared against age and sex growth charts as children gain weight and muscle a different rate with age. Normal BMI for boy’sranges from 13.8 to 16.8 at five years, 14.2 to 19.4 at ten years, and 16.5 to 23.4 at fifteen years. Normal BMI for girls ranges from 13.6 to 16.7 at five years, 14.0 to 19.5 at ten years and 163 to 24.0 at fifteen years(CDC, 2021). Discussed in this paper is the relation of parent health patterns and their probability of affecting their children’s weight.

Significance of the Practice Problem

            BMI values that lie above the higher percentiles very likely indicate obesity. Obesity puts the child at a higher risk of chronic lifestyle diseases such as hypertension, diabetes, and cardiovascular diseases (Henderson, 2021). Not only does it affect their physical well-being, but it also exposes them to psychological issues including low self-esteem issues, bullying, eating disorders and depression (Angawi, &Gaissi, 2021).

PICOT Question

In adolescent patients under the age of 12 who have obese parents (P) what is the effect of a dietitian and exercise program (I) compared to children who did not have a dietitian and exercise program (C) on preventing the adolescent from having a BMI over the 85th percentile range (O) within one year (T)?This is our main question of concern throughout this article. A child’s health and well-being are fostered by a home environment with engaged and skillful parenting that models, values, and encourages sensible eating habits and a physically active lifestyle. Parents can have a great influence on their children that is marked when they serve as role modelswho promote specific values and reinforce or punish certain behaviors. It is no surprise that sedentary behaviors and their resultant diseases tend to trail within families. Not to ignore that some of these risk factors rise from genetic components, but most are strongly influenced by behavioral aspects. The family is thus an appropriate and important target for interventions designed to prevent obesity in children through increasing physical activity levels and promoting healthful eating behaviors(Kraak, Liverman, &Koplan, 2005).

Population/Problem

The population of interest was mainly lower to middle class households where one or more of the parents is diagnosed as obese. The variables in this case were BMI values (to assess obesity), type of food eaten (fast food or home cooked meals), exercise patterns of the family members, education level of the parents and age of both the parents and children. By the end of the study, parents should be able to identify their role in encouraging healthy lifestyles in their children, combat childhood obesity, and understand the significance of teaching children healthy diet and exercise habits.

 

Intervention

            The above families were monitored for six weeks to assess their daily nutrition-exercise pattern. During the first meet-up of the parents and research assistants, the parents were given evaluator questionnaires to fill out to determine their household structure and lifestyle patterns. After the first six weeks elapsed, the families were provided with diet plans and exercise routines to follow through the next twelve weeks to help rate whether there would be a difference in the weight status of the family members, including the children. Following the 12 weeks, the familial progression was assessed. Each family met with the dietitian to review progress and measure the success of current goals. At the conclusion of this meeting, new goals were set for the next 34 weeks, and a final meeting at the one-year conclusion of the intervention was scheduled.

Do not skip this space

Comparison

The level of adherence of parents and children in this program was compared toparents and children who did not have a dietitian and exercise program in place. A comparison was also done between the households that switched to the healthier meal and exercise options and those that chose to stick to their usual routine.

Outcome

The study outcome will mainly focus on weight changes in the obese children at the end of the year. It is anticipated that the parents will cooperate and stick to the plan of action during the study period. Both the parents’ and children’s weights and height will be measured at the beginning and BMI will be calculated to determine how obese they are. These same parameters will again be measured at the end of the study to determine whether there will be any significant changes.

Timing

The study is timed at fifty-two weeks or one year. The first six to assess the sample household lifestyles while the following forty-six will focus on replacing the unhealthy lifestyles with healthier choices and assess the results. A twelve-week check-in will be scheduled to make any necessary adjustments.

Search Strategy and Results

The inclusion criteria included obese adults with children as well as non-obese adults with obese children. Parents working more than eight hours a day who leave their children under minimal supervision while they’re at work were also considered for the study. Parents with a higher level of education (those that completed their tertiary training) have greater adherence to providing healthier meal options to their families at least twice every day, compared to those that dropped out in high school. Previously obese members from households that embraced the healthier meal options and exercise plans showed a significant reduction in weight compared to those from the households that chose to stick to their routine unhealthy diet options and non-exercising lifestyle.

Do not skip this space

Conclusion

In summary, it is evident that parental diet and exercise habits are greatly reflected in their children’s weight gain patterns. Genetic obesity aside, adults who became obese because of their carefree lifestyle choices are highly likely to have obese children. As seen in the paper, they do not take the initiative to train their children through sensibly healthy eating habits and physical exercise since they themselves have not been through these choices.

 

References

Angawi, K., &Gaissi, A. (2021). Systematic Review of Setting-Based Interventions for

Preventing Childhood Obesity. BioMed Research International, 1–10. https://doi.org/10.1155/2021/4477534

Center for Disease Control and Prevention. (2021). Healthy Weight, Nutrition, and Physical

Activity. Retrieved from:

https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

 

Henderson, N. N. (2021). Childhood Obesity: Improving Outcomes Through Primary Care-

Based Interventions. Pediatric Nursing, 47(6), 267–300.

Kraak, V. A., Liverman, C. T., &Koplan, J. P. (Eds.). (2005). Preventing childhood obesity:

health in the balance.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nursing homework help

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Nursing homework help

Article

The grounded theory looks to analyze how people understand and interact with other people in their world and interpret the socially shared meanings which influence human behaviors. In practice, nurses can use grounded theory to assess health patterns in population groups and communities and predict health patterns and care concerns in nursing practice (Singh & Estefan, 2018). For example, grounded theory analyzes the causes of altered mental status among patients in the nursing home and the hazards of falls and unstable gait. Nursing homework help

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Ethnographic research analyzes people in their environment through observation and face-to-face participant interviewing (Lambert et al., 2011).

Ethnography in nursing means obtaining access to ethnicity or culture’s health beliefs and practices, for example, observing stress levels in the medical personnel in a high-volume hospital (Robertson & Boyle 1984)

Grounded theory and ethnographic research are used in qualitative studies in numerous social science fields. They are both based on inductive and systematic methods of exploring cultural aspects such as beliefs, values, behaviors, language. The particular group of the population has lived together over an extended period of time, have similar attitude, beliefs, attitudes, habits. The difference between them is that a grounded theory describes the pattern of the research aspects, the ethnographic represents the cultural interpretation of the research aspects in a particular culture.

References

Lambert et al. (2011). Employing an ethnographic approach: key characteristics. 19(1):17-24. https://doi.org/10.7748/nr2011.10.19.1.17.c8767

Robertson, M. H., Boyle, J.S. (1984). Ethnography: contributions to nursing research. Leading Global Nursing Research.  https://doi.org/10.1111/j.1365-2648.1984.tb00342.x

Singh, S., Estefan, A. (2018). Selecting a Grounded Theory Approach for Nursing Research. Global Qualitative Nursing Research. https://doi.org/10.1177/2333393618799571

(Please write a response to the article above using 200-300 words APA format with at least two references. Sources must be published within the last 5 years. There should be a mix between research and your reflections. Add critical thinking in the posts along with research. Apply the material in a substantial way.)

Nursing homework help

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Nursing homework help

Deliver to the interprofessional team a presentation (20 minutes; 12 slides) that analyzes an existing workplace quality improvement initiative related to a specific disease, condition, or public health issue of interest. The presentation’s purpose is to inform and get buy-in from the interprofessional team. Nursing homework help

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Introduction

Too often, discussions about quality health care, care costs, and outcome measures take place in isolation—various groups talking among themselves about results and enhancements. Nurses are critical to the delivery of high-quality, efficient health care. As a result, they must develop their skills in reviewing and evaluating performance reports. They also need to be able to communicate outcome measures related to quality initiatives effectively. Patient safety and positive institutional health care outcomes mandate collaboration among nursing staff members to ensure the integration of their perspectives in all quality care initiatives.

In this assessment, you will have the opportunity to analyze a quality improvement initiative in your workplace. You will then present your analysis to a group of nurses and other health care professionals. The purpose of your presentation is to inform and enlist support for the initiative from your audience.

Preparation

Quality Initiative Selection

In this assessment, you will deliver an analysis of an ongoing quality improvement initiative in your workplace. The initiative you analyze must relate to a specific disease, condition, or public health issue of personal or professional interest to you. The purpose of your analysis is to assess whether specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics. Your audience consists of nurses and selected health care professionals with specializations or interests in your selected condition, disease, or issue. You hope to inform and garner support for the initiative from your audience.

Instructions

  • Analyze a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives.
  • Explain the rationale behind the QI improvement initiative. What prompted the initiative?
  • Detail problems that were not addressed and any issues that arose from the initiative.
  • Evaluate the success of a current quality improvement initiative according to recognized national benchmarks.
    • Analyze the benchmarks used to evaluate success. Which aspects of the initiative were most successful? What outcome measures are missing or could be added?
    • Incorporate one appropriate supporting visual (such as a graph or chart) that showcases the most critical aspect of this presentation.
  • Incorporate interprofessional perspectives related to initiative functionality and outcomes.
  • Integrate the perspectives of interprofessional team members involved in the initiative. Who did you talk to? What are their professions? How did their perspectives impact your analysis?
  • Recommend additional indicators and protocols to improve and expand outcomes of a quality initiative.
    • Identify specific process or protocol changes as well as technologies that would improve quality outcomes.
  • Ensure slides are easy to read and error free. Provide detailed speaker notes. Also ensure audio is clear, organized, and professionally presented.
  • Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

Additional Requirements

  • Presentation length: A maximum of 20 minutes.
  • The number of slides: 12 slides. Balance text and visuals. Avoid text-heavy slides. Use the speaker’s notes for additional content.
  • Font and font size: Appropriate size and weight for presentation, generally 24-28 points for headings; no smaller than 18 points for bullet-point text. Use a suitable professional typeface such as Times or Arial throughout the presentation.
  • The number of references: Cite a minimum of seven current scholarly and/or authoritative sources to support your analysis. Current is defined as no older than 5 years unless a seminal work.
  • APA formatting: Adhere to APA style and formatting guidelines for citations and references. Consult these resources for an APA refresher:

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 2: Plan quality improvement initiatives in response to routine data surveillance.
  • Recommend additional indicators and protocols to improve and expand quality outcomes of a quality initiative.
  • Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
    • Analyze a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives.
    • Evaluate the success of a current quality improvement initiative according to recognized national benchmarks.
  • Competency 4: Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work life quality.
    • Incorporate interprofessional perspectives related to initiative functionality and outcomes.
  • Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Slides are easy to read and error free. Detailed speaker notes are provided. Audio is clear, organized, and professionally presented.
    • Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

 

Nursing homework help

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Nursing homework help

Writing the In-text Citation: How your in-text citation looks or how the author and year will be properly written will depend upon the type of resource and the number of authors. The table below shows some of the more common citation situations.  For additional citation situations and examples, see Section 8 of the Publication Manual of the American Psychological Association, Seventh Edition (2019). Nursing homework help

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Author type/resource Parentheticalcitation Narrative citation

 

One author (Harris, 2020) Harris (2020)

 

Two authors (Martin & Wells, 2020) Martin and Wells (2020)

 

Three or more authors (Schultz et al., 2016)Schultz et al. (2016)

 

Group author  (Chamberlain University, 2020)Chamberlain University (2020)

 

No author, article/web page (“Employee Communications,” 2020) “Employee Communications” (2020)

 

No author, no date, article/web page (“Employees and Communications,” n.d.) “Employees and Communication” (n.d.)

 

Personal Communication (D. Schultz, personal communication, April 22, 2019) D. Schultz (personal communication, April 22, 2019)

 

Indirect resource (secondary resource) (Schultz, 2016, as cited in Harris, 2020, p. 73) Schultz wrote that. . .  (as cited in Harris, 2020, p. 73)

 

Multiple Resources (Harris, 2020; Schultz, 2016)Harris (2020) and Schultz (2016) in separate studies both found. . . Nursing homework help

 

Formatting the Reference Page: Begin on a new page after the completion of the essay. Capitalize, bold, and center the word References on the first line of the page. Alphabetize all entries (see APA manual section 9.43 for details). Doublespace all entries. Use a hanging indent- the first line of each entry is flush with the left margin;all lines after are indented a half-inch for each entry.Creating the Reference Page Entry: To create each reference page entry, you need four pieces of information about yourresource author, date, title, and source presented in this order.  Knowing what information fits into each of these foursections, can help you build a correct reference entry.

References

Schultz, D. (2016). The advantages of communication skills in a professional setting. Ohio Press.

 

Qualitative Researchers Essay

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Qualitative Researchers Essay

collect in-depth descriptive data about a particular topic to have adequate knowledge about the occurrence. Qualitative research is aimed at obtaining data from the participants which helps the researcher to understand their experiences and subsequently assist them to identify appropriate interventions (Green and Johnson, 2018).   The three types of qualitative research, phenomenological, grounded theory, and ethnographic can be evaluated by using similar methods, such as identifying common themes, gathering impressions, or collecting personal experiences and perceptions. Qualitative Researchers Essay

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While phenomenological and ethnographic research seeks to understand lived experiences, phenomenological deals with individuals lived experiences and ethnography research seeks to understand a culture through individuals who actually live in that culture.  Phenomenological research deals with individuals and their experiences while developing a concept, philosophy and narration based on their lived experience, whereas Ethnography research deals with values, beliefs, and practices of cultural groups in the context of ethnic population, society, community, organization, or a social world (Hamid, 2018). Although the studies are done in their natural settings and use a holistic approach to study the phenomena, the data collection approach is different. Phenomenological data is collected through only comprehensive interviews and conversations with participants whereas; ethnography collection is done through, related documents, articles significant informant interviews and observation which allow the researcher to live in the midst of the culture to extremely observe the environment under study (Grossoehme, 2014).

For phenomenological research, analyzing phenomena in this context means researchers may gather different views from various individuals to see how the phenomenon affects their life. An example of this would be mothers with children who have asthma attacks. The study would encompass every life aspect, from triggers, using and carrying inhalers everywhere, to allergies and manipulating the environment (Grossoehme, 2014). However, ethnography study is valuable when considering topics that are multi-factorial, or multi-cultural. For instance, to explore inflammatory bowel disease (IDB) among paediatrics and to understand the impacts it has on the family when a child is diagnosed with IDB the researcher conducted a study with 3 different families to inquire about how different types of parents and children adaption to the disease and to learn which tools will help different types of parents and children with IDB (Hamid, 2018).

References

Green, S. Z. and Johnson, J. L. (2018). Research Ethics and Evaluation of Qualitative Research. In Grand Canyon University (Ed). Nursing Research: Understanding Methods for Best Practice (Chapter 2). https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/2

Grossoehme D. H. (2014). Overview of qualitative research. Journal of health care chaplaincy, 20(3), 109–122. https://doi.org/10.1080/08854726.2014.925660

Hamid R. Jamali,(2018). Does research using qualitative methods (grounded theory, ethnography, and phenomenology) have more impact?, Library & Information Science Research. 40, 3–4. https://doi.org/10.1016/j.lisr.2018.09.002.

(Please write a response to the article above using 200-300 words APA format with at least two references. Sources must be published within the last 5 years. There should be a mix between research and your reflections. Add critical thinking in the posts along with research. Apply the material in a substantial way.)

PROJECT NAVIGATION

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PROJECT NAVIGATION

SECTION 2A: PROJECT NAVIGATION

**(All previous related to Practice Issues in a clinic of STD Prevention andTreatmentwork can be used to answer it, attached you will find information for answer, but feel free to use whatever you consider pertinent). APA is required. PROJECT NAVIGATION

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Practice Issues in a clinic of STD Prevention and Treatment

  • After you communicated with the practicum site decision maker(s), what issue/problem did they state they wanted you to work on as part of your DNP practicum?

 

 

  • Provide a problem statement (no less than 5-6 fully structured sentences) to explain the issue/problem you are addressing. Please describe the current practice/process leading to the issue. Provide any reports or currently available data to document the need identified. NOTE: in this section, you must include in-text citations with your evidence-based intervention.

 

 

 

  • Provide a brief description, using in-text citations/references to support the need for change from both a global and practicum site perspective.

 

 

 

  • What is the purpose of your proposed project? Begin your formal purpose statement by stating, “The purpose of the proposed DNP project is to…”

 

 

 

  • Based on the needs of the practicum site, please provide your one-sentence PICOT question below in a clear and concise manner. Note: Your population cannot be students or faculty; your intervention cannot be educational and your time frame must be 8-10 weeks.

 

PICOT Question: What is the impact of implementing telehealth follow-up protocol for young adults missing appointments from an STDs clinic over eight weeks?

 

 

 

  • Fully describe the population (keep in mind students and/or faculty are not allowed) of your proposed project. What is your anticipated sample size and what inclusion and exclusion criteria will be used to identify your population?

 

 

  • You are required to have a minimum of 10-12 contemporary research articles (< 5 years old) to support your evidencebased practice (EBP) intervention. Please provide a full listing (APA formatted) of the evidence you have to support the EBP intervention you will implement.

 

 

  • Explain the intervention you will implement to address the issue identified based on the needs of the practicum site. Remember, educational only interventions are not allowed. The intervention should be based on the translational science model you have chosen. You must provide an overview of the intervention so the reader(s) will be able to duplicate the intervention on their own. (Include or attach any relevant documents, if available such as protocols, procedures, guidelines, etc. that you will implement)

 

 

  • Given you only have 8-10 weeks to implement your project, discuss its feasibility. Will you be able to accomplish everything you want to do as far as implementation in 8-10 weeks? What barriers might you have and how will you overcome them?

 

  • Explain your plans for data collection to measure the impact of your intervention. Include a concise description of the measurable outcome you identified in your PICOT question. Provide the name of the tool/instrument you will use (if applicable) and discuss its validity and reliability with in-text citations from supporting literature. Additionally, fill out the chart below to concisely convey your measurable outcomes and the name(s) of the valid/reliable survey instrument/tool(s) you will use.

 

 

 

  • Measurable Outcome(s) as Identified in the PICOT Question

 

 

 

  • Data Collection Process Pre- and Post-Intervention

 

 

 

  • Explain your plan for data analysis. Identify the statistical test(s) you will use to bring meaning to the final data you collect atthe completion of your project.

 

Telehealth Innovative Solution to Engage Young Adults in STDs Prevention

STDs are a leading source of morbidity in the United States, costing an estimated $15.9 billion in direct medical costs over a lifetime (Llata et al., 2021). Studies also reveal that the annual cases of STDs in the USA continue to rise, reaching an all-time high for the eighth year. The most common reported STDs are chlamydia, syphilis, and gonorrhea. There was a nearly 30% increase in STDs between 2015 and 2019 (Gebrezgi et al., 2021). These rates are alarming, considering that the rates were lower less than 20 years ago. For example, gonorrhea was at historic lows, and syphilis was close to elimination (Trepka et al., 2021). The drastic changes show a need to prioritize efforts and regain control of the grounds to minimize the spread of STDs. As per the CDC (2019), STD surveillance, assuring that everyone has access to high-quality HIV and STD prevention and treatment, is a critical component of successful public health response to rising STD prevalence.

Collaborating with a clinic forthe prevention and treatment of Sexually Transmitted Diseases (STDs), I had the opportunity to speak with relevant stakeholders and decision-makers. We were able to identify and discuss issues affecting the clinical health outcomes of STDs preventative and treatment activities. According to the stakeholders, it is common to find that some young adults with high-risk sexual behavior come to the clinic for STDs test and treatment. After that, they don’t return for continued care until they have new symptoms or an STD reinfection. Although sexually transmitted diseases (STDs) impact people of all ages, it is most noticeable among youth aged 15 to 24 (Sieving et al., 2019).Young adults are less interested in STDs prevention or behavior modification initiatives. Also, you can find other patients that start HIV PrEP medication but don’t come to the clinic for follow-up as indicated, despite the multiple efforts done by the clinical personnel.

After the discussion, I proposed that the clinic use innovative, evidence-based digital interventions to engage patients in STDs prevention and treatment while promoting community awareness. In the United States, sexually transmitted diseases (STDs) are rising, and additional research into effective prevention and treatment strategies is urgently needed (Shannon & Klausner 2018). Telehealth can serve as a tool that increases the availability of services for patients. Telemedicine has emerged as a critical resource for limiting disease spread by increasing patient surveillance, promoting early detection, allowing quick management of sick people,and ensuring continuity of care for vulnerable patients worldwide (Omboniet al., 2022).

It’s a tool that facilitates the work of directly promoting education, screening, treatment, and prevention for susceptible populations, like young people with high-risk sexual behavior. Sexually transmitted infections are significant public health concerns.

 

Recent CDC reports show that the rate of new STDs infections continues to be high; 4 of the 25 cities that top the list of infection rates are in Florida; Miami spiked upward and is currently ranked among the top 25 towns mostly affected (Butame et al., 2021).

Population: young adultsmissing appointmentsfrom an STDs clinic in Miami, Florida.

Intervention:implement telehealth follow-up protocol for patients missing appointments.

Comparison: current practice.

Outcome: improve patient outcomes, engage young adult patients in STDs prevention and treatment.

Time: eight Weeks.

PICOT Question: What is the impact of implementing telehealth follow-up protocolfor young adults missing appointmentsfrom an STDs clinic over eightweeks?

Translation science model: knowledge to action

My current priority is to engage young adultsinpreventing Sexually Transmitted Diseases so that less effort and resources will be required for treatment interventions. Implementinga telehealth follow-up protocol for patients missing appointments will make medical care more accessible for young adults that are currently missing appointments and will cut this current gap in practice.Telehealth was created to give primary treatment to individuals in remote and underserved areas. Since the coronavirus illness epidemic in 2019, numerous practitioners have increased their use of telemedicine. Increased emphasis on patient satisfaction, efficient and quality care, and cost-cutting has also led to increased telehealth adoption (Gajarawala&Pelkowski, 2021).

The use of telehealthby the patients and the clinic represents an opportunity to save money and time. Telehealth can be easily implementedand will be a valuable tool for patient education.

 

References

CDC. Sexually transmitted disease surveillance 2018. Atlanta, GA: US Department of Health and Human Services, CDC, 2019. https://www.cdc.gov/std/stats18/STDSurveillance2018-full-report.pdf [Ref list]

Gajarawala, S. N., &Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The journal for nurse practitioners: JNP, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

Llata, E., Cuffe, K. M., Picchetti, V., Braxton, J. R., &Torrone, E. A. (2021). Demographic, Behavioral, and Clinical Characteristics of Persons Seeking Care at Sexually Transmitted Disease Clinics – 14 Sites, STD Surveillance Network, United States, 2010-2018. Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C.: 2002), 70(7), 1–20. https://doi.org/10.15585/mmwr.ss7007a1

Omboni, S., Padwal, R. S., Alessa, T., Benczúr, B., Green, B. B., Hubbard, I., Kario, K., Khan, N. A., Konradi, A., Logan, A. G., Lu, Y., Mars, M., McManus, R. J., Melville, S., Neumann, C. L., Parati, G., Renna, N. F., Ryvlin, P., Saner, H., Schutte, A. E., … Wang, J. (2022). The worldwide impact of telemedicine during COVID-19: current evidence and recommendations for the future. Connected health, 1, 7–35. https://doi.org/10.20517/ch.2021.03

Shannon, C. L., & Klausner, J. D. (2018). The growing epidemic of sexually transmitted infections in adolescents: a neglected population. Current opinion in pediatrics, 30(1), 137–143.

https://doi.org/10.1097/MOP.0000000000000578

Sieving, R. E., Gewirtz O’Brien, J. R., Saftner, M. A., & Argo, T. A. (2019). Sexually Transmitted Diseases Among US Adolescents and Young Adults: Patterns, Clinical Considerations, and Prevention. The Nursing clinics of North America, 54(2), 207–225. https://doi.org/10.1016/j.cnur.2019.02.002

 

 

SOAP NOTE 6 PEDIATRICS/ URINARY TRACT INFECTION

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SOAP NOTE 6 PEDIATRICS/ URINARY TRACT INFECTION 

Faculty Comments:  Faculty Comments: Points Description
Subjective
5 Chief complaint stated in patient’s own words.
10 HPI, PMH, PSH, Family History, Social Habits,
10 Contains all systems relevant information to make assessment with normal and abnormal findings.
20 Objective present and contains all pertinent objective information available (drug allergies, physical findings, drug list, etc)
20 Assessment presents justification for Main or Primary diagnosis
15 Assessment rules out other potential disorders
5 Plan contains discussion of therapy options with pros and cons of each. Also
10 Plan stated as directives (start, stop, non-pharmacologic and pharmacologic treatment etc)
5 Plan include monitoring and follow up  SOAP NOTE 6 PEDIATRICS/ URINARY TRACT INFECTION

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(Student Name)

Miami Regional University

Date of Encounter:

Preceptor/Clinical Site:

Clinical Instructor: Dr. David Trabanco DNP, APRN, AGNP-C, FNP-C

 

Soap Note #1 DX: Allergic Rhinitis

 

PATIENT INFORMATION

Name: Ms.JD

Age: 23-year-old

Gender at Birth: Female

Gender Identity: Female

Source: Patient

Allergies: NKDA

Current Medications:

  • Cetirizine 10mg/d
  • Mucinex-D

PMH:

Immunizations: Tetanus.

Preventive Care:No history.

Surgical History: No history of surgery.

Family History: Father- alive, 60 years old, healthy.

Mother-alive, 54 years old, HTN, hyperlipidemia.

Sister-alive, 20 years old, Asthma.

Social History:Denies alcohol, tobacco or illicit drugs use. College student, lives alone in campus hostels. Physically active and occasionally does exercise.

Sexual Orientation: Active

Nutrition History: Eats balance diet but avoids excessive junk food.

Subjective Data:

Chief Complaint: “stuffy nose” that has lasted for two weeks.

Symptom analysis/HPI:

Ms. JD is a 23-year-oldpatient who presents with complaints of a stuffy nose, rhinorrhea, congestion and sneezing.She reports a spontaneous start of the symptoms that have remained consistent. Indicates no particular aggravating symptoms but reports higher severity of the symptoms in the morning. She complains of a sore throat and itchy eyes. She reports an all-day clear runny nose. She indicates consistent outdoor handball practice routine.  She reports using Cetirizine and Mucinex-D which do not help. She denies vision or taste changes. She denies fever or chills. Denies diagnosis with allergies.

Review of Systems (ROS)

CONSTITUTIONAL: Denies change in weight, fatigue, fever, night sweats or chills.NEUROLOGIC: Denies seizure, numbness or blackout.

HEENT: HEAD: Denies headache. Eyes:Reports itchy eyes. Denies vision change.Ear: Denies hearing loss, pain or discharge. Nose:Admits stuffiness, nasal congestion and clear discharge.Denies nose bleeds. THROAT: Reports a sore throat.

RESPIRATORY: Patient denies breathing difficulties, cough, wheezing, TB, pneumonia.

CARDIOVASCULAR: No palpitations or chest pain. No edema, PND or orthopnea.

GASTROINTESTINAL: Denies nausea, abdominal pains, vomiting and diarrhea. Denies ulcers hx.

GENITOURINARY: Denies change in urine color, urgency and frequency.Regular menses cycle. Denies ovulation pain. Denies hematuria anddysuria.

MUSCULOSKELETAL: Denies back and joint pains or stiffness.

SKIN: No skin rashes or lesions.

 

Objective Data:

VITAL SIGNS: Temperature: 36.7 °C, Pulse: 78, BP: 119/87 mmHg, RR 20, PO2-97% on room air, Ht- 1.60m, Wt 67kg, BMI 26.

 

GENERAL APPREARANCE: Healthy appearing. Alert and oriented x 3. No acute distress. Well-groomed and responds appropriately.

NEUROLOGIC: Alert, oriented, posture erect, clear speech. gait. to person, place, and time.

HEENT:Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses mild tenderness. Eyes: Bilateral conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No edema, no lesions, no haemorhage. Clear discharge. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Nose: Mild erythema of nasal mucosa which is paly and boggy, congested nares with rhinorrhea. No nasal crease. Throat: Posterior pharynx with no tonsillar edema, erythema or exudate. Uvula midline. Moist mucous membranes.

 

Neck: supple. No cervical or post auricular lymphadenopathy. No thyroid swelling or masses. Non tender

CARDIOVASCULAR: S1and S2.RRR w/o sound. Capillary refill in 2 sec. Pulse >3.

RESPIRATORY:Regular respiration. Thorax symmetrical. No increased respiratory effort.Breath sounds vesicular on auscultation.

GASTROINTESTINAL:Nohepatosplenomegaly. Bowel sounds present in all four quadrants. no bruits over renal and aorta arteries. Soft, non-distended, non-tender abdomen with no palpation.

MUSKULOSKELETAL:Full motion range in all extremities.

INTEGUMENTARY: intact, no lesions or rashes.

 

ASSESSMENT:

Main Diagnosis

Allergic Rhinitis(ICD-10 code J30.8)

Allergic rhinitis is an inflammatory infection of the nasal mucosa characterized by nasal congestion, sneezing and rhinorrhea (Greiner et al., 2011). It is an inflammation of the interior nasal lining due to inhalation of an allergen that results in a runny nose, stuffy nose, itchy eyes and sore throat (Seidman et al., 2015).

 

Differential diagnosis:

  • Viral Rhino Sinusitis

Characterized by headaches, sore throat, nasal congestion, fever and sneezing (Reintjes &Peterson, 2016). Patient denied headache or fever.

  • Acute Conjunctivitis

Associated with red eye and mucopurulent discharge and at times lack of itching (Azari &Barney, 2013). Patient reported itchy eyes but with a clear discharge.

PLAN:

 

Labs and Diagnostic Test to be ordered:

  • Skin prick testing
  • Serum Immunoassay test
  • Acoustic rhinometry

Pharmacological treatment:

  • Fexofenadine 120mg daily oral dose (Bernstein, Schwartz&Bernstein, 2016).
  • Fluticasone furoate 2 sprays (27.5 µg/spray) EN, once daily

 

Non-Pharmacologic treatment:

  • Allergen avoidance.
  • Allergen immunotherapy

Education

  • Patient should be educated on the nature of the disease, probability of progression and the importance of treatment (Greiner et al., 2011).
  • Education on safety concern of the medications.
  • Information on potential side effects of the medications to reduce higher treatment expectations.
  • Educate the patient on efficient nasal drug admission for effective drug compliance and treatment.
  • Education on the aims of the treatment and possible benefits to enhance adherence to the medication.

Follow-ups/Referrals

  • Follow up appointmentafter weeks to monitor the efficacy of administered medication and subsequent interventions.
  • No referrals needed at this time.

 

 

 

 

 

 

 

 

 

 

 

References

Azari, A. A., & Barney, N. P. (2013). Conjunctivitis: a systematic review of diagnosis and treatment. Jama, 310(16), 1721-1730.

Bernstein, D. I., Schwartz, G., & Bernstein, J. A. (2016). Allergic rhinitis: mechanisms and treatment. Immunology and Allergy Clinics, 36(2), 261-278.

Greiner, A. N., Hellings, P. W., Rotiroti, G., & Scadding, G. K. (2011). Allergic rhinitis. The Lancet, 378(9809), 2112-2122.

Reintjes, S., & Peterson, S. (2016). Rhino sinusitis. Oxford Medicine Online

Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R., … & Nnacheta, L. C. (2015). Clinical practice guideline: allergic rhinitis. Otolaryngology–Head and Neck Surgery, 152(1_suppl), S1-S43.

 

 

SOAP NOTE 6 OB / PRIMARY DYSMENORRHEA

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SOAP NOTE 6 OB / PRIMARY DYSMENORRHEA

Faculty Comments:  MRU Soap Note Grading Rubric
This sheet is to help you understand what is required, and what the margin remarks might be about on your comments of patients. Since most of your comments that you hand in are uniform, this represents what MUST be included in every write-up.
1) Identifying Data (5/5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

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2) Subjective Data (30/30pts.): This is the historical part of the note. It contains the following:

a) Symptom analysis/HPI (Location, quality, quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts).
b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts).
c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written in this manner.

3) Objective Data(25/25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.

a) Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts).
b) Pertinent positives and negatives must be documented for each relevant system.
c) Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts). SOAP NOTE 6 OB / PRIMARY DYSMENORRHEA

4) Assessment (10/10pts.): All diagnoses should be clearly listed and worded appropriately with ICD 10 codes. Rationale and Explanation must be evidence based and have 1-2 in text references to back up your reasoning for making your main diagnosis selection. 3 differential diagnosis must be noted, rationale not required but encouraged.

5) Plan (15/15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections. Should not be generic information and should be tailored to your patient and their needs / specific diagnosis.

6) Subjective/ Objective, Assessment and Management and Consistent (10/10pts.): Does the note support the appropriate differential diagnosis process? Is there evidence that you know what systems and what symptoms go with which complaints? The assessment/diagnoses should be consistent with the subjective section and then the assessment and plan. The management should be consistent with the assessment/ diagnoses identified.

Clarity of the Write-up(5/5pts.): Is it literate, organized, and complete? SOAP NOTE 6 OB / PRIMARY DYSMENORRHEA

Grading Rubric

 

Student______________________________________

This sheet is to help you understand what we are looking for, and what our margin remarks might be about on your write ups of patients. Since at all of the white-ups that you hand in are uniform, this represents what MUST be included in every write-up.

 

  • Identifying Data (___5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

 

  • Subjective Data (___30pts.): This is the historical part of the note. It contains the following:

 

  1. a) Symptom analysis/HPI(Location, quality , quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts).
  2. b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts).
  3. c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written u in this manner.

 

  • Objective Data(__25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.

 

  1. Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts).
  2. Pertinent positives and negatives must be documented for each relevant system.
  3. Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts).

 

  • Assessment (___10pts.): Diagnoses should be clearly listed and worded appropriately.

 

  • Plan (___15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections.

 

  • Subjective/ Objective, Assessment and Management and Consistent (___10pts.): Does the note support the appropriate differential diagnosis process? Is there evidence that you know what systems and what symptoms go with which complaints? The assessment/diagnoses should be consistent with the subjective section and then the assessment and plan. The management should be consistent with the assessment/ diagnoses identified.

 

  • Clarity of the Write-up(___5pts.): Is it literate, organized and complete?

 

Comments:

 

Total Score: ____________                                                          Instructor: __________________________________

 

 

 

 

 

 

Guidelines for Focused SOAP Notes

  • Label each section of the SOAP note (each body part and system).
  • Do not use unnecessary words or complete sentences.
  • Use Standard Abbreviations

S: SUBJECTIVE DATA (information the patient/caregiver tells you).

Chief Complaint (CC): a statement describing the patient’s symptoms, problems, condition, diagnosis, physician-recommended return(s) for this patient visit. The patient’s own words should be in quotes.

History of present illness (HPI): a chronological description of the development of the patient’s chief complaint from the first symptom or from the previous encounter to the present. Include the eight variables (Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors, Treatment, Severity-OLDCARTS), or an update on health status since the last patient encounter.

Past Medical History (PMH): Update current medications, allergies, prior illnesses and injuries, operations and hospitalizations allergies, age-appropriate immunization status.

Family History (FH): Update significant medical information about the patient’s family (parents, siblings, and children). Include specific diseases related to problems identified in CC, HPI or ROS.

Social History(SH): An age-appropriate review of significant activities that may include information such as marital status, living arrangements, occupation, history of use of drugs, alcohol or tobacco, extent of education and sexual history.

Review of Systems (ROS). There are 14 systems for review. List positive findings and pertinent negatives in systems directly related to the systems identified in the CC and symptoms which have occurred since last visit; (1) constitutional symptoms (e.g., fever, weight loss), (2) eyes, (3) ears, nose, mouth and throat, (4) cardiovascular, (5) respiratory, (6) gastrointestinal, (7) genitourinary, (8) musculoskeletal, (9-}.integument (skin and/or breast), (10) neurological, (11) psychiatric, (12) endocrine, (13) hematological/lymphatic, {14) allergic/immunologic.  The ROS should mirror the PE findings section.

0: OBJECTIVE DATA (information you observe, assessment findings, lab results).

Sufficient physical exam should be performed to evaluate areas suggested by the history and patient’s progress since last visit. Document specific abnormal and relevant negative findings. Abnormal or unexpected findings should be described. You should include only the information which was provided in the case study, do not include additional data.

Record observations for the following systems if applicable to this patient encounter (there are 12 possible systems for examination): Constitutional (e.g. vita! signs, general appearance), Eyes, ENT/mouth, Cardiovascular, Respiratory, GI, GU, Musculoskeletal, Skin, Neurological, Psychiatric, Hematological/lymphatic/immunologic/lab testing.   The focused PE should only include systems for which you have been given data.

NOTE: Cardiovascular and Respiratory systems should be assessed on every patient regardless of the chief complaint.

Testing Results: Results of any diagnostic or lab testing ordered during that patient visit.

A: ASSESSMENT:  (this is your diagnosis (es) with the appropriate ICD 10 code)

List and number the possible diagnoses (problems) you have identified. These diagnoses are the conclusions you have drawn from the subjective and objective data.

Remember:Your subjective and objective data should support your diagnoses and your therapeutic plan.

Do not write that a diagnosis is to be “ruled out” rather state the working definitions of each differential or primary diagnosis (es).

For each diagnoses provide a cited rationale for choosing this diagnosis. This rationale includes a one sentence cited definition of the diagnosis (es) the pathophysiology, the common signs and symptoms, the patients presenting signs and symptoms and the focused PE findings and tests results that support the dx. Include the interpretation of all lab data given in the case study and explain how those results support your chosen diagnosis.

P: PLAN (this is your treatment plan specific to this patient). Each step of your plan must include an EBP citation.

  1. Medications write out the prescription including dispensing information and provide EBP to support ordering each medication. Be sure to include both prescription and OTC medications.
  2. Additional diagnostic tests include EBP citations to support ordering additional tests
  3. Education this is part of the chart and should be brief, this is not a patient education sheet and needs to have a reference.
  4. Referrals include citations to support a referral
  5. Follow up. Patient follow-up should be specified with time or circumstances of return. You must provide a reference for your decision on when to follow up.

 

 

Evidence-Based Practice Inquiry

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Evidence-Based Practice Inquiry

Literature Review Table

ORDER A PLAGIARISM FREE PAPER NOW

APA reference of article

 

 Roou, B., Park, E., Perez, G., Rabin, J., Quain, K., Dizon, D., Post, K., Chinn, G., McDonough, .Jimenz, R., van de Poll-Franse, L. &Ppercron, J. (2018). Cluster analysis demonstrates the need to individualize care for cancer survivors. The Oncologist:Health Outcomes and Economics of Cancer Care, 23, 1474-1481. www.TheOncologist.com

 

  
Purpose of article

 

 

 

  

Researchers sought to identify and characterize subgroups based on client cancer survivors self-report and assessing of sociodemographics Evidence-Based Practice Inquiry

 

 

 

  
Sample size

(N= total sample size

n= portion of sample size)

 

 

  

N= 292

(n= 123.42%)  had low unmet needs Evidence-Based Practice Inquiry
(n=46, 16%) physical unmet needs

(n=57, 20%) psychological unmet needs

(n=66, 23%) – both psychological and physical unmet needs

 

Two groups of clusters had p values of <0..05 for psychological and fatigue. These low p values are significant because this means the effect is likely real and not a result of other variables

 

  
Research design

(explain the definition of the research design) and

level of evidence

(Melnyk Figure 4.2, page 116)

  

Cross sectional assessment survey – this give type of study design give a snapshot at one particular time and measures the participants at one specific time – when they questionnaire/survey is completed

 

This would be  categorized under non-experimental study – we are not changing variables we are gathering data at a particular time or event

  
Variables (independent and dependent variables)

measurement

 

 

  

Sociodemographic variables included age, gender, race, marital status, employment, internet access, educational level, and income.

Clinical variables include cancer type, years since diagnosis, treatment, and comorbidities

 

  
Results, findings

(identify percentages or p values< 0.05)

 

 

 

 

  

Two groups of clusters had p values of <0..05 for psychological and fatigue. These low p values are significant because this means the effect is likely real and not a result of other variables

  
Implications for Practice

 

 

 

 

 Cancer survivorship has unmet needs throughout the lifespan. Health care must not diminish he need for frequent screening for survivorship care

Younger the client the more unmet needs or need to meet needs to adjust to the cancer survivorship

  
Limitations of research (what is not included in the findings or research method) Research was at one institution, there is little generalizability (will have the same result) if the income level is changed.

Clients with higher comorbidities are likely being seen by a number of providers and have needs addressed

Questionnaire was in multi-language however culture can prevent a client from stating their needs at a particular time

This is a snapshot at one point in time at a cancer center

  
Comments

 

 

 

 

  

There are unmet needs that need screening every time at every provider appointment, including primary care, who likely get s the majority of clients in cancer survivorship

 

 

 

  

 

References

Groff, S., Holroyd-Leduc, J., White, D. &Bultz, B. (2019). Examining the sustainability of screening for

distress, the sixth vital sign, in two outpatient oncology clinics: A mixed-methods study. Psycho-

Oncology, 27, 141-147. doi:10.1002/pon.4388

Roou, B., Park, E., Perez, G., Rabin, J., Quain, K., Dizon, D., Post, K., Chinn, G., McDonough, .Jimenz,

R., van de Poll-Franse, L. &Ppercron, J. (2018). Cluster analysis demonstrates the need to

individualize care for cancer survivors. The Oncologist:Health Outcomes and Economics of Cancer

Care, 23, 1474-1481. www.TheOncologist.com

Module2

Weeks 3-4

 Topic Assigned Content/Readings

 

 Assignments/Due Dates
 Week 3

 

 

Models to Guide Implementation and Sustainability of EBP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Evidence-Based Practice

Models

 

 

 

Critically appraising the evidence

 

 

 

 

 ReadMelnyk & Fineout-Overholt  Ch. 14

 

Review APA Chapters 1-8

 

 

Assignment:Chose a EBP model that aligns with your PICO(T)and Complete Research Model Worksheet

Instructions:After reading Chapter 14 in Melnyk & Fineout-Overholt. Review the following models and choose one that best fits your PICO(T), the organization where you work or where you would implement the PICO(T):

IOWA Model of EBP, John Hopkins Nursing Process for EBP,Stetler Model of EBP, Stevens Start Model, Clinical Scholar Model, PARIHS Elements and Sub-elements, and ARCC Model

Once you have chosen your EBP model complete the Research Model worksheet found in this module.  This will guide your EBP study based on your specific PICO(T) ( and will be included in your  Research Paper) Please complete this worksheet using APA 7th ed format .

Review the following in Module 2 to provide guidance and examples in further detail:

Research Model Worksheet

Research Model Example

 

 

Submit Research Model Worksheet to the drop box Sunday by 11:59pm

 

 

 

 Quizzes Due:

No quiz due this week

 

Discussion:

No discussion due this week

 

Assignment: Submit Research Model worksheet to drop box Sunday by 11:59

 

 

 

 

 

 

 
Week  4

 

Quantitative and Qualitative Evidence 

 

 

  

Critically appraising the evidence

 

Technical Writing

 

 

 

 

 

 

 

Professional Writing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

ReadMelnyk & Fineout- Overholt Chapters 5, 6,17. 18

 

Review: Literature Review Content found in Module 2

 

Read: Differences between qualitative and quantitative articles handout found in the content area of Module 2.

 

Discussion:  Using the MSU library data baseidentify one Quantitative  and one Qualitative article for your PICO (T) that demonstrates support your desired clinical question/intervention outcome and complete a literature review table for those articles . Answer all discussion questions for this section.

 

Make sure to continue to add articles from searches to the Database Research Table.

 

Assignment: Follow the Literature Review Rubric and Instructions and complete the Literature Review Template for your Quantitative and Qualitative articles as part of your discussion for week 4.

 

 

Looking ahead: Week 5 is when the first draft of Research Review (Part 1)

 

 

 

 Quizzes Due:

No quiz due this week

 

Discussion:

Initial responsesdue Wednesday by 11:59pm. Response to 2 peers and self-grading quiz due by Sunday at 11:59pm

 

Assignment:Submit your literature review template to the dropbox by Sunday at 11:59pm