NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

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NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

Wk1 Competencies Initial Discussion Post

The expectations that I have, as an Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) student in NRNP 6531, are to become affluent in the examinations, procedures, and documentation skills that are expected in this advanced practice clinical course.  I have been apprehensive about starting this initial clinical because I may not immediately remember everything that I have been taught in this program, up to this point, when assessing patients with my preceptor.  I do realize that this is a learning experience, and the skills will become easier to implement with practice NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

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Strengths and challenges are evident while self-appraising one’s ability in any professional setting.  The strengths that I bring to this clinical course, and subsequent career as an autonomous nurse practitioner, are that I display critical thinking and reasoning in my patient assessments and health management, develop trusting relationships with my patients and their families, displays empathy for others, and provides education to patients and their caregivers throughout their treatment and care.  These strengths relate to the AGPCNP competencies provided by the American Association of Colleges of Nursing.  Nurse practitioner core competencies require that the provider critically evaluates information and evidence for improving advanced nursing practice and incorporates this knowledge from the humanities and sciences within the context of nursing science.  The ACPCNP competencies require that reputable sources of national data on aging be analyzed and included in patient care.  Such sources include the Centers for Disease Control and Prevention (CDC), Healthy Aging Data Portfolio, and National Health and Aging Trends Study.  Competencies also include creating a climate of mutual trust while providing comfort and emotional support to patients and their families.  Educating the patients and caregivers is required by educating management strategies among normal development, aging, and mental and physical disorders (The American Association, 2016).  The challenges that I have are that I tend to think and work in the moment, with not much thought on the patient’s future.  Advanced practice nurses are more expected to modify their care to patient responses, to contemplate beyond the immediate situation, and to relate past patient experiences with conceivable paths.  AGPCNP’s must recognize clinical trends and anticipate variations from the standard findings (Flanders et al., 2017) NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

My career goals are to become a AGPCNP in a palliative care setting.  I want to provide primary and palliative care to adult-gerontology oncology patients in need.  This course will assist me in accomplishing my goals by preparing me for advanced clinical assessments in a primary care setting.  Performing clinicals in a primary care setting will have a significant impact on the application of knowledge by immersing one’s self in skills required to care for palliative care patients (Gentry & Dahlin, 2020). NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

References

The American Association of Colleges of Nursing (AACN … American Association of Colleges of Nursing. (2016). Retrieved December 1, 2021, from https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Adult-Gero-NP-Comp-2016.pdf.

Flanders, S. A., Gunn, S., Wheeler, M., Newsome, E., & Altman Klein, H. (2017) Accelerating the Development of Higher-Level Clinical Thinking in Novice Nurses. Journal for Nurses in Professional Development, 33(5), 240-246.

Gentry, Jennifer, DNP, ANP-BC, GNP, ACHP, Dahlin, Constance, MSN, ANP-BC & ACHPN, FPCN. (2020). The Evaluation of a Palliative Care Advanced Practice Nursing Externship. Journal of Hospice & Palliative Nursing, 22, 172-179. https://doi.org/10.1097/NJH.0000000000000637.

response

Great post!  I can relate to your challenge and have not previously been mindful of planning the patient’s future on my own.  I worked with a nurse for several years in the emergency department that went back to pursue her FNP.  As I have been in this program, I have spoken with her about the journey.  I have discussed multiple challenges that I have faced throughout the program so far.  She told me once that as my role changes from RN to APRN, my perspective will change.  How I look at my responsibilities to the patient will help develop my skills as a practitioner.  She said you just look at things differently.  As I have progressed in the program, I have begun to understand what she was talking about.  I feel like as we grow and learn, we will start to put it all together and be able to make a plan for our patient’s future NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

According to Barnes et al (2018), advanced practice nurses play a vital role in expanding patients’ access to healthcare and the delivery of healthcare.  As we pursue an advanced degree, we are positively contributing to the patient’s healthcare.  The more we learn about our new role, the more we will be able to see the big picture, which involves positively contributing to our patient’s future healthcare.  Popejoy et al (2017) report that advanced practice nurses that have support to develop their skills can make positive changes.  Through our studies of evidenced-based practices, we will learn the best ways to treat and take care of our patients, therefore, positively improving patient outcomes (Moore et al, 2019).

References

Barnes, H., Richards, M. R., McHugh, M. D., & Martsolf, G. (2018). Rural And nonrural primary care physician practices increasingly rely on nurse practitioners. Health Affairs (Project Hope), 37(6), 908–914. doi: 10.1377/hlthaff.2017.1158

Moore, E. R., Watters, R., & Wallston, K. A. (2019). Effect of evidence‐based practice (EBP) courses on MSN and DNP students’ use of EBP. Worldviews on Evidence-Based Nursing, 16(4), 319–326. https://doi.org/10.1111/wvn.12369

Popejoy, L., Vogelsmeier, A., Galambos, C., Flesner, M., Alexander, G., Lueckenotte, A., Lyons, V., & Rantz, M. (2017). The APRN Role in Changing Nursing Home Quality: The Missouri Quality Improvement Initiative. Journal of Nursing Care Quality, 32(3), 196–201. doi: 10.1097/NCQ.0000000000000264 NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

An advanced practice nurse collaborates and communicates with patients, families, doctors, nurses, and specialists to ensure patients receive the care they need. As they diagnose, treat, manage, and educate patients, they are responsible for ensuring patient safety and maintaining ethical behavior. Competencies have been developed to help the advanced practice nurse to understand the practice knowledge, skills, and attitudes they need to be successful.

Photo Credit: michaeljung / Adobe Stock

For this Discussion, you will examine advanced nursing practice competencies and reflect on your strengths and challenges related to the competencies. In light of your reflection, you will consider how this course may help you attain your career goals or objectives NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

To prepare:

  • Review the Learning Resources for this week, specifically the advanced nursing practice competencies. As you review the competencies, reflect on your own strengths and challenges when working with adults across the lifespan. NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

By Day 3

Post a summary of your expectations of this course. Also, include a brief explanation of your strengths and challenges as they relate to nursing practice competencies when working with adults. Describe any career goals or objectives this course may help you accomplish in the Family Nurse Practitioner (FNP) or Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) role and explain why. Use your research to support your explanations by providing credible and scholarly sources.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days by offering a suggestion or resources to help your colleagues in addressing their personal strengths or challenges, or their career goals. Use your research to support your suggestions. Provide at least 3 credible and current scholarly sources.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

 

NRNP_6531_Week1_Discussion_Rubric

Excellent
Point range: 90–100		 Good
Point range: 80–89		 Fair
Point range: 70–79		 Poor
Point range: 0–69
Main Posting: 

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
40 (40%) – 44 (44%)

Thoroughly responds to the discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least 3 current credible sources.
35 (35%) – 39 (39%)

Responds to most of the discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least 3 current credible references.
31 (31%) – 34 (34%)

Responds to some of the discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than 2 credible references.
0 (0%) – 30 (30%)

Does not respond to the discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only 1 or no credible references.
Main Posting: 

Writing
6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Further adheres to current APA manual writing rules and style.
5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.
4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Posting: 

Timely and full participation
9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main discussion by due date.
8 (8%) – 8 (8%)

Posts main discussion by due date.

Meets requirements for full participation.
7 (7%) – 7 (7%)
Posts main discussion by due date.
0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main discussion by due date.
First Response: 

Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic, may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
First Response:
Writing
6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.
5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.
4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.
0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.
First Response:
Timely and full participation
5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.
4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic, may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
Second Response:
Writing
6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.
5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.
4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.
0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.
Second Response:
Timely and full participation
5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.
4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.
Total Points: 100

Name: NRNP_6531_Week1_Discussion_Rubric

Career goals: Strengths and challenges related to nursing practice competencies

Advanced nurse practitioners have core competencies that need to be accomplished in order for nurse practitioners to practice independently and successfully.  As nurse practitioner students, we must use current competencies for our practice.  This course is designed to introduce and guide us through the practicum experience by allowing us to learn our own strengths and weaknesses as nurses.  The purpose of this discussion is to explain my expectations of this course, my strengths and challenges when working with adults, and the career goals that this course may help me accomplish.

Summary of expectations of this course

I am anticipating this course to be the place where everything comes together as we start our practicum experience.  I expect this course to be eye-opening and satisfying as we put everything we have learned in theory together in the clinical world.  I also expect to learn even more from my preceptor, instructors, and colleagues in both the NRNP and practicum courses.  I hope to gain more confidence as I learn from my preceptor during practicum NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

Brief explanation of your strengths and challenges as they relate to nursing practice competencies when working with adults

My strengths related to nursing practice competencies are advocating for patients and their best interests by communicating and collaborating with the interdisciplinary team to improve patient outcomes and quality of care (The National Organization of Nurse Practitioner Faculties, 2017).  My experience as a registered nurse at a rehabilitation hospital has improved my communication techniques between the patients, family, physicians, and colleagues.  Education is very important for both the patient and family for them to fully take advantage of their health, so I try to educate my patients whenever possible (Chan et al., 2019).  I contribute to the design of clinical information systems in my unit because I am efficient with technology and dealing with computers on my unit.

The challenges that I am afraid of as an advanced nurse practitioner are facing ethical and legal issues with misdiagnosing and treating patients with the wrong treatments (The National Organization of Nurse Practitioner Faculties, 2017).  I am afraid of missing important details or critical tests and making mistakes all because I lack the confidence and experience in that role. NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

Describe any career goals or objectives this course may help you accomplish in the FNP role and why

As I explore all the opportunities that an FNP can do, I feel like I would like to start with family practice in a clinic to gain experience and confidence in the field.  I would like that time to learn and grow as a novice nurse practitioner treating patients of all age groups.  The surrounding towns I live in are all rural areas and I would like that opportunity to serve the community to promote education and provide more resources for healthy living.  I would also consider public health or community health by working closely with the outreach program at the local hospital in town.  This course can help me accomplish this FNP role by guiding me to analyze my professional growth and development related to advanced nursing practice (Walden University, 2020).  By the end of this course, I will be able to analyze conditions of body systems and formulate diagnoses and treatment plans for adult patients (Walden University, 2020) NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

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Summary

I am looking forward to learning and growing into the advanced practice nurse role in this next term.  I am excited to incorporate all that I have learned into the real world to find my strengths and weaknesses in this practice so I can work on strengthening those weaknesses.  I am prepared to face challenges so I can find ways to improve and be the best advocate for my patients.

References

Chan, T. E., Lockhart, J. S., Thomas, A., Kronk, R., & Schreiber, J. B.  (2019).  An integrative review of nurse practitioner practice and its relationship to the core competencies.  Journal of Professional Nursing, 36(4), 189-199.  https://doi.org/10.1016/j.profnurs.2019.11.003.

The National Organization of Nurse Practitioner Faculties.  (2017).  Nurse practitioner core competencies contents.  https://nursing.lsuhsc.edu/Docs/Quality/Nurse%20Practitioner%20Core%20Competencies%20(2017).pdf.

Walden University.  (2020).  Outcomes/Alignment Chart, NRNP 6531: Primary care of adults across the lifespan.  https://content.waldenu.edu/e96ba5fcda8f577a44864e45d4902cd2.pdf.

REPLY QUOTE EMAIL AUTHOR

9 days ago

Rowena Manzano 
RE: Rowena Manzano-Discussion Response 1 to Esai Seechan
COLLAPSE

Discussion Response 1 to Esai Seechan

Hi Esai,

Good post. I agree that educating the patient, a collaborative attitude, and good communication are vital for patient care. Collaboration with other healthcare professionals will open the channels of best practice possibilities (Haddad & Geiger, 2021). In addition, cooperation in clinical practice improved the quality of patient care as professionals shared expertise ( Buttaro et al., 2021). As we start with our practicum, there are always challenges met, but preparation is vital to gain more confidence and overcome the fear. Stimulation courses can provide interactive and real learning experiences, enhance knowledge and skills in a caring patient with a different health problem (Torkshavand et al., 2020). Therefore, it is vital to practice with our stimulation courses in I Human continually NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

Ethical and legal issues are also a challenge for me being a novice in this field. Haddad & Geiger (2021) stated that nurses must be familiar with legal and ethical issues. The authors further noted that nurses must have high-level support for all individuals and allow dignity concerning care and communication. In addition, nurses must be familiar with professional guidelines in practice and always consider the patient first. It is also an obligation to gain competence by committing to continued learning. It is vital to continue to grow with improvements to care, adopt changes or trends through research and evidence-based practice, and have the ability to practice in various healthcare settings with continued acts of advocacy (Haddad & Geiger, 2021). Getting to know the preceptor and establishing a trusting relationship are also crucial for students’ learning ‌(Nyhagen & Strøm, 2016).

 

                                       References

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2021).

Primary care: Interprofessional collaborative practice (6th ed.).

Elsevier.

Haddad, L. M., & Geiger, R. A. (2021, August 30). Nursing Ethical 

      Considerations. Nih.gov; StatPearls Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK526054/

‌Nyhagen, R., & Strøm, A. (2016). Postgraduate students’ perceptions of

high-quality precepting in critical care nursing. Nurse Education in 

       Practice, 21, 16–22. https://doi.org/10.1016/j.nepr.2016.09.002

‌Torkshavand, G., Khatiban, M., & Soltanian, A. R. (2020). Simulation-

based learning to enhance students’ knowledge and skills in

educating older patients. Nurse Education in Practice, 42, 102678 NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

https://doi.org/10.1016/j.nepr.2019.102678

response

You brought up a great point when you mentioned you are afraid of missing important details that could impact the patient’s healthcare.  I think that would probably be a fear of everyone in this course at this moment.  Smith and Rushton (2018) report student nurses are often lacking experience and confidence.  We are only beginning the training that will prepare us for such a responsibility.  As we work with experienced healthcare providers, we will gain knowledge that will help prepare us.  Torrens et al (2020) report that developing interprofessional relationships helps advanced practice nurses to be successful.  Drayton-Brooks et al (2017) report that advanced practice nursing students will further develop skills by having practicum experiences with multiple providers that see different types of patients.  As we continue through this program and have these experiences, our skills will improve, therefore, improving our confidence.

References

Drayton-Brooks, S. M., Gray, P. A., Turner, N. P., & Newland, J. A. (2017). Building clinical education training capacity in nurse practitioner programs. Journal of Professional Nursing, 33(6), 422–428. https://doi.org/10.1016/j.profnurs.2017.02.002

Smith, J., & Rushton, M. (2018). Improving student nurses’ confidence in managing the acutely ill patient. British Journal of Nursing, 27(3), 124–129. doi: 10.12968/bjon.2018.27.3.124

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies, 104. doi: 10.1016/j.ijnurstu.2019.103443 NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

Week 7: Evaluation and Management of Renal and Genitourinary Conditions

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Week 7: Evaluation and Management of Renal and Genitourinary Conditions

The renal and genitourinary system is critical to the function of the entire body. As an advanced practice nurse, obtaining a relevant, focused history is critical. Conditions involving the genitourinary system, such as prostate cancer, often create a feeling of powerlessness, frustration, anxiety, and embarrassment in patients. Having provider-patient conversations about symptoms, potential treatment options, and patient education can be overwhelming for patients under such stress. It is your role to sensitively facilitate the treatment and management process through these difficult conversations and ultimately promote their well-being and empowerment. An accurate assessment will help you recognize and address any impact on the renal and genitourinary system in order to manage and prevent damages to the kidneys or other components of the system. Your role in the clinical setting is unique, as it is not only your responsibility to evaluate, diagnose, manage, and educate patients on their conditions, but also to provide emotional and psychological support to patients and their families Evita Alonso GI ihuman assignment.

For this week, you will analyze an i-Human simulation case study about an adult patient with a gastrointestinal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and then create an appropriate treatment plan for the patient. Week 7: Evaluation and Management of Renal and Genitourinary Conditions

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Learning Objectives

Students will:

  • Formulate differential diagnoses for adult patients with renal and genitourinary conditions
  • Analyze pattern recognition in adult patient diagnoses
  • Analyze the role of patient information in differential diagnosis
  • Evaluate pharmacologic and non-pharmacologic treatment options for adult patients
  • Create an appropriate treatment plan that includes health education and follow-up care
  • Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Assignment: i-Human Case Study: Evaluating and Managing Genitourinary or Gastrointestinal Conditions

Urinary frequency is an example of a genitourinary condition that presents problems for adults across the lifespan. It can be the result of various systemic conditions such as diabetes, urinary tract infections, enlarged prostates, kidney infections, or prostate cancer. Many of these conditions have very serious implications requiring thorough patient evaluations. When evaluating patients, it is essential to carefully assess the patient’s personal, medical, and family history prior to recommending certain physical exams and diagnostic testing, as sometimes the benefits of these exams do not outweigh the risks Evita Alonso GI ihuman assignment.

Photo Credit: Crystal light / Adobe Stock

For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a gastrointestinal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and then create an appropriate treatment plan for the patient.

To prepare:

  • Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with GI or GU conditions.
  • Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with GI or GU conditions Evita Alonso GI ihuman assignment.

Assignment

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform. Week 7: Evaluation and Management of Renal and Genitourinary Conditions

By Day 7

Complete your Assignment in i-Human.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 7 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment draft and review the originality report.

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Submit Your Assignment by Day 7

To participate in this Assignment:

Week 7 Assignment Evita Alonso GI ihuman assignment

What’s Coming Up in Week 8?

Week 8 Knowledge Check

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Week 8, you will complete the next Knowledge Check, which covers the Module 3 topics from Weeks 6, 7, and 8. Refer to the Week 8 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly.

To go to the next week:

NRNP_6531_Week7_Assignment_Rubric

Novice Competent Proficient
HPI statement
0 (0%) – 5 (5%)
Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills
6 (6%) – 10 (10%)
Well written HPI statement but may be missing 1-2 key components from the history
11 (11%) – 15 (15%)
Clearly written HPI statement with comprehensive information gathering from case questions.
History
0 (0%) – 6 (6%)
Incomplete history missing 3 or more aspects of the OLDCARDS critical to patient’s diagnosis.
7 (7%) – 8 (8%)
Fairly complete history covering most of the requirements but may be missing 1-2 aspects of OLDCARDS critical to patient’s diagnosis.
9 (9%) – 10 (10%)
Complete history covering all critical components of a focus exam. Includes all aspects of OLDCARDS
Physical Exam
0 (0%) – 6 (6%)
Incomplete physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis.
7 (7%) – 8 (8%)
Fairly complete physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis.
9 (9%) – 10 (10%)
Complete physical examination covering all critical components of a focus exam.
Testing
0 (0%) – 6 (6%)
Includes 3 or more inappropriate exams or tests. May include contraindicated testing. Week 7: Evaluation and Management of Renal and Genitourinary Conditions
7 (7%) – 8 (8%)
Tests ordered are generally apprropriate. May include 1-2 unnecessary exams or tests.
9 (9%) – 10 (10%)
Tests that are ordered are appropriate for patient and cost effective.
Differential Diagnosis Summary
0 (0%) – 9 (9%)
Primary diagnosis may be wrong.Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components.
10 (10%) – 14 (14%)
Correct primary diagnosis identified. Well written differential diagnoses. May be missing 1-2 critical components. Priority list may be out of order
15 (15%) – 20 (20%)
Primary diagnosis identified. Clearly written differential diagnoses.
Plan for patient
0 (0%) – 15 (15%)
Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.
16 (16%) – 25 (25%)
Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.
26 (26%) – 30 (30%)
Clearly written plan covering all critical components for patient’s final diagnosis.
Exercises
0 (0%) – 2 (2%)
Correctly answered 0-69% of the clinical questions.
3 (3%) – 4 (4%)
Correctly answered 70-89% of the clinical questions.
0 (0%) – 5 (5%)
Correctly answered 90-100% of the clinical questions.
Total Points: 100

Name: NRNP_6531_Week7_Assignment_Rubric Evita Alonso GI ihuman assignment

NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection

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NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection

NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection

SOAP Note Template

Subjective

ID

First Name Betty

Last Name Burns

Gender Female

Age 48

CC

Lump on left breast for about one month NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

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HPI

History (including PMH, surgical, family, and social)

Other active problems: Hypertension – well controlled on Hydrochlorothiazide. Asthma – childhood diagnosis; occasional flares requiring oral steroids. Seasonal allergies – controlled. Mild fibrocystic disease. Obstetric History: Gravida 2, Para 2, Abortus 0. 1st child at age 36. 2nd child at age 38. Surgical History: 1. Appendectomy – > 20 years ago. 2. Tubal ligation after birth of second child. Hospitalizations: 1.  Births of children. 2.  Appendectomy. 3.  Tubal ligation. Preventive: Flu immunization recommended yearly. Weight loss recommended to 150 lbs. to bring her BMI to 24.2. Yearly mammograms. Seat belts – uses regularly. Texting while driving – never. Current on immunizations:1) up to date on Tdap. 2) up to date on influenza vaccination. 3) pneumovax administered at age 42 due to her asthma. Recommend shingles vaccination when turns 60. Family History: Mother – breast cancer age 55, alive and well. Father – medical history unknown. Sisters – none. Brothers – both alive and healthy. Grandparents – deceased unknown causes. Social History: Tobacco – none; secondhand smoke exposure minimal. Alcohol – social (once to twice monthly). Recreational drugs – none. Married – monogamous; two daughters, ages 8 and 10. Education – college graduate. Job – elementary-school principal. Travel – none recently. Pets – none. Home safety – no guns in household. Eating/Exercise:  eats most meals at  home, fast food only once per week, walks 1-2 times per week for exercise NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

ROS (general, skin, HEENT, neck, breasts, resp, CV, GI, peripheral vascular, urinary, genital/LMP, MSK, psych, neuro, hematologic, endocrine)

General: No evidence of fever, chills, fatigue, malaise, night sweats, excessive or unexplained weight gain or loss. Skin/Breasts: No rashes, bruising, jaundice, pruritis, acne, sores, ulcers, changes in moles, hair loss or brittleness, nails. No pain from her breasts. Reports lump on left breast x 1 month. Found during self-breast exam last month. Discoloration near nipple on left breast. Lump on left breast thickened area over lump with indentations. Occasional bloody discharge in left breast cup of bra. Last mammogram 15 months ago and normal per patient. No movement with lump. Periods are regular every 26-28 days. HEENT/Neck: Denies vision changes, blurred vision; eye pain, discharge, itching, or redness. Denies ear pain, ear discharge, hearing difficulty, vertigo, nasal congestion, epistaxis, sinus pain or pressure, sore throat, swollen glands in neck, tooth pain. Cardiovascular: No complaints of chest pain/pressure, dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, palpitations, ankle swelling. Resp: Denies shortness of breath, wheezing, cough/ sputum, hemoptysis, tightness in chest, pleuritic chest pain (pain with deep breath or cough). Abd/GI: No problems with appetite changes, dysphagia, nausea, vomiting, hematemesis, heartburn, abdominal pain, diarrhea, constipation, melena. GU: No menstrual irregularities, amenorrhea, dysmenorrhea, dyspareunia.  Denies dysuria, urinary frequency, nocturia, hematuria, incontinence, urgency, hesitancy, difficulty starting or stopping stream NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection. MSK: No joint or muscle pains, joint stiffness and swelling, limitations in movement, functionality. Neuro: No problems with headaches, syncope, presyncope, dizziness, weakness, paralysis, numbness/tingling, or balance. Allergic/Immunologic: Denies food allergies, hives, or rashes. Lymphatic/Endocrine: Denies polyuria, polydipsia, polyphagia, tremor, heat or cold intolerance, hot flashes. Hematologic: Denies excess bruising or bleeding, swollen glands/lymphadenopathy. Psychological: No problems with mood changes, feeling depressed, manic behaviors, auditory or visual hallucinations, anxiety, insomnia, suicidal or homicidal ideations.

Allergies

Seasonal hay fever. NKDA. NKFA.

Current Medications

Fluticasone (Flonase) – one spray each nostril Q AM as needed for seasonal allergies. Fluticasone/salmeterol 250/50  – one puff BID for asthma. Hydrochlorothiazide (HCTZ) – 25 mg PO daily for hypertension.

Objective

Vital Signs:

HR 80 RRR

BP 128/80 mmHg – supine/sitting. 126/72 mmHg – upon standing.

Pulse 80 RRR

RR 16 unlabored

Pain 0

Height 5’ 6”

Weight 165 lbs. (75kg)

BMI 26.26

Temp 98.6 oral

Pulse Ox 99% room air

Physical exam (general, HEENT, neck/lymph, breasts, chest/respiratory, CV, GI/abdomen, GU/rectal, back, MSK, skin, neuro, psych)

Weight:  165.0 pounds. Skin/Breasts: Atraumatic, good skin turgor, skin, and scalp normal, no evidence of suspicious pigmented lesions NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection. Breast exam consistent with known mild fibrocystic disease, left breast with subtle skin dimpling (peau d’orange appearance). Normal symmetrical breast contour bilat. No overt inflammatory signs. No previous incisions or trauma. Left breast and axilla: subtle skin dimpling (peau d’orange appearance), firm fixed, 3 cm mass palpated at the 9 o’clock position. No other suspicious mass lesions; smaller palpable nodules consistent with prior exams and consistent with history of fibrocystic disease. Expressible bloody nipple discharge. Solitary, nontender, mobile, 2 cm left axillary lymph node. Right breast small palpable nodules consistent with prior exams and known fibrocystic disease. No axillary adenopathy. No expressible nipple discharge. HEENT: Eyes: Sclera and conjunctiva normal. Pupils and irises size symmetrical and shows normal reaction to light and accommodation bilaterally. Ears: no external scars or lesions. Otoscopic exam normal with only minimal wax, no masses or foreign bodies, good light reflex bilaterally. Nose: External without abnormality. Normal nasal mucosa, septum, turbinate’s. Mouth: Good dental hygiene. Neck supple, no adenopathy, trachea midline, no carotid bruits, thyroid size 25 gm, no masses or tenderness. Cardiovascular: No JVD. No thrills, heaves, or lifts. PMI normal size and location.  Heart RRR Normal S1 and S2, no murmurs appreciated. No carotid bruits, abdominal aorta normal size no bruits, pedal pulses present and symmetrical, no evidence of peripheral edema or varicosities. NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.  Respiratory: Normal chest shape, normal respiratory movement, no tenderness, and percussion normal. Auscultation found normal breath sounds throughout without wheezing, rales or ronchi. Abdomen/GI: Flat contour. Scars consistent with prior surgical history. Normal bowel sounds present. Soft to palpation without tenderness all 4 quadrants.  Liver edge felt below the coastal margin, span normal to percussion. Spleen normal size. No masses or organomegaly. GU: Normal genitalia, no evidence of infection. Normal ovaries to manual palpation. Pap smear done. MSK: Normal ROM and muscle tone throughout. Muscle strength and flexibility throughout axial and appendicular skeleton normal. Motor 5/5 all extremities. Neurological: A & O x 4, good attention, memory, normal gait, CN 2-12 intact, reflexes 4/4 throughout. Normal cerebellar exam with finger to nose (FTN), rapid alternating movements (RAM), heal to shin (HTS) bilaterally. Allergic/Immunologic: No worrisome preauricular, posterior auricular, anterior cervical, posterior cervical, submandibular, supraclavicular lymph nodes. Lymphatic/Endocrine: Thyroid normal to palpation, 25 gm, no masses or tenderness. Hematologic: Normal capillary refill. No evidence of anemia NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

Assessment

Problem List:

  • Breast mass/lump, neoplastic
  • Invasive ductal carcinoma, left breast ER/PR negative, HER2 positive
  • Evidence of metastasis: 2 out of 2 left axillary lymph nodes positive for metastatic spread

 

Differential diagnoses:

Differential Diagnoses How Was This Diagnosis Ruled Out?
Breast hamartoma
Fibroadenoma
Breast lipoma

Plan

Include the following:

  • Medications to be prescribed (drug-dose directions)
  • Instructions to continue, discontinue, or start medications, including changes to routine medications.
  • Diagnostic tests in the proper order and reason for the order (e.g., CT abdomen and pelvis with and without contrast, Dx, LLQ abdominal pain)
  • Labs, including appropriate serum panels (e.g., BMP, CBC with diff., TSH, T4, UA, C&S)
  • Patient education pertinent to health condition
  • Follow-up plan
  • Referrals
Plan Rationale and/or results
Breast Cancer Susceptibility Genetic Test (BRCA1 and BRCA2). No mutation detected.
Diagnostic mammogram. Left breast BI-RADS 5, (3 cm irregular shaped mass in upper outer quadrant worrisome for malignancy). Right breast BI-RADS 1, normal.
Left breast biopsy with lymph node biopsy. Invasive ductal carcinoma with nuclear pleomorphism. Mitotic counts: score 2. Estrogen receptor negative. Progesterone receptor negative. HER2 receptor positive.
Breast ultrasound. Left breast solitary mass measuring 3 cm X 3.2 cm X 3.0 cm at 9 o’clock upper outer quadrant. Some skin thickening overlying the mass was also noted. In the left axilla 2.0 cm X 1.8 cm X 2.0 cm lymph node was identified. Suspicious for malignancy.
Surgical referral for modified radical left mastectomy and axillary dissection/removal of suspicious lymph nodes.
Radiation referral for therapy.
HER2 antagonist therapy (trastuzumab)
Oncology referral to discuss treatment options NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.
Referral for education, counseling, supported decision making and support groups. Life long cancer surveillance.
Lab to check lipid panel and BMP.

 

NRP/563: Management Of Women’s Health Issues

Wk 3 – Signature Assignment: iHuman Patient Betty Burns Reflection

  1. See attached SOAP note for Betty Burns.
  2. Write a 500-word summary regarding your patient encounter with Betty Burns.
  3. Include the following in your summary:
  • Explain how you arrived at your differential diagnoses.
  • Explain the steps you used to determine the final diagnosis.
  • Give examples of how you can integrate cultural preferences, values, health beliefs, and behaviors into the treatment plan using Watson’s theory.
  • Describe the appropriate management (e.g. health maintenance, diagnostics, medications/treatment) and support with evidence.)
  • Critique your overall case evaluation, highlighting takeaways to improve your clinical skills now that the diagnosis has been revealed.
  1. Cite a minimum of 3 peer-reviewed journal references within the last 5 years supporting your responses according to 7th edition APA guidelines.
  2. Course Textbooks:
  • Schuiling, K. D., Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Jones & Bartlett Learning.
  • Dunphy, L. (2019). Primary care: The art and science of advanced practice nursing (5th ed.). F.A. Davis NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

Management Of Women’s Health Issues Week 3 – Signature Assignment: iHuman Patient Betty Burns Reflection

Student’s Name

Institution

Course Code, Course Name
Instructor’s Name

Date

Explain How You Arrived At Your Differential Diagnoses

Diseases are characterized by patterns of symptoms reported by patients, the signs obtained during physical exam, and the results obtained from diagnostic tests. According to Dunphy (2019), determining the differential diagnoses is a process of distinguishing between diseases which present with the same symptoms. In Betty Burns’ iHuman case study, I arrived at   the differential diagnosis   using a systematic approach through the following steps; generating a list of Betty Burn’s medical issues through history taking, a physical exam, and evaluating  the  findings of the laboratory tests. Burns’ chief complaint was a lump on her left breast for about one month. The most common problems which present with this symptom among women aged 40 years or older are; fibroadenomas, breast lipoma, breast hamartoma, and breast adenocarcinoma. Using a local anatomic differential diagnosis framework and applying to it the pertinent positives and negatives resulted in the following differentials;

  • Fibroadenoma-presents as a painless, benign and firm lesion
  • Fibrocystic Breast Disease: it usually presents with changes in breast tissue such as lobular hyperplasia and cysts that are smooth and movable (Schuiling & Likis, 2017).
  • For Betty Burns, the physical exam was also consistent with mild fibrocystic disease.
  • Breast Cancer-Betty Burns’ breast biopsy findings was significant for an invasive ductal carcinoma with nuclear pleomorphism which is indicative of breast cancer NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

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Steps Used To Determine the Final Diagnosis

  • To determine the final diagnosis, I identified the disease that accounted for all of Betty Burn’s problems from the initial list of differential diagnoses and was supported by the diagnostic test findings. The most appropriate diagnosis that met this criterion was breast mass/lump, neoplastic. Betty Burns was 48 years old and had a family history of breast cancer (mother). The risk of breast cancer increases in women aged 40 years and older (Schuiling & Likis, 2017). . She reported discoloration near the left breast nipple, an immobile lump on the left breast with thickening and indentations over the area with the lump. She also reported occasional bloody discharge in the cup of bra of the left breast. The physical exam findings were consistent with dimpling of the skin of the left breast, a fixed and firm mass (3cm) palpated at the 9 o’clock position, and bloody nipple discharge. The diagnostic breast biopsy was positive for an invasive ductal carcinoma, HER2 positive with evidence for metastasis (2 out of 2 left axillary lymph nodes positive for metastatic spread).

How To Integrate Cultural Preferences, Values, Health Beliefs, and Behaviors Into the Treatment Plan Using Watson’s Theory

Watson bases her theory of caring on seven major assumptions starting with the notion that caring can only happen at an interpersonal level between nurses and patients. Oher assumptions posit that caring   leads to growth of the patient and family, patient satisfaction, needs acceptance, is the core of nursing, and creates an environment where individuals make wide decisions (Pajnkihar, Štiglic & Vrbnjak, 2017). Basing on the aforementioned assumptions, she mentions  10 Carative factors  that nurses can implement in practice to; instill hope, develop trust, develop values, incorporate science to address  issues, support  a positive mental,  physical, social, and spiritual environment, continuous learning, and  help with physical needs (Pajnkihar, Štiglic & Vrbnjak, 2017). Applying this theory to the care of Betty Burns, I will develop a helping-trusting relationship and allow her to share both her positive and negative feelings, being authentic to, engage Betty Burn in genuine teaching-learning experience about her health status, and try to address her spiritual and physical needs by being open to discussions and matters spirituality NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

Appropriate Management (Health Maintenance, Diagnostics, Medications/Treatment)

  • Non-pharmacological treatment: refer for modified radical left mastectomy and axillary dissection/removal of suspicious lymph nodes.
  • Pharmacological treatment: refer for radiation or/and chemotherapy (HER2 antagonist therapy (trastuzumab) (Schuiling & Likis, 2017).
  • Patient Education: breast cancer and gynecological follow up in six months, lifelong cancer surveillance screening (clinical breast exam every 6-12 months), MRI/mammogram every 6-12 months.
  • Diagnostics:
    • Genetic Testing (BRCA)-No mutation detected.
    • Left breast biopsy with lymph node biopsy- Invasive ductal carcinoma with nuclear pleomorphism. Mitotic counts: score 2. Estrogen receptor negative. Progesterone receptor negative. HER2 receptor positive.
    • CT of abdomen and chest
    • Diagnostic mammogram- Left breast BI-RADS 5, (3 cm irregular shaped mass in upper outer quadrant worrisome for malignancy). Right breast BI-RADS 1, normal.
    • Breast ultrasound-Left breast solitary mass measuring 3 cm X 3.2 cm X 3.0 cm at 9 o’clock upper outer quadrant. Some skin thickening overlying the mass was also noted. In the left axilla 2.0 cm X 1.8 cm X 2.0 cm lymph node was identified, suspicious for malignancy.
    • BMP
    • Lipid Panel
    • Referral to an oncologist for further evaluation and management

Overall Case Evaluation and Takeaways

In my next assessments, I will be keener to conduct a more focused history taking and physical exam based on a patient’s presenting complaint. A focused history using focused questions and a focused physical exam will provide more comprehensive and direct clues of a patient’s most probable diagnosis. When compared to past assessments, I must admit that my history taking and physical exam techniques have tremendously improved. Besides, I can effortlessly incorporate pathophysiology knowledge that I have obtained in class in clinical and diagnostic reasoning to determine the appropriate tests to order and make appropriate diagnoses NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

References

Dunphy, L. (2019). Primary care: The art and science of advanced practice nursing (5th ed.). F.A. Davis.

Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, e2940. https://doi.org/10.7717/peerj.2940

Schuiling, K. D., Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Jones & Bartlett Learning NRP/563: Management Of Women’s Health Issues – Betty Burns iHuman Reflection.

NURS 6531 Advanced Practice Care of Adults Across the Lifespan

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NURS 6531 Advanced Practice Care of Adults Across the Lifespan

Ken Fowler iHuman soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan

SOAP Week 7: Evaluation and Management of GU/GI Conditions

Student’s Name

Institution

Course Code, Course Name

Instructor’s Name

Date

Patient Information

Name: Ken Fowler

Age: 70 years

Sex: Male

Subjective

CC (chief complaint): Nausea and vomiting

HPI: the patient is a 70 year old who presented for further evaluation of his creatinine levels at the ED from his PCPs referral. He reports nausea and vomiting for 24 hours. The vomitus is clear with residual food particles. It is worsens with meals but reports no relieving factors. It is associated with symptoms of decreased urine output, decreased oral intake/poor appetite, and fatigue. The patient associates the onset of symptoms to intake of naproxen for lower back pain one week prior when he lifted something heavyKen Fowler i Human soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan.

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Current meds:

  • Lisinopril
  • HCTZ
  • Metroprolol

Allergies: None

Vaccinations: Up to date with all the immunizations

Pertinent PMHx: patient is a known hypertensive on medications. He also reports mild chronic renal disease with microalbuminuria (400mg) and creatinine of 1.1.

Social hx: Ken Fowler admits to drinking a glass of wine with dinner frequently  either once or twice  weekly.

Fam Hx:

Questions:

  • What is your name?
  • Where are you?
  • What time is it?
  • What happened?
  • How can I help you today?
  • Have you had nausea and vomiting like this before?
  • What does your vomit look like?
  • Has there been any change in your nausea and/or vomiting over time?
  • Have you been vomiting anything that looks like blood or coffee grounds?
  • Do you have any pain or other symptoms associated with your nausea and/or vomiting?
  • Does anything make your nausea and/or vomiting better or worse?
  • How severe is your nausea and/or vomiting?
  • Have you lost weight?
  • Do you have any pain in your abdomen?
  • Do you have frothy urine?
  • Do you have any other symptoms or concerns we should discuss?
  • Can you tell me about any current or past medical problems you have had?
  • Are you taking any over-the-counter herbal medications?
  • Do you have any allergies?
  • Are you taking any prescription medications?
  • Do you drink alcohol? If so, what do you drink and how many drinks per day?

ROS

General: the patient appears in the ED independently. He denies recent fever, chills, worsening cough, sore throat.  He reports nausea, vomiting and decreased appetite Ken Fowler iHuman soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan.

Integumentary/Skin: patient denies problems with an itchy scalp, skin changes,  moles, thinning  hair or brittle nails

Cardiovascular/Peripheral Vascular: the patient denies experiencing chest pain/pressure, exertion, chest discomfort, palpitations, decreased exercise tolerance, cold/blue fingers and toes.

Respiratory: the patient denies experiencing shortness of breath, difficulty catching breath, wheezing, chronic cough, or sputum production.

Gastrointestinal: patient reports nausea and vomiting, decreased oral intake, he denies diarrhea, constipation, bright red/dark tarry stools with bowel movements, bloating or early satiety. NURS 6531 Advanced Practice Care of Adults Across the Lifespan

Genitourinary: patient denies any pain, burning, dribbling, difficulty starting or stopping, urgency, frequency, or incontinence with urination. He reports decreased urine output

Musculoskeletal: the patient denies any muscle pains, joint pains, swelling, redness, joint stiffness, redness, and muscle cramps

Psychiatric: patient denies any problems with depression, nervousness, sadness, lack of interest, or changes in mood

Neurologic: the patient denies problems with dizziness, fainting, spinning room, seizures, weakness, numbness, and tremor or tingling

Endocrine: the patient denies problems with heat or cold intolerance, increased thirst, increased sweating, frequent urination, or change in appetite

Hematologic/lymphatic: the patient denies any bruising, bleeding gums, or nose bleeds.

Allergic/immunologic: the patient denies allergies to medication, food or environmental Ken Fowler iHuman soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan.

Physical Exam

General:  Patient is A&O x4

VS: BP- 108/62 HR-98 (apical), RR-17, O2 sat-99% RA

General Appearance: the patient is A&Ox4. He appears to be overall healthy and in no distress

HEENT: Eyes: PERRLA, no conjunctivae-rim pallor. Examination with an ophthalmoscope reveals a bilateral red reflex, and sharp optic disks. Nose/Mouth/Throat: mucous membranes are dry

Cardiovascular/Peripheral Vascular: the patient has normal heart sounds S1, S2; there are no rubs, gallops, or murmurs.  PMI slight lateral and downward displaced

Respiratory: on inspection, the chest moves symmetrically with respiration, there are no scars, the lungs are clear in all lobes bilaterally, and there are no abnormal breath sounds auscultated (wheezing, crackles, rales or rhonchi).

Gastrointestinal: the abdomen is soft non-distended and non-tender. Bowel sounds present in all quadrants with auscultation. There are no masses or lumps or protruding tumors felt with palpation and percussion.  There is no CVA tenderness but there is mild periumbilical tenderness in superficial palpation. No renal, abdominal, or femoral bruits.

Musculoskeletal/Peripheral Vascular: no edema in upper or lower extremities. Muscle strength is 5/5 in all groups.

Neurologic:  A&O x4 to person, place, time and situation. MMSE

Integumentary/Skin:  the skin is dry and warm; there is no jaundice, pallor, scaling, ulceration, or rash.  Blanche time is 3-4 seconds suggesting dehydration.

Genitourinary: normal external genitalia, no urethral discharge, no tenderness or masses

Test Ordered and Diagnostic Results

  • Complete Blood Count
  • Renal Ultrasound
  • Urinalysis
  • Basic Metabolic Panel
  • Sodium (Na+), urine
  • Eosinophils urine
  • Pelvic Ultrasound

List the Differential Diagnosis You Identified In Ihuman

  1. Medication-Related (Side Effect)
  2. Uremia (intrarenal azotemia)
  3. Uremia (prerenal azotemia)
  4. Urinary Obstruction

List your primary dx with ICD code. Briefly explain/ discuss your primary dx and the rational

  • Uremia-prerenal azotemia (Acute Kidney Failure, Unspecified N17.9)- this patient  Presented with a history of a sudden onset increment in   levels of creatinine.  He also reported   a decreased oral intake, nausea and vomiting, and fatigue. One week earlier, he reportedly self-medicated with naproxen, a drug that is highly nephrotoxic for lower back pain. These are signs and symptoms of Acute Kidney Injury and the intake of naproxen plays a major role as a precursor of the symptoms (Levey & James, 2017). The fact that he is hypertensive and on both ACEs and a diuretic,   he is at a higher risk of volume depletion, a state that is also a risk factor for AKI. Besides, the physical exam findings of tachycardia, hypotension, dehydration, and   periumbilical tenderness support AKI as the most appropriate diagnosis Ken Fowler iHuman soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan.

List the Differential Dx with ICD and A Brief Explanation the Rational

  1. ICD 10 995A Medication-Related (Side Effect)-the patient has a history of prior intake of naproxen, an NSAID. Naproxen inhibits COX enzymes reducing the synthesis of prostaglandins and this can result in renal ischemia, decrease pressure in the glomeruli and ultimately the setting of AKI.  Considering that he was also on ACE inhibitors and a diuretic, collectively, these factors increase the risks of AKI (Whiting et al., 2017).
  2. ICD 10 N00.9 Acute Nephritic Syndrome (Uremia- Intrarenal azotemia) – it includes intrinsic kidney pathologies such as glomerulopathies or renal failure. Apart from having elevated creatinine levels, patients may report nausea and vomiting, fatigue, oliguria, anorexia, and periumbilical pain. However, since there is no history to suggest an underlying systemic illness or more recent infection, this is less likely. To add on, on physical exam, the lack of findings such as periorbital and pedal edema which are primary features of potential causes intrarenal azotemia for conditions such as nephritic syndrome decreases the likelihood of this as the primary diagnosis (Hashmi & Pandey, 2020). NURS 6531 Advanced Practice Care of Adults Across the Lifespan
  3. ICD 10 9 Urinary Obstruction- the signs and symptoms of urinary obstruction which are similar to those that Ken Fowler presented with include; oliguria, delayed urination and abdominal pain. Besides Ken Fowlers age, a history of reduced urine output and hypertension are potential risk factors for obstruction.

Assessment/Plan

  • Admit to: med surge
  • Allergy: None
  • Diet: low sodium
  • Activity: mild physical activity such as walking
  • Consult/ specialty services and rational: consult with a renal physician/specialist for further evaluation and management of  renal disease to prevent  worsening outcomes
  • Nursing Orders:
    • IV Rehydration to correct dehydration and prevent the azotemia from worsening. Use IV saline until when the patient’s intravascular volume returns to normal.
  • Medication/intervention: dose, route, time
    • Discontinue the patient’s NSAIDs
    • Hold the patient’s HCTZ
    • Hold the patient’s Lisinopril
  • LABS: none
  • Ancillary orders: insert Foleys catheter to monitor input-output
  • Supportive services: consider maintaining patient on a DASH diet. And consult with a dietician on the best dietary approaches for a patient with mild chronic renal disease.
  • Patient education: educate the patient on the dangers of self-medication and  effects to the body (naproxen), educate on  hypertension and current drugs used for management, educate on medication adherence
  • Follow up or disposition: to return back immediately incase a new onset or similar symptoms begin. To return for follow up in two weeks to assess for progress including renal function Ken Fowler iHuman soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan.
  • Health maintenance and Preventive health: none

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References

Hashmi, M. S., & Pandey, J. (2020). Nephritic Syndrome. StatPearls [Internet].

Levey, A. S., & James, M. T. (2017). Acute kidney injury. Annals of internal medicine, 167(9), ITC66-ITC80.

Whiting, P., Morden, A., Tomlinson, L. A., Caskey, F., Blakeman, T., Tomson, C., & Horwood, J. (2017). What are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury? A systematic review and meta-analysis. BMJ open, 7(4).

Patient Information:

Subjective:

CC (chief complaint):

HPI:

Current meds:

Allergies:

Vaccinations:

Pertinent PMHx:

Social hx:

Fam Hx:

Questions: Copy the questions you asked in ihuman here

ROS:

Physical Exam:

Test ordered and diagnostic results:

List the differential diagnosis you identified in ihuman

List your primary dx with ICD code. Briefly explain/ discuss your primary dx and the rational

List the differential Dx with ICD and a brief explanation the rational Ken Fowler iHuman soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan

Assessment/Plan:

Admit to: (ICU, Observation, med surge, etc)

Status: (critical ill, stable, guarded)

CODE Status:

ALLERGY:

Diet:

Activity:

Consult/ specialty services and rational:

Nursing orders: (iv, monitor, i/o etc..)

Medication/intervention: dose, route, time

LABS: (do not include labs already done)

Test: CT, CXR…etc (do not include labs already done)

Ancillary orders: pain management, sleeper, bowel program, PPI protection, DVT protection, PT/OT etc.

Supportive services: There is more to being an NP than prescribing. Look at the supportive services required, PT/ OT, Dietary, REHAB, etc and make a referral. If in your opinion there is none, then state that.

Patient education: (include family if minors on disease, management and or drugs)

Follow up or disposition: Discharge planning. When coming back and why and to who?

Health maintenance and Preventive health: Age appropriate

Reference list: Minimum 3 to support your treatment plan Ken Fowler iHuman soap note – NURS 6531 Advanced Practice Care of Adults Across the Lifespan 

To prepare:

 

Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with GI or GU conditions.

Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with GI or GU conditions.

Assignment

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform. NURS 6531 Advanced Practice Care of Adults Across the Lifespan

 

Patient Information:

 

Subjective:

 

CC (chief complaint):

 

HPI:

 

Current meds:

 

Allergies:

 

Vaccinations:

 

Pertinent PMHx:

 

Social hx:

 

Fam Hx:

 

Questions: Copy the questions you asked in ihuman here

 

ROS:

 

Physical Exam:

 

Test ordered and diagnostic results:

 

List the differential diagnosis you identified in ihuman

 

List your primary dx with ICD code. Briefly explain/ discuss your primary dx and the rational

 

List the differential Dx with ICD and a brief explanation the rational

 

Assessment/Plan:

 

Admit to: (ICU, Observation, med surge, etc)

 

Status: (critical ill, stable, guarded)

 

CODE Status:

 

ALLERGY:

 

Diet:

 

Activity:

 

Consult/ specialty services and rational:

 

Nursing orders: (iv, monitor, i/o etc..)

Medication/intervention: dose, route, time

 

LABS: (do not include labs already done)

 

Test: CT, CXR…etc (do not include labs already done)

 

Ancillary orders: pain management, sleeper, bowel program, PPI protection, DVT protection, PT/OT etc.

 

Supportive services: There is more to being an NP than prescribing. Look at the supportive services required, PT/ OT, Dietary, REHAB, etc and make a referral. If in your opinion there is none, then state that.

 

Patient education: (include family if minors on disease, management and or drugs)

 

Follow up or disposition: Discharge planning. When coming back and why and to who?

 

Health maintenance and Preventive health: Age appropriate

 

Reference list: Minimum 3 to support your treatment plan. NURS 6531 Advanced Practice Care of Adults Across the Lifespan

Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis

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Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis

Week 4 | Part 4: Research Analysis

I have identified one topic of interest for further study. I have researched and identified one peer-reviewed research article focused on this topic and have analyzed this article.  The results of these efforts are shared below.

Directions: Complete Step 1 by using the table and subsequent space below identify and analyze the research article you have selected. Complete Step 2 by summarizing in 2-3 paragraphs the results of your analysis using the space identified.

 Wound care remains an important means of ensuring that physical injury does not result in medical problems arising from the infection of such wounds. The science of wound care is well defined; however, there are still possible niches in wound care that continue to benefit from the continuous exchange of information that characterizes scholarship. Lynn Welsh (year), for instance, reviews recent evidence, education, and knowledge of wound care among nurses.  The semi-systematic literature review sought to acquire an ethnographic understanding of how nurses are using evidence-based practice methods in wound care (Chapman, 2009). The emerging understanding is that evidence-based nursing practice consistently pursues optimal outcomes in wound care compared to ritualistic practice, even when the latter emerges from a structured educational background at both pre- and post-registration levels Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis.

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Step 1: Research Analysis

Complete the table below

Topic of Interest: Wound Care 

 
Research Article: Include full citation in APA format, as well as link or search details (such as DOI) Dreifke, M., Jayasuriya, A., & Jayasuriya, A. (2015). Current wound healing procedures and potential care. Materials Science And Engineering: C, 48, 651-662. https://doi.org/10.1016/j.msec.2014.12.068
Professional Practice Use: 

One or more professional practice uses of the theories/concepts presented in the article

 The article has exploited the aim of the health care concept to the core. Fundamentally, the aim of health care revolves around the need to help all persons to various objectives such as the deterrence of untimely death and incapacity, personal growth and development, and the maintenance and enhancement of quality life. The article has sought to enlighten its readers on the contemporary healing procedures and possible care that they can embrace whenever they are hurt. This way, they will not lose any blood that might make them die prematurely. The healing procedures will also enable the article’s readers to avoid contracting new infections on the wounds that they will be having. Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis
Research Analysis Matrix 

Add more rows if necessary

 Strengths of the Research Limitations of the Research Relevancy to Topic of Interest Notes
The research has provided a comprehensive outlook of the article. Thanks to the research, the readers will be able to understand what will be expected of them if they have wounds. For instance, I have known that the modern-day standard of care for enduring injuries includes swabbing for infection, washing, and dressing the wound. As a result, if I get a wound, I will easily treat it. 

 

 The research article has made a minimal effort to depict the disadvantages of the failure to follow the current day wound healing procedures, and potential care is concerned Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis. I find it to be of no essence for the author to emphasize making the readers of the article know what is expected of them when they are wounded without informing them of the adverse impacts that are likely to be upon them if they fail to do as outlined. The research that is provided in the article is highly relevant to the topic of interest, ‘wound care.’ Once individuals have fully ready and internalized the information in the scholarly article, they will be in the position to care for the wounds that might either befall them or their friends. Thus, the research is relevant to the topic of interest. 

 

 Wound care is quite significant. 

The benefits of the practice are so many; hence, all persons need to be aware of its set-down procedure.

 

 

one-paragraph justification explaining whether or not you would recommend the use of this article to inform professional practice Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis.

Step 2: Summary of Analysis

Craft a summary (2-3 paragraph) below that includes the following:

  • Describe your approach to identifying and analyzing peer-reviewed research
  • Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research
  • Identify at least one resource you intend to use in the future to find peer-reviewed research

 

I experienced no difficulties while searching for the article because it is in an electronically available and indexed repository. The benefit of having  open-source articles from peer-reviewed journals is that it improves the quality of information that is available to the public on a subject. The database is useful to nursing colleagues of all demographics. Subscription-based repositories are restrictive in the sense that professionals in impoverished surroundings are not able to access such information. The result is the unfortunate reliance on habits or outdated practice that does not acknowledge the annotation of current evidence  about wound care in patients.

The article shows that wound care practice could benefit from increased knowledge-sharing among nurses (Smith-Strøm et al., 2016). Therefore, the issue of continuous professional development for nurses in this context should not only exist for the purposes of certification, but also for benevolence in patient care Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis.

Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis

Architect Daniel Libeskind is credited with saying “To provide meaningful architecture is not to parody history, but to articulate it.” The suggestion is that his work does not copy the efforts of others but relies on it.

Understanding the work of others is critically important to new work. Contributions to the nursing body of knowledge can happen when you are able to analyze and articulate the efforts of previous research. Research analysis skills are therefore critical tools for your toolbox.

In this Assignment, you will locate relevant existing research. You also will analyze this research using a tool helpful for analysis.

To Prepare:

  • Reflect on the strategies presented in the Resources this Module’s Learning Resources in support of locating and analyzing research.
  • Use the Walden Library to identify and read one peer-reviewed research article focused on a topic in your specialty field that interests you.
  • Review the article you selected and reflect on the professional practice use of theories/concepts described by the article. Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis

The Assignment:

Using the “Module 4 | Part 4” section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:

  • Your topic of interest.
  • A correctly formatted APA citation of the article you selected, along with link or search details.
  • Identify a professional practice use of the theories/concepts presented in the article.
  • Analysis of the article using the “Research Analysis Matrix” section of the template
  • Write a 1-paragraph justification stating whether you would recommend this article to inform professional practice.
  • Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
    • Describe your approach to identifying and analyzing peer-reviewed research.
    • Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research.
    • Identify at least one resource you intend to use in the future to find peer-reviewed research.

Note: Add your work for this Assignment to the original document you began in the Module 1 Assignment, which was built from the Academic Success and Professional Development Plan Template.

By Day 7 of Week 7

Submit your analysis, including your completed section of the Academic Success and Professional Development Plan Template sections and your matrix and summary Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 7 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “Wk7Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission Assignment: Academic Success and Professional Development Plan Part 4: Research Analysis.

NURS 6050 Week 2 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

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NURS 6050 Week 2 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

Access to Mental Healthcare

Walden University  

Introduction

Public policies structured and passed by governmental units play a significant role in the public’s access to healthcare and clinical professionals and practitioners’ relative delivery. Health policies that the U.S. government has approved must be carried out to establish effective healthcare services and regulations that benefit the country’s citizens. The U.S. healthcare system heavily relies on nurses’ service as they have adept skills in communication, biomedical science, education, psychology, and direct patient care (Milstead & Short, 2019). Thus, nursing is a critical stage in carrying out health and social policies for the public’s benefit. One of the country’s healthcare system’s significant concerns is delivering adequate and accessible mental healthcare services NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief. According to Russell (2010), one in four Americans aged 18 and above have a mental illness or diagnosable mental disorder. This rate tallies to around 26% of Americans who are diagnosed within a given year. The prevalence of such mental illnesses calls for more health policies to address the public health issue and provide adequate care to those with such illnesses. NURS 6050 Week 2 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

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The purpose of this paper is to underscore the significance of health policies relating to mental healthcare and dissection of possible mental healthcare agendas that can help provide effective nursing care. Tangent to this, the paper compares the mental healthcare policies that were addressed over three presidential terms. This paper also intends to discuss and compare the agendas, and budget allocation accomplished by former U.S. Presidents Trump, Obama, and Bush and establish which policies were most effective under the three political reigns. From this information, the paper gathers an in-depth analysis of mental healthcare and nurses’ role in helping political bodies provide the most effective healthcare services and agendas NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.

Agenda Comparison Grid

Identify the Population Health concern you selected.   

Access to Mental Healthcare
Describe the Population Health concern you selected and the factors that contribute to it. The need for healthcare accessibility is a necessity for any given population. Thus, the government’s policies should cover the support for all individuals who require medical attention and treatment. That said, the recipients of healthcare should include individuals who suffer from mental illnesses. According to Russell (2010), 44 million adults and 13.7 million children suffer from mental health disorders each year, caused by psychological, physiological, and social factors. Individuals who suffer from these disorders have a higher risk of committing suicide by up to 80 to 90 percent. Russell (2010) further stressed that healthcare systems must provide equal and quality services for these individuals, similar to general medical healthcare provisions.
Administration (President Name) President Trump President Obama President Bush
Describe the administrative agenda focus related to this issue for the current and two previous presidents. Upon the republican party representative President Trump’s election, the administration stressed the reformation or entire replacement of ACA, which was passed in the former term by former democrat President Obama (Milstead & Short, 2019). Contrary to this, the recent COVID-19 pandemic and its effects drove the administration to sign Executive Order 13594, Saving Lives Through Increased Support for Mental and Behavioral Health Needs, to ameliorate mental healthcare services in the country (SAMHSA, 2020). Consequently, the Department of Health and Human Services (2021) revealed the fiscal year 2021 budget to increase for SAMHSA to address substance abuse illnesses and mental health issues. In comparison with two other terms, the Obama administration’s agenda was to provide adequate mental healthcare in parity with the general medical care through health insurance NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief. In President Obama’s term from 2009 to 2017, he promoted his goal to provide healthcare access for all citizens. Thus, his main objective was to mandate the Patient Protection and Affordable Care Act or otherwise known as Obamacare and ACA (Milstead & Short, 2019), which was ordered to regulate health insurance provisions. President Bush’s main agenda towards mental healthcare was the establishment of the President’s New Freedom Commission on Mental Health, with which he signed an Executive Order to discuss the parameters and responsibilities of the commission (Hogan, 2003). After passing the Executive Order and pushing the commission’s agenda, former President Bush was commended by mental health associations and organizations for its initiative. While the initiative to bring mental healthcare to the youth and break the stigma surrounding the relative mental health conditions began as a notable goal for the commission, the agenda was surrounded by the debate on the addition of promotional, supposedly ineffective, and expensive medication.
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. Since the Trump administration aimed to reduce the expansion of ACA due to the spike in taxes for middle-class earners, the budget proposal made last 2020 revealed a significant decline in the budget for mental healthcare, as discussed by Canady (2019). The report revealed a 1.5 trillion-dollar budget cut for Medicaid alone and 845 billion dollars for Medicare. Canady (2019) further discussed these concerns as National Alliance on Mental Illness grew concerned over the number of insurance beneficiaries who will lose their coverage due to limited budget allocation NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief. However, the latest fiscal year report of 2021 shows that the administration provides 5.7 billion dollars to SAMHSA to cover substance abuse control, mental health services and prevention, and mental health needs for students (Department of Health and Human Services, 2021). Other budget allocations were provided to cover the support for mental health accessibility. As the Obama administration was focused on providing medical health insurance for all, the Medicare and Medicaid budget in 2015 increased by up to 3.2 trillion dollars or around 9,990 dollars per person or beneficiary, which also covers those who receive health insurance for mental illness (Milstead & Short, 2019). According to the study conducted by Frank, Beronio, and Glied (2014), this agenda made for the enhancement of Medicare and Medicaid significantly increased resources needed to provide enough mental health and substance use care for the majority of the population. However, Milstead and Short (2019) discussed the cons of such an agenda, not only for mental healthcare but for the general provisions of ACA. Concerns were raised concerning insurance funding by former premium holders and its effects on the raised collection of taxes. This debate became the primary hurdle for financing the agenda and encouraging its objective. Apart from developing the New Freedom Commission on Mental Health, the Bush administration also passed SAMHSA in 2000 to enhance the care given for mental health patients. According to Sundararaman (2009), the National Health Expenditure Account (NHEA) reported an expenditure of 142 billion dollars in 2005 to deliver mental healthcare. However, the report shows that health insurance coverage was lesser among the patients with mental health conditions, which is in large disparity with the insurance coverage received by general medical patients. Although, it is essential to note that the administration increased the budget allocation for mental healthcare services by over 20 billion dollars from 1996 to 2006, which covered training of mental health professionals, primary and specialty care in community mental health institutions, facilities, equipment, education, medication, and treatment (Russell, 2010).
Explain how each of the presidential administrations approached the issue. The current administration dedicated much of the budget for Medicare and Medicaid to be reduced, affecting the insurance holders that were initially supported during the previous administration. Although the repeal or reformation of Obamacare and ACA was to correct the gaps and missteps in the executive order, the Trump administration continuously made significant budget cuts and limitations to the accessibility of health insurance (Milstead & Short, 2019). These were made to address concerns by middle-wage earners who were subject to higher tax fees due to higher funding for health insurance. Concerning the recently passed executive order, the agenda covers services to care for the accessibility of prevention and treatment services for individuals with mental health and substance abuse concerns within community-based institutions and school settings (SAMHSA, 2020). In line with the efforts for making health insurance more accessible, President Obama passed the Mental Health Parity and Addictions Equity Act (MHPEA) in 2010 to provide mental health services at par with other healthcare services for almost 103 million individuals of the population (Executive Office of the President, 2016). The motion by this administration effectively made insurance accessible to those who were formerly non-holders of health insurance. Along with providing these individuals with healthcare, medication, premiums, and insurance coverage, the ACA, in partnership with MCPHEA, extended its service to provide the same benefits for insurance holders diagnosed with mental illness and substance use disorders. The commission’s agenda was to pursue mental health promotion among the youth in school settings to provide them healthcare services that are inaccessible to them (Mills et al., 2006). The commission intended to provide easier access to mental health services such as screening, suicide prevention, proper medication. The purpose of President Bush’s agenda was initially acclaimed as he appointed a whole commission to carry out the regulations and recommendations for mental healthcare. However, Bush received backlash for the commission after other researchers claimed that the agenda was used to promote ineffective and harmful pharmaceutical medications such as those pushed by the Texas medication algorithm project (TMAP) (Lenzer, 2004).

Agenda Comparison Analysis

After analyzing all three administrations, it was observed that the three presidents were able to pass agendas that were inclined towards providing mental healthcare services to address the rise in the prevalence of this health issue among the U.S. population. Although the initiative of former President Bush to carry out a governing commission to regulate the provision of mental healthcare services (Hogan, 2003), the target of the commission was less inclusive of the more significant population as it focused mainly on treatment through pharmaceutical medication (Mills et al., 2006) NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.

The best possible administrative agency most likely to address the healthcare issue is the Obama administration basing on the number of ameliorated mental health cases alone. According to the Executive Office of the President (2016), mental healthcare services became more accessible to the population, rounding up to about 15 million people more because of the ACA. The budget allocated for promoting low-cost, accessible health insurance through the ACA and the MHPEA allowed an estimated 62 million people for mental healthcare (Frank, Beronio, & Glied, 2014). However, it is essential to note that there were several gaps in delivering mental healthcare insurance as many individuals suffered from the consequences of higher tax payments and mandated insurance.

The issues raised during the Trump administration concerning the need for a reform of the ACA were relevant to addressing these concerns. However, drastic changes were made by the Trump administration, which caused a significant decline in the budget for mental healthcare (Milstead & Short, 2019) and an overall decreased accessibility ruling out the initial objectives of ACA NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.

Overall, the Obama administration was closer to providing mental healthcare and thus is the most likely responsible for carrying out services for the issue. However, the Trump administration’s points must be addressed to devise budget solutions that anticipate budgeting concerns and alleviate the probability of higher tax collection. Taken from the agenda of President Bush (Hogan, 2003), the best possible sponsor for the success of tackling mental healthcare issues is a governing commission that can integrate the help of mental health organizations and institutions in devising the provisions and regulations for the benefit of the patients and beneficiaries without monetizing any service or support. 

Narrative

Healthcare policies legislated by the government have significant impacts on citizens’ individual lives, especially those having limited access to proper healthcare. One of the country’s recent health issues today is the prevalence of mental health illness and inadequate support and healthcare service. Earlier data from 2010 showed about 40 million adults suffering from mental health disorders (Russel, 2010) NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief. Last 2019, the rate was observed to increase as the National Institute of Mental Health reports that almost one out five adults in the U.S. have a mental illness, which correlates to about 51.5 million adults in the population (NIMH, 2019). This data alone suggests the need for more support, medication, treatment, and other health services to alleviate the prevalence of such conditions. Providing a specific agenda for advancing mental healthcare can steadily provide millions from the population with adequate mental healthcare to improve the mental health state of these patients and decrease the increasing rate of suicide. NURS 6050 Week 2 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

Mental healthcare requires the skills and expertise of mental health professionals trained to provide care and treatment for their patients. Among these professionals are nurses who directly contact these patients and have professional communication, education, medical training, psychology, and patient care (Milstead & Short, 2019). Because of this, nurses play a critical role in carrying out policies that can discuss regulations, provisions, and enhancements tailored to patient needs. According to Mrayyan and Huber (2003), nurses are actively committed to ensuring their patients’ health, which is supported by the statement of the president of the American Nurses Association, saying that “nurses are the quality and safety monitors.” Since nurses carry the responsibility of improving patient outcomes, they can directly observe which policies pose optimal care delivery effectiveness NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief. Through this observation, Ellenbecker and Edward (2016) suggest that nurses conduct research that can present evidence for policy-makers to be well-informed and knowledgeable about patient conditions.

Conclusion

Legislators hold a critical responsibility to deliver policies and agendas that can benefit the entire population. Policies made for healthcare have a significant role for the country as citizens push the need for accessible medical service (Milstead & Short, 2019). The effects of proper healthcare predetermine the effectiveness of serving citizens of the country. The government must adhere to policies and agendas that can deliver optimal healthcare for patients without compromising the country’s socioeconomic aspects. In line with this, mental health is one of the public and global health issues that require further analysis and support as it continues to increase in rate (Department of Health and Human Services, 2021). Mandating medical and mental healthcare policies requires the help of legislators and the aid of medical health professionals, especially nurses, who have firsthand knowledge of the needs of patients. Through this inclusive, multidisciplinary approach in policy-making, the government can improve solutions and responses to citizens’ needs for medication, treatment, support, education, and care NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.

References

Canady, V. A. (2019). Proposed FY 2020 budget reveals critical cuts in MH supports. Mental Health Weekly, 29(11), 4–5. https://doi.org/10.1002/mhw.31819

Department of Health and Human Services. (2021). FY 2021 President’s Budget for HHS.

Ellenbecker, C. H., & Edward, J. (2016). Conducting Nursing Research to Advance and Inform Health Policy. Policy, Politics, & Nursing Practice, 17(4), 208–217. https://doi.org/10.1177/1527154417700634

Executive Office of the President. (2016). The Mental Health and Substance Use Disorder Parity Task Force.

Frank, R. G., Beronio, K., & Glied, S. A. (2014). Behavioral Health Parity and the Affordable Care Act. Journal of Social Work in Disability & Rehabilitation, 13(1-2), 31–43. https://doi.org/10.1080/1536710x.2013.870512

Hogan, M. F. (2003). The President’s New Freedom Commission: Recommendations to Transform Mental Health Care in America. Psychiatric Services.

Lenzer, J. (2004). Bush plans to screen whole US population for mental illness. BMJ, 328(7454). https://doi.org/10.1136/bmj.328.7454.1458

Lenzer, J. (2005). Bush unveils mental health action plan. BMJ, 331(7517). https://doi.org/10.1136/bmj.331.7517.592-a

Mills, C., Stephan, S. H., Moore, E., Weist, M. D., Daly, B. P., & Edwards, M. (2006). The President’s New Freedom Commission: Capitalizing on Opportunities to Advance School-Based Mental Health Services. Clinical Child and Family Psychology Review, 9(3-4), 149–161. https://doi.org/10.1007/s10567-006-0003-3

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: a nurse’s guide. Jones & Bartlett Learning.

Mrayyan, M. T., & Huber, D. L. (2003). The Nurse’s role in Changing health policy related to patient safety. JONA’s Healthcare Law, Ethics, and Regulation, 5(1), 13–18. https://doi.org/10.1097/00128488-200303000-00006NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

NIMH. (2019). Mental Illness. National Institute of Mental Health.

Russell, L. (2010). Mental Health Care Services in Primary Care: Tackling the Issues in the Context of Health Care Reform. Center for American Progress.

SAMHSA. (2020). Executive Order Saving Lives Through Increased Support for Mental and Behavioral Health Needs. Substance Abuse and Mental Health Services Administration.

Sundararaman, R. (2009). The U.S. Mental Health Delivery System Infrastructure: A Primer. Congressional Research Service. NURS 6050 Week 2 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.

Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.

As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.

In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.

To Prepare:

  • Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
  • Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
  • Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
  • Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.

The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:

  • Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
  • Describe the administrative agenda focus related to the issue you selected NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.
  • Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
  • Explain how each of the presidential administrations approached the issue.
  • At least 3 resources must be used

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

  • Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
  • How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
  • Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

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Part 3: Narrative

Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:

  • Summarize why this healthcare issue is important and should be included in the agenda for legislation.
  • Justify the role of the nurse in agenda setting for healthcare issues.
  • The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.

 

NURS_6050_Module01_Week02_Assignment_Rubric

Excellent Good Fair Poor
Part 1: Agenda Comparison Grid- 

-Identify a population health concern

-Describe the Population Health concern you selected and the factors that contribute to it.
5 (5%) – 5 (5%)
The response clearly and accurately identifies and describes a population health concern.
4 (4%) – 4 (4%)
The response vaguely identifies and describes a population health concern.
3.5 (3.5%) – 3.5 (3.5%)
The response inaccurately identifies and describes a population health concern.
0 (0%) – 3 (3%)
Identification and description of a population health concern is missing or incomplete.
Part 1: Agenda Comparison Grid- 

– Describe the administrative agenda focus related to this issue for the current and two previous presidents.

– Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

– Explain how each of the presidential administrations approached the issue.
18 (18%) – 20 (20%)
The response clearly and accurately describes the presidential administrations’ focus related to the concern, the financial and resource allocation dedicated to the concern, and explains how each of the presidential administrations approached the issue. At least 3 resources are used.
16 (16%) – 17 (17%)
The response vaguely describes the presidential administrations’ focus related to the concern, the financial and resource allocation dedicated to the concern, and explains how each of the presidential administrations approached the issue. Only 2 resources are used.
14 (14%) – 15 (15%)
The response inaccurately describes the presidential administrations’ focus related to the concern, the financial and resource allocation dedicated to the concern, and how each of the presidential administrations approached the issue. Only 1 resource is used.
0 (0%) – 13 (13%)
The description of the presidential administrations’ focus related to the concern, financial and resource allocation dedicated to the concern, and explanation for how each of the presidential administrations approached the issue is missing. No resources are used.
Part 2: Agenda Comparison Grid Analysis- Address the following: 

-Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

-How do you think your selected healthcare issue might get on the agenda? How does it stay there?

-Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
23 (23%) – 25 (25%)
-The response clearly and accurately identifies an administrative agency most likely to be responsible for addressing the selected healthcare issue.
-Response clearly and accurately explains how the healthcare issue gets on the agenda and remains there.
– The response clearly and accurately identifies the entrepreneur/champion/sponsor of the healthcare issue selected. NURS 6050 Week 2 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief
20 (20%) – 22 (22%)
-The response vaguely identifies an administrative agency which may be responsible for addressing the selected healthcare issue.
-Response adequately explains how the healthcare issue gets on the agenda and remains there.
-Identification of the entrepreneur/ champion/sponsor of the healthcare issue selected is vague NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.
18 (18%) – 19 (19%)
-Identification of an administrative agency responsible for addressing the selected health care issue is inaccurate.
-Explanation of how the healthcare issue gets on the agenda and remains there is vague or inaccurate.
-Identification of the entrepreneur/ champion/sponsor of the healthcare issue selected is inaccurate or does not align with the healthcare issue.
0 (0%) – 17 (17%)
-Identification of an administrative agency responsible for addressing the selected healthcare issue is missing.
-Explanation of how the healthcare issue gets on the agenda and remains there is vague and inaccurate or is missing.
-Identification of the entrepreneur/ champion/sponsor of the healthcare issue selected is vague and inaccurate or is missing.
Narrative: 

Based on your Agenda Comparison Grid for the healthcare issue you selected, develop a 1-2-page narrative that you could use to communicate with a policy-maker/legislator or a member of their staff for this healthcare issue.

-Summarize why this healthcare issue is important and should be included in the agenda for legislation.

 

-Justify the role of the nurse in agenda setting for healthcare issues
32 (32%) – 35 (35%)
Creates a well-developed, accurate, and narrative.
The response provides a complete, detailed, and specific synthesis of two outside resources reviewed on why this healthcare issue is important and should be included in the agenda for legislation. The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided.

Responses accurately and thoroughly justify in detail the role of the nurse in agenda setting for healthcare issues.

28 (28%) – 31 (31%)
Creates an accurate and thorough narrative.
The response provides an accurate synthesis of at least one outside resource reviewed on why this healthcare issue is important and should be included in the agenda for legislation. The response integrates at least 1 outside resource and 2-3 course specific resources that may support the summary provided.Responses accurately justify the role of the nurse in agenda setting for healthcare issues NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.
25 (25%) – 27 (27%)
Creates a narrative that is partially accurate or incomplete.
The response provides a vague or inaccurate summary of outside resources reviewed on why this healthcare issue is important and should be included in the agenda for legislation. The response minimally integrates resources that may support the summary provided.The responses partially justifies the role of the nurse in agenda setting for healthcare issues.
0 (0%) – 24 (24%)

The response provides a vague and inaccurate summary of no outside resources reviewed on why this healthcare issue is important and should be included in the agenda for legislation, or is missing. The response fails to integrate any resources to support the summary provided.

Responses justifying the role of the nurse in agenda setting for healthcare issues is inaccurate and incomplete or is missing.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief.

5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.
Purpose, introduction, and conclusion of the assignment is vague or off topic.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.
No purpose statement, introduction, or conclusion was provided.

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 (5%) – 5 (5%)
Uses correct APA format with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) APA format errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors. NURS 6050 Week 2 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief
Total Points: 100

Presidential Agendas -NURS 6050 week 1 Discussion

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Presidential Agendas -NURS 6050 week 1 Discussion

Initial Discussion Post

This week, we will evaluate how former presidential administrations handled health care and how federal agendas promote healthcare. Healthcare issues are one of the biggest problems in elections. Some believe in universal healthcare, and some think universal healthcare would result in sub-standard healthcare. Whichever side you are on, we can not deny that health care prices and availability need to be improved. Healthcare funding often depends on the political party that is in control of the executive and legislative branches Presidential Agendas -NURS 6050 week 1 Discussion.

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The implementation of healthcare coverage has taken on many forms throughout the history of the United States. Until the turn of the century, most healthcare was the states’ responsibility ( Gluck & Huberfield, 2018). The state’s healthcare funding was often not enough to provide healthcare, so the federal government began programs to help cover the elderly and poor. President Johnson created Medicare and Medicaid to ensure healthcare for the elderly and poor ( Gluck & Huberfield, 2018). Medicare and Medicaid are still funding healthcare and have been modified several times to include more people. The Patient Protection and Affordable Care Act (ACA) was the most recent federal government attempt to provide broader healthcare access.

President George W. Bush helped lay the groundwork for future healthcare reform laws. President Bush was the first president to focus on the electronic health record and Health Saving Accounts (HSA) (Bush, 2004). Before 2001, there were very few systems in place to create and maintain patient charts electronically.  Electronic health records have helped with patient safety and quality of care because providers can access prior medical information like allergies and diseases. President Bush passed laws to reduce prescription drug prices, which helped relieve some of the financial burdens on the elderly and poor (Bush, 2014). Overall, President Bush created an environment of future healthcare reform Presidential Agendas -NURS 6050 week 1 Discussion.

President Barrack Obama came into office with the hope of reforming healthcare. President Obama, with the help of congress, passed the  Patient Protection

and Affordable Care Act (ACA).  The ACA expanded Medicaid coverage and created insurance exchanges that offered lower-priced insurance options. The ACA did not see its full potential because some states refused to implement the changes (Oberlanger, 2012). The federal government had to step in to provide insurance options in states that did not participate. The ACA was the most extensive health care reform since the creation of Medicare and Medicaid. The federal government’s involvement in providing healthcare to its citizens is criticized as being socialistic. The United States current healthcare is currently the most expensive globally and does not offer universal healthcare.

President Donald Trump promised to repeal the ACA in his campaign. President Trump offered to replace the ACA with a better plan. The planned replacement for the ACA never materialized. One of the problems in repealing the ACA is that public opinion was split between the government offering healthcare and private insurance coverage (Keckley, 2017).  President Trump tried many avenues to repeal the ACA. His administration has attempted to undermine the ACA by limiting funding and participation (Jones et al., 2018). President Trump successfully streamlined vaccine approvals for COVID-19. The vaccine approval usually would have taken years to be approved by the Food and Drug Administration (FDA). Overall, President Trump’s healthcare policies centered on repealing the ACA, but he never offered a viable replacement plan. One of his only successes in healthcare was streamlining the COVID-19 vaccine Presidential Agendas -NURS 6050 week 1 Discussion.

Universal healthcare is a significant debate. The opinion often depends on political affiliations. I feel like healthcare should be a right instead of a privilege. Many countries have implemented universal healthcare and spend much less than the United States. The argument is that with universal health coverage, you will have low healthcare quality. The reforms and policies to date have attempted to provide access to health for more Americans. If I were to offer more access to Americans, I would try to personalize the uninsured struggle.

Bush, G.W. (2004). Ensuring access to health care: The Bush plan. JAMA, 292(16), 2010-2011. https://doi:10.1001/jama.292.16.2010

Gluck, A.R., & Huberfield, N. (2018). What is federalism in healthcare for?. Stanford Law Review, 70(6), 1689–1803. https://www-proquest-com.ezp.waldenulibrary.org/docview/2064333592?accountid=14872

Jones, D.K., Gusmano, M.K., Nadash, P., & Miller, E.A. (2018). Undermining the ACA through the executive branch and federalism: what the Trump administration’s approach to health reform means for older Americans. Journal of Aging & Social Policy, 30(3-4), 282-299. https://doi.org/10.1080/08959420.2018.1462684

Keckley, P.H. (2017). What’s ahead on healthcare? The new administration favors a state-run, market-driven approach to crafting policy. Healthcare Executive, 32(2), 66-69. https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=5&sid=f1330a19-ae27-4bd5-adbe-c82d59cf5815%40sessionmgr101 Presidential Agendas -NURS 6050 week 1 Discussion

Oberlander, J. (2012). Unfinished journey-a century of health care reform in the United States. The New England Journal of Medicine, 367(7), 585-590. https://doi:10.1056/NEJMp1202111

Discussion: Presidential Agendas

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

  • Review the Resources and reflect on the importance of agenda setting.
  • Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an examplePresidential Agendas -NURS 6050 week 1 Discussion.

sample post 2

Healthcare Reform

I chose overall Healthcare Reform as my topic that rises to the presidential level. It’s been a significant issue, often being a cornerstone of presidential campaigns in recent years. The United States spent nearly 18% of the GDP on healthcare, more than any other country (Center for Medicare and Medicaid Services, 2020).

Trump

            As the White House pages have been deleted, it has been challenging to find information sources on Trump’s Healthcare plan. While the Trump Administration claimed to repeal and replace the Affordable Care Act, they seemingly only seemed to weaken the ACA throughout the administration. In 2017, Republicans in House and Senate voted in a year-end tax cut that reduced the penalty for failing to have health insurance (one of the underlying tenets of the ACA) to zero.

In October of 2020, Trump announced his “America First Healthcare Vision”. This entailed protecting patients with pre-existing conditions and protecting healthcare consumers from “surprise billing” – an effort to have more transparency in hospital costs and reduce the occurrence of unforeseen hospital bills (Brownstein et al., (2020). It also expanded access to “Association Health Plans”, which small businesses could utilize to have access to health insurance savings typically associated with large group medical coverage seen in larger companies previously.

Obama

            Obama enacted the Affordable Care Act in 2010. This provided avenues for more people to gain health insurance, utilizing subsidies for people with household incomes between 100% and 400% of the poverty level (Healthcare.gov, n.d.). The plan had a focus on individual market coverage, providing subsidies for these plans. He also expanded Medicaid to cover all adults below 138% of the poverty level. Over 20 million Americans gained health insurance from 2010-2018 under this plan (CDC, 2018).

Bush

            George W. Bush enacted several specific policy changes rather than one comprehensive healthcare reform, aiming to continue privatized insurance policies but adding options to have more people covered. These included Medicare reforms, including a prescription drug policy which provided more access to better prescription drugs (the Heritage Foundation, 2004). Bush also created Health Savings Accounts; a tax-free savings account for health expenses Presidential Agendas -NURS 6050 week 1 Discussion. He also increased funding for medical research. The president expanded flexibility for states to cover more people under Medicaid and the State Children’s Health Insurance Program (S-CHIP). Presidential Agendas -NURS 6050 week 1 Discussion

Conclusion

I don’t pretend to have a complete understanding of this complex issue. However, I think the success of other countries in implementing centralized, socialized healthcare plans for universal healthcare cannot be ignored. It seems America is spending more on healthcare with the same or even worse results than other first-world countries. Healthcare costs are crippling here. I have been fortunate in not having any major health issues thus far, but even the minor issues I have had have been enormous financial burdens. Taking away the concern over expensive healthcare scenarios would have an immediate positive effect on the overall morale of the entire population.

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At the same time, I realize the importance of figuring out policies that gear a population towards more preventative, primary care solutions rather than medical interventions once a health issue is out of hand. The mentality of many in the US needs to change – and the realization that preventative steps can prevent significant health issues down the road; but this begins with people being able to afford basic primary care to nip health issues in the bud before they potentially require expensive solutions like inpatient stays. I also would like to see some of the efforts to provide incentives for good health, like workplace checkups with bonuses for making improvements to health – such as quitting smoking, improving Body Mass Index, etc Presidential Agendas -NURS 6050 week 1 Discussion.

References

Center for Disease Control, (2018). National Center for Health Statistics. National Health Interview Survey Early Release Program. Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January-June, 2018. https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201811.pdf

Center for Medicare and Medicaid Services, (2020). National Health Expenditure Data – Historical. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical#:~:text=U.S.%20health%20care%20spending%20grew,spending%20accounted%20for%2017.7%20percent.

Healthcare.gov, (n.d.). Affordable Care Act (ACA). https://www.healthcare.gov/glossary/affordable-care-act/

The Heritage Foundation, (2004). An Examination of the Bush Healthcare Agenda. https://www.heritage.org/health-care-reform/report/examination-the-bush-health-care-agenda

Brownstein, Hyatt, Farber, and Schrek, (2020). Overview of the Trump Administration’s America First Healthcare Vision’. https://www.bhfs.com/insights/alerts-articles/2020/overvi

sample response

I agree with your statement that healthcare insurance is a complex topic that is hard to grasp a broad understanding of. Our country working towards preventative care versus secondary and tertiary care would drastically decrease the amount of spending on the federal level. “Policymakers and the general public also have little knowledge of the efficacy of primary care, its impact on individual and population health, and its role in today’s healthcare delivery” (Shi, 2012). As registered nurses working towards furthering our education; I agree it is vital for us to be the voice of change to help recognize the importance of primary preventative care Presidential Agendas -NURS 6050 week 1 Discussion.

I think your idea of incorporating more workplace health incentives is great. Most Americans spend a majority of their time at their workplace, often without other daily activities. “Therefore, programs aimed at the workplace have the potential to reach a large segment of the population who might not be exposed to other health promotion initiatives” (Pescud, Teal, Shilton, et. al., 2015). Incorporating incentives for a healthier lifestyle into other mandatory daily activities is a great way for populations to be reached and preventative care to be addressed.

References

L. Shi. (2012, December 31). The impact of primary care: a focused review. National Institute of Health. Retrieved March 4, 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820521/


M. Pescud, R.Teal, T. Shilton, et. al. (2015, July 11). Employers’ views on the promotion of workplace health and wellbeing: a qualitative study. National Institute of Health. Retrieved March 4, 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499225/ Presidential Agendas -NURS 6050 week 1 Discussion

NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem

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NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem

Main Post Week 1
The Problem
The facility at which I am employed is located on a Native American Reservation in North Central Montana. There is a high rate of enrolled members who are diagnosed with diabetes, many of which are further classified as uncontrolled and have multiple complications. I work in the Diabetes Management Department as the Diabetes Educator, Diabetes Nurse, and the Diabetic Foot Care Specialist. The patient safety problem that I have identified involves an increase in the number of patients diagnosed with diabetes who were presenting to the clinic with different types of chief complaints related to their feet. Some of those diagnoses included in-growing toenails, onychomycosis, macerations, ulcerations, fissures, corns, and callosities. Many of those patients also had musculoskeletal diagnoses such as hammertoe, claw toe, early-stage Charcot Foot, prominent metatarsal heads, and Taylor’s bunions. NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem.

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The Research and The Potential Cause

Indian Health Services (IHS) (2020) state as many as 10 – 20% of native American patients diagnosed with diabetes who attend a scheduled diabetes exam will have an acute problem related to foot care such as infection, toenail overgrowth, and callosities that needs immediate treatment. The authors continue to state that it is essential to inspect the feet of the diabetic patient at each exam visit because there may also be other factors that increase the risk of injuries such as peripheral arterial disease and sensory neuropathy (IHS, 2020).

Using the Electronic Health Record system, a report was generated to determine which patients diagnosed with any form of diabetes were due for an annual foot exam (had not had a documented foot exam in the past eleven months) and which of those patients also had a full diabetes examination scheduled. In 2018, 35% of the diabetic population of the reservation had a complex foot examination completed. In 2019, only 19% of the diabetic population had a diabetic foot exam documented. After careful review and comparison, it was noted that the patients who attended the scheduled full diabetes examinations were not always receiving the annual foot examination from the nurses or the providers. The nurses should have been removing the shoes of those patients with diabetes and performing a foot exam with 10-g monofilament plus one other sensory test, such as vibratory perception with a tuning fork. This exam was not being completed and was leading to poor outcomes.

More Research

Realizing that this facility cannot be the first facility to experience this challenge, further research was conducted to determine what evidence-based practice guidelines might have been established recently through studies that proved effective in increasing the number of diabetic foot exams. Vanderbilt University Medical Center conducted a study to improve foot exam completions by implementing posters for rooms and developing a template for charting that proved successful (Agency for Healthcare and Research Quality, 2014). The Centers for Disease Control and Prevention (CDC) (2017) reports that in 2016 over 82% of adults who are also diagnosed with diabetes in Montana have had an annual foot exam completed.

Change in Practice

The importance of annual foot exams for patients diagnosed with diabetes and the gathered data was shared with the appropriate leaders at the facility. After two weeks of collaboration, a few steps were implemented to help ensure the patients were educated, the nurses were trained and supported, and the patient outcomes were improved. Some of the critical elements of change included the following: NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem

A Diabetic Foot Exam Template was developed to help facilitate accurate and efficient documenting
Each of the nurses in the clinic participated in education related to foot exams and are provided additional education quarterly to help them learn about what may be abnormal and interventions to take.
Each exam room is stocked with 10-g monofilament (sensory testing) and a tuning fork (for vibratory perception testing)
Each exam room and every nursing station has a graphic hanging that shows how to perform the sensory testing.
Each of the 22 exam rooms has a sign hung that states, “Do You Have Diabetes? We would LOVE to see your feet” Please make sure your nurse takes off your shoes!”
The Foot Care Nurse reviews upcoming appointments and orchestrates daily huddles with providers and nurses
Impact on Patient Outcomes

To date, the changes implemented have been positive, not only for the patient outcomes but also for nurse-provider communications. At this point, I have not run updated reports to get exact numbers but have noticed differences in patient care as well as responses from patients during patient interactions. The impacts on patients and processes are as follows:

Fewer patients are presenting to Urgent Care for chief complaint related to their feet, i.e., “sore on the toe,” “infected in-grown.”
Increased number of patients scheduling appointments for routine foot care
Increased number of patients receiving Annual foot exam from nurse or provider during an office visit.
Nurses and providers are calling Foot Care Nurse more often with questions, for specific patient education, to schedule appointments for patients while they are with the patient.
The Research Question and Why

How often do nurses perform foot exams on patients diagnosed with diabetes at Rocky Boy Health Center?

To answer this question and to increase the number of foot exams performed, a quantitative methodology will be used. There is a distinct correlation in the variables; the nurse and the patient diagnosed with diabetes and foot exams. The information is easily gathered from the facility’s database. The data has been collected and compared to state and national indicators. Research has been conducted and evidence-based guidelines reviewed concerning improving nurse compliance with conducting foot exams. New processes have been established at the facility, and patient outcomes are improving. Continued monitoring and measuring are needed before I can say with certainty that these new implementations have been a real success.

 

References

Agency for Healthcare and Research Quality (2014). Toolkit for implementing the chronic care

model in an academic environment: Diabetes foot exam. Retrieved July 13, 2020 from <https://www.ahrq.gov/prevention/curriculum/chroniccaremodel/chronic3a3.html

Centers for Disease Control and Prevention, 2017. U.S. Diabetes surveillance system: Foot

exams by state. Retrieved July 13, 2020 from <https://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html

Indian Health Services (2020). Foot care: Diabetes standards of care & clinical practice

resources. Retrieved 12 July 2020, from https://www.ihs.gov/diabetes/clinician-resources/soc/foot-care1/

Discussion: Choosing the Type of Research for a Research Problem
How do you choose the type of research to conduct to address a research problem? What information should you keep in mind to ensure that your research process will adequately address your research problem?

Understanding the different types of research is a critical skill for the nurse researcher and nursing professional. As a current nursing professional, consider how understanding the different types of research may be conducive to achieving a particular mission in your health care setting, such as developing an intervention to address a quality or patient safety problem. This knowledge can also be a step toward assuming a nursing leadership position. As a critical component of your nursing toolkit, differentiating between the types of research is a fundamental step toward enacting change through the process of research. NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem.

For this Discussion, please review the following:

Think about clinical practice problems you have seen in health care that compromise patient safety and health outcomes. For example, nursing-sensitive indicators reflect high-priority practice problems, which are described in the article by Martinez, Battaglia, Start, Mastal, and Matlock (2015).
Choose one of the clinical practice problems you have seen in your current or past job in a health care setting. Consider the possible causes of this problem and how you think it is, or was, affecting patient outcomes.
Some patient safety problems are solved by making changes in clinical practice. For example, decreasing catheter-associated urinary tract infections in hospitalized patients often requires changes in clinical practice such as better adherence to preventive measures when catheters are inserted (e.g., use of disposable gloves, maintaining sterile fields, cleansing urethral meatus). For the problem you identified, what specific change in practice do you think is needed?
When a practice change is implemented, it is important to verify whether or not the change has improved patient outcomes. One way to determine this is by conducting research. One of the first steps in the research process involves developing a research question that will later serve as the foundation for your study. Using information from Chapter 5 in your textbook and the handout on developing research questions, think about a research question and about the effectiveness of the practice change you proposed in improving patient outcomes.
Another step in the research process involves identifying which type of research could be conducted to best answer your research question. In Chapter 5 of your textbook you will find a list of different types of research in the first column in Table 5-2, and Table 5-3. You can learn more about these different types of research in both Chapter 2 and the Glossary in your textbook. To locate even more information, you can also use an Internet search engine for more in-depth descriptions and examples. After learning more about the different types of research, think about which one you think is best for determining how well the clinical practice change you identified will improve patient outcomes. NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem.
By Day 3
Post a description of how you would address the following:

Part 1: Patient Safety Problem
Describe the patient safety problem you identified, its causes, and the impact you think it has on patient outcomes. For this problem, describe a specific change in practice that could help improve patient outcomes.

Part 2: Research on Patient Safety Problem
Develop a research question that tests the effectiveness of your practice change in the improvement of one or more patient outcomes. What type of research would you use to answer this question? Describe the reasons why you think this is the best approach and why you would not use the other three types of research.

Note: Post a three paragraph (at least 350 words) response. Be sure to use evidence, in-text citations, and essay-level writing skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post.

By Day 7
Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information. NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem.

Post a Discussion entry on 3 different days of the week. See the Rubric for more information.

 

Discussion – Week 1
COLLAPSE
Does an increase in nursing knowledge regarding correct blood transfusion techniques improve patient outcomes?

Utilizing blood and blood parts is a standard restorative methodology in emergency clinics. Medical caretakers have an essential job in a sheltered blood transfusion. Hence, medical caretakers must have adequate information on circumstances, sum, and techniques for utilizing blood parts, conceivable symptoms, and vital consideration. Blood is valuable, particularly in sparing the lives of patients. Blood segments are costly, and their planning is restricted. In this way, they ought to be expertly chosen and utilized for patients by all means. The point of blood and blood segments transfusion in clinical medicines is to give reasonable and safe blood items to accomplish the best clinical results (KAREN K. GIULIANO & JANE HENDRICKS, 2017).

Notwithstanding its first job in sparing lives, blood transfusion is related with dangers. Committing errors in blood transfusion and lacking control of patients who get blood during the transfusion are among the reasons for death for such patients. Since there is no subbing item for human blood, the requirement for blood transfusion is proceeding. Over half of patients hospitalized in acute consideration units and a half to 70% of patients in particular and orthopedic wards need a blood transfusion. (KAREN K. GIULIANO & JANE HENDRICKS, 2017). NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem.

Yearly reports in Britain show serious dangers of blood transfusion, for example, disregard in the distinguishing proof of blood classification and its parts, wrong ID of patients, and disregard in controlling patients during transfusion as essential drivers of mix-ups. In this manner, thinking about the strict requirement for blood and blood segments, alongside restricted sources and constrained chance of setting up each blood item. It is significant to attempt by all ways to expand the information on the clinical workforce and giving the necessary instruction to diminish the utilization of complete blood and to utilize only the segments vital for patients’ wellbeing to lessen blood waste and transfusion confusion. Studies indicated that medical caretakers and nursing understudies do not have adequate data and right execution appropriate to the significance of the issue. Medical caretakers misplay a colossal job, logical and safe use of blood and its segments. If they can do it effectively, the likelihood of the frequency of blood transfusion dangers will decrease to a base. The progressions in innovation have made a situation that makes persistent consideration progressively productive and accommodating for the patient.The adjustments in preparing, human services setting, developing duties, nursing society, and patient consideration have spared countless lives and helped it become the regarded field that it is today (KAREN K. GIULIANO & JANE HENDRICKS, 2017).

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References

KAREN K. GIULIANO, P. R., & JANE HENDRICKS, B. R. (2017). Current Nursing Knowledge. Inadvertent Perioperative, 1-12.

Discussion – Week 1
COLLAPSE
The Problem

I work in a busy emergency department at a regional medical center in rural Mississippi. I’ve noticed throughout working here that we seem to have a lot of patients returning to the ER with the same complaint as previous visits. Many times, this is because the patient did not adhere to the prescribed medications at discharge. The problem I want to focus on lies in the number of recently discharged patients that return to the ER with the same complaint who did not get their prescriptions filled versus those who utilized hospital-based Med-to-Bed services. NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem.

Change in Practice

Currently, a patient is asked during triage what pharmacy they use. This is an excellent opportunity to offer Med-to-Bed services to patients. By making the patient aware of the service early, the pharmacy tech (already housed in the ER) can meet with the patient and get their insurance verification (if any) complete, so when the provider has a disposition and medication prescriptions, it will be a quicker process to get the medications in the hands of the patient before discharge.

The Research Question

Do patients that utilize hospital-based Med-to-Bed services have fewer return visits to the ER for the same complaint?

I believe this question falls into quasi-experimental research and experimental research (Gray, J., Grove, S., Sutherland, S. 2016, p. 87) because it studies single aspects of the cause and effect relationships between medication adherence and return visits. Working in coordination with the pharmacy, I could track current Med-2-Bed utilization versus total ER visits. I will work with my ER director to have the Med-2-Bed education given at triage and see if the number of service utilization increases over three months. I can have an additional report ran to see if there is a decrease in ER revisits for the same complaint. I read about one such study that showed a reduction in 30-day hospital readmissions from 10.3% to 8.7% and a decrease in ER revisits from 18.2% to 11.9% (Conliffe et al., 2019).

References

Conliffe, B., VanOpdorp, J., Weant, K., VanArsdale, V., Wiedmar, J., & Morgan, J. (2019). Impact of an advanced pharmacy practice experience student-run “Meds 2 beds” and discarge counseling program on quality of care.. Hospital Parmacyp, 54(5), 314–322.

R., G. J., Grove Phd Rn Anp-bc Gnp-bc, Susan K., & Suzanne, S. (2016). Burns and grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence(8th ed.). Saunders. NURS 3150 3151 week 1 Discussion: Choosing the Type of Research for a Research Problem

NURS 3150 3151: Foundations of Nursing Research

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NURS 3150 3151: Foundations of Nursing Research

NURS 3150 3151: Foundations of Nursing Research
Discussion – Week 1
Pregnancy is a crucial time for the development of a human life. There are many changes and growth that is happening during nine months of pregnancy. The pregnant mother must alter her lifestyle to meet the needs of her growing baby. Some of these changes include ending drug and alcohol abuse, eating appropriate foods and avoiding harmful foods, receiving proper prenatal care and staying active to promote a healthy pregnancy.

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Patient Safety Problem

I live near an American Indian reservation and I have encountered countless mothers who had late or no prenatal care. In 2017, American Indians were most likely to report late or no prenatal care in 12 percent of births (Late or No Prenatal Care, 2019). The lack of prenatal care poses a risk for both mother and baby. In my experience, when a mother is not receiving prenatal care, they are also involved in reckless activities that are actively harming her and baby. Some of these reckless activities include using drugs and abusing alcohol. Using tobacco and drinking alcohol during pregnancy has been linked to increase the risk of sudden infant death syndrome. Drinking alcohol during pregnancy can also increase the risk of fetal alcohol spectrum disorders, intellectual disabilities, problems with vital organs and having a small head (What is prenatal care and why is it important, 2017). There are countless, long-term effects of children who have been born from a mother who used illegal substances during pregnancy while not receiving proper prenatal care. NURS 3150 3151: Foundations of Nursing Research.

Change in Practice

A change that could be beneficial for pregnant mothers on the reservation would be completing home visits. Research has shown that a home visiting program for pregnant women and their infants brings about participation and knowledge that will increase positive maternal and infant outcomes (Johnson, 2020). Often, these pregnant mothers do not have the means to go to an appointment or to provide a healthy lifestyle in pregnancy. A home visit would literally meet the expecting mother where she is, she wouldn’t have to try to find a ride to the clinic. Prenatal care and education would be completed, along with supplying necessary vitamins that include folic acid. Enrolling a mother in a drug or alcohol rehab that is safe for pregnancy could improve pregnancy outcomes for both mom and baby.

Research Question

Would home prenatal visits to low-income, high-risk expecting mothers improve pregnancy outcomes for mother and baby?

This question is an example of quantitative research. Common demographic variables utilized in quantitative research are gender and ethnicity (Grove, et al., 2013). Quantitative research contains probable designs, and this research question falls under the quasi-experimental category because it measures the cause and effect of prenatal care via home visits. I think that this type of research would best fit the question posed because quality prenatal care correlates with positive pregnancy outcomes. The other three types of research, descriptive, correlation and explanation, are not useful for this research question simply because they are not focused on the independent variable (prenatal care) that causes change in the dependent variable (pregnant mothers and their baby) (Grove, et al., 2013). NURS 3150 3151: Foundations of Nursing Research.

 

Late or No Prenatal Care. (2019, May 3). Retrieved July 14, 2020, from https://www.childtrends.org/indicators/late-or-no-prenatal-care

What is prenatal care and why is it important? (2017, January 31). Retrieved July 14, 2020, from https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/prenatal-care

Johnson, M. B. (2020). Prenatal Care for American Indian Women. MCN: The American Journal of Maternal/Child Nursing, 45(4), 221-227. doi:10.1097/nmc.0000000000000633

Grove, S. K., Burns, N., & Gray, J. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence. St. Louis, MO: Elsevier/Saunders.

Week 1: Overview of Research

What is research, and how does research relate to nursing practice?

Nursing practice is based on outcomes and best practices supported by research findings. That is, issues related to health are examined, and proposed solutions to promote patient safety and health care quality are tested to best determine nursing protocols for professional practice. Consider for example, current nursing protocols to minimize patient falls in health care settings. Without research, extensive testing, and an awareness of how to promote solutions to minimize the risk of falls, there is an increased risk that this very real patient problem would get worse.

This week you explore an overview of the different types of research uses in health care settings. You examine how each type of research is used by nurses in providing quality of care and in promoting positive patient safety outcomes. The week will conclude with an overview of the basic elements of the research process: (a) problem identification, (b) review of literature, (c) implementation of research methods, (d) analyses and presentation of findings, and (e) conclusions about implications for practice.NURS 3150 3151: Foundations of Nursing Research.

Learning Objectives

Students will:
  • Describe steps of the research process to advance knowledge about quality of care and patient safety
  • Develop a research question that guides the development of a study on patient safety
  • Develop a research question that guides the development of a study
  • Identify different types of research and their contribution to health care

Learning Resources

Required Readings

Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier.

  • Chapter 1, “Discovering the World of Nursing Research” (pp. 1-15)
  • Chapter 2, “Evolution of Research in Building Evidence-Based Nursing Practice” (pp. 18-34)
  • Chapter 5, “Research Problem and Purpose” (pp. 76-93)
  • Chapter 6, “Objectives, Questions, Variables, and Hypothesis” (pp. 98-117)

Martinez, K., Battaglia, R., Start, R., Mastal, M.F., & Matlock, A.M. (2015). Nursing sensitive indicators in ambulatory care. Nursing Economics, 33(1), 59-64.

Document: Developing a Good Research Question in Nursing (PDF)

Writing Resources and Program Success Tools

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (7th ed.). Retrieved from https://academicguides.waldenu.edu/writingcenter/templates/general

Document: Academic Writing Expectations (AWE) Checklist (Word Document)

 

This checklist will help you self-assess your writing to see if it meets academic writing standards for this course. NURS 3150 3151: Foundations of Nursing Research.

Discussion: Choosing the Type of Research for a Research Problem

How do you choose the type of research to conduct to address a research problem? What information should you keep in mind to ensure that your research process will adequately address your research problem?

Understanding the different types of research is a critical skill for the nurse researcher and nursing professional. As a current nursing professional, consider how understanding the different types of research may be conducive to achieving a particular mission in your health care setting, such as developing an intervention to address a quality or patient safety problem. This knowledge can also be a step toward assuming a nursing leadership position. As a critical component of your nursing toolkit, differentiating between the types of research is a fundamental step toward enacting change through the process of research.

For this Discussion, please review the following:

  • Think about clinical practice problems you have seen in health care that compromise patient safety and health outcomes. For example, nursing-sensitive indicators reflect high-priority practice problems, which are described in the article by Martinez, Battaglia, Start, Mastal, and Matlock (2015).
  • Choose one of the clinical practice problems you have seen in your current or past job in a health care setting. Consider the possible causes of this problem and how you think it is, or was, affecting patient outcomes.
  • Some patient safety problems are solved by making changes in clinical practice. For example, decreasing catheter-associated urinary tract infections in hospitalized patients often requires changes in clinical practice such as better adherence to preventive measures when catheters are inserted (e.g., use of disposable gloves, maintaining sterile fields, cleansing urethral meatus). For the problem you identified, what specific change in practice do you think is needed?
  • When a practice change is implemented, it is important to verify whether or not the change has improved patient outcomes. One way to determine this is by conducting research. One of the first steps in the research process involves developing a research question that will later serve as the foundation for your study. Using information from Chapter 5 in your textbook and the handout on developing research questions, think about a research question and about the effectiveness of the practice change you proposed in improving patient outcomes.
  • Another step in the research process involves identifying which type of research could be conducted to best answer your research question. In Chapter 5 of your textbook you will find a list of different types of research in the first column in Table 5-2, and Table 5-3. You can learn more about these different types of research in both Chapter 2 and the Glossary in your textbook. To locate even more information, you can also use an Internet search engine for more in-depth descriptions and examples. After learning more about the different types of research, think about which one you think is best for determining how well the clinical practice change you identified will improve patient outcomes.

By Day 3

Post a description of how you would address the following:

Part 1: Patient Safety Problem

Describe the patient safety problem you identified, its causes, and the impact you think it has on patient outcomes. For this problem, describe a specific change in practice that could help improve patient outcomes.

Part 2: Research on Patient Safety Problem

Develop a research question that tests the effectiveness of your practice change in the improvement of one or more patient outcomes. What type of research would you use to answer this question? Describe the reasons why you think this is the best approach and why you would not use the other three types of research.

Note: Post a three paragraph (at least 350 words) response. Be sure to use evidence, in-text citations, and essay-level writing skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post.

By Day 7

Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information.

Post a Discussion entry on 3 different days of the week. See the Rubric for more information.

Submission and Grading Information

Grading Criteria

To access your Rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:

Week 1 Discussion

Quiz: Nursing Research

By Day 7

Complete the quiz which covers content in the assigned readings for this week. The quiz includes questions that are multiple choice, true/false, and matching.

Note on Quiz Content: This quiz will cover (a) definition and importance of nursing research, (b) nursing research trends in the 21st century, (c) basic steps in the research process, (d) clinical origins of research problems (e.g., nursing sensitive indicators), and (e) feasibility of conducting research in clinical settings. The content is covered in this week’s Learning Resources. NURS 3150 3151: Foundations of Nursing Research.

Submission and Grading Information

Submit Your Quiz by Day 7

To submit your Quiz:

Week 1 Quiz

Week in Review

Now you… know the necessary steps to a research process and developed a research question that guides the development of a study and patient safety, including the impact it has on patient outcomes. Next week you will… conduct a literature review including all the components and demonstrate an understanding of ethical issues in conducting clinical research.

Week 2: Conducting a Literature Search on a Clinical Research Question

Have you ever conducted a literature search before? What does a literature search entail, and why might it be important for nursing practice?

As a nursing professional, you may engage in conducting a literature search in order to refine a clinical research question that you might examine through the research process. Examining, reviewing, and considering the literature in the field will help you to hone your research question and think about new ways you might address or answer a research question with clinical practice.

This week, you examine the skills needed to conduct a literature search to locate other studies that have been conducted on a clinical practice problem. Given the importance of ethical considerations throughout the research process, you will also explore the ethical implications of clinical research. You will examine the definition of research ethics, explore a historical overview of ethical problems in research, consider the ethics of using existing data in research, and the implications of the Health Insurance Portability and Accountability Act (HIPAA) on research. NURS 3150 3151: Foundations of Nursing Research.

Learning Objectives

Students will:
  • Perform a literature search on a research topic
  • Describe components of a literature review
  • Demonstrate an understanding of ethical issues in conducting clinical research

Learning Resources

Required Readings

Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier.

  • Chapter 7, “Review of Relevant Literature” (pp. 120-136)
  • Chapter 9, “Ethics in Research” (pp. 157-188)

Purdue Online Writing Lab. (2015). Retrieved from https://owl.english.purdue.edu/owl/resource/560/07/

Walden University Library. (2015b). Keyword searching: Finding articles on your topic: Searching basics. Retrieved from http://academicguides.waldenu.edu/library/keyword

Walden University Library. (2015a). How do I find databases by subject? Retrieved from http://academicanswers.waldenu.edu/faq/73256

Walden University Library. (2015c). Searching and finding information in the library databases: Overview. Retrieved from http://academicguides.waldenu.edu/searchingfinding

Writing Resources and Program Success Tools

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (7th ed.). Retrieved from https://academicguides.waldenu.edu/writingcenter/templates/general

Document: Academic Writing Expectations (AWE) Checklist (Word Document)

 

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

Required Media

Walden University Library. (2019, June). Introduction to nursing research in the Walden Library [Webinar]. Retrieved from https://academicguides.waldenu.edu/nurs3150/week2discussion

Discussion: Conducting a Literature Review

For this Discussion, view the webinar in this week’s resources by a Walden University librarian on strategies to conduct a successful literature search. The webinar provides information on available databases, the use of search engines, and the selection of search terms. Then, you will conduct a literature search on research conducted in the last 5 years on the patient safety problem you identified in Week 1. NURS 3150 3151: Foundations of Nursing Research

By Day 3

Post the following:

For the literature search, describe the following in your post:

  • The databases, search engines, and search terms you used in your literature search
  • The number of research articles you found on your patient safety problem that were published in the last year
  • The challenges you encountered locating research articles and how you overcame them
  • Who you would go to for help in your work setting if you needed help with a literature search

Note: Post a three paragraph (at least 350 words) response. Be sure to use evidence, in-text citations, and essay-level writing skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post.

By Day 7

Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information.

Post a Discussion entry on 3 different days of the week. See the Discussion Rubrics for more information.

Submission and Grading Information

Grading Criteria

To access your Rubric:

Week 2 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:

Week 2 Discussion

Quiz: Ethical Implications of Research

By Day 7

Complete the quiz which covers content in the assigned readings for this week. The quiz questions are multiple choice.

Note on Quiz Content: This quiz will cover (a) ethics in research, (b) human rights in research, and (c) clinical research. The content is covered in this week’s Learning Resources.

Submission and Grading Information

Submit Your Quiz by Day 7

To submit your Quiz:

Week 2 Quiz

Week in Review

Now you… have conducted a literature review that includes a number of research articles, shared the challenges encountered in locating them and ways to overcome them. Next week you will… be introduced to quantitative research designs and the strengths and weaknesses of those methods.

Week 3: Quantitative Research Designs and Methods

Andre is a nursing student who has just completed the first 2 weeks in a nursing research course. He has defined a clinical research question for his health care setting and has also determined that the research problem exists in the literature. However, his approach to defining a solution for his research question requires that he receive approval from his health care setting before testing it. However, Andre is not quite sure what he needs to do next. Eager to start, Andre jumps ahead in the course syllabus and sees that in the following weeks he will read about quantitative research design and methods. Slightly confused, he is not quite sure what is meant by quantitative research design and methods and begins drafting an email message to his instructor to see if he might be able to use this information for testing
his research question in practice. NURS 3150 3151: Foundations of Nursing Research

What is quantitative research design? What different methods might exist for engaging in quantitative research for nursing practice?

As you have explored in this course, your next step in the research process is to determine what type of research design and methods you will use to engage in research for your research question. While it is possible that many research designs and methods might be appropriate for your particular research question, gaining a firm understanding of different research designs and methods is another useful skill for engaging in nursing research and practice.

This week, you explore the different categories of quantitative research designs used in a clinical research studies. These include experimental, quasi-experimental, descriptive and correlational designs. You will examine the basic characteristics of each design (e.g., causality, control, bias, validity, randomization, probability). You will also examine the basic features of the methods used to conduct most quantitative research designs, such as sample selection, data collection and measurement of variables, as well as data management and analyses.

Learning Objectives

Students will:
  • Demonstrate an understanding of the basic characteristics of quantitative research designs
  • Analyze the strengths and weaknesses of methods used in quantitative research designs

Learning Resources

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

Required Readings

Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier.

  • Chapter 3, “Introduction to Quantitative Research” (pp. 37-58)
  • Chapter 10, “Quantitative Methodology: Noninterventional Designs and Methods” (pp. 192-215)
  • Chapter 11, “Quantitative Methodology: Interventional Designs and Methods” (pp. 217-248)
  • Chapter 15, “Sampling” (pp. 329-360)

Labrague, L. & McEnroe-Petitte, D. (2016). Influence of music on preoperative anxiety and physiological parameters in women undergoing gynecologic surgery. Clinical Nursing Research, 25(2), 157-173.

Sand-Jecklin, K., & Sherman, J. (2014). A quantitative assessment of patient and nursing outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 23(19/20), 2854–2863.

Steelman, V. M., Graling, P. R., & Perkhounkova, Y. (2013). Priority patient safety issues identified by perioperative nurses. AORN Journal, 97(4), 402–418.

Document: Journal Club Template for Quantitative Research (Word Document)

Writing Resources and Program Success Tools

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (7th ed.). Retrieved from https://academicguides.waldenu.edu/writingcenter/templates/general

Document: Academic Writing Expectations (AWE) Checklist (Word Document)

 

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

Required Media

Laureate Education (Producer). (2015c). Quantitative research designs [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 27 minutes.

Optional Resources

Fitzpatrick, J. J. (Ed.). (2017). Encyclopedia of nursing research (4th ed.). New York, NY: Springer.

Grove, S. K., & Gray, J. R. (2018). Understanding nursing research: Building an evidence-based practice (7th ed.) (pp. 214–263). St. Louis, MO: Elsevier.

Discussion: Reliability and Validity of Research Methodology

Selection of the appropriate sample is critical to the reliability and validity of research methodology. The sample must be representative of the population that is being studied. Researchers often report both the inclusion and exclusion criteria for the sample. There are many different methods for selecting a sample and random sampling provides the high control of outside variables but is often difficult to utilize in many studies.

For this Discussion, please review the following:

  • For this assignment, read the article by Labrague, L. & McEnroe-Petitte, D. (2016). Influence of music on preoperative anxiety and physiological parameters in women undergoing gynecologic surgery. Clinical Nursing Research, 25(2), 157-173, listed in the resource section for this week.

By Day 3

Prepare at least a 350-word post discussing the strengths and weaknesses of the sampling method used in this study and if the sampling method promoted reliable and valid results. Include in the discussion if there is anything the researcher could have done to improve the sampling process.

Note: Post a three paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post.

By Day 7

Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information.

Post a Discussion entry on 3 different days of the week. See the Discussion Rubrics for more information.

Submission and Grading Information

Grading Criteria

To access your Rubric:

Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:

Week 3 Discussion

Quiz: Basic Characteristics of Quantitative Research Designs

By Day 7

Complete the quiz which covers the content in the Quantitative Research Design PowerPoint webinar and assigned readings for this week. The quiz includes questions that are multiple choice, true/false, and matching. Be sure to familiarize yourself with the following five characteristics of quantitative research designs: (a) causality, (b) control, (c) randomization, (d) reliability, and (e) validity.

Note on Quiz Content: This quiz will cover: (a) four basic quantitative designs along with their overall strengths and weaknesses, (b) characteristics of quantitative research designs, (c) problems with the commonly pretest-posttest study [one type of quasi-experimental design], and (d) value of randomized clinical trials in health care.

Submission and Grading Information

Submit Your Quiz by Day 7

To submit your Quiz:

Week 3 Quiz

Assignment: Application: Methods Used in Quantitative Research

As you have explored this week, there are various methods a researcher may use to engage in quantitative research design. While the methods presented this week are not exhaustive, they do introduce numerous features that you will likely encounter when reviewing, accessing, and researching the nursing practice literature. Whether you are creating new research or searching the literature to add support for a research question you are interested in, understanding the quantitative research designs that may be used for nursing practice will likely inform how you will conduct research for your health care setting. As you continue to build upon your research skills as a nursing researcher and professional, understanding how to engage in quantitative research design is a valuable asset.

For this Assignment, view this week’s Quantitative Research Designs PowerPoint webinar and pay close attention to its content on the basic elements of research methods (e.g., sample, data collection, measurement, analysis). Then, be sure to review the research study by Sand-Jekline and Sherman (2014), included in this week’s resources.

Note: While not a required resource, you might find the definitions in the Encyclopedia of Nursing Research helpful for this assignment.

This assignment involves identifying and describing the strengths and weaknesses of the research method used in the Sand-Jecklin and Sherman (2014) research article in this week’s resources.

  • Focus on the research design, sample data collection methods, tools used for data collection, and the plan for data analysis as discussed in the Sand-Jecklin and Sherman (2014) article.
  • Identify at least two strengths and two weaknesses of the study based on reliability and validity by including additional support with citations from resources not assigned this week.
  • Use the copy of the Journal Club Template for Quantitative Research located in this week’s resources. The template includes an area for each element discussed in the study.
  • Be brief, paraphrase and summarize each of the elements clearly on the form.
  • Provide the full citation of the article used for this Assignment on the template.

By Day 7

Once this is complete, save your file and submit the Journal Club Template for Quantitative Research to the submission link.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your Rubric:

Week 3 Assignment Rubric

Check your Assignment draft for authenticity

To check your assignment draft for authenticity

Submit your Week 3 Assignment Draft, and review the “SafeAssign Originality Report”

Submit Your Assignment by Day 7

To submit your Assignment:

Week 3 Assignment

Week in Review

Now you have examined the basic characteristics of quantitative research designs used in nursing for clinical research questions including causality, control, randomization, reliability and validity. Next week you will….analyze the elements, strengths, and weaknesses of methods used in qualitative research designs and examine the differences between quantitative/qualitative research designs.

To go to the next week:

Week 4

Week 4: Qualitative Research Designs and Methods

[Qualitative research] is more than simply conducting research on a single individual or situation. This approach has the potential to deal with simple through complex situations. It enables the researcher to answer “how” and “why” type questions, while taking into consideration how a phenomenon is influenced by
the context within which it is situated.
– Pamela Baxter and Susan Jack,
“Qualitative Case Study Methodology”

How does qualitative research differ from quantitative research? How might a research question best be answered by using a qualitative research design approach?

Last week, you explored different quantitative research designs used in nursing research for clinical research questions. While quantitative research designs are appropriate and useful for a wide range of research questions, you might find that adopting a qualitative approach may yield different insights that might best support solutions for a given research question. Understanding the differences between quantitative/qualitative research designs, and their methods, will contribute to effective nursing practice and your role as a nursing professional.

This week, you examine qualitative research designs and methods. You will first explore the different types of qualitative research approaches used in clinical research studies, including obtrusive (e.g., participatory action, ethnography), unobtrusive (e.g., non-participatory observation, audiovisual), and observational (e.g., focus groups, in-depth interviews). Then, you examine the basic characteristics of each approach (e.g., inductive reasoning, narrative descriptions, process orientation), as well as the characteristics of different approaches used to conduct qualitative research designs, such as sample selection, data collection, data management, and interpretative techniques.

Learning Objectives

Students will:
  • Analyze the strengths and weaknesses of methods used in qualitative research designs
  • Analyze elements of qualitative research designs

Learning Resources

Required Readings

Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier.

  • Chapter 4, “Introduction to Qualitative Research” (pp. 62-73)
  • Chapter 12, “Qualitative Research Methods” (pp. 251-281)

Bamm, E. L., Rosenbaum, P., Wilkins, S., Stratford, P., & Mahlberg, N. (2015). Exploring client-centered care experiences in in-patient rehabilitation settings. Global Qualitative Nursing Research, 2, 1–11.

Sarvestani, R. S., Moattari, M., Nasrabadi, A. N., Momennasab, M., & Yektatalab, S. (2015). Challenges of nursing handover: A qualitative study. Clinical Nursing Research, 24(3), 234–252.

Stiffler, D., Cullen, D. & Luna, G. (2014). Diabetes barriers and self-care management: The patient perspective. Clinical Nursing Research, 23(6), 601-626.

Walsh, A., Meagher-Stewart, D. & Macdonald, M. (2015). Persistent optimizing: How mothers make food choices for their preschool children. Qualitative Health Research, 25(4), 527-539.

Document: Journal Club Template for Qualitative Research (Word Document)

Writing Resources and Program Success Tools

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (7th ed.). Retrieved from https://academicguides.waldenu.edu/writingcenter/templates/general

Document: Academic Writing Expectations (AWE) Checklist (Word Document)

 

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

Required Media

Laureate Education (Producer). (2015b). Qualitative research design [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 11 minutes.

Discussion: Basic Characteristics of Qualitative Research

As a nursing professional, you will likely engage in research for your health care setting. Depending on the research question you seek to address, you might choose to use a qualitative research design. Understanding when and why it is appropriate to choose a qualitative research design will be important as you develop research skills for nursing practice. As you continue throughout this course, think about what considerations you should keep in mind when choosing to engage in qualitative research. In what ways might qualitative research be more preferred than quantitative research for informing nursing practice?

For this Discussion, be sure to review the qualitative article by Sarvestani et al. (2015). Then, view this week’s Qualitative Research Design PowerPoint webinar that describes each step of the qualitative research process and different approaches used to conduct qualitative research.

By Day 3

You will need to prepare and post a 350-word response that addresses the following:

  • Qualitative research often is viewed as not having the same rigor and adherence to objective standards as quantitative studies. Using the references provided to assist you, prepare an argument to either support or refute this claim and post it to the Discussion. In your response, explain if qualitative research does or does not have the controls needed to generate the results that contribute to the nursing knowledge base.
  • Then, explain if qualitative research could be used to investigate the patient safety problem you identified in Week 1.

Note:Post a three paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post. NURS 3150 3151: Foundations of Nursing Research

Evidence

In-text Citations

Essay-Level

Transitional Material

Organizational Frames

By Day 7

Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information.

Post a Discussion entry on 3 different days of the week. See the Discussion Rubrics for more information.

Submission and Grading Information

Grading Criteria

To access your Rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:

Week 4 Discussion

Assignment: Application: Methods Used in Qualitative Research

In order to achieve credible and trustworthy results from qualitative studies, the methodology must be designed very carefully. That is, you must consider the process of conducting qualitative research to address your research question. Important considerations include selecting the research question, collecting data, engaging in data analysis and management, and selecting appropriate
interpretive techniques.

For this Assignment, be sure to view this week’s Qualitative Research Design PowerPoint webinar and pay close attention to its content on the basic elements of qualitative research methods (e.g., sample selection, data collection, plans for interpretive analysis). Then, review the two research studies presented in this week’s resources for this assignment.

Note: While not a required resource, you might find the definitions in the Encyclopedia of Nursing Research helpful for this assignment.

This assignment involves identifying and describing different elements of the research method used in the Walsh et al. (2015) article.

  • Focus on the research design, sample selection, data collection methods, and plan for data analysis as discussed in the Walsh et al. (2015) article.
  • Identify at least two strengths and two weaknesses of the article’s research method based on trustworthiness. You must provide support for your explanation with citations from additional sources.
  • Use the Journal Club Template for Qualitative Research located in this week’s resources.
  • The template includes an area for each element discussed in the study.
  • Be brief, paraphrase and summarize each of the elements clearly on the form

By Day 7

Once this is complete, save your file and submit the Journal Club Template for Qualitative Research to the submission link.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your Rubric:

Week 4 Assignment Rubric

Check your Assignment draft for authenticity

To check your assignment draft for authenticity

Submit your Week 4 Assignment 1 Draft, and review the “SafeAssign Originality Report”

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 1

Week in Review

Now you…..have analyzed the basic characteristics of qualitative research and discovered the differences between qualitative and quantitative studies. You have also examined if qualitative research has the controls needed to generate results that contribute to the nursing knowledge base. Next week you will….examine the analysis of data with a focus on common statistical techniques that include descriptive and comparative analyses.

Week 5: Analysis of Quantitative and Qualitative Data

Jaime has just completed gathering quantitative and qualitative data on causes of hospital acquired infections (HAIs) on a medical/surgical unit in his hospital. After collecting data on different patients, physicians, procedures, and infections, Jaime is ready to begin analyzing the data. However, how should Jaime proceed? What data is most telling for indicating to the hospital that the medical/surgical unit is experiencing an unexpected increase in the rate of HAIs? How will Jaime determine what type of analyses will be most important for articulating his research question and proposed nursing practice solutions? NURS 3150 3151: Foundations of Nursing Research

Once you have collected and gathered data, the next step in the research process is to engage in the analysis of the data. Whether you perform statistical tests to determine if your data is significant or pool responses to interview questions to indicate emerging themes and patterns, understanding the types of analysis available for the research process is important in order to draw necessary conclusions to inform nursing practice. As a nursing professional, if you engage in research for your health care setting, you will likely engage in the analysis of your data to help inform, implement, and evaluate nursing practice solutions.

This week, you examine the analysis of data, including a focus on common statistical techniques: (a) descriptive analyses (e.g., frequency distributions and mean scores with standard deviations) and (b) comparative analyses (e.g., t-test, chi square). You will also consider the importance of using existing quantitative health care data to address clinical questions in nursing practice, including electronic medical records and local, regional, and national quality and safety databases. For qualitative research, you will explore an overview on the common techniques used to understand themes and patterns in narrative data.

Learning Objectives

Students will:
  • Identify available local, regional, and national quantitative databases on health care issues
  • Analyze nursing quality indicators in relation to patient safety
  • Conduct descriptive analyses of quantitative and qualitative data

Learning Resources

Required Readings

Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier.

  • Chapter 21, “Introduction to Statistical Analysis” (pp. 519-533)
  • Chapter 22, “Using Statistics to Describe Variables” (pp. 535-544)
  • Chapter 12, “Qualitative Research Methodology”
    • “Qualitative Data Analysis” (pp. 268-270)

Medicare.gov. (n.d.-a). Hospital compare. Retrieved December 16, 2015, from https://www.medicare.gov/hospitalcompare/About/What-Is-HOS.html

Medicare.gov. (n.d.-b). Home health compare. Retrieved December 16, 2015, from https://www.medicare.gov/homehealthcompare/

Medicare.gov. (n.d.-c). Nursing home compare. Retrieved from https://www.medicare.gov/nursinghomecompare/search.html

Quantitative Resources

Document: Instructions: Quantitative Analysis Assignment (PDF)

Document: Codebook: Quantitative Patient Safety Data (PDF)

Document: Summary Data Analysis Form (Word document)

Document: Quantitative Data Excel Assignment (Excel spreadsheet)

Qualitative Resources

Document: Instructions: Content Coding of Student Pet Peeves (Word document)

Document: Perceived Pet Peeves Data (PDF)

Document: Code Sheet: Student Pet Peeve Data (Word Document)

Writing Resources and Program Success Tools

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (7th ed.). Retrieved from https://academicguides.waldenu.edu/writingcenter/templates/general

Document: Academic Writing Expectations (AWE) Checklist (Word Document)

 

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

Discussion: Access to Existing Databases on Patient Safety, Quality of Care, and Clinical Practice

Quantitative health care databases are developed and published to give health care providers and consumers information about patient quality and safety outcomes. These reports are often distributed to staff in patient care units and shared with health agencies. Understanding the variables and findings described in
these databases is important.

By Day 3

Post a description of one existing source of data you found with variables related to a patient quality and safety problem in your practice. Locate the data posted for your agency/facility. If you are unable to find this information for your agency, locate a national database that can be accessed by health professionals, e.g., Medicare Hospital Compare. (Data are also available for home health and nursing homes.) Include the citation and the link to use for web access. Identify three variables found in the database that are important in better understanding a patient safety problem. Explain how you would interpret the results and how they might help improve nursing practice and patient outcomes. Explain how data is used in your own agency, including nursing involvement in the process.

Medicare Hospital Compare

Note:Post a three paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post.

Evidence

In-text Citations

Essay-Level

Transitional Material

Organizational Frames

By Day 7

Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information.

Post a Discussion entry on 3 different days of the week. See the Discussion Rubrics for more information.

Submission and Grading Information

Grading Criteria

To access your Rubric:

Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:

Week 5 Discussion

Assignment: Application: Analysis of Quantitative and Qualitative Data

In order to provide meaningful results, research processes must be carefully selected and appropriate for the data being analyzed. Statistical programs such as SPSS are frequently utilized by researchers to conduct the analysis of large data sets. These data are organized to provide meaningful interpretation and often include descriptive statistics. Qualitative analysis is completed using content analysis, looking for patterns and themes that emerge from the data. Individual experiences described in interviews and focus groups are considered data and are often provided as examples to support the results in the study publication. Whether you will engage in either quantitative or qualitative research, it is likely that you will encounter both types of studies in the literature. As a nursing professional, being able to analyze and interpret both types of research designs will be important to affect nursing practice that promotes positive health outcomes in
quality of care and patient safety. NURS 3150 3151: Foundations of Nursing Research

For Part 1 of this Assignment, you will conduct descriptive statistical analyses using quantitative data. For Part 2 of this Assignment, you will conduct content coding to analyze qualitative data. Please review the Instructions: Quantitative Analysis Assignment and Instructions: Content Coding of Student Pet Peeves in this week’s resources to review how to complete both parts of this Assignment.

Part 1: Quantitative Analyses

  • Follow the step-by-step instructions provided in the Instructions: Quantitative Analysis Assignment document in this week’s resources on using the Excel program to conduct descriptive analyses of quantitative data.
  • The Quantitative Data Excel Assignment spreadsheet that you will need is in the resources for this week.
  • For this Assignment, you will need to describe the findings from your analyses and summarize what they tell you about these patients and the extent of the adverse events they experienced during their hospitalization by completing the Summary Data Analysis Form in this week’s resources.

Part 2: Qualitative Analyses

  • Follow the step-by-step instructions provided in the Instructions: Content Coding of Student Pet Peeves document in this week’s resources. The document provides detailed instructions on the step-by-step process of conducting the content analysis for this part of the Assignment.
  • Access the Perceived Pet Peeves Data document located in this week’s resources that includes the narrative descriptions of 10 students about their “pet peeves’ in courses they have taken. (In other words, what are the things that detracted from their learning experiences in these courses)?
    • The analytic method you will use to analyze the narrative data for this Assignment is called content analysis. It requires you to read each student’s narrative and then code its content using thematic categories on a coding sheet.
  • Access the Code Sheet: Student Pet Peeve Data document located in this week’s resources to carry out the coding as defined in the instructions.

By Day 7

Submit both your Part I: Quantitative Analysis and Part II: Qualitative Analysis components.

Submission and Grading Information

To submit your completed Assignment 1 for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK5Assgn1+last name+first initial.(extension)” as the name.
  • Click the Week 5 Assignment Part 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 5 Assignment Part 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn1+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your Rubric:

Week 5 Assignment 1 Rubric

Check your Assignment draft for authenticity

To check your assignment draft for authenticity

Submit your Week 5 Assignment 1 Draft, and review the “SafeAssign Originality Report”

Submit Your Assignment by Day 7

To submit your Assignment:

Week 5 Assignment 1

To submit your completed Assignment 2 for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK5Assgn2+last name+first initial.(extension)” as the name.
  • Click the Week 5 Assignment Part 2 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 5 Assignment Part 2 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn2+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your Rubric:

Week 5 Assignment 2 Rubric

Check your Assignment draft for authenticity

To check your assignment draft for authenticity

Submit your Week 5 Assignment 2 Draft, and review the “SafeAssign Originality Report”

Submit Your Assignment by Day 7

To submit your Assignment:

Week 5 Assignment 2

Week in Review

Now you…..have examined the analysis of data and the importance of using existing quantitative health care data to address clinical questions in nursing practice, and qualitative research techniques to understand themes and patterns in narrative data. Next week you will….tie it all together by examining two content areas; drawing conclusions about research findings and their implications for clinical practice and the value of research in evidence-based practice and translational science.

Week 6: Tying it All Together

Once a nursing researcher or nursing professional has conducted analyses on their collected data, what can they conclude about their research and research question?

The last and final phase of the research process involves drawing conclusions about research findings as well as tying them into meaningful solutions for clinical nursing practice. How might a nursing researcher or nursing professional relate their research findings to solutions for improved quality of care and patient safety? How might drawing certain conclusions from research findings impact your health care setting?

This week, you will examine two content areas.

Part I: Drawing Conclusions About Research Findings and Their Implications for Clinical Practice

Part I focuses on the last phase of the research process, namely drawing conclusions about the findings and discussing their implications for clinical practice. You will examine how the findings contribute to clinical practice and how the findings might add to new knowledge and the existing literature on a topic. You will consider how the characteristics of well-written conclusions and implications, including consideration of the study’s limitations, recommendations for future research, and variation in the quality of presenting these areas in published research may impact nursing practice. NURS 3150 3151: Foundations of Nursing Research

Part II: The Value of Research in Evidence-Based Practice and Translational Science

Part II focuses on what has been explored about the value of quantitative and qualitative research in evidence-based practice and translational science in nursing.

Learning Objectives

Students will:
  • Evaluate how evidence-based practice will improve patient quality and safety
  • Evaluate the importance of the interpretation, conclusion, and clinical implications of clinical research articles in evidence-based practice
  • Evaluate effectiveness of interventions on decreasing medication errors in health care settings

Learning Resources

Required Readings

Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier.

  • Chapter 26, “Interpreting Research Outcomes” (pp. 578–591)

Becker, P. T. (2009). Thoughts on the end of the article: The implications for nursing practice. Research in Nursing & Health, 32(3), 241–242.

Thoughts on the end of the article: The implications for nursing practice by Becker, P. T., in Research in Nursing & Health, 32(3), 241–242. Copyright by John Willey & Sons – Journals. Reprinted by permission of John Willey & Sons – Journals via the Copyright Clearance Center.

Titler, M. G. (2008). Chapter 7. The evidence for evidence-based practice implementation. In R.G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (Vol. 1, 113–116). Rockville, MD: Agency for Healthcare Research and Quality.

Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. (2008, April). Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Volume 1. Retrieved from http://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/nurseshdbk.pdf

Document: Writing Conclusions to Nursing Studies (PDF)

Document: Research Methods and Findings of the 2014 Verweij Study (PDF)

Writing Resources and Program Success Tools

Document: Week 6 Paper Template (Word Document)

Document: Academic Writing Expectations (AWE) Checklist (Word Document)

 

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

Discussion: Use of Research in Clinical Practice

Throughout this course, you have examined and considered how the research process contributes to the field of clinical nursing practice. More than just an exercise in developing a research question, searching the literature to guide future research, and performing actual data collection/data analysis, the conclusions you draw from your research findings are useful in helping to develop and enact effective clinical practice. In essence, the process of conducting research contributes to positive social change in that the solutions that you might propose as a nurse researcher and professional will likely impact quality of care and patient safety.

For this Discussion, read the book chapter by Titler (2008) presented in this week’s resources that describes evidence-based practice and translational science, as well as the kind of research needed for both. Then, reflect on how the knowledge you gained about research will support your effort as a nursing professional to improve patient quality and safety.

By Day 3

Describe how you will use evidence-based practice to improve patient quality and safety in your health care setting. Be specific and provide examples. Then, explain how the knowledge gained about research in this course will support your role in practice as a nursing professional. Then, describe how you will use evidence-based practice to improve patient quality and safety. Be sure to include in your Discussion any unanswered questions that need to be considered by your classmates and/or Instructor.

Note: Post a three paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post.

Evidence

In-text Citations

Essay-Level

Transitional Material

Organizational Frames

By Day 7

Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information.

Post a Discussion entry on 3 different days of the week. See the Discussion Rubrics for more information.

Submission and Grading Information

Grading Criteria

To access your Rubric:

Week 6 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:

Week 6 Discussion

Assignment: Application: Drawing Conclusions About Research Findings and Their Implications for Clinical Practice

As a current or future nursing researcher and professional, your ability to draw reasonable conclusions from research findings will determine the effectiveness of proposed solutions for clinical nursing practice. As you continue to develop your skill set to become a nursing leader, your exposure to a multitude of research designs, research findings, and evidence-based practice will likely inform how you will absorb this knowledge into meaningful clinical practice. Throughout this course and program, your exposure to different research questions, research study designs, and approaches to addressing serious issues in both nursing and health care confirms the ever-changing landscape in which you have elected to practice. While this is in its own right challenging, it also offers several opportunities to create new knowledge, improve upon current nursing practice, and exercise research skills
for positive patient outcomes.

For this Assignment, review the Research Methods and Findings of the Verweij study conducted in 2014 in this week’s resources. The primary purpose of this quantitative research study was to investigate the effectiveness of an intervention to decrease medication errors in a hospital. The citation and discussion/conclusion information is intentionally deleted so you can draw your own conclusions. NURS 3150 3151: Foundations of Nursing Research

In a 2- to 3-page, double-spaced paper, describe three conclusions you have drawn from the findings in this study, taking into consideration the limitations of the study. Next describe three implications for clinical practice. Once you have submitted the assignment, you will be given the full article for review.

Refer to the Academic Writing Expectations (AWE) Checklist document and use the Walden template from this week’s resources. No abstract or reference list is required for AWE 2000/3000.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 6 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission
Grading Criteria

To access your Rubric:

Week 6 Assignment Rubric

Check your Assignment draft for authenticity

To check your assignment draft for authenticity

Submit your Week 6 Assignment Draft, and review the “SafeAssign Originality Report”

Submit Your Assignment by Day 7

To submit your Assignment:

Week 6 Assignment

Week in Review

Now you…..have evaluated how evidence-based practice is used to improve patient quality and safety in your health care setting, and identified ways research will support your role in practice as a nursing professional. You also used conclusions about research findings to identify the effectiveness of interventions intended to decrease medication errors in health care settings. Next you will…. apply the concepts learned in this course to next courses and in the future. Best wishes in your endeavors. Congratulations! You have completed this course.

Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7. NURS 3150 3151: Foundations of Nursing Research

Emerging and Re-emerging Infectious Diseases Essay Discussion

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Emerging and Re-emerging Infectious Diseases Essay Discussion

Emerging and Re-emerging Infectious Diseases Essay Discussion
Discussion – Week 1
        Influenza, also known as the flu, is a contagious respiratory virus affecting the nose, throat, and lungs. For most people, the flu will resolve independently, but sometimes the complications can be deadly. The flu is considered most dangerous for children, adults over the age of 65, residents of long-term care facilities, pregnant women, American Indians, Alaskan natives, or people with pre-existing health conditions (Centers for Disease Control and Prevention [CDC], 2020a). Symptoms often include a runny nose, fever/chills, muscle aches, headaches, cough, sore throat, malaise, and sometimes vomiting/diarrhea (CDC, 2020a). This virus travels in air droplets when an infected person sneezes, talks, or coughs. Therefore, the most critical prevention method is covering your mouth when you sneeze or cough, as well as proper handwashing techniques.

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The flu virus can cause serious complications, including pneumonia, bronchitis, asthma exacerbations, ear infections, acute respiratory distress syndrome (ARDS), and heart problems (CDC, 2020a). Pneumonia is one of the most common complications and can potentially be fatal if not treated appropriately. Influenza viruses are continually changing with new strains appearing yearly (CDC, 2020a). Therefore, antibodies you have encountered from having the flu prior may not protect individuals from the newer influenza strains. The best prevention for influenza is by getting a yearly flu vaccine. Although they are not one hundred percent effective, it is still considered your best defense. Usually, only fluids and rest are required to treat the flu, but your doctor may prescribe an antiviral drug if symptoms are severe enough. There are four antivirals on the market used to lessen your symptoms by a day or so and decrease the risk of complications. These drugs include Tamiflu (oseltamivir), zanamivir (Relenza), peramivir (Rapivab), and baloxavir (Xofluza)(CDC, 2020a). Emerging and Re-emerging Infectious Diseases Essay DiscussionHealthcare workers have an ethical obligation to protect their patients from illnesses, including influenza. As nurses, we are in close contact with our patients, which increases the risk of the spread of infections. Since influenza is highly contagious, healthcare workers should always educate patients and their families on proper prevention techniques. Emerging and Re-emerging Infectious Diseases Essay Discussion

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The best method for managing influenza is preventing it from occurring by encouraging patients and healthcare works to get the yearly flu vaccine. Nurses are responsible for screening patients for the flu vaccine and administering it to those who do not have contraindications and documenting on those who refuse the vaccine. The CDC (200b) estimated there where 39,000,000-56,000,000 flu cases in the 2019 flu season, with an estimated 24,000-62,000 deaths. Therefore, getting vaccinated could potentially prevent the virus’s spread and reduce the number of deaths from flu-related complications.

Influenza affects my personal nursing practice of hospice and palliative care to a great extent. Many hospice patients believe the flu vaccine is pointless since they are already critically ill, and worry that the vaccine will potentially cause them to get the flu since their immune systems are already weakened. In reality, hospice patients need the vaccine more than any other population due to their chronic medical conditions and weak immune systems. During the influenza season, our agency has to increase the practices of minimizing exposure by monitoring healthcare personnel closer, increasing workers’ educational training, and monitoring flu activity. Emerging and Re-emerging Infectious Diseases Essay Discussion

The influenza virus continues to evolve as new antigenic variants are continually emerging, which leads to yearly pandemics (CDC, 2019). The antigenic drift causes the virus genes to mutate, which changes the surface proteins, also known as antigens (CDC, 2019). These changes cause the infected persons pre-existing antibodies not to recognize the new virus, thus causing infection (CDC, 2019). Since influenza A subtypes exist in birds it is considered a non-eradicable disease with prevention and control as the only option (Sharma et al., 2019). For this reason, influenza is constantly re-emerging

 

References

Centers for Disease Control and Prevention. (2019). How the flu virus can change: “Drift” and “Shift”. https://www.cdc.gov/flu/about/viruses/change.htm

Centers for Disease Control and Prevention. (2020a). Influenza (Flu). https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719

Centers for Disease Control and Prevention. (2020b). 2019-2020 U.S. flu season: Preliminary burden estimates. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

Morrow, A., (2020). Flu vaccines and hospice patients. Very Well Health. https://www.verywellhealth.com/flu-vaccines-and-hospice-patients-1132295

National Institutes of Health. (2007). Understanding emerging and re-emerging infectious diseases. https://www.ncbi.nlm.nih.gov/books/NBK20370/

Sharma, L., Rebaza, A., & Dela Cruz, C.S. (2019). When “B” becomes “A”: The emerging threat of influenza virus. European Respiratory Journal, (54)2. https://10.1183/13993003.01325-2019

 

Discussion: Emerging and Re-emerging Infectious Diseases

As presented in this week’s readings, many individuals acquire infections in the community as well as during treatment in the hospital. As a nurse, it is important to know what is going on in the world. In addition to reading scholarly literature, reading the paper and watching the news helps to keep a nurse aware of what is going on currently. In addition, many organizations like the Centers for Disease Control and Prevention (CDC) track current health trends and post updates on their websites, along with Fact Sheets to help educate, prevent, and treat new and re-emerging diseases. These Fact Sheets are made to be short and easy to read so that health care professionals and patients are more likely to read and understand the information. Emerging and Re-emerging Infectious Diseases Essay Discussion

For this Discussion, you will examine an emerging or re-emerging disease and the nurse’s role in prevention and management of the disease. Locate an article in a newspaper, in a lay magazine, or on an organizational website that discusses an emerging or re-emerging infectious disease that is currently affecting your community. Reflect on the article you selected and think about how the emerging or re-emerging disease might affect nursing practice.

By Day 3

Respond to the following:

Briefly summarize the article you selected and provide the reference. Then, address the following:

  • What implications does the disease have for nursing practice?
  • How does the emergence of this disease affect your personal practice?
  • Why do you think that this disease is emerging/re-emerging?
  • What is the nurse’s role in preventing and managing the impact of infectious diseases both from the patient and nurse perspective?

Support your response with references from the professional nursing literature.

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

By Day 7

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

Respond with a comment that asks for clarification, provides support for, or contributes additional information to two or more of your colleagues’ postings.

Post a Discussion entry on three different days of the week. Refer to the Discussion Rubric found in the Course Information and Grading Criteria area. Emerging and Re-emerging Infectious Diseases Essay Discussion

Discussion – Week 1

COLLAPSE

For this week’s discussion, and like many others I’m sure, I chose to focus on the obvious and new emerging illness that is COVID-19. The American Nurses Association recently published an article titled “Nurses, Ethics, and the Response to the COVID-19 Pandemic” that I am basing my discussion on. This is obviously a challenging time for our country and our citizens but is putting nurses and health care workers in difficult situations personally and professionally. “Professional nurses historically bring compassionate competent care to disaster response but are challenged to provide care when the nature of their work puts them at increased risk.” (ANA, 2020). In times of devastation, the world can see how crucial the nursing profession is to society.

During pandemic situations, such as the COVID-19 pandemic, nurses must consider how they will deliver quality care to patients, in addition to keeping themselves and their loved ones at the lowest risk possible. This is not something that is easily done. As frontline health care professionals, nurses are the true heroes in health care as we are willing to do whatever we need to, to aid in the care of patients.  “They are an important part of health systems, as they handle this crisis and develop strategic planning processes for the future. These processes set objectives, allocate resources, and establish policies that are the framework of the organization and will determine the degree of financial success and quality of care” (Mose et al., 2019).

The emergence of COVID-19 affects my personal practice in the aspect that I want to care for others when they are sick, but also want to protect my loved ones at home. I expose myself, like all nurses, daily and it is stressful going home knowing that my chosen line of work could negatively affect my family. I have a daughter who is 2 years old, has asthma, and as a mother, it terrifies me that she could contract COVID-19 on the premise that I gave it to her. That’s a hard pill to swallow as a mother. In addition, I’m unable to care and sit with patients as I’m accustomed to. Currently, I work in the clinic setting, and while I am very thankful that I’m not as exposed as I would be in an acute setting, I hate that my patients can’t see me smile at them, or vice versa. I hate that I am unable to sit and catch up with my patient’s that I haven’t seen in a while because I want to limit my exposure and time in patient rooms, in addition to lessening the exposure I could take to the next patient room that could be someone who is receiving cancer treatment. Overall, the pandemic has drastically affected the amount of quality of care I am able to provide.

While COVID-19 was first initially seen in China, we are seeing an emergence of this disease as it appears to be a mutation of other diseases we have seen recently and know exist. According to the Center for Disease Control “Coronaviruses, named for the crown-like spikes on their surfaces, are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. There are many types of human coronaviruses, including some that commonly cause mild upper-respiratory tract illnesses. COVID-19 is a new disease, caused by a novel (or new) coronavirus that has not previously been seen in humans.” (CDC, 2020). Emerging and Re-emerging Infectious Diseases Essay Discussion

References

American Hospital Association. (2020, May). Hospital and health systems face unprecedented financial pressures due to COVID-19. https://www.aha.org/guidesreports/2020-05-05-hospitals-and-health-systems-face-unprecedented-financial-pressures-due

American Nurse Association. (2020, April 24). Survey: Nurses fear going to work due to lack of protection from virus more than 32k nurses share experience from the front lines. https://www.nursingworld.org/news/news-releases/2020/survey-nurses-fear-going-to-work-due-to-lack-of-protection-from-virus-more-than-32k-nurses-share-experience-from-the-front-lines/   

Emerging and Re-emerging Infectious Diseases Essay Discussion