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.

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)

Writing Resources and Program Success Tools

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 evidencein-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)

Writing Resources and Program Success Tools

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 evidencein-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)

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

Writing Resources and Program Success Tools

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.

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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.

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?

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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)

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.

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

Discussion: Conducting a Literature Review

Discussion: Conducting a Literature Review
Main Post Week 2
Research is critical to the healthcare industry. The research conducted can lead to many operational and clinical changes that will improve company culture and patient outcomes. In a recent article, Ives-Erickson and Pappas (2020) state that nurses should be encouraged not just to ask questions but also to be driven to find solutions (p 243). Once a research topic is identified, knowing how to navigate resources using the appropriate search engines, databases effectively, and search terms to narrow down the search is essential. It is also necessary to include only those most recent studies from reputable sources as well. Discussion: Conducting a Literature Review.

My chosen health care topic was diabetic foot exams.  I have used the CINAHL PLUS database before and have gotten many good results, so I used this database. I am horrible at choosing search phrases. I entered the following parameters:

  • diabetic foot exam
  • AND nurse compliance

The search yielded one 2019, irrelevant result. I removed nurse compliance, and the search yielded 21 options. I added a date range of 2019- 2020 and received two very relevant studies.

I had time to play around a bit, so I tried a few other options. I entered:

  • Foot exam
  • AND diabetes
  • AND foot ulcer
  • Limited date range to 2016-2020
  • Limited publication type to research

This search yielded five relevant results, one of which was within the last year. Discussion: Conducting a Literature Review.

The biggest challenge I had with this search at first was finding information that was published within the last five years. My lack of creativity when coming up with search phrases is something that I will have to overcome. I can do that through learning to think less concretely. If I need help in my work setting with a literature search, I will reach out to our newly hired Quality Assurance Officer. She loves to research and is an excellent resource for me.

 

References

Ives-Erickson, Jeanette, Pappas, Sharon. (2020). The Value of Nursing Research. Journal of

Nursing Administration, 50, 243-244. https://doi.org/10.1097/NNA.0000000000000876

 

 Discussion – Week 2

Research is of high importance to the nursing world today. Research gives us the key to various outcomes for patient care, and education to deliver a high quality of care as a whole. Nursing research is defined as the systematic, and objective process of analysis phenomena of nursing practice. Nursing research can be simple or complex studies that proliferate conclusions for the better of mankind. Walden University Library Resource Center is a great start to the research process.

In week 1, the research topic I chose was medication error in a clinical setting. The first step in my initiation process of research was to go to the Walden University Library located on the home page. The databases I used as CINAHL, which is considered the best nursing database for nursing ( James and Presley, 2019). I then typed in my keyword as a medication error, which came up with thousands of articles on this topic. I then narrowed my search to medication error in a clinical setting from 2015-2020, which yielded 5,416 results on medication errors. Lastly, I narrowed my research year to only one year of publication which yielded 1,236 results. This did narrow my research on my research topic, but this was not enough. I needed to know medication errors in a clinic specifically. I then typed in clinics instead of the clinical setting to see if the search would narrow, but the resources increased in article research by at least 40 new articles. The challenges of my research topic were it is a broad topic that many researchers have researched to identify the problems of medication errors. How I overcame this obstacle was by narrowing my research topic and only utilizing research that was pertaining to my definite topic as a whole. Discussion: Conducting a Literature Review.

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Research is complex and requires knowledge of searching from various databases. If I need help at Walden University, I have the option to ask the librarian. This is a great tool for newcomers to the research process. This can be utilized by chatting, emailing, and calling the librarian for advice, and answers to your research questions.

References

James, J., & Presley, L. (2019, June). Introduction to nursing research in the Walden Library [Webinar]. Walden Library. https://academicguides.waldenu.edu/nurs3150/week2discussion

iscussion – Week 2

The research question that I proposed last week was, Can using Barcode Medication Administration (BCMA) decrease medication errors in the Emergency Room (ER)?  I thought that there would be a lot of research on this topic because BCMA and medication errors are a patient safety issue. Upon watching the webinar on nursing research that was made by Julie James and Lisa Presley who are both Liaison Librarians to the College of Science I learned some new and helpful information on doing research. One way is to look up research by subject and type in Nursing, or once in the search engine making sure while refining your search you have checked the Boolean tab, this includes; AND, OR, NOT (James & Presley, 2019).

  While in the library I searched by subject, nursing, I used the CINAHL PLUS full text database to search BCMA OR Barcode Medication Administration + Emergency Room OR Emergency Department + Medication errors. I limited my search to the past five years and to my surprise there were only five in the five years and only one in the past year. An even bigger surprise was all the articles were written in other countries, none were written in the United States. The challenges that I encountered were there is not enough research in the past five years and there were no studies done here in the United States.I wondered how can this be? My thought is that we can learn a lot from other countries, and expand our knowledge on the subject by doing our own research. This is a great learning opportunity for us on a topic that has such an impact on patient safety.

I know that if I needed extra help on the research I could always go to the library and ask Julie or Lisa since they are the liaisons librarians. I would also go as far as to seek help from a multidisciplinary team that would include my ER director, pharmacy, risk management, and IT. I think this team would be very vital in gathering data to see if using BCMA can decrease medication errors in our department. Discussion: Conducting a Literature Review.

 

References

James, J., & Presley, L. (2019, June). Introduction to nursing research in the Walden Library [Webinar]. Walden Library. 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.

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 evidencein-text citations, and essay-level writing skills, including the use of transitional material and organizational frames. Use the writing resources to develop your post. Discussion: Conducting a Literature Review

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.

 

Excellent Proficient Basic Needs Improvement
” Describes the number of research articles found on the patient safety problem published in the last year. Describes the data bases, search engines and search terms used in the literature search. Discusses the challenges encountered in locating research articles and how they were overcome. Discusses who might help with literature searches in the work setting if needed. (20 points) “
18 (36%) – 20 (40%)
Initial post contains well developed and insightful analysis that brings new insight into the discussion .
16 (32%) – 17 (34%)
Initial post contains reasonable analysis that brings insight into the discussion.
Discussion: Conducting a Literature Review
14 (28%) – 15 (30%)
Initial post contains minimal analysis that brings limited insight into the discussion.
(0%) – 13 (26%)
Initial post lacks analysis and/or that brings little or no insight into the discussion.
“Entered the discussion thread on 3 separate days. Wrote at least two posts to two separate peers. Responses are appropriate to the topic, substantive, and promoted discussion by one or more of the following: • contributing insight to move the discussion forward. • offering substantial and/or different points of view and asks questions to add to discussion • including extra references or websites for peers to consider • relating discussion to different areas of practice and applying concepts to practice **Additional points may be deducted for late posting per the University late policy.”
14 (28%) – 15 (30%)
Response posts add substantive ideas and perspectives that invite further analysis and discussion. Participated 3 or more days in the classroom and responded to more than 2 classmates.
12 (24%) – 13 (26%)
Response posts are proficient and provide adequate analysis and discussion. Participated 3 days in the classroom and responds to at least two classmates.
11 (22%) – 11 (22%)
Response posts are limited and provide minimal analysis and discussion. Participated less than 3 days in the classroom and/or responds to less than two classmates.
(0%) – 10 (20%)
Response posts are inadequate and provide no analysis of discussion and/ or there is no participation in the classroom.
Uses evidence to support a claim and give credit to the source. Uses course learning resources and seeks additional scholarly resources to support ideas. Displays sentence, paragraph, and essay skills. Writes in a scholarly, well-organized manner using own words by synthesizing evidence/resources. Paraphrases to avoid plagiarism of the source. APA: No more than one short, unique quote with correct APA format. Appropriate use and format of in-text citations. Lists references.
14 (28%) – 15 (30%)
Writer demonstrates excellence in all sentence and paragraph level skills within discussion board posts to meet the 3000 Academic Writing Expectations for this level.
12 (24%) – 13 (26%)
Writer demonstrates proficiency of most sentence and paragraph level skills within discussion board posts to meet the 3000 Academic Writing Expectations for this level with only one format or writing issue needing to be addressed.
11 (22%) – 11 (22%)
Writer demonstrates minimal skill in meeting sentence level and/or paragraph level skills within discussion board posts to meet 3000 Academic Writing Expectations for this level with less than or equal to three format or writing issues needing to be addressed.
Discussion: Conducting a Literature Review
(0%) – 10 (20%)
Writer demonstrates inadequate skill within discussion board posts to meet the sentence and/or and paragraph level skills in meeting the 3000 Academic Writing Expectations for this level with four or more format or writing issues needing to be addressed.
Total Points: 50

NURS 3150 3151 week 1 Discussion

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. NURS 3150 3151 week 1 Discussion

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.

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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.

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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).

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

Typhoid Fever Essay – Emerging and Re-emerging Diseases Fact Sheet

Typhoid Fever Essay – Emerging and Re-emerging Diseases Fact Sheet

Typhoid Fever

Target Population

 

Typhoid fever is an emerging and re-emerging disease in the world, mostly in Africa. The Targeted audience or population include;

  • Nurses; They are the first responders to educate, assist, and implement the measures to control and treat the disease.
  • Patients
  • The public

What is Typhoid Fever          

Typhoid fever, also known simply as typhoid, is a life-threatening bacterial infection caused by a specific type of Salmonella. Symptoms begin 6 to 30 days after exposure. It varies from mild to severe cases if not treated. There is a gradual onset of a high fever over several days. Symptoms include fever, abdominal pain, headache, vomiting, diarrhea, cough, or constipation. A confirmed case had Typhi isolated from blood, stool, or rectal swab culture. Typhoid Fever Essay – Emerging and Re-emerging Diseases Fact Sheet

The Implications of the spread of Typhoid fever

 

Due to the unsanitary environment and drinking water, most people tend to contract Typhoid disease, which can lead to death.” Among 583 patients admitted with a diagnosis of suspected typhoid, complications occurred in 79 (14%), the most common being acute kidney injury (26), anemia (10), peritonitis (nine), and electrolyte abnormalities (nine). One patient experienced intestinal perforation.

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Detection

 

Typhoid fever can be dictated by the onset of fever, abdominal pain, headache, vomiting, diarrhea, cough, or constipation. The fever can vary from mild to severe.

Prevention

 

Ø Provision of clean drinking water

Ø Adequate sanitation and clean environment

Ø safe food handling practices

Treatment of Typhoid fever

 

Ø Appropriate antibiotic use and vaccination.

Ø Proper handwashing.

“In January 2018, CDC collaborated with HCHD to standardize the collection, analysis, and interpretation of water quality data from wells, boreholes, and municipal taps. HCHD and partners paired this approach to improve water, sanitation, and hygiene (WASH) by assessing and repairing boreholes.

“Globally, overall rates of typhoid fever are reported to be falling; however, there are between 11.9 and 26.9 million cases of typhoid fever each year with 129,000 – 135,900 deaths”.

 

 

References;

Marchello, C. S., Hong, C. Y., & Crump, J. A. (2019). Global typhoid fever incidence: a systematic review and meta-analysis. Clinical Infectious Diseases, 68(Supplement_2), S105-S116. https://www.slideserve.com/sandra_john/typhoid

 

N’cho, H. S. (2019). Notes from the Field: Typhoid Fever Outbreak—Harare, Zimbabwe, October 2017–February 2018. MMWR. Morbidity and Mortality Weekly Report, 68.

 

https://www.cdc.gov/mmwr/volumes/68/wr/mm6802a5.htm

 

https://www.tandfonline.com/doi/abs/10.1080/14760584.2020.1750375

 

 

Assignment: Emerging and Re-emerging Diseases Fact Sheet

Sir Francis Bacon said, “Knowledge is power.” This is most definitely true when it comes to diseases and how to prevent and treat them. As a nurse, you are charged with teaching patients how to prevent infectious diseases and what to do if they become infected. A powerful tool in your arsenal is the Fact Sheet. Usually comprised of one page of easy-to-read content, these leaflets can be distributed easily and can effectively inform your practice.

To prepare for this Assignment:

  • Select one disease that is either emerging or re-emerging in the world today.
  • Research the disease using both scholarly and non-scholarly resources.
  • Determine your audience (patients, other nurses, schools, etc.) that you would want to share the Fact Sheet with.
  • Select pieces of information that are appropriate for your audience.

By Day 7

Submit: A 1- to 2-page Fact Sheet.

  • Indicate the audience on the Fact Sheet.
  • Give a brief history of the disease.
  • What are the implications of the spread of the disease?
  • How does one detect and prevent the spread of this disease?
  • How is this disease treated?

Your Fact Sheet should be visually stimulating, appropriate for your audience, and formatted with bullet points for easy reading.

Support your “facts” with references.

Note: Your Fact Sheet must be supported with at least three scholarly sources of evidence in the literature.

Writing Resources and Program Success Tools

For this Assignment, review the following:

  • AWE Checklist (Level 4000)
  • Assignment Rubric

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 1 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 “WK1Assgn+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.
Excellent Proficient Basic Needs Improvement
Provided a brief history an emerging/reemerging disease.
23 (15.33%) – 25 (16.67%)
Provided a fully developed history of an emerging/reemerging disease with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed history of an emerging/reemerging disease with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed history of an emerging/reemerging disease with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed history of an emerging/reemerging diseasewith little or no analysis of concepts and related issues.
Described the implications of the spread of the disease and included statistical data.
23 (15.33%) – 25 (16.67%)
Provided a fully developed description of the implications of the spread of the disease and included statistical data with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed description of the implications of the spread of the disease and included statistical data with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed description of the implications of the spread of the disease and included statistical data with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed description of the implications of the spread of the disease and included statistical data with little or no analysis of concepts and related issues.
Described how to detect the disease and how to prevent the spread of the disease.

Typhoid Fever Essay – Emerging and Re-emerging Diseases Fact Sheet

23 (15.33%) – 25 (16.67%)
Provided a fully developed description of how to detect the disease and how to prevent the spread of the disease with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed description of how to detect the disease and how to prevent the spread of the disease with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed description of how to detect the disease and how to prevent the spread of the disease with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed description of how to detect the disease and how to prevent the spread of the disease with little or no analysis of concepts and related issues.
Described how the disease is treated.
23 (15.33%) – 25 (16.67%)
Provided a fully developed description of how the disease is treated with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed description of how the disease is treated with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed description of how the disease is treated with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed description of how the disease is treated with little or no analysis of concepts and related issues.
Academic Writing Expectations (AWE 3) 4000 Level “Displays sentence and paragraph level skills: Constructs simple, complex and compound sentences; Writes without spelling, grammatical or syntax errors; Writes without sentence fragments or run on sentence; Uses punctuation appropriately; Writes appropriate introductions and conclusions. Demonstrates essay level skills: Cohesion and flow by using transition sentences; precision, clarity and academic tone; Awareness of discipline specific audience. Displays academic expression: Scholarly voice, evidence of the student’s own ideas with a well-organized presentation of evidence; Synthesizes resources by using own words; Limits use of quotes appropriately; Uses evidence from course learning resources, scholarly resources and seeks additional resources to support content as required in the assignment; A minimum of three references are required. “
23 (15.33%) – 25 (16.67%)
Demonstrates fully developed sentence, paragraph, and essay level skills. Displays academic expression through fully developed use of evidence from multiple sources to support content. Meets the 4000 AWE level with no writing issues and exceeds the minimum reference requirement.
20 (13.33%) – 22 (14.67%)
Demonstrates developed sentence, paragraph, and essay level skills. Displays academic expression through developed use of evidence from most sources to support content. Meets the 4000 AWE level with minimal writing issues and exceeds the minimum reference requirement.
18 (12%) – 19 (12.67%)
Demonstrates minimally developed sentence, paragraph, and essay level skills. Beginning to display academic expression through minimally developed use of evidence from some sources to support content. Minimally meets the 4000 AWE level with several writing issues and meets the minimum reference requirement.
Typhoid Fever Essay – Emerging and Re-emerging Diseases Fact Sheet
(0%) – 17 (11.33%)
Demonstrates limited sentence, paragraph, and essay level skills. Does not display academic expression, has limited use of evidence with few or no sources to support the content. Does not meet the 4000 AWE level of writing and does not meet the mimium reference requirement.
APA “APA Formatting: cover page, title of paper on second page, level headings, Times New Roman 12 font, 1″” margins, and page numbers. APA References: Uses in-text citations appropriately and format correctly. Paraphrases to avoid plagiarizing the source. Reference list is in alphabetical order, hanging indent, double spaced in format. Each specific entry contains all information required by APA format including author, year of publication, title of publication, pages, DOI, website, as appropriate.”
23 (15.33%) – 25 (16.67%)
Demonstrates fully developed APA formatting and referencing requirements with no formatting errors.
20 (13.33%) – 22 (14.67%)
Demonstrates developed APA formatting and referencing requirements with minimal formatting errors.
18 (12%) – 19 (12.67%)
Demonstrates minimally developed APA formatting and referencing requirements with several formatting errors.
Typhoid Fever Essay – Emerging and Re-emerging Diseases Fact Sheet
(0%) – 17 (11.33%)
Demonstrates limited APA formatting and referencing requirements with multiple formatting errors.
Total Points: 150

Emerging and Re-emerging Diseases Fact Sheet Assignment

Emerging and Re-emerging Diseases Fact Sheet Assignment

Assignment: Emerging and Re-emerging Diseases Fact Sheet

Sir Francis Bacon said, “Knowledge is power.” This is most definitely true when it comes to diseases and how to prevent and treat them. As a nurse, you are charged with teaching patients how to prevent infectious diseases and what to do if they become infected. A powerful tool in your arsenal is the Fact Sheet. Usually comprised of one page of easy-to-read content, these leaflets can be distributed easily and can effectively inform your practice.

To prepare for this Assignment:

  • Select one disease that is either emerging or re-emerging in the world today.
  • Research the disease using both scholarly and non-scholarly resources.
  • Determine your audience (patients, other nurses, schools, etc.) that you would want to share the Fact Sheet with.
  • Select pieces of information that are appropriate for your audience.

By Day 7

Submit: A 1- to 2-page Fact Sheet.

  • Indicate the audience on the Fact Sheet.
  • Give a brief history of the disease.
  • What are the implications of the spread of the disease?
  • How does one detect and prevent the spread of this disease?
  • How is this disease treated?

Your Fact Sheet should be visually stimulating, appropriate for your audience, and formatted with bullet points for easy reading. Emerging and Re-emerging Diseases Fact Sheet Assignment

Support your “facts” with references.

Note: Your Fact Sheet must be supported with at least three scholarly sources of evidence in the literature.

Writing Resources and Program Success Tools

  • AWE Checklist (Level 4000)
    This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.
  • Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved May 31, 2019, from  https://academicguides.waldenu.edu/ld.php?content_id=45326751

For this Assignment, review the following:

  • AWE Checklist (Level 4000)
  • Assignment Rubric

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 1 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 “WK1Assgn+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. Emerging and Re-emerging Diseases Fact Sheet Assignment

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Excellent Proficient Basic Needs Improvement
Provided a brief history an emerging/reemerging disease.
23 (15.33%) – 25 (16.67%)
Provided a fully developed history of an emerging/reemerging disease with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed history of an emerging/reemerging disease with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed history of an emerging/reemerging disease with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed history of an emerging/reemerging diseasewith little or no analysis of concepts and related issues.
Described the implications of the spread of the disease and included statistical data.
23 (15.33%) – 25 (16.67%)
Provided a fully developed description of the implications of the spread of the disease and included statistical data with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed description of the implications of the spread of the disease and included statistical data with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed description of the implications of the spread of the disease and included statistical data with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed description of the implications of the spread of the disease and included statistical data with little or no analysis of concepts and related issues.
Described how to detect the disease and how to prevent the spread of the disease.
23 (15.33%) – 25 (16.67%)
Provided a fully developed description of how to detect the disease and how to prevent the spread of the disease with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed description of how to detect the disease and how to prevent the spread of the disease with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed description of how to detect the disease and how to prevent the spread of the disease with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed description of how to detect the disease and how to prevent the spread of the disease with little or no analysis of concepts and related issues.
Described how the disease is treated.
23 (15.33%) – 25 (16.67%)
Provided a fully developed description of how the disease is treated with insightful analysis of concepts and related issues.
20 (13.33%) – 22 (14.67%)
Provided a developed description of how the disease is treated with reasonable analysis of concepts and related issues.
18 (12%) – 19 (12.67%)
Provided a minimally-developed description of how the disease is treated with limited analysis of concepts and related issues.
(0%) – 17 (11.33%)
Provided a under-developed description of how the disease is treated with little or no analysis of concepts and related issues.
Academic Writing Expectations (AWE 3) 4000 Level “Displays sentence and paragraph level skills: Constructs simple, complex and compound sentences; Writes without spelling, grammatical or syntax errors; Writes without sentence fragments or run on sentence; Uses punctuation appropriately; Writes appropriate introductions and conclusions. Demonstrates essay level skills: Cohesion and flow by using transition sentences; precision, clarity and academic tone; Awareness of discipline specific audience. Displays academic expression: Scholarly voice, evidence of the student’s own ideas with a well-organized presentation of evidence; Synthesizes resources by using own words; Limits use of quotes appropriately; Uses evidence from course learning resources, scholarly resources and seeks additional resources to support content as required in the assignment; A minimum of three references are required. “
23 (15.33%) – 25 (16.67%)
Demonstrates fully developed sentence, paragraph, and essay level skills. Displays academic expression through fully developed use of evidence from multiple sources to support content. Meets the 4000 AWE level with no writing issues and exceeds the minimum reference requirement.
20 (13.33%) – 22 (14.67%)
Demonstrates developed sentence, paragraph, and essay level skills. Displays academic expression through developed use of evidence from most sources to support content. Meets the 4000 AWE level with minimal writing issues and exceeds the minimum reference requirement.
Emerging and Re-emerging Diseases Fact Sheet Assignment
18 (12%) – 19 (12.67%)
Demonstrates minimally developed sentence, paragraph, and essay level skills. Beginning to display academic expression through minimally developed use of evidence from some sources to support content. Minimally meets the 4000 AWE level with several writing issues and meets the minimum reference requirement.
(0%) – 17 (11.33%)
Demonstrates limited sentence, paragraph, and essay level skills. Does not display academic expression, has limited use of evidence with few or no sources to support the content. Does not meet the 4000 AWE level of writing and does not meet the mimium reference requirement.
APA “APA Formatting: cover page, title of paper on second page, level headings, Times New Roman 12 font, 1″” margins, and page numbers. APA References: Uses in-text citations appropriately and format correctly. Paraphrases to avoid plagiarizing the source. Reference list is in alphabetical order, hanging indent, double spaced in format. Each specific entry contains all information required by APA format including author, year of publication, title of publication, pages, DOI, website, as appropriate.”
23 (15.33%) – 25 (16.67%)
Demonstrates fully developed APA formatting and referencing requirements with no formatting errors.
20 (13.33%) – 22 (14.67%)
Demonstrates developed APA formatting and referencing requirements with minimal formatting errors.
Emerging and Re-emerging Diseases Fact Sheet Assignment
18 (12%) – 19 (12.67%)
Demonstrates minimally developed APA formatting and referencing requirements with several formatting errors.
(0%) – 17 (11.33%)
Demonstrates limited APA formatting and referencing requirements with multiple formatting errors.
Emerging and Re-emerging Diseases Fact Sheet Assignment
Total Points: 150

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.

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.

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://

 

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).

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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-19https://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 lineshttps://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

NURS 4005 NURS 4006: Topics in Clinical Nursing

NURS 4005 NURS 4006: Topics in Clinical Nursing
Discussion – Week 1
This week discussion I am focusing on the emerging of Nipah Virus infection.

This virus is caused by Nipah virus that originates in fruit bats, it spreads between infected animals to human by way of direct contact. This is a new virus that was discovered in Malaysia in 2018, most physicians and health care workers did not know what this virus was and how it can into existence. The citizen of Malaysia to be treated for the virus with symptoms ranging from mild to severe. Most people who contracted the virus was unaware they had the virus before spreading it to others. About 50-75% of the population that did show symptoms presented with fever, cough, headache, shortness of breathe with confusion. 40% of the those patients went into a coma 1-2 days after complication of brain and seizure activity. CDC and WHO spent months on trying to figure out what and where the source of this virus dived from and where was the first point of contact. Scientist final discovered that the RNA of the virus was in the genus Henipa virus in fruit bats. This was confirmed by lab blood draw from the infected patients that the hospital samples and test results that where summited.
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Treatment: of this virus is supportive care, with no known vaccination or cure. We as Health care professional have to educated the public and patients on avoiding exposure with those that have came into direct contact with bats, sick pigs anther animals and drinking raw palm sap. Because, scientist have not figure out how to prevent and treat this new emerging virus, in 2018, more than 700 human cases have been reported and of those reported cases 75% died. This outbreak resulted in 17 death in the Indian State of Kerala as of this day.
What implications does the disease have for nursing practice? It has to be treated as a highly contagious infection that is contact through direct contact with droplet precaution. Patient has to be place in the same room as a TB patient and remain on quarantine ( defined as being restricted to their room without implementation of any isolation precaution) in a single room or cohorts with another patient diagnosed with Nipah and hand washing is a must and head to toe PPE when coming in contact with patient or given patient care. NURS 4005 NURS 4006: Topics in Clinical Nursing

How does the emergence of this disease affect your personal practice? This virus is deadly without a vaccine or direction on how to treat or prevention of a cure. This could impact every health care professional and the community of which the patient has come in contact within, If my staff would come in direct contact with this virus and was unaware of they had this virus, can affect my practice of having to close the facility completely down, requiring everyone to be tested for Nippah virus, require staff to staff to seek immediate emergency care if experiencing any symptoms and notification of CDC and IDPH for guidance and visits to the faculty. The time and cost its going to take to educate the staff as well as the community about the virus and if there is an outbreak, reducing the panic amongst other patients and health care professionals in the facility. Having the answers for families, staff and patients when there is no cure no treatment guidance. This will have a huge impact on my personal practice.

Why do you think that this disease is emerging/re-emerging? Because, a group of the population has chosen to eat animals that are not meant for human consummation. Some scientist are collecting sample of this animal to try to determine their history and what disease or virus they house and these virus are given to other animals as experimental and then spread to other population of non-human and/or human.
What is the nurse’s role in preventing and managing the impact of infectious diseases both from the patient and nurse perspective? The role of a nurse is to minimize the impact of any infectious disease, through use of hand washing, PPE, reviewing and interpreting lab results, assessments of patient on admission and throughout stay alerting the primary of any changes of that patient and making sure there are no delay in care. Maintaining the safety of the staff and patient by using safe practices throughout the work day.

Reference:

WHO: Emergency and Responce to Nipha (2018). Retrieved from: https://www.who.int/csr/disease/nipah/en/

Tan, C., & Wong, K. (2020). Infections among Contacts of Patients with Nipah Virus, India. Emerging Infectious Diseases, 26(8), 1963. https://dx.doi.org/10.3201/eid2608.190722.

 

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Discussion – Week 2
COLLAPSE

 

Initial Post: Genomics

Genomics plays a part in chronic illnesses and other diseases.  Certain genes increase one’s risk of getting illnesses like breast and colon cancers and diabetes (CDC, 2020).  According to the CDC genomics explores how diet, health, and behavior is impacted by genes (2020).  I have firsthand experience on how my genes have impacted my health and my life.  Therefore, this topic has always been fascinating and something that I am always interested in learning more about.

The article “Genomic Competencies for Nursing Practice” discusses the importance of educating nurses in the Veterans Healthcare Administration (VHA) about the benefits of genetic service for veterans (Boyd et al., 2017). The field of genomics is constantly changing, and nurses need to be competent and aware of such changes to provide the resources appropriate for their patients.  Veterans makeup almost 21 million of the healthcare population and only 57% use the benefits available to them at the VHA (Boyd et al., 2017).  In 2011 VHA created an initiative called the Million Veteran Program or “MVP”.  It worked with the veterans to study how genes, behavior, and environment affect health (Boyd et al., 2017).  The Office of Nursing Services (ONS) developed a strategy to establish competencies in genetics and genomics in 2010. This was a four-year plan to establish competencies, evaluate the competencies and make any further recommendations so it can be incorporated into continued education (Boyd et al., 2017).  As a result of this the course “Genomics in Your Nursing Practice” became available to nurses at the VHA via an online platform in 2014 (Boyd et al., 2017).

As nurses we are taught to advocate for our patient and provided the best care.  This includes continuing to educate ourselves on advances that impact our patients.  Genomics is a topic that is continuing to evolve and help create patient specific care that is tailored to the individual.  We must also have the resources to provide to our patients so they can make informed decisions and offer them all possible option so they can make the right choice for them.  Nurses must explore the patients’ family history in greater detail, screening, and understand the role genetics plays in chronic illnesses or the risk it may pose to the patient.  Understand available resources and care coordination is essential to providing patient centered care.

There are considerations when exploring genomics that must be addressed.  Protecting racial/personal discrimination from health insurance or employer is important to providing cost effective care for all.  A person must not be punished for their genetic makeup.  There must be laws and policies that reflect the advancement in medical care specifically related to genomics/genetics.  As nurses we must not make assumptions about our patients health related to their race/ethnic background but must also consider genetics.

References

Boyd, A., Alt-White, A., Anderson, G., Schaa, K., & Kasper, C. (2017). Genomic Competencies for Nursing Practice: Implications for Nursing Leadership. JONA: The Journal of Nursing Administration, 47(1), 62–67. https://doi-org.ezp.waldenulibrary.org/10.1097/NNA.0000000000000438

Public Health Genomics. (2020, October 01). Retrieved October 21, 2020, from https://www.cdc.gov/genomics/default.htm

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Discussion – Week 3
While working in the long term care unit, there was an incident in which a resident with dementia had been complaining of pain and had become less ambulatory. In a review of the medication administration record, the resident was receiving more pain medication than before. As a nurse manager, the staff was asked questions about the ambulation change, and no reasons for the change were documented. A couple of weeks later, there was a call-out on the 11-7 shift I had to cover as the charge nurse. When speaking with the unit secretary familiar with the resident, we began discussing the decreased mobility and pain concerns. During this conversation, the unit secretary told me,” you did not know?” and I replied, “know what?” A couple of weeks ago, the unit secretary replied that the resident was trying to stand from a sitting position and fell backward. Didn’t the nurse tell you? My response was,” I did not receive any incident report from a witnessed fall.”

At this time, I began to review documentation from the date the resident fell. There were no neurological checks, no vital signs taken, and no mention of any falls in the documentation that a fall occurred. From here, I was responsible for filling out an incident report, notified the physician, family member, and administration.  The physician was made aware of the X-ray recommendation, with findings, noted a lumbar fracture. This finding was reported to the Department of Health as it is a reportable incident. My initial thoughts were, I cannot believe the nurse would not share this information. The nurse working on duty the day of the incident was placed on administrative leave for three days while the case was being investigated. After interviewing multiple staff on all three shifts, the activities director, the maintenance staff, and the Certified nursing assistants, the investigation’s conclusion led to the termination of the Licensed Practical Nurse. As a nursing obligation, I was responsible for reporting neglect/abuse to the local Ombudsmen, Adult Protective Services, and the Department of Health Professionals. This was an unfortunate situation that affected this patient’s overall health, in which he later was admitted to hospice and expired.

The first challenge in this situation is that the patient had dementia and could not verbally express what had happened. Another challenge was that the unit secretary assumed management was aware of the fall. Strategies included interviewing the staff who provided care to the resident and interviewing those who may have had some interaction with the resident during the past couple of weeks.  A second strategy, when the patient initially was given pain medications, an X-ray should have been obtained after a few days of given pain medications.

All employees were required to complete an abuse inservice on the initial hire and yearly. After this incident, we hired a consultant to come into the facility to review abuse training, which was mandatory for all licensed staff members.” Since the knowledge influences awareness of abuse, expertise, and preparedness of caregivers, the care team, and nurses as the first line of treatment is responsible for identifying and reporting mistreatments and supporting vulnerable populations such as the elderly (Saghafi, et al., 2019, para, 7).”

Abuse is something not to take lightly and is a reportable offense in which you can lose your nursing license. I had two takeaways from this situation. The first is being more intuned to the care given to dementia residents. Secondly, some nurses will surprisingly make a poor unethical decision, affecting others’ health outcomes.

Reference:

Saghafi, A., Bahramnezhad, F., Poormollamirza, A., Dadgari, A., & Navab, E. (2019). Examining the ethical challenges in managing elder abuse: a systematic review. Journal of medical ethics and the history of medicine, 12, 7.

 

Week 1: Emerging and Re-emerging Infections Across the Lifespan

Introduction

Infections, if not treated properly, can lead to potentially fatal complications that otherwise could have been prevented. Unfortunately, patients who are sick or recovering from surgery are at greater risk of developing infections. While hospitals and other medical facilities have strict policies about cleanliness and have measures in place to help prevent the spread of infectious organisms, it is not always possible to be 100% effective. There is no firewall protection against viruses and potential infections from occurring in these health care settings. For this reason, it is critical that nurses and other medical workers be aware of potential hazards in order to recognize symptoms of infection.

This week, you will consider the many emerging and re-emerging infections that a patient may contract and examine how the quality of care provided by a nurse might help ameliorate the situation. Nurses have an obligation to learn about potential diseases or infections, their symptoms, and the best course for treatment. You will also review different types of infections and explore how nurses can improve the care provided.

Learning Objectives
Students will:
Analyze emerging and re-emerging infectious diseases for nursing practice
Analyze emerging and re-emerging infectious diseases in local communities
Analyze the role of the nurse in preventing and managing the impact of infectious diseases
Develop Fact Sheets on an infectious disease to use as a guide to improve public health

 

Learning Resources
Required Readings

Gonsalves, G., Staley, P. (2014). Panic, paranoia, and public health—The AIDS epidemic’s lessons for Ebola. New England Journal of Medicine, 371(25), 2348– 2349.

Halm, M. A., & O’Connor, N. (2014). Do system-based interventions affect catheterassociated urinary tract infection? American Journal of Critical Care, 23(6), 505-509. doi:10.4037/ajcc2014689

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

Petlin, A., Schallom, M., Prentice, D., Sona, C., Mantia, P., McMullen, K., & Landholt, C. (2014). Chlorhexidine gluconate bathing to reduce methicillin-resistant Staphylococcus aureus acquisition. Critical Care Nurse, 34(5), 17–26. doi:10.40377/ccn2014943

Pokrywka, M., Feigel, J., Douglas, B., Grossberger, S., Hensler, A. & Weber, D. (2014). A  bundle strategy including patient hand hygiene to decrease clostridium difficile infections. MedSurg Nursing, 23(3), 145-164.

Smeulers, M., Lucas, C., & Vermeulen, H. (2014). Effectiveness of different nursing handover styles for ensuring continuity of information in hospitalised patients. The Cochrane Database Of Systematic Reviews, (6), CD009979

Centers for Disease Control and Prevention. (2015). Ebola (Ebola virus disease). Retrieved from http://www.cdc.gov/vhf/ebola/hcp/index.html?s_cid=cs_4318

Centers for Disease Control and Prevention. (n.d.). Zika virus. Retrieved August 11, 2016, from http://www.cdc.gov/

Required Media

Laureate Education. (Producer). (2009c). Topics in clinical nursing: Emerging and re-emerging infections across the lifespan [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 9 minutes.

 

Accessible player
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Download Video w/CC
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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.

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.

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

 

 

Assignment: Emerging and Re-emerging Diseases Fact Sheet

Sir Francis Bacon said, “Knowledge is power.” This is most definitely true when it comes to diseases and how to prevent and treat them. As a nurse, you are charged with teaching patients how to prevent infectious diseases and what to do if they become infected. A powerful tool in your arsenal is the Fact Sheet. Usually comprised of one page of easy-to-read content, these leaflets can be distributed easily and can effectively inform your practice.

To prepare for this Assignment:

Select one disease that is either emerging or re-emerging in the world today.
Research the disease using both scholarly and non-scholarly resources.
Determine your audience (patients, other nurses, schools, etc.) that you would want to share the Fact Sheet with.
Select pieces of information that are appropriate for your audience.
By Day 7

Submit: A 1- to 2-page Fact Sheet.

Indicate the audience on the Fact Sheet.
Give a brief history of the disease.
What are the implications of the spread of the disease?
How does one detect and prevent the spread of this disease?
How is this disease treated?

Your Fact Sheet should be visually stimulating, appropriate for your audience, and formatted with bullet points for easy reading.

Support your “facts” with references.

Note: Your Fact Sheet must be supported with at least three scholarly sources of evidence in the literature.

Writing Resources and Program Success Tools

AWE Checklist (Level 4000)
This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.
Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved May 31, 2019, from  https://academicguides.waldenu.edu/ld.php?content_id=45326751

For this Assignment, review the following:

AWE Checklist (Level 4000)
Assignment Rubric
Submission and Grading Information

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

Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 1 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 “WK1Assgn+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 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 1 Assignment

 

 

Week in Review

This week, you analyzed emerging and re-emerging infectious diseases in local communities and for nursing practice and ways to prevent and manage the impact of them. You also developed a Fact Sheet on an infectious disease as a guide to improving public health.

Next week, you will explore strategies that provide better patient care for those with chronic health problems and how genetics and genomics influence nursing practice.

To go to the next week:

Week 2

Week 2: Chronic Health Problems and the Link to Genetic Nursing Care

Introduction

Disease prevention can easily be considered the best path toward a cure, but there are some diseases to which many people are hereditarily more susceptible. Chronic health problems, many of which have yet to be cured, show up in hospitals and clinics frequently.

As medical research continues to actively search for cures and better treatment options, how can you as a nurse provide the best care possible for your patients? Do you know the risks related to misdiagnosis for a patient who suffers from a chronic disease? What can a nurse do to help the patient live comfortably with chronic diseases?

Health care continues to develop through research efforts that find new treatment options. In addition, advances in genetic and genomic connections to health and illness are influencing nursing practice and becoming a routine part of taking a patient’s family history. When a nurse notices a genetic predisposition to an illness, he or she can take the opportunity to begin educating the patient as well as being more aware of possible signs and symptoms of onset.

This week, you will explore strategies for providing better patient care to patients with chronic health problems and explore how genetics and genomics influence nursing practice.

Learning Objectives
Students will:
Analyze genetics and genomics for nursing practice
Analyze the role of the nurse in addressing genetics and genomics for nursing practice
Analyze the ethical considerations relating to genetics and genomics for nursing practice

 

 

Learning Resources
Required Readings

Coleman, B., Calzone, K.A., Jenkins, J., Paniagua, C., Rivera, R., Hong, O.S….Bonham, V. (2014). Multi-ethnic minority nurses’ knowledge and practice of genetics and genomics. Journal of Nursing Scholarship, 46(4), 235-244. doi:10.1111/jnu.12083

Gaskin, D. J., Thorpe, R. J., McGinty, E. E., Bower, K., Rohde, C., Young, J. H., … Dubay, L. (2014). Disparities in diabetes: The nexus of race, poverty, and place. American Journal of Public Health, 104(1), 2147–2155. doi: 10.2105/AJPH.2013.301420

Mehrian-Shai, R., & Reichardt, J. V. (2015). Genomics is changing personal healthcare and medicine: The dawn of IPH (individualized preventive healthcare). Human Genomics, 9, 29. doi:10.1186/s40246-015-0052-0

Plavskin, A. (2016). CNE SERIES. Genetics and Genomics of Pathogens: Fighting infections with genome-sequencing. MEDSURG Nursing, 25(2), 91-96.

Shaw, R. J., McDuffie, J. R., Hendrix, C. C., Edie, A., Lindsey-Davis, L., Nagi, A., … Williams, J. W. (2014). Effects of nurse-managed protocols in the outpatient management of adults with chronic conditions. Annals of Internal Medicine, 161(2), 113–121. doi:10.7326/M13-2567

International Society of Nurses in Genetics. (2015). Retrieved from http://www.isong.org/

American Nurses Association. (2016). Personalized medicine. Retrieved from http://www.nursingworld.org/genetics

Required Media

Altman, R. (2013). Let’s test genetics before prescribing drugs. Retrieved from https://www.youtube.com/watch?v=X1iKibDqtck

Doudna, J. (2015). How CRISPR lets us edit our DNA. Retrieved from https://www.ted.com/talks/jennifer_doudna_we_can_now_edit_our_dna_but_let_s_do_it_wisely?language=en#t-190359

Wax, R. (2012). What’s so funny about mental illness? Retrieved from https://www.ted.com/talks/ruby_wax_what_s_so_funny_about_mental_illness

 

 

Discussion: Providing Genetic Nursing Care to Patients With Chronic Illnesses

There are several chronic health problems with genetic/genomic components that plague the population. These health problems are very difficult and challenging diseases to manage. Evidenced-based nursing practice must include genetic and genomic information when planning patient care. Nurses, through their knowledge and support, play an important role in positive patient outcomes when managing the challenges of these genetically linked diseases.

For this Discussion, you will consider applications of various topics to genetics and genomics. Review the Resources focusing on the application of genetics and genomics to nursing

Choose one of the following subtopics:

Pharmacogenomics and chronic illnesses
Genomics in patient assessment
Genetically competent care for those with chronic illnesses

Note: A different subtopic relating to genetics and genomics may be chosen with Instructor approval.

Locate at least one scholarly journal article that discusses your subtopic.

By Day 3

Respond to the following:

Identify your subtopic and provide a brief summary of your journal article on how this topic relates to nursing practice.
What is the nurse’s role in providing care in relation to your subtopic and the overarching theme of advocacy?
What ethical implications should be considered with regard to genetics and genomics for nursing practice? Why?

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.

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

 

 

Week in Review

This week, you analyzed the role of the nurse, as well as ethical considerations related to genetics and genomics for nursing practice.

Next week, you will explore the leading causes of the psychological implications resulting from illnesses and injuries across the lifespan.

To go to the next week:

Week 3

Week 3: Psychological Implications Resulting From Illnesses and Injuries Across the Lifespan

Introduction

Illnesses and injuries can arise from a variety of different situations and can result in psychological disorders. One psychological disorder that is a common complication of chronic illnesses is depression. Depression has many symptoms that can increase the risk of chronic and acute illnesses. Nurses can play a critical role in the prevention and treatment of depression by using strategies that are more holistic in nature.

Psychological implications can also arise when caring for patients with suspicious injuries or illnesses. Oftentimes, nurses notice signs and symptoms that may indicate physical abuse while conducting a health assessment interview or physical exam. Nurses have a responsibility in situations such as these to be an advocate for patients, ensuring that proper attention is paid not only to the injury or illness, but also to the psychological well-being of the patient.

This week, you will explore the leading causes of psychological implications resulting from injuries and illnesses across the lifespan. You will also examine how depression is manifested in different chronic illnesses. In addition, you will explore strategies nurses might use when advocating for patients with suspicious injuries.

Learning Objectives
Students will:
Analyze patient care challenges in relation to illness or injury resulting from depression
Analyze patient care challenges in relation to suspicious illness or injury
Analyze strategies that nurses might use to address patient care challenges
Analyze nurses’ advocacy for patients in situational contexts
Analyze legal and ethical implications related to patient care challenges
Analyze mental health across the illness/injury continuum
Analyze the role of the nurse in working through mental blocks and depression associated with an illness or injury
Analyze medical and non-medical approaches for treating mental health
Synthesize aspects of nursing practice related to mental health

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Learning Resources
Required Readings

Buijck, B. I., Zuidema, S. U., Spruit-van Eijk, M., Bor, H., Gerritsen, D. L., & Koopmans, R. T. C. M. (2014). Determinants of geriatric patients’ quality of life after stroke rehabilitation. Aging & Mental Health, 18(8), 980–985. doi:10.1080/13607863.2014.899969

Haugan, G., Innstrand, S.T. & Moksnes, U.K. (2013). The effect of nurse-patient interaction on anxiety and depression in cognitively intact nursing home patients. Journal of Clinical Nursing, 22(15–16), 2192-2205. doi:10.1111/jocn.12072

Frazao, S. L., Correia, A.M., Norton, P. & Magalhaes, T. (2015). Physical abuse against  elderly persons in institutional settings. Journal of Forensic and Legal Medicine, 36, 54-60.

Liu, C. H. & Tronick, E. (2013). Rates and predictors of postpartum depression by race and ethnicity: Results from the 2004 to 2007 New York City PRAMS Survey (Pregnancy Risk Assessment Monitoring System). Maternal Child Health Journal, 17, 1599-1610.  doi:10.1007/s10995-012-1171-z

Spilman, S. K., Smith, H. L., Schirmer, L. L., & Tonui, P. M. (2015). Evaluation and treatment of depression in adult trauma patients. Journal of Trauma Nursing, 22(1), 17–22. doi:10.1097/JTN.0000000000000102

United Nations Children’s Fund (UNICEF). (2014). Hidden in plain sight: A statistical analysis of violence against children. New York, NY: Author. Retrieved from http://files.unicef.org/publications/files/Hidden_in_plain_sight_statistical_analysis_EN_3_Sept_2014.pdf

Required Media

Steiner, L. M. (2012). Why domestic violence victims don’t leave. Retrieved from https://www.ted.com/talks/leslie_morgan_steiner_why_domestic_violence_victims_don_t_leave?language=en#t-58672

 

 

Discussion: Psychological Complications Resulting From Illnesses and Injuries

The nurse’s role goes far beyond that which is expected. Nurses are the main communicators between patients, doctors, and family, and they care for more than just physical ailments. Often, nurses are presented with difficult situations where being an advocate becomes paramount to the healing of the patient. One of the issues that patients with acute and chronic illnesses or extended hospitalization face is a tendency to become depressed. The nurse’s role in this situation requires more than just attention to the physical problem. Another situation where a nurse may need to shift his or her care is when a patient presents with a suspicious injury or illness. In addition to considering the legal and ethical responsibilities of the nurse, he or she must consider the psychological undertones that may be present.

For this Discussion, you will consider delicate situations that nurses often face and analyze the implications of these situations. Reflect on a patient care situation in which you have encountered one of the following:

A suspicious illness or injury
Depression resulting from illness or injury

Then, locate at least one scholarly journal article related to your patient care situation that offers strategies for managing the circumstances.

By Day 3

Respond to the following:

Explain your patient encounter, highlighting the challenges the situation presented, and briefly summarize the contents of your journal article.
What strategies did you employ to help handle the situation? What other strategies could you have used?
How did you advocate for the patient in the situation?
What are some of the legal and ethical implications that need to be considered when providing care for patients with depression resulting from illnesses or injuries or suspicious illnesses or injuries?

Note: Avoid using personal information (e.g., names, facility name, etc.) in your post.

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.

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

 

 

Assignment: How Illnesses and Injuries Affect the Mind

Health complications can be stressful, especially in more vulnerable populations like young children and the elderly. With stress and loss of function often come depression and other psychological manifestations. As a nurse, part of your job is to recognize and educate patients and caregivers on how to deal with the psychological complications of a health crisis.

In this Assignment, you will educate either a caregiver of an elderly patient or a caregiver of a young child patient on ways to prevent and manage psychological manifestations. Review the Learning Resources dealing with injuries and depression and anxiety.

The Assignment:

Develop a teaching plan for treating the potential psychological issues that may result from health crises in either the elderly or young children. You will use PowerPoint to present your teaching plan. Some considerations to make include:

In what ways does mental health need to be considered across the illness/injury continuum?
How can nurses help both patients and caregivers work through mental blocks and depression associated with an illness or injury?
Although treatment will take place in a medical facility, how can non-medical treatments be used as a supplement?

Support your idea with a minimum of three references from the professional nursing literature in the assigned course readings and other references in the Walden Library. If they are relevant, you may use one or two professional Web sites in addition to the literature references.

Include the main elements of your presentation to a group of parents or elderly or their caregivers. This PowerPoint presentation should include between 8–10 slides. It will be assessed using the Week 3 Assignment. Prior to submitting your Assignment, make sure to review the rubric, which is located in the Course Information area.

Note: Be sure to use the Walden Power Point template included in the Writing Resources and Program Success Tools.

Writing Resources and Program Success Tools

AWE Checklist (Level 4000)
This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.
http://academicguides.waldenu.edu/writingcenter/templates/general
http://academicguides.waldenu.edu/writingcenter/scholarlyvoice
http://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859
http://academicguides.waldenu.edu/writingcenter/apa/citations/commonsources
Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.).
Retrieved May 31, 2019, from  https://academicguides.waldenu.edu/ld.php?content_id=45326751

For this Assignment, review the following:

AWE Checklist (Level 4000)
Writing Resources and Program Success Tools
Week 3 Assignment Rubric
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 “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 originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 3 Assignment

 

 

Week in Review

This week, you analyzed various challenges related to illness or injury resulting from depression, including suspicious illness or injury and several strategies that nurses might use to address those challenges and advocate in situational contexts. NURS 4005 NURS 4006: Topics in Clinical Nursing

Next week, you will explore the importance of nurse empowerment in effecting change and how action plans are created based on the results of the NDNQI as presented on a dashboard.

To go to the next week:

Week 4

Week 4: Nurse/Patient Empowerment in Practice

Introduction

As a registered nurse, you have the power to influence change in patient outcomes. An important aspect of influencing change is identifying areas that need improvement. This is done primarily through measurement of data. There are several different measures to gather data within organizations as well as on a national scale. Some of these measurements include core measures, standards, best practices, evidence-based practices, and the National Database of Nursing Quality Indicators (NDNQI). These support mechanisms have also been discussed as a means for helping nurses to deliver quality care and improve patient safety. Each measurement essentially focuses on providing care that is safe, effective, patient-centered, timely, efficient, and equitable.

Although there are several different measurements, NDNQI data is used in the process of attaining Magnet Recognition. Magnet Recognition is the highest honor a health care organization can receive for nursing excellence and high-quality patient care. The nurse-specific measures presented in the NDNQI help inform nursing staffs and their organizations of areas where nursing practices can be improved and where nursing practice efforts are producing positive clinical outcomes. Nurses must be directly involved in developing and implementing action plans based on the data presented by the NDNQI.

This week, you will explore the importance of nurse empowerment in effecting change and how action plans are created based on the results of the NDNQI as presented on a dashboard. You will also consider how nurses advocate for patients’ rights, even when that means supporting a patient whose personal choices may have negative health outcomes.

Learning Objectives
Students will:
Evaluate strategies to empower both the nurse and the patient to improve quality of care
Analyze the use of National Database of Nursing Quality Indictors for nurse empowerment in practice
Analyze nurse empowerment in relation to use of quality improvement data for practice
Analyze practice experiences for patient or nurse empowerment
Analyze quality improvement dashboards for nursing plans

Note: The Assignment related to these Learning Objectives is introduced this week and submitted in Week 5. NURS 4005 NURS 4006: Topics in Clinical Nursing

 

 

Learning Resources
Required Readings

Brown, D. S., Aydin, C. E., & Donaldson, N. (2008). Quartile dashboards: Translating large data sets into performance improvement priorities. Journal of Healthcare Quality, 30(6), 18–30. doi: 10.1111/j.1945-1474.2008.tb01166.x

Typically, references should be within five to seven years of publication. However, this publication is considered a classical research reference pertaining to quality improvement and the use of data sets.

Cole, C., Wellard, S., & Mummery, J. (2014). Problematising autonomy and advocacy in nursing. Nursing Ethics, 21(5), 576–582. doi: 10.1177/0969733013511362

Garrard, L., Boyle, D. K., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western Journal Of Nursing Research, 38(1), 111-128. doi: 10.1177/019394591454281

Giancarlo, C., Comparcini, D., & Simonetti, V. (2014). Workplace empowerment and nurses’ job satisfaction: A systematic literature review. Journal of Nursing Management, 22(7), 855-871. doi: 10.1111/jonm.12028

Guglielmi, C. L., Stratton, M., Healy, G. B., Shapiro, D., Duffy, W. J., Dean, B. L., & Groah, L. K. (2014). The growing role of patient engagement: Relationship-based care in a changing health care system. AORN, 99(4), 517–528. doi: 10.1016/j.aorn.2014.02.007

Rock, M.J. & Hoebeke, R. (2014). Informed consent: Whose duty to inform? MedSurg Nursing, 23(3), 189-194.

American Hospital Association. (2003). The patient care partnership: Understanding expectations, rights and responsibilities. Retrieved from http://www.aha.org/content/00-10/pcp_english_030730.pdf NURS 4005 NURS 4006: Topics in Clinical Nursing

 

Read through this document created by the American Hospital Association. This document was created for inpatient hospital stays. However, it is applicable to other practice settings as well.

Montalvo, I. (2007). The national database of nursing quality indicators. The Online Journal of Issues in Nursing, 12(3). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.html

Institute for Healthcare Improvement. (2016). Retrieved from http://www.ihi.org/Pages/default.aspx

 

The IHI offers numerous resources for improving nursing practice and patient care. Explore a variety of topics and examine some of the resources available.

National Quality Forum. (2016b). Retrieved from http://www.qualityforum.org/Home.aspx

 

The National Quality Forum (NQF) strives to improve patient safety and reduce medical errors. Explore the NQF’s endorsed standards and consider how they apply to nursing practice.

Document: Dashboard Directions (Word document)

Document: Sample Dashboard (Excel workbook) NURS 4005 NURS 4006: Topics in Clinical Nursing

Required Media

Laureate Education. (Producer). (2009a). Topics in clinical nursing: Accountability and nursing practice [Video file]. Baltimore, MD: Author.

 

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

 

Accessible player
–Downloads–
Download Video w/CC
Download Audio
Download Transcript

 

Discussion: Nurse/Patient Empowerment

As a nurse, you are the individual who has the ability to empower patients in the decision-making process pertaining to their health care. In addition, you are in a unique position to empower your nursing colleagues to improve job satisfaction and use performance indicator data from dashboards to effect social change.

In this week’s Learning Resources, you examined both the National Database of Nursing Quality Indicators (NDNQI) and the key role nurses play as advocates for patient rights. To assist nurses in being better prepared for this role, programs such as Patient Care Partnership provide guidance.

For this Discussion, you will analyze the use of quality improvement data and discuss how this data can help empower both patients and nurses. Review the Patient Care Partnership information presented in this week’s Resources. In addition, reflect on the media presentation and the information shared by Ms. Manna on patients’ rights. NURS 4005 NURS 4006: Topics in Clinical Nursing

By Day 3

Respond to the following:

What are the best strategies the nurse can employ to empower patients and support patients’ rights to improve quality of care? (Some considerations to keep in mind may include: providing information on effectiveness, risks, and benefits of alternative treatments.)
In what ways can NDNQI data from dashboards or quality improvement data be used to support nurse empowerment in practice?
How has your institution empowered the nursing staff through the use of quality improvement data?
Provide an example of how you have personally empowered either a patient or a fellow nurse.

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. NURS 4005 NURS 4006: Topics in Clinical Nursing

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.

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: Dashboard Analysis and Nursing Plan

As Dr. Rempher and Ms. Manna discussed this week, data from the NDNQI is used to improve nursing practices and support the strategic outcomes of an organization. This data is also used to create the Dashboard. The Dashboard, then, is used to create an action plan. Correctly interpreting information presented on the Dashboard provides nurses with a better understanding of the goals of the action plan.

To prepare

For this Assignment, use the Dashboard located in this week’s Resources, to interpret the data and frame a nursing plan based on best practices.

Review the Week 5 Assignment Rubric, provided in the Course Information area.
Review the Week 4 Resources that pertain to the NDNQI and use of dashboards
Choose a Nurse-Sensitive Quality Indicator that needs improvement based on the data presented in the Dashboard. Reflect on how you would develop a nursing plan with suggestions on how to improve performance in the chosen area.
Develop a nursing plan that outlines suggestions on how to improve performance in the chosen area.
Provide at least three best practices from evidenced-based literature to support your nursing plan.

Assignment

Draft a 3- to 4 page paper analyzing areas where there is good performance and areas of opportunity from the sample Dashboard.
Analyze the data provided in the Dashboard and select an area of performance that needs improvement. Include information on why this area was chosen.
Develop a nursing plan that includes suggestions on how to improve performance on the selected indicator. Be sure to provide at least three best practices from the evidenced-based literature to support your suggested nursing plan.

This Assignment is due on Week 5 Day 7. It will be assessed using the Week 5 Assignment Rubric. Writing Resources and Program Success Tools

AWE Checklist (Level 4000)
This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.
Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.). NURS 4005 NURS 4006: Topics in Clinical Nursing
Retrieved May 31, 2019, from  https://academicguides.waldenu.edu/ld.php?content_id=45326751

For this Assignment, review the following:

AWE Checklist (Level 4000)
Walden paper template (no abstract or running head required)
Submission and Grading Information

There is no submission this week.

Grading Criteria

To access your rubric:

Week 5 Assignment Rubric

Submit Your Assignment by Day 7 of Week 5

 

Week in Review

This week, you evaluated strategies and analyzed practice experiences. You also evaluated the use of the National Database of Nursing Quality Indicators to empower both the nurse and patient to improve quality of care, including quality improvement dashboards for nursing plans.

Next week, you will consider the emerging role of nursing in palliative and end-of-life care, including any ethical issues and considerations. NURS 4005 NURS 4006: Topics in Clinical Nursing

To go to the next week:

Week 5

Week 5: Holistic and Patient-Centered Care

Introduction

An important area in nursing practice is in palliative and end-of-life care. Palliative care provides a more holistic approach to patient care and attempts to slow the progression of a disease. Palliative care can include an array of non-pharmaceutical therapies such as massage therapy or yoga. It can also include shorter or smaller treatments aimed at reducing negative side effects.

End-of-life care is about the process of dying. Helping patients and their families through this time can be difficult yet rewarding. Patients deserve respect and quality care through this time as well. Like nurses who practice in palliative care organizations, hospice nurses are moving toward alternative therapies to aid in comforting the terminally ill patient. As more care is being delivered in the home, the role of the nurse in providing palliative and end-of-life care will continue to evolve.

This week, you will consider the emerging role of nursing in palliative and end-of-life care. In addition, the ethical issues nurses face with end-of-life care are examined. Finally, you will complete work on your Dashboard nursing plan Assignment.

Learning Objectives
Students will:
Identify challenges related to the nurse’s role in providing alternative therapies for patient care
Analyze the use of Complementary and Alternative Medicine approaches in relation to alternative therapies for patient care
Evaluate Complementary and Alternative Medicine approaches in teaching plans for nurses
Analyze the role of the nurse and patient in developing care plans
Analyze quality improvement dashboards for nursing plans

 

Learning Resources
Required Readings

Aldridge, M. D., Hasselaar, J., Garralda, E., van der Eerden, M., Stevenson, D., McKendrick, K., … Meier, D. E. (2016). Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliative Medicine, 30(3), 224–239. doi: 10.71177/0269216315606645

Anderson, J.G.& Taylor, A.G. (2012). Use of complementary therapies for cancer symptom management: Results of the 2007 National Health Interview survey. The Journal of Alternative and Complementary Medicine, 18(3), 235-241

Dabney, B.W. & Tzeng, H.M. (2013). Service quality and patient-centered care. MedSurg Nursing, 22(6), 359-364.

De Jonge, K.E., Jamshed, N., Gilden, D., Kubisiak, J., Bruce, S.R. & Taler, G. (2014).  Effects of home-based primary care on Medicare costs in high-risk elders. Journal of the American Geriatrics Society, 62(10), 1825-1831. doi: 10.1111/jgs.12974

Moir, C., Roberts, R., Martz, K., Perry, J., & Tivis, L. J. (2015). Communicating with patients and their families about palliative and end-of-life care: Comfort and educational needs of nurses. International Journal of Palliative Nursing, 21(3), 109–112. doi: 10.129768/ijpn.2015.21.3.109

National Cancer Institute. (2015). Complementary and alternative medicine for health professionals. Retrieved from http://www.cancer.gov/about-cancer/treatment/cam/hp

American Cancer Society. (2016). Retrieved from http://www.cancer.org/

 

The American Cancer Society’s website provides information regarding the progress of cancer research, support systems for patients with cancer, and survivor stories. Explore current research on non-invasive and alternative treatment options for cancer patients.

Hospice & Palliative Nurses Association. (2016). Retrieved from http://hpna.advancingexpertcare.org/

National Quality Forum. (2016a). Palliative care and end-of-life care. Retrieved from http://www.qualityforum.org/Topics/Palliative_Care_and_End-of-Life_Care.aspx

EthnoMed. (2016). Clinical topics. Retrieved from http://ethnomed.org/clinical

 

The EthnoMed site has great resources regarding cultural diversity and beliefs, patient handouts in different languages, research articles, et cetera. NURS 4005 NURS 4006: Topics in Clinical Nursing

Document: Dashboard Directions (Word document)

Document: Sample Dashboard (Excel workbook)

Required Media

Laureate Education. (Producer). (2009d). Topics in clinical nursing: Future directions of nursing care [Video file]. Baltimore, MD: Author.

 

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

 

Accessible player
–Downloads–
Download Video w/CC
Download Audio
Download Transcript

 

Discussion: Holistic Care and Treatments

The use of complementary and alternative therapies in the treatment of cancer patients, terminal patients, and many other types of patients is steadily increasing. The Resources also contain much information about the various alternative therapies currently being used.

For this Discussion, you will consider alternative therapies and discuss the challenges associated with them.

To prepare for this Discussion:

Review the Resources pertaining to alternative therapies.
Select one of the following areas where alternative therapies are being used:
Cancer treatment
Cancer symptom management
End-of-life care
Palliative care
Find at least one scholarly journal article discussing alternative therapies in your chosen subtopic.
By Day 3

Respond to the following:

Identify at least one challenge associated with the nurse’s role in providing alternative therapies for patient care.
Explain how the nurse might integrate the use of Complementary and Alternative Medicine (CAM) approaches in your chosen subtopic and discuss the ethical issues nurses may face.
What are the main elements you would include in a teaching plan for nurses on the use of CAM in your chosen subtopic?
What is the shared role of the nurse and patient in developing care plans?

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 CourseInformation and Grading Criteria area. NURS 4005 NURS 4006: Topics in Clinical Nursing

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: Dashboard Analysis and Nursing Plan DUE
By Day 7

This Application Assignment, assigned last week, is due. Prior to submitting your Assignment, make sure to review the Week 5 Assignment Rubric, which is located in the Course Information area.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK5Assgn+last name+first initial.(extension)” as the name.
Click the Week 5 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 5 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 “WK5Assgn+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.
Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.
Grading Criteria

To access your rubric:

Week 5 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 5 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 5 Assignment

 

 

Week in Review

This week, you identified the challenges for nurses in providing alternative therapies for patient care and analyzed the use of Complementary and Alternative Medicine approaches in relation to those therapies. You also analyzed the role of nurse and patient in developing care plans and quality improvement dashboards for nursing plans.

In the final week, you will consider a series of articles that focus on strategies for ensuring safety and quality care for patients. You will also explore how successful and efficient teamwork can help prevent and decrease the likelihood of Never Events occurring.

To go to the next week:

Week 6

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

Introduction

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

As a nurse, how can you help to prevent these types of medical errors? What is your accountability for clinical outcomes? There are standards and core measures in place that guide nursing practice. In addition, the National Database of Nursing Quality Indicators (NDNQI) examines those components of clinical care that are specific to nursing. The NDNQI quantifies, or assesses, these nurse-sensitive components and provides specific feedback on how well nursing practice is being executed in those areas related to patient care. NURS 4005 NURS 4006: Topics in Clinical Nursing

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

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

 

Learning Resources
Prior Knowledge

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

Required Readings

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

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

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

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

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

Thornlow, D.K. & Merwin, E. (2009). Managing to improve quality: The relationship between accreditation standards, safety practices, and patient outcomes. Health Care Management Review, 34(3), 261-272. doi: 10.1097/HMR.0b013e3181a16bce

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

 

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

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

 

“Since 1967, the American Organization of Nurse Executives (AONE) has provided leadership, professional development, advocacy and research to advance nursing practice and patient care, promote nursing leadership excellence and shape public policy for health care nationwide. AONE is a subsidiary of the American Hospital Association” (AONE, 2016). NURS 4005 NURS 4006: Topics in Clinical Nursing

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

 

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

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

 

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

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

 

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

Required Media

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

 

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

 

Accessible player
–Downloads–
Download Video w/CC
Download Audio
Download Transcript

 

Discussion: Promoting Safety and Quality

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

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

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

To prepare for this Discussion:

Review the information at the Joint Commission and Centers for Medicare & Medicaid Services websites on the core measures and standards presented in this week’s Resources.
Consider the nurse’s role in supporting the organization’s strategic agenda as it relates to improving clinical outcomes.
Conduct an Internet search for either a Never Event or a core measure, and select one to address in your post.
By Day 3

Respond to the following:

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

Support your response with references from the professional nursing literature.

Note Initial Post: A 3-paragraph (at least 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).

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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.

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

 

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Week in Review

In this final week, you analyzed the core measures and standards for nursing practice that promote patient safety and quality of care outcomes, as well as the impact of the nurse’s role in clinical outcomes. You also analyzed nurse-specific challenges for influencing change in quality improvement and in supporting an organization’s strategic agenda in improving clinical outcomes.

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.

Discussion – Week 3

 

 

When patients are newly diagnosed with chronic illness/conditions, they are more likely to experience depressive symtoms. Studies conducted in China and United States, indicates  the prevalence of depression among patients with chronic diseases; and recommended that primary care and healthcare providers be alert and knowledgeable regarding  the signs/symtoms of depression. Patients with chronic conditions may have to adjust their lifestyle, enployment, aspiration, meanwhile many others will grieve about their predicament before they adjust to it; but others have protracted distress and may develop mental disorders especially deppresion and anxiety (H. Li, 2019)

Some few years ago I was working with a young adult (age 45) newly diagnosed with colorectal cancer. It was not only a devastating new to the patient but also his care team. The patient did not want his mom to know about his diagnosis because the he was afraid the mom will not received the information well he was a single dad and the sole provider in the family of three. This was a huge challenge to the whole family as the patient would have to adjust his lifestyle, his enployment and aspiration in order to plan for treatments. The patient was in denial about the diagnosis, there was a lot of grieving and fear that he would loose his life. The strategy I used to handle the situation was to allow allow him to air out his emotions (fears and sadness), while I listern, asked him open ended questions so he could talk more. Rather than being judgemental, I tried to understand the root cause of his fears and other emotions associated with the new diagnosis (S. J. Calloway et el, 2019). In addition, I also made some referrals such as counseling, surgical oncology services and other community resources. Another strategy I could have used was to monitor or screen the patient for depression. NURS 4005 NURS 4006: Topics in Clinical Nursing

Some of the legal and ethical implications that need to be considered when providing care for patients with depression resulting from chronic illnesses include providing consent for treatment, clinical decision making. The patient must collaborate with the physician to make medical care decisions. The information provided by the physician must be sufficient and well understood for the patient to make the best decision possible under the circumstances. But when the patient is suffering from depression because of a chronic illness, consenting or making the right decisions about their care becomes difficult.

When depression is undetected and untreated especially in patients with chronic illnesses, physical and mental health can deteriorate. Thus, as nurses, we can screen and address depression, provide evidence-based education as well as make referrals to mental health specialists and community resources.

References

Hongjin Li, Song G. E., […], & Jacqueline Dumber-Jacob (Jan 10th, 2019). Depression in the context of chronic diseases in the United States and China. Retrieved from https://www.ncbi.nlm.nih.gov

Susan J. Calloway, Rosalinda Jimenez, & Dianne Lavin (Aug. 30th, 2019). Depression and Chronic medical illness in adults. Retrieved from MyAmericanNurse.com

Providing Genetic Nursing Care to Patients With Chronic Illnesses

Discussion – Week 2
COLLAPSE

Pharmacogenomics and chronic illnesses

 

This article gives a brief history and definition of pharmacogenomics as well as gives some examples of nursing implications as it is translated into clinical practice. According to Cheek et al, “while the terms pharmacogenetics and pharmacogenomics are often used interchangeably, pharmacogenetics is generally used to refer to the role of single genes in drug response while pharmacogenomics is the broader term that encompasses the role of the entire genome, including gene-gene interactions in drug response” (2015, para. 2). Expanding on that, pharmacogenomics is defined as “the knowledge of the specific genetic factors that affect drug response”, with the ultimate goal being the ability to adjust drug doses or suggest alternate therapies to avoid toxicities in patients and yield optimal patient outcomes (Cheek et al 2015). There are several chronic illnesses where the patients would benefit tremendously from this concept. For example, according to Cheek et al, “the most common disease that benefits from pharmacogenomics is cancer. Targeting of specific pharmacological therapies will assist in a greater understanding of the molecular causes of cancer” (2015, para. 12). They also note, “the Clinical Pharmacogenetics Implementation Consortium of the National Institute of Health Pharmacogenomics Research Network recommends that pharmacogenomics information be used in adjusting doses of Warfarin…” (2015, para. 13). Warfarin is often used as anticoagulation therapy in patients diagnosed with certain cardiac arrythmias. And also, per Cheek et al, “pharmacogenomics is also utilized in determining drug efficacy with the antiplatelet agent clopidogrel…” (2015, para. 14). Clopidogrel is often used in patients who have coronary artery disease and have undergone cardiac catheterizations with stent placement to maintain stent patency long-term. Pharmacogenomics is also used in the drug management of mental health disorders  Providing Genetic Nursing Care to Patients With Chronic Illnesses.Cheek et al notes, “this is the second largest therapeutic area that the FDA has identified with pharmacogenomics biomarkers in drug labeling” (2015, para. 25). In summary, the use of pharmacogenomics gives providers the ability to prescribe the precise drug and dosages for maximum efficacy and patient outcomes and minimizes, if not completely eliminates, the risk for adverse drug reactions.

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The nurse’s role is critical because one of our primary duties is safe medication administration. Advocacy involves advocating for and demanding implementation of all available safe administration practices, including precision drug and dosing practices made possible by pharmacogenomics. Nurses also have a duty to communicate with providers results of genetic testing if/when available. Nurses in certain specialties should also be competent to know when genetic testing is actually indicated before certain drugs are prescribed. For example, HIV+ patients with a certain genetic allele can have an adverse drug reaction to the commonly prescribe antiviral medication abacavir, resulting in fatal multi-organ hypersensitivity (Cheek et al, 2015). Nurses have the responsibility of monitoring, assessing, and advocating for the patients, as well as communicating and collaborating with other members of the health care team for the best possible outcomes for the patients. Nurses should also be educating the patients and their families about information that needs to be passed along to other specialties or providers and just so that the patient is aware and informed of his/her own health care information. We also have a duty to safely administer medications based on the correct patient, drug, dose, route and time. We should be monitoring and reassessing for the patient’s response to the drug. Nurses should be communicating immediately with the provider about any adverse drug reactions and provide interventions as indicated. Nurses also have an ethical responsibility to our patients. We have to first ensure that the patient is aware of genetic testing and understands how that information will be used in their health care. We should also ensure that they agree and are willing to have the testing done prior to the actual testing. This is important because it not only affects the patient, but also their family members who may be genetically predisposed, at risk for or managing some of the same conditions or diseases. Cheek et al notes,

The area of precision medicine is here, and the ability to tailor treatment for a myriad of acute and chronic health problems are vast due to the genomic, pharmacogenomic, and genetic explosion. Genetic testing can have a life-altering impact on patients and families. Nurses need to be prepared to first educate patients and families on the value of genetic testing, and then how the information can be used to help families make decisions about the medical management of family members.. Nurses serve as patient advocates for the best possible health outcomes by educating patients about the role pharmacogenomics play in their treatment plan. (2015, para. 31). NURS 4005 NURS 4006: Topics in Clinical Nursing

Pharmacogenomics provides an opportunity for nurses to safely administer the most effective drug and dosage, based on genetics, ultimately resulting in optimal patient outcomes with a minimized risk of adverse drug reactions.

 

Reference:

Cheek, D., Bashore, L., Brazeau, A. (2015). Pharmacogenomics and implications for nursing practice. Journal of Nursing Scholarship., 47(6), 496-504. Doi: 10.1111/jnu.12168

 

Discussion: Providing Genetic Nursing Care to Patients With Chronic Illnesses

There are several chronic health problems with genetic/genomic components that plague the population. These health problems are very difficult and challenging diseases to manage. Evidenced-based nursing practice must include genetic and genomic information when planning patient care. Nurses, through their knowledge and support, play an important role in positive patient outcomes when managing the challenges of these genetically linked diseases. Providing Genetic Nursing Care to Patients With Chronic Illnesses

For this Discussion, you will consider applications of various topics to genetics and genomics. Review the Resources focusing on the application of genetics and genomics to nursing

Choose one of the following subtopics:

  • Pharmacogenomics and chronic illnesses
  • Genomics in patient assessment
  • Genetically competent care for those with chronic illnesses

Note: A different subtopic relating to genetics and genomics may be chosen with Instructor approval.

Locate at least one scholarly journal article that discusses your subtopic.

By Day 3

Respond to the following:

  • Identify your subtopic and provide a brief summary of your journal article on how this topic relates to nursing practice.
  • What is the nurse’s role in providing care in relation to your subtopic and the overarching theme of advocacy?
  • What ethical implications should be considered with regard to genetics and genomics for nursing practice? Why?

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.

 

Discussion – Week 2
COLLAPSE

 

This week, I chose the subtopic of genomics in patient assessment, but the journal article also falls under the subtopic of genetically competent care for those with chronic illness. This week’s article focuses on the fact that in 2006, the American Nurses Association (ANA) created important competencies for all RNs, but over half of the nurses in practice receive no pre-licensure education on genetics and genomics (G/G) competencies. The article subsequently describes the current utilization of G/G nursing competencies in the acute setting in hospitals and the nurses’ perceptions of them (Newcomb et al., 2019).

The completion of the Human Genome Project has broadened the opportunities for the prevention, diagnosis and management of many diseases resulting in more demands for genetic services. The increasing demands are utilizing nongenetic health professionals to take family histories, conduct family history assessments, interpret results of genetic tests, provide G/G education, and advocate for patient referrals for genetic evaluations. For non-genetic nurses, mostly staff nurses, keeping up with genetic advancements is difficult partially because of the lack of genomic competencies, skills and confidence in integrating G/G into patient education and assessments. Because of the increasing demands of bedside nursing and the education involved to maintain staff nurse competencies, little attention is paid to G/G assessment competencies and patient education (Talwar, et al., 2017). Providing Genetic Nursing Care to Patients With Chronic Illnesses

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Clinical performance for nurses is usually evaluated using competencies that compare nurses’ current work performance with previously established standards of performance. Competencies should reflect the current realities in practice, connecting to performance improvement data and is ever changing. That being said, clinical nurses are expected to master many competencies directly related to their work specific environment, and there are some universal competencies, regardless of practice setting. NURS 4005 NURS 4006: Topics in Clinical Nursing

The ANA created a new set of essential G/G competencies because they usually have a disease or health disorder component. However, most clinical nurses are age 34 and over, with the average age being 48 years old. Many currently practicing nurses who attended nursing school immediately after high school or those who graduated before 2006, received no education about the G/G competencies in their prelicensure programs, but currently, there is very little empirical evidence of that clinical nurses are actually using these competencies. This journal takes a quick look at 10 hospitals over a four -week period and assess in a 38-item questionnaire and direct observation of the EMR to assess for evidence of RN documentation of G/G related care activities (Newcomb, et al., 2019).

While nurses with a graduate degree tended to report more significant competency performance, bedside nurses performed less if any and generally didn’t report any continuing education focusing on G/G. Only six components were performed by most of the respondents in the study with two of them being more concrete activities such as collecting health histories and conducting a physical exam with G/G in mind. Obtaining a family history has been taught as a nursing fundamental for decades, but the ANA suggests going back three generations, which was rarely performed (Newcomb, et al., 2019).

Medical management of chronic illness consumes 75% of money spent on healthcare in the United States making accessible, high quality care a major concern (Shaw, et al., 2014). With the vast amount of ever improving advances in personal  monitors, smart phones, watches, and the plethora of data on the internet, many conditions can be identified early, but an ethical issue remains of misuse of information or patients who may manipulate data to get information or push for a diagnosis of an illness that may not actually be appropriate. Genome sequencing is getting more affordable, allowing for the identification of risks that in some cases can be mitigated if not eliminated completely. However sometimes, more information can cause more ethical dilemmas and complicates decision making because genome sequencing is accurate in some case but can be just a predictor in other cases (Mehrian-Shai, et al.,2015).

Yearly competencies added to the multiple online and in person education for nurses both inpatient and outpatient settings, would be a great step towards obtaining pertinent data and increasing nurse confidence related to the education and integration of G/G. Much of this education should include the ethical complications of more advanced G/G testing. Also, a brief understanding of the role genetics plays in the treatment and prevention of disease should be reviewed each year to help bridge the gap for nurses who need a reminder of competencies and those who didn’t receive it in nursing school prior to actual nursing practice.

 

References

 

Mehrian-Shai, R., & Reichardt, J. K. V. (2015). Genomics is changing personal healthcare and medicine: the dawn of iPH (individualized preventive healthcare). Human Genomics9, 29. https://doi-org.ezp.waldenulibrary.org/10.1186/s40246-015-0052-0

 

Newcomb, P., Behand, D., SLEUTEL, M., WALSH, J., BALDWIN, K., & LOCKWOOD, S. (2019). Are genetics/genomics competencies essential for all clinical nurses? Nursing49(7), 54–60. https://doi-org.ezp.waldenulibrary.org/10.1097/01.nurse.0000554278.87676.ad NURS 4005 NURS 4006: Topics in Clinical Nursing

 

Shaw, R. J., McDuffie, J. R., Hendrix, C. C., Edie, A., Lindsey-Davis, L., Nagi, A., Kosinski, A. S., & Williams, J. W., Jr. (2014). Effects of nurse-managed protocols in the outpatient management of adults with chronic conditions: a systematic review and meta-analysis. Annals of Internal Medicine161(2), 113–121. https://doi-org.ezp.waldenulibrary.org/10.7326/M13-2567

 

Talwar, D., Tseng, T.-S., Foster, M., Xu, L., & Chen, L.-S. (2017). Genetics/genomics education for nongenetic health professionals: a systematic literature review. Genetics in Medicine : Official Journal of the American College of Medical Genetics19(7), 725–732. https://doi-org.ezp.waldenulibrary.org/10.1038/gim.2016.156 NURS 4005 NURS 4006: Topics in Clinical Nursing Providing Genetic Nursing Care to Patients With Chronic Illnesses.

Assignment: How Illnesses and Injuries Affect the Mind

Assignment: How Illnesses and Injuries Affect the Mind

Health complications can be stressful, especially in more vulnerable populations like young children and the elderly. With stress and loss of function often come depression and other psychological manifestations. As a nurse, part of your job is to recognize and educate patients and caregivers on how to deal with the psychological complications of a health crisis.

In this Assignment, you will educate either a caregiver of an elderly patient or a caregiver of a young child patient on ways to prevent and manage psychological manifestations. Review the Learning Resources dealing with injuries and depression and anxiety.

The Assignment:

Develop a teaching plan for treating the potential psychological issues that may result from health crises in either the elderly or young children. Assignment: How Illnesses and Injuries Affect the Mind. You will use PowerPoint to present your teaching plan. Some considerations to make include:

  • In what ways does mental health need to be considered across the illness/injury continuum?
  • How can nurses help both patients and caregivers work through mental blocks and depression associated with an illness or injury?
  • Although treatment will take place in a medical facility, how can non-medical treatments be used as a supplement? Assignment: How Illnesses and Injuries Affect the Mind

Support your idea with a minimum of three references from the professional nursing literature in the assigned course readings and other references in the Walden Library. If they are relevant, you may use one or two professional Web sites in addition to the literature references. Assignment: How Illnesses and Injuries Affect the Mind

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Include the main elements of your presentation to a group of parents or elderly or their caregivers. This PowerPoint presentation should include between 8–10 slides. It will be assessed using the Week 3 Assignment. Prior to submitting your Assignment, make sure to review the rubric, which is located in the Course Information area.

Note: Be sure to use the Walden Power Point template included in the Writing Resources and Program Success Tools.

Writing Resources and Program Success Tools

  • AWE Checklist (Level 4000)
    This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.
  • http://academicguides.waldenu.edu/writingcenter/templates/general
  • http://academicguides.waldenu.edu/writingcenter/scholarlyvoice
  • http://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859
  • http://academicguides.waldenu.edu/writingcenter/apa/citations/commonsources
  • Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.).
    Retrieved May 31, 2019, from  https://academicguides.waldenu.edu/ld.php?content_id=45326751

For this Assignment, review the following:

  • AWE Checklist (Level 4000)
  • Writing Resources and Program Success Tools
  • Week 3 Assignment Rubric

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 “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. Assignment: How Illnesses and Injuries Affect the Mind. Assignment: How Illnesses and Injuries Affect the Mind

NURS 4005 Discussion: Psychological Complications Resulting From Illnesses and Injuries

NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries
Discussion – Week 3

          For this week’s post, I will discuss a case from my time working on an inpatient psychiatric unit. A patient had come to the ER after concerned family and friends urged them to do so. During the

assessment, the patient divulged having suicidal ideations and depression related to a terminal cancer diagnosis. The patient was admitted to our unit for these very reasons. The task of providing hope and

helping the patient heal became difficult. How do you discuss the importance of choosing life when you’re faced with death?

          Our treatment team had to think. The psychiatrists and providers on the team decided to treat the depression and provide comfort. Discussions with nursing staff normalized death and touched on the

beautiful aspects of life the patient enjoys. Incorporating music the patient loved and the family that supported them was critical in finding peace for the individual. Psychiatric palliative nursing includes

interventions that form a support system for the patient and their family, affirms life, recognizes death as a normal process, and incorporates spiritual components into coping and treatment (Lindblad et al.,

2019). When offered specific medications to treat anxiety and depression associated with their cancer diagnosis, the patient would relay information about side effects and dissatisfaction with the mediation. As

a nursing staff, it was our job to ensure the patient adhered to a schedule to achieve therapeutic dosing. At the next day’s treatment team, we offered the patient’s medication preference as it comforted the

patient and assured compliance. The patient’s ordering providers well-received this. During shift assessments and follow-ups from the providers, however, the suicidal ideations did not dissipate.

         The patient talked with staff about physician-assisted suicide (PAS), but this was not an option for our treatment team. PAS is illegal in Pennsylvania; however, California, Colorado, District of Columbia,

Hawaii, Maine, New Jersey, Oregon, Vermont, and Washington allow individuals that are deemed mentally competent to make this choice (2020). This decision and process leads to many ethical and legal

questions. Even the providers and psychiatric liaisons involved in PAS have uncertainties about establishing a patient’s competency regarding assisted suicide. 6% of psychiatrists felt they could determine this

competence after a single session with the individual requesting physician-assisted suicide (Kelly & McLoughlin, 2009). NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries

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         While the patient’s chronic suicidal ideations would typically warrant intensive inpatient treatment, the patient’s discharge plan included palliative nursing care orders in the home. The treatment team felt

that inpatient psychiatric admission was furthering anxiety, as the patient felt certain aspects of their life were “passing by.” Through education and collaboration, a discharge plan was made. The patient felt

that with the medication regimen, identified coping skills, and family support, safety and treatment could be carried on at home. This discussion post made me reflect on difficult mental health nursing tasks

and how specialties in the nursing profession cross paths more often than I realized. It also brings thoughts of preparedness and education regarding this special patient situations. In the future, I would like to

have more informed treatment ideas for those suffering mental illness as related to terminal or debilitating illness/injury. NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries

References:

Kelly, B. D., & McLoughlin, D. M. (2009). Physician-assisted suicide and psychiatry. Psychiatry, 8(7), 276–279. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mppsy.2009.04.011

Lindblad, A., Helgesson, G., & Sjöstrand, M. (2019). Towards a palliative care approach in psychiatry: Do we need a new definition? Journal of Medical Ethics, 45(1), 26.

doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1136/medethics-2018-104944

Resources. (2020, March 17). Retrieved October 27, 2020, from https://www.deathwithdignity.org/learn/ NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries

 

 Discussion – Week 3

COLLAPSE

I have an interesting relationship and experience(s) with a patient of mine. When I first graduated nursing school I started working on a Neuro/Stroke unit. I frequently cared for an elderly woman (above the age of 65), who was experiencing a significant number of falls, and subsequently resulting in traumatic brain injuries. This became suspicious to me and the other nurses on my unit due to the number of admissions this patient had over a short period of time. Oddly, once I left the hospital and moved to a private neurosurgery practice, the physician I work for is the same physician who operated on this patient and oversees her outpatient care. It’s interesting as a nurse to have seen her in the acute setting, but also in the outpatient setting as well. Elder abuse is something near and dear to my heart as I believe it is overwhelmingly occurring in the health care world. Elder mistreatment is defined as intentional actions that cause harm or risk of harm (even if unintended), or failure to meet the elder’s basic needs and to protect them from harm (Wangmo, T., Nordstrom, K., Kressig R.W., 2016).  

Prior to her first known incident, she was known to have Alzheimer’s Dementia and lived at home with her husband, which she still does at this time. When she was admitted the first time, she had been wandering on the side of a highway and was hit by a truck. While she sustained several locations of brain bleeds, and then in turn Hydrocephalus, you can imagine the number of other injuries sustained as well. One of my first questions upon her admission was “why and how was she out on the main highway at night?” Turns out, this incident occurred while her husband was sleeping, and she escaped their home. So, we thought “no big deal, just a crazy accident.” However, we began to see more and more admissions over the period of 3-6 months. Every admission was something new (UTI’sunstageable bed sores, gangrene, etc.) she continued to decline cognitively and physically and was every bit related to the care or lack thereof she was receiving at home. I will never forget one incident that resulted in her admission. She was a diabetic that suffered from diabetic neuropathy and was also blind. When she came into the hospital maggots were literally eating her feet. I’ve never seen anything like it.  

Obviously, at this point in her inpatient care, there were a lot of team members involved such as social work and care management. They were our initial strategy in this situation as it was clear the patient was not being cared for at home. I’m not entirely sure of the intricate details of her situation, but her husband was an attorney and refused to place her in a long-term care facility. I remember discussing with the social worker how much disbelief I was that she was able to return home with him. I tried to advocate for her safety as she was unable to do so for herself. However, as a nurse in an inpatient setting, I felt our voices weren’t heard. Decisions at this level were made by physicians and social work. So then at that point, our focus shifted to educating the husband on her care, seeing if any other family members or friends could assist in the care, and having home health aide in care as well.  

Fast forward, she hasn’t had any recent hospitalizations, but we often see her in our clinic. How she is still under the care of her husband is beyond me. Last week when she was in our office for a follow-up, she was pulled out of the back of a van where a newspaper laid underneath her. Her hair was matted, her face from her chin to her eyebrows was covered by her mask, she had obviously not been bathed, and had been sitting in fecesWhen she arrived at our office, we contacted social services. I am still unaware of what has come of this situation. I expressed my concerns to her husband for her safety, and our physician urged placement in a long- term care facility.  NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries

According to research, elder mistreatment is defined by five types of abuse/neglect. These consist of physical abuse, emotional/psychological abuse, sexual abuse, financial exploitation, and neglect (Wangmo, T., Nordstrom, K., Kressig R.W., 2016). Shockingly, for every case of elder abuse and neglect (EAN) reported, 24 more cases remain unreported (Wangmo, T., Nordstrom, K., Kressig R.W., 2016). When examing elder abuse further and the statistics correlating with the abuse, 40% of Americans over the age of 65 experience some type of functional limitation (Zeranski, L., Halgin, R.P., 2011). It is also estimated that 13% of older Americans have a diagnosis of Alzheimer’s, and another 20% experience cognitive disabilities without dementia relating to issues such as depression, stroke, diabetes (Zeranski, L., Halgin, R.P., 2011). Research shows that older adults with the conditions as stated about are at much-increased risk of becoming victims of abuse and neglect and in turn, can experience significant issues with depression (Zeranski, L., Halgin, R.P., 2011). So, in examining my patient’s demographics and medical history, she easily falls into more than one of these categories and further explaining her risk of abuse.

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In addressing the legal and ethical issues with elder abuse and the reporting of such abuse, there are laws requiring investigation of these reports in all 50 states. However, each state has its own definition of elder abuse, and who is protected by these laws varies as well. (Zeranski, L., Halgin, R.P., 2011). Looking beyond the actual legal implications of elder abuse, there are a lot of ethical issues arising from this as well. Reporting elder abuse is keeping with ethic codes of beneficence and nonmaleficence, and respect for the patient’s rights and their dignity (Zeranski, L., Halgin, R.P., 2011). When looking at my patient’s situation specifically, she lacks the capacity to make her own decisions due to her medical issues. Her Dementia diagnosis alone creates an argument for lack of competency as it relates to her care. It is obvious that she is not being cared for adequately but, a nurse should examine the “cultural beliefs and patterns of adaptation of family members who neglect an elderly person’s personal and environmental health requirements rather than consider it a pathological finding” (Saghafi, A., Bahramnezhad, F., Poormallamizra, A., Dadgari, A., Navab, E., 2019). NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries

 

References  

Wangmo, T., Nordstrom, K., & Kressig, R. W. (2016, December 23). Preventing elder abuse and neglect in geriatric institutions:Solutions from nursing care providers. Elsevier. https://reader.elsevier.com/reader/sd/pii/S0197457216303111?token=5A239EB7C8AAFEFD10A10DFAFE842DE0D5F209EAB9390786083CFF20CE18AD0BE3D7634F6F4A9F77D20FE7EB661EA8DC 

Zeranski, L., & Halgin, R. P. (2011). Ethical issues in elder abuse reporting: A professional psychologist’s guide. Professional Psychology: Research and Practice, 42(4), 294–300. https://doi.org/10.1037/a0023625 

Saghafi, A., Bahramnezhad, F., Poormollamirza, A., Dadgari, A., & Navab, E. (2019). Examining the ethical challenges in managing elder abuse: a systematic review. Journal of medical ethics and history of medicine12, 7. 

 

Discussion: Psychological Complications Resulting From Illnesses and Injuries

The nurse’s role goes far beyond that which is expected. Nurses are the main communicators between patients, doctors, and family, and they care for more than just physical ailments. Often, nurses are presented with difficult situations where being an advocate becomes paramount to the healing of the patient. One of the issues that patients with acute and chronic illnesses or extended hospitalization face is a tendency to become depressed. The nurse’s role in this situation requires more than just attention to the physical problem. Another situation where a nurse may need to shift his or her care is when a patient presents with a suspicious injury or illness. In addition to considering the legal and ethical responsibilities of the nurse, he or she must consider the psychological undertones that may be present. NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries

For this Discussion, you will consider delicate situations that nurses often face and analyze the implications of these situations. Reflect on a patient care situation in which you have encountered one of the following:

  • A suspicious illness or injury
  • Depression resulting from illness or injury

Then, locate at least one scholarly journal article related to your patient care situation that offers strategies for managing the circumstances.

By Day 3

Respond to the following:

  • Explain your patient encounter, highlighting the challenges the situation presented, and briefly summarize the contents of your journal article.
  • What strategies did you employ to help handle the situation? What other strategies could you have used?
  • How did you advocate for the patient in the situation?
  • What are some of the legal and ethical implications that need to be considered when providing care for patients with depression resulting from illnesses or injuries or suspicious illnesses or injuries? NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries

Note: Avoid using personal information (e.g., names, facility name, etc.) in your post.

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.

Submission and Grading Information NURS 4005 4006 Discussion: Psychological Complications Resulting From Illnesses and Injuries