Critically evaluate contemporary nursing practice and justify the need for future development in light of current evidence and policy direction in the field of adult nursing.

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Dignity from the service users perspective

For this assignment, you will conduct a narrative literature review of 4000 words on a topic that is related to Service users’ perspective.  interprofessional team working

Research topic: Dignity from a service user’s perspective

Aim– The aim is to identify, analyse and synthesise the qualitative evidence of dignity views and factors affecting it from the service users perspective in the context of nursing care and to compare synthesised finding from both nurses and older service users perspective in hospitals.

The essay should include;

1.Introduction

-Have an essay topic sentence that sets the whole scene

-Background information to elaborate the rationale for your
-chosen topic. Explain how the assignment developed and why a literature review on your chosen topic is.
-Mention how this literature review will contribute to your field of adultnursing.
-Mention which theme you have chosen (service user theme).

-State the aim of the essay, followed by sentences that tell the reader how you are going to achieve this. This can be done by presenting or introducing to the reader, in a chronological order, what you will be discussing throughout the essay.

2.Search strategy 300 words

To include;

-The types and nature of literature searched

-Search engines and databases used

-The use of Boolean operators (e.g. AND, OR, NOT), truncation, etc.

–  List the keywords used together with the Boolean operators, truncation or quotation marks used in searching.

– Search parameters/limiters applied (filters) e.g. date range, English language, peer-reviewed, country/ies of publication.

– Present the retrieval rate i.e. (1) the number of results from the initial search, (2) the number of results after applying limiters, and then (3) the final number of studies that you will review.

– Explain the criteria for including those particular studies in the review. In other words, state how you narrowed down the number of studies that you will review and how you were able to pick out the literature that is most relevant to the topic.

– The critical appraisal tool used

3.Review of the literature 2500 words

-Compare and contrast analyses made by the authors of the literature

· Identify any strengths, weakness or limitations of the literature (e.g. critically appraising the methodology used in the study, sampling method, the findings of the study, etc.)

· Offer your interpretation and judgement of the evidence.Present your analyses and arguments based on the knowledge you have gained from the literature.

· Present your appraisal of the literature with the help of the critical appraisal tool that you used.

· Remember, you must read each literature in detail for you to create a comprehensive body of knowledge in your essay. And from that body of knowledge, you will then generate your analyses, arguments and conclusions.

4.Summary 500 words

In this section, you are expected to draw together the key findings and judgements that you have made from your review of the literature section, and the implications of your findings to your field of nursing.There is no need to introduce new literature here as you are basically condensing the 2500 words that you used in your review of the literature section into 500 words. The purpose of this is to highlight your key findings, analyses, arguments and judgements based on the review that you have conducted. This is where the synthesis of the literature can be clearly established.

5.Conclusion 200 words

Revisit the aim of your essay, was it achieved?
– Reflect on your review, did it answer your research question?
– Evaluate the body of knowledge that you have produced, does it satisfy your research topic? Or did you identify gaps?
– If the literature doesn’t satisfy your research topic or if they not comprehensive enough, what do you recommend?

Ps-To consider

-Critically evaluate contemporary nursing practice and justify the need for future development in light of current evidence and policy direction in the field of adult nursing.

-Demonstrate the ability to assess and evaluate the delivery of care to individuals with complex health needs in the field of adult nursing.

-Critically evaluate the skills required by the nurse to engage and involve individuals, families and communities in decisions regarding their health and well-being in the field of adult nursing.

-Demonstrate the knowledge and skills required by the nurse when advocating for and on behalf of service users/clients in the field of adult nursing.

-Critically appraise the skills required for partnership working with service users / clients and other professionals in the field of adult nursing.

-Reflect on individual professional development within the field of adult nursing, and identify ongoing personal training and development needs

 

Provide an example of a non‐healing interaction that occurred between you and a coworker or patient. How did you handle the situation? What information from the literature could you have used in the situation?

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Non-Healing Behavior and Communication.

  • Provide an example of a non‐healing interaction that occurred between you and a coworker or patient.
  • How did you handle the situation?
  • What information from the literature could you have used in the situation?
  • Explain why these were effective.
  • Use examples and references from at least three sources of literature.

Completion:

The initial discussion posting should be at least five paragraphs. The initial discussion posting should be typed, copied, pasted, and entered in the discussion forum space.  Attach the word document.

To successfully complete the discussion forum, you must post your initial discussion and reply to TWO different student posts by the due date in Moodle. Spread your responses to other student posting over three days to get a variety of postings to respond to.

Support your narrative with citations and references with information from your text or the literature. The student is to observe rules of grammar, spelling, and punctuation and demonstrate a good writing style and flow as established by the APA Style Manual.

 

In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain?

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CASE STUDY ANKLE

Evaluate abnormal musculoskeletal findings
Apply concepts, theories, and principles relating to health assessment techniques and diagnoses for the musculoskeletal system
Evaluate musculoskeletal X-Ray imaging
Case 2: Ankle PAIN

A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?

Demonstrate a critical understanding of the importance of individualised assessment, planning, delivery, and evaluation of post-anaesthesia care using evidence-based practice. Critically examine the need for effective communication to ensure safe transfer of patients into and out of the post-anaesthesia care unit.

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Mastectomy Surgical Case Study

INTRODUCTION

Welcome to module PUP 2230 Principles of Post-Anaesthetic Care.

On successful completion of all the elements within the module, you will be awarded 20 credits at Level 5.  

This module is intended to enable the student to develop knowledge and understanding of post-anaesthesia recovery. The core elements, in accordance with the AAGBI guidelines, will include communication, assessment and management of the airway, assessment and management of breathing, assessment and management of circulation, assessment of level of conscious, assessment and management of postoperative pain, nausea and vomiting, monitoring during recovery, intravenous access and fluid balance, applied knowledge of pharmacology in perioperative care, managing recovery emergencies and post-surgical care. This module will also cover some aspects of maintaining health and safety and clinical governance, safeguarding/child protection.

Throughout the module we will be your module leaders and our contact details are listed on this handbook cover.  If you wish to arrange a tutorial outside the timetabled support, please contact us to arrange an appointment.  This will ensure that we are available to see you and will prevent a wasted journey for yourself.

On behalf of all the staff within the Faculty of Health, Social Care and Medicine, we would like to offer you a warm welcome, we hope that you enjoy this module and wish you every success.

ONLINE LEARNING  

Module materials will be delivered via a web-based platform in keeping with the existing modules within the BSC ODP curriculum.  All classroom materials will be available from within the VLE as web pages. This offers the advantage of learning materials being available to students beyond the classroom thus enabling students to have additional learning opportunities should they miss a session or choose to revisit materials at a later date.  Web based materials will also include short videos and interactive case notes that form the basis of online discussion. Unit activities will be via asynchronous online discussion, which facilitates enhanced peer collaboration, sharing of ideas and reflection on practice.

  LEARNING OUTCOMES 

On successful completion of the module students will be able to:

 

  1. (ODP 2001) Apply the principles of pharmacology to perioperative care and demonstrate the ability to manage medicines safely. (HCPC 2.6, 10.1, 10.2, 14.8, 14.9)
  2. Demonstrate a critical understanding of the importance of individualised assessment, planning, delivery, and evaluation of post-anaesthesia care using evidence-based practice. (HCPC 4.1-4.3, 13.1-13.4, 13.7, 13.10, 13.14, 13.15, 14.2-14.3, 14.5-14.7, 14.10, 14.12)
  3. Critically examine the need for effective communication to ensure safe transfer of patients into and out of the post-anaesthesia care unit. (HCPC 7.1-7.3, 8.1-8.11, 9.19.5, 14.13-14.20, 14.25)
  4. Demonstrate the ability to adhere concisely to the requirements contained within the assessment brief

In inpatient pediatric psychiatric patients who are experiencing acute behavioral crisis, how does administering a PRN medication compared with a non-pharmacological intervention, affect the time and/or efficacy it takes for overall success of the resolution of the crisis behavior?

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Resolution of the crisis behavior

In inpatient pediatric psychiatric patients who are experiencing acute behavioral crisis, how does administering a PRN medication compared with a non-pharmacological intervention, affect the time and/or efficacy it takes for overall success of the resolution of the crisis behavior?

Describe a situation in the workplace that pertained to team effectiveness and culture of safety that you either observed or were a part of and how the nurse manager or leader responded.  Identify appropriate and inappropriate behaviors that were manifested. 

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Discussion Board 2: Managing Conflict and Team Building

An unhealthy work environment is predisposed to disruptive behaviors, errors and adverse outcomes, poor patient satisfaction, and increased problems with staff dissatisfaction and burnout.  All staff are responsible ethically and legally to promote a safe and healthy work environment that fosters respect and collaboration.

The goal of giving high-quality patient care and promoting a culture of safety for both staff and patients is of the highest priority for nursing staff.

This discussion allows the student to apply some of the principles learned in this course to actual situations.  It is important to feel confident about applying these principles to actual situations.

1 – Week Discussion Board Rubric

 

Discussion Board Objectives 

  1. Describe types of conflict observed in the workplace (Course Objectives 2, 4, 5 and Student Learning Objectives 1, 2, 6, 8)
  2. Assess how the principles of conflict resolution apply (Course Objectives 2, 3, 4 and Student Learning Objectives 1, 2, 5, 6, 8)
  3. Create applicable approaches to manage conflict (Course Objectives 1, 2, 3, 4 and Student Learning Objectives 1, 2, 6, 8)
  4. Evaluate types of workplace violence (Course Objectives 1, 2, 4, 5 and Student Learning Objectives 1, 2, 5, 6, 7)
  5. Compare methods nurse leaders can utilize to create and sustain a healthy work environment (Course Objectives 1, 2, 3, 4, 5, and Student Learning Objectives 1, 2, 3, 5, 7, 8)
  6. Develop the role of nurse leaders in fostering teamwork and collaboration (Course Objectives 1, 2, 3, 4 and Student Learning Objectives 1, 2, 4, 6, 8)

 

Learning Activities

Read: Murray, E. (2017).  Nursing leadership and management. Chapters 6, 14, and 15

Appreciative Inquiry: Building Teamwork and Leadership (Links to an external site.)

View the following videos:

Read the information on the following website and take the brief quiz

Directions:

  1. Describe a situation in the workplace that pertained to team effectiveness and culture of safety that you either observed or were a part of and how the nurse manager or leader responded.
  2. Identify appropriate and inappropriate behaviors that were manifested.
  3. What principles of conflict resolution were observed?
  4. Describe the outcome of the situation and whether or not it contributed to a healthy work environment and culture of safety.
  5. Give an example of how AI could be used to focus on a positive resolution.
  6. If the situation had an undesirable outcome, discuss strategies and principles of conflict resolution that could have improved the outcome.

 

What is the rationale for immediately starting BF on oxygen? Keeping in mind BF’s health history and presenting complaints, what are the most important areas you need to evaluate during your physical assessment?

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Nursing case study

Respiratory Case Study:

Scenario: BF, a 31 year-old man who lives in a small mountain town in West Virginia, is highly allergic to dust and pollen and has a history of mild asthma.  BF’s wife drove him to the emergency room when his wheezing was unresponsive to his fluticasone/salmeterol (Advair) inhaler, he was unable to lie down, and he began to use accessory muscles to breathe.  BF is immediately started on 4L of oxygen by nasal cannula and intravenous (IV) D5W at 75 mL/hr.  A set of arterial blood gases (ABG) is sent to the laboratory.  BF appears anxious and says that he is short of breath.

 

Chart:

Vital signs:

BP                          152/84

Pulse                     124 bpm

Resp rate             42 breaths/min

Temp                    100.® F

 

Discussion topics:

  1. What is the rationale for immediately starting BF on oxygen?
  2. Keeping in mind BF’s health history and presenting complaints, what are the most important areas you need to evaluate during your physical assessment?

Chart:

ABGs

pH          7.31

Paco2    48

HCO3     26

Pao2      55

 

Chart:

Medication Orders:

Albuterol 2.5mg plus ipratropium 250 mcg nebulizer treatment stat

Albuterol (Ventolin) inhaler 2 puffs po q4hrs

Metaproterenol sulfate (Alupent) 0.4% nebulizer treatment q3hrs

Fluticasone (Flovent HFA) MDI: 220 mcg, 1 puff twice daily

 

  1. What is the rationale for the albuterol 2.5 mg plus ipratropium 250 mcg nebulizer treatment STAT (immediately)?
  2. Indicate the drug classification and expected outcome BF should experience with using metaproterenol sulfate (Alupent) and Fluticasone (Flovent).

You assess BF and find that he has diminished lung sounds with inspiratory and expiratory wheezing in all lung fields with a nonproductive cough and accessory muscle use.  His skin is pale, warm, and dry.  The electrocardiogram shows sinus tachycardia without ectopy.  He is alert and oriented x4 spheres.  He appears anxious and is sitting upright, leaning over the bedside table, and continuing to complain of shortness of breath.

  1. What is your primary nursing goal at this time?
  2. You will need to monitor BF closely for the next few hours. What is the most serious complication to anticipate?
  3. Identify four signs and symptoms of this complication you will assess for in BF.
  4. When combination inhalation aerosols are prescribed without specific instructions for the sequence of administration, you need to be aware of the recommendations for safe drug administration. Describe the correct sequence for administering BF’s treatments.
  5. What are your responsibilities for administering aerosol therapy?

 

After several hours and aerosol treatments, BF’s wheezing and dyspnea resolve, and he is able to expectorate his secretions.  The provider discusses BF’s asthma management with him; BF says he has had several asthma attacks over the last few weeks.  The provider discharges BF with a prescription for oral steroid “burst” (prednisone 40 mg/day X 5 days), fluticasone/salmeterol (Advair HFA 230/21) two inhalations every morning and evening, albuterol (Proventil) metered-dose inhaler (MDI) two puffs q6h as needed (prn) with spacer, and montelukast (Singulair) 10 mg daily each evening.  He instructs BF to call the pulmonary clinic for follow-up with a pulmonary specialist.

  1. What is the rationale for BF being on the oral steroid burst?
  2. How does montelukast (Singulair) differ from other asthma medications?

BF state that h had taken his Advair that morning, then again when he started to feel short of breath.  He states, “It did not help,” and wants to know why he has to remain on it.  Is fluticasone/salmeterol (Advair) appropriate for use during an acute asthma attack? Explain.

  1. Based on this information, what specific issue do you need to address in discharge teaching with BF?

You ask BF to demonstrate the use of his MDI.  He vigorously shakes the canister, holds the aerosolizer at an angle (pointing toward his cheek) in front of his mouth, and squeezes the canister as he takes a quick, deep breath.

  1. What common mistakes has BF made when using the inhaler?
  2. You review the proper use of an MDI with BF and possible side effects he may experience, including hoarseness, dry mouth, white spots in the oral cavity, coughing, and headaches. What actions can you teach him to prevent or diminish the incidence of these effects? Select all that apply:
    1. Decrease his fluid intake
    2. Use a spacer on the inhaler
    3. Use the inhaler only as prescribed
    4. Rinse out his mouth immediately after using the inhaler
    5. Clean the spacer in the dishwasher on “hot cycle with heated dry” daily

 

The health care provider suspects Mrs. Pelletier has osteoporosis. What are her risk factors for osteoporosis? What studies could be done to support the diagnosis of osteoporosis? Mrs. Pelletier’s diagnostic testing yielded a bone density T-score of -3. What does this mean?

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OSTEOPOROSIS

Use the Osteoporosis case study to complete the assignment. Review the client profile, subjective date, objective data and diagnostic studies to complete the case study in Sherpath. After completing the case study, use the information to answer the following discussion questions.

The health care provider suspects the client has osteoporosis. What are her risk factors for osteoporosis?
What studies could be done to support the diagnosis of osteoporosis?
What clinical manifestations of osteoporosis does the client present with?
The client is prescribed alendronate. What instructions will you provide the client in regards to taking this medication?
What nutritional teaching is important of the client with her new diagnosis of osteoporosis?
What other teaching is appropriate for this client?
Answer the questions and format in an essay style paper. Introduce the client prior to answering the questions. Your conclusion is the evaluation of the teaching plan. It is required that you use APA format for your essay and references.Case Study
Musculoskeletal Problems
Case Study: Osteoporosis
approx 30 min
Patient Profile

Mrs. Pelletier is a 75-year-old female who presents to the health care provider’s office for back pain. She has a history of hypertension, Crohn’s disease, and hypothyroidism. She is currently taking the following medications:

Metoprolol 50 mg PO twice daily
Sulfasalazine 500 mg PO twice daily
Prednisolone 5 mg PO twice daily
Levothyroxine 75 mcg PO daily,/li>
Subjective Data

Has had some mid-back pain for the past week, which is worse when standing or walking and is relieved a little by lying down
Her back pain at the moment is a level 4, on a 1 to 10 scale
Denies any recent injury to her back
Broke her wrist a few months ago, but doesn’t know how
Her Crohn’s disease just ‘flared up’ a couple of weeks ago
Lactose intolerant
Objective Data

Temperature 98.2° F, pulse 74, respirations 16, blood pressure 130/78
Height 5 feet 3 inches, Weight 100 lb, BMI 17.7 kg/m2
Kyphosis of the spine

Question 1
The health care provider suspects Mrs. Pelletier has osteoporosis. What are her risk factors for osteoporosis?

Mrs. Pelletier’s risk factors for developing osteoporosis are her gender (female), age (>65 yr), low body weight, Crohn’s disease (due to malabsorption problems), nontraumatic fracture of her wrist, and use of corticosteroids for her Crohn’s disease and levothyroxine for her hypothyroidism.

Question 2
What studies could be done to support the diagnosis of osteoporosis?

Bone mineral density (BMD) measurements are typically used to assess the mass of bone or how tightly the bone is packed. Types of BMD studies include quantitative ultrasound (QUS) and dual-energy x-ray absorptiometry (DEXA).

Question 3
Mrs. Pelletier’s diagnostic testing yielded a bone density T-score of -3. What does this mean?

A T-score of -3 means that Mrs. Pelletier’s BMD is 3 standard deviations below the mean BMD of young adult. Any score greater than 2.5 standard deviations is defined as osteoporosis.

Question 4
Mrs. Pelletier is prescribed alendronate. What instructions should Mrs. Pelletier receive regarding taking this medication?

There are gastrointestinal side effects associated with taking bisphosphonates such as alendronate including dyspepsia, abdominal pain, and the most common one, esophageal irritation or esophagitis. To decrease these side effects, teach Mrs. Pelletier to take her alendronate with a full glass of plain water 30 minutes before food or other medications, and to remain upright for at least 30 minutes after taking it.

Question 5
What nutritional teaching is important for Mrs. Pelletier with her new diagnosis of osteoporosis?

Treatment of osteoporosis focuses on adequate calcium intake. Teach Mrs. Pelletier to take calcium 1500 mg/day. Due to Mrs. Pelletier’s lactose intolerance, she is not able to consume dairy products to get her daily calcium intake. Foods that are high in calcium that do not have lactose include almonds, sardines, salmon, turnip greens, and spinach. Supplemental calcium is likely if dietary intake of calcium is inadequate. Vitamin D is also necessary for calcium absorption and function and may have a role in bone formation. The recommended dosage for postmenopausal women is 800-1000 IU/day.

Question 6
What other teaching is appropriate for Mrs. Pelletier?

Moderate amounts of exercise are important to build up and maintain bone mass. The best exercises are weight-bearing exercises that force the individual to work against gravity. Exercises that are low impact, such as walking, hiking, weight training, and dancing, are recommended to avoid stress fractures associated with high-impact activities. Review with her general measures to reduce her risk of falling, including getting up slowly, wearing well-fitting shoes, removing any loose rugs in the house, making sure all of the walkways are kept clear, using grab bars and nonskid mats in the bathroom, and having appropriate lighting, particularly at nighttime.

Analyse the epidemiology of Acute Kidney Injury. Discuss underlying pathophysiological processes which lead to Acute Kidney Injury.

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Assessment and Management of Patients with Acute Kidney Injury

1. Analyse the epidemiology of Acute Kidney Injury.

2. Discuss underlying pathophysiological processes which lead to Acute Kidney Injury.

What is something new you learned while listening to the webinar that may change your practice as an advanced practice nurse. What is something new you learned when completing the learning activity that may change your practice as an advanced practice nurse.

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ADHD Assessment

Application of Learning Activity:

Review the assessment below and think about either your own child, someone in your family or someone that you know.

https://chadd.org/wp-content/uploads/2019/01/ADHD_Parent_Initial.pdf

Student Time Allocation:  Approximately 6 hours each

  • Webinar attendance – 1 hour
  • Suggested readings – 2 hours
  • Application of learning (independent field experiences) – 2 hours
  • Debrief including written reflection– 1 hour

 

Debrief

Answer the Following Questions:

  1. What is something new you learned while listening to the webinar that may change your practice as an advanced practice nurse.
  2. What is something new you learned when completing the learning activity that may change your practice as an advanced practice nurse.
  3. Reflect on how you will apply what you have learned to educating nursing students or if you are in a professional development role, nursing and hospital staff.

Student Documentation of Learning:

  • Students will enter the Direct Care Application Activities on the Practicum Log
  • Students will attend or engage with all of the following:
    • Webinar
    • Assigned Reading
    • Field experiences to put learning into practice
    • Debrief to include written Reflection
  • Student will complete the above questions on this document and upload this document along with the practicum log to get credit for the webinar.