Do your interventions address further monitoring of the patient’s response to your interventions and to the achievement of the desired outcome? Are qualifiers: when, how, amount, time, and frequency used?

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ABNORMAL ASSESSMENT FINDINGS: Recognize Cues

Obtain information from various sources (e.g., the environment, the pt., the family, another nurse, EHR) in different formats (e.g., visual observation, audio perception, lab results, text description, etc.). TIME OUT!!!  Do you have an accurate match or are additional data required, or does another cue from abnormal assessment findings need to be investigated?

Assessment:  What are the identified abnormal findings:

  • List S&S= (Signs and symptoms, i.e., Abnormal Subjective and Objective Assessment Findings/lab results, etc.)

 

Analysis Cues

Interprets cues from their existing knowledge base and nursing perspective, evaluate cues in terms of relevancy, importance, and interrelationship among other cues, organize cues in the mental representation of the scenario (e.g., organize cues in clusters), and then develops a group of probable client needs/concerns and problems.

Prioritize Hypotheses

Evaluates the hypotheses generated previously in various dimensions (e.g., urgency, likelihood, risk/difficulty/time/cost of providing care to that hypothesis, etc.), and organize them into an ordered list where the priority hypotheses (i.e., client needs/concerns/problems) are on the top.

Analysis/Hypothesis: What is the cause of the patients problem that must be prioritized at this time?

  • Evaluate the Hypothesis = (Signs and symptoms, i.e., Abnormal Subjective and Objective Assessment Findings/lab results, etc.)

_________________________________________________________________________________________

Planning (Patient goals focus on resolving the problem), Must be SMART goals Generate Solutions

Develops a list of actions to address the priority hypothesis. The student nurse then selects the appropriate action from the list and carries out the action. TIME OUT!! The desired outcome must meet criteria to be accurate. The outcome must be specific, realistic, measurable, and include a time frame for completion. Does the action verb describe the patient’s behavior to be evaluated? Can the outcome be used in the evaluation step of the nursing process to measure the patient’s response to the nursing interventions listed below?

  • will (verbalize, demonstrate, be able to, increase & maintain, or decrease & maintain) __________________________________________________________________________
  • by the: (end of shift, end of day, discharge day) or within: (two hours; 12 hours, etc.) ____________________________________________________________________________________                                                 

Implementation (Specific nursing interventions that were performed during your shift): Take Action

Sorts the hypotheses (probable client needs, concerns, problems) in order (based on their evaluation in various dimensions) and carries out the action(s) to address the hypothesis/hypotheses with highest priority.

Must contain the following: Assess {observe, auscultate, palpate, percuss}; Monitor; Prepare, administer; Collaborate w/ specific multi-disciplinary team; & teach, i.e., VERBS

1._____________________________________________________________________________________                                                                                        

2.____________________________________________________________________________________                                                                                         

3._____________________________________________________________________________________                                                                                         

4. ____________________________________________________________________________________

Evaluation (What was the outcome: Did you meet your desired goal?) TIME OUT!! Re-Assess the Patient: Do your interventions address further monitoring of the patient’s response to your interventions and to the achievement of the desired outcome? Are qualifiers: when, how, amount, time, and frequency used? Is the focus of the action’s verb on the nurse

Goal; Met or Not met or partially met and how to revise.)

Goal: □ Met                          Goal: □ Not Met                  Goal: □ Partially Met                           Goal: □ Unable to Assess

Explain what your nursing diagnosis is (What is the main problem for this patient? What need to be addressed?). Explain what your goal is for helping the patient recover (What do you want to change for the patient?).

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Case study

In order to write a case study paper, you must carefully address a number of sections in a specific order with specific information contained in each. The guideline below outlines each of those sections.

Section Information to Include
Introduction (patient and problem)
  • Explain who the patient is (Age, gender, etc.)
  • Explain what the problem is (What was he/she diagnosed with, or what happened?)
  • Introduce your main argument (What should you as a nurse focus on or do?)
Pathophysiology
  • Explain the disease (What are the symptoms? What causes it?)
History
  • Explain what health problems the patient has (Has she/he been diagnosed with other diseases?)
  • Detail any and all previous treatments (Has she/he had any prior surgeries or is he/she on medication?)
Nursing Physical Assessment
  • List all the patient’s health stats in sentences with specific numbers/levels (Blood pressure, bowel sounds, ambulation, etc.)
Related Treatments
  • Explain what treatments the patient is receiving because of his/her disease
Nursing Diagnosis & Patient Goal
  • Explain what your nursing diagnosis is (What is the main problem for this patient? What need to be addressed?)
  • Explain what your goal is for helping the patient recover (What do you want to change for the patient?)
Nursing Interventions
  • Explain how you will accomplish your nursing goals, and support this with citations (Reference the literature)
Evaluation
  • Explain how effective the nursing intervention was (What happened after your nursing intervention? Did the patient get better?)
Recommendations
  • Explain what the patient or nurse should do in the future to continue recovery/improvement

Your paper should be 3-4 pages in length and will be graded on how well you complete each of the above sections. You will also be graded on your use of APA style and on your application of nursing journals into the treatments and interventions.

What is meant by evidence for nursing? Describe the difference between local and global evidence? In what situation would the use of local evidence be more desirable than external evidence?

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Critical thinking question

Create a Microsoft Word document and answer the following questions based on this module’s readings. Your response should be a minimum of 3–5 sentences in length, original (in your own words), and use professional writing.

  1. What is meant by evidence for nursing?
  2. Describe the difference between local and global evidence?
  3. In what situation would the use of local evidence be more desirable than external evidence?
  4. What databases/electronic sources of information enable you to access international evidence?
  5. You are having coffee with a fellow student or colleague who thinks that theory, frameworks, and models are a waste of time and have nothing to do with practical nursing care. How might you argue that they can help you in daily nursing practice?
  6. Can you imagine different situations or contexts in which one model may fit better and another in which you might adapt another model? Explain.

Create a patient who has presented to the office for a health assessment as a new patient. Provide the demographics of the patient and background that includes factors that impact their care.

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Adapting Nursing role

OBJECTIVE

The purpose of this discussion is to consider how individual factors can impact the health assessment. These factors include but are not limited to age, gender, mental health, literacy, disability, and culture. Students will discuss the impact of individual factors on the assessment and then collaborate on strategies to adapt the environment and assessment techniques to best facilitate the provider-patient relationship and data collection.

NOTE THE FOLLOWING:

  1. Scholarly sources include current peer-reviewed sources, practice guidelines from professional organizations, and databases used for clinical decisions making (such as UpToDate). Your course materials, textbooks, and websites do not count as scholarly sources.
  2. In order to obtain full credit, you must interact on more than three days. Posting your initial post and each peer post on a different day for three days total is only an 8/10 for this section of the rubric. An additional post that is substantive and adds to the conversation (not just “I agree” or “nice work”) is required to get 10/10 in this area of the rubric.
  3. A 100 in the discussion means you have exceeded the minimum requirements and the faculty does not have any suggestions for room for improvement for you.

INITIAL POST

Create a patient who has presented to the office for a health assessment as a new patient. Provide the demographics of the patient and background that includes factors that impact their care. Please then discussion how the age and these other individual factors have the potential to impact the provider-patient relationship and the health assessment (both subjective and objective findings).

These individual factors may include any factor that has the potential to impact the relationship or the assessment. Examples are age, gender, mental health, literacy, disability, culture, and language.

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. Make three decisions concerning the medication to prescribe to this client. Consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

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Nurs 6630 Psychopharmacological approaches to treatment of psychopathology

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Explain the topics in the worksheet by age. Identify one milestone and one expected norm for each category by age group.

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Observation Data

Explain the topics in the worksheet by age. Identify one milestone and one expected norm for each category by age group.

After you fill out the milestones and expected norms for each category by age group, observe a child of any age for 30 minutes to an hour, and apply the knowledge that you learned to the child you are observing and record this information in the purple Observation Data column.

Provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected.

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Literature Evaluation Table

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.

The assignment will be used to develop a written implementation plan.

For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws. What is the current benchmark for the organization and the numeric score for the underperformance?

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Nursing Question

Instructions

Propose an organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. ( diabetic foot exams metric) precise, professional, and persuasive in demonstrating the merit of your proposed actions.

Requirements

The policy proposal requirements outlined below correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.

  • Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
  • What is the current benchmark for the organization and the numeric score for the underperformance?
  • How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
  • What are the potential repercussions of not making any changes?
  • What evidence supports your conclusions?
  • Summarize your proposed organizational policy and practice guidelines.
  • Identify applicable local, state, or federal health care policy or law that prescribes relevant performance benchmarks that your policy proposal addresses.
  • Keep your audience in mind when creating this summary.
  • Analyze the potential effects of environmental factors on your recommended practice guidelines.
  • What regulatory considerations could affect your recommended guidelines?
  • What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)?
  • Explain ethical, evidence-based practice guidelines to improve targeted benchmark performance and the impact the proposed changes will have on the targeted group.
  • What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
  • How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law?
  • How can you ensure that these strategies are ethical and culturally inclusive in their application?
  • What is the direct impact of these changes on the stakeholders’ work setting and job requirements?
  • Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines.
  • Why is it important to engage these stakeholders and groups?
  • How can their participation produce a stronger policy and facilitate its implementation?
  • Present strategies for collaborating with the stakeholder group to implement your proposed policy and practice guidelines.
  • What role will the stakeholder group play in implementing your proposal?
  • Why is the stakeholder group and their collaboration important for successful implementation?

Organize content so ideas flow logically with smooth transitions.

Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.

Use paraphrasing and summarization to represent ideas from external sources.

Be sure to apply correct APA formatting to source citations and references.

Policy Proposal Format and Length

It may be helpful to use a template or format for your proposal that is used in your current organization. The risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your organization does not have these resources, many appropriate templates are freely available on the Internet.

Your policy should be succinct (about one paragraph). Overall, your proposal should be 4–6 pages in length.

Supporting Evidence

Cite 3–5 references to relevant research, case studies, or best practices to support your analysis and recommendations.

Portfolio Prompt: You may choose to save your policy proposal to your ePortfolio.

Explain and describe cultural and/or ethical, legal or regulatory issues related to your topic. Analyze and evaluate these articles in your submission.

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Searching and evaluating cultural and or ethical resources

This week, you will find three scholarly, peer-reviewed research articles on your topic. Remember that next week you will submit a paper on Cultural and/or Ethical perspectives of inquiry, so use this week’s assignment to prepare materials and collect information for that purpose.

Use articles that will help you explain and describe cultural and/or ethical, legal or regulatory issues related to your topic. You will analyze and evaluate these articles in your submission, which should include:

  • A brief introductory paragraph
  • Three separate paragraphs, one for each of the three articles, each presenting:
    • A brief 3–4 sentence summary of the article (use in-text citations)
    • An explanation as to what makes this source credible (in the WCU Library go to Research Guides > Research Basics > Evaluating Resources)
    • An explanation of why the article will be useful in addressing your problem or issue
  • A brief conclusory paragraph
  • An APA Style reference list on a separate page

Your paper should be 1–3 pages in length (including the References page). Adhere to APA Style throughout.

Review the rubric for further information on how your assignment will be graded.

Describe two risk factors associated with the selected outbreak, the route of transmission of the disease, and one epidemiological determinant for the selected outbreak.

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COMMUNICABLE DISEASE

B. Select one of the given communicable diseases that has had a regional outbreak in region C according to the “National Center for Chronic Disease Prevention and Health Promotion Regions” in the Web Links section. The outbreak must have occurred in the last 50 years:

  • influenza
  • measles
  • respiratory syndrome coronavirus
  • HIV/AIDS
  • Ebola virus
  • tuberculosis
  • Zika virus

C. Describe the outbreak of the disease selected in part A, including each of the following:

  • the name of the disease
  • the name of your CDC region impacted by the outbreak
  • the date (i.e., month and year) the outbreak was discovered in your CDC region
  • the other CDC regions impacted by the outbreak
  1. 1. Describe two risk factors associated with the selected outbreak, the route of transmission of the disease, and one epidemiological determinant for the selected outbreak.

D. Discuss how an outbreak of the disease from part A would impact your community at a systems level (e.g., the functioning of schools, local government, businesses, hospitals).

  • 1. Compare a community outbreak that occurred in a country outside of the U.S. at a systems level.
  • 2. Explain the reporting protocol for the community from local levels to the CDC if an outbreak of the selected disease were to occur in your CDC region.
  • 3. Discuss two strategies (e.g., patient education, community vaccine promotion) that you would recommend to prevent an outbreak of the selected disease in your CDC region and include why each strategy is recommended.D

D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

E. Demonstrate professional communication in the content and presentation of your submission.