You are the registered nurse (RN) on duty for the morning shift in the Emergency Department (ED) of a regional hospital. Your shift commenced at 0700 hours on Monday March 30, 2015 and you have been assigned to care for Mr Ben Forrester. Ben has a past history of pancreatitis and diabetes.

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Critical care nursing

Order Description

Instructions to students
When addressing the assignment topic it is expected that you will write in the third person, read widely around the topic and correctly reference your paper using APA referencing style. Please note: referencing constitutes 20% of your overall mark for this assessment.. Please ensure all assessable items are in the body of the paper, as the appendix will not be marked.
A 3500 word limit has been set for this assignment. A 10% leeway on either side of the word limit will be accepted. Word count will be measured from the first word of the introduction to last word of the conclusion and include intext references and page numbers. Not included in the word count are the abstract, contents page and reference list. Use 10 peer Journals and 10 database’s no older than 3 yrs. Intext referencing with page numbers included in the intext

Assignment Task
You are the registered nurse (RN) on duty for the morning shift in the Emergency Department (ED) of a regional hospital. Your shift commenced at 0700 hours on Monday March 30, 2015 and you have been assigned to care for Mr Ben Forrester. Ben has a past history of pancreatitis and diabetes.
Examine the case study available and address the following questions. Be sure to clearly relate your answers to the person in the case study:
1. Briefly discuss pancreatitis and diabetes and explain how these medical conditions would affect Ben (300 words)
2. Discuss the collaborative care needs of Ben during your shift (500 words).
3. Prioritise the nursing care needs of Ben. Develop a plan of care for Ben for your shift that recognises his individual needs. Please note this should not be a nursing care plan but a plan of what you would do for the person in the case study and the care priority order for your shift. This plan should include primary assessment, allocation of a triage score and secondary assessment. Be sure to include ethical and legal issues as well as nursing interventions to assist family members cope with their loved one’s illness and hospitalisation (2700 words).
Self Reflection
Critical thinking and problem solving skills are key attributes required by the registered nurse. To be able to effectively critically think and problem solve the registered nurse must also be able to critically reflect on their own knowledge and skills.
The assignment for this course requires you to assess your client, identify collaborative strategies and develop the plan you will use to care for the client for your 8 hour shift. You will need to make judgments about the care already ordered or undertaken. You may conclude that your client requires certain procedures and medications and will need to discuss how you will obtain these for the client. You need to use your nursing assessment skills and judgments to plan the client’s care and make nursing decisions. Please remember, this is not a nursing care plan but a plan of how you will provide care to your client for your shift.

You should use relevant journal articles when doing the assignment for this course.
So please ensure you focus on using the latest evidence rather than relying on textbooks which maybe out of date.

APA style, 20 references, use the latest journals also in text referencing to be used 3,500 words. No data bases to be older than 2 years old.

1. Title page needed.
2. Abstract What is an abstract?
An abstract is a stand-alone statement that briefly conveys the essential information of a paper, article, document or book. Like an executive summary, an abstract presents the objective, methods, results, and conclusions of a research project. It is a brief summary that appears as the first section of a paper.
The abstract should be a clear, concise summary of the essential information in all the sections of your research paper. As such, it should be written last and appear as an overall summary of essential information only. The abstract’s length will depend on the depth of the original source. However, it is usually between 150 and 250 words. The abstract is a very brief summary–it does not take the place of the introduction.
Often, abstracts are published without the complete paper either in abstract journals or in online databases. A researcher often makes a decision on whether to read the paper on the basis of the abstract so it must be a compact and concise summary of the complete paper.
An abstract should:
describe the objective, methods, results, and conclusions of the complete paper
omit background information, a literature review, and detailed description of methods
avoid reference to other literature and sources.
I am happy to accept acronyms in the abstract but the full word then acronyms are need for the first time in the body of the paper. You can then use acronyms in the paper.
3. Contents page
4. Introduction – sets the scene – gives a brief overview of the client and enables the reader to know the direction of the paper.
5. Contents of the paper – this can be in any style including table format.
Q1 you need to broadly identify pathophysiology issues related to the client’s condition. This does not need to be detailed just a brief look at the issues as this is not a paper on pathophysiology or disease processes.
Q2 You can do this by person needing to be consulted and for your shift it would be the primarily the MO – or by system as outlined in Q1 e.g. – related to alterations GIT in function.
Also need to discuss medications with MO e.g. Ben’s need for pain relief.
Doing by person needing to be consulted may be more word economical as you could include all you need to discuss with the MO under the heading of MO. Again it only needs to be brief and only for your shift.
Q3 In this section of the paper you discuss your nursing assessment in detail and your nursing interventions for your shift plan and rationale for these – this is your shift plan. So you can start with preparing the bed area – but this could be done in the introduction or as the first point in your shift plan. This would be followed by discussion of airway e.g airway is patent as client talking but continual airway assessment needed during shift to detect any changes. Something such as this is all that is needed.
Breathing – resp assessment, change of oxygen delivery device, etc and so on and why you need to do these nursing interventions.
Then you do C, D and E
Triage
Then Secondary Survey
Remember to include rationales for cares and important – this is only for one shift.
6. Conclusion

healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event such as the one described below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood

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leadership nursing 2-2

healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event such as the one described below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario, you have been selected as a member of the team investigating the incident.

Scenario:

It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time, Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog.

Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, R-32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates pain at ten out of ten on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s leg is stabilized and then he is further evaluated and discharged from triage to the emergency department (ED) patient room. He is admitted by Nurse J. The admitting nurse finds that Mr. B has a history of impaired glucose tolerance and prostate cancer. At Mr. B’s last visit with his primary care physician, laboratory data revealed elevated cholesterol and lipids. Mr. B’s current medications are atorvastatin and oxycodone for chronic back pain. After the nurse completes Mr. B’s assessment, Nurse J informs the ED physician of admission findings and the ED physician proceeds to examine Mr. B.

Staffing on this day consists of two nurses (one RN and one LPN), one secretary, and one emergency department physician. Respiratory therapy is in-house and available as needed. At the time of Mr. B’s arrival, the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing headache. The patient rates current pain at four out of ten on numerical verbal pain scale. The patient states that she has a history of migraines. She received treatment, remains stable, and discharge is pending. The second patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for this patient. Both of these patients were examined, evaluated, and cared for by the ED physician and are awaiting further treatment or orders.

After evaluation of Mr. B, Dr. T, the ED physician, writes the order for Nurse J to administer diazepam 5 mg IVP to Mr. B. The medication diazepam is administered IVP at 4:05 p.m. After five minutes, the diazepam appears to have had no effect on Mr. B, and Dr. T instructs Nurse J to administer hydromorphone 2 mg IVP. The medication (hydromorphone) is administered IVP at 4:15 p.m. After five minutes, Dr. T is still not satisfied with the level of sedation Mr. B has achieved and instructs Nurse J to administer another 2 mg of hydromorphone IVP and an additional 5 mg of diazepam IVP. The physician’s goal is for the patient to achieve skeletal muscle relaxation from the diazepam, which will aid in the manual manipulation, relocation, and alignment of Mr. B’s hip. The hydromorphone IVP was administered to achieve pain control and sedation. After reviewing the patient’s medical history, Dr. T notes that the patient’s weight and current regular use of oxycodone appear to be making it more difficult to sedate Mr. B.

Finally at 4:25, the patient appears to be sedated and the successful reduction of his (L) hip takes place. The patient appears to have tolerated the procedure and remains sedated. He is not currently on any supplemental oxygen. The procedure concludes at 4:30 p.m. and Mr. B is resting without indications of discomfort and distress. At this time, the ED receives an emergency dispatch call alerting the emergency department that the emergency rescue unit paramedics are en route with a 75-year-old patient in acute respiratory distress. Nurse J places Mr. B on an automatic blood pressure machine programmed to monitor his B/P every five minutes and a pulse oximeter. At this time Nurse J leaves his room. The nurse allows Mr. B’s son to sit with him as he is being monitored via the blood pressure monitor. At 4:35, Mr. B’s B/P is 110/62 and his O2 sat is 92%. He remains without supplemental oxygen and his ECG and respirations are not monitored.

Nurse J and the LPN on duty have received the emergency transport patient. They are also in the process of discharging the other two patients. Meanwhile, the ED lobby has become congested with new incoming patients. At this time, Mr. B’s O2 saturation alarm is heard and shows “low O2 saturation” (currently showing a sat of 85%). The LPN enters Mr. B’s room briefly and resets the alarm and repeats the B/P reading.

Nurse J is now fully engaged with the emergency care of the respiratory distress patient, which includes assessments, evaluation, and the ordering respiratory treatments, CXR, labs, etc.

At 4:43, Mr. B’s son comes out of the room and informs the nurse that the “monitor is alarming.” When Nurse J enters the room, the blood pressure machine shows Mr. B’s B/P reading is 58/30 and the O2 sat is 79%. The patient is not breathing and no palpable pulse can be detected.

A STAT CODE is called and the son is escorted to the waiting room. The code team arrives and begins resuscitative efforts. When connected to the cardiac monitor, Mr. B is found to be in ventricular fibrillation. CPR begins immediately by the RN, and Mr. B is intubated. He is defibrillated and reversal agents, IV fluids, and vasopressors are administered. After 30 minutes of interventions, the ECG returns to a normal sinus rhythm with a pulse and a B/P of 110/70. The patient is not breathing on his own and is fully dependent on the ventilator. The patient’s pupils are fixed and dilated. He has no spontaneous movements and does not respond to noxious stimuli. Air transport is called and, upon the family’s wishes, the patient is transferred to a tertiary facility for advanced care.

Seven days later, the receiving hospital informed the rural hospital that EEG’s had determined brain death in Mr. B. The family had requested life-support be removed, and Mr. B subsequently died.

Additional information: The hospital where Mr. B. was originally seen and treated had a moderate sedation/analgesia (“conscious sedation”) policy that requires that the patient remains on continuous B/P, ECG, and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria (i.e., fully awake, VSS, no N/V, and able to void). All practitioners who perform moderate sedation must first successfully complete the hospital’s moderate sedation training module. The training module includes drug selection as well as acceptable dose ranges. Additional (backup) staff was available on the day of the incident. Nurse J had completed the moderate sedation module. Nurse J had current ACLS certification and was an experienced critical care nurse. Nurse J’s prior annual clinical evaluations by the manager demonstrated that the nurse was “meeting requirements.” Nurse J did not have a history of negligent patient care. Sufficient equipment was available and in working order in the ED on this day.

Task:

A. Complete a root cause analysis (RCA) that takes into consideration causative factors, errors, and/or hazards that led to the sentinel event (this patient’s outcome).

B. Discuss a process improvement plan that would decrease the likelihood of a reoccurrence of the outcome of the scenario.

1. Discuss a change theory that could be used to implement the process improvement plan developed in B.

C. Use a failure mode and effects analysis (FMEA) to project the likelihood that the process improvement plan you suggest would not fail.

1. Identify the members of the interdisciplinary team who will be included in the FMEA.

2. Discuss steps for preparing for the FMEA.

3. Apply the three steps of the FMEA (severity, occurrence, and detection) to the process improvement plan created in part B.

4. Explain how you would test the interventions from the process improvement plan from part B to improve care in a similar situation.

Note:You are not expected to carry out the full FMEA, but you should explain each step, and how you would apply it to your process improvement plan.

D. Discuss how the professional nurse may function as a leader in promoting quality care and influencing quality improvement activities.

E. When you use sources to support ideas and elements in a paper or project, provide acknowledgement of source information for any content that is quoted, paraphrased or summarized. Acknowledgement of source information includes in-text citation noting specifically where in the submission the source is used and a corresponding reference, which includes:

• Author

• Date

• Title

• Location of information (e.g., publisher, journal, or website URL)

Note: The use of APA citation style is encouraged but is not required for this task. Evaluators will offer feedback on the acknowledgement of source information but not with regard to conformity with APA or other citation style.

Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly

Please include all parts see below:
Evaluation Method
A rubric is used in this Evaluation.

The candidate provides substantial articulation of response.

The candidate completes an appropriate root cause analysis (RCA), with substantial detail, that takes into consideration causative factors, errors, and/or hazards that led to the sentinel event (this patient’s outcome).

The candidate provides a logical discussion, with substantial detail, of a process improvement plan that would decrease the likelihood of a reoccurrence of the outcome of the scenario

The candidate provides a logical discussion, with substantial detail, of a change theory that could be used to implement the process improvement plan developed in B.

The candidate uses a failure mode and effects analysis, with substantial support, to project the likelihood that the process improvement plan suggested would not fail.

The candidate accurately identifies the members of the interdisciplinary team who will be included in the FMEA.

The candidate provides a logical discussion, with substantial detail, of the steps for preparing for the FMEA

The candidate appropriately applies, with substantial detail, the 3 steps of the FMEA (severity, occurrence, and detection) to the process improvement plan created in part B.

The candidate provides a logical explanation, with substantial support, of how the candidate would test the interventions from the process improvement plan from part B to improve care in a similar situation.

The candidate provides a logical discussion, with substantial detail, of how the professional nurse may function as a leader in promoting quality care and influencing quality improvement activities.

The candidate provides source information for all quoted, paraphrased and summarized content. Source information appears to include accurate and complete acknowledgement of source information regarding the author, date, title and location of the information (e.g., publisher, journal or website URL) as well as appropriate in-text citation. This level is also appropriate if there is no evidence of quoted, paraphrased or summarized content, and it is not required by the instructions.

Obtain an occupational history on ONE employed worker in an occupational setting. (any occupation or job except nursing) Identify the occupation, associated job tasks, the potential health hazards and interventions to decrease these health hazards.

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Journal 4

Order Description

Students must submit all journals through the Assignment Tool
The journal due dates are listed on the document titled, “Course Schedule.” and in the Weekly Modules. These due dates are not open to debate or negotiation. As a senior nursing student, your status as a professional nurse is imminent. As such you are expected to manage time effectively and make submissions of critical course requirements on or before due dates. Students not faculty are responsible for deadlines and submitting assignments on or before due dates. Failure to submit the journals will result in zero points for the assignment.
GUIDELINES FOR SUBMITTING CLINICAL JOURNAL #4

Obtain an occupational history on ONE employed worker in an occupational setting. (any occupation or job except nursing) Identify the occupation, associated job tasks, the potential health hazards and interventions to decrease these health hazards. A write-up is due in Journal #4. Journal #4 needs to include:

1. A narrative of the occupational history clinical activity described above. (4 points)
Journal 4 Question 1
Students, the rubric for the occupational interview are very specific. It is worth 4 points. You do not have to follow an assessment guide. Most important is to interview someone in an occupation other nursing or closely related field. Good examples: (factory, farming, etc.)

2. A summary of clinical activities the student (be specific) has done since the submission of journal #3. (Clinical activities must be population –focused) (2 points)

3. Student clinical outcomes met to date. (refer to student clinical outcomes for the course) ) The outcomes and the clinical activity that supports achievement of the outcomes must be written out. (1 point)

4. Documentation of course theory as it relates to clinical activities. (Must document at least three areas of content from classroom theory) (3 points)

5 Documentation of five different concepts the student has been introduced to in the course this semester and how the student will use these concepts in practice. (5 points)

Students must submit all journals through the Assignment Tool
The journal due dates are listed on the document titled, “Course Schedule.” and in the Weekly Modules.  These due dates are not open to debate or negotiation. As a senior nursing student, your status as a professional nurse is imminent. As such you are expected to manage time effectively and make submissions of critical course requirements on or before due dates.  Students not faculty are responsible for deadlines and submitting assignments on or before due dates. Failure to submit the journals will result in zero points for the assignment.
GUIDELINES FOR SUBMITTING CLINICAL JOURNAL #4

Obtain an occupational history on ONE employed worker in an occupational setting. (any occupation or job except nursing) Identify the occupation, associated job tasks, the potential health hazards and interventions to decrease these health hazards. A write-up is due in Journal #4.  Journal #4 needs to include:

1. A narrative of the occupational history clinical activity described above. (4 points)
Journal 4 Question 1
Students, the rubric for the occupational interview are very specific. It is worth 4 points.  You do not have to follow an assessment guide.  Most important is to interview someone in an occupation other nursing or closely related field.Good examples:  (factory, farming, etc.)

2. A summary of clinical activities the student (be specific) has done since the submission of journal #3.  (Clinical activities must be population –focused)  (2 points)

3. Student clinical outcomes met to date. (refer to student clinical outcomes for the course) )  The outcomes and the clinical activity that supports achievement of the outcomes must be written out. (1 point)

4. Documentation of course theory as it relates to clinical activities. (Must document at least three areas of content from classroom theory)  (3 points)

5 Documentation of five different concepts the student has been introduced to in the course this semester and how the student will use these concepts in practice. (5 points)

Total of 15 points

Historical Development of Nursing Timeline

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Historical Development of Nursing Timeline

• Create a 700- to 1,050-word timeline paper of the historical development of nursing science, starting with Florence Nightingale and continuing to the present.

o Explain the historical development of nursing science by citing specific years, theories, theorists, and events in the history of nursing.

o Explain the relationship between nursing science and the profession.

o Include the influences on nursing science of other disciplines, such as philosophy, religion, education, anthropology, the social sciences, and psychology.

2

General(Mental Health) nursing considerations and care, therapeutic communication/relationship

Order Description

1.General nursing consideration for young people with psychosis ;include such as risk assessment, medication, mental state examination, saliva test etc
For people who are Self harm, isolation , hallucination BPD, schezophreania etc

2.Therapeutic communication – respect, trust, empathy, active listening etc

Example is write benefits of general nursing consideration for young person with psychosis
Benefit of therapeutic communication for young person with psychosis
Pls write as simple a you can
It is a speech make it understandable
References only 5 year latest peer reviewed articles or journals
Make seperate paragraphs for both points

3

strategy for disseminating the results of the project to key stakeholders and to the greater nursing community.

Details:

Using 250-500 words, summarize your strategy for disseminating the results of the project to key stakeholders and to the greater nursing community.
Refer to the “Topic 4: Checklist.”
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
You are not required to submit this assignment to Turnitin.
6 NRS 441v.11R.Module 4_Checklist.doc

Case Studies on Nursing Theories

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Nursing
Topic: Case Studies on Nursing Theories

Paper details:

Case study #1 Ms. P and her daughter came into the office for a “checkup.” Ms. P said “I am fine, maybe a little forgetful; I have never been good with names.” Her daughter rolls her eyes and stated “But Mom, you are having a hard time finding my house now” as her eyes tear up. Her daughter has made this appointment for her mother as she has been getting more and more disoriented, forgetful and repetitive. The daughter is concerned that her mother probably should not be driving any longer as she has been having many “fender benders” lately. · Based on the case study, what do you think matters most to Ms. P and her daughter and why? · What can the nurse do to honor Ms. P and her daughter’s concern for her memory? · Create a pattern manifestation that will resonate with Ms. P and her daughter. Case Study #2 The hospice nurse sat with Ann’s husband, Ben. Ann was resting quietly as the increased dosage of IV pain medication gradually reached its therapeutic level. Ben turned his head and slowly turned, looking out the room’s only window. As he glanced up, a small flicker of light caught his breath. It was a shooting star. A tear fell from the corner of his eye and he turned to Ann. The nurse sensed that something significant to Ann and Ben was unfolding. Shuffling to Ann’s bedside, he took her small fragile hand in his. These hands had rocked cradles, burped babies, and groomed the horses she loved to ride. Gently holding her hand, he turned to the nurse. “She would ride like the wind was chasing her.” Looking back to Ann his voice broke; choking back tears “Ann, Ann I saw Jessie…Jessie is calling.” Ben turned “Jessie was our daughter. She died having a baby that was too big. When she died it was a pitch-black night. Cold, so cold, the baby died too, a little boy, named him Abe, Jr. after Jessie’s husband. I took Ann outside so she could cry to God above and there in this dark sky we saw two falling stars…together…just falling. We knew it had to be Jessie and Abe…two angels to light up the night.” Ben turned back as a deep sign escaped from Ann’s lips. A soft smile remained as she joined Jessie and Abe. · Based on this case study how would the nurse actualize Parse’s theory of Human Becoming? · How might Parse’s understanding of transcendence guide the nurse, as Ann’s death became a reality to Ben? · What would be the focus of the nurse as Ann’s body was transitioned to the mortuary? Case Study #3 Mr. O was brought by EMS to the ED with a complaint of increasing shortness of breath. He was extremely tachypneic, but managed to say, “I do not want to be admitted.” Mr. O has been suffering with end-stage cardiomyopathy and is not a heart transplant candidate; he believes he will die and this will be his last hospitalization. Evidently, he is also experiencing GI bleeding. Before he is finished with his ED workup, it is clear that he will need to be admitted. His wife arrives and Mr. O is much more consolable. Medical care has eased his shortness of breath and he is able to state, “Every time I am admitted they will not let my wife stay with me, they send her home.” The nurse calls the ICU before he is officially admitted and advocates for Mr. O that he desires to have his wife with him while hospitalized. The ICU staff is very understanding and makes special arrangements to make his wife comfortable in the ICU room with him. Mr. O agrees and will be admitted. · Based on the case study, what do you think matters most to Mr. O and why? What can the nurse do to honor Mr. O’s request and address his fears? · Recognizing that Mr. O’s illness is only one manifestation of his life, describe a plan of care that explores situational freedom

What personal, cultural, and spiritual values contribute to your worldview and philosophy of nursing? How do these values shape or influence your nursing practice?

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Personal Ethics
Order Description
After reading the Topic 1 materials, complete the questionnaire titled, “My Nursing Ethic.”

Using the reading and the questionnaire, write a paper of 750-1,000 words in which you describe your professional moral compass. As you write your paper, include the following:

What personal, cultural, and spiritual values contribute to your worldview and philosophy of nursing? How do these values shape or influence your nursing practice?
Define values, morals, and ethics in the context of your obligation to nursing practice. Explain how your personal values, philosophy, and worldview may conflict with your obligation to practice, creating an ethical dilemma.
Reflect and share your own personal thoughts regarding the morals and ethical dilemmas you may face in the health care field. How do your personal views affect your behavior and your decision making?
Do not be concerned with the use of ethical terminology for this paper.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Community Health And Population – Focused Nursing Practicum

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Community Health And Population – Focused Nursing Practicum
Requirements:

Write a narrative description of your field project by doing the following:
A. Assessment
1. Describe the community where you performed your fieldwork by identifying each of the following items:
• geographical area (e.g., county, city, town)
• area size
• population size
• demographics
• physical and social environment (use the windshield survey from task 1 of C228)
2. Discuss the health concern you studied in your fieldwork.
a. Provide background information in relation to Healthy People 2020 and local public health data that characterizes the health concern.
b. Provide data from national, state, and/or local levels related to the health concern.
3. Describe the target population affected by the health concern you studied in your fieldwork, including each of the following components:
• gender
• age
• demographics, including socioeconomic status and educational level
a. Explain how the health concern is linked to a health inequity/health disparity for the population of interest.
i. Provide specific data to support the health inequity/disparity conclusion.
4. Discuss the primary community resources and partners currently involved with the health concern.
a. Describe how your fieldwork interviews support your chosen health concern, including a summary of the interviews.
5. Discuss aspects of the population health concern not being addressed despite the efforts of the partners involved.

B. Outcomes Identification
1. Explain the desired outcome(s) or goal(s) for improvement related to the health concern.

Note: This outcome or goal should be in alignment with Healthy People 2020 objective.

C. Planning
1. Create a nursing action plan to address the identified population health concern.
a. Recommend two population-focused specific objectives.

Note: The recommended objectives should be measurable ones.

b. Recommend two population-focused specific nursing interventions to improve the health concern.

Note: Use the attached “Minnesota Intervention Wheel” as an aid in selecting the broad areas for nursing action. Select primary and secondary prevention activities only. For example, explain how you and other nurses might work with the community and your chosen target population of interest to improve the health concern.

2. Discuss potential public and private partnerships from your field experience that could be formed to implement your recommendations from parts C1a and C1b.
3. Create a specific timeline for your population-focused nursing interventions.

D. Evaluation
1. Explain how you would evaluate the effectiveness of the nursing action plan created in part C.
a. Identify the measurable tools necessary to perform the evaluation.

E. Conclusion
1. Reflect on how your perspective of the community’s health and the national, state, and local efforts toward a healthier population has changed as a result of your fieldwork.

F. Supplemental Materials
1. Include a reference list in APA format that lists all sources used in your paper.

Note: Corresponding in-text citations should be used throughout your paper as well.

2. Include appendices if necessary (e.g., charts, graphs, copies of any surveys, maps)

critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight. To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.

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Instructions: A major skill that is learned in this course is how to critically read and critique nursing research articles. The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight. To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.
Here’s how you should approach completing this week’s assignment to finish critiquing an article:
1. First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week. This will introduce you to the critique skills you will need for the week.
2. Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about. Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully the methods, results, discussion, implications, and conclusions sections of the article again.
3. Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.
4. Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook. Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.
5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus. Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document.
6. You will have two access attempts to record your answers. This is given to you so that if you encounter technical difficulties on your first attempt, you will have another attempt to enter your answers successfully.
If you have questions about this assignment, you can post them to your group discussion board for help. Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.

Questions 1 – 9: Sample. (For help with these questions, refer to chapters: 9 & 12)
1. What sampling method or plan was used by the authors in this study?

a. simple random sampling
b. systematic sampling
c. convenience sampling
d. network sampling
e. none of the above

2. According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?

a. this is a strong probability sampling method with very little potential for bias
b. this method is used when an ordered list of all members of the population are available, and
provides a random but not equal chance for inclusion in the study.
c. this method provides little opportunity to control for bias because subjects are included in
the study merely because they happen to be in the right place at the right time.
d. this method is specific to the individuals who were recruited and the information gained
cannot be generalized to others who don’t share these types of experiences.
e. none of the above biases best describe the sampling method chosen by the author.

3. What was the final sample size reported by the authors for this study?

a. 193
b. 152
c. 125
d. 100

4. Was a power analysis conducted? If so, which statement best describes the results of the power analysis?

a. The authors indirectly mention that a power analysis was conducted by describing the desired effect size, alpha, and power desired.
b. The authors mention that a power analysis was conducted, and 193 subjects were
determined to be needed for the study.
c. The authors do not report that a power analysis was conducted.

5. Which of these statements would be considered to be an inclusion criterion for the sample in the research article? (select all that apply).

a. The author did not report inclusion criteria.
b. Older than 18 years old.
c. First time clinical presentation of stroke.
d. Satisfactory cognitive function as recorded on the Scandinavian Stroke Scale

6. Which of these statements would be considered to be an exclusion criterion for the sample in the research article?

a. The patient is cognitively incompetent.
b. The patient has satisfactory cognitive function determined by the Scandinavian Stroke Scale.
c. First time clinical presentation of stroke.
d. The author did not report exclusion criteria.

7. What is the refusal rate for this study? (Hint: see page 253 in your text)

a. 125/152 X 100% = 82%
b. The authors did not report an acceptance rate.
c. 27/152 X 100% = 18%
d. 6

8. Which of the following would be accurate for the attrition rate for this study?

a. 19/119 X 100% = 16%
b. 100/119 X 100% = 84%
c. 125/152 X 100% = 82%
d. There is no attrition rate recorded for this study because it is a cross-sectional study.

9. What was the setting for this research study? Briefly describe the setting and indicate whether it was appropriate for conducting this study.

a. The setting for this study was a natural or field setting and was appropriate for this study’s research design.
b. The setting for this study was a partially controlled setting and was appropriate for this study’s research design.
c. The setting for this study was a highly controlled setting and was appropriate for this study’s research design.
d. The setting for this study was not well described by the authors and therefore not appropriate for conducting this study.

Question 10 – 14: Measurement Methods. (For help with these questions, refer to chapters 10 & 12.)

10. Which of these questionnaires, scales, or physiologic measures are used in this research study? Select all that apply.

a. The Beck Depression Inventory (BDI)
b. Physical Functioning (PF) from the Short Form-36, acute version (SF-36-A)
c. The Pittsburgh Sleep Quality Index (PSQI)
d. Motionlogger Actigraph (AA-32)

11. How do the authors describe the CURRENT reliability of The Pittsburgh Sleep Quality Index (PSQI)?

a. they compared two pencil and paper forms of the test to determine their equivalence
b. they compared two observers of the same group of subjects to determine their equivalence
in making observations
c. they tested the current group of subjects twice using the same questionnaire or scale.
d. they computed a Cronbach’s alpha on the questionnaires that were administered to this
group of subjects.

12. How do the authors describe the validity of Physical Functioning (PF) from the Short Form-36, acute version (SF-36-A)?

a. content validity
b. evidence of validity from contrasting groups
c. evidence of validity from convergence
d. evidence of validity from divergence
e. the authors did not describe the validity of this questionnaire using any of these methods.

13. Did the authors develop a questionnaire or survey for this research study?

a. No, they used only previously developed questionnaires or surveys.
b. Yes, they developed their own questions to ask about demographic information.
c. Interviews were reportedly used, but the authors do not expound on what was included.
d. Yes, they reported adding a few of their own “short-answer” questions at the end of the
questionnaire.
e. Yes, they developed the Sleep-Awake Questionnaire.
f. This study did not use any questionnaires or surveys.

14. Did the authors use any physiological measurements in this study?
a. Yes
b. No

Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)

15. Which of the following best describes the data collection process used in this study. Select all that apply.

a. questionnaires / surveys were completed and returned to the researchers
b. questionnaires / surveys were completed via the internet
c. data was collected by two of the authors or a trained research assistant (all nurses)
d. trained observers watched the subjects and collected the data
e. nurse researchers interviewed the study participants
f. questionnaires / surveys were completed via the telephone

16. If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?

a. yes, and the authors reported their efforts to achieve inter-rater reliability.
b. yes, but the authors do not discuss any efforts to achieve inter-rater reliability.
c. no, the issue of inter-rater reliability does not apply here.

Question 17 – 19: Data Analysis. (For help with these questions, refer to chapters 11 & 12)
17. What descriptive statistics are used in this study? Select all that apply.

a. mean
b. median
c. mode
d. range
e. standard deviation
f. scatterplot
g. standard error of the mean

18. What inferential statistics are used to examine the data obtained from the subjects? Select all that apply.

a. Pearson’s Product-Moment Correlation
b. Factor Analysis
c. Regression Analysis
d. Chi-Square
e. ANCOVA
f. ANOVA
g. t-Test
h. None of the above inferential statistics were used in this study.

19. What is the level of significance (alpha) set at for this study? ( Hint: is there an alpha given under the
tables?)

a. .05 or 5%
b. .10 or 90%
c .01 or 1%
d. a level of significance was not specifically mentioned by the author.

Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)

20. There are many significant findings in this study. Which of these statements from the article would be considered a significant and predicted result? Select all that apply.

a. Women reported better sleep quality at the 6-month follow-up than in the acute phase of
stroke (t = 2.36, p =0.02)
b. Women reported worse habitual sleep efficacy than men based on PSQI scores
(t = -2.81, p = 0.01)
c. Subjective sleep quality was poorer overall (for both men and women) at the 6 month
follow-up.
d. None of the above.

21. Which one of these statements from the article would be considered a non-significant result.

a. Women reported better sleep quality at the 6-month follow-up than in the acute phase of
stroke (t = 2.36, p =0.02)
b. Women sleep more minutes each night in the acute phase of stroke based on actigraphy than men.
c. There were no non-significant results reported in this study.
d. None of the above.

22. Which one of these statements from the article would be considered clinically important?

a. Nurses should screen for sleep disturbances after a stroke.
b. The environment is not important for sleep hygiene of the stroke patients in the acute
phase.
c. Men should get more sleep than women during the day.

23. Which one of these statements from the article would be considered a limitation of the study?

a. This study has shown that subjective and objective measures of sleep are not always comparable after a stroke.
b. The size of the sample was not sufficient for evaluating the impact of stroke type and
location on sleep.
c. Using a longitudinal design is a weakness of the study.
d. There are no limitations discussed in this study.

24. Which one of these statements from the article would be considered a statement regarding
generalization of these results?

a. The sample consists of stroke survivors without severe disabilities and results cannot be
generalized to persons with severe disabilities.
b. The sample consists of stroke survivors without severe disabilities and results can be
generalized to persons with severe disabilities.
c. Due to the function of actigraphy, being awake at night and inactive may underestimate
sleep time.
d. Since women report better sleep quality, they need fewer minutes of sleep per night.

25. Which one of these statements from the article would be considered a recommendation for future studies?

a. Nurses should screen for sleep disturbances after a stroke.
b. Further studies on the role of sleep quality and the effect on rehabilitation after stroke are needed.
c. Even if this convenience sample appears to have characteristics in common with the target
population, the views of non-responders are unknown.
d. The authors did not give any recommendations for future studies

A Case Study on the Nervous System by Allison Russo, Morgan Falk, and Phil Stephens Biology Department, Villanova University.

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Nursing case study

The Tired Swimmer: A Case Study on the Nervous System by Allison Russo, Morgan Falk, and Phil Stephens Biology Department, Villanova University.

Part I?Meet Annie Annie felt despondent. Her team mates were being kind to her, but she knew that she was the reason that her team lost the swim meet against the neighboring college. How many people could lose with a four-second lead on the anchor leg of a ??-yard relay against someone they had beaten so easily last year? As she walked out of the locker room she noticed that the blurred vision and eye strain had returned, even though she was wearing glasses instead of her usual contacts. Maybe no one will recognize me with these on, she thought. Annie hated wearing glasses. Her eye strain had become worse over the past month. Over the last week she had had mid-term exams and papers to write and recently typing made her hands and fi ngers ache and they felt weak. Even swim practice, which helped relieve her stress in the past, had become taxing. Her coach noticed that her times were getting worse, even though he could see that she was working hard in practice. As Annie walked out of the locker room she looked up and she saw her boyfriend, Matt, waiting for her. He attended another college and had made a detour to drive her home for mid-term break. ?Th anks for driving all this way to take me home, Matt. I?m sorry that you made it early enough for the meet; I was really bad. I just don?t know what?s wrong with me these days.? Matt didn?t know what to say, so he smiled and took her hand. As they walked back to her dorm, Annie thought how nice it was to have Matt to support her during such a tough time. Annie was gasping for air and felt weaker than ever after they had walked up the two fl ights of stairs to her fl oor. She told herself that she must set some time aside next week to do something about this constant fatigue. Annie had already packed her bags for the trip home and Matt was able to carry all of her stuff to his car in one trip. When he returned to the room he found Annie lying on the bed with her eyes closed. He asked her if she was ready to go. ?Sure, just can?t keep my eyes open these days. I am sure I?ll be better when we?re home.? Matt knew that Annie liked to drive, so when they got to the car he handed her the keys. She tried to take them, but her fi ngers didn?t seem to work and she dropped his keys on the ground. Matt grabbed the keys and opened the passenger door for Annie. As they set off for home, Matt asked, ?Are you feeling okay? You?re not usually so exhausted after a swim meet, and you seem to be having trouble catching your breath. I am worried about you.? ?I have been feeling really tired over the past month or so, and I guess mid-terms took more out of me than usual.? The Tired Swimmer: A Case Study on the Nervous System by Allison Russo, Morgan Falk, and Phil Stephens Biology Department, Villanova University ?The Tired Swimmer? by Russo, Falk, and Stephens Page 2 ?Why don?t you take a nap for the next couple of hours; I?ll wake you when we?re home.? Matt thought that this was probably not the best time to suggest that she see a doctor. Questions ?. What vital signs or symptoms does Annie exhibit? ?. Can you see any common features in Annie?s signs and symptoms? ?. Why is Annie having problems breathing? ?. What are the possible reasons for Annie?s condition?
CASE STUDY WRITING ASSIGNMENT
Now that you have gone through this case, you have a writing assignment. You must pretend that
you are knowledgeable healthcare professional (nurse, nurse practitioner, physician assistant,
doctor, “1…); and that you are either a concerned friend of Annie’s family or a very caring medical professional. Your assignment can take one of two formats:
1. You write a letter explaining Annie’s condition to someone in the family who may be distraught and not knowledgeable about Annie’s disorder. While you want to discuss the seriousness of the disease, you want to be reassuring. Remember that the person receiving the lefter is not in the medical profession so you need to keep it in simple terms. Your letter must also follow the criteria listed below.
2. You write a medical report as a healthcare professional explaining Annie’s condition. Your report
should look like a report written by whatever medical professional you are portraying to be. This
report must also follow the criteria listed below.
Other criteria:
. lt must be between 500 and 1000 words written in a word processor.
. lt must show an understanding of the disorder in question (signs, symptoms, diagnosis,
treatments, prognosis).
. You need to use several resources such as books and the internet (document your sources at
the end).
. Assume the reader’s knowledge of the disorder is limited.
. Use the questions in the case study to guide you.
. You may be creative.
. Do not fold your report and do not use a folder or plastic
cover to turn in your report. You may turn it in
electronically,
Below is the rubric that will be used to grade your
assignment in conjunction with the grading system found on
the right,
GRADE MEANING: Most have manor minor problems and done well to get points.

REPORT COMPONENT GRADE VALUE TOTAL
Participated in case study x 3pt pt
Followed directions x 2pt pt
Was factual and thorough x 3pt pt
Showed a good understanding of the disorder x 3pt pt
Was well organized and written in APA and easy to read x 3pt pt
Used good grammar, proper spelling & punctuation x 2pt pt
Used and cited McKinley, O’Loughlin and Bidle. Anatomy & Physiology 2016. 2nd ed. Benjamin Cummings pluse 6 good and appropriate other sources x 2pt pt
Wild card: neatness, creativity, etc… x Zpt pt to make a total of 50 points.

Public Health/ Nursing Theory

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Public Health/ Nursing Theory

Order Description
Benchmark Assignment: Applying Theory to a Practice Problem: Part 3: Application of Borrowed Theory to Problem and Conclusion
It is important to understand how borrowed theory can help you in your everyday environment as a nurse. In the previous assignment, you identified a practical problem that emerged from the evidence in the extant literature or professional practice, and you explored how middle-range theory could be applied to solve the problem. In this assignment, you will explore and apply borrowed theory to solve the specific problem that you identified previously, and you will synthesize the applications of the middle-range theory and the borrowed theory into the most appropriate solution to the problem.

DIRECTIONS:

Consider the problem that you described in the previous assignments and the instructor feedback about those assignments.

Write a paper (1,700 words) that describes how borrowed theory can be applied to the identified problem. The paper should include the following:

A brief summary of the problem including the potential middle-range theory that could be applied.
A description of a borrowed theory that could be applied to the problem. Is this borrowed theory appropriate to your identified problem?
A brief history of the borrowed theory’s origins.
A discussion of how the borrowed theory has been previously applied.
A discussion of the application of the borrowed theory to the identified problem. How would your practice change by incorporating this theory?
A discussion of how application of both the borrowed theory and the middle-range theory can be integrated to create the most appropriate solution to the identified problem.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin.
USE RUBRIC PLEASE
A summary of the problem including the potential middle-range theory that could be applied is thoroughly presented with rich detail and includes all necessary elements. 5%
70.0 %Content
A description of a borrowed theory that could be applied to the problem is thoroughly presented with rich detail and includes all necessary elements.5%
15% A history of the borrowed theory’s origins is present, thorough, and well-detailed. The description is well supported with current and/or seminal research
15% A discussion of how the borrowed theory has been previously applied is present, thorough, and well-detailed. The description is well supported with current and/or seminal research
15% A discussion of the application of the borrowed theory to the identified problem is present, thorough, and well-detailed. The description is well supported with current and/or seminal research
15% A discussion of the integration of the borrowed theory and the middle-range theory is present, thorough, and well-detailed. The description is well supported with current and/or seminal research.
20.0 %Organization and Effectiveness

7.0 %Thesis Development and Purpose
10.0 %Format

5.0 %Paper Format (use of appropriate style for the major and assignment)
8% Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Application of Middle-Range Theory to ProbleM
Name: Ngulefac Richard Achaleke

Influenza is a very common disease that needs attention in the medical field. Mandatory immunization of HCP against influenza is an area that have been severally covered in the current literature. I have also experienced this practice in the course of my nursing professional practice. Ultimately, this paper concludes in line influenza vaccination policy among HCP.
The mortality rate of influenza victims continues to rise especially during the influenza pandemic. For instance there were a considerable number of people who died because of influenza and especially the Spanish flu that claimed the life of 20million people. Therefore, there is a great need to create influenza awareness and find remedies to address this problem. One way is to introduce mandatory health care personnel vaccination against influenza. Mandatory care personnel vaccination against influenza is a problem that needs to be addressed to ensure that it is implemented and well established in healthcare setting (Goldsmith, 2011).
Middle-range theories are made up of an inadequate number of ideas and proposal that are written at a comparatively tangible and precise level. Middle-range theories are created or tested by researching, and they are used as the confirmation for practice activities, such as evaluation and involvement. To be precise, middle range theories are the theories that lie between the trivial but essential working proposition that develop a number of research and the comprehensive methodical efforts to expand integrated theory that will clarify all the experiential uniformities of social behavior, organization and social change (Roy & Roy Adaptation Association, 2014).
One theory that could be used to address the above named problems is the intellectual capital theory. This theory is essential since it is able to provide conceptualization of the knowledge available within an organization and it explains the potential mechanisms that are responsible for the impact of that particular knowledge on the patient as well as the organization outcomes. The intellectual capital theory is a middle range theory since it has a limited number of concepts and propositions and it can be measured and tested in different context. The theory does propose meaningful interrelationships among characteristics within the work environment quality of patient care included (Meleis, 2010).
This theory emerged in the past decade and it was as a response to the ever growing realization of the importance of information and knowledge. The theory was conceptualized when the ideas of knowledge management and human capital became important part of organization discussion.
Intellectual capital theory has been used in different fields and especially the nursing field to conceptualize the source of nursing knowledge available within an organization and it also defines its relationship to patient and organization outcome. This theory has been very essential especially when it comes to guiding research on quality work environments and how such environment assists the administrative decision making to nursing human resource management and the continuing professional development (Roy & Roy Adaptation Association, 2014).
Therefore, the intellectual impact theory can be applied on the mandatory health care personnel vaccination against influenza. The theory will be able to be applied on the identified problem since it offers a conceptualization of the knowledge available within an organization and it explains the potential mechanisms that are responsible for the impact of that particular knowledge on the patient as well as the organization outcomes. Influenza as mentioned above has been the cause of great worry since it can even lead to death. This means that there is a need to gather more information on influenza and use this knowledge to find tangible solutions. Intellectual capital theory could greatly impact on the mandatory health care personnel vaccination against influenza .it will not only provide the needed information but it will also provide the theoretical framework and the practical means of how the mandatory health care personnel vaccination against influenza will be administered (Meleis, 2010). Through the intellectual capital theory the provided information on influenza will be tested and verified to ensure that the above named remedy is well utilized to combat influenza deaths and pandemics.
By incorporating intellectual capital theory on mandatory health care personnel vaccination against influenza the health organization will be assisted in the following ways. the doctors and the service providers will be made aware of the influenza its causes, symptoms, how it is treated, and curative and preventive measures among others. Most importantly, the service providers will be given tangible information on how to go about caring for people with influenza and also how to tackle the influenza pandemic. Furthermore, this theory will give comprehensive details on how to vaccinate against influenza. It is well put that influenza kills in millions and it is very hard to prevent its outbreak. Therefore, using intellectual capital theory will be of great importance since it will be giving some guidelines and policies on the already identified problem. Vaccination is the way to go when it comes to something that could bring so much problem and challenges in future. Intellectual capital theory will guide research pertaining to influenza and it will provide the much needed information about it. This way it will help to facilitate the combination of medication that could be used in vaccination to ensure that the influenza problem does not in any way cause havoc in the world (Goldsmith, 2011). This way quality environment will be created where influenza will become a history using the intellectual capital theory. It can be rare to find a study discussing health ailments without mentioning influenza or anything related to this disease. This paper also reviewed influenza statistics to indicate the need to adopt countermeasures of curbing influenza

References:
Goldsmith, C. (2011). Influenza. Minneapolis: Twenty-First Century Books.
Meleis, A. I. (2010). Transitions theory: Middle-range and situation-specific theories in nursing research and practice. New York: Springer Pub. Co.
Roy, C., & Roy Adaptation Association. (2014). Generating middle range theory: From evidence to practice. New York: Springer Pub.