May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion. To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
By Day 3 of Week 2
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 1, “The History and Interviewing Process” (Previously read in Week 1)This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.
Chapter 2, “Cultural Competency”This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.
The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving healthcare services at primary healthcare centers.
Module 2 Introduction
Dr. Tara Harris reviews the overall expectations for Module 2. Consider how you will manage your time as you review your media and Learning Resources for your Discussion, Case Study Lab Assignment, and your DCE Assignment (3m).
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Functional Assessments and Cultural and Diversity Awareness in Health Assessment – Week 2 (10m)
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Discussion: Searching Databases
When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems.
The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.
· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
· Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
· Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course.
To Prepare:
**Clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. ** Please choose a clinical issue that is easy to work with as this will remain for the rest of the course.
1. Transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently.
2. Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
DISCUSSION:
3. Post a brief description of your clinical issue of interest.
4. Share PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.
5. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators.
6. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.
**AT LEAST 3 REFERENCES**
**THIS DISCUSSION IS DIVIDE IN TWO PARTS
–
1.
MAIN DISCUSSION POST BY TUESDAY 03/
23
/2021 BEFORE 8:00 PM EST
2.
TWO REPLIES BY FRIDAY 03/
26
/2021 BEFORE 8:00 PM EST
Discussion: Searching Databases
When you decide to purchase a new car, you first decide what is important to you. If mileage and
dependability are the important factors, you will search for data focused more on these factors and
less on color options and sound systems.
The same holds tru
e when searching for research evidence to guide your clinical inquiry and
professional decisions. Developing a formula for an answerable, researchable question that
addresses your need will make the search process much more effective. One such formula is t
he
PICO(T) format.
·
Review the Resources and identify a clinical issue of interest that can form the basis of a
clinical in
quiry.
·
Review the materials offering guidance on using databases, performing keyword searches,
and developing PICO(T) questions provided in the Resources.
·
Review the Resources for guidance and develop a PICO(T) question of interest to you for
further study.
It is suggested that an Intervention
–
type PICOT question be developed as these
seem to work best for this course.
To Prepare:
**C
linical issue will remain the same for the entire course and will be the basis for the
development of your PICOT
question. *
* Please
choose
a clinical issue that is easy to work
with as this
will remain for the rest of the cou
rse.
1.
T
ransform a clinical inquiry into a searchable question in PICO(T) format, so you can search
the electronic databases more effectively and efficiently.
2.
Based on the clinical issue of interest and using keywords related to the clinical issue of
interest,
search at least two different databases in the Walden Library to identify at least four
relevant peer
–
reviewed articles related to your clinical issue of interest.
You should not be
using systematic reviews for this assignment, select original research ar
ticles.
DISCUSSION:
3.
Post a brief description of y
our clinical issue of interest.
4.
S
hare
PICO(T) question and examine strateg
ies you might use to increase the rigor and
effectiveness of a database search on your PICO(T) question.
5.
Describe your search results in terms of the number of articles returned on original research
a
nd how this changed as you added search terms using your Boolean operators.
6.
Finally, explain strategies you might make to increase the rigor and effectiveness of a
database search on your PICO(T) question.
Be specific and provide examples
.
**AT LEAS
T
3 REFERENCES**
**THIS DISCUSSION IS DIVIDE IN TWO PARTS –
1. MAIN DISCUSSION POST BY TUESDAY 03/23/2021 BEFORE 8:00 PM EST
2. TWO REPLIES BY FRIDAY 03/26/2021 BEFORE 8:00 PM EST
Discussion: Searching Databases
When you decide to purchase a new car, you first decide what is important to you. If mileage and
dependability are the important factors, you will search for data focused more on these factors and
less on color options and sound systems.
The same holds true when searching for research evidence to guide your clinical inquiry and
professional decisions. Developing a formula for an answerable, researchable question that
addresses your need will make the search process much more effective. One such formula is the
PICO(T) format.
Review the Resources and identify a clinical issue of interest that can form the basis of a
clinical inquiry.
Review the materials offering guidance on using databases, performing keyword searches,
and developing PICO(T) questions provided in the Resources.
Review the Resources for guidance and develop a PICO(T) question of interest to you for
further study. It is suggested that an Intervention-type PICOT question be developed as these
seem to work best for this course.
To Prepare:
**Clinical issue will remain the same for the entire course and will be the basis for the
development of your PICOT question. ** Please choose a clinical issue that is easy to work
with as this will remain for the rest of the course.
1. Transform a clinical inquiry into a searchable question in PICO(T) format, so you can search
the electronic databases more effectively and efficiently.
2. Based on the clinical issue of interest and using keywords related to the clinical issue of
interest, search at least two different databases in the Walden Library to identify at least four
relevant peer-reviewed articles related to your clinical issue of interest. You should not be
using systematic reviews for this assignment, select original research articles.
DISCUSSION:
3. Post a brief description of your clinical issue of interest.
4. Share PICO(T) question and examine strategies you might use to increase the rigor and
effectiveness of a database search on your PICO(T) question.
5. Describe your search results in terms of the number of articles returned on original research
and how this changed as you added search terms using your Boolean operators.
6. Finally, explain strategies you might make to increase the rigor and effectiveness of a
database search on your PICO(T) question. Be specific and provide examples.
As you establish your goals and objectives for this course, you are committing to an organized plan that will frame your practicum experience in a clinical setting, including planned activities, assessment, and achievement of defined outcomes. In particular, they must address the categories of clinical reasoning, quality in your clinical specialty, and interpersonal collaborative practice.
For this Assignment, you will consider the areas you aim to focus on to gain practical experience as an advanced practice nurse. Then, you will develop a Practicum Experience Plan (PEP) containing the objectives you will fulfill in order to achieve your aims. For this practicum experience, be sure to develop goals and objectives that allow you to synthesize knowledge and skills related to assessment, diagnosis, and treatment planning.
To Prepare
Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?
Review the information related to developing objectives provided in this week’s Learning Resources. Your practicum learning objectives that you want to achieve during your practicum experience must be:
Specific
Measurable
Attainable
Results-focused
Time-bound
Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)
Discuss your professional aims and your proposed practicum objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.
Select one nursing theory and one counseling/psychotherapy theory to best guide your clinical practice. Explain why you selected these theories. Support your approach with evidence-based literature.
Create a timeline of practicum activities that demonstrates how you plan to meet these goals and objectives based on your practicum requirements.Master of Science in Nursing
Practicum Experience Plan
Overview:
Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.
As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one (1) journal entry.
Complete each section below.
Part 1: Quarter/Term/Year and Contact Information
Section A
Quarter/Term/Year:
StudentContact Information
Name:
Street Address:
City, State, Zip:
Home Phone:
Work Phone:
Cell Phone:
Fax:
E-mail:
PreceptorContact Information
Name:
Organization:
Street Address:
City, State, Zip:
Work Phone:
Cell Phone:
Fax:
Professional/Work E-mail:
Part 2: Individualized Practicum Learning Objectives
Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.
As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.
Objective 1: <write your objective here> (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)
Planned Activities: Mode of Assessment: (Note: Verification will be documented in Meditrek)
PRAC Course Outcome(s) Addressed:
· (for example) Develop professional plans in advanced nursing practice for the practicum experience
· (for example) Assess advanced practice nursing skills for strengths and opportunities
Objective 2: <write your objective here> (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)
Planned Activities:
Mode of Assessment: (Note: Verification will be documented in Meditrek)
PRAC Course Outcome(s) Addressed:
·
Objective 3: <write your objective here> (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)
Planned Activities:
Mode of Assessment: (Note: Verification will be documented in Meditrek)
PRAC Course Outcome(s) Addressed:
· Part 3: Projected Timeline/Schedule
Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.
This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.
I intend to complete the 144 or 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.
Number of Clinical Hours Projected for Week
Number of Weekly Hours for Professional Development
Number of Weekly Hours for Practicum Coursework
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Total Hours (must meet the following requirements)
144 or 160 Hours
Part 4 – Signatures
Student Signature (electronic): Date:
Practicum Faculty Signature (electronic)**: Date:
** Faculty signature signifies approval of Practicum Experience Plan (PEP)
Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.
Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.
Assignment 1: Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat
Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment.
Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.
In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical assessment and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions. To Prepare
Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.
PLEASE USE TEMPLATE TO COMPLETE ASSIGNMENT
With regard to the case study you were assigned:
· Review this week’s Learning Resources and consider the insights they provide.
· Consider what history would be necessary to collect from the patient.
· Consider what physical and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. Case Study 1: Focused Nose
A 28 year old female comes in complaining of a runny nose and itchy eyes. States runny nose, itchy eyes, and ears felt full approximately 9 days ago. “I get this every spring and it seems to last six to eight weeks”. Describes nose is runny with clear mucus. Sneezes on and off all day. Eyes itch so bad she just wants to scratch them out, sometimes feels a tickle in her throat and ears feel full and sometimes pop. Last year took Claritin with relief. Charlotte is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous. The Assignment
Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each. Episodic/Focused SOAP Note Template
Patient Information:
Initials, Age, Sex, Race S. CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patient’s own words – for instance “headache”, NOT “bad headache for 3 days”. HPI: This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example:
Location: head
Onset: 3 days ago
Character: pounding, pressure around the eyes and temples
Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia
Timing: after being on the computer all day at work
Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better
Severity: 7/10 pain scale Current Medications: include dosage, frequency, length of time used and reason for use; also include OTC or homeopathic products. Allergies: include medication, food, and environmental allergies separately (a description of what the allergy is ie angioedema, anaphylaxis, etc. This will help determine a true reaction vs intolerance). PMHx: include immunization status (note date of last tetanus for all adults), past major illnesses and surgeries. Depending on the CC, more info is sometimes needed Soc Hx: include occupation and major hobbies, family status, tobacco & alcohol use (previous and current use), any other pertinent data. Always add some health promo question here – such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system. Fam Hx: illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent. ROS: cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows: General:Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.
Example of Complete ROS:
GENERAL: Denies weight loss, fever, chills, weakness or fatigue.
HEENT: Eyes: Denies visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat: Denies hearing loss, sneezing, congestion, runny nose or sore throat.
SKIN: Denies rash or itching.
CARDIOVASCULAR: Denies chest pain, chest pressure or chest discomfort. No palpitations or edema.
RESPIRATORY: Denies shortness of breath, cough or sputum.
GASTROINTESTINAL: Denies anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.
GENITOURINARY: Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY.
NEUROLOGICAL: Denies headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.
MUSCULOSKELETAL: Denies muscle, back pain, joint pain or stiffness.
HEMATOLOGIC: Denies anemia, bleeding or bruising.
LYMPHATICS: Denies enlarged nodes. No history of splenectomy.
PSYCHIATRIC: Denies history of depression or anxiety.
ENDOCRINOLOGIC: Denies reports of sweating, cold or heat intolerance. No polyuria or polydipsia.
ALLERGIES: Denies history of asthma, hives, eczema or rhinitis. O. Physical exam: From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head to toe format i.e. General: Head: EENT: etc. Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines) A. Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence based guidelines. P.
This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.
References
You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.
Maya is a 5-year-old who presents for a well-child visit. She is a healthy child with no complaints. Physical examination is normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood, leukocytes, and nitrites. Her blood pressure is normal, and she is at the 60th percentile for height and weight.
To prepare:
•Review “Genitourinary Disorders” in the Burns et al. text.
•Review and select one of the three provided case studies. Analyze the patient information.
•Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
•Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
•Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder.
POST 1 TO 2 PAGES PAPER ON :An explanation of the differential diagnosis for the patient in the case study you selected.
Explain which is the most likely diagnosis for the patient and why.
Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder.
REFERENCE:
Readings
•Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.
American Academy of Pediatrics, Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. (2011). Urinary tract infection: Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics, 128(3), 595–610. Retrieved from http://pediatrics.aappublications.org/content/128/3/595.full?sid=cc35023c-502d-474a-9856-bfb5e38eed54
•Cox, A. M., Patel, H., & Gelister, J. (2012). Testicular torsion. British Journal of Hospital Medicine, 73(3), C34–C36. Retrieved from the Walden Library Databases.
In 2011, Mason General Hospital was named by Hospitals & Health Networks magazine as one of the “Most Wired” hospitals in the United States. What makes this particularly significant is that Mason General is a small, 25-bed, rural hospital in the state of Washington. It credits its success to nurse Eileen Branscome, director of clinical informatics. Under her leadership, the hospital adopted such innovations as visual smart boards where real-time patient information is always available. According to the magazine, those hospitals designated as “Most Wired” “show better outcomes in patient satisfaction, risk-adjusted mortality rates, and other key quality measures through the use of information technology (IT)” (Mason General Hospital and Family of Clinics, 2012).
Developments in information technology have enabled patients and health care providers to collaborate for quality improvement at an unprecedented level, and nurses have consistently been at the forefront of these efforts. This week you focus on the IOM report “To Err Is Human” and consider how health information technology has helped to address the issues of patient safety and quality health care.
References:
Weinstock, M., & Hoppszallern, S. (2011). Health care’s most wired 2011. Hospitals & Health Network Magazine, 85(7), 26–37.
Analyze the utilization of health information technology to address issues raised in the IOM report “To Err Is Human”
Assess the role of informatics in improving health care safety
Photo Credit: Angela Schmidt/iStock/Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
American Nurses Association. (2015). Nursing informatics: Scope & standards of practice (2nd ed.). Silver Springs, MD: Author.
“Introduction”This portion of the text introduces nursing informatics and outlines the functions of the scope and standards.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 1, “Nursing Science and the Foundation of Knowledge”This chapter defines nursing science and details its relation to nursing roles and nursing informatics. The chapter also serves as an introduction to the foundation of knowledge model used throughout the text.
Chapter 2, “Introduction to Information, Information Science, and Information Systems”In this chapter, the authors highlight the importance of information systems. The authors specify the qualities that enable information systems to meet the needs of the health care industry.
Wakefield, M. K. (2008). The Quality Chasm series: Implications for nursing. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (Vol. 1, pp. 47–66). Rockville, MD: U. S. Department of Health and Human Services.
Pages 1–12These 12 pages highlight the issues raised by the Quality Chasm Series and examine their long-term implications for nursing. The text reviews external drivers of safety and quality, design principles for safe systems, and guidelines for health care redesign.
Cipriano, P. F., & Murphy, J. (2011). Nursing informatics. The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 282, 286–289.
Retrieved from the Walden Library databases.
In this article, the authors focus on how nurses can use health information technology to help transform health care using the recommendations included in the 2010 Institute of Medicine report “The Future of Nursing, Leading Change, Advancing Health.” The author also discusses the 2011 National Strategy for Quality Improvement in Health Care.
Plawecki, L. H., & Amrhein, D. W. (2009). Clearing the err. Journal of Gerontological Nursing, 35(11), 26–29.
Retrieved from the Walden Library databases.
This article presents a summary of the Institute of Medicine report “To Err Is Human: Building a Safer Health System.” The authors provide an overview of what has been accomplished in the decade following the IOM report, focusing in particular on health information technology.
Note: The approximate length of this media piece is 8 minutes.
In this video, Doris Fischer, Richard Rodriguez, Carina Perez, and Carmen Ferrell introduce the concept of nursing informatics. These individuals provide insight into how informatics is transforming the health care system by improving efficiency and quality of care.
Optional Resources
Hilts, M. E. (2010). Up from the basement. Health Management Technology, 31(9), 14–15.
Retrieved from the Walden Library databases.
Institute of Medicine. (1999). To err is human: Building a safer health system. Retrieved from http://iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf
Kohn, L. T., Corrigan, J. M., & Donaldson, M.S. (Eds.). (2000). To err is human: Building a safer health system. Washington, D. C.: Institute of Medicine. Retrieved from the National Academies Press website: /orders/download.nap.edu/catalog.php?record_id=9728
Discussion: The Effects of “To Err Is Human” in Nursing Practice
The 1999 landmark study titled “To Err Is Human: Building a Safer Health System” highlighted the unacceptably high incidence of U.S. medical errors and put forth recommendations to improve patient safety. Since its publication, the recommendations in “To Err Is Human’ have guided significant changes in nursing practice in the United States.
In this Discussion, you will review these recommendations and consider the role of health information technology in helping address concerns presented in the report. To prepare:
Review the summary of “To Err Is Human” presented in the Plawecki and Amrhein article found in this week’s Learning Resources.
Consider the following statement:
“The most significant barrier to improving patient safety identified in “To Err Is Human” is a “lack of awareness of the extent to which errors occur daily in all health care settings and organizations (Wakefield, 2008).”
Review “The Quality Chasm Series: Implications for Nursing” focusing on Table 3: “Simple Rules for the 21st Century Health Care System.” Consider your current organization or one with which you are familiar. Reflect on one of the rules where the “current rule” is still in operation in the organization and consider another instance in which the organization has effectively transitioned to the new rule.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
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Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
LopesWrite Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
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Assignment: Lab Assignment: Assessing The Genitalia And Rectum
Patients are frequently uncomfortable discussing with healthcare professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. To Prepare
Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.Based on the Episodic note case study:
Review this week’s Learning Resources, and consider the insights they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment.
Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.
Consider what history would be necessary to collect from the patient in the case study.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition.
How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
The Lab Assignment
Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.
Analyze the subjective portion of the note.
List additional information that should be included in the documentation.Analyze the objective portion of the note.
List additional information that should be included in the documentation.
Is the assessment supported by the subjective and objective information? Why or why not?
Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or why not?
Identify three possible conditions that may be considered as a differential diagnosis for this patient.
Explain your reasoning using at least three different references from current evidence-based literature.
Case Study
Subjective:
•CC: “I have bumps on my bottom that I want to have checked out.”
•HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.
•PMH: Asthma•Medications: Symbicort 160/4.5mcg
•Allergies: NKDA
•FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD
•Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)
Objective:
•VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs•Heart: RRR, no murmurs
•Lungs: CTA, chest wall symmetrical
•Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia
•Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney
•Diagnostics: HSV specimen obtained
Assessment:•Chancre
Plan: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.
NOTE: THIS IS THE LINK TO DOWNLOAD THE BOOK: /orders/www.sendspace.com/file/3dx3zx
CHECK THE ASSIGNMENT FOR PLAGIARISM
Learning Resources
Required Readings (click to expand/reduce)
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
· Chapter 17, “Breasts and Axillae” This chapter focuses on examining the breasts and axillae. The authors describe the examination procedures and the anatomy and physiology of breasts.
· Chapter 19, “Female Genitalia” In this chapter, the authors explain how to conduct an examination of female genitalia. The chapter also describes the form and function of female genitalia.
· Chapter 20, “Male Genitalia” The authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to perform an exam of these areas.
· Chapter 21, “Anus, Rectum, and Prostate” This chapter focuses on performing an exam of the anus, rectum, and prostate. The authors also explain the anatomy and physiology of the anus, rectum, and prostate.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
Chapter 5, “Amenorrhea” Amenorrhea, or the absence of menstruation, is the focus of this chapter. The authors include key questions to ask patients when taking histories and explain what to look for in the physical exam.
Chapter 6, “Breast Lumps and Nipple Discharge” This chapter focuses on the important topic of breast lumps and nipple discharge. Because breast cancer is the most common type of cancer in women, it is important to get an accurate diagnosis. Information in the chapter includes key questions to ask and what to look for in the physical exam.
Chapter 7, “Breast Pain” Determining the cause of breast pain can be difficult. This chapter examines how to determine the likely cause of the pain through diagnostic tests, physical examination, and careful analysis of a patient’s health history.
Chapter 27, “Penile Discharge” The focus of this chapter is on how to diagnose the causes of penile discharge. The authors include specific questions to ask when gathering a patient’s history to narrow down the likely diagnosis. They also give advice on performing a focused physical exam.
Chapter 36, “Vaginal Bleeding” In this chapter, the causes of vaginal bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle. The authors discuss key questions to ask the patient as well as specific physical examination procedures and laboratory studies that may be useful in reaching a diagnosis.
Chapter 37, “Vaginal Discharge and Itching” This chapter examines the process of identifying causes of vaginal discharge and itching. The authors include questions on the characteristics of the discharge, the possibility of the issues being the result of a sexually transmitted infection, and how often the discharge occurs. A chart highlights potential diagnoses based on patient history, physical findings, and diagnostic studies.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
· Chapter 3, “SOAP Notes” (Previously read in Week 8)
Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing adenosis of the breast: Report of two cases and review of the literature. Polish Journal of Radiology, 80, 122–127. doi:10.12659/PJR.892706. Retrieved from /orders/www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/
Sabbagh, C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men. Digestive and Liver Disease, 46(12), 1082–1085. doi:10.1016/j.dld.2014.08.045 Note: You will access this article from the Walden Library databases.
Westhoff, C. L., Jones, H. E., & Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete? Journal of Women’s Health, 20(1), 5–10. Note: You will access this article from the Walden Library databases.
This article describes the benefits of new technology and guidelines for pelvic exams. The authors also detail which guidelines and technology may become obsolete.
Centers for Disease Control and Prevention. (2019). Sexually transmitted diseases (STDs). Retrieved from http://www.cdc.gov/std/#
This section of the CDC website provides a range of information on sexually transmitted diseases (STDs). The website includes reports on STDs, related projects and initiatives, treatment information, and program tools.
Week 4: Data-Driven Decision Making for Health care Administration
Confidence Intervals and Hypothesis Tests
You have likely encountered confidence intervals and hypothesis tests in your previous statistics courses. How are confidence intervals and hypothesis tests related to healthcare administration practice?
As a healthcare administration leader, you will likely want to test whether certain improvement initiatives are working more effectively than others. Additionally, you might want to test whether a certain improvement initiative is worth investing in given positive health outcomes and cost of resources. Hypothesis tests are valuable tools that may assist the healthcare administration leader in executing such decision making.
1. This week, you apply confidence intervals and hypothesis tests for healthcare administration problems. You also reflect on the types of information healthcare administration leaders might derive from hypothesis testing.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Albright, S. C., & Winston, W. L. (2017). Business analytics: Data analysis and decision making (6th ed.). Stamford, CT: Cengage Learning.
Chapter 8, “Confidence Interval Estimation”
Chapter 9, “Hypothesis Testing”
Fulton, L. V., Ivanitskaya, L. V., Bastian, N. D., Erofeev, D. A., & Mendez, F. A. (2013). Frequent deadlines: Evaluating the effect of learner control on healthcare executives’ performance in online learning. Learning and Instruction, 23, 24–32.
Required Media
The Doctoral Journey. (2013). SPSS tutorial: One-way ANOVA. Retrieved from /orders/www.youtube.com/watch?v=jYn5Jv7Gh4s
The Doctoral Journey. (2013). SPSS tutorial: Independent t test. Retrieved from /orders/www.youtube.com/watch?v=l0TMKRkpuNU
Healthcare administration leaders are asked to make evidence-based decisions on a daily basis. Sometimes, these decisions involve high levels of uncertainty, as you have examined previously. Other times, there are data upon which evidence-based analysis might be conducted.
1. This week, you will be asked to think of scenarios where building and interpreting confidence intervals (CIs) would be useful for healthcare administration leaders to conduct a two-sided hypothesis test using fictitious data.
For example, Ralph is a healthcare administration leader who is interested in evaluating whether the mean patient satisfaction scores for his hospital are significantly different from 87 at the .05 level. He gathers a sample of 100 observations and finds that the sample mean is 83 and the standard deviation is 5. Using a t-distribution, he generates a two-sided confidence interval (CI) of 83 +/- 1.984217 *5/sqrt(100). The 95% CI is then (82.007, 83.992). If repeated intervals were conducted identically, 95% should contain the population mean. The two-sided hypothesis test can be formulated and tested just with this interval. Ho: Mu = 87, Ha: Mu<>87. Alpha = .05. If he assumes normality and that population standard deviation is unknown, he selects the t-distribution. After constructing a 95% CI, he notes that 87 is not in the interval, so he can reject the null hypothesis that the mean satisfaction rates are 87. In fact, he has an evidence-based analysis to suggest that the mean satisfaction rates are not equal to (less than) 87.
2. For this Discussion, review the resources for this week, and consider how a CI might be used to support hypothesis testing in a healthcare scenario.
By Day 3
3. Post a description of a healthcare scenario where a CI might be used, and then complete a fictitious two-sided hypothesis test using a CI and fictitious data.
By Day 5
Continue the Discussion and respond to your colleagues in one or more of the following ways:
· Ask a probing question, substantiated with additional background information, evidence, or research.
· Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
· Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
· Validate an idea with your own experience and additional research.
· Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
· Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 4 Discussion Rubric
Post by Day 3 and Respond by Day 5
To participate in this Discussion: Week 4 Discussion
Assignment Part(5 pages) APA format 7th ed.
Confidence Intervals and Hypothesis Testing in Medical Scenarios
Confidence intervals (CIs) and hypothesis tests assist healthcare administration leaders in executing decision making for a wide variety of conditions or experiences in a health services organization. Interpreting the significance of the information provided in hypothesis testing can ensure that healthcare administration leaders execute the best and appropriate measures possible to ensure effective healthcare delivery.
1. For this Assignment, review the resources for this week. Then, review your course text, and complete Problem 66 on page 410 and Case Study 9.3 on pages 412-413. Consider the type of analysis tools you may use to best fit the case study provided.
The Case Study: Removing VIOXX from The Market
For years, the drug VIOXX, developed and marketed by Merck, was one of the blockbuster drugs on the market. One of a number of so-called Cox-2 anti-inflammatory drugs, Vioxx was considered by many people a miracle drug for alleviating the pain from arthritis and other painful afflictions. VIOXX was marketed heavily on television, prescribed by most physicians, and used by an estimated two million Americans. All of that changes in October 2004, when the results of a large study were released. The study, which followed approximately 2600 subjects over a period of about 18 months, concluded that VIOXX use over a long period of time caused a significant increase in the risk of developing serious heart problems. Merck almost immediately pulled Vioxx from the American market and doctors stopped prescribing it. On the basis of the study, Merck faced not only public embarrassment but the prospect of huge financial losses.
More specifically, the study had 1287 patients use Vioxx for an 18-months period, and it had another 1299 patients use a placebo over the period. After 18 months, 45 of the Vioxx patients had developed serious heart problems, whereas only 25 patients on the placebo developed such problems.
Given these results, would you agree with the conclusion that Vioxx caused a significant increase in the risk of developing serious heart problems? Given these results, would you agree with the conclusion that Vioxx caused a significant increase in risk of developing serious heart problem?
First, answer this from a purely statistical point of view, where significant means statistically significant. What hypothesis should you test, and how should you run the test? When you run the test, what is the corresponding p-value?
Next, look at it from the point of view of patients. If you were a Vioxx user, would these results cause you significant worry?
After all, some of the subjects who took placebos also developed heart problems, and 45 might not be considered that much larger than 25. Finally, look at it from Merck’s point of view. Are the results practically significant to the company? What does it stand to lose? Develop an estimate, no matter how wild it might be, of the financial losses Merck might incur. Just think of all those American VIOXX users and what they do.
For Chapter 9, problem 66, you will need to download the file P09_66.xlsx from the textbook companion website http://www.cengage.com/cgi-wadsworth/course_products_wp.pl?fid=M20b&product_isbn_issn=9781305947542. Under “Book Resources”, click on “Student Downloads” to view the downloadable files. Click “Problem Files” and download the zipped file 1305947541_538885.zip. Open the zipped file, and select folder “Problem Files” and then select folder “Chapter 09” to access the file P09_66.xlsx.
Page 410 on Textbook Problem 66
A company is concerned with the high cholesterol levels of many of its employees. T help combat the problems, it opens an exercise facility and encourages its employees to use this facility. After a year, it chooses a random 100 employees who claim they use the facility regularly, and another 200 who claim they don’t use it at all. The cholesterol levels of these 300 employees are checked, with the results shown in the file P09_66.xlsx.
(a) Is this sample evidence “proof” that the exercise facility, when used, tends to lower the mean cholesterol level? Phrase this as a hypothesis-testing problem and do the appropriate analysis. Do you feel comfortable that your analysis answers the question definitively (one way or the other)? Why or why not?
(b) Repeat part a, but replace “mean cholesterol level” with “percentage with level over 215” (The company believes that any level over 215 is dangerous.)
(c) What can you say about causality? Could you ever conclude from such a study that the exercise causes low cholesterol? Why or why not?
The Assignment: (5 pages)
· Complete Problem 66 on page 410 of your course text using SPSS.
· Complete Case Study 9.3, “Removing Vioxx From the Market,” on pages 412-413 of your course text.
· This case study requires only calculations and analysis of them, so you may complete this case study using any tool you choose.
By Day 7
Submit your answers and embedded analysis (SPSS and other analysis) as a Microsoft Word management report.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
· Please save your Assignment using the naming convention “WK4Assgn+last name+first initial. (extension)” as the name.
· Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
· Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
· Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial. (extension)” and click Open.
· If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
· Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 4 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 4 Assignment draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment: Week 4 Assignment
Assignment: Legislation Comparison Grid And Testimony/Advocacy Statement 2
As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.
Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.
To Prepare:
Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Comparison Grid; 1-page Legislation Testimony/Advocacy Statement) Part 1: Legislation Comparison Grid
Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:
Determine the legislative intent of the bill you have reviewed.
Identify the proponents/opponents of the bill.
Identify the target populations addressed by the bill.
Where in the process is the bill currently? Is it in hearings or committees?
Part 2: Legislation Testimony/Advocacy Statement
Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:
Advocate a position for the bill you selected and write testimony in support of your position.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Name: NURS_6050_Module02_Week04_Assignment_Rubric
· Grid View
· List View
Excellent
Good
Fair
Poor
Federal and State Legislation Part 1: Legislation Comparison Grid Based on the health-related bill you selected, complete the Legislation Comparison Grid Template. Be sure to address the following: • Determine the legislative intent of the bill you have reviewed. • Identify the proponents/opponents of the bill. • Identify the target populations addressed by the bill. • Where in the process is the bill currently? Is it in hearings or committees?
32 (32%) – 35 (35%)
The response clearly and accurately summarizes in detail the legislative intent of the health-related bill. The response accurately identifies in detail the proponents and opponents of the health-related bill. The response accurately identifies in detail the populations targeted by the health-related bill. The response clearly and thoroughly describes in detail the current status of the health-related bill.
28 (28%) – 31 (31%)
The response accurately summarizes the legislative intent of the health-related bill. The response accurately identifies the proponents and opponents of the health-related bill. The response accurately identifies the populations targeted by the health-related bill. The response accurately describes the current status of the health-related bill.
25 (25%) – 27 (27%)
The response vaguely or inaccurately summarizes the legislative intent of the health-related bill. The response vaguely or inaccurately identifies the proponents and opponents of the health-related bill. The response vaguely or inaccurately identifies the populations targeted by the health-related bill. The response vaguely or inaccurately describes the current status of the health-related bill.
0 (0%) – 24 (24%)
Summary of the legislative intent of the health-related bill is vague and inaccurate or is missing. Identification of the proponents and opponents of the health-related bill are vague and inaccurate or is missing. Identification of the populations targeted by the health-related bill is vague and inaccurate or is missing. The description of the current status of the health-related bill is vague and inaccurate or is missing.
Advocating for Legislation Part 2: Legislation Testimony/Advocacy Statement Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following: • Advocate a position for the bill you selected and write testimony in support of your position. • Describe how you would address the opponent to your position. Be specific and provide examples.
45 (45%) – 50 (50%)
Testimony clearly and thoroughly provides statements that fully justifies a position for a health-related bill. Response provides a detailed, thorough, and logical explanation of how to address opponents to the position for the health-related bill and includes one or more clear and accurate supporting examples. A complete, detailed, and specific synthesis of two outside resources is provided. The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the responses provided.
40 (40%) – 44 (44%)
Testimony clearly and accurately provides statements that somewhat justifies a position for a health-related bill. Response provides an accurate explanation of how to address opponents to the position for the health-related bill and may include at least one supporting example. An accurate synthesis of at least one outside resource is provided. The response integrates at least 1 outside resource and 2-3 course specific resources that may support the responses provided.
35 (35%) – 39 (39%)
Testimony used to justify a position for a health-related bill is vague or inaccurate. Explanation of how to address the opponents to the position for the health-related bill is vague or inaccurate, lacks logic, and/or the supporting examples are vague or inaccurate. A vague or inaccurate synthesis of outside resources is provided. The response minimally integrates resources that may support the responses provided.
0 (0%) – 34 (34%)
Testimony used to justify a position for a health-related bill is vague and inaccurate, incomplete, or is missing. Explanation of how to address the opponents to the position for the health-related bill is vague and inaccurate, or is missing. A vague and inaccurate synthesis of no outside resources is provided, or is missing. The response fails to integrate any resources to support the responses provided. The recommendation of an amendment to the bill in support of the position is inaccurate and incomplete, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 (5%) – 5 (5%)
Uses correct APA format with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) APA format errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Describe how you would address the opponent to your position. Be specific and provide examples.
NURS 3020 Health Assessment/walden-nurs6053-all-weeks-discussions/ Week 2 Discussion
Caring and Ethics in Your Practice
Some things in nursing never change. Caring has been the basic work of nurses from the genesis of nursing.
Caring and nursing are inextricably intertwined. For example, caring is defined as, “feeling and exhibiting concern and empathy for others; showing or having compassion†(The Free Dictionary by Farlex, 2015, para. 2). Nurse is defined by Merriam-Webster (2018) as, “a person who cares for the sick or infirm†(para. 3). As these definitions demonstrate, caring is a feeling that also requires an action.
The theory of the ethics of care has evolved over time between obligation-based ethics and responsibility-based ethics. The former asks, “What obligation, if any, do I have to this person?†In the latter, responsibility-based ethics, the relationship with others is a given. The only question is how to best meet the responsibility for effective care.
According to the Code of Ethics for Nurses, “Optimal nursing care enables the patient to live with as much physical, emotional, social, and religious or spiritual well-being as possible†(American Nurses Association, 2015, p. 2).
Caring is an essential part of patient care. There are four phases of caring. They are attentiveness, responsibility, competence, and responsiveness. Caring requires the nurse to put aside personal biases and prejudices to effectuate the four phases of caring. The four phases of caring suggest that good care demands more than just good intention; good care. It is a practice of combining activities, attitudes, and knowledge of the situation.
To Prepare
Review the Week 2 Discussion Rubric provided in the Course Information area.
Review Chapters 7–10 and 12–16 in the course text.
Review, this week’s Resources.
Review this week’s Writing Resources and Program Success Tools.
Consider types of caring techniques and strategies that can be used during a health assessment.
Think about a time when you had the opportunity to encourage a patient to comply with a health promotion activity, and whether you did so successfully or not.
By Day 3
Post a substantive 2-paragraph response (at least 350 words) to one of the options below. Develop and post cohesive paragraphs, and use evidence to support your ideas.
Cohesive paragraphs
Evidence
What caring techniques/strategy can you use during the health assessment of a patient to encourage the patient’s adherence to a treatment plan?
Describe an instance in your practice when you successfully encouraged a patient to comply with a health promotion activity. If you have not successfully encouraged a patient to comply with a health promotion activity, how might you have done so based on what you know now?
By Day 7
Read two or more of your colleagues’ postings for the Discussion question.
Respond to at least two of your colleagues in one of the following ways:
Expand upon the proposed technique(s).
Suggest an alternative technique to encourage adherence to a treatment plan.
Ask a clarifying question about a colleague’s proposed technique or strategy, or about the instance when your colleague successfully encouraged a patient to comply with a health promotion activity.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of the comments your colleagues made.
Provide a Discussion entry on three different days of the week. See the Discussion Rubric for more information.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
NURS 3020 Health Assessment Week 3 Discussion
It’s a Small, Small World
Health conditions, including heart disease and respiratory infections, have no borders. What happens in one part of the world has ripple effects through the other parts, including the United States. Technology has created an even smaller world, with nurses in instant contact and eager to share information.
You and your nursing colleagues live and work around this shrinking professional world. Your nursing experience working with diverse populations presents a rich opportunity to share your international health perspectives. This exercise is a growth opportunity in terms of how we see ourselves, the world, and how we interact with our patients during the health interview and health assessment process.
In this week’s Discussion, your stories will illustrate relevant social and cultural differences among yourselves and your patients. The collective experience will expand your individual nursing knowledge; improve upon our cultural humility and perspectives, in order to foster social and culturally-sensitive health interviews and assessments. This, in turn, contributes to safer and higher quality outcomes for your patients. Consider how your sensitive care is expressed through choice of your words, maintaining a distance that is culturally appropriate, and utilizing other techniques to negotiate through established social and cultural values. This leads to patient trust and comfort and a respectful nurse-patient relationship.
To Prepare
Review the Week 3 Discussion Rubric provided in the Course Information area.
Review Chapters 8 and 18–20 in the course text.
Review the article “Many Faces: Addressing Diversity in Health Care,†provided in this week’s Resources.
Review this week’s Writing Resources and Program Success Tools.
By Day 3
Post a substantive 2-paragraph response (at least 350 words) to one of the options below. Develop and post cohesive paragraphs, and use evidence to support your ideas.
Cohesive paragraphs
Evidence
Complete one of the following options (Option One, Option Two, or Option Three). Use the Discussion Rubric to develop your post.
Reflect on your reading from this week, and then address one of the following:
Option One:
Describe an incident, or incidents, in your own nursing practice in which you expressed social or cultural sensitivity in order to elicit a competent health history or assessment. Explain the positive impact your sensitivity had on patient care or collegial efficacy of patient care.
Option Two:
Describe a situation in which the absence of social or cultural sensitivity adversely impacted patient care or collegial efficacy of patient care. How could the situation been handled to produce a more positive outcome during the health interview or assessment?
Option Three:
Describe one or more situations that illustrate social or cultural humility, or insensitivity, among your colleagues in a manner that fostered improved peer cooperation or efficacy of patient care or impeded such care.
By Day 7
Read two or more of your colleagues’ postings for the Discussion question.
Respond to at least two of your colleagues in one of the following ways:
Expand upon their Discussion.
Suggest an alternative to their viewpoint.
Ask a clarifying question about a colleague’s proposed technique or strategy.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of the comments your colleagues made.
Provide a Discussion entry on three different days of the week. See the Discussion Rubric for more information.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
NURS 3020 Health Assessment Week 4 Discussion
Promoting Nutrition in Older Adults
Older adults are the fastest growing age group in North America. This demographic is expected to continue for the next several decades and has demanded increased attention to promoting and supporting their health and well-being.
Nurses must be adept in nutrition assessment and education and guiding older adults in their self-management and care activities. Each nurse needs to understand valid information sources as they relate to patient’s health literacy skills.
Patients over the age of 65 are at an increased risk for lower levels of health literacy. Health literacy is believed to be a stronger predictor of health outcomes than are social and economic status, education, gender, and age.
A nurse must know how to overcome multiple barriers when caring for a patient with low health literacy. Mistrust is one barrier. When the nurse is different from the patient in terms of age, ethnicity, education, and socio-economic status, the patient may have difficulty asking questions or be reluctant to disclose personal information.
To Prepare
Review the Week 4 Discussion Rubric provided in the Course Information area.
Review Chapters 11 and 21 in your course text.
Review the Writing Resources and Program Success Tools.
Review this week’s Writing Resources and Program Success Tools.
Using the Nursing Databases in the Library, seek out a professional article that was published within the past 5 years pertaining to one of the three Discussion options below. Some topics to look for might include:
Nutrition and age groups
Abdominal differences
Reaching a higher level of care
Health promotion and patient centered care
Ethics
Population health
From the article, pick out three important key points or “take-a-ways.†Be sure to cite and reference the professional article selected along with other sources of evidence.
By Day 3
Post a substantive response (at least 350 words) to one of the following options. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Use the writing resources and the Discussion Rubric to develop your post.
Evidence
In-text citations
Essay-level
Transitional material
Organizational frames
Option One:
In the text, you read about the various types of nutritional assessments that can be utilized during the health history and assessment process. From a professional article you selected, describe one effective nutritional assessment that can be used specifically for an older individual in outpatient care clinics, hospitals, or long-term facilities.
Option Two:
As older adults live longer, they may have more than one chronic disease. Or, they may have a health problem that can lead to another condition or injury if not properly managed. The older adult requires careful nutritional management to ensure proper care and improve or maintain quality of life. From the professional article you selected, describe the unique nutritional needs of this population.
Option Three:
With the rapid population increase of older adults and the surge in online health information, efforts targeted at older adults and their health literacy are both relevant and crucial to promoting and supporting overall health. From the professional article you selected, describe effective nurse strategies aimed to improving the health literacy of this population.
Use the Writing Center to help you cite correctly: http://academicguides.waldenu.edu/writingcenter/apa/citations
Use the Nursing Research Databases in the Library to search for professional articles: http://academicguides.waldenu.edu/nursingresearch
Learn how to evaluate resources in the Library: http://academicguides.waldenu.edu/library/evaluating
By Day 7
Read two or more of your colleagues’ postings for the Discussion question.
Respond to at least two of your colleagues in one of the following ways:
Expand upon their Discussion.
Suggest an alternative to their viewpoint.
Ask a clarifying question about a colleague’s proposed technique or strategy.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of the comments your colleagues made.
Provide a Discussion entry on three different days of the week. See the Discussion Rubric for more information.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
NURS 3020 Health Assessment Week 5 Discussion
Patient-Centered Care—At First Contact
Nurses and patient-centered care (PCC) go hand-in-hand. Nurses enjoy taking care of patients in a holistic, personalized, relationship-based way that honors the patients’ preferences, needs, and values. In its landmark book, Crossing the Quality Chasm (2001, p. 40), the Institute of Medicine (IOM) defined patient-centered care as “…providing care that is respectful and responsive to individual patient preferences, needs, and values—ensuring that patient values guide all clinical decisions.â€
This is the last week in which we are reviewing health assessment techniques. We end by covering cognitive assessments and musculoskeletal and neurological examinations. The purpose of this discussion is for you to reflect on your relationships with your patients and to identify ways that you can strengthen your PCC approaches beyond health interviews and assessments.
As you move forward in the program, you will learn more about encouraging patients to be engaged at every level of care design and implementation within the health care system. After all, PCC is connected to improved quality and patient outcomes, and you will learn more about that too!
To Prepare
Review the Week 5 Discussion Rubric provided in the Course Information area.
Review Chapters 5, 22, and 23 in the course text.
Choose two of the six dimensions of patient-centered care (PCC), listed below, on which to focus for this Discussion.
Think about how you might implement the two dimensions you selected into your health interview and assessment process in order to improve quality in patient collaboration and outcomes.
Respect for patients’ values, preferences, and expressed needs
Coordination and integration of care through collaboration and teamwork
Accessibility and free flow of information, communication, and education
Physical comfort
Sensitivity to non-medical and the spiritual dimension of care (emotional support)
Involvement of family and friends
By Day 3
Post a substantive 3-paragraph response (at least 350 words) discussing the selected dimensions of patient-centered care.
Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Use the writing resources and the Discussion Rubric to develop your post.
Evidence
In-text citations
Essay-level
Transitional material
Organizational frames
Define the two dimensions of patient-centered care that you selected.
Describe how your implementation of the two dimensions in your health interview and assessment will improve quality in patient collaboration and outcomes.
By Day 7
Read two or more of your colleagues’ postings for the Discussion question.
Respond to at least two of your colleagues in one of the following ways:
Expand upon their Discussion.
Suggest an alternative to their viewpoint.
Ask a clarifying question about a colleague’s proposed technique or strategy.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of the comments your colleagues made.
Provide a Discussion entry on three different days of the week. See the Discussion Rubric for more information.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
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