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End of Life Decisions/ Death and Dying Case study

Case Study on Death and Dying

Introduction

Death and the process of dying is a very difficult and unpleasant part of life, yet an inevitable part of life. Death is normally associated with some deep philosophical and religious connotations. Euthanasia refers to the practice of ending the life of a very sick person in order to relieve them the suffering. Euthanasia is a contentious issue in bioethics and it is viewed differently in Christianity and philosophically (Saybey, 2016). The purpose of this paper is to provide an analysis of George’s case study. George had amyotrophic lateral sclerosis (ALS) diagnosis. ALS is a degenerative disease that leads to loss of the ability to speak, eat, move, breath, and the patient finally dies. Specifically, the imminent death for George and the option of euthanasia, according to the Christian view will be analyzed. End of Life Decisions/ Death and Dying Case study.

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George’s Suffering in Light of the Christian Narrative & The Fallenness of the World

In Christianity, the fallenness of the world and suffering are closely connected. The fallenness of the world started when Adam and Eve were put in the garden of Eden by God. Eve and Adam were taking care of God’s creation. They both enjoyed everything for free and they did not suffer in any way, until when they tasted the forbidden fruit and they were chased from Eden. As a result, God separated Himself from humankind and this is was the start of the fallenness of the world. As per the Christian narrative, the beginning of the suffering for mankind was the fallenness of the world (Shelly & Miller, 2009). A curse was declared upon mankind that would have to work to get food. Accordingly, the suffering among the humankind is a curse from God. End of Life Decisions/ Death and Dying Case study.

Similarly, as per the narrative of the fallenness of the world, George can associate his suffering with being sinful because sin is the main cause of suffering among human beings. Humankind keeps sinning continually and falling short of the will of God. Therefore, George can compare his suffering as being the consequences of his sinful nature, as a human being. Human beings do not like experiencing God’s curse, that God declared in the Garden of Eden after Eve and Adam disobeyed Him (Shelly & Miller, 2009).  End of Life Decisions/ Death and Dying Case study. George can thus find the consolation in that suffering is inherent for every human being because all have sinned against God.

Interpretation of George’s Suffering in Light of the Christian Narrative

Christians believe that everything was created by God and Jesus was sent on earth by God to represent God and enable humanity to feel and experience God through him. Thus, as a Christian, George would construe his sickness as being the will of GOD. According to Saybey (2016), such as being experienced by George is meant to bring people closer to God and make humans understand the suffering Christ experienced. The death of Jesus changes the whole experience of death. Even though death as per the worldview, is evil and tragic, Jesus was able to defeat death on the cross.

In the Christian narrative, death is thus a defeated enemy. Humanity will conquer when Jesus comes back as all people who died in Christ will resurrect. The Christian God is always providing redemption and similarly will redeem and save humanity from death. Therefore, human beings should remain close to God and always follow God’s teachings. End of Life Decisions/ Death and Dying Case study. Viewing suffering as God’s will assists Christians to remain steadfast in their Faith, making the Christian faith stronger. When Christians believe that suffering is because of their sins, a person gets an opportunity to repent and turn their back to the sinful life, and their face towards God (Shelly & Miller, 2009). God is very methodical and orderly as He allows human beings to experience suffering to make them stop sinning in order to experience the love of God. Even if there are people who may perceive their suffering as punishment from God, this also indicates that God greatly loves human beings because He comes with ways to encourage humans to lead their lives as per God’s purpose.

The end result is that even after death, Christians still have the hope of resurrection the same way Jesus defeated death and resurrected. Therefore, this reasoning can help George to reassess his life, repent, and go back to God and have faith that all the suffering he might experience will cease after dying (Shelly & Miller, 2009). After repentance, George has the hope of defeating death through resurrection when Christ comes for those who died in Him. End of Life Decisions/ Death and Dying Case study.

How the Christian Worldview Inform George’s View about the Value of His Life as a Person?

As per the Christian worldview, even when he is suffering from ALS, George is supposed to perceive his life as a priceless gift from God, and thus only God has the authority and right to take away a human life. Therefore, even with the fatal and unbearable disease, George is supposed to endure the suffering and pain that comes with the disease just like Christ did (Shelly & Miller, 2009). The agonizing experiences like the ones George is undergoing are not supposed to make people decide to end their lives. Christians believe that people should uphold their faith even when undergoing unbearable suffering.

Even in the face of an incapacitating and devastating disease such as ALS, George remains a valuable human being in God’s eyes. Even in sickness, the life of George is still priceless and a gift from the Almighty and there are good reasons why God allowed George to suffer from ALS. George should, therefore, try to understand God’s teachings through his sickness and use his condition and the teaching to further glorify God. As per Christian worldview, George ought to continue enduring his current suffering while respecting the fact that life is sacred and God-given and thus a very priceless and valuable gift (Saybey, 2016) End of Life Decisions/ Death and Dying Case study.

 

Values and Considerations the Christian Worldview Focus on in Deliberating about Whether or Not George Should opt for Euthanasia

The values the Christian worldview to consider when making a decision if George should undergo euthanasia or not, is the suffering is inherent in the life of human beings and the same way Jesus suffered, people ought to accept suffering and let the will of God to happen, just like Jesus did (Shelly & Miller, 2009). When Jesus was crucified on the cross, he suffered immensely before he died and he even asked God to take away the suffering He was experiencing if it was His will. It is, therefore, the will of God for George to experience the current disease, and thus George should accept the suffering and ask God to provide him with the strength to carry on. Moreover, since God sometimes uses suffering to bring human beings closer to Him, George should try to figure out God’s teachings through his sickness (Meilaender, 2013).

The belief of life after death is a major determining factor in how an individual views imminent death (Meilaender, 2013). Christianity views pain and death as the will of God and the resurrection of Jesus as the hope that there is life after death. Therefore, George is supposed to perceive his life and sickness as the will of God over his life. God is the giver of life and only He should take away George’s life.

Options that Would be Morally Justified in the Christian Worldview for George and Why

The option that is morally justified for George as per the Christian worldview is for him to continue bearing the suffering and continue living until when God decides to take away the pain and suffering through death. Accordingly, the Christian worldview does not support euthanasia as an option. Life is a gift from God and thus euthanasia equates to interfering with God’s plans for a human being and this is both morally wrong and unacceptable in Christianity. Suffering is also inherent for all human beings, being even Jesus suffered immensely while on earth so euthanasia is not an option for any suffering Christian (Shelly & Miller, 2009).

My Decision if in George’s Situation

Despite being a Christian, in case I was experiencing George’s suffering from a very painful and disabling disease like ALS, I would consider the option of voluntary euthanasia. Euthanasia is against the teachings of Christianity; however, as a nurse, I witness patients experiencing so much suffering especially when facing terminal diseases. Accordingly, I would not want to undergo such pain and suffering in the face of unavoidable death in the option of euthanasia is available. The Bible indicates that God is very forgiving and understanding and hence no sin is unforgivable, including euthanasia.

Conclusion

From Christian’s perspective, life is a priceless gift from God and only the creator should take away life. Suffering is a part and parcel of a human being and God uses suffering to bring humanity closer to him and make them turn away from sin. From the Christian perspective, George ought to accept his disease condition and the ensuing suffering as God’s will and try to figure out what God is teaching him through the sickness. In Christianity, euthanasia is a morally wrong option for George. End of Life Decisions/ Death and Dying Case study.

References

Meilaender G. (2013). Bioethics:
A Primer for Christians
, 3rd Edition. Michigan: Eerdmans.

Saybey B. (2016). Definitions of death: brain death and what matters in a person.
J Law Biosci
. 3(3), 743–752.

Shelly J & Miller A. (2009).
Called to Care: A Christian Worldview for Nursing
2nd Edition, Illinois: IVP Academic.

 

End of Life Decisions/ Death and Dying Case study

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and acceptance of a diversity of faith expressions.

The purpose of this 
End of Life Decisions
/ Death and Dying Case study paper is to complete a comparative ethical analysis of George’s situation and decision from the perspective of two worldviews or religions: Christianity and a second religion of your choosing. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from include Sikh, Baha’i, Buddhism, Shintoism, etc.

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In your comparative analysis, address all of the worldview questions in detail for Christianity and your selected faith. Refer to Chapter 2 of Called to Care for the list of questions. Once you have outlined the worldview of each religion, begin your ethical analysis from each perspective. End of Life Decisions/ Death and Dying Case study.

In a minimum of 1,500-2,000 End of Life Decisions/ Death and Dying Case study words, provide an ethical analysis based upon the different belief systems, reinforcing major themes with insights gained from your research, and answering the following questions based on the research:

How would each religion interpret the nature of George’s malady and suffering? Is there a “why” to his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?)

In George’s analysis of his own life, how would each religion think about the value of his life as a person, and value of his life with ALS? v.

What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia?

Given the above, what options would be morally justified under each religion for George and why?

Finally, present and defend your own view.

Support your position by referencing at least three academic resources (preferably from the GCU Library) in addition to the course readings, lectures, the Bible, and the textbooks for each religion. Each religion must have a primary source included. A total of six references are required according to the specifications listed above. Incorporate the research into your writing in an appropriate, scholarly manner.

Case Study: End of Life Decisions

George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching post at the local university law school in Oregon. George is also actively involved in his teenage son’s basketball league, coaching regularly for their team. Recently, George has experienced muscle weakness and unresponsive muscle coordination. He was forced to seek medical attention after he fell and injured his hip. After an examination at the local hospital following his fall, the attending physician suspected that George may be showing early symptoms for ALS (amyotrophic lateral sclerosis), a degenerative disease affecting the nerve cells in the brain and spinal cord. The week following the initial examination, further testing revealed a positive diagnosis of ALS. End of Life Decisions/ Death and Dying Case study.

ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the point of complete muscle control loss. There is currently no cure for ALS, and the median life expectancy is between three and five years, though it is not uncommon for some to live 10 or more years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the ability to speak, move, eat, and breathe. However, sight, touch, hearing, taste, and smell are not affected. Patients will be wheelchair bound and eventually need permanent ventilator support to assist with breathing. End of Life Decisions/ Death and Dying Case study.

George and his family are devastated by the diagnosis. George knows that treatment options only attempt to slow down the degeneration, but the symptoms will eventually come. He will eventually be wheelchair bound, and be unable to move, eat, speak, or even breathe on his own. End of Life Decisions/ Death and Dying Case study.

In contemplating his future life with ALS, George begins to dread the prospect of losing his mobility and even speech. He imagines his life in complete dependence upon others for basic everyday functions, and perceives the possibility of eventually degenerating to the point at which he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his own dignity and power? George thus begins inquiring about the possibility of voluntary euthanasia. End of Life Decisions/ Death and Dying Case study

Directions: For this assignment, read the story and then list the HIPAA violations that you find.

Heather was at home when she began to experience severe abdominal pain. She decided she needed to go to the nearest emergency room for help. Upon her arrival she was met by the intake specialist who asked her why she was there. Heather explained she had been having severe abdominal pain for two days and it was getting worse and she was having a hard time standing up. The intake specialist, shouted across the room, “We have Heather here for abdominal pain, do we have a room?”

At this time, a nurse stuck her head out of a hallway and shouted that she would be right there to take Heather back to a room. Meanwhile, Heather was asked to wait in the holding area, until the nurse would come and get her. As Heather waited in the room, she noticed several patient’s names scribbled on the white board with a reason for visit. She wondered if she knew any of those people, so she read the entire list and discovered her neighbor, Stephanie was there for an apparent anxiety attack. Heather thought to herself, “I knew this neighbor was a bit odd, and now it is confirmed!” After twenty minutes of waiting, Heather felt she could have memorized the list. After all, what else was there to do? No one offered her any activities to keep her busy while she waited. Finally, the nurse came in and led her to her room. As she entered the room, she noticed, her full name was posted outside of the door for all to see. Well, Heather, thought, this might be good because with the names on the door, family members will be able to find their loved ones easily. HIPAA Violations.

The nurse took her vitals and prepared her for the doctor to examine her. The doctor walked in the room and said, “I apologize for the delay, but I was putting sutures in Mrs. Donaldson’s hand. She has had a bad night. Her dog bit her and left a deep hole on the back of her hand. Well, enough about her, how can I help you?”

Once again, Heather explained that she was having severe abdominal pain. The doctor then examined her and ordered an ultrasound to rule out gall stones. He said for her to sit tight and someone will be in to take her down to x-ray. As she waited, Heather heard the nurses outside her door, talking about a patient named Amanda Johnson who came in with scabies. The nurses were making fun of Amanda because she was a large woman. They were laughing and laughing. Just then, the ultrasound tech arrived and took Heather down for her test. HIPAA Violations.

Heather’s ultrasound was over rather quickly and the tech took her back to her room. The tech stated that the results should take no more than 30 minutes. Heather waited patiently and suddenly, she heard the doctor in the hallway, telling the nurses that Heather had gall stones and should be referred to a surgeon for a consult. Heather noticed that there were visitors hanging out in the same area where the doctor was talking loudly about her diagnosis.

The doctor came into the room and began to tell Heather the results but she interrupted him and said, “Yes, I heard you tell everyone out there I have gall stones.” The doctor proceeded to tell her that they would give her the name of a surgeon, and she should follow up A.S.A.P. for possible gall bladder removal. He told her that her discharge papers would be ready soon. HIPAA Violations.

After an hour of waiting, the nurse arrived with her discharge paper work. She handed them to her and asked her to, “Sign here”. Heather just wanted to leave, so she signed the form. Once she got into her car, she looked at the discharge form and discovered, it was not her discharge paperwork at all, it was her neighbor Stephanie’s!

List all of the HIPAA Violations in the story above.

Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient

Assessment name: Case Study: The Deteriorating Patient

Task description: For this essay you are required to select ONE case scenario related to the clinical deterioration of a patient: Option 1: Traumatic Brain Injury Option 2: Septic Shock

What you need to do: In order to undertake this 1500 word essay you will need to research the topic using current and relevant peer reviewed literature and review of:

The lecture and tutorial material associated with the relevant topic.

Your knowledge and understanding related to: 1. The physiology and pathophysiology of the primary

diagnosis and associated clinical data identified within the chosen case study;

2. The physiological assessments relevant to the features within the case study.

The assessment tasks requires you to:

1. Identify and discuss two (2) signs or symptoms of clinical deterioration associated with the presenting problem, from chosen case study. This discussion should consider the potential impact of case study data (e.g. pathology results, past medical history) on the health status of the patient in the chosen case. 2. Following on from your presented discussion associated with point one (1), develop a clinical plan of care which identifies: Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

One (1) priority of clinical care and;

Discuss three (3) nursing interventions that directly address the identified clinical priority. The discussion should refer to relevant clinical assessments. Measurable outcome parameters for each intervention will be discussed to justify the intervention and evaluate its efficacy. Discussion is to be supported with contemporary research.

Length: 1500 words +/-10% (word length includes in-text referencing and excludes your reference list)

Estimated time to complete task:

Approximately 30 hours

Weighting: 50%

How will I be assessed: As a percentage using a 7-point grading scale rubric. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Due date: Friday September 21st submitted via Turnitin in your Blackboard site by 23:59 hours. More information about Turnitin is available on the FAQs about Turnitin page.

Presentation requirements:

This assessment task must:

Be a written academic essay containing an introduction, body

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and conclusion, addressing the task. Use QUT APA referencing for citing academic literature (see

http://www.citewrite.qut.edu.au/). Assignment cover sheet must be included as the first page of

your document. Be submitted in electronic form via Turitin. A minimum of 15 relevant references to be cited from valid,

contemporary journal articles or books no older than 7 years. The use of websites as references is NOT permitted. The submitted essay should NOT contain tables, figures or

appendices. The uses of dot points are NOT permitted.

Your assignment should be prepared as follows: Has a cover sheet with the assessment title, your name, student

number, tutor name and word count. Coversheet template is recommended. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Include a ‘footer’ on each page with your name, student number, unit code and page number.

3 cm margins on all sides, double-spaced text Times new roman, font size 12 APA style referencing (see http://www.citewrite.qut.edu.au/) Headings can be used to structure your assignment logically (if

applicable)

be submitted in electronic format via Turnitin.

Learning outcomes assessed:

1. Consolidate knowledge of key NMBA Registered Nurse Standards for Practice, National Safety and Quality Health Services Standards, and National Health Priorities to enable effective decision planning and action in a range of complex clinical situations across the lifespan.

2. Apply knowledge of anatomy, physiology and pathophysiology to

support evidence based decision making associated with planning and action.

3. Demonstrate structured decision making and clinical reasoning to review a range of health situations, synthesise evidence and data, determine priorities and formulate plans of care and interventions in line with timeframes and agreed goals.

What you need to submit:

One word document that contains the following items: 1. Assignment Cover Sheet & responses to Question 1 & 2 2. Must be submitted in electronic form via Turitin by the assigned date. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Resources needed to complete task:

Case studies and clinical documents available within this document.

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Documents such as additional readings available on your blackboard site.

Access to the prescribed texts for this unit as outlined in the unit details.

QUT Cite|Write APA guide. Turnitin Tip Sheets.

Academic Integrity The School of Nursing takes academic integrity very seriously. All work submitted must be your own work and work not previously submitted for other study. The work of others needs to be correctly acknowledged and referenced according to the APA guidelines. There are serious consequences that will be imposed should you be found to breach academic integrity. Make sure you are familiar with the MOPP C/5.3 Academic Integrity and view the Academic Integrity video and explore the Academic Case Studies available on your Blackboard site. Maintaining academic integrity is your responsibility. If in doubt, check it carefully. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Assignment Hints This assignment requires you to critically consider the signs and symptoms associated with clinical deterioration in relation to the patient’s primary clinical diagnosis, with consideration to:

The change in health status associated with the primary clinical diagnosis; How the patients clinical history may impact on assessment data and core

interventions; The identified clinical priority which should clearly emerge from your

discussion of the primary health alteration. The application of clinical data and research to identify three (3) core

interventions and assessments that address the stated clinical priority. Evaluation data supported by research to effectively determine success of

the intervention. The SMART goals format may be of assistance in guiding you in structuring this. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Demonstration of your clinical reasoning for your selected case study. Demonstrating your understanding and application of evidence based care

i.e. the research you have to support your discussion and ideas regarding clinical interventions and assessment outcomes.

Format example: The introduction to your paper should provide the reader with background

regarding the primary pathophysiological concepts being discussed, a brief overview of the case study (summation of the primary points), the objective of the paper (what you intend to address), and the rationale for the paper (why is it important to apply and understand the content).

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The body should include: o Discuss the physiology of the health alteration and how the signs and

symptoms you have identified reflect these changes (you may wish to consider the clinical data provided to support your discussion of ideas e.g. blood results, medical imaging and/or past medical history).

o Research you have undertaken is discussed in relation to the change in the health status of your patient, and the one (1) priority of clinical care. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

o A discussion of research relevant to nursing interventions that address the clinical priority that you have identified. What can be implemented that would help address the priority of care, and why such interventions are likely to be helpful based on your research. Remember this should address key considerations for deteriorating patient, therefore nursing interventions such pressure area care may not be a major clinical priority in this context.

The research you have undertaken should assist you in identifying and discussing the key assessment parameters: e.g. what are the current research recommendations, how will you evaluate the impact of an intervention on the patient (this should be measurable e.g. oxygen saturations are greater than 95% and a justification for why 95% is the chosen target)

Conclusion: The conclusion should bring together the main objective of the paper (which you outlined in the introduction), provide a summation of the key points that you discussed (do not introduce need content into the conclusion), and provide a concluding comment regarding the clinical application of the concepts. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

This unit has three main texts assigned to it, which should form the basis of your initial research and conceptual development relating to the assessment concepts, these are:

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Case Option 1: Traumatic Brain Injury

James “Jimmy” Parsons is a 26 year old flight engineer who was admitted post- operatively to the High Dependency Unit approximately 46 hours ago. He was out with friends on Saturday night when he was involved in an altercation out the front of a bar with another group of males who had been making lude remarks about female acquaintances of Mr Parsons. During this altercation, it is alleged that one of the individuals punched Mr Parsons in the face, and as a result he lost consciousness, fell, and hit the back of his head on the pavement. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

On arrival to the Emergency Department he underwent an urgent CT brain scan which revealed a sub-dural hemorrhage with 1cm mid-line shift and petechial hemorrhages, which was drained intra-operatively. A Codman’s intracranial pressure monitoring device was placed in order to monitor ICP levels post operatively. Mr Parson’s blood alcohol levels were noted to be elevated on assessment at the ED and his blood toxicology screen was negative for illicit substances. Over the immediate post-operative period he has been deemed to be stable and he has been extubated approximately 6 hours ago and is currently on Hiflow Nasal Prongs (HFNP). Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Past medical History Type 1 Diabetes, smoker (7-10 cigarettes per day), social drinker (6-10 beers on weekends), wisdom teeth removal x 4 (2010).

On assessment: He is lying supine (head of bed elevated 30%), Codman’s ICP monitoring insitu, GCS 10/15 (E3, V3, M4), Pupils equal and reactive to light and accommodating. There is visual evidence of raccoon eyes (see below image) and battle sign (right sided) (refer to below image).

– Assessment Task # Page 8 of 15

Vitals

Time 08:00hrs 10:00hrs

ICP (mmHg) 10 12

Temp (°C) 36.9 37.2

Respirations (breaths/min)

18 (eupnic) 23 (increased work of breathing, associated with agitation)

Blood pressure and Mean Arterial Pressure (MAP) (mmHg)

128/92 (98) 122/68 (86)

Heart rate (beats/min)

87 96

SpO2 (Fio2) 97% (Fio2 30%, 30L high flow nasal prongs (HFNP))

96 (FiO2 30%, 30L, HFNP)

BGL 6 (Actrapid infusion at 2units/hr)

6.4 (Actrapid infusion at 2 units/hr)

At 13:00 hours Mr Parson’s becomes tachycardic with a HR 118 without a clear precipitating cause, a 12 lead ECG confirms the rhythm to be sinus tachycardia. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

– Assessment Task # Page 9 of 15

At 13:10 his BP is 108/54mmHg (MAP 72), Heart rate 118-123 beats/min, temp 37.8°C (mildly diaphoretic), ICP 21mmHg, Sp02 95% (HFNP FiO2 30%, 30L), respiratory rate 11breaths/min with apneic periods (on auscultation air entry is decreased to both the left and right bases), BGL 12.1 mmol/L (Actrapid infusion at 2 units/hr), pupils equal (right side 4mm, slow reaction to light, left 4mm – brisk reaction to light). An urgent arterial blood gas is taken:

Temperature corrected result (37.8°C)

Results Reference range

pH 7.31 7.35-7.45

PaCO2 51 35-45

PaO2 88 80-100

Na 132 135-145

Cl- 105

Ca++ 1.11

Gluc 12.4

Lac 1.9 <2 Hb 89 SaO2 89 HCO3 23 22-24 Pa02/FiO2 ration 293

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Case Option 2: Shock Jedda Merindah 33 year old male of indigenous heritage who has been admitted to the Hematology/Oncology unit. Jedda was admitted post a medical emergency call for hypotension, via the oncology day unit where he was receiving chemotherapy for his Acute Myeloid Leukemia (AML). Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Background: AML – induction phase chemotherapy treatment

Patient reports nil temperatures – self monitors at home

Routine blood cultures taken from Hickman’s line 1 week ago – nil growth to date.

Past Medical History Acute Rheumatic Fever as a child – previous echocardiogram reveals no structural abnormalities, mild dilation of the left ventricle, normal ejection fraction.

Depression – Citalopram 10mg daily

Previous suicide attempt (2003) – drug overdose

Hypercholesterolemia – Atorvastatin 40mg

On assessment: Neuro: GCS 15/ 15, pupils equal and reactive to light, appears anxious and restless.

Cardiovascular: HR 118 beats/min- ECG reveals atrial fibrillation, non -invasive blood pressure 92/65mmHg, 250ml NaCl 0.9% fluid challenge given in ED, Febrile (38.8°C), diaphoretic, capillary refill time (CRT) < 3 sec., cool peripheries, Hickman’s line in situ, central venous catheter line inserted by ED senior registrar. Respiratory: Decreased air entry to left and right bases, non-productive cough, tachypneoic 28 breaths per minute, using accessory muscles, Fi02 44% via Hudson mask, SpO2 >95%. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

– Assessment Task # Page 11 of 15

GIT: nil reports of vomiting, decreased nutritional intake secondary to mouth ulcers, some loose bowel actions over last 2/7 days, nil malena, abdomen lax and non- tender, BGL 9.6mmol.

Renal: Decrease urinary output, patient reports dark in colour, IDC insertion pending.

Blood pathology results:

Results Reference ranges

Hb 89 130-180 g/L

White cell count 3.4 4-11 (x10*9/L)

Platelets 114 150-300 (x10*9/L)

Sodium 140 135-145 mmol/L

Potassium 4.7 3.5-5 mmol/L

Creatinine 138 60-120 µmol/L

Urea 11.2 3.6-9.3 µmol/L

Albumin 31 35-52 g/L

APTT 47 25-35 sec.

INR 2.4 0.8-1.2 units/kg

– Assessment # Page 12 of 15

NSB236 Assessment Task 1 Rubric Name: Learning outcomes assessed: 1,2,& 3 Weighting: 50%

Criteria 7 6 5 4 3 2 – 1 Critical thinking and knowledge

Weighting: 25%

Assignment content: critical explanation reflects a comprehensive interpretation and critical explanation of the assessment data; Comprehensive understanding of the central issues of the case – all key pathophysiological concepts and physical assessment issues addressed to determine priorities of care; Demonstrated a comprehensive depth of reasoning and logical and analytical thinking.

Assignment content: critical explanation reflects good interpretation and critical explanation of the assessment data; Good understanding of the central issues of the case – almost all key pathophysiological concepts and assessment issues addressed to determine priorities of care; Mostly demonstrated a depth of reasoning and logical and analytical thinking.

Assignment content: critical explanation reflects sound interpretation and some critical explanation of the assessment data; Sound understanding of the central issues of the case – most key pathophysiological concepts and assessment issues addressed to determine priorities of care; Soundly demonstrated a depth of reasoning and logical and analytical thinking.

Assignment content: critical explanation reflects basic interpretation and some or no critical explanation of the assessment data – content not overly discerning; Fair understanding of the central issues of the case – some key pathophysiological concepts and assessment issues addressed to determine priorities of care; Adequately demonstrated depth of reasoning and logical and analytical thinking .

Assignment content: limited critical explanation reflects poor interpretation and no critical explanation of the assessment data – content not discerning; Poor understanding of the central issues of the case – not all key pathophysiological concepts and assessment issues addressed to determine priorities of care; You have not adequately demonstrated depth of reasoning and logical and analytical thinking. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Assignment content: no critical explanation reflects poor interpretation and no critical explanation of the assessment data – content not discerning; No understanding of the central issues of the case – limited demonstrated understanding of pathophysiological concepts and assessment issues to determine priorities of care; You have not demonstrated depth of reasoning and logical and analytical thinking. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

– Assessment # Page 13 of 15

Applied knowledge of pathophysiology to inform clinical reasoning, clinical priority, assessment and outcome measures

Weighting: 25%

Comprehensive application of pathophysiological and physiological concepts which demonstrated an understanding of links between the patient condition, and assessments to formulate plans of care and interventions. Outcome measures discussed are comprehensively supported by contemporary evidence and makes association with physiological concepts.

Good application of pathophysiological and physiological concepts which demonstrated an understanding of links between the patient condition, assessments and outcome measures discussed to formulate a plan care of care and interventions.

The approaches are supported to a high level by contemporary evidence and makes association with physiological concepts.

Sound application of pathophysiological and physiological concepts which demonstrated an understanding of links between the patient condition, assessments and outcome measures discussed to formulate a plan of care and interventions. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

The approaches are supported to a good level by contemporary evidence and makes association with physiological concepts.

Fair application of pathophysiological and physiological concepts which demonstrated a fair understanding of links between the patient condition, assessments and outcome measures discussed to formulate a plan care and interventions.

The approaches are supported to a satisfactory level by contemporary evidence and makes association with physiological concepts. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Poor application of pathophysiological and physiological concepts which demonstrated little understanding of links between the patient condition, assessments and outcome measures discussed to plan care and appropriate interventions.

The approaches are supported by citation of research which may/may not be contemporary, but lacks insight and understanding of the association with physiological concepts.

No application of pathophysiological and physiological concepts which demonstrated no understanding of links between the patient condition, assessments and outcome measures discussed to plan care.

The approaches omitted physiological assessments for outcomes, may not adequately consider the correlation of physiological assessment and outcomes in relation to critical physiological concepts. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Application of evidence

Weighting: 25%

Demonstrates skilful and insightful use of high quality, credible and relevant sources to develop ideas, rationalise approaches and decision making that are appropriate to the clinical scenario.

There is an excellent demonstration of conceptual understanding of

Demonstrates skilful use of high quality, credible and relevant sources to develop ideas, rationalise approaches and decision making that are appropriate to the clinical scenario.

There is a good demonstration of conceptual understanding of

Demonstrates consistent use of credible, relevant sources to support ideas and decision making that are situated within the thought question.

There is a well-grounded demonstration of conceptual understanding of content.

Demonstrates an attempt to use credible and/or relevant sources to support ideas and decision making that are appropriate for the thought question.

There is a satisfactory demonstration of conceptual understanding of content.

Demonstrates an attempt to use sources to support ideas and decision making in the writing.

May have a number of 3-4 direct quotes that could have been paraphrased to demonstrate synthesis and understanding of content.

Limited evidence used to support ideas, poorly cited and or paraphrased. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Demonstrates limited critical application and understanding of content being applied. Frequent use of direct quotes.

The discussion does not demonstrate a strong grasp of

– Assessment # Page 14 of 15

content. content. The conceptual understanding of the content requires further development.

conceptual understanding to support decision making. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Academic writing

Weighting: 25%

Comprehensive, Clear and logical presentation; good development of an argument.

Used correct terminology and professional language consistently with the case study.

Uses language that skillfully communicates meaning to readers with clarity and fluency. Clear, readable, prose. Good use of transitions; no problems with spelling, punctuation, or grammar. Infrequent and minor mechanical problems. Errors do not impair readability. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Did not use direct quotes

All relevant aspects

Clear and logical presentation; good development of an argument. Used correct terminology and professional language for most of the handover the case study.

Uses language that effectively communicates meaning to readers with clarity and fluency. Clear, readable, prose. Some issues with transitions; no to minimal (2-4) problems with spelling, punctuation, or grammar. Infrequent and minor mechanical problems. Errors do not impair readability.

Rarely used direct quotes; Adhered to prescribed word limit.

Presentation is organized but does not present a clear argument for a given position.

Used correct terminology and professional language for some of the handover the case study.

Uses straightforward language that generally conveys meaning to readers. Occasional errors and minor problems with mechanics of language. Occasional awkward sentences and poor transitions reduce readability.

Sometimes used (1-2) direct quotes ;

Adhered to prescribed work limit

Infrequent errors in APA style; errors involve only minor aspects of APA style – no errors in style for citations & references.

Minor problems of organization or logic; Needs work on creating transitions between ideas.

Used correct terminology and professional language for part of the handover the case study. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

Uses language that generally conveys meaning to readers with clarity, although writing may include some errors. Frequent problems with mechanics of language. Awkward sentence construction. Poor or absent transitions. Frequently difficult to understand.

Sometimes used direct (3- 4) quotes;

Attempted to use APA style but errors are frequent and include errors in citations and references.

Word limit under/over the 10% allowance.

Logical flow and organisation is hampered by poor expression of ideas and grammatical errors Mechanics of writing impedes the discussion of ideas and the submission would benefit from further editing. You have not used correct terminology and professional language for the majority of the handover the case study. Overuse (4-5) of direct quotes; Not within required word limit. (15% over or under prescribed work limit).

No logical order to the information provided; sentences rambling; ideas are repeated.

Correct terminology and professional language used infrequently the case study.

Uses language that sometimes impedes meaning because of errors in usage. Problems with the mechanics of language serious enough to interfere with effective communication. Frequent errors in punctuation, spelling, sentence structure, etc.

Overuse of direct quotes (>5);

Did not adhere to word limit and is under or exceed by >/<15% Minimal use of APA style; multiple errors in

– Assessment # Page 15 of 15

of APA style are used correctly. Title page properly formatted, use of intext citations, format of references cited.

Adhered to prescribed word limit. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient.

use of APA style. Issues identify associated with breaches to academic integrity. Traumatic Brain Injury / Septic Shock Case Study: The Deteriorating Patient

NSG6999 Graduate Project in Nursing Discussions

Week 1 Discussion

Contains unread posts

To complete this week, after reading chapter one in Melnyk and reviewing the lectures you need to consider the topic of interest to you. List a ONE to two-word topic that you want to explore further and why you are interested in this topic. This topic encompasses the question that you have been generating throughout your program.

As an example I may choose the topic of depression, as I am interested in all of the depression I am seeing in the primary care office. Next week I will explore the background of this topic and this will lead to my PICOT question.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By the due date assigned
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this Discussion Area. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week, comment on the responses of at least two other students by supporting a minimum of one post and challenging a minimum of one post. You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area. 
Please only start a new thread with your original post. Hit reply to respond to a peer.

Week 2 Discussion

Contains unread posts

 

Post your background question and your strategy for getting a comprehensive understanding of the clinical issue. As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By the due date assigned
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week
 
comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

Week 3 Discussion

Contains unread posts

 

State your PICOT question.

Indicate in parentheses after each segment, what part of PICOT the preceding words represent.

For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T).

Provide feedback to your classmates that focuses on:

The use of correct PICOT format for the question to guide the literature search.

Does the question reflect a clinical issue and one appropriate for an evidence-based practice project?

Provide feedback to your classmates that focuses on:

The use of correct PICOT format for the question to guide the literature search.

Does the question reflect a clinical issue and one appropriate for an evidence-based practice project?

Support a minimum of one and challenge a minimum of one.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By
 
the due date assigned
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By
 
the due date assigned
 comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

Week 4 Discussion

Contains unread posts

 

Using the following table—search the 5 databases based on your PICOT Question—under findings note the number of relevant articles found—you may not find something in every database. Under features discuss what you liked about that database. ON the discussion board summarize your search—attach your chart for those that would like to see your search. You may not find what you are looking for in every search—and that is OK—but you must search every database to see what may be out there.

Exploring the Literature

Picot Question: 

 Research Tool

 Search Tips

 Search Terms &  Limits

 Findings

 Features

CINAHL

CINAHL is an 
SU subscription-only
resource that offers full text access to 336 scholarly journals and indexes over 3,000 journals from the fields of nursing and allied health. Indexed journals do not provide access to 
full-text
. Just because it is indexed in does not mean the library has full-text access to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous

Look at the Major Subject Heading in the Full Record

Use the Limits Feature:

Example: Publication Type=Systematic Review

Try the CINAHL Heading search:

 

Keyword search:

Limits:

CINAHL Heading search:

Limits:

PubMed

PubMed is a free health science citation & abstracts index from the National Center for Biotechnology Information at the U.S. National Library of Medicine.

 

Look at MeSH Terms in Full Record

Use the Limits Feature:

Examples: Article Type=Meta-Analysis; Age=All Adult

Look for the open access Free articles!

 

Keyword search:

Limits:

 

MESH search:

Limits:

 

Cochrane Library

Cochrane Library provides access to the Cochrane Library of Systematic Reviews. Full text of reviews are subscription only. Index summaries are a public resource. Indexed journals do not provide access to full-text. Just because it is indexed in does not mean the library has 
full-text
access to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous

Use the Simple Search and the Advance Search Features

Allows you to search with MeSH Terms

Check out the New Reviews

 Browse reviews by topic

Keyword search:

 

Limits:

MESH search:

Limits:

 

Dynamed

 

Use the Simple Search and the Advance Search Features

Allows you to search with MeSH Terms

Check out the New Reviews

Browse reviews by topic

Keyword search:

 

Also browse by:

 

TRIP Database

TRIP is a clinical search engine to locate publicly available clinical evidence.

 

Limit to:

Systematic Reviews

Guidelines-US

 

Keyword search:

Limits
:

SU Library Search

Library Search is setup just like an EBSCO

The Library even has a specialized PICOT search setup in Library Search—must go to Advance search to get to PICOT option

 

Other Databases:

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By the due date assigned
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources. Be sure to spend some time in Library Search it is setup just like an EBSCO database and gives you the experience of learning how to navigates databases, and provides you with a larger pool of information within which to search.

Supporting one—Challenging one.

By the end of the week, comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
 You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

Week 5 Discussion

Contains unread posts

 

We will be reviewing a “keeper study” this week—evaluate an article by working through the following 7 question

Again, keeper studies can be identified using handy Rapid Critical Appraisal checklists consisting of a set of simple but important questions. Below are sample questions developed for use with quantitative studies that are applicable to most appraisal situations (it’s important to note that qualitative evidence, if it’s relevant to the clinical question, should not be dismissed):

Why was the study done?
 Make sure the study is directly relevant to the clinical question.

What is the sample size?
 Size can and should vary according to the nature of the study. Since determining a valid minimum sample size in a single study can be difficult, taking into account multiple studies is beneficial.The answer to this question alone should not remove a study from the appraisal process.

Are instruments of the variables in the study clearly defined and reliable?
Make sure the variables were consistently applied throughout the study and that they measured what the researchers said they were going to measure.

How was the data analyzed?
Make sure that any statistics are relevant to the clinical question.

Were there any unusual events during the study?
 If the sample size changed, for example, determine whether that has ramifications if you wish to replicate the study.

How do the results fit in with previous research in this area?
 Make sure the study builds on other studies of a similar nature.

What are the implications of the research for clinical practice? 
Ask whether the study addresses a relevant and important clinical issue.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By
 
the due date assigned
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week, comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

14

Week 6 Discussion

 

On the discussion board, using a minimum of two articles that are supporting your PICOT question, submit one paragraph synthesizing the research into clear, concise statements 
without separately 
reviewing each of the studies in the paragraph—but by paraphrasing and synthesizing the work that was done.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By
 
due date assigned 
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this
 Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week, comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

Week 7 Discussion

 

This week you will be creating an Implementation Plan that will be attached to your final EBP.  For the discussion board this week—outline your implementation steps 1-2-3.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By
 
the due date assigned
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week , comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

Week 8 Discussion

 

This week you will be working on an evaluation plan that will be attached to your EBP in 
Week 9
.  Submit your Evaluation Plan to the DB –listed as 1-2-3…

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights.
 By due date assigned
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week , comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

Week 9 Discussion

 

Post your Presentation of your EBP on Discussion Board for feedback before final submission in 
Week 10
.

Provide Feedback to 2 Peers–

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By due date assigned 
, go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week , comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

0

0

Week 10 Midweek Assignment

 

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By the due date assigned,
 go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week, comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
.

0

0

Week 10 Discussion

 

Post Final EBP presentation to DB. As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. 
By the due date assigned,
 go to the 
Discussion Area
 and post responses to the discussion question. All responses should be posted to the appropriate topic in this 
Discussion Area
. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

Supporting one—Challenging one.

By the end of the week, comment on the responses of at least two other students by 
supporting a minimum of one post and challenging a minimum of one post.
  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this 
Discussion Area
. Please only start a new thread with your original post. Hit reply to respond to a peer.

Benchmark – Effective Approaches In Leadership And Management

In this assignment, you will be writing a 1,000-1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

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Select an issue from the following list: nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation. Benchmark – Effective Approaches In Leadership And Management.

Compare and contrast how you would expect nursing leaders and managers to approach your selected issue. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.

Identify the approach that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal leadership style. Benchmark – Effective Approaches In Leadership And Management.

Identify a possible funding source that addresses your issue. Consider looking at federal, state, and local organizations. For example: There are many grants available through the CDC, HRSA, etc.

Use at least two references other than your text and those provided in the course.

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. Benchmark – Effective Approaches In Leadership And Management.

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. Benchmark – Effective Approaches In Leadership And Management

Nursing Resume

Write an introductory cover letter of no more than 500 words in which you explain your professional objectives, professional interests, and strengths as an applicant. Nursing Resume.

Create a resume detailing your license(s), earned degree(s), certification(s), professional experiences, previous positions held, membership in professional organizations, publications, and skills.

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Both the cover letter and resume should be formally written using a professionally accepted format. Review “Resume Resources,” located at for
http://www.resume-resource.com/examples-medical.html
for examples of approved formats; however, other professional templates may be used.

Share your resume with a colleague and elicit their feedback. Revise your resume if needed and submit the resume in the assignment section of the course. Nursing Resume.

APA style is not required, but solid academic writing is expected.

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

Complex public health issues

How do you think public health professionals and policy decision makers can work together more effectively to prepare for complex public health issues, such as health insurance accessibility or flu pandemics?

What leadership skills do you think are necessary when working in emergency public health situations?

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Give reasons and examples in support of your responses. Be sure to cite any relevant resources. Complex public health issues.

Write your initial response in approximately 300 words. Your responses should clarify your understanding of the topic. They should be your own, original, and free from plagiarism. Follow the APA format for writing style, spelling and grammar, and citation of sources. Complex public health issues.

Ancillary services vs. inpatient services trends

Jacobs, L.P. (2017).
10 Health Care Trends for 2017.
Retrieved from http://www.trusteemag.com/articles/1184-10-health-care-trends-for-2017

Utica College. (2017).
10 New Trends in Health Care Management in 2017.
Retrieved from http://programs.online.utica.edu/articles/10-trends-in-health-care-management-0321

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 Nelson, M. L., Nelson, M. L., & Sen, R. (2014). Decision support systems: Business rules management in healthcare: A lifecycle approach.
Elsevier
. doi:10.1016/j.dss.2012.10.044. Ancillary services vs. inpatient services trends .

based on these readings

Analyze and evaluate the two most salient trends impacting the business operations and/or administration.

Are these trends uniquely different for ancillary services vs. inpatient services?

Where do you see these trends going in the future and why? Ancillary services vs. inpatient services trends

Scholarly Activity Summary – Grand grand canyon university GCU

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

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You are required to post one scholarly activity while you are in the BSN program, which should be documented by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

Submit, as the assignment, a summary report of the scholarly activity, including who, what, where, when and any relevant take-home points. Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment. Scholarly Activity Summary – Grand grand canyon university GCU.

Scholarly Activity Summary

This document describes the scholarly activity elements that should be included in a five paragraph summary. You may use this resource to help guide the preparation of the Scholarly Activities assignment, due in Topic 10. Scholarly Activity Summary – Grand grand canyon university GCU.

Overview

This section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you.

Problem

This section consists of either a short narrative or a list of bullet points that concisely identifies the problems the scholarly activity is designed to solve. Educate: What is the current state of the activity topic? Explain why this is a problem, and for whom is it a problem? Inspire: What could a nurse achieve by participating in the scholarly activity? Use declarative sentences with simple words to communicate each point. Less is more. Scholarly Activity Summary – Grand grand canyon university GCU .

Solution

This section consists of either a short paragraph or a list of bullet points that concisely describes the solution to a proposed practice problem that the scholarly activity addressed and how it addresses the problem outlined in the previous section.

Opportunity

This section consists of short paragraphs that define the opportunity that the scholarly activity is designed to capture. It is important to cover the objectives and goals that were met. How will attending/participating in this scholarly activity help you grow as a nurse? Scholarly Activity Summary – Grand grand canyon university GCU .

Program Competencies Addressed

This section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP. Scholarly Activity Summary – Grand grand canyon university GCU .

Byvalson Medication Paper

The Medication Paper Final Draft “Byvalson”

paper must be a minimum of seven pages, not including your title or reference pages. You should include at least five recent references (published within the last five years), and the paper must be presented in APA format (see rough draft requirements in week 6).

The paper must include the following content information:

Manufacturing company

Brand name

Indication

First in class, or not first in class

Common side effects profile

Known contradictions

Make sure you explain the special considerations that your chosen drug has on the unique populations/client groups listed below. Special considerations should include absorption, clearance/elimination, distribution, metabolism half-life, loading dose, route of drug administration, and steady state. Byvalson Medication Paper.

Pediatric Patients

Pediatric patients are not little adults. There are special pharmacokinetic and pharmacodynamics variations in this patient group. Their reaction to medication can be very unpredictable. Accurate dosing is the key due to their limited body mass.

Geriatric Patients

Geriatric patients have altered pharmacokinetic and pharmacodynamics responses to medication. The process of aging and disease will change how the body responds to drug therapy. Memory limitations and increased sensitivity to drug therapy may cause unique problems with this population.

Patients With Renal Dysfunction

Many medications are excreted through the renal glands or metabolized and excreted renally. Dosage adjustment is the key in this population. Many agents may cause nephrotoxicity.

Patients With Liver Dysfunction

Liver disease produces alterations in the physiology of the drugs’ pharmacokinetics in the body. Special attention should be given to all drugs used in this client population

Obese Patients

Obese patients have alterations in their pharmacokinetic and pharmacodynamic response to medication. Many comorbidities and altered nutritional status can be seen as responses to taking these medications. Accurate dosing is paramount.

Pregnancy/Lactation

Pregnancy and lactation can be challenging. Concerns of effects to the unborn fetus must be considered. Will treating the mother harm the unborn fetus or nursing infant? Byvalson Medication Paper.