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  • Insomnia sleep/wake disorders Essay

    Insomnia sleep/wake disorders Essay

    Students will:

    Analyze diagnostic criteria for sleep/wake disorders

    Analyze evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders

    Analyze criteria for referring clients to primary care physicians for treatment of sleep/wake disorders

    Compare differential diagnostic features of sleep/wake disorders

    Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit! Insomnia sleep/wake disorders Essay.

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    To prepare for this Discussion:

    By Day 5 of Week 9, your Instructor will have assigned you a sleep/wake disorder, which will be the focus of your original post for this Discussion. Insomnia sleep/wake disorders Essay.

    Review the Learning Resources.

    By Day 3

    Post:

    Explain the diagnostic criteria for your assigned sleep/wake disorder.

    Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned sleep/wake disorder.

    Describe at what point you would refer the client to their primary care physician for an additional referral to a neurologist, pulmonologist, or physician specializing in sleep disorders and explain why.

    Support your rationale with references to the Learning Resources or other academic resource. Insomnia sleep/wake disorders Essay.

    Diagnostic Criteria for Insomnia

    DSM-5 diagnostic criteria for insomnia includes the dissatisfaction with the quality or quantity of sleep characterized by symptoms such as: difficulties in sleep initiation, difficulty in maintaining sleep due to regular awakenings or difficulty going back to sleep after awakenings; as well as waking up early-morning and being unable to go back to sleep (Ellis et al, 2015). In addition, insomnia should cause clinically considerable distress during daytime functioning. Finally, insomnia should occur for a minimum of three nights weekly and should persist for a minimum of three months, in spite of an individual having ample opportunity for sleep (Asnis et al, 2016). Insomnia sleep/wake disorders Essay.

  • NR451 RN – Capstone PowerPoint presentation – Implementing Change Project

    NR451 RN – Capstone PowerPoint presentation – Implementing Change Project

    Educating Staff: Implementing Change Guidelines

    P
    URPOSE
    T

    he purpose of this assignment is to create the 
    Educating Staff: Implementing Change Project 
    PowerPoint presentation. Your plan is to educate the staff that will be involved in the pilot 
    program. You will need to educate them on the problem, show the supporting evidence, and 
    how your pilot plan will be implemented. NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

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    C
    OURSE 
    O
    UTCOMES 

    This assignment enables the student to meet the following Course Outcomes.
    CO2: Proposes leadership and collaboration strategies for use with consumers and 
    other healthcare providers in managing care and/or delegating responsibilities for health 
    promotion, illness prevention, health restoration and maintenance, and rehabilitative 
    activities. (PO #2)
    CO3: Communicates effectively with patient populations and other healthcare providers 
    in managing the healthcare of individuals, families, aggregates, and communities. (PO
    #3)
    CO7: Integrates the professional role of leader, teacher, communicator, and manager of
    care to plan cost-effective, quality healthcare to consumers in structured and 
    unstructured settings. (PO #7) NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

    Capstone Project   

    Purpose

    The purpose of this assignment is to create the Educating Staff: Implementing Change Project Powerpoint presentation. Your plan is to educate the staff that will be involved in the pilot program. You will need to educate them on the problem, show the supporting evidence, and how your pilot plan will be implemented. NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

    Directions

    Create an educational presentation for staff before the launch of your change project. This should inform the staff of the problem, your potential solution, and their role in the change project.NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

    The format for this proposal will be a powerpoint presentation.

    The length of the powerpoint presentation should be
    15-20 slides
    : excluding the title and reference slides.

    Below are the main topics or bullet points for your

     NR451 RN – Capstone PowerPoint presentation – Implementing Change Project

    a.Title Slide

    Description of the Ace Star Change model that you used for the project.

    Practice issue (Using the required article )

    Scope of the problem- use basic statistics from what you know of the problem in your work area. NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

    your team/stakeholders

    Evidence to support your need for change-from your evidence summary.

    Action plan

    Timeline for the plan.

    The nurses role and responsibility in the pilot program.

    Procedure ( what steps are to be taken to complete this change process, from start to finish)

    Forms that will be used ( if applicable). NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

    Resources available to the staff- including the including yourself. ( dietician and pharmacist)

    Summary

    References

     

    Citations and references must be included to support the information within each topic area. Scholarly sources are expected, which means choose peer-reviewed journals and credible websites. NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

     

     

    Best practices in preparing this presentation

    Be creative

    Incorporate graphics, clipart or photographs for interest.

    Make easy to read with short bullet points and large font.

    Cite all sources within the slides with (author, year) as well as on the reference slide

    NR451 RN – Capstone PowerPoint presentation – Implementing Change Project

     

    G
    UIDELINES


    Application: Use Microsoft PowerPoint 2010.

    Length: The PowerPoint slide show is expected to be
    between 15-20 slides
    in length (not
    including the title slide and reference list slide).

    Submission: Submit your files via the basket in the Dropbox: “Educating the Staff:
    Implementing the Change Project” by 11:59 p.m. Sunday of Week 6.

    Late Submission: See the course policy on late submissions.

    Tutorial: If needed, Microsoft Office has many templates and tutorials to help you get started. NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

    B
    EST 
    P
    RACTICES 
    IN 
    P
    REPARING 
    A 
    P
    OWER
    P
    OINT 
    P
    RESENTATION

    The following are best practices in preparing this project.
    1.
    Slides should be easy to read with
    short bullet points
    and large font.
    Do not
    use
    paragraphs.
    2.
    Be creative, but realistic with your intervention and evaluation tool.
    3.
    Incorporate graphics, clip art, or photographs to increase interest.
    4.
    Review directions thoroughly.
    5.
    Cite all sources within the slide show with in-text citations, as well as a reference page.
    6.
    Proofread prior to final submission.
    7.
    Spell check for spelling and grammar errors prior to final submission.
    8.
    Abide by the Chamberlain College of Nursing academic integrity policy. NR451 RN – Capstone PowerPoint presentation – Implementing Change Project.

  • Code of Fair Testing Practices in Education Essay – Nursing Seminar II

    Code of Fair Testing Practices in Education Essay – Nursing Seminar II

    1.Review “Code of Fair Testing Practices in Education,” located on the American Psychological Association:

    https://www.apa.org/science/programs/testing/fair-testing.pdf

    What are your thoughts after reading the document? Did you realize it existed? How does the code apply to nursing education? The “Code of Fair Testing Practices in Education” is over 10 years old. Is it still relevant today? Why? If not, how should it be revised? Use correct APA format when citing. Code of Fair Testing Practices in Education Essay – Nursing Seminar II.

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    2.As we start this week’s discussion, I want to emphasize the significance of selecting effective strategies for evaluating learning objectives/outcomes. What are some of the important points nursing faculty member must take into consideration when selecting strategies? Although responding to CAT questions is not required, substantive responses will count towards weekly participation points.

     

    What would be a reasonable evaluation strategy for patient education?

     

    Compare and contrast three forms of evaluation:  
    formative, summative
    and  
    confirmative
    . 
    Which evaluation method or methods do you find effective and why? Although responding to CAT questions is not required, substantive responses will count towards weekly participation points.

    Use 2 citing for each question. Code of Fair Testing Practices in Education Essay – Nursing Seminar II.

  • ENURESIS ESSAY

    Enuresis Essay

    ENURESIS

    • How the disorder is diagnosed

    How Enuresis is diagnosed

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    Please use the following references.

    Thanks

    1

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Enuresis Essay.

    • “Elimination Disorders” Page 355.

    2

    Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer. Enuresis Essay.

    • Chapter 31, “Child Psychiatry” (pp. 1215)

    3

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251068/

    Avicenna J Med. 2014 Oct-Dec; 4(4): 77–86.

    doi: 10.4103/2231-0770.140641

    PMCID: PMC4251068

    PMID: 25506580

    Nocturnal enuresis: A topic review and institution experience

    John Michael DiBianco, Chad Morley,1 and Osama Al-Omar1

    Author information ► Copyright and License information ► Disclaimer

     

    Enuresis is the medical term used to describe the involuntary discharge of urine

    beyond the age when a child is old enough to be able to control urination (usually

    considered to be six years of age for nighttime control), or more commonly, bedwetting.

    There are several types of enuresis: diurnal enuresis is wetting that occurs during waking

    hours, primary nocturnal enuresis is a lack of the achievement of total bladder control

    during sleep, and secondary nocturnal enuresis is loss of bladder control that happens

    after a child (or adult) has been dry a night for a long period of time (usually three to six

    months). The facts, causes, and treatments of this disorder can help bring a greater

    awareness and understanding of enuresis. Enuresis Essay.

    Nocturnal enuresis is a common problem. It is estimated that there are five to

    seven million children in the United States who have NE. Many children have no lasting

    problems from bed-wetting, however, some children who wet the bed can develop

    psychological problems, including low self-esteem. This disorder also affects family

    members through anger and frustration because of the condition. Enuresis Essay.

    One important reminder to parents with children who suffer from this condition is

    that bed-wetting should not be thought of as a behavioral problem. There is no medical

    proof to show that children wet the bed to spite their parents. Also, most children will

    outgrow bed-wetting eventually. As parents, the best way to help your child is to be

    understanding and remember that punishing or making fun of a child who wets the bed

    can only make the situation worse….. Enuresis Essay.

    Bedwetting, or what most scientist call nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for bed wetting, whether dressed during the day or in bed at night. Another name for enuresis is urinary incontinence. For infants and young children, urination is unconsciously done . Wetting the bed is very normal for them. Most children gain some degree of bladder control by 4 years of age. Daytime control is usually gained first while nighttime control comes later.

    Most people are very uneducated on how Enuresis is effective on our personality. Enuresis is a bed wetting disorder; a lot of people are not sure on why they have this urine problem. To my surprise they have a description on this disorder, however I never heard of it. But it seems so common within our community. It’s a voluntary and involuntary release of urine. Completely unaware of why their body can’t notice recognition when it has to urinate. So they make mistakes in their bed, clothes, or just outside when it is not time to do so. A lot of people suffers from Alzheimer’s disease in the latest stage has been known to suffer with this problem as well, or other forms of dementia. To best way to describe Enuresis is, you mainly urine on yourself at night time it is called nocturnal. But if it occurs all the time during the daytime hours it’s called diurnal. This disorder affects young kids; and they don’t know why they are urinating on themselves… Enuresis Essay.

    A cross sectional study was conducted on prevalence and risk factors of mono symptomatic nocturnal enuresis in school children of Ankara. Among 15150 children, 9% children had mono symptomatic nocturnal enuresis.it was found that Frequency was higher in boys than girls. Analysis revealed that gender, toilet training methods , problems of sleep, school performance, and approach of the family members to such children are significant factors. Age, male gender, experience of toilet training with threatening methods, deep sleep, sleep walking,and introverted and shy behavior were significantly increased the risk of nocturnal enuresis (Secil Ozkan, et al., 2010).Enuresis Essay.

    An epidemiological cross sectional study was conducted to determine the prevalence of nocturnal enuresis in children 5-14 years in Sudan, 218 children were involved in the study and out of that 33.5% children were found to have nocturnal enuresis. Frequency was high among girls than boys and the prevalence of bedwetting decrease as the age of the child increased from 13.3% at 5-7 years of age to 2-3% at 12-14 years ( Magdi, A. H., 2010)……Enuresis Essay.

  • Evidence-based practice guidelines and ethical considerations

    Evidence-based practice guidelines and ethical considerations

    You will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

    Scenario 1:

    The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines. Evidence-based practice guidelines and ethical considerations.

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    Scenario 2:

    A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance.

    Scenario 3:

    A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment. Evidence-based practice guidelines and ethical considerations.

    Scenario 4:

    A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled.

    Scenario 5:

    A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days.

    Scenario 6:

    A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity. Evidence-based practice guidelines and ethical considerations.

    Scenario 7:

    A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home. Evidence-based practice guidelines and ethical considerations.

    To prepare:

    • Select one scenarios, and reflect on the material presented.

    • What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

    • Consider how you would respond as a nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected. Evidence-based practice guidelines and ethical considerations.

    To complete:

    Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as a practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least 3 different references from current evidence based literature. Evidence-based practice guidelines and ethical considerations.

  • Manage your boss essay

    Manage your boss essay

    Executive Summary (1 page)

    summarize the advice such that someone who has not listened to the podcast will be able to glean the main points. Please include the steps along with a brief explanation of each step. This section should be single-spaced. Present the summary in a format that will be easy for others that to read.

    Up to 5 ref if needed but not necessary. Manage your boss essay.

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    Analysis of the Advice (2-3 pages)

    think like an Industrial Psychologist, reflect on the advice, and offer your opinion on the validity of the advice they give in the podcast. Are their suggestions practical? Will they work in your organization? If you do not have a job, think about a student or volunteer organization you’re in. What advice can you immediately implement? How should you change your behavior to be in line with their suggestions? You do not have to answer all of these questions – these are merely suggestions for what to write about. Do not summarize their advice in this section. This section is to analyze the advice they gave. This section should be double-spaced. 5 ref. if needed but not necessarily. Manage your boss essay.

    Managing Your Boss

    We had intended to cover Managing Upwards back in December, during our sessions on

    writing reviews. As it turned out, while we barely scratched the surface on how to do

    reviews, it nevertheless took us FOUR casts. We didn’t want to delay those casts,

    obviously, in light of their time sensitivity. So, we delayed this topic until now.

    Managing Upwards for the most part boils down to Creating a Good Relationship with Your

    Boss. There is a lot to be said about politics in organizations, and whom you should know

    and whom you should stay in touch with. We’ve found that those topics don’t lend

    themselves easily to a simple cast if we want to give you actionable guidance. That IS what

    we’re about, after all. Manage your boss essay.

    So, we’re going to focus on some things you can do that will help you improve your

    relationship with your boss.

    Managing_Your_Boss_Shownotes

    Managing_Your_Boss_Shownotes-2

    Outline

    1. A True Story

    2. The Basics.

    a. Boss Goals

    b. Boss Communications

    c. Boss Schedule/Time Management

    d. Boss Work style

    e. Boss Relationships

    Shownotes

    managertools.com

    ©Manager Tools | Page 1

    1. A True Story .

    Mark recently worked with an Executive Vice President of a multi billion dollar service

    company who had lost her job. To give you an idea of how different life is for senior

    executives, for those of you who are not in that rarefied air yet, she wasn’t going to the

    office, and technically hadn’t been fired…but it had been made clear she was no longer

    employed. She stayed home for 2 and a half months, until the performance compensation

    she was mostly entitled to were paid. She was paid salary while she was not working.

    This executive had been with her firm for 21 years. She had worked largely in the back

    office, and had created a record that was so stellar even Mark was impressed. Not only

    had she hit home run after home run, in TOUGH situations, but she was one of the most

    loved people in a large company he’s ever known. Everyone who ever worked for her loved

    her. She was pretty clearly special. Big barbecues at her and her husband’s house were so

    well known that they stopped inviting people and just told people to come on along (and

    got it catered). Truly, a wonderfully successful, effective executive.

    She was asked to take a special assignment not long ago, to “go fix” the financial systems

    of the company. She was asked by the CEO, and even though she would report to the CFO,

    it was pretty clear he had a mandate from the top.

    In 30 days, she was fired…and hundreds if not thousands of managers in the company

    were DEVASTATED. What happened? Manage your boss essay.

    What happened was that she had thought that because the CEO sent her over, she could

    actually make things happen and fix things. But she didn’t know/understand/appreciate

    the CFO’s position. When she suggested to the CFO that a big re-org needed to be done,

    the politically minded and nervous CFO walked into the CEOs office and described her as

    power hungry and backstabbing, and then put together some half truths the CEO bought

    into.

    This manager did the RIGHT THING.. and was fired because she didn’t understand her

    boss. Didn’t know what he wanted, how we wanted it, when he wanted it, or who else he

    needed to please. Manage your boss essay.

    Don’t let this happen to you.

    managertools.com | Managing Your Boss / p.2

    ©Manager Tools | Page 2

    2. The Basics.

    There are FIVE areas that we recommend you focus on in your relationship with your boss.

    (By the way, it’s possible you’ll hear some of these topics repeated when we cover what to

    do in the first 90 days on the job. however, we’ve discovered that managers tend to

    dismiss things that they think don’t apply to them, so we’ve excluded those parts of this

    topic that are only about starting out. These recommendations ALWAYS work, and are

    worth revisiting annually.)

    We list these topics in their order of importance to you, and the order in which you ought

    to go about thinking about them. It’s not a rote one at a time process, of course. You’re

    going to learn about all the topics at various times. This just suggests where your focus

    should be, and what will help you the soonest. Manage your boss essay.

    And remember, you’re unlikely to change your boss… so be ready to change yourself.

    a. Boss Goals

    This is the SINGLE MOST IMPORTANT thing you should know about your boss. And, its

    likely you don’t know what these things are, except for those issues that relate to you

    and your team. If you learn what your boss’s goals are, and which are most important to

    him, you will be more effective at getting what you want from him. he will also perceive

    you as sensitive to his needs and politically savvy.

    This starts with asking, what are you responsible to YOUR boss for? What are your

    revenue, cost, and profitability requirements? What metrics do they use to measure

    you and by extension, me and my team supporting you? Which of those is most

    important to you? What does your boss ask that is above and beyond or different than

    what the org wants? What are your budget responsibilities? What do you have to create

    your budget, and how long does it take? May I look at your budget to get me ready for

    the next cycle (if you need to scrub it before I can see it, that’s fine.) What reporting are

    you required to do on your budget, and when do you have to do it?

    Continuing, you’ll note that above we focused on financials. Well, DUH. The quickest

    way to trouble in most places is ignoring financials. An easy way to think about

    responsibilities is to break them down into financials, operations, and people.

    managertools.com | Managing Your Boss / p.3

    ©Manager Tools | Page 3

    Remember, we’re looking for Goals and RESPONSIBIILITIES in these areas.

    Once you’ve asked the financial questions, the people and operational questions are

    much easier, and are much more company/industry dependent. On the other hand,

    we’ve found that bosses tend to be much more forthcoming on other goals they have

    once you ask, for the most part. And often, they just spill everything they’ve got as soon

    as you ask.

    The second part of this line of inquiry is “What’s my role in helping you achieve that?”

    For each of the above questions, you can ask what your boss sees your role as being.

    Now, you might be thinking, what do I DO? Just walk in and start asking away? Well, no,

    not exactly. But, regardless of what time of year it is, or how long you’ve worked for

    your boss, THESE FIRST QUESTIONS AROUND GOALS JUSTIFY A SEPARATE MEETINGS

    WITH YOUR BOSS TO LEARN THE ANSWERS. So, schedule a meeting with him/her, email

    the questions in advance, and ask for as much detail as you can.

    If you’ve worked for a boss for a while, we’ve found the best way to address the fact

    that you know some of this is to send both the questions and those answers which you

    know in advance. Having them written out will allow her to add/change/delete/leave

    alone/save time.

    If you’re wondering how to preface these questions, because you’re afraid you’re going

    to be thought weird/stupid/incompetent… this is the way Mark recommends to clients:

    “I’m doing an annual reassessment of my roles and goals, and want to include your

    guidance…” Another that I’ve seen work is, “My professional development effort this

    year is around being EFFECTIVE, and that means focusing on what’s most important…”

    Okay, so you’re going to set up a meeting, email the questions in advance (with answers

    you think you already know), and then take great notes in the meeting. If you think

    you’re going to run over, bail out and ask for more time later. (This is because we’re

    cleverly assuming you don’t know what his approach to time management is yet, not

    having asked. ;-))) )

    We consider this important enough that if you don’t konw all of her goals now, you

    managertools.com | Managing Your Boss / p.4

    ©Manager Tools | Page 4

    must within THRITY DAYS.

    b. Boss Communications

    This area seems pretty simple, and yet it is the one most often missed. We put it second

    because you usually can’t ask directly, but it has BIG implications for every other area.

    The sooner you start paying attention to your boss’s comm style, the sooner you’ll be

    able to adapt. Manage your boss essay.

    Peter Drucker has a clever way of thinking about this. In all his years of working with

    managers, he discovered that they tend to learn (take in new information) with a

    preference towards one of two ways: Listeners, and Readers. His simple technique for

    using that bit of boss knowledge is summed up as, “if she’s a listener, brief her verbally

    first, then follow up with a report. If he’s a reader, send a memo first, then follow up

    with a briefing.” Manage your boss essay.

    Wow simple!!!

    To go a bit further. here are some questions to look for clues to.

    Does he prefer voicemail or email? Do you get individual emails from him about work

    that he could have just asked you about? Do you get long voicemails at night or on the

    weekends? What does he choose to share in person? Is his comm channel choice

    always a function of topic? Projects by email, announcements by vmail, operations in

    meetings? It happens, and it’s confusing unless you know to think about it.

    How does she run meetings? Tight agendas means more advance work for you. What

    kind of sharing does she do from meetings she goes to? If not a lot, you’ll need to be

    asking about them and their fallout.

    When it comes to face to face: what are his verbal, Vocal and visual clues? Verbally, for

    instance, does he tend to ask questions, or make statements? Take a seat, or would you

    like to sit down? Does he tend to talk first, or a lot, or listen first, or more than talking?

    Does he reserve opinions, or come right out with them?

    Vocally, is her delivery steady and even? or noticeably varied? is it forceful or not (can

    you see them giving a speech?) Is it lower than average volume, or up there? Is it faster

    managertools.com | Managing Your Boss / p.5

    ©Manager Tools | Page 5

    than you, or slower? (Forget about where they’re from.)

    Visually, what kind of handshake – gentle or firm? Regular eye contact or intermittent?

    Small gestures or big? What kind of colors in their clothes? Lots of facial expressions, or

    few? Does he make contact with you or not?

    It’s not necessary for you to MIMIC your boss – it will irritate her and make you look

    foolish. But knowing where you’re different and moderating your differences will make

    you ENORMOUSLY more effective. ENORMOUSLY. Besides smiling and being willing to

    subordinate oneself to others, Mark believes that this awareness and moderation are

    the most powerful interpersonal tools he uses every day.

    c. Boss Schedule/Time Management

    This is one that you really don’t HAVE to ask about… you’ll learn it pretty quickly if you

    remind yourself to pay attention. That said, if you’re having a great meeting early on,

    and want to ask about scheduling, go for it!

    This is as simple as knowing what your boss’s schedule is. I bet you’ve been thinking you

    know what it is. But if she doesn’t publish it, answer this: how many standing meetings

    does she go to that you don’t, when are they, how often are they changed, and what

    are the topics? Manage your boss essay.

    See, you don’t.

    Some things you should know: What, when, where and with whom are his standing

    meetings? WHEN DOES HE MEET WITH HIS BOSS AS PART OF STAFF OR IN A ONE ON

    ONE? And would you leave him alone during the hour before it? And would you expect

    some things to change within 6 hours after it?

    When is he busiest? Morning or late afternoon? When is he NOT busy but wants to be

    left alone? How tightly does he run his time? Ho much at risk will you be if you handle

    time differently than he does? What nights does he go home on time, and when does

    he stay late? How often does he send night and weekend emails? How in general does

    he feel about the start and end of the workday?

    The way you get to these is, as we said above, not necessarily by interviewing the boss.

    managertools.com | Managing Your Boss / p.6

    ©Manager Tools | Page 6

    We recommend asking your peers for insight. Ask his assistant for a printed copy of his

    weekly schedule. Review YOUR calendar for meetings he’s called.

    d. Boss Work style

    This is one of the harder things to discern quickly if you are new. Specifically, what we’re

    asking you to ask here is, “What level of involvement does he want to have, on what

    topics?” This boils down to what he delegates, and how involved he stays. The issue for

    you is how much you’ll have to tolerate of his interaction after you own a task (if he

    thinks you EVERY own it), and what amount of reporting will help her stay out of things,

    or at least give you SOME room. Manage your boss essay.

    e. Boss Relationships

    This is one that we don’t recommend you tackle right away. If you get the other four

    areas down pat, this one will probably happen naturally. You can discern this with the

    answer to one simple question, but it may take some knowledge of your company we

    can’t teach you how to get.

    With whom, outside of her chain of command, does this manager regularly meet? (This

    could be lunch, dinner, breakfast, hanging out in each others’ offices, etc. COULD be

    work related, may not be).

    We’d like you to tell US why this is important to you. first one with the right answer gets

    a free copy of The Effective Executive, Getting Things Done, or The World is Flat, your

    choice, mailed to you.

    Special Tips:

    There are three other things we recommend you do in terms of managing your

    relationship with your boss. (Have you picked up on the fact that we don’t say

    “managing your boss”? We think that’s kinda funny… at least we would if we were your

    boss.)

    Weekly One on Ones with your boss. If you have to couch it as an update meeting, fine.

    Ask for a half hour, and only take YOUR FIFTEEN MINUTES. If he wants to go longer, let

    him take over…and you’re having something approximating a O3. Don’t do this until you

    managertools.com | Managing Your Boss / p.7

    ©Manager Tools | Page 7

    start with YOUR team, though… If he cuts you off when you’re done, and YOU WILL BE

    DONE in 15 minutes if you’re smart… fine. You’re getting the best you can get.

    Quarterly performance review. Ask your boss for an hour to get feedback over the

    previous 3 months. If he wont’ give it to you, fine… fill out a review form and get it to

    him. If he wonders why, tell him, “to make it easier for both of us to keep track of stuff

    3-6-9 months from now.” You will forget just like she will. (You can do this along with

    updating your resume… it’s like we know what we’re talking about!) Manage your boss essay.

    Share all this about YOU with YOUR TEAM. Don’t make them ask… walk them through

    all five areas. Do a Jerry Maguire… help them help you!!!

    Wrap Up

    1. A True Story

    2. The Basics.

    a. Boss Goals

    b. Boss Communications

    c. Boss Schedule/Time Management

    d. Boss Work style

    e. Boss Relationships

    managertools.com | Managing Your Boss / p.8

    Manage your boss essay

  • PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay

    PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay

    In a 3page paper:

    Restate your PICOT question and its significance to nursing practice.

    Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.

    Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

    ORDER A PLAGIARISM-FREE PAPER HERE

    PLEASE USE THESE REFERENCES FOR THE PAPER

    1-   Ahern, T. L., Herring, A. A., Miller, S., & Frazier, B. W. (2015, July). Brief research report: Low-dose ketamine infusion for emergency department with severe pain. Pain , 16(7), 1402-1409. Retrieved from
    https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/delivery?sid=641349b8-3177-45ba-953c-c5a2d79612aa%40sessionmgr102&vid=3&ReturnUrl=https%3a%2f%2feds.b.ebscohost.com%2feds%2fpdfviewer%2fpdfviewer%3fvid%3d2%26sid%3d641349b8-3177-45ba-953c-c5a2d79612aa%2540sessionmgr102

    2-  Boker, G., & Anderson, P. (2014, March 20). Ketamine: An update on its abuse. J Pharm Pract, 27(6), 582-586.
    http://dx.doi.org/10.1177/0897190014525754

    3.-  Ku, J., & Lei, H. (2014, October 28). Ketamine: An update on its clinical uses and abuses. CNS Neuroscience & Therapeutics, 20, 1015-1020.
    http://dx.doi.org/10.1111/cns.12363

    4-  Pourmand, A., Mazer-Amirshahi, M., Royall, C., Alhawas, R., & Shesser, R. (2017, March 2). American Journal of Emergency Medicine. Low dose ketamine use in the emergency department, a new direction in pain management, 35(6), 918-921.
    http://dx.doi.org/10.1016/j.ajem.2017.03.005

    5-  Sassano-Higgins, S., Baron, D., Juarez, G., & Esmaili, N. (2016). A review of ketamine abuse and diversion. Depression and Anxiety, 33(8), 718-727.
    http://dx.doi.org/10.1002/da.22536

     

    Literature Review

    The literature review is intended to determine if ketamine would be a viable alternative pain management strategy to address pain control for opioid abusers in the Emergency Department (ED).  This literature review consists of 5 articles. The studies evaluated entailed use of a nonrandomized control trial and evidence from systematic or integrative reviews published by scholarly journals.  This literature review will synthesize the comparisons and contrasts of each article. The studies used different combined routes for administering ketamine primarily, as intravenously (IV).  Studies also yield in considerations of alternative routes of administration. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Comparison and Contrast

    The 5 literature studies and reviews suggest, ketamine to have a correlation suggesting adequate pain management for different types of pain control.  In contrast, Boker and Anderson (2014) notes that although ketamine is an effective pain reliever it is subject to abuse.  Additionally, it alters brain function to include alterations in time, reaction, cognition, attention, memory and color perception.  Some studies have resulted in inappropriate prescribing patterns linked to knowledge deficits, safety perceptions, and inadequate pain assessment associated with under-treatment. Xu and Lei (2014) report ketamine abuse to be increasing and produce a dissociative state and hallucinations. This review confirms the alterations in the brain including; color perception, memory, attention, cognition, reaction time, and since of time, and can produce psychological addiction.  Addiction to prescription medication is considered a national wide occurrence and can be actively addressed through use of less addictive medications with comparable medications.  Sassano-Higgins et al (2016) reveal limited withdrawal symptoms reported for users of ketamine.  Pourmand et at (2017) reports the ED involvement in the opioid epidemic to be unclear although, opioids are prescribed often in the ED for pain control. This review suggests ketamine given in the ED to be a safe and effective alternative for pain control. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Patient side effects was of high importance of quality while performing the literature review. Side effects were revealed in multiple reviews. All 5 literatures state ketamine as a dissociative type of anesthetic. Ketamine is also considered a type of drug that has been used as a street drug.  Xu and Lei (2014); Boker and Anderson (2014); Sassano-Higgins et al (2016); and Pourmand et at (2017) reports the apprehension for over use of ketamine and have potential toxicity to the gastrointestinal tract and the urinary tracts.  Gastrointestinal issues revealed to have epigastric pain, hepatic dysfunction, colic like behaviors with a dilated common bile duct, abnormal liver function test, choledochal cysts.  Urinary tract side effects report ketamine users to present with dysuria, suprapubic pain, and painful hematuria. This can result in cystitis or renal failure. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    In contrast, Ahern et al (2015) reports ketamine to be safe and have limited to mild side effects during a 2-hour monitoring experimental trial. The conclusion is contradictory due to the trial also added narcotics subsequently to the ketamine for assistance in pain management during the experiment. This study is based on the research hypotheses that ketamine is an alternative for pain management.  This research would not benefit the opioid abuser’s due to the relevance of using a narcotic as an adjunct. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Pourmand et al (2017) encourages nurses should be cautious when administering LDK (Low Dose Ketamine) due to the lack of experience. Suggestions for ketamine to be administered under the supervision of pain specialist or anesthesiologist. Texas Board of Nursing considers ketamine to be safe for an RN to administer by an order from a pain specialist or anesthesiologist therefore contraindicating the use for ED. If the nurse is to provide ketamine as an analgesic ensure proper protocols are in place. Ketamine when in larger doses can result in respiratory depression.

    Alternative Uses and Locations

    The literature reviewed combined inconsistences for multiple uses on ketamine to be effective for the use of major depression, suicidal ideations, bipolar depression, and asthmaticus attacks and was not limited to only pain. The subjects that were treated for pain were located in numerous areas including ED, postoperative, perioperative, conscious sedation, and medical floors. The limitation was only one resource with patients presenting from the ED. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Conclusion

    Although the reviewed literature portrays there is high potential for opioid pain medication to be abused and even turn addictive with ketamine presenting a viable non-addictive alternative, some of the information is not based on primary data and clinical trials therefore questioning the clinical significance.  Due to lack of resources, additional limitations in the study include absence of placebos and subjectivity of pain assessment tools.  Conducting a clinical trial using patients with opioid addiction and monitor for a new development of addiction for the use of ketamine would determine if ketamine would be an effective alternative.  There is need for more clinical trials on research and data to provide enough evidence to promote ketamine as a safe alternative for opioid abusers. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    PICOT Question

    Pain control is a number one priority in the patient satisfaction scores for the Emergency Departments. With patient satisfaction survey scores driving how healthcare is being performed many physicians feel pressured to prescribe to customer satisfaction instead of medical necessity.  (Zgierska, Miller, Rabago, &, 2013) Prescribing opioids in this manner has caused an epidemic of opioid dependence. The deaths from narcotics are superseding the deaths from suicide and motor vehicle accidents. (Manchikanti et al., 2012) The government is now monitoring prescriptions of opioid prescribing and more patients are coming to the Emergency Department (ED) due to the need for pain control and due to opioid addiction.  Physicians are looking for a non-opioid pain relief.  Ketamine has started to appear in the emergency room for an alternative route for opioid abusers. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Alternative uses for non-opioid pain relief in the emergency rooms have incorporate low doses ketamine (LDK) to assist with acute pain, chronic pain, and refractory pain. Adverse effects to ketamine results in dizziness, nausea, vomiting, mild hallucinations or agitation.  (Pourmand, Mazer-Amirshahi, Royall, Alhawas, & Shesser, 2017) There are different types of psychological factors that can have detrimental effects on patients being given ketamine for pain control.  According to Bokor and Anderson, “ketamine can alter numerous functions in the brain including color perception, memory, attention, cognition, reaction time, and sense of time can produce psychological addiction” (Boker & Anderson, 2014) Ketamine is a scheduled class III drug which potentiates the likely increase for abuse and addiction. (American Addiction Centers, 2018). Knowledge of the side effects and levels of abuse the patient can develop from ketamine are concerning for another rising type of addiction to start in the medical field.  Currently ketamine is a recreational drug on the streets known as the “date rape drug”. (American Addiction Centers, 2018) The rationale to utilize ketamine instead of opioids is in need of recurring research to ensure safe prescribing for patients. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    PICO

    In developing my clinical question, I utilized the formula of patient, intervention, comparison, and outcome. I then was able to develop the question, Is Ketamine a safe effective alternative to pain relief in the Emergency Department for opioid abusers?    The patient criteria of the question involve the group of opioid abuser.  The problem is the need for an alternate non-opioid pain management for patients who have history of opioid abuse.  The alternative needs to be a safe alternative to pain management and not just a cover up or another drug to start an addiction.   The intervention is giving low doses of ketamine for pain management to opioid abusers.  The comparison component is substituting opioids for low-dose ketamine.  The outcome component is highly important, are we managing patients pain safely or is being prescribed ketamine fueling another type of addiction.PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Questions

    Deciding on the five questions I have developed involved understanding the reasoning, safety, and effects of giving ketamine. Patient safety is the number one priority. One correlation I perceived is are we going to be seeing more people returning to the ED for ketamine?  Is this going to be another type of addiction for opioid abuser? To understand and research the problem I have developed these five questions:

    What is the mechanism of action for ketamine to provide pain relief?

    What are side effects of ketamine?

    Is ketamine addictive?

    Should ketamine be given on a patient’s own pain scale rating?

    When should ketamine be contraindicated?

    Question one was developed with needing to know knowledge on how ketamine provides pain relief in the body.  This can be beneficial in knowing how the drug will affect the patient.  Question two is needing to be researched for patient safety.  Side effects can be synergistic to other diagnosis’s the patient may have. Question three is beneficial in understanding ketamine addiction could be a prevalence for patients with opioid abuse to also become addicted to ketamine.  Question 4 rational includes understanding the pain scale and when to give ketamine is being given for pain.  Should this be a common substitute for acute pain?  Should there be other factors to patient reaction when deciding when to give ketamine besides patient’s pain scale rating. Drug abusers will tell you they have a pain of 10 to try and ensure having opioids prescribed to them.  Question 5 is indicative to understanding if it is safe or not safe to given in situations when patients present with multiple diagnosis including history of addiction. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

    Keywords

    Keywords are important in researching the best evidence reviews and practice for developing an outcome to your PICO question.  Keywords that I chose to utilize for my database search includes; low dose ketamine, opioid abuse, pain management, adverse effects, drug seekers, analgesia, addiction, acute pain, emergency department, and subdissociative dose ketamine.  The keyword chosen correlates to the significance of the PICOT question.  The low dose ketamine and subdissociative dose ketamine is the dosage that would be given to patients who need acute pain management. Opioid abuse, drug seekers, and addiction are pertinent words to understand the reasoning for the need of an alternate solution to opioids.  Pain management, analgesia, acute pain is the types of pain or synonyms for the research of pain management in the Emergency Department for opioid abusers.  The keyword Emergency Department is important in understanding the location and setting where the patient is being given ketamine. Knowledge of adverse effects of ketamine can play an important role in understanding if the medication is safe to give in an ED setting.

    Knowledge of ketamine can further inquire on the safety with administration of ketamine.  Correlating side effects, adverse effects, and mechanism of action will allow for a base understanding of the scientific purpose for treating pain with ketamine.  Further investigation and research needs to be applied in relevance to the later effects of using this type of drug for pain control. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

  • Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay

    Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay

    Details:

    Each student will select one technology application and describe its use within nursing in general or in patient education. Address the significance of the selected technology, attributes of the selected technology (i.e., accuracy, cost, accessibility, etc.), and provide specific examples with rationale of situations in which the technology application as an educational tool would provide advantages as well as disadvantages. In addition, relate the use of the selected technology application to the appropriate professional standards and competencies. Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay.

    ORDER A PLAGIARISM-FREE PAPER HERE

    This assignment may be completed in one of the following formats (with quantitative criteria) listed below:

    APA-formatted paper (1,000-1,250 words)

    PowerPoint presentation with comprehensive speakers’ notes (12-15 slides)

    Podcast (10-15 minutes)

    Blog or Web page (1,000-1,250 words)

    Any other technology application as approved by the instructor

    Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay.

    Course materials:

    Educating Nurses: A Call for Radical Transformation

    Benner, P., Sutphen, M., Leonard, V., & Day. L. (2010). 
    Educating nurses: A call for radical transformation
    . San Francisco, CA: Jossey-Bass. ISBN-13: 9780470457962 (Available as print text only)

    Nurse Educator Competencies: Creating an Evidence-Based Practice for Nurse Educators

    Halstead, J. A. (Ed.). (2007). 
    Nurse educator competencies: Creating an evidence-based practice for nurse educators
    . New York, NY: National League for Nursing. ISBN-13: 9781934758380.

    3. The Scope of Practice for Academic Nurse Educators 2012 Revision

    National League for Nursing Certification Governance Committee. (2012). 
    The scope of practice for academic nurse educators 2012 revision
    . New York, NY: National League for Nursing. ISBN-13: 9781934758175 (For students interested in academic education). Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay.

    4. Teaching in Nursing: A Guide for Faculty

    Billings, D. M., & Halstead, J. A. (2016). 
    Teaching in nursing: A guide for faculty
     (5th ed.). St. Louis, MO: Elsevier-Saunders. ISBN-13:9780323290548 (Available as print text only)

    In addition to course materials, you are required to use a minimum of three current scholarly, peer-reviewed resources (less than 5 years old). Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay.

    APA format is required for essays only. Solid academic writing is always expected. For all assignment delivery options, documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay.

    You are required to submit this Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay assignment to Turnitin. Please refer to the directions in the Student Success Center.

     

    RUBRICS
    Application of Technology in Nursing and Patient Education 

     

    1

    Unsatisfactory 0%-75%

    0.00%

    2

    Less than Satisfactory 76-80%

    80.00%

    3

    Satisfactory 81-88%

    88.00%

    4

    Good 89-92%

    92.00%

    5

    Excellent 93-100%

    100.00%

    70.0 %Content

     

    10.0 %Describes the Use of the Selected Technology in the Specified Population (Nursing in General or Patient Education)

    Does not describe the use of the selected technology’s effects in the specified population. Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay

    Describes the use of the selected technology in the specified population, but the information provided is incomplete, inaccurate, or otherwise deficient.

    Describes the use of the selected technology in the specified population in a perfunctory manner. Minimal detail or support is provided.

    Describes the use of the selected technology in the specified population in full. The submission further encompasses essential details and provides appropriate support.

    Describes the use of the selected technology in the specified population clearly and comprehensively. The submission additionally incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

    10.0 %Addresses The Significance Of The Technology

    Does not address the significance of the selected technology. Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay

    Minimally addresses the significance of the selected technology, but the information provided is incomplete, inaccurate, or lacks both scope and/or clarity.

    Addresses the significance of the selected technology in a perfunctory manner. Minimal detail or support is provided. Discussion is somewhat lacking in scope or clarity.

    Addresses the significance of the selected technology in full. The submission further encompasses essential details and provides appropriate support.

    Addresses the significance of the selected technology clearly and comprehensively. The submission additionally incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

    15.0 %Discusses Attributes Of The Selected Technology (i.e., Accuracy, Cost, Accessibility, Etc.)

    Does not discuss attributes of the selected technology.

    Minimally discusses attributes of the selected technology, but the information provided is incomplete, inaccurate, or lacks both scope and/or clarity.

    Discusses attributes of the selected technology in a perfunctory manner. Minimal detail or support is provided. Discussion is somewhat lacking in scope or clarity.

    Discusses attributes of the selected technology in full. The submission further encompasses essential details and provides appropriate support.

    Discusses attributes of the selected technology clearly and comprehensively. The submission additionally incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

    10.0 %Provides Specific Examples With Rationale Of Situations In Which The Technology Application Would Present Advantages As An Educational Tool.

    Does not provide specific examples with rationale of situations in which the technology application would present advantages as an educational tool.

    Minimally provides specific examples with rationale of situations in which the technology application would present advantages as an educational tool, but the information provided is incomplete, inaccurate, or otherwise deficient.

    Provides specific examples with rationale of situations in which the technology application would present advantages as an educational tool in a perfunctory manner. Minimal detail or support is provided.

    Fully provides specific examples with rationale of situations in which the technology application would present advantages as an educational tool. The submission further encompasses essential details and provides appropriate support.

    Clearly and comprehensively provides specific examples with rationale of situations in which the technology application would present advantages as an educational tool. The submission additionally incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

    10.0 %Provides Specific Examples With Rationale Of Situations In Which The Technology Application Would Present Disadvantages As An Educational Tool.

    Does not provide specific examples with rationale of situations in which the technology application would present disadvantages as an educational tool. Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay

    Minimally provides specific examples with rationale of situations in which the technology application would present disadvantages as an educational tool, but the information provided is incomplete, inaccurate, or otherwise deficient.

    Provides specific examples with rationale of situations in which the technology application would present disadvantages as an educational tool in a perfunctory manner. Minimal detail or support is provided.

    Fully provides specific examples with rationale of situations in which the technology application would present disadvantages as an educational tool. The submission further encompasses essential details and provides appropriate support.

    Clearly and comprehensively provides specific examples with rationale of situations in which the technology application would present disadvantages as an educational tool. The submission additionally incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

    15.0 %Relates the Use of Technology to Appropriate Professional Standards and Competencies

    Does not relate the use of the selected technology application to the appropriate professional standards and competencies.

    Minimally relates the use of the selected technology application to the appropriate professional standards and competencies, but the information provided is incomplete, inaccurate, or otherwise deficient.

    Relates the use of the selected technology application to the appropriate professional standards and competencies in a perfunctory manner. Minimal detail or support is provided.

    Fully relates the use of the selected technology application to the appropriate professional standards and competencies. The submission further encompasses essential details and provides appropriate support.

    Clearly and comprehensively relates the use of the selected technology application to the appropriate professional standards and competencies. The submission additionally incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

    13.0 %Assignment Criteria

     

    5.0 %Assignment Quantitative Criteria (word count, timespan, slide number, etc.)

    Unacceptable adherence to applicable assignment quantitative criteria. Submission incorporates 0 – 25 percent of the required criteria for the chosen format.

    Poor adherence to applicable assignment quantitative criteria. Submission incorporates 25- 50 percent of the required criteria for the chosen format.

    Weak adherence to applicable assignment quantitative criteria. Submission incorporates 50 – 75 percent of the required criteria for the chosen format.

    Adequate adherence to applicable assignment quantitative criteria. Submission incorporates 90 percent of the required criteria for the chosen format.

    Excellent adherence to applicable assignment quantitative criteria. Submission incorporates 100 percent of the required criteria for the chosen format.

    5.0 %Scholarly references (Utilizes a minimum of three current scholarly, evidence-based, peer-reviewed resources less than five years old, in addition to course materials)

    Submission utilizes only course materials. Selected references are absent or do not meet stated criteria.

    Weak selection, or inappropriate use of scholarly materials to accompany course materials. Does not use evidence-based sources when available.

    Fair selection of scholarly materials. Uses evidence-based sources when available, but minimal relevance or support is present.

    Strong selection of scholarly materials. Uses appropriate evidence-based sources when available which provide appropriate support.

    Excellent and extensive selection of scholarly materials. Evidence-based sources are suitable and relevant. Level of detail is appropriate.

    3.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.)

    Inappropriate word choice and or sentence structure, or lack of variety in language use is present, suggesting unawareness of the audience. Writing and transitions consistently lack unity and coherence. Composition is disjointed.

    Some distracting and or inconsistencies in language choice, sentence structure, and / or word choice are present. Some writing and transitions may lack logical progression of ideas, unity, coherence, and or cohesiveness. Some degree of composition is evident.

    Sentence structure is correct and occasionally varies. Word choices and language are appropriate to the targeted audience. Writing is generally competent, but ideas may show some inconsistency in composition and/or in their relationship to each other.

    Clearly aware of audience; uses a variety of sentence structures and appropriate vocabulary; uses figures of speech to communicate clearly. Writing exhibits a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are used appropriately.

    Uses a variety of sentence constructions, figures of speech, and word choices in unique and creative ways that are appropriate to purpose, discipline, and scope. There is a sophisticated writing in terms of construction and transitions. Individually and collectively, written sections are coherent and cohesive.

    12.0 %Organization and Effectiveness

     

    5.0 %Thesis Development and Purpose

    Submission lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear.

    Thesis is apparent and appropriate to purpose.

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    5.0 %Argument Logic and Construction

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

    Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    2.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

    Writer is clearly in command of standard, written, academic English.

    5.0 %Format

     

    3.0 %Paper Format (use of appropriate style for the major and assignment)

    Template is not used appropriately or documentation format is rarely followed correctly.

    Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

    Appropriate template is used. Formatting is correct, although some minor errors may be present.

    Appropriate template is fully used. There are virtually no errors in formatting style.

    All format elements are correct.

    2.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    100 %Total Weightage

    Application of Technology in Nursing and Patient Education PowerPoint Presentation Essay

  • NURSING SEMINAR DISCUSSIONS

    Nursing Seminar Discussions Questions

    1.The assigned reading from 
    Teaching in Nursing: A Guide for Faculty 
    discusses the use of technology in nursing education. Consider the types of technology devices available today such as eReaders, smartphones, and net books, to name just a few. Select one type of technology application and explain how it is changing the nature of the learning environment and/or the learner’s experience in it. Nursing Seminar Discussions.

    ORDER A PLAGIARISM-FREE PAPER HERE

    2.Application of technology in nursing education is one of the most  groundbreaking incentives that was carried on in the past decade. However, transition from traditional to innovative methods can be challenging. What are some identified barriers to utilization of  technology in academic or clinical settings? Although responding to CAT questions is not required, substantive responses will count towards weekly participation points. Nursing Seminar Discussions.

    Select a specific technology and describe how the use of that technology in nursing education would differ with different types of students. Nursing Seminar Discussions.

    What are some strategies administrative body can utilize to ensure that faculty members are well prepared to transition from traditional methods to innovative methods (application of technology). Although responding to CAT questions is not required, substantive responses will count towards weekly participation points. Nursing Seminar Discussions.

    Please use 2 citing per question

     

    Also may use for citing

    Teaching in Nursing: A Guide for Faculty

    Billings, D. M., & Halstead, J. A. (2016). 
    Teaching in nursing: A guide for faculty
     (5th ed.). St. Louis, MO: Elsevier-Saunders. ISBN-13:9780323290548. Nursing Seminar Discussions.

  • Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone

    Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone

    You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet from your Capstone Project Milestone 1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Course Outcomes

    This assignment enables the student to meet the following course outcomes.

    CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO1)

    CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO2)

    Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Milestone 2 consists of the proposal for your Design for Change Capstone Project. Use the Turnitin Inbox to submit this assignment by the end of Week 4.

    Points

    Milestone 2 is worth 225 points.

    You are required to use the assignment specific item(s) (article/systematic review/topic/form/templates) or you will earn a ”0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required item, as defined above, will be evaluated for evidence of an academic integrity violation. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    view the feedback you received from your instructor for Milestone 1, and use it to develop this milestone.

    Create a proposal for your Design for Change Capstone Project. Open the recommended assignment specific Milestone 2 Design Proposal Outline (Links to an external site.)Links to an external site.. Use this to write your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    The format for this proposal will be a paper following the Publication manual of APA 6 th edition.

    The paper is to be four- to six-pages excluding the Title page and Reference page.

    As you organize your information and evidence, include the following topics.

    Introduction: Write an introduction but do not use ”Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.

    Change Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.

    Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.

    Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.

    Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, ”How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Submit your paper by 11:59 p.m. MT by Sunday of the end of Week 4.

    **Academic Integrity Reminder**

    By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

    NR451_Milestone2_2

    NR451_Milestone2_2

    Criteria Ratings Pts

    This criterion is linked to a Learning Outcome Introduction

    Introduction to the plan is nursing focused, with evidence-based problem identification and potential solutions clearly identified.) Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    25.0 pts

    Introduction to the plan is nursing focused, and evidence-based. Potential interventions clearly identified.

    22.0 pts

    Introduction to the plan is missing one of the elements listed in the first column.

    20.0 pts

    Introduction to the plan is missing two elements listed in the first column.

    10.0 pts

    Introduction lacks evidence to support need for change and/or potential solution is not evidenced-based.

    0.0 pts

    Introduction is missing.

    25.0 pts

    This criterion is linked to a Learning Outcome Change Model Overview

    An overview of the ACE Star model as a guide for change is given. Scope of the problem is identified. Stakeholders are identified. Team members and their roles and practice area are identified and discussed. State how nurses should use this model as a guide to facilitate change.

    50.0 pts. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Overview of the ACE Star model is given. Scope of problem is identified. Rationale for change is present. Stakeholders are identified. Practice area, team members and role are discussed.

    44.0 pts

    All elements in the first column are included but discussion of one or more items lacks details.

    40.0 pts

    Overview is missing one of the elements from the first column.

    19.0 pts

    Overview of the ACE Star model is given. Scope of problem is not identified. Rationale for change is not present. Stakeholders are not identified. Practice area, team members and role are not discussed. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    0.0 pts

    Change Model Overview is missing all elements of the first column.

    50.0 pts

    This criterion is linked to a Learning Outcome Evidence

    Evidence is provided thru basic information that indicates a change is needed. For example, there have been 6 urinary tract infections over the last two months and there were none present the last two years at the same time period. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use? Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    50.0 pts

    Evidence summary is thoroughly provided with information of the current problem in the work setting indicating a change is needed. Interventions discovered in Evidence Summary are used in planning for change.

    44.0 pts

    Evidence summary contains all elements in the first column, however, one or more items lacks detail.

    40.0 pts

    Evidence is vaguely provided through information of the current problem in the work setting indicating a change is needed. Some of the interventions discovered in Evidence Summary are used in planning for change. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    19.0 pts

    Evidence is provided through information of the current problem but is not convincing. Interventions discovered in Evidence Summary are not used in planning for change.

    0.0 pts

    Evidence summary is not provided.

    50.0 pts

    This criterion is linked to a Learning Outcome Translation

    Activities to achieve the final steps of change are fully described. What is needed to achieve? How do you translate what information you have gathered into practice? Include measurable outcomes. How do you inform staff? What is your plan of action to pilot the plan? What is the timeline?

    50.0 pts

    Activities to achieve final steps of change are fully described. Ways to translate evidence into practice are discussed (outcomes). Methods to inform staff, activities planned for plan of action and timeline are discussed. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    44.0 pts

    Activities to achieve final steps of change are adequately described.

    40.0 pts

    Activities to achieve final steps of change are briefly described.

    19.0 pts

    Minimal description of the activities to achieve final steps of change.

    0.0 pts

    Activities for final change plan are missing. Translation of evidence into practice is missing.

    50.0 pts

    This criterion is linked to a Learning Outcome Conclusion

    Clear, solid summary of the key points, ACE Star model and steps of the change plan are included; ways to sustain the change plan are described. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    25.0 pts

    Detailed summary of main points using ACE Star model. Ways to sustain plan are thoroughly described.

    22.0 pts

    Summary of main points/model is brief. Ways to sustain plan are briefly described.

    20.0 pts

    Summary of main points/model is vague. Ways to sustain plan are vaguely described.

    10.0 pts

    Summary of main points/model OR ways to sustain plan are not described.

    0.0 pts

    Summary is missing. There is no plan to sustain change.

    25.0 pts

    This criterion is linked to a Learning Outcome Mechanics

    APA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    25.0 pts

    APA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors

    22.0 pts

    Two to three errors in elements from the first column.

    20.0 pts

    Four to five errors in elements from the first column.

    10.0 pts

    Six to seven errors in elements from the first column.

    0.0 pts

    More than seven errors.

    25.0 pts

    Total Points: 225.0

    Capstone Project Milestone 2- Design for Change Proposal Guidelines

    Capstone Project Milestone 1:

    Practice Issue and Evidence Summary Worksheets

     

    Student Name:
                                                            
    Date:

    Directions

    Refer to the guidelines for specific details on how to complete this assignment.

    Type your answers directly into the worksheets below.

    Submit to the Drop box by the end of Week 3, Sunday at 11:59 p.m. MT.

    Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

     

    Practice Issue Worksheet

     

    List the topic and include the citation for the systematic review you have selected from our approved list (optional: an additional scholarly source of support):

    Preventing 30-day hospital readmissions, of the congestive heart failure patient.

    Leppin, A. L., Gionfriddo, M. R., Kessler, M., Brito, J. P., Mair, F. S., Gallacher, K., & … Montori, V. M. (2014). Preventing 30-day hospital readmissions: a systematic review and meta-analysis of randomized trials. JAMA Internal Medicine, 174(7), 1095-1107. doi:10.1001/jamainternmed.2014.1608

     

    What is the nursing practice issue you have identified related to the topic you have chosen?

    Will initiating a patient care plan on heart failure education and providing a 48-hour post discharge follow up on a hospital cardiac unit; minimize the readmission rates of heart failure patients within 30 days? Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Congestive Heart failure patient’s accounts for one of the largest group of patients with frequent hospital readmission. Education both inpatient and outpatient can help minimize hospital readmission. Combining multiple teaching models has shown to be more effective in reducing the number of hospital readmissions.

    Hospital readmissions for Congestive heart failure create a huge impact on the healthcare system as well as on the patient. Finding ways to help reduce the rate of readmissions is important for the patient’s quality of life and also minimizing costs incurred to the hospitals. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Readmissions within weeks after a congestive heart failure discharge are associated with negative patient outcomes, and increased hospital costs. Patients require knowledge and self care skills to manage this condition. Patients need the understanding of the basics of heart failure discharge instructions and if education is poor, that could potentially increase the rate of readmission.

    Fully describe the scope of the practice issue:

    20% of all Medicare covered patients are readmitted to the hospital within thirty days of discharge. These readmissions can cost the American public billions of dollars a year. Because the Affordable Care Act has implemented incentives to reduce readmission, it is important for our hospital to develop and implement practices to help prevent readmissions

    Education at discharge and throughout the hospital stay is a vital component of improving outcomes in heart failure patients. Patient and family education that involves a multidisciplinary team that emphasizes medication adherence, sodium and fluid restrictions, and recognizing signs and symptoms that indicate progression of disease may be as important as ensuring that patients are prescribed appropriate medical therapy and attend a follow up. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    In addition to verbal information, a combination of educational materials is used to enhance a patient’s ability to absorb information. Books, medication pamphlets, education print outs, teach back, follow up, and outpatient resources such as websites need to be used. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

     

    What is the practice area?

    __X_ Clinical

    _X__ Education

    ___ Administration

    ___ Other (List):

    How was the practice issue identified?
    (check all that apply)

    ___ Safety/risk management concerns

    _X__ Unsatisfactory patient outcomes

    ___ Wide variations in practice

    _X__ Significant financial concerns

     

     

    ___ Difference between hospital and community practice

    __X_ Clinical practice issue is a concern

    ___ Procedure or process is a time waster

    ___ Clinical practice issue has no scientific base

    __ Other:

    Describe the rationale for your checked selections:

    CHF is a common disease that can be difficult to manage; with poor patient outcomes. Since the implementation of the Affordable Care Act, hospitals lose reimbursement for extensive readmissions. If a hospital that makes $30,000,000 a year in Medicare reimbursement and 3% is taken off for extensive readmissions that is a $900,000 reduction in revenue for the hospital. Even without the decrease in reimbursement, poor patient outcomes are enough of an incentive to reevaluate our treatment plans and develop ways to help these patients. Hospitals need to focus on enhancing the effects of an education program, which includes: Education from admission to discharge, teach back, call back nurse, follow up, home health, community service resource, etc. We need to help patient’s capacity for self-care in their transition from hospital to home. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

     

    What evidence must be gathered? (check all that apply)

    Studies regarding follow-up and education from a literature search will be helpful in deciding which interventions would be most effective. Knowledge about the Affordable Care Act and its requirements for reimbursement is another area that would be helpful in developing cost-effective interventions to prevent readmissions. A financial analysis would provide the evidence needed to know how the hospital’s reimbursement is paid and if there has been a decrease in reimbursement since the adoption of Affordable Care Act. The Hospital Readmission Reduction Program, in conjunction with the Affordable Care Act to monitor hospitals readmissions rates for myocardial infarctions, congestive heart failure, pneumonia and COPD, which were added in 2015.

    Hospital readmission rates are at a high; however, evidence about hospital strategies that are associated with lower readmission rates is limited. We would need to identify hospital strategies that were associated with lower readmission rates for patients with heart failure. We would need to distinguish which type of education is retained and keeps the patient compliant. What is the RN’s perception of patient discharge education and what are their practices.

    Is there a difference in the perception of heart failure discharge education of registered nurses. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    employed in an acute care setting and those employed in a non-acute care setting?

    The studies I read showed that patient education and continuous post discharge follow-up interventions conducted by nurses could significantly reduce the rates of readmissions to the hospital or to the physicians’ office. This aims at the permanent training, reinforcement, improvement and evaluation of self-care of the heart failure patient, which include weight monitoring, sodium and fluid restriction, physical activities, compliance of medications, monitoring of signs and symptoms of worsening and when to seek medical help. This will test nursing interventions with a direct effect on improved heart failure patient readmissions. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    As more is learned about the important effects of education and self- care on patients’ outcomes, the need to move away from the traditional view of patients as passive recipients of information is clear. Patients should be viewed as active partners in the management of their health. Cardiac nurses play a fundamental role in the

     

    __X_ Literature search

    _X__ Guidelines

    ___ Expert Opinion

    ___ Patient Preferences

    _X__ Clinical Expertise

    __X_ Financial Analysis

    __X_ Standards (Regulatory, professional, community)

    ___ Other

     

    Describe the rationale for your checked selections:

    Literature research will be collected to assess whether following up with patients should be implemented and whether or not it would be beneficial to the patient in preventing readmission. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Clinical expertise will need to be assessed to determine whether staff doing the education is well educated and compliant in the teaching and able to answer any questions the patient may have. Clinicians must apply their expertise to assess the patient’s problem and should integrate effective interventions as evidenced by research

    Standards; these include Federal, State, local and other regulatory frameworks that are necessary for the adoption of effective intervention strategies. The patient may need professional resources outside in the community, so getting information on local resources will Also be beneficial to inform the patient during the discharge and follow up. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Financial analysis would provide the evidence needed to the hospital’s reimbursement

     

    Evidence Summary Worksheet

    Directions
    : Please type your answers directly into the worksheet.

     

    Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms:

    Reducing hospital readmissions is a national focus for healthcare. Consequently, patient discharge education is increasingly important for improving clinical outcomes and reducing hospital costs. Hospital readmissions are widespread, costly, and often avoidable. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Overall, hospital readmission is a challenge every institution faces. Even after you implement better processes to focus on decreasing your readmission rate, there will always be cases in which a patient must be readmitted. Unplanned hospital readmission, or a patient’s return to the hospital for the same or related issue is not only inconvenient for the patient; it also poses a significant concern for hospitals.

    The successful implementation of multiple interventions is essential to produce a significant reduction in heart failure readmissions. The majority of these interventions is “nurse-driven”, and can most efficaciously be implemented in structured nurse-led heart failure programs. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Include the APA reference for any additional
    optional
    supplemental scholarly source related to the review you wish to use.

    Leppin, A. L., Gionfriddo, M. R., Kessler, M., Brito, J. P., Mair, F. S., Gallacher, K., & … Montori, V. M. (2014). Preventing 30-day hospital readmissions: a systematic review and meta-analysis of randomized trials. JAMA Internal Medicine, 174(7), 1095-1107. doi:10.1001/jamainternmed.2014.1608

     

    Identify the objectives of the article:

    The objective of the article was to synthesize the evidence of the effectiveness of interventions to decrease early hospital readmissions and identify intervention features—including their impact on treatment burden and on patients’ capacity to enact post discharge self-care—that might explain their varying effects. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Provide a statement of the questions being addressed in the work and how these relate to your practice issue:

    The high readmission rates experienced in the health-care system are generally attributed to inadequate skills for patients to administer self-care after discharge from hospitals. This is evidenced by the fact that approximately 20 percent of patients are readmitted to the hospital within 30 days after discharge. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.

    The authors suggest that more effective interventions despite being complex are an important aspect of supporting patient capacity for self-care and should be adopted. Further, they claim that the efficiency of interventions tested recently is minimal. Interventions used to improve patient outcomes included in the discharge planning process: case management, telephone follow up, tele-monitoring, patient education, self management, medication intervention, home visits, scheduled follow ups, patient hotlines and streamlining. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper
    .
    (If an
    optional
    supplemental source is also used, include a statement of relevance to it as well.)

    OBJECTIVE is to synthesize the evidence of the efficacy of interventions to reduce early hospital readmissions and identify intervention features–including their impact on treatment burden and on patients’ capacity to enact post discharge self-care–that might explain their varying effects. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Addressing the early hospital readmission has been recognized and is a costly occurrence. Patients were discharged from hospital without social support and lack of education on how to care for their selves or diagnosis at home and are one of the factors that contribute to hospital readmission. If hospitals provide the supported intervention such as patient education, discharge planning (prepare for discharge), self-management, follow up, home visit, and community resource, this would enhance patients’ capacity for self-care in their transition from home to hospital and in turn reduce the risk of early readmission. The findings also showed that the majority of the interventions tested were effective at reducing readmissions into the hospital. The interventions that supported the patient’s once returning home were most favorable. This is relevant to my project proposal because contacting a patient via phone allows the patient to be comfortable and independent. The author emphasized the risk of cause in unplanned readmission with or without hospital deaths at 30 days post discharge. The study selected randomized trials to assess the effect of interventions on the readmission within 30 days of discharge in adult patients hospitalized. The finding is if patients who receive follow up, and support on post discharge at home to patients and families related to diagnosis and treatment will reduce readmissions. Both clinician from hospital and primary care need to get involve in patients’ care. The strength of evidence for main outcome is to provide support to patients, which can play an important role to reduce hospital readmission rates. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Outline evidence-based solutions that you will consider for your project
    .

    Plan the research by meeting with the multidisciplinary team and to discuss what is trying to be implemented.

    –          Engage co-workers to be involved

    –          Execute the research plan.

    –          Evaluate the outcome of readmissions.

    –          Address patient communication needs during discharge

    –          Engage patients and families in discharge planning and instruction

    –          Provide discharge instruction that meets patient needs

    –          Identify follow up providers that can meet patient needs

    The follow-up phone call consists of five components:

    –          Assessment of health status.

    –          Medication check.

    –          Clarification of follow up appointments.

    –          Post discharge home resources.

    –          Review of what to do if a health or medical problem arises (signs & symptoms).

    Evidence-based research has shown that programs that provide appropriate patient education; increases patient participation in his/her care, assists individuals in making informed decisions and increases patient adherence to treatment. Patient education needs to be individualized and based according to the individual’s needs and skills. Before establishing patient education it is important to keep in mind, the patient’s health literacy, their willingness in participating in their self-care and resources available. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Discuss any limitations to the studies that you believe impacts your ability to utilize the research in your project.

    Patient and family education through out the hospital stay, through teach-back along with patient follow up, could be increasingly useful in heart failure education programs. However, significant barriers to patient self-care education are often present, such as cognitive impairment, and poor health literacy. Studies have demonstrated that we may not relay information to patients in a way they can understand. Instructions at discharge should be given in plain language, use verbal, audio, and visual instruction, be repeated by multiple providers (physician, nurse, dietician, physical therapy, and pharmacist, etc.), and be confirmed using a teach-back method where patients are asked to repeat back what they understand regarding their discharge instructions. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

     

    Practice Issue and Evidence Summary Worksheets

     

    Title

    Your Name

    Chamberlain College of Nursing

    NR451 RN Capstone Course

    Term and Year

     

     

    Your title here

    This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so
    you cannot use first person
    . Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Change Model Overview

    In this first paragraph, provide an overview of the ACE Star model Evidence-Based Practice Process. Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the ACE Star model EBP Process. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Define the Scope of the EBP

    Restate your practice issue. Why is this a problem? Give statistics and information to back the scope of the problem at your facility/work area. How does this problem impact healthcare on a broader scale?

    Stakeholders

    You will be the leader of the team since this is your project. Who will you also include in your team? Make sure you choose relevant stakeholders. You should have no more than eight members. Do not list your team members by name but instead by position (pharmacists, charge nurse, etc.).

    Determine Responsibility of Team Members

    Why are the members chosen important to your project? What are their roles?

    Evidence

    Conduct internal/ external search for evidence. What type of evidence did you find in addition to you Evidence Summary? EBP guidelines? Quality improvement data? Position statements? Clinical Practice Guidelines?  Briefly discuss the strength of this research. This is
    not
    where you describe the results of your studies. This is done in the following steps. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Summarize the Evidence

    In this section, you need to synthesize the information from the systematic review article. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use? Be sure and cite all of your references, in proper APA format, from any and all articles into this one paragraph.

    Develop Recommendations for Change Based on Evidence

    What is your recommendation based on the research? Ideally, you will have found enough support in your evidence to proceed with implementing your pilot program. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Translation

    Action Plan

    You have not implemented your project yet, therefore, this section will be hypothetical. Develop your plan for implementation. What are the specific steps you will take to implement your pilot study?  What is the timeline for your plan? Make sure you include a plan for evaluation of outcomes and method to report the results. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Process, Outcomes Evaluation and Reporting

    What are the desired outcomes? How will they be measured? How will you report the results to the key stakeholders?

    Identify Next Steps

    How will you implement the plan on a larger scale? Will this be applicable to other units or the facility as a whole? What will you do to ensure that the implementation becomes permanent?

    Disseminate Findings

    How will you communicate your findings internally (within your organization) and externally (to others outside of your organization)? Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.

    Design Proposal Outline

    Conclusion

    Provide a clear and concise summary. Review the key aspects of the problem as well as the change model. Be sure to include important aspects of the five points of the ACE Star change model EBP process and ways to maintain the change plan. Practice Issue, Evidence Summary Worksheets and Design for Change Proposal Capstone Project Milestone.