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Differential diagnosis and primary care practicum.

Briefly and concisely summarize the history and physical (H&P) findings as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations. Avoid redundancy and irrelevant information.

Provide a differential diagnosis (minimum of 3) which might explain the patient’s chief complaint along with a brief statement of pathophysiology for each.

Analyze the differential by using the pertinent findings from the history and physical to argue for or against a diagnosis. Rank the differential in order of most likely to least likely Differential diagnosis and primary care practicum.

Identify any additional tests and/or procedures that you feel is necessary or needed to help you narrow your differential. All testing decisions must be supported with an evidence-based medicine (EBM) argument as to why it is necessary or pertinent in this case. If no testing is indicated or needed, you must also support this decision with EBM evidence.

The rest of the information from this case study will be attached as a PDFs file.

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Briefly and concisely summarize the history and physical (H&P) findings as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations. Avoid redundancy and irrelevant information Differential diagnosis and primary care practicum.

· Provide a differential diagnosis (minimum of 3) which might explain the patient’s chief complaint along with a brief statement of pathophysiology for each. NR511: Differential Diagnosis and Primary Care

· Analyze the differential by using the pertinent findings from the history and physical to argue for or against a diagnosis. Rank the differential in order of most likely to least likely.

· Identify any additional tests and/or procedures that you feel is necessary or needed to help you narrow your differential. IF you ordered a test or performed a procedure, identify the corresponding Current Procedural Terminology (CPT) code(s). If not applicable, list n/a. All testing decisions must be supported with an evidence-based medicine (EBM) argument as to why it is necessary or pertinent in this case. If no testing is indicated or needed, you must also support this decision with EBM evidence Differential diagnosis and primary care practicum.

The rest of the information for the HPI, ROS, and physical exams will be in the “my orders” section

Guide to NR511 Case Studies (Week 3 & 6)

Part 1

In Part 1, you are given a patient scenario.  Using the information given, answer the following questions:

 

Briefly and concisely summarize the H&P findings
as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations.  Avoid redundancy and irrelevant information.

Example:

“J.S. is a 34yo male with a CC of acute onset ST x 3 days” [provide additional information from the history that is relevant]. 

 
“Physical exam is significant for” [provide relevant physical exam findings].

 
*Do not simply rewrite the information as it is presented in the case report. This should mimic how you would present this patient to your preceptor.

 

Provide a differential diagnosis (plural) which might explain the patient’s chief complaint
along with a
brief statement of pathophysiology for each
.

 

Example:

 

Diagnosis #1

-Pathophysiology statement

 

Diagnosis #2

-Pathophysiology statement

 
Diagnosis #3

-Pathophysiology statement

Analyze the differential
by using the pertinent findings from the history and physical to argue for or against a diagnosis.
Rank the differential
in order of most likely to least likely.
(This is where you present your argument for EACH DIAGNOSIS in your differential using the patient’s subjective and objective information that was given).

Example:

 
Diagnosis # 1, 2, & 3 (provide an analysis for each of the diagnoses listed above)

A brief
argument
as to why this condition should be considered plus:

-Pertinent positive symptoms which support the diagnosis

-Pertinent negative symptoms which support the diagnosis

Identify any additional tests and/or procedures
that you feel is necessary or needed to help you narrow your differential. All testing decisions must be supported with an EBM argument as to why it is necessary or pertinent in this case.  If no testing is indicated or needed, you must also support this decision with EBM evidence.
(This is where you identify, based on what you know thus far, test or test(s) that you would perform TODAY which would help you narrow your differential diagnosis). Differential diagnosis and primary care practicum.

 

*
Do not list all of the possible tests that can be done. You are being evaluated on your diagnostic reasoning skills as well your ability to make decisions that are in-line with current practice recommendations. Just because a test is available does not mean it needs to be done.

Example:

Let’s say my differential included bronchitis and pneumonia.  In this case, a CXR might be useful in differentiating the 2 conditions.  However, remember that you have to have an EBM argument for this decision Differential diagnosis and primary care practicum. 
So make sure you are telling the reader why this is the best choice based on the literature (i.e., it is not enough to say the test and cite the author & date).
  In this instance, my argument might look like this:  “According to the Infectious Disease Society of America (2012) a CXR is considered the gold standard for diagnosing pneumonia.”  Keep in mind that you also need an EBM argument if you decide NOT to test too. 

 
Part 2

In Part 2 you might be given some additional history, exam or test findings.  Using this information
and
the information in Part 1, answer the following questions:

What is your
primary diagnosis
for this patient?
Tell the reader how you came to this conclusion using the information that you were given (i.e., CXR result, lab result).  Interpret the results into your diagnosis decision (i.e., tell how this information helped you to narrow your differential to the one diagnosis that you chose).

 

Example:

Diagnosis: Pharyngitis, streptococcal

 
Rationale:
The CBC results are normal which rules out infection and anemia. The RSA test was + which tells me that she has a very strong likelihood of streptococcal pharyngitis.

In the case where a diagnosis was made based on clinical presentation and history, explain the criteria with an EBM argument to support.

 

Identify the corresponding ICD-10 Code
for the diagnosis.

 

Example:

 

J02.0

You can find a link to an ICD-10 code finder by going to the Library homepage>Browse guides>Course directory tab>select NR511 from the drop down box>select Go. Otherwise, a google search will provide you with several free options you can use Differential diagnosis and primary care practicum.

 

Provide a treatment plan
for this patient’s primary diagnosis which includes:

 

a)
Medication
–
all prescriptions and OTC medications should be written in RX format with an EBM to support:

Medication Name & Medication Strength

Dispensing quantity:

Sig:

RF:

 

b)
Any additional testing
necessary for this particular diagnosis-t
ypically done when you need more information to confirm a diagnosis or differentiate the diagnosis. Do not state all of the possibilities that are available. To assess your diagnostic reasoning skill, you will need to be decisive.

 

c)
Patient education
–
self explanatory

 

d)
Referral
-self explanatory

 

e)

F/U plan
-include if and when the patient should follow-up

 

*If part of the plan does not warrant an action, you must explain why. ALL medication and testing decisions (or decisions not to treat with medication or additional testing) MUST be supported with an EBM argument as you did in Part 1 Differential diagnosis and primary care practicum.

 

Example:

 

Penicillin VK 500mg, Disp #20, Sig: 1 tab twice daily x 10days; RF: 0 (full RX required)

 

Rationale: Penicillin is the 1
st
line treatment recommendation for Group A Beta-hemolytic streptococcal pharyngitis, based on their narrow spectrum of activity, infrequency of adverse reactions, and modest cost.  (Shulman, Bisno, Clegg, Gerber, Kaplan, Lee, Martin, & Van Beneden, 2012).  My patient has no noted allergies, so PCN VK is appropriate.

 

No additional testing will be performed today.

 

Rationale:  Point of care, rapid strep antigen tests are highly specific (approximately 95%) when compared with throat cultures, so false-positive test results are highly unusual.  Consequently, a therapeutic decision can be confidently made based on the positive result which was reported for this patient in the scenario (Shulman, Bisno, Clegg, Gerber, Kaplan, Lee, Martin, & Van Beneden, 2012) Differential diagnosis and primary care practicum. 

 

Patient instructions:

-take all medication as prescribed (Reference, date)

-F/U in 10-14 days if symptoms are not resolved or sooner if they become worse, etc., (Reference, date)

-Etc..

 

Provide an active problem list
for this patient
based on the information given
in the case.
This is where you list all of the known medical problems of the patient.  This is different than a differential. Differential diagnosis and primary care practicum.

 

Example:

 

Streptococcal Pharyngitis

Hypertension

Obesity

 

 

List your references that were cited above according to APA rules. Format is not graded (Canvas does a poor job in formatting the tabs and spaces) BUT all other APA elements are required.

 

References

Shulman, S., Bisno, A., Clegg, H., Gerber, M., Kaplan, E., Lee, G., Martin, J., & Van Beneden, C. (2012).  Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis:  A 2012 Update by Infectious Diseases Society of America. 
Clinical Infectious Disease, 55(10), e89.
  DOI: 10.1093/cid/cis629 Differential diagnosis and primary care practicum.

Tips for Finding a Preceptor & Practicum Site

Finding a Practicum Site & Preceptor

Ask those you have professional relationships with if they have recommendations for you

A physician or FNP you know

Your current place of work, or an affiliate facility

Your own family physician

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Also consider

A retail clinic

http://
npfinder.aanp.org/

Practicum Site Considerations

Practicum Site Selection: Focus Should be on Primary Care

Preceptor Requirements

Patient Population Exposure

NR-511: Differential Diagnosis and Primary Care Practicum

Must take place at a family practice or retail clinic

Core Focus

Formulating differential diagnoses of individuals within the primary care setting

Practicum experiences may include:

Processing client information

Interpreting lab studies

Cardiovascular risk assessment/management

NR-601: Primary Care of the Maturing and Aged Family Practicum

Must take place at a family practice or retail clinic

Core Focus

Common health problems and healthcare needs of the middle-aged and older adult

Further develop your skills related to patient education, protocol development, follow-up and referral Finding a Practicum Site & Preceptor.

Practicum experiences may include:

Older adult cognitive/functional ability assessment

Older adult nutritional assessment

Performance of primary care-related skills within scope of preceptor

NR-602: Primary Care of the Childbearing and Childrearing Family Practicum

Core Focus

Healthcare needs of women and families throughout reproductive and childrearing years

Practicum experiences may include:

Performing well-woman and well-child exams

STD diagnosis and treatment

Performing full pelvic exams

NR-603: Advanced Clinical Diagnosis and Practice across the Lifespan Practicum Finding a Practicum Site & Preceptor

Core Focus

Expand the theoretical and practical knowledge of health assessment principles specific to the role of the FNP

Practicum experiences may include:

Health promotion and prevention of illness

Diagnosis and management of health problems across lifespan

Performance of primary care-related skills within scope of preceptor

NR-661: APN Capstone Practicum

Core Focus

Clinical management skills, case studies, chart reviews, and practice critique, with a capstone product evidencing increasing complex clinical management skills Finding a Practicum Site & Preceptor

Practicum experiences may include:

Performance of primary care-related skills within scope of preceptor

Imbedded national certification exam review program

Developed by APEA, Advanced Practice Education Associates

You may complete your practicums with your current employer as long as …

üPreceptor is not your direct supervisor

üSite provides necessary patient exposure

üPracticum experiences are outside of your typical work area

Scheduling and Time Management

Why Start So Early?

Unplanned situations can occur

Scheduling conflicts with preceptors

Practicum sites not delivering as planned

Trouble finding appropriate patient exposure

Clinical Affiliation Agreement

Can take several weeks to months to obtain

Practicum Site Requirements

Contacting Sites & Preceptors

Be Professional

Sites may evaluate you for future employment

Be Prepared

Have your goals, preceptor requirements,  practicum requirements, timeframe and expectations clearly outlined

These can be found in your FNP Practicum Handbook and Toolkit

Be Appreciative Finding a Practicum Site & Preceptor.

Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet

Practice Issue Worksheet Directions

A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..

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Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.

Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.

Your practice issue will be the same for all three Milestone assignments in this course.

Please type your answers directly into the worksheet Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.

Document this on the evidence summary portion of the worksheet.

You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.

Please type your answers directly into the worksheet. Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

Practice Issue Worksheet Directions

A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..

ORDER A CUSTOM-WRITTEN,  PLAGIARISM-FREE PAPER NOW

Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.

Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.

Your practice issue will be the same for all three Milestone assignments in this course.

Please type your answers directly into the worksheet. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.

Document this on the evidence summary portion of the worksheet.

You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.

Please type your answers directly into the worksheet.

Guidelines

Purpose

Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star Model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project.

Course Outcomes

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

CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO4)

CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO8)

Due Dates

Milestone 1 consists of the completion of ONE form with two worksheets. Complete both worksheets and submit the form (Attached)

You are required to use the linked article (
under order 201804) and Worksheets or you will earn a “0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required Worksheet or article will be evaluated for evidence of an academic integrity violation.

Practice Issue Worksheet Directions

Choose the 
ONE
systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List( submitted under order 201804)

Follow the grading criteria below to formulate your practice issue, 
which must be based on the topic of the systematic review you have selected
.

Download the required worksheets (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions. –
Attached

Your practice issue will be the same for all three Milestone assignments in this course.

Please type your answers directly into the worksheet Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.

Document this on the evidence summary portion of the worksheet.

You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.

Please type your answers directly into the worksheet.

Rubric

NR451_Milestone_1_2

NR451_Milestone_1_2

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomePractice Issue Statement, Scope of Practice, Practice Area

Identifies a practice issue statement that is an independent nursing decision, and is relevant to the systematic review topic chosen from among the approved list provided in the course. Describes the scope of practice issues. Example: The number of falls in your facility has been increasing, especially during shift change. What do you believe may be causing this? Are there any new interventions that could be put into place that would lessen or eliminate the falls? This is where you begin your initial search into the problem or practice issue identified. Identifies the practice area.

20.0 pts

Practice issue is identified based on the approved systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is fully described. Practice area identified.

18.0 pts

Practice issue is identified but is not clear, however it is based on the approved systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is described in simple terms. Practice area identified.

16.0 pts

Practice issue is identified but is not clearly related to a nursing practice issue, however it is based on the approved systematic review topic chosen. Practice issue is not an independent nursing decision. Scope of practice issue is described but is not clear. Practice area identified.

8.0 pts

Practice issue is unclear. Practice issue is not based on the approved systematic review topic. Practice Issue is not an independent nursing decision. Scope of practice issue is not described. Practice area identified.

0.0 pts

Practice issue is not identified; practice issue is not an independent nursing decision; scope of practice issue is not described; practice area is not identified.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

20.0 pts

This criterion is linked to a Learning OutcomePractice Issue-Rationale for Selections

Identifies how rationale behind how the practice issue was selected as a practice issue/problem. Documents the practice issue in a logical manner.

35.0 pts

Identifies and documents what types of evidence is needed for review. Thoroughly describes rationale for all checked types of evidence selected.

31.0 pts

Identifies and documents what types of evidence is needed for review. Briefly describes rationale for all checked types of evidence selected.

28.0 pts

Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence.

13.0 pts

Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence.

0.0 pts

Does not document types of evidence or rationale.

35.0 pts

This criterion is linked to a Learning OutcomeTypes of Evidence Gathered-Rationale for Selections

Identifies and documents types of evidence that must be gathered for review of the Practice Issue. Describes rationale for each type of evidence that is selected.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

20.0 pts

Identifies and documents what types of evidence is needed for review. Thoroughly describes rationale for all checked types of evidence selected

18.0 pts

Identifies and documents what types of evidence is needed for review. Briefly describes rationale for all checked types of evidence selected.

16.0 pts

Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence.

8.0 pts

Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence.

0.0 pts

Does not document types of evidence or rationale.

20.0 pts

This criterion is linked to a Learning OutcomePractice Problem Description

States practice problem in own words, with reference to the population, setting, and magnitude and in measurable terms. Describes practice setting in measureable terms. Example: Consider the example given in the evidence summary above. The setting is the long term care facility where falls have been increasing and a trend has been identified that it seems to occur mainly during shift change. What do you believe may be causing this? What can be done to lessen or eliminate the falls? How does this number of falls relate to other months that have been tracked?

10.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is identified -Magnitude of problem is discussed. -The practice issue is stated in measurable terms.

9.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is discussed. -The practice issue is stated in measurable terms.

8.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is not discussed. -The practice issue is stated in measurable terms.

4.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is not discussed. -The practice issue is stated but not measurable.

0.0 pts

-Practice problem is not in own words -There are no references to the population of interest. -Setting and magnitude of problem is not discussed -The practice issue is not stated in measurable terms.

10.0 pts

This criterion is linked to a Learning OutcomeSource(s) of Evidence

Identifies a source of evidence that is a nursing topic and is the subject of a systematic review article. Provides a complete reference for the systematic review article that was chosen from the list, as well as any optional scholarly source in support of the project topic.

20.0 pts

Full Marks

-Source is a Systematic Review article chosen from the approved list (plus optional scholarly article of support). Complete APA formatted reference(s) is given for with no errors. The source (s) must be relevant to the practice issue identified.

18.0 pts

-Source is a Systematic Review article chosen from the approved list (plus optional scholarly article of support). -A reference is given, but it has APA formatting errors. -The source must be relevant to the practice issue identified.

16.0 pts

-Source is a Systematic Review article chosen from the approved list. (plus optional scholarly article of support). -No reference is provided. -The source must be relevant to the practice issue identified.

8.0 pts

-Source of evidence is a research article or systematic review not on the approved list. -A reference for the article or systematic review is given. -The source is not relevant to the practice issue identified.

0.0 pts

-Source of evidence is not provided, or is not a research article or systematic review. -Reference is missing.

20.0 pts

This criterion is linked to a Learning OutcomeArticle Objectives/Statement of Questions

Identifies the objectives of the article. Identifies questions being addressed by author/s. Explains relationship to the chosen practice issue

20.0 pts

-Objectives of article are identified. -Questions addressed by author/s are thorough. -Relationship to your practice issue is explained.

18.0 pts

-Objectives of article are identified. -Questions addressed by author/s are explained but not thorough. -Relationship to your practice issue is explained.

16.0 pts

-Objectives of article are identified. -Questions addressed by author/s are not thorough. -Relationship to your practice issue is vague.

8.0 pts

-Objectives of article are identified. -Questions addressed by author/s is missing. -Relationship to your practice issue is not explained.

0.0 pts

-Objectives of article are not identified. -Questions addressed in article and relationship to own practice is not identified.

20.0 pts

This criterion is linked to a Learning OutcomeInterventions/Main Findings Summary

Summarizes, in own words, suggested interventions by the author/s to improve patient outcomes. Summarizes main findings of the author/s including strength of evidence for each main outcome. Describes the relevance to the Milestone 2 paper.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

30.0 pts

-Thoroughly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Thoroughly summarized main findings of the author/s. -Included strength of evidence for each main outcome.

26.0 pts

-Briefly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Briefly summarized main findings of the author/s. -Included strength of evidence for each main outcome.

24.0 pts

-Vaguely summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Vaguely summarized main findings of the author/s. -Included strength of evidence for most of main outcomes.

11.0 pts

-Summary of interventions is not in own words. -Summarized main findings of the author/s is not apparent. -Did not include strength of evidence for any of the main outcomes.

0.0 pts

-Summary of the interventions the author(s) suggest to improve patient outcomes is missing. -Summary of the main findings of the author is missing. -The strength of the evidence for outcomes are missing.

30.0 pts

This criterion is linked to a Learning OutcomeEvidence-based Solutions and Limitations

Outlines evidence-based solutions to consider for the capstone project. Discusses any limitations to the studies included in the systematic review that he/she believes may impact use of the evidence provided in their project

20.0 pts

-Outline of evidence-based solutions considered for project is documented and clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project.

18.0 pts

-Outline of evidence-based solutions being considered for project is documented but not clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project.

16.0 pts

-Outline of evidence-based solutions considered for project is documented but not clear. Discussed most limitations to the studies performed. Documents limitations believed may impact use in project.

8.0 pts

-Outline of evidence-based solutions being considered for project is not documented. -Discussed most limitations to the studies performed. Documents limitations believed may impact use in project.

0.0 pts

-Outline of evidence-based solutions, limitations of studies and potential impact to project is missing.

20.0 pts

Total Points: 175.0

NR451_W3_Milestone1_Worksheets

Capstone Project Milestone 1:

Practice Issue and Evidence Summary Worksheets

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

 

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 Dropbox 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 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):

Health-Associated Infection

Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults.
Cochrane Database of Systematic Reviews
, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

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

The nursing practice issue to be addressed is whether or not incorporating antibiotic prophylaxis when using long-term indwelling urinary catheters reduces the incidence of symptomatic bacteruria for adults’ patients with lower urinary tract problems. As a result, it intends to answer the question: In adults with lower urinary tract problems, does the use of long-term indwelling urinary catheters in combination with antibiotic prophylaxis, versus indwelling urinary catheters used in isolation, affect the incidence of symptomatic bacteruria over a period of three months?

Fully describe the scope of the practice issue:

Nurses are typically advised to use antibiotics with caution, particularly when facing the possibility of resistance development. Still, for adult patients suffering from lower urinary tract problems and using long-term indwelling urinary catheters, the catheters present an additional risk of infection. That is because they act as avenues for infection, especially from repeated handling. Despite the warning linked with antibiotics use, analysis shows that reducing the risk of infection is the best outcome for the patient. Antibiotic prophylaxis improves the capacity for preventing infection, thus presenting a good possibility for application by nursing personnel Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

What is the practice area?

_X_
Clinical

___ 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

___ 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:

Using catheters increases the risk of the patients’ acquiring opportunistic infections. As such, the research intends to show that using antibiotic prophylaxis can reduce the risk of acquiring opportunistic infection.

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

_X_
Literature search

___ Guidelines

_X_
Expert Opinion

___ Patient Preferences

_X_
Clinical Expertise

___ Financial Analysis

___ Standards (Regulatory, professional, community)

___ Other

 

Describe the rationale for your checked selections:

A literature search will be conducted to understand how past publications view the current topic.

Expert opinion and clinical expertise will be collected to understand how nursing personnel understand the problem. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 

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:

Even when used in clear environments, catheters still present a route for opportunistic infection. This occurs through regular handling by the nursing personnel. The risk for infection is higher among adult patients suffering from lower urinary tract problems since their immune system appears compromised and they can easily be infected. As such, it is prudent to adopt a proactive approach by using antibiotic prophylaxis that effectively prevents the possibility of opportunistic infection.

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.

Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults.
Cochrane Database of Systematic Reviews
, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

Identify the objectives of the article:

The article intended to determine the effectiveness different policies for replacing long-term indwelling urinary catheters in adults.

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

The article answer the question of whether there are any differences in the outcomes from the different policies applied in replacing long-term indwelling urinary catheters in adults. This is an acknowledgement that each policy presents a risk of infection although at different levels. This shows that even with the best policy, there is still some risk of infection Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. By including antibiotic prophylaxis, the risk of infection is greatly reduced.

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

The article concludes that the best policy for replacing urinary catheters must take into account certain factors that include the patients’ satisfaction, quality of life, type of trauma on the urinary tract, economics, replacement method used, environment-specific performance difference at home and hospital, catheter replacement strategy, and lubrication used.

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.)

The article makes it clear that additional evidence is required before a conclusion can be reached. More information must be collected on the different policies for a complete evaluation.

 

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

The project considers the position that antibiotic prophylaxis can play in reducing the possibility of infection so that the differences in policies for handling catheters become of less significance.

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

The major study limitation will be how to decide from among the many types of antibiotics that are available in the market. In essence, there are many pathogens that can cause infection. Using the many types of antibiotics on a single patient is unrealistic, while using one type means that the prophylaxis does not offer protection against the other types of antibiotics Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 

Capstone Project Milestone 2: Design for Change Proposal

Purpose

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.

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)

Rubric

Click to view and download the 
NR451 Milestone 2: Design for Change Proposal Rubric (Links to an external site.)Links to an external site.
.

Points

Milestone 2 is worth 
225 points
.

You are required to use one of the required articles from the Week 3 Milestone 1 assignment or you will earn a “0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required article will be evaluated for evidence of an academic integrity violation.

After the due date, there will be no opportunity for revision or resubmission of assignments that have been uploaded to the submission area. It is your responsibility to submit the correct assignment to the correct submission area.

Directions

A tutorial with tips for completing this assignment may be viewed at 
https://atge.webex.com/atge/ldr.php?RCID=b0c912eaf53b4aabb1347a026466c60e(Links to an external site.)Links to an external site.

Review 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 Template(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.

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

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 Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

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.

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.

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. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

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.

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.

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.

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. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

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.

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)? Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

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. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 

References

 

NR451 Milestone2 Rubric

 

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.)

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.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

25 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

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.

0.0 pts

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

50 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?

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.

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 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.

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 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.

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 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

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 pts

Total Points: 225 Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

 

Design for Change Proposal

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

Design for Change Proposal

Urinary Tract Infect (UTI) is a common medical condition in which the urinary tract is considered infected, to include either the kidneys, bladder or urethra with the result is a persistent pain in the urinary tract. UTI classification occurs based on the specific organ that is infected with infection of the kidneys called pyelonephritis, infection of the bladder called cystitis, and infection of the urethra called urethritis. Medical studies indicate that 50% of women and 5% of men will report a UTI during their lifetime Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. The condition is typically caused by microorganisms (such as
Escherichia coli
) colonizing the tract, in which case antibiotics will be prescribed to combat them and subsequently clear the microorganisms as well as their associated symptoms. Although UTI is a common medical concern, the concern is heightened by the use of a catheter in the bladder and urethra. That is because the catheter is a foreign that presents an opportunity for microorganisms to gain entry when it is being handled (Brooks, 2012). In this respect, a UTI is construed as an infection of the urinary tract and caused by colonization by microorganisms that gain entry through catheters.

Change Model Overview

The most appropriate model for guiding both the evidence-based practice process and change as a strategy for motivating stakeholders is the Stetler Model of Evidence-Based Practice. The selection of this model is directed by the understanding that change is best achieved through use of a conceptual framework that acts as a guide for the different aspects of evidence-based practice to interact. The most important aspect of the model is that it acknowledges sources of information beyond primary research as being capable of influencing evidence-based practice. At its core is the understanding that every assertion or change recommendation must be substantiated with clear, replicable, observable, credible, verifiable and supportable evidence from both internal and external sources (Ellis, 2016) Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. In the present case, the problem (identified as the position that antibiotic prophylaxis can play in reducing the incidence of symptomatic bacteruria for persons using urinary catheters) is recognized as one that requires a solution to improve medical care outcomes. For a solution to garner support, it must be based on acceptable evidence.

Define the Scope of the EBP

The project intends to determine whether or not incorporating antibiotic prophylaxis when using long-term indwelling urinary catheters reduces the incidence of symptomatic bacteruria for adults’ patients with lower urinary tract problems. In fact, it intends to answer the question: In adults with lower urinary tract problems, does the use of long-term indwelling urinary catheters in combination with antibiotic prophylaxis, versus indwelling urinary catheters used in isolation, affect the incidence of symptomatic bacteruria over a period of three months?

Stakeholders

A six-person team that includes the research as team manager, four nurses concerned with catheter management, and a hospital administrator.

Determine Responsibility of Team Members

The team manager is responsible for presenting the project details, assigning responsibilities to the other team members, collecting the outcomes, and presenting the results. The four nurses are responsible for applying the policy of incorporating antibiotic prophylaxis when using long-term indwelling urinary catheters Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. The hospital administrator is responsible for communicating the hospital management’s outlook and support for the project.

Evidence

Available literature was evaluative through a systematic review that identified one journal that presented supporting evidence to highlight the existing problem and need for a solution.

Summarize the Evidence

Cooper et al. (2016) evaluates the impact of policy changes on outcomes when using long-term indwelling urinary catheters. It notes that each of the available policies for handling catheters presents some element of risk. As such, it recommends that the best policy for handling catheters must at least take into account patients’ satisfaction, quality of life, type of trauma on the urinary tract, economics, replacement method used, environment-specific performance difference at home and hospital, catheter replacement strategy, and lubrication used.

Develop Recommendations for Change Based on Evidence

Based on the results from Cooper et al. (2016) that identify the best features for handling catheters that reduces the risk of infection, there is a possibility that using antibiotic prophylaxis in combination with the catheters would reduce the risk of infection even as it meets the set features.

Translation

Action Plan

The project will first be implemented by the team. Following which results will be collected at the end of the project to note the differences in infection levels between the group that used antibiotics and those that used other policies. The results of the project will then be presented to stakeholders with recommendations for practice change made based on the results. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Process, Outcomes Evaluation and Reporting

The anticipated result is that including antibiotic prophylaxis will reduce the risk of infection. That is because the antibiotics target the pathogens that have gained entry and eliminates them. This results will be verified by comparing the infection incidence for those who use the antibiotic prophylaxis against those who do not use the prophylaxis. Once the results are collected and evaluated, they will be presented to stakeholders who would use them as evidence to implement policy and practice changes.

Identify Next Steps

Should the results show that antibiotic prophylaxis is effective in reducing the risk of infection for catheter users, that support will be sought to conduct a larger scale study that verifies the results. The larger scale study would improve the results generalizability by targeting a larger demographic of subjects. If the results are verified as true, then a recommendation will be made for policy changes to be applied on a larger scale to improve care outcomes. The recommendation would be made to the government and medical organizations that are capable of effecting change at the national level Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Disseminate Findings

The project results will be published in peer-reviewed journals to facilitate access by other stakeholders who are interested in the same subject.

Conclusion

One must accept that the high risk of infection associated with catheter use is worrying for medical practitioners. That is because the infection has the capacity to reverse medical care gains. The issue is best addressed by introducing a catheter management practice element that eliminates the pathogens that cause infection. Given this awareness, the present project suggests that antibiotics be used in combination with catheters to eliminate the pathogens so that the risk of infection is reduced. Should the project verify that using antibiotic prophylaxis reduces the risk of infection for catheter users, then the results will be availed to health stakeholders with the recommendation that antibiotic prophylaxis be routinely used to reduce the incidence of symptomatic bacteruria for persons using urinary catheters.

References

Brooks, D. (2012).
Urinary Tract Infection
. New York, NY: Springer.

Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults.
Cochrane Database of Systematic Reviews
, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

Ellis, P. (2016).
Evidence-based Practice in Nursing
(3
rd
ed.). London: Learning Matter/SAGE Publications Ltd. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Nursing Leadership Health Policy Paper

Details:

The IOM Future of Nursing report calls for an increase in leadership from nurses at all levels. One way nurses demonstrate their role as a leader, is through public policy change. A leader does not always carry an official title or position, but demonstrates leadership through the work and the stance the leader takes to make a change for the good of others. Nurses have been noted by the Gallop poll year after year as the most trusted professionals.

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This assignment requires thought about a public policy that is needed or needs to be changed that relates to nursing, health care, or the public. Policy changes can occur by working with members of your legislature, and state or national nurses associations, to introduce a new bill and/or change to a current law in your state or federal government Nursing Leadership Health Policy Paper.

Examples of public policy includes any component of the current legislation governing health care, Medicare Part D, Medicaid, nursing regulation, medication technicians, etc.

In 750-1,000 words, propose a health policy change (that is currently a bill, a law, or may not exist at all) at the state or federal level that you believe needs to change and why.

The policy must not be a clinical care policy for individual care. The policy involved may include public or community health, legislative or regulatory, professional organization (nursing-oriented), advanced nursing practice, health plan, or hospital plan Nursing Leadership Health Policy Paper.

Include a specific section for the exact wording for the bill or change in wording of the law.

Include the plan for the implementation of your policy development, to lobbying for passage, to next steps after passage.

Discuss who would be the champion for the bill/law change from your state advocates (legislators, federal legislators, local or national state nursing organizations). Are these individuals also influential in making changes occur? Did you vote for the individual in office that you want to help you make this change? Nursing Leadership Health Policy Paper.

Resources:

Review different pieces of legislation for ideas on wording.

Visit your state’s legislative governmental affairs website site to understand the process your policy change could take if you wanted to introduce to into legislation.

 

Legislative Change

The policy must not be a clinical care policy for individual care. The policy involved may include public or community health, legislative or regulatory, professional organization (nursing-oriented), advanced nursing practice, health plan, or hospital plan. Include a specific section for the exact wording for the bill or change in wording of the law.

The Medicare Prescription Drug, Improvement, and Modernization Act that was passed in 2003 presents a policy for managing Medicare. The legislation added a new section (Part D) to the Medicare Program that allowed private entities to be reimbursed by Medicare for prescription drugs they provide to Medicare beneficiaries. Although the new legislation offers greater benefits for the beneficiaries, it presents an opportunity for fraud. This is particularly true when claims are made for improper rebates, red-lining, enrollment fraud, overcharging, and duplicate billing (False Claims Act, 2018) Nursing Leadership Health Policy Paper. The implication is that the legislation has a glaring loophole that can easily be exploited through fraud.

The loophole in the legislation should be addressed through institutional changes that include greater oversight, inclusion, and control from a body comprised of representatives from all stakeholders, with stricter checks and double verification systems. In fact, there is a need to revise the legislation by calling for mandatory institutional changes. This conceptualized change is best understood by exploring the causes of fraud in health care. Harris (2015) mentions that greater control, inclusion and oversight should minimize the opportunities for fraud in medical care. This assessment is based on the fact that these measures would improve healthcare efficiency and competitiveness while encouraging good governance, values and norms (Harris, 2015).

Emanuel (2014) mentions that although fraud is considered a vice by most stakeholders, there are those who embrace the practice and would be resistant to any change that eliminates fraud. This is especially true for the health care industry where both personnel and facilities readily participate in fraudulent activities in quid pro quo trade that sees benefits flowing both ways. For instance, some medical facilities earn substantial profits from fraudulent Medicare claims that they then share with the personnel who facilitated the earnings. This makes it clear that there is a need to consider the distinguishing features of both personnel and facilities (along with other stakeholders in the medical industry). The consideration helps in defining how the stakeholders would apply their strategic plans. For example, it would show how a facility that benefits from fraud would react to legislative efforts to curb fraud (Emanuel, 2014).

Political economists confirm that fraud is resultant of resource scarcity and limited competition. In fact, a succinct assessment shows that weak governance enables fraud. Case in point, some facilities are pressured by their environment to enable fraud as a salient industry practice. In such cases, the facilities that do not enable fraud may finds that they position becomes insecure within the industry with some of them being targeted (Teitelbaum & Wilensky, 2013) Nursing Leadership Health Policy Paper. In this respect, the proposed change to the legislation would entail including a clause that calls for mandatory institutional changes (greater oversight, inclusion, and control) with stricter checks and double verification systems to reduce the opportunities for fraud. In essence, the proposed legislative change argues that adequate oversight and regulation through the current legislation’s loopholes will allow for greater accountability, oversight and regulation to reduce the opportunities for fraud Nursing Leadership Health Policy Paper.

Include the plan for the implementation of your policy development, to lobbying for passage, to next steps after passage.

The first step in implementing the policy development is to explore the existing problem. In this case, the shortcomings in the current legislation must be identified and explored with the opportunities for fraud well highlighted. Next, a range of solutions are developed through exploring literature and holding discussion. This is followed by identifying the most viable solution with the best chance of succeeding. The solution is then framed as a legislation and further explored for its value in solving the existing problem. The key stakeholders would then be identified, focusing on the persons with the potential to influence legislative activities. Lobbying for the legislative change would ensure whereby these stakeholders are approached to improve their buy in into the proposed legislative change Nursing Leadership Health Policy Paper. Once their stakeholders support is garnered, the proposed legislative change would then be presented to the appropriate legislative assemblies (such as Congress) to discuss the change and pass it based on its merits. The final step would be to implement the legislative change to include monitoring in action.

Discuss who would be the champion for the bill/law change from your state advocates (legislators, federal legislators, local or national state nursing organizations).

The champion for the legislative change would be legislators. That is because their primary responsibility is to ensure that public resources are allocated to areas that are most in need. By eliminating opportunities for fraudulent Medicare claims, legislators are able to save the funds that would then be allocated towards other healthcare needs. Nursing Leadership Health Policy Paper.

Are these individuals also influential in making changes occur?

It is notable that legislators are influential in making the change occur since their official responsibility is to debate legislation, discarding those without public merit and passing those with public merit.

Did you vote for the individual in office that you want to help you make this change?

Although I did not vote for my legislator, this will not influence whether or not I would receive help. That is because the legislator is a publicly elected official who is accountable to the whole electorate and would evaluate the proposed change based on its merits and demerits Nursing Leadership Health Policy Paper.

References

Emanuel, E. (2014).
Reinventing American Health Care: How the Affordable Care Act will improve our terribly complex, blatantly unjust, outrageously expensive, grossly inefficient, error prone system
. New York, NY: Public Affairs Publications.

False Claims Act (2018).
Health Care Fraud and False Claims
. Retrieved from https://www.falseclaimsact.com/common-types-of-fraud/health-care-fraud

Harris, M. (2015).
Handbook of Home Health Care Administration
(6
th
ed.). Burlington, MA: Jones & Bartlett Learning.

Teitelbaum, J. & Wilensky, S. (2013).
Essentials of Health Policy and Law
(2
nd
ed.). Sunbury, MA: Jones & Bartlett Learning Nursing Leadership Health Policy Paper.

Feasibility of Your Design Proposal and Importance of Communication

This week’s graded discussion topic relates to the following Course Outcome (CO).

CO3 Communicates effectively with patient populations and other healthcare providers in managing the healthcare of individuals, families, aggregates, and communities. (PO 3)

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Now that you have identified your capstone change project, it is time to look at its feasibility.

What tangible and intangible resources will be needed to implement your project?

What improved outcomes do you anticipate will occur that could indicate the project produced a successful return on investment (ROI) of these resources?

How will you communicate your plan for change with key decision makers so that they will support the allocation of the resources you are seeking? Feasibility of Your Design Proposal and Importance of Communication.

Design Proposal Feasibility and Communication

Question 1: What tangible and intangible resources will be needed to implement your project?

The research will require both tangible and intangible resources during the implementation stage. The tangible resources include all visible inputs that can be directly measured to include funding and personnel. For instance, funding is necessary to pay for the software that would be used in data analysis Feasibility of Your Design Proposal and Importance of Communication. The intangible resources include incorporeal project contents that include the raw medical data showing how each variable performed in the project (Pasian, 2015). Including the two resource types will allow the project to proceed.

Question 2: What improved outcomes do you anticipate will occur that could indicate the project produced a successful return on investment (ROI) of these resources?

A successful ROI for the resources will be achieved if data on the research variables can be accurately collected and in the right quantities. This is important because it will allow for the link between variable to be determined, particularly in showing whether including antibiotic prophylaxis reduces the risk of infection. In essence, a successful ROI must have all the project steps followed as documented in the methodology section. This would allow for the results to be trusted, since they can be verified. If any single step is left out or not followed as indicated, then the conclusion will be erroneous thereby resulting in an unsuccessful ROI of the resources (Kloppenborg, 2015) Feasibility of Your Design Proposal and Importance of Communication.

Question 3: How will you communicate your plan for change with key decision makers so that they will support the allocation of the resources you are seeking?

The results will be communicated through two strategies to support the allocation of resources. Firstly, tangible data from reliable resources will be collected and presented to key decision makers as part of the project proposal to inform them of the project merits thereby garnering their support since the project would be a logical step Feasibility of Your Design Proposal and Importance of Communication. Secondly, information to support the project will be published in independent peer-reviewed publications where they will be scrutinized. The successful publication will be an indication that the information supporting the project has be verified to show that allocating resources towards the project is justified (Kloppenborg, 2015).

References

Kloppenborg, T. (2015).
Contemporary Project Management
(3
rd
ed.). Stamford, CT: Cengage Learning.

Pasian, B. (2015).
Designs, Methods and Practices for Research of Project Management
. Surrey: Gower Publishing Limited Feasibility of Your Design Proposal and Importance of Communication.

Electronic Medical Record (EMR) Application Essay Paper

EMR-Abraxas Medical Systems (iConnect network)

This scholarly paper is to be presented using the format set forth in the Manual of the American Psychological Association 6th edition. The list of references includes all reference sources used to support your paper. Citation required where appropriate.

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Analysis must include: How does the EHR provide solutions / capabilities / for:

1. Legal, Privacy, Confidentiality and Organizational components

2. Reporting capabilities – operational and analytical

3. Describe how the EHR may help or hinder your duties as a nurse? What can you do to improve your organization/team/staff approach to the EHR in the future?

4. An abstract for your scholarly paper is required Electronic Medical Record (EMR) Application Essay Paper.

Attached is a copy of the rubric criteria. Only the highlighted sections on this rubric need to be completed for this Electronic Medical Record (EMR) Application Essay paper.

Do a literature search from at least (2) nursing/healthcare journal articles. Analyze the key issues in the articles and support your position.

 

Electronic Health Record Application Paper Criteria:

Percentage

1. Purpose of the Electronic Medical Record application

10%

2. Analysis

How does the EHR provide solutions / capabilities / for:

40% total from 8 sections below

§ 
Performance measures, Core Measures, Quality Measures CMS reporting

5%

§ 
Legal, Privacy, Confidentiality and Organizational components

5%

§ 
HIMSS EMR Adoption Model Score – Stage 0-7

5%

§ 
ARRA, HITECH, and Meaningful Use

5%

§ 
Reporting capabilities – operational and analytical

5%

§ 
Options for mobile platforms (smartphones, iPad, portable devices)

5%

§ 
Patient Education before, during, and after clinical encounter Electronic Medical Record (EMR) Application Essay Paper

5%

§ 
How would nurse informaticist support the Change Management of implementing or modifying EMR? (Super User, Subject Matter Expert, etc.)

5%

3. Impact on nursing practice, administration, education and research as applicable

20%

4. Describe how the EHR may help or hinder your duties as a nurse? What can you do to improve your organization/team/staff approach to the EHR in the future?

10%

5. Current literature research supporting all aspects of paper. At least (2) References from nursing/healthcare journal articles

10 %

6. APA Format:

Title page – header in APA format, student name, affiliation, title of paper, course & date.

Body of paper – headings (one or two levels), references cited correctly in text, quotes are appropriate in amount & length, paragraph structure, spelling, grammar, punctuation is appropriate. Avoid jargon, slang, and conversational tone. Clear, concise, organized.

Reference page – Citations according to 6th edition, all citations on the reference page are found in the Electronic Medical Record (EMR) Application Essay Paper

Overall format – Margins are 1 inch, new times roman, 12 pitch font, double spaced

Note: Papers may/will be submitted to Turnitin to check for plagiarism.

10%

Total

100%

Abraxas Medical Systems Electronic Medical Record (EMR) Application Paper

Abstract

Following many decades of development, Electronic Medical Records (EMRs) are currently exerting an essential effect on health care practices than it was previously. Although the primary reasons for instigating EMRs concentrates on refining medical care system as a whole, one must consider the effect and the application of increased EMR to patient-physician encounter and the medical system as a whole. In this paper, the writer analyzes how Electronic Health Record provides solutions and capabilities for privacy, legal and confidentiality components of a healthcare organization as well as the operational and analytical reporting capabilities. The paper describes how Electronic Health Record helps or hinders the nurse’s duties and what I can do as a nurse to improve the organizational approach to EMR in the future Electronic Medical Record (EMR) Application Essay Paper.

EMR-Abraxas Medical Systems (iConnect network)

According to Blechman, Electronic Health Record (EHR) is a real-time patient-centered digital record of patients’ data which makes the information available securely and instantly to users who are authorized (2015). EHR can streamline and automate workflow, allow access to evidence-based tools essential in the decision-making process about the care of the patient and stores medical records of a patient with their laboratory test results. Abraxas Medical Solutions Inc. has specialized in developing and marketing software solutions for healthcare institutions to enhance efficient charting and clinical workflow functionalities of the stated institutions above.

How Abraxas EHR software provides solutions and capabilities to legal, privacy, confidentiality and organizational components.

The Electronic Health Record software stores the patient’s data electronically which can only be retrieved by authorized users hence improving privacy and confidentiality of the patient’s information. A paper-based medical record lacked security where the access was controlled by locks, doors, tedious sign-out procedures for authorized persons and use of identification cards to access the information. Such measures do not provide sufficient privacy and confidentiality of the patient’s information Electronic Medical Record (EMR) Application Essay Paper. Due to such a doubt, EHR has been designed to restrict the number of users to have access to the data. The EHR provides legal capabilities through its ability to allow the patient routinely review their electronic medical records which contain clinical documentation concerning their diagnosis.

According to Hanauer (2015), the data which is shared as an outcome of a medical affiliation is often deliberated as private hence such information must be secured. The patient’s information ought to be unrestricted to third parties merely by the consensus of the patient or the regulation permitting a nurse to do so. EHR allows a two-tier approach to authentication, enhancing biometric identifier scans to permit the access to the patient’s medical records hence improving the privacy and confidentiality of patient’s information. In Electronic Health Record systems, user access to patient’s confidential report is based on pre-established and role-based privileges Electronic Medical Record (EMR) Application Essay Paper.

How EHR improves operational and analytical reporting capabilities

When healthcare institutions have access to accurate and complete records, patients will obtain efficient and improved health care. Electronic Health Records can advance the aptitude to detect ailments, prevent or reduce medical faults and improve the reporting capabilities for operations and analysis. According to research by Blechman, ninety-two percent of healthcare institutions who use EHR system make patient’s record readily available at any point of care hence efficient operational reporting (2015) Electronic Medical Record (EMR) Application Essay Paper. Also, the health care providers reported that EHR permits clinicians to deliver enhanced patient’s care and also enjoys clinical benefits in their analytical reporting capability. EHR always alerts a clinician in the event of an emergency such as patient’s lethal allergy which makes the emergency supervisor modify care correctly even when the patient is cataleptic thus improving operations.

Hanauer (2015) mentions that EHR system aids in diagnosis through making health institutions to have reliable access to the complete health information of the patient. Such comprehensive picture makes the health professionals diagnose the patient’s problem soonest due to the ready availability of data. Similarly, EHR keeps the record of the medication for the patient. Consequently, the system spontaneously checks for hitches every time a new prescription is issued hence signals the nurse thus improving operational capabilities Electronic Medical Record (EMR) Application Essay Paper. Furthermore, EHR instantly and systematically identifies and corrects any operational errors thereby improving the operational and analytical abilities. Such problems are difficult to adjust on a paper-based setting since it may take a lot of time.

How EHR can help or hinder my duties as a nurse and what I can do to improve my organization’s approach in future

Personally, EHR speeds up my process to offer medication, getting reports and communicate efficiently with other facilities. On the contrary, EHR affects how I do my work through slowing down and also speeding up the process of charting and investigating the records of the patient. Occasionally the computers may be down which eventually slows down the chatting process. It is sometimes frustrating when the network goes down unexpectedly especially when I don’t know what to do.

I will do the following to improve my organizational approach to EHR in future. I will ask our management to advocate for enhanced and regular surveillance and monitoring of the system to allow for efficiency and reduce errors and technicalities which may occur as a result of operation slowing down. I will also propose support team who will regularly check the system and computer functionality to prevent EHR from slowing down Electronic Medical Record (EMR) Application Essay Paper.

References

Blechman, E. (2015). “Electronic health records.” U.S. Patent Application No. 14/588,304.

Hanauer, D. A., Mei, Q., Law, J., Khanna, R., & Zheng, K. (2015). Supporting information retrieval from electronic health records: A report of University of Michigan’s nine-year experience in developing and using the Electronic Medical Record Search Engine (EMERSE). 
Journal of biomedical informatics
, 
55
, 290-300 Electronic Medical Record (EMR) Application Essay Paper.

E-Health ethical considerations Reflection Paper Essay example

Apply what you have learned (this course is nursing informatics). Reflect on all you have learned from this class (HIPAA, EMR, meaningful use, etc.). Given the future of E-Health, with the prospect of Digital patient engagement and empowerment. In your opinion, what are some of the ethical considerations.

The advancement of technology has necessitated the transformation of healthcare to a digital platform where it is commonly referred to as E-Health (Electronic Health). This is designed to enhance provision of health care in general E-Health ethical considerations Reflection Paper Essay example. However, it has been established that there are medical risks that could harm patients that are associated with this transformation. This has necessitated laying down of numerous ethical considerations that are supposed to guide the healthcare practice to minimize the possibility of having the potential medical harm associated with E-health occur.

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For example, when recommending digital technology, care providers are supposed to consider technical skills and knowledge of the digital economy of the patient. This will enable them give necessary assistance to those who may not be well versed in digital matters e.g. the poor and uneducated fellows, whom if directed to use the technology without guidance can end up causing themselves harm health wise (Armontrout J, et al., 2016) E-Health ethical considerations Reflection Paper Essay example.

It is also important for physicians to recommend a small number of websites with quality medical information by basing on the assumption that all patients use the digital technology occasionally to diagnose and perhaps start medication of certain health conditions. This will help minimize having patients getting lost into the internet websites maze while seeking relevant medical assistance when some of these websites provide poor quality information on health that can result in medical harm to patients E-Health ethical considerations Reflection Paper Essay example.

General practitioners and healthcare administrators should have basic knowledge in digital technology used in routine healthcare such as EMR (Electronic Medical Records). This basic knowledge will enable them analyze potential negative consequences associated with of tracking data of individual patients whom they directed to use technology.

To sum up, much as the advent of E-health comes with positive impacts on healthcare such as enhancing the sector and raising cost-efficiencies through use of monitoring devices and digital apps, and application of analytics to manage large and diverse sources of data, there are inherent medical issues that require properly outlined ethical considerations such as the ones discussed above to minimize their occurrence.

References

Armontrout J, Torous J, Fisher M, Drogin E, Gutheil T. (2016).
Mobile mental health: navigating new rules and regulations for digital tools. E-Health ethical considerations Reflection Paper Essay example.

Purpose: The intent of this theory development in nursing sample essay paper assignment is to help students to evaluate theory development in nursing.

Guidelines: Each student will develop a theoretical model that can be used to guide research on your topic from your Review of Theoretical Perspectives paper.

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1. From the major theoretical approaches that you described above, choose one theoretical orientation, or theory, that you would like to apply to your study. You may use an existing middle-range theory, you may derive a theory from a grand theory, or you may synthesize one or more theories to create a new middle-range theory. Provide a brief rationale for your choice of theory.

2. Describe the parent theory. Identify the key constructs and relational statements. Include a diagram of the parent theory.

3. Describe your proposed theoretical model.

a. Identify and explain the key concepts in your model and provide conceptual definitions.

b. Identify and explain the relationships between your concepts theory development in nursing sample essay paper.

4. Include a visual model (diagram) of your theory.

5. Using your theory as a guide, develop three testable research questions and three corresponding hypotheses.

6. Write clearly and succinctly. Present your ideas logically. Use transitions. Include an introduction and summary. Adhere to APA style (6th edition), cover sheet, headers, pagination, references, etc. Use APA format and label each section using the evaluation outline below. Use headings below to identify sections of your theory development in nursing sample essay paper.

Theory Development in Nursing

Theory development in nursing is an important aspect that medical practitioners apply in current days. Through precise identification and application of relevant theory constructs, nurses are able to apply and incorporate strategies that ensure desired patient outcomes. The application of theories in nursing is essential since they aid practitioners to predict the possible outcomes of aspects in the medical field. Theory development in nursing is the means by which nurses define the areas that raise concern during the treatment of sick victims. Through a well-guided and theoretically-based investigation, nursing practitioners can carefully scrutinize the specific constructs of a theory and integrate its provisions for better results. Besides, its application ensures the effectiveness of nurses when dealing with the specific phenomena present in the field, through collaboration with other professionals in the field. It is therefore important for health care professionals to develop or evaluate theories, to exercise responsibility, which would guarantee control within the nursing practice theory development in nursing sample essay paper.

Rationale for Theory Choice

The self-efficacy theory previously originated from the social cognitive theory, a model developed by Albert Bandura. The model explains that, behavior, environment and personal factors can influence the self-efficacy of an individual in a variety of ways.  According to Neimeyer (2015) performances, motivation and frustrations related to repeated failures are directly related to behavior.  Self-efficacy philosophies are essential in the human behavioral traits and motivations. These aspects influence directly and indirectly on one’s ability to perform actions in life. In the nursing field, the various educational orientations may lead to confusion in newer clinical settings. Duane & Satre (2014) explains that achievement, motivation, and self-efficacy play a crucial part in the nursing practice and professional development.  It is, therefore, necessary to comprehend the levels of self-efficacy in different educational levels of nurses, to guarantee cohesion and better organizational cultures theory development in nursing sample essay paper. Self-efficacy is mostly related to success, which improves an individual’s overall motivation and confidence.  Current healthcare systems face a lot of pressure to deliver quality services due to the influx of patients and the rise in lifestyle diseases. Through these aspects, nursing practitioners are required to respond to the demands in the most appropriate and precise manner. To effectively accomplish these tasks, nurses ought to be confident.  Researchers elaborate that successful nurses need sufficient self-confidence to perform actions that lead to better patient outcomes.  It is evident that handling patients is a daunting task and therefore, application of the self-efficacy theory is most relevant.

Social Cognitive Theory (parent theory)

According to Neimeyer (2015), the social cognitive theory entails a perspective whereby people learn from others through observations. The theory states that learners acquire newer experiences and practice the behaviors by observing a model. Specifically, a role model is an individual that demonstrates certain behaviors and traits to another person. The main constructs of the social cognitive theory entail observation and behavioral changes as displayed in figure 1.  The theory stipulates that learning is an internal process that may occur immediately, or through a lengthy process and time theory development in nursing sample essay paper. Characteristically, the observer of a certain model could process a specific behavior cognitively and apply it instantly, or at a later stage in life. Besides, social cognitive theorists state that individuals set goals that consequently, direct their behaviors towards achieving them. Through this, they acquire the motivation and eagerness to attain their accomplishments. Additionally, the theory stipulates that behavior can be self-regulated. Social cognitivists state that an individual can standardize and adjust his/her learning of a certain behavior. Classically, after observing and admiring a particular practice from a model, an individual can reinforce the trait through repeated rehearsal.  An individual continuously perfects the moves and compares them with those of the models, achieving perfection in the long run (Zhao,Lei, He, Gu, & Li,  2015).  Additionally, the theory explains that punishment and reinforcement bear indirect effects on an individual.  Through reinforcement, a person develops expectations about the possible consequences on responses that would occur in the future, based on the manner in which current responses are reinforced.  Commonly referred to vicarious experiences, individuals observe and evaluate the consequences that that occur due to other people’s behaviors.

Fig.1. Displaying the Social Cognitive Theory. Adapted from https://wikispaces.psu.edu/display/PSYCH484/7.+Self-Efficacy+and+Social+Cognitive+Theories

 

Description of Proposed Theoretical Model (self-efficacy)

Self-efficacy theory for agentic positive psychology refers to the beliefs in one’s capabilities to organize, plan and execute the course of actions that are required to manage, coordinate and control prospective situations, which lead to the achievement of desired results. Theory development in nursing sample essay paper It entails what an individual believes that would enable him/her accomplish a set of objectives effectively, by a precise application of learned skills under particular environments and situations (Duane& Satre, 2014). Specifically, the theory states that individuals are more likely to engage in activities that they are well-endowed in terms of skills and knowledge than those they are not well conversant with.  The main constructs of the self-efficacy theory are motivation, frustration, and performance. The correlations between these aspects lead to behavioral alignments of a person during execution of duties theory development in nursing sample essay paper.

Key Concepts of the Self-Efficacy Model

The self-efficacy theory contains four main concepts that individuals can employ to judge the levels of effectiveness. The components are significant since they aid in the determination of belief and capacity of a person to accomplish a set of goals.  Individuals encounter an array of tasks that display different levels of complexity. However, Slavich and Irwin (2014) explain that people with high levels of efficacies approach more difficult tasks as a challenge, to expose their weaknesses and help derive amicable solutions.  Contrariwise, Slavich and Irwin (2014) state that individuals with lower intensities of self-efficacy view complex situations as threats and may put in minimal or no effort at all to provide workable resolutions.

Performance outcomes
– Performance outcomes entail the past experiences a person exhibits in mind after the accomplishment of duties. According to the self-efficacy theory model, they are very vital, since they determine one’s level of practicality. Performance outcomes may be positive or negative.  For instance, if a person executes a task successfully and achieves better results, he/she is likely to develop competence and gain motivation. The levels of confidence are boosted and such individuals are bound to perform even better if assigned such similar tasks. This way, an individual’s self-efficacy increases. On the contrary, if an individual experiences failure during execution of tasks, the results are likely to be detrimental to their overall efficacy (Smith & Liehr, 2013). However, the model provides that persuasion can help alleviate the disappointments, and increase self-motivation.  Through this aspect, one persists to work on similar situations if the results are achievable, leading to improved self-efficacy theory development in nursing sample essay paper.

Vicarious Experiences-
Since the model relies on the social cognitive theory as its parent source, it provides that the self-efficacy of individuals can be affected by observing other people’s performances.  Characteristically, one can observe another person’s competence when in a similar position of performing duties (Young, Plotnikoff, Collins, Callister, & Morgan, 2014).  The manner in which one maneuvers to complete assigned tasks successfully increases one’s productivity.  For instance, in the nursing field, a nurse can be easily motivated through observing a fellow practitioner handling situations in a healthcare institution with ease. Through such observations, one strengthens his/her ability and perfects the skills to ensure better outcomes.

Verbal Persuasion-
Researchers explain that through adequate and meaningful encouragement made precisely through careful choice of words, one’s levels of self-efficacy is bound to improve drastically (Parahoo, 2014).  For instance, healthcare administrators who encourage their nurses on improvement in their departments are likely to receive better results, since such inspiration enables an individual to put more effort to achieve desired goals.

Physiological Feedback-
The model elaborates that emotional arousal and sensations often bear considerable effects on one’s self-efficacy. For instance, a person who experiences ease in making speeches in front of big crowds is likely to display high levels of self-efficacy.

Fig. 2. Displaying the Self-Efficacy Theory. Adapted from https://wikispaces.psu.edu/display/PSYCH484/7.+Self-Efficacy+and+Social+Cognitive+Theories

 

Relationship of Concepts

The theoretical model of self-efficacy is very important in ensuring best outcomes in many institutions if applied appropriately. In the nursing field, all the stakeholders especially the practitioners can employ the models and integrate its concepts to guarantee better outcomes. It is common to encounter nurses endowed with different abilities in one health institution. Besides, some may be novices while others boast of vast experiences. The correlation between the aspects of the self-efficacy model guarantees better provision of services through relevant integration. For instance, performance outcomes lead to the formation of experience amongst employees (Wyer Jr, 2014). After accomplishment of duties, one achieves a sense of satisfaction if excellent results are yielded.  In the nursing field, a medical practitioner is bound to handle patients effectively if his/her initial strategies proved operative theory development in nursing sample essay paper.  This way, the nurse is more likely to perform using the same methods and even put more effort to yield results in a better way.  Through, this, newer and novice nurses are likely to observe in the manner in which a successful medical practitioner executes his/her duties. The new recruits can imitate and apply learned skills to accomplish their tasks, therefore, improving levels of self- efficacy.

Questions and Hypotheses

Q1. Can physiological feedbacks affect the levels of self- efficacy on an individual?

Physiological feedbacks on an individual are able to affect their levels of self-efficacy in a variety of ways.

Q2. What is the importance of self-efficacy in the nursing profession?

High self-efficacy is related to better patient outcomes in the medical field.

Q3. What case slow self-efficacy among people?

Low self-efficacy is associated with poor skills in workplaces.

Conclusion

Theory development in nursing is a significant facet that many health care institutions choose to employ. Evidently, healthcare organizations that employ relevant theories and integrate their aspects precisely achieve better outcomes. It is apparent since these theories provide frameworks through which one can predict the final outcomes, and implement strategies that would correct bad situations in case they occur. Specifically, the self-efficacy theory, a model of the social cognitive theory explains that through the application of learned skill, a person’s belief on performing certain tasks guarantees accomplishment and achieving desired results. Through the integration of its aspects, one can develop and improve self- effectiveness, leading to better outcomes at workplaces theory development in nursing sample essay paper.

References

Duane, B. T., & Satre, M. E. (2014). Utilizing constructivism learning theory in collaborative testing as a creative strategy to promote essential nursing skills.
Nurse Education Today
,
34
(1), 31-34

Neimeyer, R. A. (Ed.). (2015). Death anxiety handbook: Research, instrumentation, and application. Taylor & Francis.

Slavich, G. M., & Irwin, M. R. (2014). From stress to inflammation and major depressive disorder: a social signal transduction theory of depression.
Psychological bulletin
,
140
(3), 774

Smith, M. J., & Liehr, P. R. (Eds.). (2013). Middle range theory for nursing.
Springer Publishing Company theory development in nursing sample essay paper.

Parahoo, K. (2014). Nursing research: principles, process and issues.
Palgrave Macmillan
.

Young, M. D., Plotnikoff, R. C., Collins, C. E., Callister, R., & Morgan, P. J. (2014). Social cognitive theory and physical activity: A systematic review and meta‐analysis.
Obesity Reviews
,
15
(12), 983-995.

Wyer Jr, R. S. (Ed.). (2014). Knowledge and memory: The real story: Advances in social cognition (Vol. 8).
Psychology Press.

Zhao, F. F., Lei, X. L., He, W., Gu, Y. H., & Li, D. W. (2015). The study of perceived stress, coping strategy and self‐efficacy of Chinese undergraduate nursing students in clinical practice.
International journal of nursing practice
,
21
(4), 401-409 theory development in nursing sample essay paper.

Nursing Informatics Presentation

Describe standardized order sets and its Role used to manage information in nursing.

1. Define standardized order sets and their use in nursing practice.

2. Review current literature and research associated with standardized order sets Nursing Informatics Presentation.

Here are some current literature and research associated with standardized order sets:

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Grissinger, Matthew. “Guidelines for Standard Order Sets.” Pharmacy and Therapeutics, MediMedia USA, Inc., Jan. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC3956384/.

Payne, Thomas H., et al. “Preparation and Use of Preconstructed Orders, Order Sets, and Order Menus in a Computerized Provider Order Entry System | Journal of the American Medical Informatics Association | Oxford Academic.” OUP Academic, Oxford Unity Health, July, 2003

“Registered Nurses’ Association of Ontariol’Association Des Infirmières Et Infirmiers Autorisés De L’Ontario.” Nursing Order Sets | Registered Nurses’ Association of Ontario, Registered Nurses’ Association of Ontario, 2017, rnao.ca/ehealth/nursingordersets.

Wright, A., Feblowitz, J., Pang, J., Carpenter, J., Krall, M., & Middleton, B. (2013). Use of Order Sets in Inpatient Computerized Provider Order Entry Systems. Electronic Health Records,229-256. doi:10.1201/b16306-18

Wright, Adam, et al. “Order Sets in Computerized Physician Order Entry Systems.” AMIA Annual Symposium Proceedings, American Medical InformaticsAssociation,2010,www.ncbi.nlm.nih.gov/pmc/articles/PMC3041397/ Nursing Informatics Presentation.