Tag: Clinical-Nursing

Practicum Project Methodology and Evaluation Discussion Essay

Consider the following scenario:

With a clear conception of her Practicum Project goal and objectives, Sandra was optimistic that she was on the right track. Then she started to consider the methodology for her project and realized how much she still needed to figure out. She began to think about the theories and concepts she had examined in her program of study and how they might inform her methodology. The biggest challenge, she discovered, was in mapping the strategies that would help her achieve each objective. Practicum Project Methodology and Evaluation Discussion Essay. How would she decide what would be most effective? What barriers were likely to arise? She also realized that she needed to think about evaluation early in order to establish appropriate criteria and make sure she could assess the evidence related to the process, impact, and outcomes of her project. She wondered how she might use formative evaluation to develop and improve the project, as well as how she could use summative evaluation following the implementation of the project to determine if it had been successful.

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Consider the models, theories, and concepts you have examined in your program of study as they relate to your project. Which of these can be applied to the development of methodology to help you achieve the project objectives? Which ones can be used to help you establish criteria and methods of evaluation for your project?

In this Discussion, you examine and propose the methodology for your Practicum Project, as well as evaluation methods. The insights you gain through this Discussion should be integrated into your Practicum Project Plan, which is due in Week 5. Practicum Project Methodology and Evaluation Discussion Essay.

To prepare:

Reflect on the Practicum Project goal and objectives you developed in Week 3.

Refer to the Practicum Project Plan (PPP) Overview document as needed for information related to the assignment.

Consider the models, theories, and concepts you have examined in your program of study as they relate to your project. How can this information be applied to the development of the methodology and evaluation for your project?

Review the information on methodology in the Learning Resources, and conduct additional research to facilitate your analysis for your project. Evaluate the who, what, how, where, and when associated with each objective: Who will make what change, by how much, where, and by when? Consider the methods you could use to meet each objective. Practicum Project Methodology and Evaluation Discussion Essay. Devise your methodology in as much detail as possible to identify how you could meet each objective. For example, identify which professional organizations or regulatory bodies you would consult (by viewing their websites or contacting them directly) to gather evidence.

Review the information on formative and summative evaluation in this week’s Learning Resources, and conduct additional research to facilitate your analysis for your project. How could you evaluate achievement of your Practicum Project objectives using formative and/or summative evaluation? Begin to develop an evaluation plan for your Practicum Project.

Post a brief summary of your Practicum Project focus, including the goal and objectives of your Practicum Project (to serve as a reminder for your colleagues). Explain your selected methodology, and justify your selection. Include a detailed explanation of how you could meet each objective using this methodology. Practicum Project Methodology and Evaluation Discussion Essay. Also explain your evaluation plan, noting at which points during your Practicum Project formative and/or summative evaluation will occur.

Respond to at least two of your colleagues on two different days, using one or more of the following approaches:

Comment on your colleague’s methodology, offering suggestions for improvement as appropriate.

Suggest an alternative evaluation method for your colleague’s project.

Required Readings

Reminder: Review resources from previous courses as necessary.

Black, P. (2010). Formative assessment. In P. Peterson, E. Baker, & B. McGaw (Eds.), International encyclopedia of education (3rd ed., pp. 359–364). St. Louis, MO: Elsevier.

Note: Retrieved from the Walden Library databases.

 

This article outlines the history of formative assessment and its application and use as an evaluation tool. Practicum Project Methodology and Evaluation Discussion Essay.

Duers, L. E., & Brown, N. (2009). An exploration of student nurses’ experiences of formative assessment. Nurse Education Today, 29(6), 654–659.

Note: Retrieved from the Walden Library databases Practicum Project Methodology and Evaluation Discussion Essay.

This article compares formative and summative assessment and presents examples of the application of formative assessment in nursing education.

Gantt, L. T. (2013). The effect of preparation on anxiety and performance in summative simulations. Clinical Simulation in Nursing, 9(1), e25–e33.

Note: Retrieved from the Walden Library databases.

This article provides an example of how formative and summative evaluation is used in a nursing simulation lab. The article discusses strategies for improving nurses’ performance on summative evaluations and explores the use of formative evaluation as a strategy for improving performance on summative evaluations.

Pellegrino, J. W. (2010). Technology and formative assessment. In P. Peterson, E. Baker, & B. McGaw (Eds.), International encyclopedia of education (3rd ed., pp. 42–47). St. Louis, MO: Elsevier.

Note: Retrieved from the Walden Library databases.

 

The author discusses the importance of formative assessment and examines how technology can be used to support the assessment process.

oject Methodology and Evaluation

Consider the following scenario:

With a clear conception of her Practicum Project goal and objectives, Sandra was optimistic that she was on the right track. Then she started to consider the methodology for her project and realized how much she still needed to figure out. Practicum Project Methodology and Evaluation Discussion Essay. She began to think about the theories and concepts she had examined in her program of study and how they might inform her methodology. The biggest challenge, she discovered, was in mapping the strategies that would help her achieve each objective. How would she decide what would be most effective? What barriers were likely to arise? She also realized that she needed to think about evaluation early in order to establish appropriate criteria and make sure she could assess the evidence related to the process, impact, and outcomes of her project. She wondered how she might use formative evaluation to develop and improve the project, as well as how she could use summative evaluation following the implementation of the project to determine if it had been successful.

Consider the models, theories, and concepts you have examined in your program of study as they relate to your project. Which of these can be applied to the development of methodology to help you achieve the project objectives? Which ones can be used to help you establish criteria and methods of evaluation for your project?

In this Discussion, you examine and propose the methodology for your Practicum Project, as well as evaluation methods. The insights you gain through this Discussion should be integrated into your Practicum Project Plan, which is due in Week 5. Practicum Project Methodology and Evaluation Discussion Essay.

To prepare:

Reflect on the Practicum Project goal and objectives you developed in Week 3.

Refer to the Practicum Project Plan (PPP) Overview document as needed for information related to the assignment.

Consider the models, theories, and concepts you have examined in your program of study as they relate to your project. How can this information be applied to the development of the methodology and evaluation for your project?

Review the information on methodology in the Learning Resources, and conduct additional research to facilitate your analysis for your project. Evaluate the who, what, how, where, and when associated with each objective: Who will make what change, by how much, where, and by when? Consider the methods you could use to meet each objective. Devise your methodology in as much detail as possible to identify how you could meet each objective. For example, identify which professional organizations or regulatory bodies you would consult (by viewing their websites or contacting them directly) to gather evidence. Practicum Project Methodology and Evaluation Discussion Essay.

Review the information on formative and summative evaluation in this week’s Learning Resources, and conduct additional research to facilitate your analysis for your project. How could you evaluate achievement of your Practicum Project objectives using formative and/or summative evaluation? Begin to develop an evaluation plan for your Practicum Project.

Post a brief summary of your Practicum Project focus, including the goal and objectives of your Practicum Project (to serve as a reminder for your colleagues). Explain your selected methodology, and justify your selection. Include a detailed explanation of how you could meet each objective using this methodology. Also explain your evaluation plan, noting at which points during your Practicum Project formative and/or summative evaluation will occur.

Respond to at least two of your colleagues on two different days, using one or more of the following approaches:

Comment on your colleague’s methodology, offering suggestions for improvement as appropriate.

Suggest an alternative evaluation method for your colleague’s project.

Required Readings

Reminder: Review resources from previous courses as necessary.

Black, P. (2010). Formative assessment. In P. Peterson, E. Baker, & B. McGaw (Eds.), International encyclopedia of education (3rd ed., pp. 359–364). St. Louis, MO: Elsevier.

Note: Retrieved from the Walden Library databases.

 

This article outlines the history of formative assessment and its application and use as an evaluation tool.

Duers, L. E., & Brown, N. (2009). An exploration of student nurses’ experiences of formative assessment. Nurse Education Today, 29(6), 654–659.

Note: Retrieved from the Walden Library databases.

 

This article compares formative and summative assessment and presents examples of the application of formative assessment in nursing education.

Gantt, L. T. (2013). The effect of preparation on anxiety and performance in summative simulations. Clinical Simulation in Nursing, 9(1), e25–e33.

Note: Retrieved from the Walden Library databases Practicum Project Methodology and Evaluation discussion Essay.

This article provides an example of how formative and summative evaluation is used in a nursing simulation lab. The article discusses strategies for improving nurses’ performance on summative evaluations and explores the use of formative evaluation as a strategy for improving performance on summative evaluations.

Pellegrino, J. W. (2010). Technology and formative assessment. In P. Peterson, E. Baker, & B. McGaw (Eds.), International encyclopedia of education (3rd ed., pp. 42–47). St. Louis, MO: Elsevier.

Note: Retrieved from the Walden Library databases.

 

The author discusses the importance of formative assessment and examines how technology can be used to support the assessment process. Practicum Project Methodology and Evaluation Discussion Essay.

Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report

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.

Examples of public policy includes any component of the current legislation governing health care, Medicare Part D, Medicaid, nursing regulation, medication technicians, etc
. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

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.

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?

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.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

 

 

 

Benchmark Assignment – Nursing Leadership Health Policy Paper 

 

1

Unsatisfactory

0.00%

2

Less than Satisfactory

80.00%

3

Satisfactory

88.00%

4

Good

92.00%

5

Excellent

100.00%

75.0 %Content

 

10.0 %Rationale/purpose/overall presentation addresses an analysis of a public policy. Description of a health policy change (that is currently a bill, a law, or may not exist at all) at the state or federal level that student believes needs to be changed and why.

Rationale/purpose lacks any discernible overall purpose or organizing claim, and does not adequately address the policy process that is actually conducted for a public health policy. Rationale for topic selection, purpose, and objectives of presentation is not described. Ideas are not focused.

Rationale/purpose is insufficiently developed and/or vague; purpose is not clear. Rationale for topic selection, purpose, and objectives of presentation is minimally delineated.

Rationale/purpose is appropriate. Rationale for topic selection, purpose, and objectives of presentation is partially delineated. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report

Rationale/purpose is clear, descriptive, and reflective of the arguments and appropriate to the purpose. There are few inconsistencies

Rationale/purpose is comprehensive, supports the purpose of policy process that is actually conducted for a public health policy, and clearly shows logical progression of how development took place. Purpose and objectives of presentation are clearly delineated. At least three learner objectives are stated in behavioral terms.

20.0 %Paper includes a specific section for the exact wording for the bill or change in wording of the law.

Paper lacks the ability to communicate wording for the proposed health policy change.

Paper insufficiently addresses the wording for the proposed health policy change.

Paper appropriately addresses the wording for the proposed health policy change.

Paper is clear and successfully addresses the wording for the proposed health policy change.

Paper completely addresses the beginning wording for the proposed health policy change.

15.0 %Presentation of the legislative process for state to propose new legislation.

Paper lacks the ability to communicate the process.

Paper insufficiently addresses the legislative process.

Paper is appropriate. Minimal information is presented on the legislative process.

Paper is clear and presents substantial information on the legislative process.

Paper completely addresses the key legislative process.

15.0 %Paper implementation plan including who would be the champion for the bill/law change from state legislators/federal legislators/local or national state nursing organizations. Are these individuals also influential in making changes occur?

Paper lacks the ability to communicate the implementation plan.

Paper insufficiently addresses the implementation plan. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report

Paper is appropriate. Minimal information is presented in the implementation plan.

Paper is clear and presents substantial information addressing the implementation plan.

Paper completely addresses the implementation plan Presentation is specific and easily understood.

15.0 %Style

Paper lacks unity and coherence. No connections are apparent between slides. Transitions are inappropriate to purpose and scope. Organization is disjointed.

Some paragraphs may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.

The paper is generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

A logical progression of ideas between the paragraphs is apparent. The paper exhibits a unity, coherence, and cohesiveness.

There is a sophisticated construction of the presentation paper. Ideas universally progress and relate to each other.

10.0 %Organization and Effectiveness

 

5.0 %Mechanics of Writing (includes spelling, punctuation, and grammar)

Paper errors are pervasive enough that they impede communication of meaning.

Frequent and repetitive mechanical errors that distract the reader.

Some mechanical errors or typos are present, but are not overly distracting to the reader.

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

Writer is clearly in control of standard, written American English.

10.0 %Organization and Effectiveness

 

5.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.)

Inappropriate word choice, lack of variety in language use. Writer appears to be unaware of audience. Use of ?primer prose? indicates writer either does not apply figures of speech or uses them inappropriately.

Some distracting inconsistencies in language choice (register) and/or word choice are present. The writer exhibits some lack of control in using figures of speech appropriately.

Language is appropriate to the targeted audience for the most part.

The writer is clearly aware of audience; uses a variety of appropriate vocabulary for the target audience, and uses figures of speech to communicate clearly.

The writer uses a variety of sentence constructions, figures of speech, and word choice in unique and creative ways that are appropriate to purpose, discipline, and scope.

15.0 %APA and Documentation

 

15.0 %valuating and Documenting Sources (includes use of appropriate style, correct citation format in-text and in Reference section related to APA format)

Paper has no title page, no References section, and no correctly cited references within the body of the paper and no reference page. APA format not used.

Title page is incomplete or inaccurate. References section includes sources, but many citation errors. Citations within the body of the paper are included, but with many citation errors including major issues on References section.

Title page has major errors. References section includes sources, but they are not consistently cited correctly. Citations are included within the body of the paper, but References section includes with major errors.

Title page has minor errors. References section includes sources, but they are not consistently cited correctly. Citations are included within the body of the paper, but with some citation errors. References section is mostly free of errors.

Title page is complete. References section includes correctly cited sources. Citations within the body of the paper and in the Reference section are included and correctly cited.

100 %Total Weightage

 

REFERENCES

H.R.2392 – Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017

 

https://www.congress.gov/bill/115th-congress/house-bill/2392?r=9

Improving Nurse Staffing to Improve Care QualityCongress has enacted many amends in the medical care section to boost the admission to healthcare facilities for the citizens in the United States. The Affordable Care Act introduced these changes and has made the number of patients currently seeking health care to increase drastically. For instance, the increase in the number of patients demands for many nurses and physicians who will handle the influx of patients in the system. Such changes aggravate the problem that already exists and that is the insufficient number of direct health care registered nurses present in the hospital staff. According to Dellefield, research has proven that more direct care registered nurses in the hospital staff makes medical and medication errors to reduce (2015).  Dellefield adds that an increased number of direct care nurses on staff causes the mortality rate to decrease, improves the working environment which in turn enhances the patients’ outcome. However, with the reason best known to them, a number of hospitals ignore scholarly consent, and they do not have sufficient nurse patient ration. As a matter of fact, if a bill can be enacted and passed into a law which demands that all hospitals to employ satisfactory staffing to efficiently care for patients and minimize the impacts of having lower nurse patient ratios then their states will have many health facilities which will comply to such evidence. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

Current Legislation

The current legislation is the Patient Protection and Affordable Care Act (P.L. 111-148) which mandates the hospitals to have sufficient staffing levels and constitute a language that is indistinct. The provision allows for loopholes which the hospitals exploit. According to the American Nurses Association (2016), such gaps formulate mechanisms so that the hospitals can avoid having hospital staff levels that are unsafe. Just to mention, at the state level are only fourteen states which have enacted staffing nurse laws. ANA (2016) indicates the states with the nurse staffing laws which are WA, VT, OH, OR, RI, TX, NY, MN, NV, NJ, CT, MA, CA, and IL. While the step as mentioned earlier may be appealing and a step to the right direction, contrarily, only two states out of the stated fourteen states mentioned herein which have specifically addressed the levels of nurse staffing and have put all the hospital requirements in place. Conversely, California has formulated strict policies over having sufficient RNs on its staff in varied settings and Massachusetts which has constituted several ICU RNs who are on duty. Sadly, there are forty-eight states which require much legislation that can oversee more RNs on hospital staff to deliver best quality care services to patients. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

Change to the Current Legislation

One of the congresswomen Schakowsky Jan supported and sponsored a motion which requires the instigation of a nationwide task for increasing the figures for direct health care nurses registered on duty in any United States’ healthcare institutions which obtain funding from central government and recommends the least number of nurses who should be on duty (ANA, 2016). The enacted bill has a selection of initiatives which serves as an incentive for any healthcare care facility to conform to the new law. The bill also outlines rules which help in subsidizing the hiring of new nursing staff, ensuring long-term return on investments through creating retention programs as well as sponsoring learning progression for nurses who are on staff. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

 

The New Law

The new law which has been passed by the United States of America’s Congress is the H.R 1602 bill: “Improving Nurse Staffing to Improve Quality of Care for Patients Act.” For instance, title XXIV of the Act concerns with direct care nurse staffing ration who are registered. The enacted bill involves The Sovereign Authority; Bill H, R 1602 Improving Nurse Staffing to Improve the Quality of Care for Patients Act. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report. Despite the federal and political subdivisions of the country, the United States of America has successfully constituted a law which requires all healthcare institutions and facilities to have a bare minimum figure of registered nurses to patient ration for the for direct care. The minimum number of nurses on staff will raise the value of health care for the patients, enhance the patient’s contentment as well as improve the working environment for the nurses. The new bill includes:

None of the hospital unit shall function if they do not meet the minimum threshold of direct care registered nurses on their staff.

Hospitals ought to execute their plans of staffing which lessens the burnout and decrease errors. In increased quantity units like intensive healthcare, the direct care registered nurse patient ratio must be 1:2 or 1:1. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

Ensure the patients are assured of receiving high-quality conscription practice who is well outfitted with a way to give feedback about insufficient enrollment strategies.

Whistleblower safeties for healthcare professionals who notice contravention yet operate in the traditions of contentment. The bill safeguards the position of nurses which calls for interest in the violations of guiding principle from reprisal.

 
Implementation Plan

Many resources are required to undertake the massive program of the implementation magnitude successfully. Mainly, it indicates that there will be a time frame for the healthcare institutions to comply with the fresh legislation (Knight, 2016). The time frame is meant to be used for the preparation of enacting and putting into practice measures to attain conformity with the health institutions. However, the American Nurses Association will help the stakeholders understand what the new law means with the lobbying endeavors for the change in the nursing practice. There ought to be proper utilization of dailies, local and state news, social media and blogs to spread the news about the new law. The pre and post measures of implementation will assist in gauging the attitude of the change in the Health Act. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

The champion from my State

The United States of America requires this law urgently. The congresswoman Schakowsky Jan is the key pillar in championing this new legislation in the Congress. Delegate Jan trusts that every patient deserve nothing but the high quality health care. Increasing direct health care nurses on duty raise the health status of the population which Jan believes that it will be the outcome of the new law. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

References

American Nurses Association. (2016). State Legislative Agenda. Online. August 2016. From http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios

Dellefield, M. E., Castle, N. G., McGilton, K. S., &Spilsbury, K. (2015). The relationship between registered nurses and nursing home quality: An integrative review (2008-2014).
Nursing Economics
,
33
(2), 95.

Knight, L. D. (2016). Staffing Ratios and Patient Outcomes: Looking Beyond Nurses, Doctors, and Survival at ICU Discharge.
Critical care medicine
,
44
(2), e107-e108. Improving Nurse Staffing to improve Care Quality Essay – IOM Future of Nursing report.

Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template

You will complete a Comprehensive SOAP note on the approved Pediatric SOAP Note template based on the findings of the iHuman case – then major research and discussion of the disease process are presented.

This case study should be a summative evaluation supported by a minimum of 5 evidence-based articles.

Evaluation of the case study should be no more than 3-4 substantive paragraphs. A minimum of five evidence-based sources (in addition to your text) should be used for your case study.

Course texts will not count as a scholarly source; if using data from websites you must go back to the literature source for the information-no secondary sources are allowed, ie, Medscape, UptoDate, etc. Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

This week, complete the iHuman case titled ”Tommy Acker V3”.

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STUDENT NAME:

DATE OF ASSIGNMENT:

Patient Initials: Tommy Acker

Date of Encounter:

 

Sex: Male

Age/DOB/Place of Birth: 26 months old

2/5/2017

SUBJECTIVE

Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template

Historian: Mother

Present Concerns/CC: “Stomach ache” (abdominal pain)

Child Profile: Listless and ill appearing 26-month-old, male with a history of Downs’s syndrome and …. The mother states … as other children. She states that he is clumsy. He is always tripping, falling, or bumping into things as if he does not see that it is there. None of his … in him requiring medical attention. She states that he is normally … and does not require much else. He does not go to day care and lives at home with his two siblings and mother. His mother works and their neighbors or mother’s boyfriend babysit the children. Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

HPI:

Onset: xx days ago

Location/Radiation: xxx pain

Duration: xxx over 2 days

Character: xxx

Aggravating factors: xxx

Relieving Factors: none

Timing: constant

Severity: severe

Tommy, a 26-month-old male with Down syndrome, was brought into the ED by his mother who reports he has been “complaining” of… days, had emesis x 1, is lethargic, sweati…is grossly distended with significant epigastric bruising, in a distribution that is atypical for a fall. It is firm to Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template… tenderness. A reducible 2.0-cm umbilical hernia is present.

 

Medications: None currently.

PMH: Normal pregnancy and no complications noted at birth.

 

Allergies: None

Medication Intolerances:  None

Chronic Illnesses/Major traumas: Atrioventricular septal defect, tra….

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… thus, meeting more than two criteria for SIRS.

3.       Child Abuse: Act of Commission (T74.12XA): According to the Centers for Disease Control (CDC), physical, … and neglect (CDC, 2019). Neglect is defined as the failure to meet a child’s basic physical and emotional needs, including food, shelter, clothing, education, and access to medical care (CDC, 2019). Physical abuse is intentionally using physical force that may result in injury, such as, hitting, kicking, burning, or shaking of a child (CDC, 2019). Emotional abuse refers to the behaviors that harm a child’s self-worth or emotional well-being, such as shaming, rejection, or withholding love or affection (CDC, 2019). Abuse can come from …factors. In the situation with T.A., the mother was neglecting her children to be able to provide basic needs for them, while depriving them of education and exposing them to physical abuse from her boyfriend. Tommy’s injuries also do not match up to the stories his mother is reporting, and she seemed to take some time to bring him in to be evaluated and became defensive when possible questions that may point toward abuse were asked. Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

4.       Volvulus (K56.2): Volvulus can vary in presentation from vague, recurrent gastrointestinal discomfort to sudden onset of an acute abdomen with associated shock symptoms (Saxena, 2017). It may present in any age group and is not associated with traumatic injury. More often it occurs as a result of a congenital malrotation of the midgut (Saxena, 2017).

PLAN including education

Initial resuscitation and stabilization protocol:

1.       Assess airway, circulation and breathing. Provide oxygen for hypoxia.

2.       Place on …, continuous pulse oximetry, and monitor vital signs.

3.       Place two …. as they are needed.

4.       Complete Primary (airway, breathing, circulation, disability, and exposure) and secondary (head-toe exam) surveys (Kaplan, 2018). Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

T.A. is a child that is critically-ill. He will require further testing such as a … with contrast and an emergent surgical consult. He will also be admitted to the intensive care unit for further management. It is important to contact child protective services, police, and social-work personnel as needed.

 

 

NSG 6435 Week 7 W7 Assignment 1

Assignment 1: Comprehensive Case Study

General Guidelines for Comprehensive Case Study – Week 7 Assignment 1

Your case study should not be just a SOAP note of a patient encounter—it should be a comprehensive evaluation of an iHuman patient case.

You will complete a Comprehensive SOAP note on the approved Pediatric SOAP Note template based on the findings of the iHuman case – then major research and discussion of the disease process are presented.

This case study should be a summative evaluation supported by a minimum of 5 evidence-based articles.

Evaluation of the case study should be no more than 3-4 substantive paragraphs.A minimum of five evidence-based sources (in addition to your text) should be used for your case study.

Course texts will not count as a scholarly source; if using data from websites you must go back to the literature source for the information-no secondary sources are allowed, ie, Medscape, UptoDate, etc.

This week, complete the iHuman case titled “Tommy Acker, Child Abuse”.Click here for information on how to access and navigate Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

Name your SOAP note document SU_NSG6435_W7_A1_lastname_firstinitial.doc

i-Human

i-Human is an interactive cloud based system that provides comprehensive learning that

integrates clinical experience.The i-Human system helps students develop patient assessment

and diagnostic reasoning skills at various levels of education.Students will receive online

guidance, feedback, and coaching during the learning process.

Student Login Instructions for Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template

Logging in to i-Human:

Log on at:

http://toolmanagement.next.ecollege.com/tools/thirdparty/blti.ed?launch=LS:iHuman:Patients

Next Steps:

1) If you were unable to attend a Student Orientation Webinar, please watch this introduction

video: https://vimeo.com/185046053/228aea3fc9

2) Additional tutorial videos can be found on the i-Human home screen under the title “Player

Screencast Tutorials”

3) After attending the webinar or viewing the tutorial you are ready for your first practice

case.

4) The i-Human Student Support Center (link on the home screen under the videos) is a

resource for our most frequently asked questions.The Student Manual is also located here.

5) If you are having any issues that are not answered through the webinars, videos or support

center, you can email: support@i-human.com Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

 

PEDIATRIC FILLABLE SOAP NOTE TEMPLATE

STUDENT NAME:

Patient Initials:

 

Sex:

 

SUBJECTIVE

Historian:

Present Concerns/CC
:

DATE OF ASSIGNMENT:

Date of Encounter:

 

Age/DOB/Place of Birth:

 

Reason given by the patient for seeking medical care “in quotes”

Child Profile
:  (
Sexual History (If appropriate); ADLs (age appropriate); Safety Practices; Changes in daycare/school/after-school care; Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

Sports/physical activity; Developmental Hx)

 

HPI:
(must include all components – OLD CARTS)

 

Medications
:
(List with reason for meds)

 

PMH:

Allergies:

 

Medication Intolerances:

 

Chronic Il nesses/Major traumas:

 

Hospitalizations/Surgeries:

 

Immunizations: Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

 

1 |
P E D I A T R I C   S O A P   N O T E

 

PEDIATRIC FILLABLE SOAP NOTE TEMPLATE

 

Family History
 
(please identify al  immediate family)

 

 

Social History
(Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

and marijuana.  Safety status)

 

Review of Systems (ROS)

 

General

 

Skin

 

Eyes

 

Ears

 

Nose/Mouth/Throat

 

Breast

 

Heme/Lymph/Endo

 

2 |
P E D I A T R I C   S O A P   N O T E

Cardiovascular

 

Respiratory

 

Gastrointestinal

 

Genitourinary/Gynecological

 

Musculoskeletal

 

Neurological

 

Psychiatric

PEDIATRIC FILLABLE SOAP NOTE TEMPLATE

OBJECTIVE  (plot height/weight/head circumference along with noting percentiles)

Attach growth chart

 

Weight

 

Height

Temp

 

Pulse

BP

 

Resp

 

 

OBJECTIVE (Physical Examination)

 

General Appearance and parent
–
child interaction

 

Skin

 

HEENT

 

Cardiovascular

 

Respiratory

 

Gastrointestinal

 

Breast

 

Genitourinary

 

Musculoskeletal

 

3 |
P E D I A T R I C   S O A P   N O T E

 

PEDIATRIC FILLABLE SOAP NOTE TEMPLATE

 

Neurological

 

Psychiatric

 

In-house Lab Tests – document tests (results or pending)

 

Pediatric/Adolescent Assessment Tools (Ages & Stages, etc) with
results and rationale

For adolescents (HEADSSSVG Assessment)

 

ASSESSMENT (Diagnosis – 3 Differentials and Primary)

     Include at least three differential diagnoses with ICD-10 codes.  (Includes Primary dx and 2

differentials) Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template.

    
Document Evidence based Rationale for ROS and each differential with pertinent

positives and negatives

     Primary diagnosis

     Is #1 on list of differentials

     Evidence for primary diagnosis should be supported in the Subjective and Objective

exams.

1)

 

2)

 

3)

 

4 |
P E D I A T R I C   S O A P   N O T E

 

PEDIATRIC FILLABLE SOAP NOTE TEMPLATE

PLAN including education

PLAN including education

     Plan:  Treatment plan should be for the Primary Diagnosis and based on EB literature.

     Include
EB rationale
for all aspects of your treatment plan:

     Vaccines administered this visit

     Vaccine administration forms given

     Medication-amounts and mg/kg for medications

     Laboratory tests ordered

     Diagnostic tests ordered

     Patient education including preventive care and anticipatory guidance

     Non-medication treatments

Fol ow-up appointment with detailed plan of  f/u

 

*ALL references must be
Evidence Based (EB)

 

5 |
P E D I A T R I C   S O A P   N O T E

Pediatric_Fillable_SOAP_Note_Template–

growth_chart

Tommy Acker ihuman case study: Pediatric Fillable Soap Note Template

Your written Fluid Imbalances Essay assignment for this module should be a 1-2 page paper (not including title page and reference page) that describes the following:

Describe what a fluid and electrolyte imbalance is and how this is important to the function of the body?

Pick a fluid or electrolyte imbalance and describe how the patient would present, in addition to the treatment (nursing and expected medical)?

You should include a minimum of 3 scholarly references. Include a title page, in-text citations, and a reference page in APA format.

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Module 08 – Fluid Imbalances

Scoring Rubric:

Criteria

Points

Describe what a fluid and electrolyte imbalance and how this is important to the function of the body? Fluid Imbalances Essay.

3

Pick a fluid or electrolyte imbalance and describe how the patient would present, in addition to the treatment (nursing and expected medical)? Fluid Imbalances Essay.

5

Grammar, APA and Organization

2

Total

10

NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

PET

Your Plan – How Would You Meet this Step in your Project Plan?

Practice Question

 

Step 1
: Recruit interprofessional team

 

Step 2
: Define the problem

 

Step 3
: Develop and refine the EBP question

In
Adolescents with substance abuse
(
P
), how
does cognitive behavioral therapy
(
I
) compared
to no cognitive behavioral therapy
(
C
) affect
reduction of substance use behavior
(
O)

within 6- months post intervention
(
T
)?

Step 4
: Identify stakeholders

 

Step 5
: Determine responsibility for project leadership

 

Step 6
: Schedule team meetings

 

Evidence

 

Step 7
: Conduct internal and external search for evidence

NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

Step 8
: Appraise the level and quality of each piece of evidence

 

Step 9
: Summarize the individual evidence

 

Step 10
: Synthesize overall strength and quality of evidence

 

Step 11
: Develop recommendations for change based on evidence synthesis

·      Strong, compelling evidence, consistent results

·      Good evidence, consistent results

·      Good evidence, conflicting results

·      Insufficient or absent evidence

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Translation

 

Step 12
: Determine fit, feasibility, and appropriateness of recommendation(s) for translation path

 

Step 13
: Create action plan

 

Step 14
: Secure support and resources to implement action plan

 

Step 15
: Implement action plan

NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

Step 16
: Evaluate outcomes

 

Step 17
: Report outcomes to stakeholders

 

Step 18
: Identify next steps

 

Step 19: 
Disseminate findings

John_Hopkins_PET_Worksheet

 

 

NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

The John Hopkins Hospital/John Hopkins University School of Nursing (2017)

The value of the PET worksheet is to help you practice implementation of an evidencebased practice (EBP) project using an EBP implementation model. The PET Worksheet begins

with planning and goes through dissemination (compare to Melnyk’s EBP Process Step 0 – Step

6 that we have been working with). To answer the questions, you can use your textbook as a

guide as the concepts are discussed, but you are developing an individualized plan. The website

for the John Hopkins model is also valuable: https://www.hopkinsmedicine.org/evidence-basedpractice/ijhn_2017_ebp.html

You want to think about how you would implement your proposed intervention at an

organization using the implementation model. This should not be a lengthy document as it is a

plan/outline. You can bullet or write a few sentences/short paragraph if needed. Question 13

may require more detail.

PET Your Plan – How Would You Meet this

Step in your Project Plan?

Practice Question

Step 1: Recruit interprofessional team List other professionals that will be involved

in your project implementation.

Step 2: Define the problem Discuss your problem – if you give specifics

from the literature you will need to cite and

reference.

Step 3: Develop and refine the EBP question List your PICOT.

Step 4: Identify stakeholders Who are the stakeholders in the project – who

has a stake in the problem, intervention, and

outcome? NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

See p. 536 in Melnyk for discussion on

stakeholders.

Step 5: Determine responsibility for project

leadership

Who is the leader of the project? Will other

professionals have assigned roles?

Step 6: Schedule team meetings How often will the team meet?

Evidence

Step 7: Conduct internal and external search

for evidence

Discuss your literature search. Is there

internal data that should also be considered?

Step 8: Appraise the level and quality of each

piece of evidence

List the levels of evidence used to support the

intervention.

Step 9: Summarize the individual evidence What is the synthesis of the evidence? If you

give specifics from the literature you will

need to cite and reference.

Step 10: Synthesize overall strength and

quality of evidence

Is the supporting evidence strong? See Step

11 below.

Step 11: Develop recommendations for

change based on evidence synthesis

 Strong, compelling evidence, consistent results

 Good evidence, consistent results

 Good evidence, conflicting results

 Insufficient or absent evidence

Would you recommend a change based on the

evidence? NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

The John Hopkins Hospital/John Hopkins University School of Nursing (2017)

Translation

Step 12: Determine fit, feasibility, and

appropriateness of recommendation(s) for

translation path

Consider fit of intervention, appropriateness

of intervention, and feasibility of intervention

for patient and organization

Step 13: Create action plan List or bullet a step by step plan for project

implementation beginning with

identification/recruitment of patient through

measurement of outcomes.

Step 14: Secure support and resources to

implement action plan

What resources will be needed? Consider

cost of staff and supplies.

Step 15: Implement action plan Consider timeline.

Step 16: Evaluate outcomes How/when will you measure outcomes?

Step 17: Report outcomes to stakeholders How/when will you report outcomes to

stakeholders? NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

Step 18: Identify next steps Consider sustainability of project.

Step 19: Disseminate findings How will you disseminate findings of project

so that others may benefit?
John_Hopkins_PET_Worksheet_Guide_2019

NSC 892 John Hopkins Evidence-Based Practice Model PET Worksheet

Emergency Plan For The Older Adult Assignment Description

Emergency Plan for the Older Adult

Locate the American Red Cross in your area:
http://www.redcross.org/
or in person.

Identify what is necessary for emergency supplies to have on hand for a healthy older adult. Consider visiting with an older family member or friend to identify specific needs for this older adult (reasonable for this person)

Assist the older adult (OA) in creating their Personal Emergency Plan and contacts

Describe what the OA was surprised to need or what they seemed to predict on their own

Why is this important for OA singles or couples who live independently without services?

Complete at least two slides for each bullet point with a total of 10 slides

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Assignment Expectations:

Length: Minimum of 10 content slides

Structure: Include a title slide, objective slide, content slides, and reference slide in APA format. The title/objective/reference slides do not count towards the minimum slide count for this assignment. lots of pictures to compliments.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this Emergency Plan For The Older Adult assignment.

Discussion: Data Analysis

As a nurse engaged in evidence-based practice, it is important to recognize how statistics and other data analysis tools are used to generate and assess evidence. Most nurses need only a foundational understanding of statistical tools and terminology to understand the majority of research studies. As a nurse, you should be able to recognize the most commonly used statistical tests, how and when they are used, and how significance is determined.

In this Discussion, you examine different types of statistics and statistical tests, when and why these particular tests would be selected for use, and, most importantly, what the results indicate. You will develop a study sheet on their chapter that will be shared with the other groups.

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Review the information in your assigned chapter.

As a group, develop a 1-page study sheet that includes the following:

The key concepts of the chapter 24: Focus on the basic concepts that are important for nurses to understand as they review research studies.

A description of the statistical methods covered in the chapter 24, what they measure, and under what circumstances they are used. Identify examples of how the statistical methods have been used in research studies. Discussion: Data Analysis.

An explanation of the key statistical tests and how they measure significance (if applicable).

Note: This should be a collaborative effort, with each member of the group making contributions to the design and content of the study sheet. Use the Groups link on the left navigation bar to collaborate with your group. When you have developed your 1-page study sheet, select one member to post it to the Week 9 Discussion Forum so that the rest of your colleagues can access it. Discussion: Data Analysis.

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 24, “Qualitative Data Analysis”

The focus of this chapter is qualitative data analysis, which is more difficult in some ways than quantitative analysis, because there are not specific tests that can be used. Instead, much of the analysis is based on the researcher’s ability to identify patterns of behavior or similarities in events. Suggestions are provided for analysis of each of the major types of qualitative studies and how to document findings. Discussion: Data Analysis.

Katherine Harris iHuman Case Study – HEENT and Respiratory Infections

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For the iHuman Case Study – HEENT and Respiratory Infections assignment, make sure you post your initial response to the Discussion Area by Saturday, August 19, 2017.

To support your work, use your course textbook readings and the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. Katherine Harris iHuman Case Study – HEENT and Respiratory Infections.

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Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for the iHuman Case Study – HEENT and Respiratory Infections assignment by Wednesday, August 23.

For the iHuman Case Study – HEENT and Respiratory Infections assignment, you will complete an iHuman case study based on the course objectives and weekly content. iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice. Katherine Harris iHuman Case Study – HEENT and Respiratory Infections.

iHuman Case Study – HEENT and Respiratory Infections

The iHuman assignments are highly interactive and a dynamic way to enhance your learning. Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Katherine Harris.”

Apply information from the iHuman Case Study to answer the following questions:

Do you recommend a limited or an involved use of antibiotics in treatment of these diseases and other unconfirmed bacterial illnesses and why? What are the standards regarding the use of antibiotics in pediatric population, and what assessment findings would warrant prescribing an antibiotic for Asthma symptoms?

Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.

Do the etiology, diagnosis, and management of a child who is wheezing vary according to the child’s age? Why or why not? Which objective of the clinical findings will guide your diagnosis? Why? When is a chest x-ray indicated in this case? Katherine Harris iHuman Case Study – HEENT and Respiratory Infections.

iHuman Case Study – HEENT and Respiratory Infections Sample

Case study i-human- Katherine Harris

Chief Complaint:  Cough and Difficulty in breathing

History:

Miss Katherine Harris is 16 years of age is an understudy who presents with dynamic shortness of breath for a few days now. Her concern started four days prior when she got a bug. Her “cold” comprised of a sore throat, rhinorrhea and myalgia. Her tutoring compels her to go to classes even in the harsh elements and moist air. At first, she just felt tired yet later she built up a cough* and shortness of breath. At first, the cough was dry yet within 24 hours of beginning, it delivered plentiful yellow-green sputum. She states, “I cough up a measure of this stuff each day”. She didn’t think much about a cough since she consistently coughs amid the winter of every year. Her mom expresses that she “hacks and spits up” each morning when she gets up from the bed.

The shortness of breath has compounded so she can scarcely talk now. She likewise has torment in the left half of her chest when she coughs. She turns out to be exceptionally worn out subsequent to strolling up a flight of stairs amid a coughing spell. She denies hemoptysis, night sweats, chills, and paroxysmal nighttime dyspnea Katherine Harris iHuman Case Study – HEENT and Respiratory Infections. Nonetheless, she complains of swelling of her lower legs: “I’ve had this for over a year.”

Ms. Katherine has been dealt with for hypertension, pneumonia and diseases of her hands. She has been dealt with for comparable scenes of coughing and shortness of breath amid the previous two years. When she was hospitalized because “I was drinking excessively and my pancreas misbehaved.” A past specialist gave her nitroglycerin.

Physical Examination:

The patient seems considerably older than her expressed age of 16 years. She is a stocky fellow who seems rough, worn out and on edge. She talks about trouble, rapidly getting to be winded. There is cyanosis which heightened amid coughing spells. Pulse is 146/82 mmHg. Apical heart rate is 96 moment and customary. Respiratory rate is 28/minute. Temperature is 100.2o F.

Examination of the head and neck uncovers the utilization of extra muscles amid breath. Jugular veins are enlarged to 5 cm. with a conspicuous “a” wave Katherine Harris iHuman Case Study – HEENT and Respiratory Infections.

Examination of the chest uncovers utilization of extra respiratory muscles. The front-back measurement of the chest is expanded. Breath rate is expanded; respiratory is standard and longer in termination. Fremitus is diminished and the lung fields are hyper-resounding (diffusely) with percussion. Percussion additionally uncovers diminished outing of the stomach (reciprocal). Breath sounds are reduced respectively. Coarse crackles, rhonchi and expiratory wheezes are heard reciprocally. A large portion of these sounds clear with coughing.

Examination of the cardiovascular system uncovers soft heart sounds: S2 is part and louder than S1. The P2 segment appears loader than A2 and is heard best at the base of the heart. An S4 is heard best along the left lower sternal fringe. A mumble isn’t recognized.

The stomach area is round however soft. Inside sounds are not heard. The liver edge is round, somewhat delicate and discernable 2 cm. underneath the privilege costar edge in the mid-clavian line. The prostate is developed and nodular on rectal exam.

Both feet show hallux valgus. There is pitting edema of the ankles Katherine Harris iHuman Case Study – HEENT and Respiratory Infections.

Laboratory Tests:

The patient is first found in the emergency room. The accompanying information reflects the underlying tests.

CBC:

Leukocytes check is 12,500/mm3, 58% neutrophils, 7% groups, 28% lymphocytes, 6% monocytes, 1% eosinophils. Hemoglobin = 19.8 g/dL; Hematocrit = 60%; Platelet check = 320,000/mm3.

Chem:

Glucose 112 mg/dL (non-fasting); BUN 16 mg/dL, Creatinine 1 mg/dL; Cholesterol 240 mg/dL; Aspartate aminotransferase (AST) 18 U/L, Alanine aminotransferase (ALT) 32 U/L, Creatine kinase 72 U/L; Sodium 130 mEq/L, Potassium 4.8 mEq/L; Chloride 90 mE1/L, Bicarbonate 33 mEq/L.

ABGs*:

PH 7.38, Pa 02 44 mmHg, PaC02 58 mmHg, HCO3 31 mEq/L.

Electrocardiogram:

Chest x-ray PA and parallel perspectives

Sputum culture results are pending.

The patient is hospitalized. Spirometry is performed. The stream volume circle and results are as per the following:

FEV1 = 0.5L, Predicted = 2.9L, Percent of Predicted = 17%

FVC = 1.7L, Predicted = 3.9L, Percent of Predicted = 43%

FEV1/FVC = 29%

iHuman Case Study – HEENT and Respiratory Infections

NSG 6435 Week 4 
 Assignment 4

Assignment 4: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley Katherine Harris iHuman Case Study – HEENT and Respiratory Infections.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W4_A4_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Discussion: iHuman Case Study – HEENT and Respiratory Infections

iHuman Case Study – HEENT and Respiratory Infections

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

For this iHuman Case Study – HEENT and Respiratory Infections assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Katherine Harris.”

Apply information from the iHuman Case Study to answer the following questions:

Do you recommend a limited or an involved use of antibiotics in treatment of these diseases and other unconfirmed bacterial illnesses and why? What are the standards regarding the use of antibiotics in pediatric population, and what assessment findings would warrant prescribing an antibiotic for Asthma symptoms?

Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.

Do the etiology, diagnosis, and management of a child who is wheezing vary according to the child’s age? Why or why not? Which objective of the clinical findings will guide your diagnosis? Why? When is a chest x-ray indicated in this case?

NSG 6435 Week 4 
 Assignment 4

Assignment 4: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W4_A4_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document. Katherine Harris iHuman Case Study – HEENT and Respiratory Infections.

Standardized Procedure Pediatrics Essay

Standardized Procedure for Nurse Practitioners: General Policy

I           Purpose

To establish a standardized procedure, in compliance with the California Board of Registered Nursing (BRN) and the 11 components of the BRN’s guidelines for Nurse Practitioners (NPs) to perform specified functions without the immediate supervision of a Physician.

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II         Development and Review

All standardized procedures are developed through the collaborative efforts of the members of the organization’s established interdisciplinary committee (IDC). The IDC will consist of physicians, nurse practitioners, registered nurses and administrative representatives of the organization.

All standardized procedures will be approved through the IDC made readily available and contain signed and dated approval sheets of all professionals covered by the procedures.

All standardized procedures will be reviewed every 3 years or more often as necessary by the IDC. Standardized Procedure Pediatrics Essay.

All NPs and their supervising physicians will signify agreement to the standardized procedures upon hire, annually and with changes as needed as evidenced by a signed and dated approval sheet.

Signature on the statement of approval and agreement implies the following: Approval of all procedures in the document, intent to abide by the procedures and willingness to maintain a collegial and collaborative relationship with all parties.  The signed statement of approval and agreement form will serve as the record of those NPs who have been authorized to perform the procedures.  The signature page will be kept on file and readily available together with Standardized Procedures.

III        Scope and Setting

A         NPs may manage those functions outlined in the standardized procedures, within their trained area of specialty and consistent with their experience and credentialing.  Such functions include assessment, management and treatment of acute and chronic illness, contraception, health promotion and overall evaluation of health status.  Additional functions include the ordering of diagnostic procedures, physical, occupational, speech therapies, diet and referral to specialty care as needed Standardized Procedure Pediatrics Essay.

B         NPs are authorized to practice standardized procedures in the organization’s Outpatient Clinics.

IV        Education and Training/Qualifications

A         NPs must have the following

1          Current California registered nurse (RN) license

2          Certification by the State of California, BRN as an NP

3          Board certification from the American Nurses Credentialing    Center

4          NP furnishing number

5          DEA registration number

6          Current Health Care Provider Card from the American Heart Association

7          Credentialed by the organization’s medical staff

B         In addition to the required education and training all NPs will be required to complete competency validation upon hire and annually.  The supervising physician is charged with observing the NP and documenting competency validation.  The competency validation checklist is managed, maintained and made available by the Office of Medical Staff as a component of the privilege process.   Checklist will be reviewed and updated annually by the IDC. Standardized Procedure Pediatrics Essay.

V         Supervision and Evaluation

A NP is authorized to implement the approved standardized procedures without the direct or immediate observation or supervision of a physician unless otherwise specified within a particular procedure.

B         Supervising physicians will conduct a weekly case review of a minimum of 10% of each NPs cases for the week.  The review will be documented within the electronic medical record and must be completed within 30 days of the visit selected for review. Cases will be selected randomly unless a request for review is received by a medical professional.

C         No single physician will supervise more than 4 NPs at any one time.

VI        Consultations

A         Physician consultation is to be obtained as specified in individual procedures or when deemed appropriate.

VII      Patient Records

A         NPs will be responsible for the documentation of a complete electronic medical record for each patient contact/encounter in accordance with existing clinic and medical staff policies.

Protocol:

Croup initial visit in the outpatient clinic setting

I           Rationale

To assist Nurse Practitioners in the outpatient clinic setting in the differentiation between

croup and other upper airway conditions and to establish guidelines for the management   of croup in this setting.

II         Definition

Swelling and erythema of the upper airway resulting in narrowing of these airways, usually as a result of viral infection and in some instances bacterial.  Most cases are usually mild and self-limiting however, children can be seriously ill or at risk for rapid progression of disease leading to further narrowing of the airways and respiratory compromise Standardized Procedure Pediatrics Essay.

III        Epidemiology

A         Typically occurs in children between the ages of 6 months to 6 years, with a peak

incidence between 6 and 36 months.

B         Most often occurs in the fall and is usually but not limited to parainfluenza type 1 viral infection.

C         Cases occurring in winter are usually but not limited to influenza A and B viruses

D         Risk factors include familiar history, parental smoking and male gender.

 

IV        History

A         Symptoms of upper respiratory infection for several days.

B         Rhinorrhea

C         Cough

D         Low grade fever

E          Symptoms occurring most often at night

F          Sore throat

G         Stridor

H         Intermittent barking, seal like cough

V         Physical Exam

A         Barking seal like cough, stridor

B         Tachypnea

C         Use of accessory muscles for respiration

D         Tachycardia

E          Wheezing

F          Low grade fever however, can be elevated to 104F

G         Visualization of mouth and epiglottis normal

VI        Diagnostic tests

A         Diagnosis typically made based on clinical presentation

B         Plain imaging of soft tissue of the neck may display classic pattern of subglottic narrowing (steeple sign) on posteroanterior view. Standardized Procedure Pediatrics Essay.

C         Pulse oximetry

D         Laboratory tests are not necessary for the diagnosis of croup however, may be used to assist with differential diagnosis.

1          CBC

2          Viral Serology

3          Tissue culture

VII      Differential Diagnosis

A         Epiglottitis

B         Foreign body aspiration

C         Retropharyngeal or peritonsillar abscess

D         Compression due to tumors, trauma or congenital malformations

E          Angioedema

F          Asthma exacerbation

G         Bacterial traceitis

VIII     Management – According to severity of disease by means of the Westley Croup Score based on the presence or absence of stridor at rest, degree of chest wall retractions, air entry, the presence or absence of pallor or cyanosis and the mental status.

A        
Mild croup (Westley croup score of ≤2)

No stridor at rest (although stridor may be present when upset or crying), a barking cough, hoarse cry, and either no, or only mild, chest wall/subcostal retractions.

B        
Moderate croup (Westley croup score of 3 to 7)

Stridor at rest, has at least mild retractions, and may have other symptoms or signs of respiratory distress, but little or no agitation Standardized Procedure Pediatrics Essay.

C        
Severe croup (Westley croup score of ≥8)

Significant stridor at rest, although the loudness of the stridor may decrease with worsening upper airway obstruction and decreased air entry. Retractions are severe (including indrawing of the sternum) and the child may appear anxious, agitated, or pale and fatigued.

D
         Impending respiratory failure (Westley croup score of ≥12)

Fatigue and listlessness

Marked retractions (although retractions may decrease with increased obstruction and decreased air entry)

Decreased or absent breath sounds

Depressed level of consciousness

Tachycardia out of proportion to fever

Cyanosis or pallor

E         
Treatment

Mild Croup:

1          Single dose of
dexamethasone
0.15 to 0.6 mg/kg orally or parentally to a max dose of 10mg.

2          Disposition home with the following instructions:

a          Fever management with acetaminophen 15mg/kg po every 4-6hrs as needed not to exceed 75mg/kg/day.

b          Anticipatory guidance of potential worsening and instructions on when to seek care.

c          Use of humidified air, cool mist or hot stream

d          Return for follow-up next day.

Moderate Croup

Follow mild croup guidelines

Observe patient for up to 4 hours

If improved

Disposition home following instructions for mild croup

If no improvement

a          Consult with supervising physician and prepare to administer

b         Inhaled racemic epinephrine 0.05 ml/kg per dose (maximum of 0.5 ml) of a 2.25% solution diluted with normal saline for a 3ml total volume via nebulizer.

c          If pulse oximetry is <92% provide supplemental oxygen at a rate to maintain 02 Sat < 92% d          Refer or disposition child via emergency transport to emergency department Severe croup and impending respiratory failure   a          Activate 911 and provide the following until emergency transport arrives: b          Ensure open airway c          Administer supplemental 02 to maintain 0s sat 92% d          Single dose of dexamethasone 0.15 to 0.6 mg/kg parentally. e          Inhaled racemic epinephrine 0.05 ml/kg per dose (maximum of 0.5 ml) of a 2.25% solution diluted with normal saline for a 3ml total volume via nebulizer. f           Notify supervising physician of need for emergency transport IX        Development and Approval of the Standardized Procedure This standardized procedure was developed and approved through the organization’s Interdisciplinary Committee and will be reviewed and approved every 3 years or more often as needed. Standardized Procedure Pediatrics Essay. Revision Date_____________                       Review Date______________ X         Standardized procedure was approved by the following members of the Interdisciplinary Committee. _______________________________                      Date_______________________ Pediatric Department Chair _______________________________                      Date_______________________ Supervising Physician _______________________________                      Date_______________________ Director of Nursing Practice _______________________________                      Date_______________________ Administration XI        Practitioners authorized to function under this standardized procedure: This list of Nurse Practitioners will be maintained on file in  the department in which Nurse Practitioners practice and hospital administration. References An explanation of standardized procedure requirements for nurse practitioner practice. (1998). Retrieved from http://www.rn.ca.gov/pdfs/regulations/npr-b-20.pdf Bjornson, C., & Johnson, D. (2015). Croup. Retrieved from https://online.epocrates.com/diseases/68111/Croup/Key-Highlights Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric Primary Care (5th ed.). Philadelphia, PA: Elsevier. Ferri, F. F. (2016). Ferri’s Clinical Advisor . Philadelphia, PA: Elsevier. Woods, C. R. (2015). Croup. Retrieved from https://www.uptodate.com/contents/croup-approach-to-management?source=see_link&sectionName=Respiratory+care&anchor=H91700#H1 Zoorob, R., Sidani, M., & Murray, J. (2011). Croup: An overview. Retrieved from http://www.aafp.org/afp/2011/0501/p1067.html Standardized Procedure Pediatrics Essay.

Gender in the Workplace Assignment

Week 3 Gender in the Workplace Assignment. Often times it appears that genders are equal in the workplace. While we like to think this, research will prove that is not the case. Women are still paid less and do not hold as many higher level positions. This week you will research current events to help understand and deconstruct this issue. Some examples of topics you may want to research regarding gender and:Pay Gap Academics Research Leadership Promotions Small Business Careers Technology Glass Ceiling Your Gender in the Workplace assignment for this week is to find two articles that discuss the issue of gender in the workplace. To help guide your analysis, complete the following steps: – Summarize each article, focusing on main ideas and primary examples (2-4 Paragraphs)- Discuss the relationship between the articles and key terms and ideas in social psychology (2-3 Paragraphs) – Provide recommendations with ideas on how to change the issue and utilize social psychology ideas to support your recommendation (1-2 paragraphs) – Provide APA citations for both articles and additional references.

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Gender in the Workplace

Summarize each article, focusing on main ideas and primary examples

Verniers and Vala (2018) discusses the gender discrimination that working women are subjected to. It notes that although there have been many policies to improve gender equalities in the workplace, inequality still exists particular in recruitment, salary and promotion that is skewed against the female gender. Using structural equation modelling, the authors note that discrimination against women is justified that women must balance between their family and work life thereby reducing their productivity Gender in the Workplace Assignment. The article concludes that gender inequality has been justified by motherhood myths.

Danielsson et al. (2015) applies a gender perspective in understanding workplace conflict. The study applied a multivariate analysis stratified for gender in which it was noted that noise had a greater impact on women and cause them to engage in more workplace conflict when compared to their male counterparts. The authors conclude that offices employing women should focus on reducing noise pollution to preempt the possibility of conflicts occurring.

Discuss the relationship between the articles and key terms and ideas in social psychology

Verniers and Vala (2018) and Danielsson et al. (2015) present some ideas on gender equality that are explained by social psychology theories. Firstly, social learning and symbolic interactionist theories explore the concept of socialization, showing how gendered expectation and norms interrelate Gender in the Workplace Assignment. This is seen in the biased expectations of women, particularly the assumption that women must balance between home and the workplace. In fact, these theories explain how the gender differentiated selves are sustained in the workplace. Secondly, affect control theory show how females have adopted self-sentiments that allowed them to adopt a gendered identity that is supported by differentiation whereby males are considered to be the dominant gender. Finally, identity control theory can be seen whereby gendered identity allows males to behave in a dominant manner and even ignore noise when their female counterparts are effected (McLeod, Lawler & Schwalbe, 2014). Gender in the Workplace Assignment.

Provide recommendations with ideas on how to change the issue and utilize social psychology ideas to support your recommendation

Gender equality in the workplace is best achieved by changing the prevailing mentality. Firstly, there is a need to change the biased expectations of women by showing that they can perform as well as their male counterparts. This recommendation relies on the social learning and symbolic interactionist theories. Secondly, there is a need to change the prevailing notion that males are the dominant gender. In essence, there should not be gendered identity. Rather, people should be viewed as individuals and evaluated in terms of workplace output and not in terms of gender. This recommendation relies on the affect control theory. Applying the two recommendations should go some way in reducing gender inequality in the workplace Gender in the Workplace Assignment.

References

Danielsson, C., Bodin, L., Wulff, C. & Theorell, T. (2015). The relation between office type and workplace conflict: A gender and noise perspective.
Journal of Environmental Psychology
, 42, 161-171. doi: 10.1016/j.jenvp.2015.04.004

McLeod, J., Lawler, E. & Schwalbe, M. (2014).
Handbook of the Social Psychology of Inequality: The social psychology of gender inequality
. New York, NY: Springer. Gender in the Workplace Assignment.

Verniers, C. & Vala, J. (2018). Justifying gender discrimination in the workplace: The mediating role of motherhood myths.
PLoS ONE
, 13(1), e0190657. doi: 10.1371/journal.pone.0190657 Gender in the Workplace Assignment.