Tag: Clinical-Nursing

MN568 Headaches Essay

Headaches

Headaches are classified as primary and secondary. Primary headaches include migraine, tension-type, cluster, and other such as sinus-related or hormonal. Secondary headaches are red flags for trauma, metabolic, neurological or substance withdrawal (Hainer & Matheson, 2013). Secondary headaches can be emergent because of intracranial pressure, infection, or disturbance of homeostasis (Hainer & Matheson, 2013). Sudden onset of headaches and the patient describing the headache as “the worst headache they have ever had” require immediate attention for potential life-threatening causes such as subarachnoid hemorrhage, post lumbar puncture dissection or TIA’s (Dunphy, Windland-Brown, Porter, & Thomas, 2015). MN568 Headaches Essay.

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Pathophysiology

The pathophysiology of headaches is poorly understood. Migraine headaches are believed to be caused by a neurological dysfunction with involvement of the cranial nerves (Ferri, 2018). Not every patient with migraine headaches have been found to also have a neurological dysfunction. Migraine headaches are also believed to have a genetic disposition with an instability of the nervous system; specifically, with serotonin and neurotransmitters (Diener, Holle, Solbach, & Charly, 2016). Migraine headaches are often debilitating to patients. Patients with migraine headaches can experience photophobia, nausea, vomiting and an aura.

Patients with cluster headaches are believed to have an overactive parasympathetic nervous system (Hainer & Matheson, 2013). The headache causes mild-moderate pain and pressure. Hainer and Matheson (2013) describe tension headaches as pericranial myofascial tissues as the likely cause of these headaches. MN568 Headaches Essay.

Cluster headaches are commonly rare and involve brief episodes of severe pain that is unilateral and disturbance of routine activities of daily living. The headache involves a short duration of severe pain. Dunphy et al. (2015) describe triggers of these painful headaches caused by hypersensitized ophthalmic nerve (Dunphy et al., 2015).

Episodic

Cluster headaches are episodic and short duration. MN568 Headaches Essay. The pain is severe and often does not last longer than an hour. The headaches are often misdiagnosed within one year of the first episode (Hainer & Matheson, 2013). The pain of these headaches is deep and may involve the eyes and nose. The patient may experience tearing or nasal congestion.

Acute

Acute headaches are an onset of a severe headache and can be classified as a red flag. Red flag headaches or primary headaches present related to an emergent underlying condition. This type of headaches is often described as the worst headache the patient has ever had MN568 Headaches Essay. A patient who reports this type of headache, especially in the age group of fifty and older are red flags for intracranial hemorrhage, hypertensive emergencies, or potential carotid dissections (Hainer & Matheson, 2013). Acute headaches could also be caused by meningitis, head trauma, or cancerous tumors.

 

Chronic

Chronic headaches are daily tension-type headaches or migraine headaches. The headaches can be hormonal related in nature. Common trigger of a migraine headache may include: hormones such as low estrogen, disturbance in sleep cycle, food/drink agents such as caffeine, artificial sweeteners, processed or canned foods (Dunphy et al., 2015).

Physical Assessment

The nurse practitioner can assist in the determination of an old versus new headache by questioning the patient of the duration and frequency of the headache. Hainer and Matheson (2013) describe criteria of duration and frequency of primary headaches as a migraine is a headache that last of four to seventy-two hours, a cluster headache is brief with a fifteen to one hundred eighty-minute episode that occur numerous with a period of relapse (Hainer & Matheson, 2013). The nurse practitioner should ask specific questioning of duration and frequency of the patients headache for subjective data collection MN568 Headaches Essay.

Hainer and Matheson (2013) describe subjective data that would be a red flag symptom includes: complaints of a sudden severe headache, headache triggers with exertion or cough, neurological symptoms, new onset of headache during or after pregnancy, and complaints of neck stiffness (Hainer & Matheson, 2013).

The collection of an open-ended history and focused questions will assist the nurse practitioner in determining if the headache is primary or secondary. If the headache is primary focused questions will lead diagnostics of a migraine, tension, cluster or other headache MN568 Headaches Essay. A physical assessment with concentration on the neurological system and laboratory tests are essential before a final diagnosis. The physical exam should include assessment of the neurological system and cranial nerves II-X An assessment of the patient’s head and neck in attempts to mimic the pain is important. The physical assessment should be focused to alleviate muscular and skeletal disorders.

It is important for the nurse practitioner to obtain vital subjective data from the patient and complete a thorough physical assessment to distinguish between benign and headaches that require urgent attention. MN568 Headaches Essay.

Red flags through patient data collection and physical assessment that require urgent attention include complaints of a sudden onset of a severe headache, papilledema, altered mental status, high fever, muscle rigidity, nuchal rigidity, and symptoms of a CVA, or TIA (Dunphy et al., 2015).

Evidence-Based Treatment Plan

Diagnostic testing for a definite diagnosis should include a comprehensive blood panel, with electrolytes. Consideration should be taken to check the female patient’s hormone level, thyroid levels and urinalysis to rule out infection. The patient should have a computed tomography (CT) scan with or without contrast completed to the brain to rule out any abnormalities and diagnosis of secondary headaches, or a magnetic resonance imaging (MRI).

Secondary headaches are treated mainly with over-the-counter analgesics. Evidence-based treatment for non-responsive conservative and over-the-counter treatment supports six classifications of medications: beta blockers, antidepressants, calcium channel blockers, antiepileptic, anticonvulsants, and nonsteroidal anti-inflammatory medications (Ferri, 2018). MN568 Headaches Essay.

 

Patient Education

           
Management of headaches is patient-centered. Headaches can be managed with drug therapy. Patient education should include the proper use of the drug therapy and over-the-counter analgesics. Patients should be encouraged to participate in stress relieving activities such as meditation or physical activity that does not aggravate a headache. Complementary therapy such as acupuncture, herbal therapy, and plenty of sleep should be encouraged by the nurse practitioner (Dunphy et al., 2015). MN568 Headaches Essay. The nurse practitioner should encourage the patient to drink plenty of fluids, and to eat a healthy diet rich in vitamin C foods.

Discussion

Headache management should always be closely monitored and follow-up from the nurse practitioner is essential. Treatment plans should be closely monitored for the effectiveness of drug therapy, and potential referral to a specialist for the management of the headaches. MN568 Headaches Essay.

 

References

Diener, H. C., Holle, D., Solbach, K., & Charly, G. (2016). Medication-overuse headache: risk

factors, pathophysiology, and management.
Nature Reviews: Neurology, 12
(10), 575-

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O. & Thomas, D. J. (2015)
Primary Care: The

Art and Science of Advanced Practice Nursing
. Philadelphia, PA: F. A. Davis Company.

Ferri, F. (2018).
Ferri’s Clinical Advisor 2018: 5 books in
1. Philadelphia, PA:  Elsevier.

Hanier, B. L., & Matheson, E. M. (2013). Approach to Acute Headaches in Adults.
American

Family Physician, 15
(87), 682-687. MN568 Headaches Essay.

MN566 NP I Scope of Practice Essay Example Scope of Practice

MN566 NP I – Introduction to Primary Care for the Nurse Practitioner

Scope of Practice

The Advanced Practice Registered Nurse (APRN) Consensus Model standardizes each aspect of the regulatory process for advanced practice registered nurses. MN566 NP I Scope of Practice Essay Example By doing this it increases the state to state mobility for practicing APRNs, the ability to provide needed care will be increased nationwide (Brassard, 2014).  The American Nurses Association has pushed this initiative in order to advance the scope of practice and change licensure laws to ensure unrestricted practice authority for advanced practice registered nurses across the United States.

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At this present time only twenty-three states and the District of Columbia have granted full practice authority to advanced practice registered nurses. Granting full practice authority to advanced practice registered nurses would “promote safety and contribute to the protection of the public and provision of quality care” (Burke, Richardson & Smith, 2017).  Holtschneider (2016) pointed out that practitioners are educators, mentors, leaders, researchers, and advocates. MN566 NP I Scope of Practice Essay Example.

How My Practice is Affected

In order to provide quality, cost effective care to patients, advanced practice registered nurses must be able to practice to the full extent of their education and skills set in every state across the nation (American Nurses Association, n.d.).  Unfortunately, in my home state of Texas, we are forced to work under restrictions as outlined in Tex. Admin. Code §22-11-221.13 (Texas Scope, 2018).  Texas’ state practice and licensure laws require advanced practice nurses to work under the supervision on a physician for the entirety of their careers (AANP, 2018).  This restrictive environment is due in great part to the funding by physician’s groups who are intent on maintaining a physician controlled medical environment MN566 NP I Scope of Practice Essay Example.

Granting full practice authority would change the entire dynamic of health care in the state of Texas and prevent qualified advanced practice registered nurses from pursue careers in other states.   My career will be greatly hampered by these unjust restrictions.  Not only will I be forced to work under physician doing the same work, but I will be forced to accept a significantly lower reimbursement from insurances.

Unless our state legislators wake up and realize that they must remove the restrictions to our practice authority I plan on relocating to another state.  This would be one of the most difficult decisions that I have ever been forced to make in my life.  It would mean leaving all my family and friends. MN566 NP I Scope of Practice Essay Example.

What My Future Holds.

It was not until I began working towards my master’s degree that I learned about practice restrictions and how it would hamper my future clinical practice.  This knowledge has motivated me to become involved in the legislative process to help promote change.  In order to do that we must make it a priority to become fully informed about legislative candidates at all levels of government and their position on licensure restrictions (Newland, 2016).

Soon my career will lead me to another state unless Texas removes the practice restrictions on advanced nurse practitioners.  Regardless of where my path leads, I will be an active participant in the legislative process to help ensure changes that benefit our profession are made.  Without nurses in numbers fighting for our rights, changes will not come. MN566 NP I Scope of Practice Essay Example.

Conclusion

In a country where the primary care physician shortage is becoming increasingly worse each year, to restrict the practice authority of advanced practice registered nurses is detrimental the wellbeing of the nation.  Utilizing APRNs with unrestricted practice authority as primary care health care providers would ensure that more people would have access to affordable, quality care MN566 NP I Scope of Practice Essay Example.  According to Rudner Lugo (2016), nurses will have to work together utilizing grass-root efforts to gain political support from legislators to change the licensure restrictions for APRNs.  If these restrictions are not lifted, the exodus of APRNs to unrestricted states will continue.

References

AANP. (2018). State Practice Environment. Retrieved from
https://www.aanp.org/advocacy/state/state-practice-environment

American Nurses Association. (n.d.). Nursing Scope of Practice. Retrieved from
https://www.nursingworld.org/practice-policy/scope-of-practice/

Brassard, A. (2014). Overview and Summary: APRN Roles: Opportunities and Challenges for Practice and Education. Online Journal of Issues in Nursing, 19(2), 10.
https://doi.org/10.3912/OJIN.Vol19No02ManOS

Burke, K. G., Richardson, C., & Smith, B. A. (2017). Implementing Nursing Professional Development. Journal for Nurses in Professional Development, 33(5), 269-271. doi:10.1097/nnd.0000000000000375

Holtschneider, M. E. (2016). Implementing the Nursing Professional Development Practitioner Scope and Standards of Practice 2016 Revisions. Journal for Nurses in Professional Development, 32(5), 269–270.
https://doi.org/10.1097/NND.0000000000000285

Newland, J. (2016). Editor’s Memo. The 28th Annual APRN Legislative Update beyond the 50 states. Nurse Practitioner, 41(1), 8. doi:10.1097/01.npr.0000475960.38934.73

Rudner Lugo, N. (2016). Full Practice Authority for Advanced Practice Registered Nurses is a Gender Issue. OJIN, 21(2). doi:10.3912/OJIN.Vol21No02PPT54

Texas Scope of Practice Policy – State Profile. (2018). Retrieved from
http://scopeofpracticepolicy.org/states/tx/#

MN566 NP I Scope of Practice Essay Example

Disorders of Renal Function MN551 Case Study.

MN551: Advanced Physiology and Pathophysiology Across the Life Span

Case Study 5: Disorders of Renal Function

Case study number five is focused on a forty-four-year-old man named Fred.  Fred stays healthy and fit by working outside.  After working outside one particularly warm summer day, he returned home only to begin experiencing lower back discomfort and unexplained nausea later that evening.  Having lost his appetite due to the nausea and unable to enjoy the dinner that his wife had prepared, he decided to go to bed early.

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Later that night his symptoms worsened.  He began complaining of excruciating stomach, back and groin pain.  The pain would come in waves that would be followed by diaphoresis and vomiting.  Once his pain eased, his wife rushed him to the hospital to be evaluated. Disorders of Renal Function MN551 Case Study.

After being evaluated and having abdominal scans, emergency room physicians diagnosed him with renal calculi in the right ureter or right urolithiasis.  With a diagnosis the hospital physicians and staff can work with Fred and his wife on a plan of care and begin treatment.  Based on medical literature it is critical that renal disorders are properly diagnosed and treated to prevent further renal injury.

Mechanism of Stone Formation in the Kidney.

There are four different types of kidney stones: calcium, uric acid, struvite, and cystine.  The precise mechanism of forming kidney stones or urolithiasis is not completely understood despite significant research (Evan, Worcester, Coe, Williams & Lingeman, 2015).  Research has shown that a nidus is required along with a urinary environment conducive to the crystallization of components found in kidney stones (Grossman & Porth, 2014).

It has been hypothesized that the kidneys become supersaturated with crystalline liquid structures that they cannot break down.   These crystalline liquid structures begin to precipitate together rapidly to form solid particles. The solid particles begin binding together and arrange into a crystal pattern in a process known as crystal nucleation (Jena, Panigrahi & Dey, 2016).  Varying in size and shape, the crystals adhere to the renal tubular epithelial cells (Chaiyarit & Thongboonkerd, 2017).  Disorders of Renal Function MN551 Case Study  Then the crystals begin to form an adhesive agglomeration within the renal tubules.  It is at this point that the kidney stone causes a restriction or blockage of the renal tubules.

Role of Citrate in the Kidneys.

Citrate is a tricarboxylic acid that is a natural byproduct of the citric acid cycle in renal cells (Grossman & Porth, 2014).  Citrate makes the renal environment unfavorable to stone formation by reducing the supersaturation and increasing the pH of urine (Kaygisiz, 2017).  This effectively inhibits the crystallization of calcium salts thus reducing to probability of forming calcium oxalate stones.

Studies have noted that individuals with a lower urinary citrate excretion or hypocitraturia have higher incidences of kidney stone formation (Coe, Worcester & Evan, 2016).  It has also been shown that citrate therapy inhibits the growth and reduces the reoccurrence of new stone formation in the kidneys (Phillips, Hanchanale, Myatt, Somani, Nabi & Biyani, 2015).  The most effective way to prevent the formation of kidney stones is to maintain the acid-base balance within the bladder. Disorders of Renal Function MN551 Case Study.

Calcium Supplements and Calcium Oxalate Stones.

According to Grossman and Porth (2014), seventy-five to eighty percent of kidney stones are calcium stones.   A differential diagnosis of hypercalciuria is a common indicator of calcium kidney stones.  Patients who have an excessive amount of calcium excreted through the urine may also have a supersaturation of urinary calcium salts (Sorensen, 2014).

Patients are completely dependent on their dietary intake for the absorption of calcium.  If their intake is too low, then there can be in increase of urinary oxalate.  Calcium supplementation helps to bind oxalate in the intestine and effectively reduce its absorption (Grossman & Porth, 2014). Disorders of Renal Function MN551 Case Study.

Hydronephrosis.

Swelling in one or both kidneys resulting from a buildup of urine is hydronephrosis.  This condition can lead to kidney damage and/or failure if not treated.  The amount of damage depends on duration, severity and location of the obstruction (Grossman & Porth, 2014).

One cause for this condition is an obstruction in the ureters preventing the outflow of urine to the bladder.  A second cause of this condition occurs when urine in the bladder refluxes into the kidney causing an enlargement of the renal pelvis (Hydronephrosis, 2017).  Both causes result in renal injury but diagnosed and treated early can reverse the damage.

Relating to this case study the probable location of the kidney stone related blockage would be the ureteropelvic junction.  Fred exhibited symptoms consistent with hydronephrosis which included complaints of pain in his back, abdomen and groin.  He also was suffering from nausea and vomiting. Disorders of Renal Function MN551 Case Study.

Back Pressure in the Kidneys.

For this paper the focus of case study number five is on an obstruction caused by a kidney stone.  Back pressure occurs in the kidneys because of hydronephrosis caused by an obstruction, or reflux.  This condition causes a back or buildup of pressure in the kidneys.  If the condition persists, the kidneys will begin to suffer damage or nephropathy.

Progressive atrophy and damage of the kidney is caused by the dilation of the renal pelvis and calices which occurs because of the continued glomerular filtration.  The back pressure continues to build because of this ongoing filtration and the kidney’s inability to release the urine due to the blockage.  Renal vasculature becomes compressed when the increased pressure in the renal pelvis is forced back through the kidney’s collecting ducts (Grossman & Porth, 2014).

This back pressure causes a restriction in blood flow to the kidneys causing ischemic damage and intrarenal pelvic pressure which combined result in mechanical damage to the nephrons.  This causes the progressive destruction of nephrons.  Disorders of Renal Function MN551 Case Study. Remaining nephrons work to compensate by increasing their function until the assault is halted or the remaining nephrons are destroyed.  According to Grossman and Porth (2014, pg. 1089), “in advanced cases the kidneys can become thin walled cystic structures with parenchymal atrophy, total obliteration of the pyramids and thinning of the cortex.”

Conclusion.

In case study number five, it is clear through medical literature and research that time is of the essence when diagnosing and treating with renal disorders.  In this case study, Fred had worked outside in the heat all day.  His early symptoms could have easily been mistaken for exhaustion, pulling a back muscle or dehydration.

Patients who delay seeking help are at greater risk for renal injury that could result in permanent damage and renal failure.  One specific condition that can devastate a patient’s renal health if left untreated is hydronephrosis.  The damage from this condition can destroy the kidney’s nephrons and lead to renal failure. Disorders of Renal Function MN551 Case Study.

Despite the abundance of research into the formation of renal stone formation, there is still more to be learned.  Health care providers should educate patients about the causes, signs and symptoms of kidney stones.  As evidenced by medical literature, it is clear that early diagnosis and treatment can potentially slow, stop and reverse renal injury.

References

Chaiyarit, S., & Thongboonkerd, V. (2017). Defining and Systematic Analyses of Aggregation Indices to Evaluate Degree of Calcium Oxalate Crystal Aggregation.
Frontiers in Chemistry, 5
, 113. http://doi.org/10.3389/fchem.2017.00113

Coe, F. L., Worcester, E. M., & Evan, A. P. (2016). Idiopathic hypercalciuria and formation of calcium renal stones.
Nature Reviews Nephrology, 12
(9), 519-533. doi:10.1038/nrneph.2016.101

Evan, A. P., Worcester, E. M., Coe, F. L., Williams, J., & Lingeman, J. E. (2015). Mechanisms of Human Kidney Stone Formation.
Urolithiasis, 43
(0 1), 19–32.
http://doi.org/10.1007/s00240-014-0701-0

Grossman, S. C., & Porth, C. (2014).
Porth’s pathophysiology: Concepts of altered health states
(9th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Hydronephrosis. (2017, February 03). Retrieved from
https://www.kidney.org/atoz/content/hydronephrosis

Jena, S. C., Panigrahi, P. N., & Dey, S. (2016). Urolithiasis: Critical Analysis of Mechanism of Renal Stone Formation and Use of Medicinal Plants as Antiurolithiatic Agents.
Asian Journal of Animal and Veterinary Advances, 11
(1), 9-16. doi:10.3923/ajava.2016.9.16 Disorders of Renal Function MN551 Case Study

Kaygısız, O. (2017). Metaphylaxis in Pediatric Urinary Stone Disease.
Updates and Advances in Nephrolithiasis – Pathophysiology, Genetics, and Treatment Modalities
. doi:10.5772/intechopen.69982

Phillips, R., Hanchanale, V. S., Myatt, A., Somani, B., Nabi, G., & Biyani, C. S. (2015). Citrate salts for preventing and treating calcium containing kidney stones in adults.
Cochrane Database of Systematic Reviews
. doi:10.1002/14651858.cd010057.pub2

Sorensen, M. D. (2014). Calcium intake and urinary stone disease.
Translational Andrology and Urology, 3
(3), 235–240.
http://doi.org/10.3978/j.issn.2223-4683.2014.06.05

Last Name, F. M. (Year). Article Title.
Journal Title
, Pages From – To.

Last Name, F. M. (Year).
Book Title.
City Name: Publisher Name. Disorders of Renal Function MN551 Case Study

MN566 Introduction to Primary Care Midterm Quiz

Unit 5

Your quiz has been submitted successfully.

Subsection

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Question 1

1 / 1 point

Which of the following would be considered the research design for Level IV evidence?

Question options:

Single descriptive or qualitative study

Opinion of authorities and expert committees

Systematic review of randomized clinical trial studies

Well-designed case Control or Cohort Study Level

Question 2

MN566 Introduction to Primary Care Midterm Quiz

1 / 1 point

It is always important to consider the pathological process that could be causing the patients problems. Choose all that should be considered when creating your differential list using a mnemonic..

Question options:

Inflammatory

Neoplastic

toxic or metabolic

infectious

congenital

traumatic

Question 3

0 / 1 point

Choose all that should be considered when ordering a diagnostic test.

Question options:

patients request for test to be done

cost

sensitivity and specificity of the test

convenience of test

Will the outcome of the test change your plan of care

diagnosis by exclusion

Question 4

MN566 Introduction to Primary Care Midterm Quiz

1 / 1 point

Which of the following would be considered the research design for Level I evidence?

Question options:

Single, well-designed randomized clinical trial

Systematic review of randomized clinical trial studies

Well-designed controlled trials without randomization

Systematic reviews of descriptive or qualitative studies

Question 5

1 / 1 point

The Goals of Diagnostic Reasoning is to:(choose all that apply)

Question options:

Solve a problem

establish a relationship with your patient

screen for disease and illness

promote healthy lifestyles

support research

Question 6

1 / 1 point

Using mnemonics for gathering a health history can be helpful when trying to analyse the symptoms presented and create a differential list.Which mnemonic will give you the most comprehensive approach to collecting your history?

Question options:

OLDCARS

COLDSPA

MEDLIST

OLDCARTS

Question 7

1 / 1 point

A 37 year old man that was diagnosed with cluster headaches and takes high doses of aspirin.

Indicate the appropriate course of action :

Question options:

head CT

head MRI C.

neither for the following patient.

All of the above

Question 8

1 / 1 point

Generalized patterns of nursing care are represented in The Circle of Caring Model as:(choose all that apply)

Question options:

self care

Patience

listening

courage

Authentic presence

advocacy

knowing

commitment

Question 9

1 / 1 point

Choose all the following that are essential in developing clinical practice guidelines:

Question options:

Identification of A topic

Enlist and expert panal

Review of literature ‘D. Rate evidence

Draft a proposal

External review of draft

Revised draft based on recommendations

Question 10

1 / 1 point

Applying evidence at the point of care requires:

Question options: MN566 Introduction to Primary Care Midterm Quiz

Readily available evidence-based resources

Ability to review research literature

Single articles in journals

Current textbooks

Question 11

0 / 1 point

Identify the choice that best completes the statement or answers the question.

Which of the following are parts of evidence-based practice?

Question options:

Clinician

Patient

Evidence

All of the above

Question 12

0 / 1 point

Different kinds of thinking and learning also include the Affective Domain. This model described by Krathwohl (1964), is :

Question options:

Complex to include conceptual knowledge

A metacognitive model

Based on an organized hierarchy

Based on an individual’s commitment to living and valuing

Question 13

1 / 1 point

When evaluating a patient with a an acute headache all of the following observations would indicate the absence of a more serious underlying condition except:

Question options:

Onset of headache with exertion, coughing or sneezing

History of previous headaches

Supple neck

normal neurological examination result.

Question 14

1 / 1 point

What are the questions you should ask yourself before using clinical guidelines in your practice? All are correct except (mark the ones that apply)

Question options:

How strong are the recommendations

Are the guidelines applicable to my patients

Can I get reimbursed for using these guidelines

Are the guidelines clinically important

Are these guidelines from a reliable source

How old are these guidelines

Question 15

1 / 1 point

The Circle of Caring Model is a new and more contemporary approach to medicine. Choose the characteristics that best describe this model of care in the primary care setting. MN566 Introduction to Primary Care Midterm Quiz.

Question options:

AIl includes both traditional nursing as well as traditional medical practice

It is a transformative model

It considers both assessment and patient outcomes

It is a patient centered model

All of the Above

Question 16

1 / 1 point

Which of the following would be considered the research design for Level V evidence?

Question options:

Systematic review of randomized clinical trial studies

Well-designed controlled trials without randomization

Systematic reviews of descriptive or qualitative studies

Single descriptive or qualitative study

Question 17

1 / 1 point

Understanding other factors that can be causing the patients problems include:. Choose all that should be considered

Question options:

Demographics

Age

Gender

weight

medications

education

Question 18

1 / 1 point

MN566 Introduction to Primary Care Midterm Quiz

The Circle of Caring Model has grown out of and is rooted in the assumption that caring is the central concept in nursing and is uniquely known and expressed in nursing.

Question options:

True

False

Question 19

1 / 1 point

Bloom’s (1956) taxonomies of learning includes all of the following except:

Question options:

the cognitive domain

the communication and leadership domain

the affective domain

psychomotor domain

Question 20

1 / 1 point

Diagnostic test should be the deciding factor when making your final diagnosis.

MN566 Introduction to Primary Care Midterm Quiz Question options:

True

False

Question 21

1 / 1 point

Practice Standards are designed to be flexible and can be tailored to be used in any medical arena.

Question options:

True

False

Question 22

1 / 1 point

Indicators that a headache can be the presenting symptom of a serious illness and may require neuroimaging include all the following except:

Question options:

Headaches that occur periodically in clusters

Increase frequency and severity of headaches

Headaches causing confusion, dizziness and or lack of coordination.

Headaches causing you to wake at night.

Question 23

1 / 1 point

Practice guidelines are designed to:

Question options:

Be inflexible

Be utilized in every circumstance

Provide a reference point for decision making

Be created by a professional organization to guide the practice of a profession

Question 24

1 / 1 point

Nursing research should be utilized by:

MN566 Introduction to Primary Care Midterm Quiz Question options:

Nurses at the bedside

Advanced practice nurses

Nurse researchers

Nurses at all levels of practice

Question 25

1 / 1 point

Clinicians who use clinical guidelines are responsible for reviewing their usefulness in their practice.

Question options:

True

False

Attempt Score:

22 / 25 – 88 %

Overall Grade
 (highest attempt)
:

22 / 25 – 88 %

 

Done

MN566 Introduction to Primary Care Midterm Quiz

MN566 – Intro to NP- Unit 1 Discussion

 

Discuss the differences between a Primary Care Nurse Practitioner and an Acute Care Nurse Practitioner and their scope of practice. Why is this important to know as you move from being a nurse into your new role as an NP?

The American Nurses Association (ANA) describes a scope of practice for nurse practitioners as guidelines for who, what, when, where, why and how (American Nurses Association, 2018). The scope of practice for Nurse Practitioner’s varies based on state legislation. MN566 – Intro to NP- Unit 1 Discussion. States scope of practice are defined as physician relationship required, transition to independent practice required, and full practice authority (Scope of Practice Policy, 2018). The state of Florida scope of practice for nurse practitioners is a physician relationship required.

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The Acute Care Nurse Practitioner (ACNP) is an advanced level nurse who has completed five hundred supervised clinical hours in an acute care setting. Many master level programs offer the nurse a dual adult-gerontology acute care nurse practitioner (AG-ACNP). The ACNP specializes in the care of patients with acute and chronic illness. These settings include: intensive care, emergency rooms, nursing homes, urgent care, and private physician settings. The ACNP performs pharmacological and non-pharmacological treatments. The ACNP focuses on the assessment and diagnosis of chronic, and acute conditions MN566 – Intro to NP- Unit 1 Discussion. The ACNP manages comorbid conditions across lifespan with epidemiological, cultural, genetic considerations (Kilpatrick, 2012). The ACNP develops a treatment plan in collaboration with the patient.

The Primary Nurse Practitioner (PNP) is an advanced level nurse whose focus is on primary care. The PNP has completed supervised clinical hours across life spans such as: geriatrics, pediatrics, primary care, and women’s health. The PNP completes an advanced assessment for treatment and diagnosis of patients with chronic illness and manages comorbid conditions (American Association of Nurse Practitioners, 2018). The PNP performs pharmacological and non-pharmacological treatments. MN566 – Intro to NP- Unit 1 Discussion.

The demand of specialty and primary nurse practitioners continues to rise. As a nurse transitioning into an advanced level nurse it is important to understand state specific legislation for scope of practice. The scope of practice is significant to the advanced level nurse’s board certification, and safety for patients.

References

American Nurses Association. (2018). Scope and Standards of Practice. Retrieved from

http://www.nursingworld.org/scopeandstandardsofpractice

American Association of Nurse Practitioners. (2018). All About an NP. Retrieved from

https://www.aanp.org/all-about-nps

Kilpatrick, K. (2012). Understanding acute care nurse practitioner communication and decision-

making in healthcare teams. Journal of Clinical Nursing, 22(2), 168-171. doi: 10.1111/

j.1365—2701.2012.04119.x MN566 – Intro to NP- Unit 1 Discussion

Scope of Practice Policy. (2018). Nurse Practitioner Overview. Retrieved from

http://scopeofpracticepolicy.org/practitioners/nurse-practitioners/

MN566 – Intro to NP- Unit 1 Discussion

Based on ”Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:

What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?

Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?

How does the theory determine or influence each of their recommendations for action?

What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Remember to support your responses with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.

The Question of Moral Status: A Case of Fetal Abnormality and the Dilemma of Abortion versus Religious Beliefs

Introduction

Moral status is the employment of ethical principles in the consideration of the importance of living things and their value, in as far as life is concerned (Gray, 2019). In an examination of the theories of moral status, some theorists clearly believe that life is equal regardless of the living thing under consideration, while others believe it is not. These theories have placed some sort of hierarchy or levels of consideration for moral standing. For example, Tauer (2001) quotes Warren in her1997 book
Moral Status
as considering all living things to be having the same moral standing (status). This is from human beings with complete full moral status (FMS) to the least significant single-celled organisms. This paper examines in this context the matter of a deformed fetus that is also likely to have cognitive deficiencies if carried to term.

The Christian View

The Christian view of the nature of human persons is that human beings right from conception are entitled to full moral status just by virtue of being a human being, all other considerations (like cognition status) notwithstanding (Gray, 2019; Studocu.com, n.d.). This view is compatible with the theory of moral status that is based on human properties (Studocu.com, n.d.). This is the religious or philosophical theory (Gray, 2019). The theory states that it is only human beings that possess moral status among all the other living things. All the others, including plants and animals, were created to serve the interests of the human being. It goes on to elaborate that the human person acquires this full moral status the moment that they are conceived in the womb. Thus according to this Christian and philosophical theory based on human properties, the status of a fetus and that of a grown complete human person with all cognitive functions intact is the same in as far as full moral status is concerned (Gray, 2019; Studocu.com, n.d.). This is related to the intrinsic human value and dignity in that the only characteristic for FMS is the fact of becoming a human being (at conception). What this implies is that this quality is innate or intrinsic, and human beings are conceived with it. In other words, human life is sacred right from conception.

The Theories Exhibited by Jessica, Marco, Maria, and Dr. Wilson in the Case Study

This case study involves a fetus that will not only be born with a deformity (lack of limbs), but also a 1 in 4 probability of having Down syndrome. This means that there is a high likelihood that the child will also be mentally challenged with cognitive (learning and thinking) deficiencies. From the case scenario, therefore, Jessica and Aunt Maria clearly subscribe to the religious/ philosophical theory of moral status based on human properties. As such, to them a human being possesses full moral status right from conception, regardless of their physical and mental deficiencies (Gray, 2019; Studocu.com, n.d.). Despite being concious of the reality of her precarious socio-economic status into which a mentally and physically challenged infant would impose further strain, Jessica still believes that “all life is sacred.” She therefore does not agree with Dr. Wilson’s view that aborting the baby is the best option. As for Aunt Maria, she is clearly religious and would not entertain any thought of terminating any life, whether already born or intra-uterine. She is clearly of the same theory as Jessica, which says that based on (intrinsic) human properties (of full moral status) all human life from conception is sacred. She characteristically therefore advises Jessica, despite the overwhelming medical evidence, to carry the pregnancy to term and play her role “as a mother.” Dr. Wilson on his part clearly subscribes to the moral status theory based on cognitive properties (Studocu.com, n.d.). Other authorities refer to this theory as the Kantian theory of moral status after Emmanuel Kant (Gray, 2019).  This particular theory of moral status holds that a living thing (human being) is only entitled to full moral status if they possess and can demonstrate “awareness, memory, understanding, and thinking.” This is capacity for cognition. Clearly, this being still a fetus it does not satisfy this criterion and hence it does not possess any moral status. But most importantly, the Kantian theory avers that this is essentially an “all-or-nothing position” (Gray, 2019). That is one either has cognitive ability or not, for possession of moral status. This fetus, from the medical tests, will certainly likely not have this cognitive capacity even if it s let to be born and grow (because of the possibility of Down syndrome). Dr. Wilson additionally belongs to the school of thought of the moral status theory based on relationships. He has a doctor-patient obligation which in this case does not confer moral status to Jessica’s unborn child (Studocu.com, n.d.). Finally, Marco – although apparently ambivalent – belongs also to the moral status theory of Kant that is based on cognitive properties. He “find[s] it difficult [that] the pregnancy and the … disabled child [will be] a burden and a barrier to their economic security and plans.” As such the fetus has no moral status because of the physical and possible cognitive disability.

My Position

I take the view that moral status in this case should be decided solely based on the theory of Kant or cognitive properties. The fetus either has cognitive potential (now) or cognitive ability (later) or not. This is what will confer moral status on it. I take this position as it will be in the best interest of the child to be aborted as a fetus rather than being born only to suffer the rest of their life. In fact, the moral status theory of sentience is in support of this (pain and suffering should not be caused to a living thing) (Studocu.com, n.d.). As the case study presents, however, the fetus has a significant likelihood of being born with Down syndrome-induced cognitive deficiency which they’ll carry for life. My theory position will thus influence recommendation for action in that letting the fetus live will be tantamount to condemning it to a lifetime of misery and suffering because of its physical and cognitive deficiencies.

 

References

Gray, K. (2019). Moral status: Definition, philosophy, and criteria. Retrieved from
https://study.com/academy/lesson/moral-status-definition-philosophy-criteria.html

Studocu.com (n.d.). Theories of moral status. Retrieved from
https://www.studocu.com/en/document/oakland-university/biomedicine-and-disease/lecture-notes/theories-of-moral-status/1044276/view

Tauer, C.A. (2001). Review: The types of moral status.
The Hastings Centre Report
, 31(1), p. 45. Doi: 10.2307/3528734

DN713: Epidemiology and Social Determinants of Population Health

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This course focuses on comprehending, synthesizing, and applying emerging scientific knowledge specific to clinical prevention and population health. You will synthesize trends among epidemiologic, biostatistical, and environmental data to derive solutions to tenacious or new health care problems based on existing health data sets and the scientific literature. Social determinants of health in the processes of conducting risk assessment, intervention development and implementation, health care delivery planning, and evaluation will be considered. Models of clinical prevention and population health care delivery will be evaluated. This course requires 20 supervised practice hours focused on population health. DN713: Epidemiology and Social Determinants of Population Health

Quarter Credit Hours: 5 | Prerequisite: None | Corequisite:
 DN703

Worldview Analysis and Personal Inventory essay example

Based on the required topic study materials, write a reflection about worldview and respond to following:

In 250-300 words, explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care.

In 250-300 words, explain what scientism is and describe two of the main arguments against it.

In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview: (a) What is ultimate reality? (b) What is the nature of the universe? (c) What is a human being? (d) What is knowledge? (e) What is your basis of ethics? (f) What is the purpose of your existence?

Remember to support your reflection with the topic study materials. Worldview Analysis and Personal Inventory essay example.

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While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Worldview Analysis and Personal Inventory essay example.

Worldview analysis and personal inventory

Part 1.

Christians view spirituality as the prism of religion and theology in which an all-powerful God exists that has control over everything. In fact, the spirituality is a reflection of the Christian quest for purpose, meaning and truth in life, seeking to introduce a transcendental perspective to the human experience. This implies that spirituality serves both a symbolic and theological function. In addition, Christians view ethics as conformity with the dictates of spirituality especially when there is no ambiguity over expectations. The Christian perspective of spirituality and ethics has implications for health care through evaluating it as practiced ethics since it seeks to lessen human suffering from disease with restoring and augmenting wellbeing (Igboin, 2015). Worldview Analysis and Personal Inventory essay example.

Postmodern relativism is based on the notion that there is no absolute truth. It acknowledges that although there are those who subscribe to spirituality and believe that human life has transcendental implications, it would be wrong to disparage the belief that human life does not have transcendental implications. In essence, postmodern relativism accepts that all contrasting ideas are equally valid and should not be discarded simply because they are contradictory. Concerning ethics, postmodern relativism considers it as a truth that changes based on the circumstances. That is because what is unethical for one group will similarly be unethical for another group. This has implication for health care since it forces medical personnel to be more cognizant of what the patients want. For instance, medical personnel could consider assisted suicide as ethically right, particularly in palliative care, while a group of patients could consider it as unethical (Zavada, 2019). Worldview Analysis and Personal Inventory essay example.

Part 2.

Scientism is the view that hard sciences that can provide factual and testable data that can be replicated (such as astronomy, physics, biology and chemistry) are the only source of genuine and true knowledge about reality. In fact, it notes that although soft sciences offers some knowledge about reality, only hard sciences can offer superior knowledge. That is because hard science is based on falsification, experimentation and skepticism in the search for basic explanatory principles about world reality. In addition, soft sciences (such as religion, ethics and philosophy) are only partially acceptable on the basis of their inherent subjective nature and are considered as private issues of personal opinion. This implies that any claims that accept knowledge from soft sciences as factual scientific truth is an indication of intolerance and bigotry. Overall, scientism advances the notion that only hard sciences have the intellectual authority to provide real knowledge (Moreland, 2018).

Although scientism appears valid, there are two arguments that invalidate the notion. Firstly, any reality presented by hard science is simply a propositional truth that is provisional and is likely to change as scientific approaches become more advanced. To be more precise, hard sciences apply methodological approaches that only offers a perspective of reality, and is not a catalog of irrefutable facts or inflexible principles. Similar to the way hard sciences is disputable, is the same way in which soft science is disputable and adapts to newly presented evidence. Secondly, scientism is tyrannical since it promotes a dangerous brand of bloodless rationalism that disregards soft science although they are important for hard science. For instance, it disregards noble human endeavors such as literature, painting and music that are thought provoking through willfully denying or ignoring conclusions from hard sciences (Briggs, 2019).

Part 3.

(a) What is ultimate reality?

The ultimate reality is that humans are the product of interactions with the environment to include the neighborhood, education, parents, government, media, and so on. Through interaction with the environment, every individual is subtly influenced and shaped to comprehend how and why they exist. For instance, it is not surprising for an individual to ascribe to the religion that his or her parents ascribe to. Overall, the ultimate reality is only limited by experience and reason, which can influence the capacity to adequately understand and truly grasp the nature of human existence. Worldview Analysis and Personal Inventory essay example.

(b) What is the nature of the universe?

The universe is a static existence that is subject to constant change through the process of evolution, competition, and energy conversion. Firstly, the universe experiences evolution through adaptability and selection where only the most suitable biological entities that can outcompete other biological entities are able to survive even as they acquire the limited available resources. Secondly, competition is an inherent occurrence that determines who gets the best or worst resources. Finally, the universe is reliant on energy conversion in a well-structured system with the sun being the main source of energy that powers all other activities to include life and gravitational rotation of the earth.

(c) What is a human being?

A human being is a biological entity characterized through biological speciation and the capacity for higher thinking. Firstly, they are characterized through biological speciation with every human being identified as
Homo sapiens
. The speciation is validated by DNA profile similarities that indicated biological capacity to reproduce. Secondly, they have a capacity for higher thinking that allows them to adapt the environment to their needs through developing better food, clothing and machines as well as controlling all other animals. Worldview Analysis and Personal Inventory essay example.

(d) What is knowledge?

Knowledge refers to the set of skills, information and facts that are acquired through experience (practical) and education (theoretical that can be from formal or informal processes). Through acquiring knowledge, individuals gain an awareness and familiarity with different situations. In fact, it consists of recognizing differential awareness whose limitations are defined through awareness. Worldview Analysis and Personal Inventory essay example. For instance, all nurses have knowledge of nursing concepts, but the depth of knowledge will differ based on experience and level of education that determine awareness limitations of the different nursing concepts.

(e) What is your basis of ethics?

There are two basis of ethics. The first basis of ethics is the personal perspective that is reliant on what I consider right and wrong based on my beliefs through interacting with the environment, such as what my religion, culture, community, and family believe in Worldview Analysis and Personal Inventory essay example. The second basis of ethics is the public perspective that is based on public beliefs expressed through principles such as confidentiality principles that protect personal information. The personal and public perspectives all determine how I approach ethics with the public perspective taking precedence when the two perspectives are in conflict.

(f) What is the purpose of your existence?

The purpose of my existence is to live to my full potential, improve the world, and leave this world not worse than I found it so that my future generations are not placed at a disadvantage. I can live to my full potential through acquiring competent professional skills and applying this skills in earning a living. I can improve the world by having an analytical mind that notices the problems around me and proposing solutions to these problems. I can leave the world not worse that I found it through being cognizant of the impact of all my actions on eth environment and ensuring that I do not contribute to environmental degradation. Worldview Analysis and Personal Inventory essay example.

References

Briggs, W. (2019).
In opposition to scientism
. Retrieved from https://wmbriggs.com/post/26885/

Igboin, B. (2015). Spirituality and medical practice: a Christian perspective.
Indian Journal of Medical Ethics
, 12(4). doi: 10.20529/IJME.2015.054. Retrieved from http://ijme.in/articles/spirituality-and-medical-practice-a-christian-perspective/?galley=html

Moreland, J. (2018).
What is scientism?
Retrieved from https://www.crossway.org/articles/what-is-scientism/

Zavada, J. (2019).
Postmodernism definition
. Retrieved from https://www.learnreligions.com/what-is-postmodernism-700692 Worldview Analysis and Personal Inventory essay example

DN703: Scientific Foundations for Practice Doctorate

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In this course, you will examine the evolution of nursing science and the emergence of the DNP degree based on the utilization of evidence to influence the health of populations. You will be introduced to advanced levels of systems thinking with a focus on designing programs to improve patient, population, and health system outcomes based on levels of evidence available. You will appraise new practice approaches based on theories from nursing and other disciplines. During this course, you will analyze a health care problem or relevant clinical inquiry for the DNP project and identify the population focus for the DNP project. This course requires 50 supervised practice hours, which may be applied to the doctoral project. DN703: Scientific Foundations for Practice Doctorate

Quarter Credit Hours: 5 | Prerequisite: None

Prepare this Research Critiques and PICOT Statement Final Draft Sample assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study). Research Critiques and PICOT Statement Final Draft Sample.

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Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to ”Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

 

Research Critique Guidelines

Qualitative Study

Background of Study:

Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem. Research Critiques and PICOT Statement Final Draft Sample.

Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

Were the purpose and research questions related to the problem?

Method of Study:

Were qualitative methods appropriate to answer the research questions?

Did the author identify a specific perspective from which the study was developed? If so, what was it?

Did the author cite quantitative and qualitative studies relevant to the focus of the study? What other types of literature did the author include?

Are the references current? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a qualitative study.

Did the author evaluate or indicate the weaknesses of the available studies?

Did the literature review include adequate information to build a logical argument?

When a researcher uses the grounded theory method of qualitative inquiry, the researcher may develop a framework or diagram as part of the findings of the study. Was a framework developed from the study findings? Research Critiques and PICOT Statement Final Draft Sample
 

Results of Study

What were the study findings?

What are the implications to nursing?

Explain how the findings contribute to nursing knowledge/science. Would this impact practice, education, administration, or all areas of nursing?

Ethical Considerations

Was the study approved by an Institutional Review Board?

Was patient privacy protected?

Were there ethical considerations regarding the treatment or lack of?

Conclusion

Emphasize the importance and congruity of the thesis statement.

Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

Integrate a summary of the knowledge learned. Research Critiques and PICOT Statement Final Draft Sample.
 

 

Quantitative Study

Background of Study:

Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem. Research Critiques and PICOT Statement Final Draft Sample.

Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

Were the purpose and research questions related to the problem? Research Critiques and PICOT Statement Final Draft Sample.

 Methods of Study

Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?

Was informed consent obtained from the subjects or participants?

Did it seem that the subjects participated voluntarily in the study?

Was institutional review board approval obtained from the agency in which the study was conducted?

Are the major variables (independent and dependent variables) identified and defined? What were these variables? Research Critiques and PICOT Statement Final Draft Sample.

How were data collected in this study?

What rationale did the author provide for using this data collection method?

Identify the time period for data collection of the study.

Describe the sequence of data collection events for a participant.

Describe the data management and analysis methods used in the study.

Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis? Research Critiques and PICOT Statement Final Draft Sample.

What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses?

Results of Study

What is the researcher’s interpretation of findings?

Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings?

What limitations of the study were identified by researchers?

Was there a coherent logic to the presentation of findings?

What implications do the findings have for nursing practice? For example, can the findings of the study be applied to general nursing practice, to a specific population, or to a specific area of nursing?

What suggestions are made for further studies? Research Critiques and PICOT Statement Final Draft Sample.

Ethical Considerations

Was the study approved by an Institutional Review Board?

Was patient privacy protected?

Were there ethical considerations regarding the treatment or lack of?

Conclusion

Emphasize the importance and congruity of the thesis statement.

Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

Integrate a summary of the knowledge learned. Research Critiques and PICOT Statement Final Draft Sample.

Reference

Burns, N., & Grove, S. (2011).
Understanding nursing research
(5th ed.). St. Louis, MO: Elsevier. Research Critiques and PICOT Statement Final Draft Sample.