Tag: Clinical-Nursing

Applying a change Model to the Implementation Plan

2. apply a change model to the implementation plan. Include the following:

3. Apply the Iowa model of E-BP, and carry your implementation through each of the stages, phases, or steps identified in the chosen model.

This is the PICOT Question for this capstone project. PICOT (P) For post-operative patients, (I) can standardized hourly rounding by a medical team be a better deterrent (C) compared to bed alarms or other tools that are readily available within a hospital (O) and designed to reduce patient fall risk (T) during hospitalization.

 

Applying the Iowa Model to the Implementation Plan

Student’s Name

Institution of Affiliation

Course Name

Date

BUY A PLAGIARISM-FREE PAPER HERE

 

Selected Evidence-Based Practice Model

           
Numerous conceptual and theoretical models used in the implementation of evidence-based research findings to clinical practice in healthcare organizations exist.  In an organizational context, leadership has to decide the most recommended evidence-based changes to make and the approach of doing it. Most of these models are a representation of methodological approaches and tend to break the entire procedure into simpler and smaller steps. As supported by Nilsen (2015), the use of these models tends to increase the chances of success, a complete implementation process, improves the allocation of resources and provides an avenue of evaluating outcomes. Applying a change Model to the Implementation Plan.

The Iowa evidence-based practice model is a perfect example of such a model. This model has been used in different organization and education settings and proven effective in facilitating the implementation of evidence-based practice. For the implementation of the findings of this EBP project, the Iowa model was the preferred model to explore new strategies that could influence a reduction in falls among post-operative patients during hospitalization. This was the model of choice since it emphasizes on multidisciplinary collaboration, incorporates organizational change and utilizes inputs from the implementation team (White & Spruce, 2015).  Post-operative care involves numerous disciplines which collaborate to ensure timely and full patient recovery. Therefore, since this model is highly dependent on collaboration, it is the most reasonable choice. It is also worth mentioning the Iowa model can easily be understood and interpreted thus user-friendly (Schaffer, Sandau & Diedrick, 2013). Since it allows trial runs of a proposed evidence-based practice change before the actual implementation, the chances of failure are significantly reduced. Applying a change Model to the Implementation Plan.

Applying the Iowa Model To The Implementation Plan

The Iowa model will promote the implementation of fall reduction strategies in the surgical unit. The model’s algorithm has three decision-making points, the initial being determining if the subject should be a priority for the organization (Brown, 2014). While some subjects may be triggered by problems, others may be triggered by problems. For this healthcare organization, implementing new evidence-based fall reduction strategies is the organization’s priority which was triggered by an increase in fall incidences among post-operative patients. The falls resulted in prolonged hospital stays, poor health outcomes and significant financial loses.

The next step is the formation of a multidisciplinary team which should comprise of specific stakeholders from every discipline and any other interested stakeholder. When initiated by frontline practitioners in the surgical unit rather than the organization’s leadership, it is inarguable that the change process will be more successful (White & Spruce, 2015). In this case, the team will comprise of the nurse manager, direct patient care nurses, physiotherapist, nutritionist, nurse practitioner, and surgeon.

The team’s first assignment will be searching for evidence. Therefore, they will need to decide on the keywords to use in scientific databases regarding fall reduction strategies for post-operative patients. After collecting enough evidence, the team will have to critique and synthesize it. Therefore, should the team have inadequate skills or experience in conducting literature searches and assessing the strength of evidence found, it will be vital to ask for the assistance of someone in the organization (Nilsen, 2015). Applying a change Model to the Implementation Plan. The team will likely find guidelines, systematic reviews and pre-appraised researches that discuss fall prevention and fall-reduction strategies for different patient populations. Based on the evidence found, the team will be able to identify the potential gaps in knowledge that exist.

The next point would be deciding if the evidence found is adequate to guide evidence-based practice. Based on the team’s judgment, if the evidence found will be considered sufficient, they should progress to pilot an evidence-based change. On the other hand, in case of lack of a solid research base, the team can progress to use other types of available scientific evidence such as expert opinions and case studies. Otherwise, the implementation team may consider conducting the unavailable research.

If the implementation team progresses with the adoption of new fall-reduction strategies, the next stage is piloting the change in actual practice.  In this phase, there are six steps to follow.  The initial is determining the expected outcomes. The project aims at reducing the fall risks of post-operative patients during hospitalization through standardized hourly rounding by a medical team. Therefore, the most expected outcomes to measure will be; fall incidences, post-operative recovery duration, and length of stay (Pelt, et al., 2014). Secondly, baseline data should be obtained and the outcomes measured before the implementation of the change Applying a change Model to the Implementation Plan.

The third stage is the development of written policies and guidelines which define the new fall-reduction strategies and protocols for post-operative patients. In the surgical unit, the team can consider testing the new fall-risk reduction strategy for two weeks or one month. However, this requires that all personnel directly or indirectly involved with the care of post-operative patients are included and the expectations are well communicated. Next is evaluating the new strategy by making a comparison between the outcome measures and the baseline data that was initially obtained Applying a change Model to the Implementation Plan. This helps to establish if the new fall reduction strategy for post-operative patients (standardized hourly rounding by a medical team) positively influences fall incidences (Morgan, 2019).  Lastly, the protocols and guidelines developed should be modified based on the outcomes.

Conclusion

In today’s highly diverse healthcare environment, the significance of utilizing evidence-based practice in clinical settings to improve care outcomes cannot be overemphasized.  Nurse leaders are responsible for ensuring that quality care is provided in cost-effective ways and that the goals of care are adequately addressed. For the implementation plan of this EBP project, the Iowa EBP model that promotes quality care is the best guide to ensuring success in implementation. The model will particularly be helpful in the implementation of evidence-based strategies that would ensure a reduction in the fall risks of post-operative patients during hospitalization. Applying a change Model to the Implementation Plan

 

References

Brown, C. G. (2014). The Iowa Model of Evidence-Based Practice to Promote Quality Care: An Illustrated Example in Oncology Nursing. 
Clinical Journal of Oncology Nursing
, 
18
(2).

Morgan, K. (2019). Improving Nurse Responsiveness through Advanced Call Bell Implementation & Hourly Rounding.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. 
Implementation Science
, 
10
(1), 53.

Pelt, C. E., Anderson, A. W., Anderson, M. B., Van Dine, C., & Peters, C. L. (2014). Postoperative falls after total knee arthroplasty in patients with a femoral nerve catheter: can we reduce the incidence?. 
The Journal of arthroplasty
, 
29
(6), 1154-1157.

Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence‐based practice models for organizational change: overview and practical applications. 
Journal of Advanced Nursing
, 
69
(5), 1197-1209.

White, S., & Spruce, L. (2015). Perioperative nursing leaders implement clinical practice guidelines using the Iowa Model of Evidence-Based Practice. 
AORN Journal
, 
102
(1), 50-59. Applying a change Model to the Implementation Plan.

›Applying

›

Proposed EBP Project Solution

proposed evidence‐based practice project solution. Address the following criteria:

1. Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing.

2. Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.

BUY A PLAGIARISM-FREE PAPER HERE

Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT. PICOT (P) For post-operative patients, (I) can standardized hourly rounding by a medical team be a better deterrent (C) compared to bed alarms or other tools that are readily available within a hospital (O) and designed to reduce patient fall risk (T) during hospitalization.

3. Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.

4. Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient‐centered quality care, efficiency of processes, environmental changes, and/or professional expertise. Proposed EBP Project Solution

 

Proposed Evidence‐Based Practice Project Solution

Student’s Name

Institution of Affiliation

Course Name

Date

 

Proposed Solution

Postoperative patients are at high risk of falls in acute care settings. The outcomes associated with falls in this patient population include disability, prolonged hospital stays, additional medical costs, loss of independence and loss of hospital revenue. Some of the most prevalent causes of falls among post-operative patients are associated with mental, physical, emotional, social and physiological symptoms of an individual (Mitchell et al., 2014). The most preferred approach to ensure a reduction in fall incidences among post-operative patients in clinical settings is through standardized hourly rounding by healthcare teams.

Standardized hourly rounding has proven to be a highly effective and proactive approach of communicating with families and patients to address their needs during hospitalization. As noted by Moorer et al., (2017), it is used in the clinical setting to promote the ability of the healthcare team members to assess the most potential risks that are likely to result to falls among post-operative patients and institute prevention measures where necessary. Standardized hourly rounding has also shown to increase patient safety, nursing efficiency and to reduce documentation (Morgan, 2019). When conducting around, the medical team should assess the 4 P’s (pain, personal needs, position, and placement).

During the rounding process, a patient’s pain level should be assessed and if need be, pain mediation administered. Members of the medical team can also address a patient’s needs such as offering assistance to use the toilet, nutrition or hydration. For patients who are wrongly positioned, medical team members can help them to get into a comfortable position. For post-operative patients who are immobile, they should be turned to ensure that the integrity of the skin is maintained. With regards to placement, an hourly rounding process would help to ensure that the patient’s most vital needs such as equipment for toileting, phone or bed alarm can easily be reached. Lastly, with regards to preventing falls, in this case, a patient or family caregiver can be asked to sound the bell alarm when the patient needs to get out of bed.

The proposed intervention has been embraced in most care settings as a quality improvement strategy that increases patient safety and the satisfaction of staff and patients. The implementation of this intervention is realistic since there’s available staff who are adequately informed on the need to deliver this intervention. Besides, the intervention is cost-effective as it will not incur any additional costs. Instead, it will help the organization to save on additional healthcare-related costs and collect more revenue.

Organization Culture

The organization purposes to provide quality surgical care for individuals suffering from both chronic and acute illnesses and uphold an environment that promotes healing as revealed in its mission, vision, goals, and objectives. It is also determined to prevent additional harm and complications to post-operative hospitalized patients through interprofessional collaboration, evidence-based research, effective leadership, and communication. Post-operative patients have numerous needs that should be addressed including spiritual, emotional, nutritional, physical, psychological, physiological and social needs. This requires intervention from different providers including a nutritionist, physiotherapist, psychologist, physician and pharmacist among others. As supported by Jacobs (2014), the adoption of a multidisciplinary team approach for standardized rounding will promote nurses ability to change specific clinical practices with the consent, input and approval of other stakeholders and all a patient’s needs will be addressed.

To promote evidence-based research, the organization has been transformed into a learning organization and has a library that is fully equipped with adequate resources. Besides, the staffs have adequate knowledge and skills in conducting literature searches, critiquing and synthesizing literature to address specific clinical problems. Therefore, integrating the proposed evidence-based solution into clinical practice will be efficient and effective. Proposed EBP Project Solution

Method to Achieve Outcomes

The outcomes to be achieved following the implementation of standardized hourly rounding by a medical team are as follows:

A significant reduction in fall incidences among post-operative patients in the surgical unit based on outcome data as compared to baseline data

Shorter hospital stays, reduced mortality and morbidity rates based on monthly mortality and morbidity data

Increased staff and patient satisfaction as evidenced by low readmission rates

Increased hospital revenue based on financial outcome and baseline financial data

Potential barriers to the achievement of the aforementioned outcomes that may hinder the implementation of the proposed solution can be categorized under individual and organizational characteristics. To ensure success, these barriers ought to be assessed and eliminated. Individual barriers: some nurses lacking the skills to locate research sources and opting to seek for information from colleagues as opposed to conducting a scientific search in scientific databases (Odias, 2015). Other stakeholders may have the skills to critique, appraise and synthesize literature but lack technology/computer skills which can, however, be addressed through training. A potential organizational barrier is the lack of adequate time to participate in the entire process since staffs in the surgical department are often engaged.

Outcome Impact

Following the implementation of standardized hourly rounding with a medical team, it is expected that the outcomes will impact the following indicators: improving patient-centered quality care since every patient’s need will be addressed separately by members of a healthcare team. Interprofessional collaboration will promote members of the medical team to acquire new knowledge and skills which enhances professional expertise.  Since the proposed solution aims at reducing the incidence of falls among post-operative patients, it is expected that it will result to shorter hospital stays, reduced medical costs and improved health outcomes which denote an improvement in the quality of care. Proposed EBP Project Solution

 

References

Jacobs, D. (2014). Evidence-Based Falls Management Program in the Nursing Home.

Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. (2014). Hourly rounding to improve nursing responsiveness: a systematic review. 
The Journal of nursing administration
, 
44
(9), 462.

Morgan, K. (2019). Improving Nurse Responsiveness through Advanced Call Bell Implementation & Hourly Rounding.

Moorer, M. B. A., Kunupakaphun, S., Delgado, E., Moody, M., Wolf, M. S. N., Moore, R. N., & Eamranond, M. D. (2017). Using appreciative inquiry as a framework to enhance the patient experience. 
Patient Experience Journal
, 
4
(3), 128-135.

Odias, M. J. B. (2015). Barriers encountered by nurses and nursing assistants that prevent purposeful rounding.

Tatevossian, A. (2017). Fall Prevention: Responder 5 Bed Connectors. Proposed EBP Project Solution

Neuman’s Systems Theory in Home Health Essay

This module has given you an overview of multiple theorists both nursing and non-nursing. Choose a theorist of your choice(The Neuman Systems Theory) and explain how it relates to nursing practice. Give an example of how this theory was applied in your own practice.

1. The Neuman Systems Theory

2. Practice- Home Health

 

Applying Neuman’s Systems Theory in Home Health

Student’s Name

BUY A PLAGIARISM-FREE PAPER HERE

Institution

Course

 

The significance of nursing theories and conceptual models in clinical nursing practice for the growth of the nursing profession is broadly acknowledged. The theory of choice for this discussion is the systems model theory which was developed by Betty Neuman. Betty Neuman   was a counselor, a community health nurse, and professor. The theory emphasizes on the need for nurses to view a patient as an integrated and is based on the relationship of an individual to stress, how one reacts to it and the dynamic reconstitution factors (Jukes & Spencer, 2016). Hence, for an individual’s well-being and balance, the theory affirms that a person is interdependent and inter-relational due to stressful situations that result to associated socio-cultural, psychological, environmental and physiological effects (de Almeida et al., 2018).  In this case, a nurse’s role is to retain the stability of this system.

Betty Neuman’s system model can be reformulated and applied in home-health practice to ensure that clients can meet the activities of daily life by providing daily assistance while at home as opposed to long-term or residential care centers. These services can be provided through three prevention levels: primary, secondary and tertiary levels.  Primary prevention should focus on safeguarding and strengthening the flexible line of defense especially for seniors, adults and pediatric patients in recovery after staying in hospital to prevent unnecessary admissions (Landers et al., 2016). This can be achieved through disease education and vaccination. Secondary prevention ought to strengthen resistance lines, reduce reaction and increase factors of resistance. Secondary prevention can be attained through wound care, disease management, and pain management. Lastly, tertiary prevention should aim at readapting and stabilizing the return to wellness after treatment. It may include activities in occupational therapy, physical therapy, and speech therapy. Neuman’s Systems Theory in Home Health Essay.

References

de Almeida, N. G., de Oliveira, M. R., Guedes, M. V. C., da Silva, L. D. F., de Freitas, M. C., Torres, R. A. M., & de Melo Fialho, A. V. (2018). Betty Neuman Systems Model: Analysis according to Meleis.

Jukes, M., & Spencer, P. (2016). Neuman’s Systems Model. 
Nursing times
, 
112
(27), 20-23. Neuman’s Systems Theory in Home Health Essay

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., & Lee, T. (2016). The future of home health care: a strategic framework for optimizing value. 
Home health care management & practice
, 
28
(4), 262-278.

Narrative research support for proposed project / problem

3- two

Write a narrative of 750‐1,000 words that presents the research support for the projects problem and proposed solution.

Problem Statement: Reduction of Fall Rates for Post-Operative Patients

Make sure to do the following:

1. Include a description of the search method (e.g., databases, keywords, criteria for inclusion and exclusion, and number of studies that fit your criteria).

2. Summarize all of the research studies used as evidence. The essential components of each study need to be described so that readers can evaluate its scientific merit, including study strengths and limitations.

3. Incorporate a description of the validity of the internal and external research. Narrative research support for proposed project / problem

BUY A PLAGIARISM-FREE PAPER HERE

It is essential to make sure that the research support for the proposed solution is sufficient, compelling, relevant, and from peer‐reviewed professional journal articles.

These are the references used in assignment 2

Everhart D, Schumacher, J.R., Duncan R.P., Hall A.G., Neff, D.F., & Shorr, R.I. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics. Health Care Management Review. 39(4), 352–360.

Kobayashi, K., Kei, A., Yuko, I., Yusuke, S., Nagao, Y., & Shiro, I. (2018). Characteristics of falls in orthopedic patients during hospitalization. Nagoya Journal of Medical Science. 80(3), 341–349.

Luzia, M., Victor, G., & Lucena, F. (2014). Nursing diagnosis risk for falls: Prevalence and clinical profile of hospitalized patients. Revista. Latino-Americano. Enfermagem. 22(2), 262–268. Narrative research support for proposed project / problem

Mata, L., Cissa, A., Gabrielle, P., & Moraes, T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study. Revista Latino-Americano Enfermagem. 25(2904).

Shida, D., Wakamatsu, K., Tanaka, Y., Yoshimura, A., Kawaguchi, M., Miyamoto, S. (2015). The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40. BioMed central Cancer. 15(799), 1–6.

Vitor, A., Moura, L., Fernandes, L., Botarelli, F.R., Araújo, J., & Vitorino, I. (2015). Risk for falls in patients in the postoperative period. Cogitare Enferm. 20(1), 29–37.

 

Reduction of Fall Rates for Post-Operative Patients

Description of the Search Method

A comprehensive bibliographic search was performed using various electronic databases such as PubMed, Wiley library databases, EbscoHost, Web of science, Google Scholar and CINAHL. The purpose of performing bibliographic search was to locate the relevant and quality research articles to be used in the study topic. Reference lists of the retrieved research articles were also analyzed and any article in the list that was found to have met the inclusion criteria of this study was searched. In addition, to conduct the search, the PICO was broken down into difference terms as indicated below:

In post-operative patients (P), what are the evidence-based practice nursing interventions (I), when compared to no interventions (C), that can reduce the fall rate (O)?

The keywords used during the search included fall rates, fall prevention, patient falls, nursing interventions, and safety and inpatient falls.

The inclusion criteria include peer-reviewed research studies; studies published between 2014-2019; studies investigating fall rates among inpatients; and studies published in English language.

Summary of Research Studies used as Evidence

According to Mata et al (2017) falls sustained during hospitalization results to increased length of hospital stay, complications and even increment of the healthcare costs. Luzia et al (2014) further explains that falls in inpatients can result to trauma of fractures that further reduce the quality of life and the ability of the patient to perform activities of daily living. Vitor et al, (2015) explains that the inpatients are unfamiliar with the hospital setting and this increases the probability of the patients sustaining falls. The reason is that the hospital setting is completely different with the home setting where facilities like toilet and bathrooms are located in completely different locations, as well as electricity switches; this can lead to confusing among post-operative patients and thus increase their risk for falls and the subsequent injuries.

Shida et al, (2015) opines that post-operative patients normally try to achieve their mobility and regain independence in order to be able to return to performing the normal activities of daily living. post-operative period is also characterized with pain which hinders the patient in so many aspects such as walking properly. This shows that surgeries increase the risk of fall for the patients because of the associated physical weakness. This is the reason post-operative patients are at an increased risk for falls. Everhart et al (2014) further explain that patient fall in healthcare setting represent a major patient safety concern.  Kobayash et al (2018) majority of patients undergoing surgeries need special circumstances that enable them to adapt to the perioperative period in order to reduce the risk of fall.  This is supported by Victor et al (2014) who exlians that patients in hospitals especially those within the postoperative during are predisposed to a number of complications and one of the complications is the risk for falls. Accordingly, falls rate among the common adverse incidents that occur among the inpatients.

Everhart et al (2014) conducted longitudinal study in an acute care hospital while Kobayash et al (2018) prospectively used a database within the institution’s incident reporting system. Luzia et al (2014) conducted a cross-sectional study with a sample of 174 patients. The data collection was done using a computerized nursing care prescriptions system and then statistical data analysis was done. Mata et al (2017) used quantitative and cross-sectional method and used 257 adult patients. The data collection was done utilizing sociodemographic and clinical questionnaire. Shida et al (2014) used the QoR-40 and questionnaire to assess the patients’ postoperative recovery. Vitor, et al (2015) used a quantitative approach to perform a descriptive cross-section study. Narrative research support for proposed project / problem

Validity of the Internal and External Research

The validity of the studies that were selected to be used in this proposal was addressed using different kinds of validity that include convergent validity, face validity, and content validity. According to Dini et al., 2014) these are the key elements used to assure quality in research. Reliability was achieved by examining the consistency of the studies. Various tools used to text the consistency included instruments like Cronbach’s alpha and KMO Bartlett’s test (Dini et al., 2014). However, in some studies the author developed own tools to collect the data while other authors used data collection tools that reliability and validity has been validated. Finally, rigor of the research ensured the validity of the research. This was achieved by performing a wide literature review to locate all available relevant studies and research on the study topic. Tools such as McMaster appraisal checklists and CASP were also used to rate all the articles included in this study to further ensure their quality (Dini et al., 2014).

 

References

Dini, A.P., Alves, D.F.D.S., Oliveira, H.C. and Guirardello, E.D.B., 2014. Validity and reliability of a pediatric patient classification instrument. 
Revista latino-americana de enfermagem
, 
22
(4), pp.598-603.

Everhart D, Jessica S, Duncan P, Hall A, Neff D & Shorr R. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics.
Health Care Manage Rev
. 39(4), 352–360. Narrative research support for proposed project / problem

Kobayashi K, Kei A, Yuko I, Yusuke S, Nagao Y, & Shiro I. (2018). Characteristics of falls in orthopedic patients during hospitalization.
Nagoya J Med Sci
. 80(3), 341–349.

Luzia M, Victor G & Lucena F. (2014). Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients. Rev.
Latino-Am. Enfermagem
. 22(2), 262–268.

Mata L. Cissa A, Gabrielle P & Moraes T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.
Rev Lat Am Enfermagem
. 25(2904). Narrative research support for proposed project / problem

Shida D, Wakamatsu K, Tanaka Y, Yoshimura A, Kawaguchi M, Miyamoto S, et al. (2015). The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40.
BMC Cancer
. 15(799), 1–6.

Vitor A, Moura L, Fernandes L, Botarelli FR, Araújo J & Vitorino I. (2015). Risk for falls in patients in the postoperative period.
Cogitare Enferm
. 20(1), 29–37.

NUR 621-D2Q2R1

Minimum of 250 words with at least 2 peer review reference in APA format

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Uninsured patients can impact the financial status of a health care organization. What are the ethical implications of distributing scarce resources? How do you balance the cost of business versus the quality of care in order to ensure all patients are treated fairly and receive the care that they need?

Anatomy & Physiology Essays

Students will 
choose a topic
 to present in front of the class by the last week of class. Please prepare a 5 to 10 minute PowerPoint presentation for your classmates on your one
 chosen chapters
 to be presented at the beginning of class as a Key Points Final Review on January 6th. Submit your presentation no later than 24 hours before you will be presenting the material.

Ch 1- Organization of the Body

Ch 2- Homeostasis

Ch 3- Chemistry of Life

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Ch 4- Biomolecules

Ch 5- Cell Structure

Ch 6- Cell Function

Ch 7- Cell Growth and Development

Ch 8- Introduction to Tissues

Ch 9- Tissue Types

Ch 10- Skin

Ch 11- Skeletal Tissues

Ch 12- Axial Skeleton

Ch 13- Appendicular Skeleton

Ch 14- Articulation

Ch 15- Axial Muscles

Ch 16- Appendicular Muscles

Ch 17- Muscle Contraction

Ch 18- Nervous System Cell

Ch 19- Nervous Signaling

Ch 20- Central Nervous System

Ch 21- Peripheral Nervous System

Ch 22- Autonomic Nervous System

Ch 23- General Senses

Ch 24- Special Senses

Rubric

Teaching Plan Assignment
Teaching Plan AssignmentCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeGaining Attention of the Class
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomeThree teaching objectives
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomeTeaching Strategies
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomePresenting for 10-15 minutes
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomeProvides Examples with Questions
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts Anatomy & Physiology Essays

This criterion is linked to a Learning OutcomeSummary Slide at End
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomeTextbook Reference
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomeReferences in APA format
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomeSubmitted to Assignments 24 hours prior
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

This criterion is linked to a Learning OutcomeQuiz Questions for Students
10.0
 
ptsFull Marks0.0
 
ptsNo Marks
10.0 pts

Total Points: 100.0 Anatomy & Physiology Essays

NRS 490 RS Scholarly Activity Summary Example

Scholarly Activities NRS-490

Student’s Name

Institution of Affiliation

Course Name

Date

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Overview

This week, the scholarly activity that I took part in was a wound care seminar which lasted for four days. Routine seminars were a major part of this organization’s culture. The seminars were a source of empowerment and inspiration for nurses, physicians and other healthcare providers working in various units. The seminars provided the latest wound care management standards as a way of attaining excellence and improving patient health outcomes. It also presented an opportunity to obtain ongoing education credits and improve clinical outcomes in nursing practice. As a nurse, I always believe that the most significant aspects of nursing practice are: maintaining professional membership and remaining committed to lifelong learning. I also attended a pressure ulcer IDT meeting through which healthcare professionals learned from various wound specialization experts, asked questions and acquired new knowledge on what wasn’t taught in class. NRS 490 RS Scholarly Activity Summary Example

The pressure ulcer IDT meeting had four major goals: to develop a new pressure ulcer prevention program through well-defined roles and responsibilities of staff, to develop unit-level plans and to train staff on new strategies to reduce pressure ulcers. Both the seminar and the pressure ulcer IDT meeting were well planned for. The seminar was sponsored and organized by the American Professional Wound Care Association. The IDT meeting was headed by a certified wound care nurse and comprised of nutritionists, pharmacists, nurse practitioners, and physicians. To actualize its goal, the IDT meeting, identified and replaced routine clinical practices that either delayed or prevented wound healing based on organizational wound management guidelines. This resulted in the development of three teams: an implementation team, a wound care team and a unit-based team.

The whole activity was a motivation for nurses who were passionate about specializing in wound care. The key target of the seminar and pressure ulcer IDT meeting were healthcare professionals working in the surgical unit, palliative care, and the ICU.

Problem

Pressure ulcer IDT meeting reviewed two major issues who one quality of care and care coordination.

Quality of Care In Pressure Ulcer Management (1)

Coordination of care with Interdisciplinary Team(1)

NRS 490 RS Scholarly Activity Summary Example

Members of the IDT meeting analyzed each of the cases and listened to the input provided by every staff member who was present. In every case that was reviewed, a  particular set of questions were used to determine whether depending on the patient’s outcome the pressure ulcer care provided was either excellent, good or poor with regards to quality and care coordination. The findings were scored as 3, 2 or 1 respectively.

Solution

Quality of Care In Pressure Ulcer Management- the staff members gave it a score of 2. There were numerous gaps identified in nursing practice such as: failing to provide ongoing reports and communication, failure to integrate the prevention of pressure ulcer in continuous nursing processes. To address this, the implementation team, a wound care team and a unit-based team were formed. These teams were to come up with a communication policy that could clearly explain the how unit champions, unit managers and staff can communicate, give updates using collected data and probably share essential changes in patient safety in wound care plans. The unit-based team was mandated to identify communication strategies of telling families/patients on care progress and sharing skin and risk assessment data when handing over shift reports.

Coordination of care with Interdisciplinary Team (1) – the staff members gave it a score of 3 to imply that wound management care within the unit was excellent due to good coordination. Although there were no gaps in care that were identified, several recommendations were given on how to make care more coordinated including having more specific roles and responsibilities for every member of the interdisciplinary team.

Opportunity

           
By actively participating in this activity, I was able to improve individual knowledge and skills on wound management and ability to work with other professionals in interdisciplinary teams to provide coordinated care. I achieved the professional competency role (Domain 1) through teamwork with the surgical unit staff namely: nutritionist, pharmacists, wound care nurse specialist, wound specialization physicians and nurse practitioners to address key issues in pressure ulcer wound management (1.1), took management and leadership roles with an aim of  promoting holistic and cultural competent care(1.3) and  actively participated in the development of guidelines and policies to improve care delivery and accountability among healthcare team members for  improved clinical outcomes of patients with pressure ulcers (1.4). NRS 490 RS Scholarly Activity Summary Example

Similarly, by taking part in this scholarly activity, I was able to explore nursing theories and how they can be applied in clinical practice to positively influence clinical outcomes (Domain 2) This influenced the ability to use critical thinking to solve real patient scenarios (2.3). Since intense discussions were held and decisions made in the pressure ulcer the IDT meeting with the certified wound care nurse as the first line communication manager, the domain of informatics (Domain 4) was similarly addressed.

Program Competencies Addressed

The program competencies addressed by participating in this scholarly summary activity were competency 1.1, 1.3, 1.4, 2.3 and 4.3

 

References

Coffey, M., Fry, L., Cardenas, L. A., Wing, W., & Skinner, M. (2015). An interdisciplinary approach to pressure ulcer reduction.
Journal of the American Medical Directors Association
, 
16
(3), B18-B19.

Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: prevention and management. 
Journal of the American Academy of Dermatology
.

Mwebaza, I., Katende, G., Groves, S., & Nankumbi, J. (2014). Nurses’ knowledge, practices, and barriers in the care of patients with pressure ulcers in a Ugandan teaching hospital.
Nursing research and practice
, 
2014
.

 

Scholarly Activity Summary

 

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

Overview

This section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you. NRS 490 RS Scholarly Activity Summary Example

Problem

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

Solution

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

Opportunity

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

Program Competencies Addressed

This section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP. NRS 490 RS Scholarly Activity Summary Example

Behavioral systems model essay example

Paper 4 – Nursing or Interprofessional “Theory”: Philosophy, Conceptual Model, or Grand Theory – Describe a nursing or interprofessional “theory” (i.e., a philosophy, conceptual model, or grand theory

Within your Paper 4, in addition to the specifications below, include a brief discussion of the relevance of the theory for your chosen advanced nursing practice role (psychiatric mental health nurse practitioner role) with diverse populations.

10% Introduction – Briefly introduce the focus of the paper.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

70% Discussion – Clearly, thoroughly, and succinctly discuss the focus of the paper, showing evidence of reading of professional literature and synthesis of the focus

10% Summary – Briefly summarize the key points and conclusions from the discussion.

10% Format – Consistently use APA format (6th edition) and correct English grammar across these papers, from the title page through the reference list. These papers must adhere to the following guidelines (all of which are in agreement with APA, 6th ed., format), as well as the other guidelines specified in the APA Manual (6th ed.): (a) be typed in a current version of Microsoft Word that can be opened by the course faculty; (b) be typed in Times New Roman typeface, with 12-point font size; (c) have doublespacing between all lines, including the title page and reference list; (d) have 1-1½ inch margins (top, bottom, right, and left); (e) include a title page and reference page; (f) have headings between sections; and (g) have a running head and page numbers..

Grading Rubric for Papers 1-4 The points for the first three criteria for Papers 1-4 are based on the level of evidence of critical thinking and synthesis related to the criteria and specific focus of the paper, including clarity, thoroughness, evidence of reading professional literature (as applicable to the criteria). For the fourth criteria (i.e., Format), the points are based on the level of evidence/achievement in terms of the accuracy of the format (APA, 6th edition), including grammar, across the paper. Behavioral systems model essay example

*Note: Your grade on your papers will be reduced by 10% within each section of the paper each time that a primary reference is needed and is not included in the section of the paper and/or for each secondary reference used within the section of the paper. Again, it is essential that you only include primary references.

 

Behavioral systems model

Name

Institution

Behavioral systems model

Models in nursing practice are tools that verbalize awareness of professional expectations. An example of this can be seen in the behavioral systems model (BSM) that was first presented by Dorothy Johnson. The model focuses on Johnson’s understanding that research-based knowledge plays a critical role in nursing care and outcomes, proposing that effective and efficient behavioral functioning are important in patients to prevent illness (Masters, 2015). The present paper explores BSM as a tool that facilitates efficient and effective nursing care.

Discussion

BSM is based on the awareness that nursing care focuses on applying external elements to optimize patients’ behaviors through preservation the organization and integration of these behaviors so that they do not become threats to the patients’ physical and social health to result in illness. In this case, patients are identified as having a behavioral system comprised of seven subsystems that include achievement, aggression, sexuality, eliminative, ingestive, dependency, and affiliative. The seven subsystems are expected to meet three functional requirements for the patient to be healthy. The first requirement is stimulation for growth. The second requirement is the provision of a nurturing environment. The third requirement is offering protection from noxious influences. Inabilities to meet any one of the three functional requirements results in a state of imbalance whereby nurses intervene to create balance (Masters, 2015). Behavioral systems model essay example

Johnson’s conceptualization of BSM is based on the premise that nurses act in their professional capacity to improve society’s welfare through distinctive approaches. This awareness resulted in the model identifying four nursing goals. The first goal of nursing is to aid patients whose behavior is proportional to (commensurate with) social demands. The second goal of nursing is to aid patients who have the capacity to modify their behavior to support biological imperatives. The third goal of nursing is to aid patients who are able to maximize the benefits received from the skills and knowledge of medical personnel. The fourth goal of nursing is to aid patients whose behavior does not offer evidence of unnecessary trauma as a consequence of illness (Alligood, 2014).

BSM makes assumptions about systems and the structure and function of subsystems. There are four assumptions for each system. First, a system is comprised of the elements and parts of behavior to include integration, interdependency, interaction, and organization. Secondly, a system seeks to balance the forces that act upon and within it, using automatic adaptations and adjustments to balance the natural forces. In addition, behavior is characterized by constancy and regularity seen in the results and requirements, and this is necessary for functionality. Finally, balances in the system reflect successful adaptations and adjustments (Chinn & Kramer, 2015).

There are four assumptions for the structure and function of each subsystem. First, subsystems produce observable outcomes. Also, subsystems have a definite scope of actions and repertoire of choices. In addition, the behavior is characterized by predisposition to act with reference to an objective in certain ways rather than other ways. The fourth assumption is that the objectives of behaviors are based on the drive for the behavior and the form that it takes. In addition, three functional requirements are presented based on the awareness that behaviors are amenable to explanation and description if they are sufficiently stable, predictable, recurrent, purposeful and orderly. Secondly, each subsystem serves the primary function of preventing stagnation and enhancing growth. Thirdly, systems are protected to harmful influences (Chinn & Kramer, 2015).

Based on BSM, the nursing process has four components.  Assessment that offers details about the biological system in terms of the subsystems. Secondly, diagnosis is presented based on behavioral performance to include dominance, incompatibility, discrepancy, and insufficiency. Thirdly, planning and implementation occur to bring about system balance through stimulating, nurturing and protecting the relevant subsystems. Finally, evaluation is conducted to determine if the system has achieved balance (Zaccagnini & White, 2011). Behavioral systems model essay example

Conclusion

BSM is a nursing care model that advocates for fostering effective and efficient behavioral functioning as important for preventing illness. In addition, patients are defined by a behavioral system comprised of seven subsystems with each one having four structural characteristics. Besides that, each subsystem has four functional requirements that include protection, providing a nurturing environment, and stimulating growth. In this respect, BSM is a tool that facilitates efficient and effective nursing care.

References

Masters, K. (2015). Nursing
theories: a framework for professional practice
(2
nd
ed.). Burlington, MA: Jones & Bartlett Learning.

Alligood, M. (2014).
Nursing theorists and their work
(8
th
ed.). St. Louis, MO: Elsevier/Mosby.

Chinn, P. & Kramer, M. (2015).
Knowledge development in nursing: theory and process
(9
th
ed.). St. Louis, MO: Elsevier/Mosby.

Zaccagnini, M. & White, K. (2011).
The doctor of nursing practice essentials: a new model for advanced practice nursing
. Sudbury, MA: Jones & Bartlett Learning. Behavioral systems model essay example

NURS 4100 Common Flaws in Quantitative nursing Studies

NURS 4100 -Quality and Safety Through Evidence-Based Practice

BSN Completion Program

Walden University

Critical Appraisal of Qualitative Research

Smucker, D., Regan, S., Elder, N., &   Gerrety, E. (2014). Patient safety   incidents in home hospice care:

The experiences of hospice interdisciplinary team members. 
Journal of Palliative Medicine,

17
(5), 540-544.

Quality

Is the journal peer-reviewed?

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Are the authors qualified to conduct the research?

Focus of Study

What experience or situation are the researchers seeking to understand?

Study Design

What is the expected outcome of the study?

Do the researchers want to describe an event, explain a cultural experience or generate a theory?

What is the study design?

Data Collection

Who were the sample and how were they recruited?

How were the data collected?

Control

How did the researchers control their biases or preconceptions during the data collection process?

Data Analysis

How were the data analyzed?

Do the authors include direct quotes and generalized statements as examples of data?

Results

What are the main findings of the study?

What themes emerged from the analysis?

Recommendations

Do the authors provide recommendations for future research?

Limitations

Are the limitations of the study discussed?

 

APPENDIX F

Appraisal Guide:

Findings of a Quantitative Study

 

 

APA Formatted Citation: (4 pts.)

Answer Here:

 

 

Synopsis
(16 pts.)

What was the purpose of the study (research questions, purposes, and hypotheses)?

Answer Here:

 

How was the sample obtained?

Answer Here:

 

What inclusion or exclusion criteria were used?

Answer Here:

 

Who from the sample actually participated or contributed data (demographic or clinical profile and dropout rate)?

Answer Here:

 

What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?

Answer Here:

 

Was an intervention tested? Answer Yes or No

 

How was the sample size determined?

Answer Here:

 

Were patients randomly assigned to treatment groups?

Answer Here:

 

What are the main findings of the study? (10 pts.)

Answer Here:

 

Credibility
(14 pts.)

 

Yes

No

Not Clear

Is the study published in a source that required peer review?

 

 

 

*Did the data obtained and the analysis conducted answer the research question?

 

 

 

Were the measuring instruments reliable and valid?

 

 

 

*Were important extraneous variables and bias controlled?

 

 

 

*If an intervention was tested, answer the following five questions:

 

 

 

Were participants randomly assigned to groups and were the two groups similar at the start (before the intervention)?

 

 

 

Were the interventions well defined and consistently delivered?

 

 

 

Were the groups treated equally other than the difference in interventions?

 

 

 

If no difference was found, was the sample size large enough to detect a difference if one existed?

 

 

 

If a difference was found, are you confident it was due to the intervention?

 

 

 

Are the findings consistent with findings from other studies?

 

 

 

 

All

Some

No

ARE THE FINDINGS CREDIBLE?                  

 

 

 

 

 

 

 

 

Clinical Significance
(6 pts.)

 

Note any difference in means, r
2
s, or measures of clinical effects (ABI, NNT, RR, OR)

Answer Here: NURS 4100 Common Flaws in Quantitative nursing Studies

 

Yes

No

Not Clear

*Is the target population clearly described?

*Is the frequency, association, or treatment effect impressive enough for you to be confident that the finding would make a clinical difference if used as the basis for care?

 

All

Some

No

ARE THE FINDINGS CLINICALLY

SIGNIFICANT?
                                                    

 

*= Important criteria

 

Comments

Answer Here:

 

Common Flaws in Quantitative Studies

The common flaws associated with quantitative studies include inappropriate representation of the target population; requires large sample size to collect data; lack of ability to control the environment; limited outcomes; and complicated data analysis methods (Rahman, 2017).

Inappropriate representation of the target population can interfere with the study’s targeted aims and objectives. In spite of using the suitable sampling plan, representation of the study participants depends on the probability distribution of the available data. This can result in inaccuracy of probability distribution and result in inaccuracy in proposition (Ponto, 2015). Secondly, quantitative studies need large sample sizes and lack of adequate resources may hinder use of adequate sample size when conducting research and hence affect generalization of the study results (Regnault et al, 2018). Moreover, controlling the environment when conducting quantitative research is difficult. As Rahman (2017) explains, when conducting quantitative research, it can be problematic to control the environment where the respondents give answers during the survey or in the questionnaires. The responses are dependent on specific time and conditions existing during that specific time-frame. NURS 4100 Common Flaws in Quantitative nursing Studies

In addition, quantitative researches are associated with limited outcomes due to the structured questionnaires and surveys with close-ended questions. Therefore, the respondents have limited options when it comes to responses and the close-ended questions leads to restricted outcomes delineated within the research proposal (Ponto, 2015). Therefore, the findings do not always represent the actual happenings, in a generalized form. Finally, quantitative studies require complex data analysis methods such as statistical analysis which can be challenging to researchers without knowledge on statistics (Queirós et al, 2017). The requirement to perform efficient statistical confirmation of findings is very challenging within a quantitative study.

 

 

References

Queirós A, Faria D & Almeida F. (2017). Strengths and Limitations of Qualitative and Quantitative Research Methods.
European Journal of Education Studies
. 3(9).

Ponto J. (2015). Understanding and Evaluating Survey Research.
J Adv Pract Oncol
. 6(2), 168–171.

Rahman, S. (2017). The advantages and disadvantages of using qualitative and quantitative approaches and methods in language “testing and assessment” research: a literature review.
Journal of Education and Learning
. 6(1), 102-112. NURS 4100 Common Flaws in Quantitative nursing Studies

Regnault A, Tom W & Barbic S. (2018). Towards the use of mixed methods inquiry as best practice in health outcomes research.
J Patient Rep Outcomes
. 2(19).

 

 

APPENDIX F

Appraisal Guide:

Findings of a Quantitative Study

 

 

APA Formatted Citation: (4 pts.)

Answer Here:

 

 

Synopsis
(16 pts.)

What was the purpose of the study (research questions, purposes, and hypotheses)?

Answer Here:

 

How was the sample obtained? NURS 4100 Common Flaws in Quantitative nursing Studies

Answer Here:

 

What inclusion or exclusion criteria were used?

Answer Here:

 

Who from the sample actually participated or contributed data (demographic or clinical profile and dropout rate)?

Answer Here:

 

What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?

Answer Here:

 

Was an intervention tested? Answer Yes or No

 

How was the sample size determined?

Answer Here:

 

Were patients randomly assigned to treatment groups?

Answer Here:

 

What are the main findings of the study? (10 pts.)

Answer Here:

 

Credibility
(14 pts.)

 

Yes

No

Not Clear

Is the study published in a source that required peer review?

 

 

 

*Did the data obtained and the analysis conducted answer the research question?

 

 

 

Were the measuring instruments reliable and valid?

 

 

 

*Were important extraneous variables and bias controlled?

 

 

 

*If an intervention was tested, answer the following five questions:

 

 

 

Were participants randomly assigned to groups and were the two groups similar at the start (before the intervention)?

 

 

 

Were the interventions well defined and consistently delivered? NURS 4100 Common Flaws in Quantitative nursing Studies

 

 

 

Were the groups treated equally other than the difference in interventions?

 

 

 

If no difference was found, was the sample size large enough to detect a difference if one existed?

 

 

 

If a difference was found, are you confident it was due to the intervention?

 

 

 

Are the findings consistent with findings from other studies?

 

 

 

 

All

Some

No

ARE THE FINDINGS CREDIBLE?                  

 

 

 

 

 

 

 

 

Clinical Significance
(6 pts.)

 

Note any difference in means, r
2
s, or measures of clinical effects (ABI, NNT, RR, OR)

Answer Here:

 

Yes

No

Not Clear

*Is the target population clearly described?

*Is the frequency, association, or treatment effect impressive enough for you to be confident that the finding would make a clinical difference if used as the basis for care?

 

All

Some

No

ARE THE FINDINGS CLINICALLY

SIGNIFICANT?
                                                    

 

*= Important criteria NURS 4100 Common Flaws in Quantitative nursing Studies