Tag: Clinical-Nursing

How to Write Nursing Thesis Statements – Basics of Thesis Statements

Do you know How to Write Nursing Thesis Statements? The
thesis statement
is the brief articulation of your paper’s central argument and purpose. You might hear it referred to as simply a “thesis.” Every scholarly paper should have a thesis statement, and strong thesis statements are
concise, specific, and arguable
.
Concise
means the thesis is short: perhaps one or two sentences for a shorter paper.
Specific
means the thesis deals with a narrow and focused topic, appropriate to the paper’s length.
Arguable
means that a scholar in your field could disagree (or perhaps already has!).

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Strong thesis statements address specific intellectual questions, have clear positions, and use a structure that reflects the overall structure of the paper. Read on to learn more about constructing a strong thesis statement.

How to Write Nursing Thesis Statements – Being Specific

This thesis statement has no specific argument:

Needs Improvement:
In this essay, I will examine two scholarly articles to find similarities and differences.

This statement is
concise
, but it is neither
specific
nor
arguable
—a reader might wonder, “Which scholarly articles? What is the topic of this paper? What field is the author writing in?” Additionally, the purpose of the paper—to “examine…to find similarities and differences” is not of a scholarly level. Identifying similarities and differences is a good first step, but strong academic argument goes further,
analyzing what those similarities and differences might mean or imply. 
How to Write Nursing Thesis Statements.

Better:
In this essay, I will argue that Bowler’s (2003) autocratic management style, when coupled with Smith’s (2007) theory of social cognition, can reduce the expenses associated with employee turnover.

The new revision here is still concise, as well as specific and arguable.  We can see that it is
specific
because the writer is mentioning (a) concrete ideas and (b) exact authors.  We can also gather the field (business) and the topic (management and employee turnover). The statement is
arguable
because the student goes beyond merely comparing; he or she
draws conclusions from that comparison
(“can reduce the expenses associated with employee turnover”). How to Write Nursing Thesis Statements.

Making a Unique Argument

This thesis draft repeats the language of the writing prompt without making a unique argument:

Needs Improvement:
The purpose of this essay is to monitor, assess, and evaluate an educational program for its strengths and weaknesses. Then, I will provide suggestions for improvement.

You can see here that the student has simply stated the paper’s assignment, without articulating specifically how he or she will address it. The student can correct this error simply by phrasing the thesis statement as
a specific answer to the assignment prompt.

Better:
Through a series of student interviews, I found that Kennedy High School’s antibullying program was ineffective. In order to address issues of conflict between students, I argue that Kennedy High School should embrace policies outlined by the California Department of Education (2010).

Words like “ineffective” and “argue” show here that the student has clearly thought through the assignment and analyzed the material; he or she is putting forth a
specific and debatable position.
The concrete information (“student interviews,” “antibullying”) further prepares the reader for the body of the paper and demonstrates
how the student has addressed the assignment prompt
without just restating that language.

How to Write Nursing Thesis Statements – Creating a Debate

This thesis statement includes only obvious fact or plot summary instead of argument:

Needs Improvement:
Leadership is an important quality in nurse educators.

A good strategy to determine if your thesis statement is too broad (and therefore, not
arguable
) is to ask yourself, “Would a scholar in my field disagree with this point?” Here, we can see easily that no scholar is likely to argue that leadership is an unimportant quality in nurse educators.  The student needs to come up with a more
arguable
claim, and probably a narrower one; remember that a short paper needs a more focused topic than a dissertation.

Better:
Roderick’s (2009) theory of participatory leadership  is particularly appropriate to nurse educators working within the emergency medicine field, where students benefit most from collegial and kinesthetic learning. How to Write Nursing Thesis Statements.

Here, the student has identified a particular type of leadership (“participatory leadership”), narrowing the topic, and has made an arguable claim (this type of leadership is “appropriate” to a specific type of nurse educator). Conceivably, a scholar in the nursing field might disagree with this approach. The student’s paper can now proceed, providing specific pieces of evidence to support the arguable central claim.

Choosing the Right Words

This thesis statement uses large or scholarly-sounding words that have no real substance:

Needs Improvement:
Scholars should work to seize metacognitive outcomes by harnessing discipline-based networks to empower collaborative infrastructures.

There are many words in this sentence that may be buzzwords in the student’s field or key terms taken from other texts, but together they do not communicate a clear, specific meaning. Sometimes students think scholarly writing means constructing complex sentences using special language, but actually it’s usually a stronger choice to write clear, simple sentences.
When in doubt, remember that your ideas should be complex, not your sentence structure.

Better:
Ecologists should work to educate the U.S. public on conservation methods by making use of local and national green organizations to create a widespread communication plan. How to Write Nursing Thesis Statements.

Notice in the revision that the field is now clear (ecology), and the language has been made much more field-specific (“conservation methods,” “green organizations”), so the reader is able to see concretely the ideas the student is communicating.

Leaving Room for Discussion

This thesis statement is not capable of development or advancement in the paper:

Needs Improvement:
There are always alternatives to illegal drug use.

This sample thesis statement makes a claim, but it is not a claim that will sustain extended discussion. This claim is the type of claim that might be appropriate for the conclusion of a paper, but in the beginning of the paper, the student is left with nowhere to go. What further points can be made? If there are “always alternatives” to the problem the student is identifying, then why bother developing a paper around that claim? Ideally, a thesis statement should be complex enough to explore over the length of the entire paper. How to Write Nursing Thesis Statements.

Better:
The most effective treatment plan for methamphetamine addiction may be a combination of pharmacological and cognitive therapy, as argued by Baker (2008), Smith (2009), and Xavier (2011).

In the revised thesis, you can see the student make a specific, debatable claim that has the potential to generate several pages’ worth of discussion. When drafting a thesis statement,
think about the questions your thesis statement will generate:
What follow-up inquiries might a reader have? In the first example, there are almost no additional questions implied, but the revised example allows for a good deal more exploration.

Extra Tips on How to Write Nursing Thesis Statements

Thesis Mad Libs

If you are having trouble getting started, try using the models below to generate a rough model of a thesis statement! These
models are intended for drafting purposes only and should not appear in your final work.

In this essay, I argue ____, using ______ to assert _____.

While scholars have often argued ______, I argue______, because_______.

Through an analysis of ______, I argue ______, which is important because_______.

Words to Avoid and to Embrace

When drafting your thesis statement, avoid words like
explore, investigate, learn, compile, summarize
, and
explain
to describe the main purpose of your paper.
These words imply a paper that summarizes or “reports,” rather than synthesizing and analyzing.

Instead of the terms above, try words like
argue, critique, question
, and
interrogate
. These more analytical words may help you begin strongly, by articulating a specific, critical, scholarly position. How to Write Nursing Thesis Statements.

Anorexia Nervosa Essay

Anorexia nervosa is a serious eating disorder that results in unhealthy, often dangerous weight loss. While it is most common among adolescent women, anorexia can affect women and men of all ages and is characterized by a refusal to maintain a healthy body weight, an intense fear of gaining weight, and a distorted body image… Anorexia Nervosa Essay

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Anorexia nervosa is a life threatening eating disorder defined by a refusal to maintain fifteen percent of a normal body weight through self-starvation (NAMI 1). Ninety-five percent of anorexics are women between the ages of twelve and eighteen… Anorexia Nervosa Essay.

Anorexia Nervosa is one of the most commonly known and yet least recognized eating disorders. Anorexia is a mental illness, which affects both boys and girls within normal weight ranges who think they are overweight. The early stages of Anorexia are often difficult to detect. A person should know what to look for as far as early symptoms and know what steps to take to help, but the most important thing would be to try to figure out what underlying problems could be responsible for the condition. Anorexia Nervosa Essay.

Anorexia begins with feelings of self-confidence and higher self esteem as the result of a more “attractive” appearance making the person feel as if they are more capable of handling social interaction (Anorexia, Dying to Be Thin p.1-13). As the anorexia progresses, his/her preoccupation with staying thin, which he or she believes gave his/her feelings of success, caused his/her to concentrate even more on his/her weight (Anorexia, Dying to Be Thin p.1-13). Eventually, the anorexic’s body will start to deteriorate, his/her self-esteem will diminish, and he or she will begin to remove themselves from social interaction (Anorexia, Dying to Be Thin p.1-13). Communication with his/her family or friends will also be reduced or strained (Anorexia, Dying to Be Thin p.1-13)… Anorexia Nervosa Essay.

Every generation has a set of values that they believe make a person beautiful. In the 1940’s and 50’s it was considered beautiful to be a voluptuous woman. A woman with a large chest and full hips was the ideal woman, such as Marylyn Monroe. The difference between then and now is, young women could escape this image if need be. Today it is impossible to ignore the stick thin super models on bill boards, TV, and in magazines. The influence of society on teenagers is so much that men actually expect a woman to be that stick thin model or they are considered “fat”, “tubby”, etc… Anorexia Nervosa Essay.

Attempting to comprehend why society demands a high standard for a slender appearance is bewildering. Some individuals take extreme measures to acquire this desired look, assuming that if they achieve this look the pain within will disappear. For most men and women suffering from anorexia there are deeper, more complex emotional/mental issues to be resolved. Anorexia is common destructive eating disorder that individuals can develop overtime by giving into their deranged thoughts and perceptions. My research paper will describe in detail the actions and behaviors that someone who is suffering from Anorexia Nervosa demonstrates. I will be discussing the social attitudes towards the illness from the past to the present. Furthermore, I will give information on different ways to treat Anorexia Nervosa and also preventative measure that can be taken… Anorexia Nervosa Essay.

…Many of anorexics died before they could get a well treatment. Anorexics that are in a very underweight condition, must be treated carefully, or hospitalized. After anorexics get the medical treatment, they need to get psychological counseling in order for them learn about healthy foods and lifestyle. The psychological counseling may includes nutritional counseling, individual counseling and group counseling. Nutritional counseling will teaches anorexics to count calories of body needed in comfortable method. And to help with weight gain, doctors usually use liquid food supplements. Anorexics may also need some therapies such as cognitive-behavioral therapy or known as CBT in the individual counseling. CBT teachers will help anorexics to change their attitudes and behaviors about eating. Group counseling is also needed for anorexics, to share their experiences and to encourage their friends (who also experience anorexia) to recover. Family therapy is very helpful, especially for teen with anorexics. Parents and siblings could support the anorexics during treatment emotionally and physically. Another effort to help anorexics recover is by letting them expressing their feelings and doing something enjoyable for them for instance doing their hobbies. Then, doing relaxation is also important. By having yoga, massage and the traditional Chinese relaxation exercises will build a healthy relationship with their body. Anorexia Nervosa Essay.

APA nursing paper template 6th edition

 

Title of the Paper in Full Goes Here

Student Name Here

Institution

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Abstract

This is the abstract, which is typed in block format with no indentation. The abstract briefly summarizes your paper in 120 words or less. Through your abstract, your readers should be able to fully understand the content and the implications of the paper. Also, note that writing this section after the paper itself may be helpful. See section 2.04 APA for tips and more information on writing abstracts. This template was updated April 25, 2016.

 

Title of the Paper

APA nursing course paper template 6th edition

This template’s margins, page numbers, and page breaks are set for you, and you do not need to change them. Do not add any extra spaces between the heading and the text (you may want to check
Spacing
under
Format
,
Paragraph
in your word processor, and make sure that it is set to 0”). Instead, just double space as usual, indent a full ½ inch (preferably using the tab button), and start typing. The introduction should receive no specific heading because readers assume that the first section functions as your paper’s introduction.

After considering these formatting issues, you will need to construct a thesis statement, which lets readers know how you synthesized the literature into a treatise that is capable of advancing a new point of view. This statement provides readers with a lens for understanding the forthcoming research presented in the body of your essay (after all, each piece of literature should support and apply to this thesis statement). APA nursing paper template 6th edition.

Once you have established your thesis, begin constructing the introduction. An easy template for writing an introduction follows:

Start with what has been said or done regarding the topic.

Explain the problem with what has been said or done.

Offer a solution in a concise thesis statement that can be supported by the literature.

Explain how the thesis brings about social change.

Level 1 Heading

This text will be the beginning of the body of the essay. Even though this section has a new heading, make sure to connect this section to the previous one so readers can follow along with the ideas and research presented. The first sentence in each paragraph should transition from the previous paragraph and summarize the main point in the paragraph. Make sure each paragraph contains only one topic, and when you see yourself drifting to another idea, make sure you break into a new paragraph. Also, avoid long paragraphs (more than three-fourths of a page) to help hold readers’ attention; many shorter paragraphs are better than a few long ones. In short, think this: new idea, new paragraph. APA nursing paper template 6th edition.

Another Level 1 Heading

Here is another Level 1 heading. Note that, when you add additional headings, you should use the APA levels available in the Styles area of your toolbar. If you enter them manually instead, you may need to delete the automatic indent that appears because Word thinks you are beginning a new paragraph. Again, the topic sentence of this section should explain how this paragraph is related or a result of what you discussed in the previous section. Consider using transitions between sentences to help readers see the connections between ideas. Below are a few examples of how to transition from one statement to another (or in some cases, one piece of literature to another):

Many music teachers at Olson Junior High are concerned about losing their jobs (J. Thompson, personal communication, July 3, 2013), largely due to the state’s recent financial cutbacks of fine arts programs (Babar, 2007). APA nursing paper template 6th edition.

Obesity affects as much as 17% of the total population of children, an increase which may lead to other chronic health problems (Hera, 2008; Sinatra, 2008).

For more examples, see some of the transitions handouts on the Writing Center’s website.

Level 2 Heading

The Level 2 heading designates a subsection of the previous section. Using headings is a great way to organize a paper and increase its readability, so be sure to review heading rules on APA 3.02 and 3.03 in order to format them correctly. For shorter papers, using one or two levels is all that is needed. You would use Level 1 (centered, bold font with both uppercase and lowercase) and Level 2 (left aligned, bold, both uppercase and lowercase). This template provides examples of APA’s four heading levels, but remember that at least two headings on the same level are needed before the next heading level. For example, a paper must have at least two level 3 headings before a level 4 heading.

Level 3 heading.
Note that you should write Level 3 and 4 headings in sentence case, meaning that only the first word and any proper nouns are capitalized. The number of headings needed in a particular paper is not set, but longer papers may benefit from another heading level, such as this Level 3 heading (which is an indented, bold, lowercase paragraph heading).

Level 4 heading.
One crucial area in APA is learning how to cite in academic work. Make sure to cite source information throughout your paper to avoid plagiarism. This practice is critical: you need to give credit to your sources and avoid copying others’ work at all costs. Look at APA starting at 6.01 for guidelines on citing source information in your text. APA nursing paper template 6th edition.

Level 4 heading.

You will want to include at least two of each kind of heading in your paper, hence this additional paragraph modeling effective heading usage. See below for further tips on using headings effectively.

Level 3 heading.
Again, if you choose to use Level 3 or 4 headings, at least two of each heading level should appear in the paper. Otherwise, if only one heading appears, your readers may question the need for a heading at all. If you find yourself questioning whether or how to use headings, consider consulting your instructor or committee chair for his or her input.

Level 1 Heading

APA can seem difficult to master, but following the general rules becomes easier with use. The Writing Center also offers numerous resources on its website and by email to help. APA nursing paper template 6th edition.

And so forth until the conclusion…..

Level 1 Heading

The conclusion section should recap the major points of your paper. However, perhaps more importantly, the conclusion should also interpret what you have written and what it means in the bigger picture. To help write your concluding remarks, consider asking yourself these questions: What do you want to happen with the information you have provided? What do you want to change? What is your ultimate goal in using this information? What would it mean if the suggestions in your paper were taken and used? APA nursing paper template 6th edition.

 

References

(Please note that the following references are intended as examples only. Also, these illustrate different types of references but are not all cited in the text. In your paper, be sure every reference entry matches a citation, and every citation refers to an item in the reference list.)

Alexander, G., & Bonaparte, N. (2008). My way or the highway that I built.
Ancient Dictators
,
25
(7), 14–31. doi:10.8220/CTCE.52.1.23-91

Babar, E. (2007). The art of being a French elephant.
Adventurous Cartoon Animals,

19
, 4319–4392. Retrieved from http://www.elephants104.ace.org. APA nursing paper template 6th edition.

Bumstead, D. (2009). The essentials: Sandwiches and sleep.
Journals of Famous Loafers
,
5
, 565–582. doi:12.2847/CEDG.39.2.51-71

Hansel, G., & Gretel, D. (1973).
Candied houses and unfriendly occupants.
Thousand Oaks, CA: Fairy Tale Publishing.

Hera, J. (2008). Why Paris was wrong.
Journal of Greek Goddess Sore Spots
,
20
(4), 19-21. doi: 15.555/GGE.64.1.76-82

Laureate Education, Inc. (Producer). (2007).
How to cite a video: The city is always Baltimore
[DVD]. Baltimore, MD: Author.

Laureate Education, Inc. (Producer). (2010).
Name of program
[Video webcast]. Retrieved from http://www.courseurl.com

Sinatra, F. (2008). Zing! Went the strings of my heart.
Making Good Songs Great, 18
(3), 31–22. Retrieved from http://articlesextollingrecordingsofyore.192/fs.com. APA nursing paper template 6th edition.

Smasfaldi, H., Wareumph, I., Aeoli, Q., Rickies, F., Furoush, P., Aaegrade, V., … Fiiel, B. (2005).
The art of correcting surname mispronunciation.
New York, NY: Supportive Publisher Press. Retrieved from http://www.onewaytociteelectronicbooksperAPA7.02.com

White, S., & Red, R. (2001).
Stop and smell the what now? Floral arranging for beginners
(Research Report No. 40-921). Retrieved from University of Wooded Glen, Center for Aesthetic Improvements in Fairy Tales website: http://www.uwg.caift/~40_921.pdf. APA nursing paper template 6th edition.

Case Study: An Elderly Iranian Man With Alzheimer’s Disease

Examine 
Case Study: An Elderly Iranian Man With Alzheimer’s Disease
. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

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At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Note
: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Decision Tree Assignment

Here is a general framework for what I am looking for on the decision tree assignments.

Provide an 
introduction to the disease state
 discussed in the case. I am looking for a high-level summary that briefly describes the key aspects of that disease state. I do not want several pages of information related to the diagnosis of the disease state. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Provide a 
high-level summary of the important pieces of information from the case-study
 that is presented. I do not want the entire case study presented. The goal is that you would be able to give your essay to someone that does not know anything about the assignment and for that individual to be able to understand the purpose of your essay. Again….focus on the important pieces of information that will help you make your decision. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

You also want to mention the 
purpose of the assignment
. This can be brief.

Decision Point 1, 2, and 3.

At each decision point, 
list the options that are presented and describe your rationale for choosing the option you chose
.

I 
do not want general answers
….”I chose sertraline because sertraline is an SSRI and SSRIs are approved for depression/anxiety”. I want VERY SPECIFIC reasons you chose the option you chose. These reasons must be backed by good evidence. Feel free to include studies comparing agents, side effects, dosing, patient considerations, therapeutic practice guidelines, comorbid conditions, etc….  You will also need to 
explain your rationale for not choosing the other two options.
  This is very important in your learning. Please remember that you will have MANY more medications to chose from than three in clinical practice. When you make your choice, you also need to describe your 
goals of treatment
. What do you want to achieve by initiating the therapy you picked. Again….be specific. Defend your choices like you are in a courtroom.

After each decision, you will be presented with the outcome of that decision. You need to 
discuss how that outcome was what you expected or if it was different than what you expected and why.

You will do the above for all three decision points.

You need to use evidence to support your rationale. [Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Credible reference material only will be accepted. Sites such as WebMD and drugs.com (among others) will not be counted.] Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Don’t forget to include information related to the 
ethical considerations
 and how they might impact your treatment plan and communication with your clients. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

In summary: What needs to be in your essay.

Introduction regarding disease state

High-level summary of patient case

Purpose of the essay statement

Decision 1

What options were listed

What option did you choose?

Why did you select that option?

Why didn’t you select the other two options?

What was your goal of treatment

Was the outcome what you expected? Why?

Case Study: An Elderly Iranian Man With Alzheimer’s Disease

Decision 2

What options were listed

What option did you choose?

Why did you select that option?

Why didn’t you select the other two options?

What was your goal of treatment

Was the outcome what you expected? Why?

Decision 3

What options were listed

What option did you choose?

Why did you select that option?

Why didn’t you select the other two options?

What was your goal of treatment

Was the outcome what you expected? Why?

Conclusion with Ethical considerations

***Do not use the start over button and complete several different times. That is not the point. If you do use the START OVER button, I do not want your paper to reflect this. I have had students do it multiple times and address incorrect outcomes in their paper. I have also had students submit a paper that defends using all three options presented at decision point number one. You will need to click the option to move to the next screen which will provide you with the outcome and the options for the next decision point.  You will receive a ZERO on the assignment if you do not follow the instructions correctly. I had a handful of students last semester complete the assignment incorrectly.  Please ask questions if you do not understand. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Alzheimer’s Disease

76-year-old Iranian Male

BACKGROUND

Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

 

SUBJECTIVE

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

 

MENTAL STATUS EXAM

Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

 

RESOURCES

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

 

Decision Point One

Select what the PMHNP should do:

Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks

: Begin Aricept (donepezil) 5 mg orally at BEDTIME

Begin Razadyne (galantamine) 4 mg orally BID

Case Study: An Elderly Iranian Man With Alzheimer’s Disease

Razadyne (galantamine) 4 mg decision tree essay

Decision Point One

Begin Razadyne (galantamine) 4 mg orally BID

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RESULTS OF DECISION POINT ONE

 Client returns to clinic in four weeks

 The client is accompanied by his son who reports that his father is “no better” from this medication

 He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors

 You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

Razadyne (galantamine) 4 mg decision tree essay

Decision Point Two

 

Increase Razadyne to 24 mg extended release daily

 

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks

 The client’s son accompanies the client to his appointment today. The client is in a wheelchair and is somewhat agitated. Razadyne (galantamine) 4 mg decision tree essay.

 You are informed by the son that his father has not taken his medication since he got out of the hospital. Apparently, about 7 days after starting the Galantamine extended release, the client began having seizures which resulted in a fall and fractured hip. The son reports that his father is agitated with everyone and is asking for help in treating his agitation

Decision Point Three

 

Restart Razadyne extended release 24 mg

 

Guidance to Student

Razadyne extended release 24 mg is a “target” dose—not a starting dose. Side effects of Razadyne include GI side effects as well as dizziness. Rare side effects include seizures. If no other medications were added to the client’s medication regimen and no other physical issues were present (e.g., metabolic derangements), then the high dose of Razadyne in this client would most likely be responsible for his seizures, which resulted in the fall and the hip fracture. This would represent malpractice. If the PMHNP were to consider restarting Razadyne, it should be restarted at a proper starting dose, as side effects are often dose dependent. Razadyne (galantamine) 4 mg decision tree essay.

Risperdal would not be appropriate to treat agitation in this client as the FDA has issued a black box warning against the treatment of agitation in dementia with antipsychotic medications. Although they can still be used despite black box warnings, the PMHNP should conduct a comprehensive assessment of this client to see if a physical issue is causing the agitation. A hip fracture is often associated with pain, and untreated pain may be the cause of the client’s agitation. Therefore, assessment for pain would be the correct choice in this scenario.

Never use psychotropic drugs to treat behaviors until physical causes of the behavior have been ruled out (e.g., pain, infection, constipation). Razadyne (galantamine) 4 mg decision tree essay.

Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern. Razadyne (galantamine) 4 mg decision tree essay.

Management of African American Males with Congestive Heart Failure in the Primary Care Clinics Essay

Using the downloaded table, do a comprehensive literature review of 8 research articles on the Management of African American Males with congestive heart failure in the primary care clinics.

Important components to include in the assignment are:

Theoretical framework: Describe any theoretical or conceptual frameworks that serve as a guide for your project, summarize the frameworks, and explain how they relate to and provide support for your problem or population of interest.

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Synthesis and analysis of evidence (research) related to the problem or population of interest: Address the overall strengths, weaknesses, limitations, and gaps of the research. It is very important that this section provide a comprehensive review of the literature and contain a minimum of eight pages. Management of African American Males with Congestive Heart Failure in the Primary Care Clinics Essay

Assessing Context and Culture

• Kent and McCormack (2010) explore the importance of context and culture and their relationship to the implementation of evidence-based practice.

• After reading Developing Effective Research-Practice Partnerships for Creating a Culture of Evidence-Based Decision Making,

• Describe and demonstrate how context and culture affect the implementation of evidence with MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS

Reference:

Riemer, M., Kelley, S., Casey, S., and Taylor Haynes, K. (2012). Developing effective research-practice partnerships for creating a culture of evidence-based decision making. Administration and Policy in Mental Health, 39(4), 248–257. doi: 10.1007/s10488-011-0368-6

Write your initial response in 300 words: Cite your sources in your work and provide references for the citations in APA format. Management of African American Males with Congestive Heart Failure in the Primary Care Clinics Essay.

 

ORGANIZATIONAL LEADERSHIP EVIDENCE AND APPLICATION

•Discuss organizational leadership evidence as it pertains to your topic MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS. Everything we do in nursing should be supported by evidence. Whether we are looking to understand the organizational barriers that exist to change a policy or conduct a root-cause analysis to understand organizational failure, we know all too well that there are types of organizations that are more prone to success and those that are more prone to failure. Management of African American Males with Congestive Heart Failure in the Primary Care Clinics Essay.

•Discuss organizational leadership evidence as it pertains to your topic (MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS)

•Retrieve two peer-reviewed articles pertaining to organizational research ON MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS

•Critique each article, highlighting the strengths and the weaknesses of each article.

•Interpret the statistical analysis and significance of results.

•Lastly, analyze the feasibility of applying this evidence to your population/problem within MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS primary care practicum setting. Management of African American Males with Congestive Heart Failure in the Primary Care Clinics Essay.

. Both articles should support nursing standards and patient safety within MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS.

Write your initial Management of African American Males with Congestive Heart Failure in the Primary Care Clinics Essay response in 300 words

Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay

Health Promotion and Disease Prevention

Discuss health promotion and disease prevention as they pertain to MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS. Everything we do in nursing should be supported by evidence. Whether we are looking for ways to improve a hospital department\’s internal efficiency or looking how to improve a population\’s outcome, there is underlying evidence that supports the principles of health promotion and disease prevention. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

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• Retrieve two peer-reviewed articles pertaining to psychosocial research on MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS.

• Critique each article, highlighting the strengths and the weaknesses of each article. Interpret the statistical analysis and significance of results. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

• Finally, analyze the feasibility of applying this evidence to your topic (MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS.

• Both articles should directly correlate MANAGEMENT OF CHF IN AFRICAN AMERICAN MALES IN THE PRIMARY CARE CLINICS and Objectives of Healthy People 2020 (US Department of Health and Human Services, 2014)

Write your initial response in 300 words. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

Reference:

US Department of Health and Human Services. (2014). 2020 topics &

objectives – Objectives A–Z. Retrieved from http://www.healthy

people.gov/2020/topicsobjectives2020/

The discussion question is centered around the following assigned reading

PLEASE READ THIS ARTICLE

Shirey, M. R., Hauck, S. L., Embree, J. L., Kinner, T. J., Schaar, G. L., & Phillips,

L. A. (2011). Showcasing differences between quality improvement,

evidence-based practice, and research. The Journal of Continuing

Education in Nursing, 42(2), 57–68. doi:10.3928/00220124-20100701-

01

After you have read the article, respond to the following questions:

•Which category does Management of African American males with CHF in the primary care clinics project fit (quality improvement, evidence-based practice, or research)? Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

• Provide a rationale and evidence for your answer.

•Interprofessional collaboration has been shown to improve multiple outcomes.

• How will your project on Management of African American males with CHF in the primary care clinics include interprofessional collaboration? Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

. How will this collaboration occur after the project is complete

Overview of Project: Management of African American males with CHF in the primary care clinics

PLEASE USE HEADINGS TO ADDRESS EACH

Ø Create an overview of the PROJECT (Please be detailed)

Instruments; What instruments will you use? What evidence or research exists for the instruments? Have they been determined to be valid or reliable? If so, for what groups? If you are using an instrument or tool that has not been well studied, ensure that you provide evidence to justify its use in your project. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

• Data collection methods: Are there any other points of data that you will be collecting that have not previously been mentioned? The emphasis in this section should be on fully describing specifically what data you will be using in your study. Part of the purpose of doing this is to detect flaws in the plan before they become problems in the project.

• Data analysis plan. Data Analysis Plan: How will you analyze your data? This section should explain in some detail how you will manipulate the data that you assembled to get at the information that you will use to answer your question. When describing statistical tests, ensure that you have specified the appropriate information, such as the significance level and type of confidence interval (one- or two sided). Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

Ø Describe what meaning the output of any statistical tests will help answer and how it relates to your PICOT/clinical problem.

Ø Please Create a substantive paper to develop a solid plan for the project that incorporates deliverable implementation.

PICOT question

PICOT QUESTION: In African American males with CHF, what are the tools needed for the effective management of this condition in the primary care clinics to help improve the overall outcome among? Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

P= Pt population: African American males with CHF

I= Interventions: Management of CHF among African American males in the US through effective educational and monitoring and evaluation tools in the primary care clinics,

C= Comparison: As compared to noneducational and monitoring tools in the management of CHF among African American males in the US in the primary care cl

O Outcome: Decrease in the frequency of adverse events and an improved overall outcome among this population of patients with CHF.

T= Time: Over one-year period.

PLEASE USE REFERENCES THAT ARE CURRENT AND LESS THAN 5 YEARS OLD

Informatics and Data Mining Evidence and Application

• In this assignment, you will discuss informatics or data mining evidence as it pertains to the topic. (Management of CHF in African American Males in the primary care clinics). Consider whether your site is a Stage 1 or 2 meaningful use site. How does this impact clinical quality? Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

• Retrieve two peer-reviewed articles pertaining to informatics research and your topic of interest (Management of CHF in African American Males in the primary care clinics). Critique each article, highlighting the strengths and the weaknesses of each article. Interpret the statistical analysis and significance of results. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

• Finally, analyze the feasibility of applying this evidence to your topic of interest in your current practicum setting. Both articles should support nursing standards and patient safety within your chosen topic. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

Quality Improvement and Evidence Application

In this assignment, you will discuss quality improvement evidence (research) as it pertains to your topic and clinical practicum. Everything we do in nursing should be supported by evidence. Quality improvement initiatives that address practice patterns, healthcare organizations, and variances in health outcomes, in order to promote safe, efficient, ethical, and patient-centered care are often the hallmark of many scholarly projects. Use authentic internet sources and retrieve two peer-reviewed articles pertaining to quality improvement (or quality improvement initiatives) related to your topic of interest(management of chf in african american males in the primary care clinic) Critique each article, highlighting the strengths and the weaknesses of each article. Interpret the statistical analysis and significance of results. Finally, analyze the feasibility of applying this evidence to your topic of interest in your current practicum setting. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

**Please use current articles/source that are less than 5 years old

INTERPROFESIONAL COLLABORATION

Retrieve two peer-reviewed research articles from authentic internet sources highlighting interprofessional collaboration related to your topic. Critique each article, highlighting the strengths and the weaknesses of each article. Interpret the statistical analysis and significance of results. Finally, analyze the feasibility of applying this evidence to your topic of interest(management of African American males in the primary care clinics) in your current practicum setting (cardiologist clinic).Both articles should support nursing standards and patient safety within your chosen topic. Management of Congestive Heart Failure (CHF) In African American Males in the Primary Care Clinics Essay.

This Health Policy & Politics Essay paper explores a nurses role in health care, policies implemented, and the legislative process in which they operate. Nurses are not only advocates for themselves; they are also an advocate for their patients. Health Policy & Politics Essay. Therefore, it is important for nurses to be active in lobbying for much needed policies that concern their healthcare and wellbeing. It sheds some light on various organizations set into place in which these nurses can come together and have a voice in which to enable the changes desired and needed for individual voices that may not have been heard otherwise. It explores a few specific healthcare policies that have had major influences on healthcare management as well as the nurses themselves. Health Policy & Politics Essay. In addition, it outlines some of the legislative processes, budgetary and bill policies, as well as some of the programs not otherwise known to have been started through nurses rallying together to allow citizens better healthcare regardless of race, socio-economic status, or age. Nurses truly are the apex of healthcare policy and legislature. Health Policy & Politics Essay.

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Legislature, by definition, is a powerful and intimidating body of officials that seem to do works above that of your everyday individual out in the workforce living pay check to paycheck. However, when closely examined, legislature starts with that very individual. It is said that it takes an entire village to raise a child; as is the case of health care policies and legislature. Health care is universal to everyone in the fact that everyone needs healthcare and is therefore, affected by its policies. Everyone has the power to make changes that can benefit them as an individual. These individuals bind with other like-minded individuals and form a united voice in which a platform is set for desired changes to be heard. Nurses are at the very apex of this voice as they are on the front-lines with these individuals giving the day to day care and have first-hand knowledge to help in health care policies and legislature…Health Policy & Politics Essay.

A healthcare policy is a set of rules and regulations that are put into effect to assist in the operation and the shape of health delivery. A healthcare policy covers a range of issue including public health, chronic illness and disability, long-term care, the financing of health care, preventive health care and mental health. There are two models of a healthcare which consist of the single payer and the social insurance system. In the single payer model, taxes are paid to the government which then pays healthcare providers such as nurses, doctors, and dentists to provide health services to individuals. In a social insurance system, citizens must purchase health insurance from non-profit insurance companies who will then use this health insurance to pay for services provided by healthcare providers. Healthcare is financed through private insurance companies which individuals can access through their employers and for the many Americans that are uninsured, there are three programs in which they can go through called Medicare, Medicaid, and The State Children’s Health Insurance Program. Health Policy & Politics Essay. Medicare mainly deals with Americans who are over the age of 65 or disabled. Medicaid deals with people who are of low income or maybe classified as being poor. The State Children’s Health Insurance Program deals with people who are uninsured or low income children. There are so many aspects that can make up healthcare policy and there will be many more that will have an impact on healthcare in the future…

The legislative process is a pivotal process that shapes the health care policy within the country. The US healthcare system requires a lot of influencing and lobbying in order to adopt or to implement the necessary health care reform policies. The nurses are the relevant people to push for these reforms through their associations or alliances e.g. The Nursing Organizations Alliance (NOA).

The nurses hold the most influential position in driving for the necessary healthcare reforms; this is because of their numbers, expertise and also their positions. The evidence of these numbers is demonstrated by a statistical report which shows that in every 44 female voters in the US there is one nurse. Secondly, in every 100 voters there is one nurse. Finally, there is evidence that there are 100,000 nurses in every congressional district (source: Leavitt, 2003)…

The Need for Nurses to Engage in Political Involvement There has been a pandemic apathy towards political activism among the nursing fraternity, despite the fact that politics to a greater extent affects the way these medical practitioners carry out their duty of providing care. Nurses have not seen any reason for political involvement citing that no direct relationship exists between nursing and political activism (Boswell, Canon and Miller 5). Health Policy & Politics Essay. They claim that nursing is about application and service, demonstration by involvement and more of ‘walking the walk’ rather than the political ‘talking the talk’ (Rains and Barton-Kriese 219). Political activism to them is a waste of the precious time that could be used to provide healthcare to…Health Policy & Politics Essay

The public policy issue selected is childhood obesity. I selected this issue because childhood obesity has a considerable longstanding impact on the health of the public as well as the cost of health care. This is becoming a more significant issue in the public realm because childhood obesity emanates from the main reason that these children grow up into obese adults who might end up suffering a great deal of health problems. According to the Centers for Disease Control and Prevention (CDC) (2015), childhood obesity has more than doubled and increased fourfold in adolescents in the past three decades. Statistics indicate that by 2012, more than 33% of the children and adolescents in the United States were obese or overweight. This implies that there is a need for policy intervention addressing this health hazard. Health Policy & Politics Essay.

Research studies undertaken have indicated that childhood obesity is a relevant public policy issue to the health of the general public. According to Karnik and Kanekar (2012), childhood obesity is a growing issue of concern with regard to the health and welfare of the child. The cause of childhood obesity is the disparity between calorie consumption and calories that are used up. There are several factors that are causal to this public policy issue, which include genetic, environmental and behavioral factors. Health Policy & Politics Essay. The pervasiveness of childhood obesity is increasing in both developed and developing nations. It is ranked as one of the major health problems indicating that incidence of childhood obesity has amplified over the years. The augmented pervasiveness of childhood obesity may have detrimental ill health and transience repercussions in the adult phase of the child. In particular, physical, psychosomatic, and social health complications are caused as a result of childhood obesity (Karnik and Kanekar, 2012)…Health Policy & Politics Essay.

Health Care Reform is a concern for people that have health insurance, for those that can’t afford health insurance and the price of healthcare for all of us. Health Policy & Politics Essay. There are the difference views on Health Care Reform: The healthcare view, the public opinion and The House and the Senate. The Center for Medicare and Medicaid will withhold 2% of base payments that would serve as incentive payments to hospital based on their total performance score derived from separate domains. The current domains include process measure, outcome and patient satisfaction…Health Policy & Politics Essay.

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

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

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Course Outcomes

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

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

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

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

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

Points

Milestone 2 is worth 225 points.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

**Academic Integrity Reminder**

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

NR451_Milestone2_2

NR451_Milestone2_2

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Introduction

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

25.0 pts

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

22.0 pts

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

20.0 pts

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

10.0 pts

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

0.0 pts

Introduction is missing.

25.0 pts

This criterion is linked to a Learning Outcome Change Model Overview

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

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

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

44.0 pts

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

40.0 pts

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

19.0 pts

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

0.0 pts

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

50.0 pts

This criterion is linked to a Learning Outcome Evidence

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

50.0 pts

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

44.0 pts

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

40.0 pts

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

19.0 pts

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

0.0 pts

Evidence summary is not provided.

50.0 pts

This criterion is linked to a Learning Outcome Translation

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

50.0 pts

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

44.0 pts

Activities to achieve final steps of change are adequately described.

40.0 pts

Activities to achieve final steps of change are briefly described.

19.0 pts

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

0.0 pts

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

50.0 pts

This criterion is linked to a Learning Outcome Conclusion

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

25.0 pts

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

22.0 pts

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

20.0 pts

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

10.0 pts

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

0.0 pts

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

25.0 pts

This criterion is linked to a Learning Outcome Mechanics

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

25.0 pts

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

22.0 pts

Two to three errors in elements from the first column.

20.0 pts

Four to five errors in elements from the first column.

10.0 pts

Six to seven errors in elements from the first column.

0.0 pts

More than seven errors.

25.0 pts

Total Points: 225.0

Capstone Project Milestone 2- Design for Change Proposal Guidelines

Capstone Project Milestone 1:

Practice Issue and Evidence Summary Worksheets

 

Student Name:
                                                        
Date:

Directions

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

Type your answers directly into the worksheets below.

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

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

 

Practice Issue Worksheet

 

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

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

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

 

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

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

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

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

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

Fully describe the scope of the practice issue:

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

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

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

 

What is the practice area?

__X_ Clinical

_X__ Education

___ Administration

___ Other (List):

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

___ Safety/risk management concerns

_X__ Unsatisfactory patient outcomes

___ Wide variations in practice

_X__ Significant financial concerns

 

 

___ Difference between hospital and community practice

__X_ Clinical practice issue is a concern

___ Procedure or process is a time waster

___ Clinical practice issue has no scientific base

__ Other:

Describe the rationale for your checked selections:

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

 

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

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

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

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

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

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

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

 

__X_ Literature search

_X__ Guidelines

___ Expert Opinion

___ Patient Preferences

_X__ Clinical Expertise

__X_ Financial Analysis

__X_ Standards (Regulatory, professional, community)

___ Other

 

Describe the rationale for your checked selections:

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

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

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

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

 

Evidence Summary Worksheet

Directions
: Please type your answers directly into the worksheet.

 

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

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

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

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

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

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

 

Identify the objectives of the article:

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

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

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

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

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

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

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

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

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

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

–          Engage co-workers to be involved

–          Execute the research plan.

–          Evaluate the outcome of readmissions.

–          Address patient communication needs during discharge

–          Engage patients and families in discharge planning and instruction

–          Provide discharge instruction that meets patient needs

–          Identify follow up providers that can meet patient needs

The follow-up phone call consists of five components:

–          Assessment of health status.

–          Medication check.

–          Clarification of follow up appointments.

–          Post discharge home resources.

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

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

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

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

 

Practice Issue and Evidence Summary Worksheets

 

Title

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

 

 

Your title here

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

Change Model Overview

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

Define the Scope of the EBP

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

Stakeholders

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

Determine Responsibility of Team Members

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

Evidence

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

Summarize the Evidence

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

Develop Recommendations for Change Based on Evidence

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

Translation

Action Plan

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

Process, Outcomes Evaluation and Reporting

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

Identify Next Steps

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

Disseminate Findings

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

Design Proposal Outline

Conclusion

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

Nursing Seminar Discussions Questions

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

ORDER A PLAGIARISM-FREE PAPER HERE

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

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

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

Please use 2 citing per question

 

Also may use for citing

Teaching in Nursing: A Guide for Faculty

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