Evidence-Based Practice and the Quadruple Aim
Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.
More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.
To Prepare:
· Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
· Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
· Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.
To Complete:
Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.
Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:
· Patient experience
· Population health
· Costs
· Work life of healthcare providers
Name: NURS_6052_Module01_Week01_Assignment_Rubric
Excellent
Good
Fair
Poor
Write a brief analysis of the connection between evidence-based practice and the Quadruple Aim. Your analysis should address how evidence-based practice might (or might not) help reach the Quadruple Aim, including each of the four measures of:
· Patient experience
· Population health
· Costs
· Work life of healthcare providers
77 (77%) - 85 (85%)
The analysis clearly and accurately addresses in detail how evidence-based practice either supports or does not support the Quadruple Aim.
The analysis accurately and thoroughly explains in detail how the four measures of patient experience, population health, costs, and work-life of healthcare providers either supports or does not support the Quadruple Aim.
The analysis provides a complete, detailed, and specific synthesis of two outside resources reviewed on the four measures supporting or not supporting the Quadruple Aim. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the analysis provided with credible and detailed examples.
68 (68%) - 76 (76%)
The analysis accurately addresses how evidence-based practice either supports or does not support the Quadruple Aim.
The analysis accurately explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim.
The analysis provides an accurate synthesis of at least one outside resource reviewed on the four measures supporting or not supporting the Quadruple Aim. The response integrates at least 1 outside resource and two or three course-specific resources that may support the analysis provided and may include some detailed examples.
60 (60%) - 67 (67%)
The analysis inaccurately or vaguely addresses how evidence-based practice either supports or does not support the Quadruple Aim.
The analysis inaccurately or vaguely explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim.
The analysis provides an inaccurate or vague analysis of the four measures supporting or not supporting the Quadruple Aim with a vague or inaccurate analysis of outside resources. The response minimally integrates resources that may support the analysis provided and may include vague or inaccurate examples.
0 (0%) - 59 (59%)
The analysis inaccurately and vaguely addresses how evidence-based practice either supports or does not support the Quadruple Aim or is missing.
The analysis inaccurately and vaguely explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim or is missing.
The analysis provides a vague and inaccurate analysis of the four measures supporting or not supporting the Quadruple Aim with a vague and inaccurate analysis of outside resources. The response fails to integrate any resources to support the analysis provided or is missing.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
4 (4%) - 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.
3.5 (3.5%) - 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time.
Purpose, introduction, and conclusion of the assignment is vague or off topic.
0 (0%) - 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
4 (4%) - 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors.
3.5 (3.5%) - 3.5 (3.5%)
Contains several (three or four) grammar, spelling, and punctuation errors.
0 (0%) - 3 (3%)
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 (5%) - 5 (5%)
Uses correct APA format with no errors.
Course Readings
Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. doi:10.1111/wvn.12126
Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171
Policy Proposal Presentation
Prepare a presentation of the policy proposal you developed in Assessment 2 for one of the stakeholder groups identified in your proposal. Inform the group about the future of organizational policy and practices, the current performance shortfalls, and the rationale for why the new policy and practices are needed. In addition, explain how the group will benefit from this change in order to obtain their buy in and support.
Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.
Improving quality and outcomes is a key focus for health care organizations. With a focus on quality, the Centers for Medicare and Medicaid Services (CMS) publish publically reported data online and update it quarterly, which allows patients to compare hospitals on a wide range of metrics. These metrics can also be used to inform policy changes at local, state, and federal levels.
It is important that health care leaders be able to clearly articulate policy positions and recommendations and garner buy in and support from stakeholder groups for policy and practice changes in their organizations. Unfortunately, there is often a lack of effective communication. Consequently, it is important for health care leaders, when leading change, to ensure that clear and open communication is ongoing and informative.
An important aspect of change leadership is the ability to address diverse groups of stakeholders and create buy in and support for your ideas and proposals for change. This assessment provides you with an opportunity to demonstrate and hone these skills.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the effects of health care policies, laws, and regulations on organizations, interprofessional teams, and personal practice.
Analyze how proposed institutional policy or practice guidelines related to an existing health care policy or law would impact a stakeholder group.
Competency 3: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
Propose an institutional policy or practice guidelines related to an existing local, state, or federal health care policy or law.
Advocate for how the proposal would improve quality and outcomes relevant to the stakeholder group.
Competency 4: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, for health care policies and law for patients, organizations, and populations.
Interpret for stakeholders the relevant benchmark metrics that illustrate the need for a policy or practice guidelines.
Competency 5: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
Propose strategies for collaborating with a stakeholder group to implement and apply proposed institutional policy or practice guidelines related to a local, state, or federal health care policy or law.
Competency 6: Apply various methods of communicating with policy makers, stakeholders, colleagues, and patients to ensure that communication in a given situation is professional, clear, efficient, and effective.
Apply persuasive and effective communication strategies when presenting to a group of stakeholders.
Preparation
The policy proposal you developed was well received by senior leadership. As a result, they have asked you to put together a presentation for one of the stakeholder groups that you identified in your proposal.
Your deliverable for this assessment is a slide deck to support your presentation. You may use Microsoft PowerPoint or any other suitable presentation software. Please use the notes section of each slide to develop your talking points and reference your sources, as appropriate.
If you choose to use PowerPoint and need help designing your presentation, you may wish to explore the Guidelines for Effective PowerPoint Presentations [PPTX] and Record a Slide Show With Narration and Slide Timings resources.
If you need any additional guidance for recording a presentation in Kaltura, the Using Kaltura [PDF] resource may be helpful.
The Building Buy In and Communicating With Stakeholders | Transcript media piece may help to provide context for you presentation or refine your communication strategy for specific stakeholders.
The design and organization of your presentation will determine how many slides you need. However, in this instance, senior leaders have suggested that 8–12 slides is a reasonable expectation for this presentation.
Presentation Design Tips
Being able to effectively address any audience is a necessary leadership skill. Remember that you are the speaker, not a projectionist. Your purpose is not to present a slide show. Your audience is there to listen to what you have to say, not read your slides—or worse, listen to you read them. Design your presentation slides to compliment and reinforce your message and engage your listeners.
The following tips will help you create presentation slides that work to your advantage:
Focus on the content of your presentation and the development of your main points. Remember that your purpose is to deliver a message on ethics that is clear, well organized, and engaging.
Consider your intended audience and how best to communicate effectively with them.
Create slides that support your presentation. They should not be your presentation.
Use a professional presentation template, or one used in your organization.
Ensure that your slide background provides sufficient visual contrast for your text and graphics.
Avoid filling your slides with text. Use speaker notes to record the details you want to communicate to your audience.
Be judicious in your use of bulleted lists. Consider a separate slide for each point.
Use images and graphics, when appropriate, to illustrate information and make your points. Presentation slides are a visual medium. Images are more effective than text at capturing viewers' attention.
Avoid using images that are simply decorative. They can be a visual distraction and do not contribute to your message.
Avoid using flashy slide transitions and animations. They can be both distracting and annoying. Keep your slide transitions consistent throughout the presentation.
Add a slide to the end of your presentation to prompt questions from the audience.
Instructions
Note: The tasks outlined below correspond to grading criteria in the scoring guide.
In your presentation, in an order that makes sense for your presentation, senior leaders have asked that you:
Interpret for stakeholders the relevant benchmark metrics that illustrate the need for a change in organizational policy and practice.
Provide a brief review of the metrics you are trying to improve for this stakeholder group, based on the dashboard benchmark evaluation you completed in Assessment 1.
Be sure to interpret the dashboard metrics in a way that is understandable and meaningful to the stakeholder group to which you are presenting.
Explain your proposed change in policy and practice guidelines and how it relates to applicable local, state, or federal health care laws or policies.
What specific changes are you proposing?
How will these changes help drive performance improvement?
Why are policy and practice guidelines important, from an organizational standpoint?
What is the overall goal of the proposed policy or practice guidelines?
Explain how your proposed change in policy or practice guidelines will affect the tasks and responsibilities of the stakeholder group to which you are presenting.
How might your proposal change what tasks the stakeholder group performs or how they currently perform them?
How might your proposal affect the stakeholder group's workload?
How might your proposal alter the responsibilities of the stakeholder group?
How might your proposal improve working conditions for the stakeholder group?
Explain how your proposed change in policy or practice guidelines will improve the quality of work and outcomes for the stakeholder group to which you are presenting.
How will your proposed changes improve the group's quality of work?
How will your proposed change improve outcomes for the group?
How will these improvements enable the stakeholder group to be more successful?
Explain your strategies for collaborating with the stakeholder group to implement your proposed change in policy or practice guidelines.
What role will the stakeholder group play in implementing your proposal?
How could the stakeholder group collaborate with you and others during the implementation of your proposal?
Why is the stakeholder group's collaboration important to successful implementation of your proposal?
Design your presentation to be persuasive and effective in communicating with the stakeholder group.
Is your presentation logically organized, clear, and professional?
Additional Requirements
Format and length of presentation: A PowerPoint Presentation containing 8–12 slides.
Recorded audio of you presenting your PowerPoint that is targeted at key stakeholders in your audience.
If you have technical difficulties in recording your audio, you may instead include a full script of what you intended to say in the notes section of each slide in place of recording audio.
Number of references: Cite a minimum of 3–5 sources of scholarly, professional, or policy evidence to support your analysis and recommendations.
APA formatting: Resources and citations are formatted according to current APA style.
Submit your PowerPoint presentation and any other necessary documentation or links (if you used other technology) when you turn in this assessment.
Grading Rubric:
1. Propose an institutional policy or practice guidelines related to an existing local, state, or federal health care policy or law.
Passing Grade: Proposes an institutional policy or practice guidelines related to an existing local, state, or federal health care policy or law, and identifies assumptions on which the proposal is based.
2. Interpret for stakeholders the relevant benchmark metrics that illustrate the need for a policy or practice guidelines.
Passing Grade: Interprets for stakeholders the relevant benchmark metrics that illustrate the need for a policy or practice guidelines, including details or perspectives that will be especially relevant for the specific stakeholder group .
3. Analyze how proposed institutional policy or practice guidelines related to an existing health care policy or law would impact a stakeholder group.
Passing Grade: Analyzes how proposed institutional policy or practice guidelines related to an existing health care policy or law would impact a stakeholder group; identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the analysis).
4. Advocate for how the proposal would improve quality and outcomes relevant to the stakeholder group.
Passing Grade: Advocates for how the proposed changes would improve quality and outcomes relevant to the stakeholder group, and impartially considers and addresses conflicting data or perspectives.
5. Propose strategies for collaborating with a stakeholder group to implement and apply proposed institutional policy or practice guidelines related to a local, state, or federal health care policy or law.
Passing Grade: Proposes strategies for collaborating with a stakeholder group to implement and apply proposed institutional policy or practice guidelines related to a local, state, or federal health care policy or law; shows insight to stakeholder perspectives by addressing possible objections.
6. Apply persuasive and effective communication when presenting to a group of stakeholders.
Passing Grade: Applies persuasive and effective communication when presenting to a group of stakeholders, and includes details that demonstrate attention to the interests and concerns of the stakeholder audience.
Future of Nursing: Leading Change, Advancing Health
makes recommendations for lifelong learning and achieving higher levels of education.
In 1,000-1,250 words, examine the importance of nursing education and discuss your overall educational goals.
Include the following:
Discuss your options in the job market based on your educational level.
Review the IOM Future of Nursing Recommendations for achieving higher levels of education. Describe what professional certification and advanced degrees (MSN, DNP, etc.) you want to pursue and explain your reasons for wanting to attain the education. Discuss your timeline for accomplishing these goals.
Discuss how increasing your level of education would affect how your competitiveness in the current job market and your role in the future of nursing.
Discuss the relationship of continuing nursing education to competency, attitudes, knowledge, and the ANA Scope and Standards for Practice and Code of Ethics.
Discuss whether continuing nursing education should be mandatory. Provide support for your response.
You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Egyptian and Filipino Heritage
Present an essay discussing the health care beliefs of both heritages, and similarities between both cultures beliefs. Also, discuss how their beliefs influence the delivery of evidence-based healthcare focusing on the nursing care.
The essay must be presented in an APA format, word document, Arial 12 font. The assignment must include at least 2 evidence-based references. Reference should not be older than five years.
A minimum of 700 words (excluding the first and references page) is required.
Patricia Benner's Five Stages of Proficiency
Please read Patricia Benner's Five Stages of Proficiency. Explain the importance of this theory through a nurse's perspective. No references are required. Your summary should be at least 300 words using good spelling and grammar. Can be single or double spaced. Attached Files:
Dr. Patricia Benner is a nursing theorist who first developed a model for the stages of clinical competence in her classic book “From Novice to Expert: Excellence and Power in Clinical Nursing Practice”. Her model is one of the most useful frameworks for assessing nurses’ needs at different stages of professional growth. She is the Chief Faculty Development Officer for Educating Nurses, the Director of the Carnegie Foundation for the Advancement of Teaching National Nursing Education and honorary fellow of the Royal College of Nursing.
Dr. Benner was born in Hampton, Virginia, and received her bachelor’s degree in Nursing from Pasadena College in 1964, and later a master’s degree in Medical-Surgical Nursing from the University of California, Berkeley. After completing her doctorate in 1982, she became an Associate Professor in the Department of Physiological Nursing at the University of California, San Francisco. Dr. Benner is an internationally known lecturer and researcher on health, and her work has influenced areas of clinical practice as well as clinical ethics.
This nursing theory proposes that expert nurses develop skills and understanding of patient care over time through a proper educational background as well as a multitude of experiences. Dr. Benner’s theory is not focused on how to be a nurse, rather on how nurses acquire nursing knowledge – one could gain knowledge and skills (“knowing how”), without ever learning the theory (“knowing that”). She used the Dreyfus Model of Skill Acquisition as a foundation for her work. The Dreyfus model, described by brothers Stuart and Hubert Dreyfus, is a model based on observations of chess players, Air Force pilots, army commanders and tank drivers. The Dreyfus brothers believed learning was experiential (learning through experience) as well as situation-based, and that a student had to pass through five very distinct stages in learning, from novice to expert.
Dr. Benner found similar parallels in nursing, where improved practice depended on experience and science, and developing those skills was a long and progressive process. She found when nurses engaged in various situations, and learned from them, they developed “skills of involvement” with patients and family. Her model has also been relevant for ethical development of nurses since perception of ethical issues is also dependent on the nurses’ level of expertise. This model has been applied to several disciplines beyond clinical nursing, and understanding the five stages of clinical competence helps nurses support one another and appreciate that expertise in any field is a process learned over time.
Dr. Benner’s Stages of Clinical Competence
Stage 1 Novice: This would be a nursing student in his or her first year of clinical education; behavior in the clinical setting is very limited and inflexible. Novices have a very limited ability to predict what might happen in a particular patient situation. Signs and symptoms, such as change in mental status, can only be recognized after a novice nurse has had experience with patients with similar symptoms.
Stage 2 Advanced Beginner: Those are the new grads in their first jobs; nurses have had more experiences that enable them to recognize recurrent, meaningful components of a situation. They have the knowledge and the know-how but not enough in-depth experience.
Stage 3 Competent: These nurses lack the speed and flexibility of proficient nurses, but they have some mastery and can rely on advance planning and organizational skills. Competent nurses recognize patterns and nature of clinical situations more quickly and accurately than advanced beginners.
Stage 4 Proficient: At this level, nurses are capable to see situations as “wholes” rather than parts. Proficient nurses learn from experience what events typically occur and are able to modify plans in response to different events.
Stage 5 Expert: Nurses who are able to recognize demands and resources in situations and attain their goals. These nurses know what needs to be done. They no longer rely solely on rules to guide their actions under certain situations. They have an intuitive grasp of the situation based on their deep knowledge and experience. Focus is on the most relevant problems and not irrelevant ones. Analytical tools are used only when they have no experience with an event, or when events don’t occur as expected.
Beginner nurses focus on tasks and follow a “to do” list. Expert nurses focus on the whole picture even when performing tasks. They are able to notice subtle signs of a situation such as a patient that is a little harder to arouse than in previous encounters.
The significance of this theory is that these levels reflect a movement from past, abstract concepts to past, concrete experiences. Each step builds from the previous one as these abstract principles are expanded by experience, and the nurse gains clinical experience. This theory has changed the perception of what it means to be an expert nurse. The expert is no longer the nurse with the highest paying job, but the nurse who provides the most exquisite nursing care.
The Nurse Leader as Knowledge Worker
The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?
Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.
In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.
Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.
To Prepare:
Review the concepts of informatics as presented in the Resources.
Reflect on the role of a nurse leader as a knowledge worker.
Consider how knowledge may be informed by data that is collected/accessed.
The Assignment:
Explain the concept of a knowledge worker.
Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
Develop a simple infographic to help explain these concepts.
Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–19)
Chapter 2, “Introduction to Information, Information Science, and Information Systems” (pp. 21–33)
Chapter 3, “Computer Science and the Foundation of Knowledge Model” (pp. 35–62)
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212–221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
Note: You will access this article from the Walden Library databases.
Required Media
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
Accessible player --Downloads--Download Video w/CCDownload AudioDownload Transcript
Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health [Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo
Annotated Bibliography
The purpose of this assignment is to demonstrate progress in compiling research and to indicate a methodology for organizing research sources.
Recommended: Before you begin, review chapters 4–6 in A Pocket Style Manual (APA).
Include the following in your annotated bibliography:
APA citations and annotations for three (3) sources you deem relevant to your problem statement (thesis).
Add these three sources onto your work from last week so that you now have a total of six (6) sources
For each source:
Cite the source in proper APA format. The citations should be organized in alphabetical order by author as in an APA References page.
Follow with a brief annotation that summarizes the source (approximately 3–5 sentences). You may quote from the source, but do not copy and paste from the abstract.
In 1 or 2 sentences, explain and evaluate the source’s relevance and significance to your research.
Use an academic tone and style.
Review the rubric for further information on how your assignment will be graded. Include a copy of your working thesis statement at the top of your assignment submission
Trends in healthcare
From the daily briefs, Kaiser Health News Morning Briefing or POLITICO Pulse.
List the interest groups that are mentioned in the brief and what their interest is in the piece.
Categorize the issues in the brief according to the following—politics and politicians, access to health care, health care insurance, health care legislation, money, drugs, or other."
Discussion
: A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate. The roommate states that he does not know how long the patient had been lying there. Patient received naloxone in the field and has become responsive. He complains of burning pain over his left hip and forearm. Evaluation in the ED revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm. EKG demonstrated prolonged PR interval and peaked T wave
Serum potassium level 6.9 mEq/L
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
· The role genetics plays in the disease.
· Why the patient is presenting with the specific symptoms described.
· The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
· The cells that are involved in this process.
· How another characteristic (e.g., gender, genetics) would change your response
Nursing Theory Comparison Paper
The purpose of this assignment is to draft and submit a comprehensive and complete rough draft of your Nursing Theory Comparison paper in APA format. Your rough draft should include all of the research paper elements of a final draft, which are listed below.
The two approved theories to compare are:
Grand Nursing Theory: Hildegard Replau: Interpersonal Relations in Nursing.
Middle Range Nursing Theory: Kristen M. Swanson: Theory of Caring.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II-------this is our text book
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 10 and 11), select a middle-range theory
The following should be included:
An introduction, including an overview of both selected nursing theories
Background of the theories
Philosophical underpinnings of the theories
Major assumptions, concepts, and relationships
Clinical applications/usefulness/value to extending nursing science testability
Comparison of the use of both theories in nursing practice
Specific examples of how both theories could be applied in your specific clinical setting
Parsimony
Conclusion/summary
References: Use the course text and a minimum of three additional sources, listed in APA format
The paper should be 8–10 pages long and based on instructor-approved theories. It should be typed in Times New Roman with 12-point font, and double-spaced with 1"" margins. APA format must be used, including a properly formatted cover page, in-text citations, and a reference list. The proper use of headings in APA format is also required.
