Identifying A Clinical Question
Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least five (5) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Identify a clinical question related to your work environment, write the question in PICOT format and perform a literature search on the identified topic.
Purpose
To enable the student to identify a clinical question related to a specified area of practice and use medical and nursing databases to find research articles that will provide evidence to validate nursing interventions regarding a specific area of nursing practice.
Review the Application Case Study for Chapter 3: Finding Relevant Evidence to Answer Clinical Questions as a guide for your literature search.
Guidelines
Identify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.
Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).
Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.
Assignment Expectations:
Length: 1000 – 1500 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of five (5) scholarly sources are required for this assignment to support the topic.
Special topics in nursing practice
With each passing year, the United States is becoming more racially, ethnically, and culturally diverse. This growth of diversity is not occurring in our population of healthcare professionals and this lack of parallel growth results in the provision of discordant patient care. Nurses must be educated to be able to negotiate across cultural divides that may occur during our interactions with patients whose cultural background is different from our own. Nurses must become culturally competent to provide safe, high-quality care for diverse patient populations for improved patient outcomes.
Part 1. Discuss the following questions:
How does culture shape nurses’ concepts of health and their nursing practice?
What does it mean to be culturally competent and culturally sensitive? Why are these important in nursing?
Part 2. Discuss the meaning of healthcare disparities.
Choose one of the following cultural groups. Discuss the healthcare disparities they encounter and culture-specific nursing considerations.
1. Asian/Pacific Islander Americans
2. Black Americans
3. Latino/Hispanic Americans
4. Native Americans/Alaska Natives/American Indians
5. White Americans
Part 3: Discuss what learned in the OMH Cultural Competency Assignment.
Support your discussion with information from one or more of the ANA textbooks
Personal Theoretical Framework for Advanced Practice Nursing
Discuss a personal nursing philosophy. Apply what you have learned about nursing theory in this course. Identify a nursing philosophy that best matches your personal philosophy. Discuss a nursing framework or theory that fits that philosophy including how it fits your personal philosophy. Identify a possible situation in which that framework or theory would be a poor fit and discuss why it is a poor fit for that situation. While it is an important skill to be able to match a theory with a situation, it is also critical to understand when a theory or framework does not fit a situation
Wait Times
The Institute of Medicine defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”. Waiting to obtain an appointment with your MD or sitting for long periods in the Emergency Room can have negative health effects.
You open your social media app and you see a story on your timeline from your local news station that stated the following: Deaths due to long wait times
At Memorial hospital (inpatient and outpatient services), wait times to be seen for the emergency room (ER) and for primary care exceed quality standards. The wait times could range between three to four hours at the ER and an hour or two to be seen at the primary care clinic. Appointments to see a surgeon for surgical procedures are booking out weeks, unfortunately leading to deaths. Because of this, the Center for Medicare & Medicaid Services (CMS) is sending a team to conduct an audit. One possible result of the visit could be a reduction or loss of federal funding. Your job is to write a report that lead to a positive outcome for the hospital.
Examine this report: Measuring Health Care Quality: An Overview of Quality Measures
Implement quality measures at Memorial Hospital
Include the following aspects in the report:
Ø Choose a quality measure for each problem you identify
Ø Consider how you will implement changes to achieve the standards
Ø Outline the financial impact of your changes
Ø What kinds of systems need to be created to track progress?
Ø Please use this template
Reflective journal
Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.
This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).
In each week's entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below. In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.
New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
Ensuring the integrity of human dignity in the care of all patients
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Case Study Analysis
An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.
Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.
Photo Credit: Getty Images/Hero Images
An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
The Assignment (1- to 2-page case study analysis)
Develop a 1- to 2-page case study analysis in which you:
Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
Explain the process of immunosuppression and the effect it has on body systems.
By Day 7 of Week 2
Submit your Case Study Analysis Assignment by Day 7 of Week 2.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.
CASE STUDY
Scenario 4: A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.
Learning Resources
Required Readings (click to expand/reduce)
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Chapter 1: Cellular Biology; Summary Review
Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents(pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases,
Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
Chapter 7: Innate Immunity: Inflammation and Wound Healing
Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
Chapter 10: Infection (stop at Infectious parasites and protozoans); (start at HIV); Summary Review
Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review Note: You previously read these chapters in Week 1 and you are encouraged to review once again for this week.
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
Credit Line: Immediate Hypersensitivity Reactions - StatPearls - NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls.
Note: This article was presented in the Week 1 resources. If you read it previously you are encouraged to review it this week.
Required Media (click to expand/reduce)
Foundational Concepts of Cellular Pathophysiology - Week 2 (8m)
Accessible player --Downloads--Download Video w/CCDownload AudioDownload Transcript
Immunity and Inflammation
Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk
Note: The approximate length of the media program is 14 minutes.
Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds
Note: The approximate length of the media program is 37 minutes.
Acid-Base Balance #1
MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE
Note: The approximate length of the media program is 13 minutes.
Acid-Base Balance #2
MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI
Note: The approximate length of the media program is 15 minutes.
Hyponatremia
MedCram. (2017, December 23). Hyponatremia explained clearly [LK1] (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M
Note: The approximate length of the media program is 15 minutes.
Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.
Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student
To Register to View the Content
Go to https://evolve.elsevier.com/cs/store?role=student
Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
Complete the registration process.
To View the Content for This Text
Go to https://evolve.elsevier.com/
Click on Student Site.
Type in your username and password.
Click on the Login button.
Click on the plus sign icon for Resources on the left side of the screen.
Click on the name of the textbook for this course.
Expand the menu on the left to locate all the chapters.
Navigate to the desired content (checklists, videos, animations, etc.).
Community/public health nursing
Communicate therapeutically with patients.
The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.
Note: The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.
Select one of the following as the focus for the teaching plan:
Primary Prevention/Health Promotion
Secondary Prevention/Screenings for a Vulnerable Population
Bioterrorism/Disaster
Environmental Issue
Working With Children and Adolescents Versus Adults
Infant, childhood, and adolescent development are a continual interplay between nature (genetic or biologic predisposition) and nurture (environmental experiences). The nature/nurture continuum and debate will always be a part of your career as a PMHNP. Knowing common developmental milestone is important in the role as a child provider. Not only is it essential to the diagnostic process, but it is also important to the interdisciplinary interactions with other mental health professionals. The study of normal developmental processes, however, is only one tool that allows the mental health professional to understand the child being evaluated. There are many different assessment instruments and interviewing techniques that PMHNPs can have in their toolkit when working with children and adolescents.
In this Discussion, you examine the differences in assessing and treating children and adolescents versus adults. You take into consideration your own clinical experiences, as well as your experiences in your clinical rotation, and the information from the readings thus far.
Learning Objectives
Students will:
Analyze the importance of developmental assessments
Analyze assessment instruments used for evaluating children and adolescents
Analyze treatment options used for children and adolescents
Analyze roles parents play in assessment and treatment
To Prepare for the Discussion
Review the Learning Resources concerning psychiatric assessments and assessment tools.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post your answers to the following:
Explain why a developmental assessment of children and adolescents is important.
Describe two assessment instruments and explain why they are used for children and adolescents but not adults.
Describe two treatment options for children and adolescents that may not be used when treating adults.
Explain the role parents play in assessment and treatment
Healthcare policy
Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays.
APA format , turniting report , 250 words , only 1 reference
Medicare
As the Administrator of a Medicare certified home health agency you are responsible for analyzing and controlling cost variances to maintain agency viability. Identify three metrics you would use to analyze agency financial performance on a daily basis. Discuss why you have selected these metrics.
250-350 words
