Discussion Assignment
View the video below - If We Could See Inside Other People. After viewing the video , respond to the following questions:
1. How will this video influence your nursing care?
2. Describe three things will you implement in your nursing practice and why?
https://youtu.be/IQtOgE2s2xI
PICOT Question and Literature Search
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the ""Literature Evaluation Table"" to complete this assignment.
Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
Discussion of study results, including findings and implications for nursing practice, is complete and includes relevant details and explanation.
The setting is indicated for each article. Some detail is needed to fully illustrate the physical, social, or cultural site in which the researcher conducted the study.
The PICOT question will provide a framework for your capstone project.
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment
Discussion
INITIAL POST EXPLAINIGN WHAT YOU HAVE LEARNED ABOUT
1-WHEN WAS PRESCRIPTION AUTHORITY FOR APRN APPROVED, SPECIFICALLY IN FLORIDA?2-WHICH ARE THE REQUIREMENTS FOR THE APRN BE GRANTED AUTHORIZATION/PRIVILAGES TO PRESCRIBED CONTROLLED SUBSTANCE?
3-WHAT IS CONSIDERED CONTROLLED SUBSTANCES.
4-HOW TO APPLY FOR DEA NUMBER?
5-VISIT THE CD WEBSITE, AND ELABORATE ON THE CURRENT ISSUE WITH CONTROLLED SUBSTANCE ABUSE IN THE USA AND FLORIDA?
use all this sites for this assigment.
https://floridasnursing.gov/new-legislation-impacting-your-profession/
https://www.flmedical.org/Florida/Florida_Public/Docs/FMA-Opioid-HB21.pdf
https://fnpn.enpnetwork.com/nurse-practitioner-news/133651-dea-licensure-information-for-florida-
https://www.cdc.gov/drugoverdose/prescribing/guideline.html
https://www.cdc.gov/drugoverdose/data/index.html
APA style 700 words, 2 references not older than 5 years old.
Discussion
Read the following scenario and answer the question:
You started as the new HIM Manager a couple of weeks ago. Your department began using workflow technology about 2 months ago with an imaging system that has been used for 1 year. With the implementation of workflow, the department started coding and analyzing charts online. One of the first things that you noticed when you started work was the stress level of the coders – they are panicking. When you meet with them, both as a group and independently, you find out that they hate the new system. They say they do not feel comfortable using it, they only had a short training period, and they were not involved in the selection or the implementation.
What are your plans to improve the situation?
(300-350 words
Case study
There is two different case studies and their plan of action all you need to do is respond back to both students because these are discussion board. like 1 and 1/2 paragraphs for each study
The client who I chose to do a mini nutritional assessment on is an 84-year-old male Caucasian male with a late stage of dementia. He is my grandfather and lives in my house with my family and I. He has been living with us for at least five years up to this point. This person is not at risk for malnutrition and is not malnourished. The MNA shows that he is actually in a normal range for his nutritional status. As you can see from the form attached, he is pretty much all within good ranges for each concept in regards to his nutrition. He has no pressure ulcers, he can feed himself, and with him living her with us we are constantly taking care of him and making sure he is getting enough of the needed nutrients and is safe and moving around frequently. He is in good spirits, just needs a little extra help sometimes.
Care Plan: Short-term Goals
First short term goal would be to limit his sugar intake in the mornings. He has been seen consuming too much coffee cake/desserts/pie in the morning with his coffee while reading the paper.
He is often uninterested in drinking water, so I think it would help him if he were to incorporate more glasses of water in his day/diet.
Care Plan: Long-term Goal
One long-term goal that would be crucial for this person would be what will his future nutrition going to look like? Right now, with him being here constantly around a family member, he is getting his medications on time with water and food, he is getting at least 3 square meals a day, and he is getting good healthy meals during the day with snacks intermittently. At some point, he will require the need for professional help either in an assisted living center or a nursing home. It is a concern that he will not be given the proper amount of attention or adequate nutrition when in a place like that. So, a long-term goal for him in regards to his nutrition, would be to make sure that if he ever changes locations, he is monitored and helped very frequently in this area.
Education
For right now, this patient does not need to be educated on how to feed himself and on how to eat/chew/swallow. He is sufficient in that area. He needs to be educated on why it is important to eat three meals a day and why it is important to drink enough water. The problem with him though is that with his dementia he forgets to do so, but if he has the help of our family he will continue to have adequate nutrition levels as he does now. Again, if he were to change locations, the staff would need to make sure he is being taken care of as we take care of him here. If this happens, I have no doubt he will meet these goals listed above and he will be able to successfully maintain optimum nutrition. He should be sure to stay away from beer, processed meats and cheeses, microwavable popcorn, and white foods specifically since these foods are not good for dementia patients (Mole, 2018).
Follow-up Care
As stated earlier, right now this patient is not at nutritional risk. However, in a few weeks it would make sense to check again his levels and make sure he is still within proper range. When doing so, we can check to see if he is more hydrated, has clear urine, and this would help indicate that he has been drinking more water. Also, we can try to take away the coffee cakes in the morning to reduce the sugar intake. Giving him once slice and putting it away would be helpful and this could be a part of his education, as well as a part of the follow-up care. Lastly, follow-up care would involve checking with a professional to see if his nutrition is still normal if he switched locations. If he was still living with my family in a few weeks, we would check at his next doctor’s appointment to see if we are making sure we are doing a good job to keep his nutritional levels where they need to be.
The person that I interviewed is a 69 year old male. He is relatively active and does not show much if any signs of cognitive decline. His total MNA assessment score was 20, which puts him at risk for malnutrition. The main factors placing him at a risk for malnutrition are a moderate decrease in food intake leading to a loss of 4.5 lbs in the past 3 months. The patient does not have adequate intake of legumes or vegetables in his diet either.
Short Term Goals
Increase his intake of legumes, fruits and vegetables to at least 2 servings per day. Especially his intake of vegetables as he has expressed that he does not eat very much vegetables at all.
Increase his overall food intake including well rounded, nutritious meals.
Long Term Goal
Gain back the 4.5 pounds that were lost due to decreases in food intake over the next 3 months.
Education
Research has showed a direct link between the intake of fruits and vegetables to a reduced risk of mortality among older adults (Nicklett & Kadell, 2013). The patient should increase his intake of green, leafy vegetables as this will give him vitamin K which promotes blood clotting and reduce bone fragility. Increasing the patients intake of legumes will also be helpful to supply him with good energy for his daily activities as they are filled with carbohydrates. Increasing his legume intake will also provide him with his daily fiber which will help with digestion. The patient should continue being active as this will keep his mind sharp and promote healthy cognitive function.
Follow Up Care
In 3 months, revisit the patient to see if he has accomplished his long term goal in gaining back the 4.5 pounds that he had lost from decreased food intake. Also, assess his diet and ensure that he is taking at least 2 servings of fruits and vegetables per day
Nursing Leadership and Management
Signature Assignment Title: What Makes a Good Leader?
Signature Assignment Description/Directions:
Choose one or more leadership topic(s) from your textbook or from a scholarly source from a previous discussion or assignment from this course and write about its application to nursing practice. Provide definitions, history/background, and major concepts of chosen topic. Describe the topic’s function in nursing practice by examining at least three different nursing roles (for example, bedside nurse, public health nurse, CNO, unit manager, etc.). Discuss how the leadership topic can be used in your own practice. Discuss your personal growth in regard to your chosen leadership topic. Evaluate personal strengths, weaknesses, opportunities, and threats to your career advancement.
Then, discuss the top three traits you feel makes a good nurse leader. Support your statements with examples from your practice experience and scholarly sources.
Assignment Expectations:
Length: 1700 words in length
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 three scholarly sources plus the textbook are required.
Fundamentals of Nursing
Fluid, Electrolyte, and Acid-Base Balance
1. You are a nurse who frequently cares for post-surgical patients in your hospital unit. Most of the medical-surgical patients have IV fluids infusing during their admission. Due to the frequent use of IV fluids on your floor, understanding fluid balance and electrolyte function is primary to your nursing practice. a. What conditions might lead to the development of hypovolemia? b. How would the amount of patient fluid loss be determined? c. Describe how hypovolemia and third-space fluid shifts correlate. d. Outline the major difference between hypovolemia and third-space fluid shift. e. Which conditions can result in third-space fluid shift?
2. You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons, 15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of congestive heart failure (CHF). She consistently struggles with balancing her fluids and electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on a fluid restriction---much to her chagrin, as she loves ice cream. a. What within her history would indicate she was at risk for hypervolemia? b. How would dill pickles and sauerkraut impact her fluid volume?c. What body areas offer observational evidence of excessive interstitial extracellular fluid (ECF)? d. Why would your patient be on a strict fluid restriction while hospitalized? e. Outline nursing interventions used while a patient is on fluid restriction.
PLEASE follow the instructions. Answer each question in the order it appears and separately. This is the bibliography to guide you:
1.Potter, P.A., &Perry, A. G. (2017). Fundamentals of Nursing: Concepts, Process, and Practice (9th ed.). St. Louis: MO: Mosby. ISBN: 9780323327404.
Windshield Survey Response
Community health nurses conduct community health assessments (CHA) to examine the health status indicators for a specific community to identify key health problems and health-related resources in the community. Salman, Turek, and Donovan (2020) indicate that a CHA helps them plan services for families, individuals, and the community. A windshield survey allows a healthcare professional to get a visual overview of the community while driving around, researching, and recording his or her observations. During this drive, healthcare professional notes trends and conditions in the community that impact the population's health. This data gives insight and background for conducting CHA or working in the community. In this windshield survey tool, the community under observation is Flagami, a neighborhood in Miami-Dade County, Florida.
Community Description
Flagami is a lower-middle-income community in Miami-Dade County, Florida, located on the western part of the Red Road and southeast of the Tamiami Canal. The average elevation of the neighborhood is 3 feet. Alameda and Fairlawn are subdivisions and sub-neighborhood within the community, respectively. The former lies on the western edge of the Tamiami Canal, and the latter comprises a large portion of the western end of the neighborhood. The majority of the community members are of Hispanic origin, followed by whites and African Americans. The physical appearance of most people indicates that they are neat and have a specific place of residence. The neighborhood is dominated by parks, coffee shops, and restaurants. Public schools are above average, based on neatly constructed structures. Flagami offers a variety of housing opportunities. The majority of homes in the community have one storey homes, colonial-themed two storehouses, and aluminum houses. The neighborhood also has some apartments and condominiums. Most of the houses were built in the 1990s, apart from the aluminum houses. Even though most homes have small yards, they are well-maintained with flowers and shrubs. The lighting is adequate, with security lighting systems on roads and inside the community. The community has many attractions sites, including a botanical garden, ocean breeze Water Park, and a boardwalk.
Community Health Status
Flagami has numerous health problems. An assessment report by The Florida Department of Health in Miami-Dade identifies factors, trends, and vents that can potentially impact community well-being and the value of life in Miami-Dade County. The report indicates the leading issues that are likely to affect health in Flagami include mental health, lack of affordable housing, gun violence, and opioid addiction (The Florida Department of Health in Miami-Dade County Releases Forces of Change Assessment Report, 2018). Opioid addiction is a major risk in HIV infections since heroin users are at high risk for contracting the virus when they share syringes and injection paraphernalia. Opioid addiction could be the primary cause of the high HIV cases among Hispanics in the community. Nationally, Florida ranks second in HIV infection cases.
The Role of the Community as a Client
The community as a client is a concept that allows community health nurses to focus on increasing the community's health benefits instead of individual needs. Even though nurses may work with individuals and communities, the resulting changes affect the entire community. In Flagami, the Florida Department of Health in Miami-Dade County is a significant health resource. The Department's Forces of Change Assessment creates an inclusive assessment of the residents' well-being and value of life. The assessment acts as an essential resource for health improvement within the neighborhood. It assists the Miami-Dade community in working or reducing threats and exploiting opportunities to protect and enhance community health. Community health nurses are obligated to collaborate with the Florida Department of Health to respond to the high rates of mental health, gun violence, and opioid addiction in the community (Florida Department of Health in Miami-Dade County, 2020). Nurses can promote mental health and prevent mental illness in the Flagami community by identifying people at increased risk and screen. Also, the nurse can collaborate with the Department to map risk factors and identify resources and assets. Secondly, the community nurse can prevent opioid addiction in the community by implementing interventions for people at risk and building community resilience. Lastly, nurses can prevent gun violence in the Flagami community by taking a leadership position in educating parents and adolescents about injury and violence prevention.
Healthy People 2020
The leading health indicators in Miami-Dade County that aligns with the Healthy People 2020 objectives are clinical preventive services of chronic diseases. The Florida Department of Health Bureau and Chronic Disease Prevention has defined goals and established objectives that address the Healthy People 2020 initiatives' health needs. The Bureau has identified key chronic conditions that include cancer, arthritis, diabetes, nutrition, overweight and heart disease, and stroke (Healthy People 2020 | Florida Department of Health in Miami-Dade, 2020). For instance, the Department promotes recommended levels of physical activities to improve diet and nutrition and prohibit tobacco use to lessen cardiovascular disease and enhance the quality of life. The Department has also introduced early detection and access to high-quality care to reduce cancer mortality and morbidity. To reduce the burden of diabetes mellitus to persons in the community, the Department has implemented initiatives to reduce health disparities and increase the accessibility of quality healthcare in Miami-Dade and its communities. These goals align with Healthy People 2020's preventive services goal to prevent and detect illness at more treatable stages, thereby reducing disability, risk of illness, early mortality, and medical care costs (Florida Department of Health in Miami-Dade County, 2020).
Conclusion
Flagami is a lower-middle-income community in Miami-Dade County, Florida. The key health problems in this community are mental health, lack of affordable housing, gun violence, and opioid addiction. Nurses play a role in the community through programs of prevention and screening. The majority of people in the community use their own cars as a principal transport. The Florida Department of Health is an essential resource in this community, representing the various ways of assessing community health needs. The Department collaborates with community health professionals to devise and implement strategies that promote healthcare. The Department's health objectives also align with the Healthy People 2020 goals in preventive services.
Quality Improvement Proposal
Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply ""The Road to Evidence-Based Practice"" process, illustrated in Chapter 4 of your textbook, to create your proposal.
Include the following:
Provide an overview of the problem and the setting in which the problem or issue occurs.
Explain why a quality improvement initiative is needed in this area and the expected outcome.
Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Group therapy
Create progress notes
Create privileged notes
Justify the inclusion or exclusion of information in progress and privileged notes
Evaluate preceptor notes
To prepare:
Reflect on the client family you selected for the Week 3 Practicum Assignment.
Assignment
Part 1: Progress NoteUsing the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following:
Treatment modality used and efficacy of approach
Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals)
Modification(s) of the treatment plan that were made based on progress/lack of progress
Clinical impressions regarding diagnosis and or symptoms
Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job)
Safety issues
Clinical emergencies/actions taken
Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them
Treatment compliance/lack of compliance
Clinical consultations
Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists)
The therapist’s recommendations, including whether the client agreed to the recommendations
Referrals made/reasons for making referrals
Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
Issues related to consent and/or informed consent for treatment
Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
Information reflecting the therapist’s exercise of clinical judgment
Note: Be sure to exclude any information that should not be found in a discoverable progress note.
Part 2: Privileged NoteBased on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment.In your progress note, address the following:
Include items that you would not typically include in a note as part of the clinical record.
Explain why the items you included in the privileged note would not be included in the client family’s progress note.
Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why
