Nimmy James     Re: Topic 7 DQ 1  response 

The main objective of dissemination is to rise and encourage to spread the knowledge regarding evidence- based interventions. The main goal of enhancing better applications and patient outcome. There are various internal and external methods of disseminating evidence- based project. However, the method applied should be effective. The effectiveness characterized by positive engagement of the targeted audience, which enhances awareness, understanding and motivation to implement in the workplace. One of the hardest aspects of evidence-based practice (EBP) is making sure that the change we wanted to occur actually happens. So, evaluation of the results is a major component of evidence-based practice. It shows the progress that you have made throughout the process, it shows the failures and it also shows the success. As Ginex p states “Share the outcomes but also the process of your project: what worked, what didn’t, what you learned, and what you would do (or not do!) again” (Ginex, 2018).  “Dissemination can occur in many forms within your organization and beyond, and it should be part of the planning process for the full project” (Ginex, 2018). One internal method of dissemination of the project can be the hospital board, nurses and physicians and other professionals involved in patient care. These people have the most power to make the most change necessary to make the EBP successful. An internal method of disseminating of my EBP is through my unit counsel group and policy committee. These groups to ensure my EBP project will be implemented according to unit needs. One external method of dissemination can be the patients and families. External dissemination doesn’t even have to be through people it can be used through posters or even through on-line media. The internal and external groups are very important to facilitate sharing knowledge and data in the nursing field. Moreover, when reporting the finding to the groups would facilitate constructive criticism of the result, it will provide the opportunity to improve before implementation.     References:   Ginex, P. K. (2018). Use these methods to evaluate EBP outcomes and disseminate results. Oncology Nursing Society Voice.           

   Retrieved from https://voice.ons.org/news-and-views/use-these-methods-to-evaluate-ebp-outcomes-and-disseminate-results

Reference must include doi or retrieval URL 

  

In this assignment I need a peer response for the main discussion, that show below.

The peer’s responses

Discussion Grading Criteria: Agreeing and disagreeing do not mean just voicing one’s opinion. The focus of the discussions should remain on the ideas posed in the readings. Agreeing and disagreeing mean making scholarly arguments from the literature that may support your own ideas. Faculty expects you to support your ideas from the readings or similar scholarly writing about the topic in nursing literature. Always cite your source(s) and reference in APA format.

Remember the post and responses should include scholarly writing about the topic in nursing literature.

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

…The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi 

 

Main POst of my peer:

Ileana Dominguez Baute 

Discussion #4- Challenges of the APRN interview- ileanaDominguez

COLLAPSE

During a job interview, it is highly suggested to always make eye contact with your potential employer or anyone in the room for that manner. Always be sure to greet with a smile and although you may be nervous, you want to maintain confidence. The best way to maintain confidence is to study your resume so that you are prepared to answer any potential questions in regard to skills and prior experience. Another form of adding to your confidence during an interview would be to research the company prior to your interview date. This will not only give you some insight on the company, but it will allow you to ask questions during your interview and many companies and potential employers love this quality.

What is your biggest Weakness?

I would have to say my biggest weakness might be that at times I may attempt to perform too many tasks at once, which I may be overwhelmed and it stress out myself. However at that time I use my biggest strength that consist in take a moment for deep breath, mentally organize my task list and determinate those with priority.

Describe how you resolved conflict with a co-worker or patient?

Working in a BH unit as a psych nurse I can said that in my job environment the most difficult situation involving a patient is management of an aggressive situation. A patient had become highly aggressive both verbally and physically. At this time, my team and I performed the techniques of de-escalation as per protocol. When this was not successful, I, as the lead nurse had to make the difficult decision to call the psychiatrist and receive an order for physical and chemical restraint for the safety of all, the patient, milieu and staff. The psychiatrist led the order and the patient was placed on a four-point restraint in addition to receiving medication to assist in calming the patient. The goal should be always, controlling the situation with the minimal physical and psychological damage for patients and staff members. Always keeping a professional, calmed, team working and positive attitude.

Tell me about yourself?

I am naturally from Cuba. I am privileged enough to be a mother whilst attaining a professional education and career. In 1997, I had the honor of graduating from General Medicine in Cuba, which would be the equivalence of Family Medicine in the United States. I then came to the U.S. and obtained my Registered Nurse certification by 2007. At this time, I began working in a home health setting. This basically involved, but was not limited to: wound care, diabetic management, colostomy management and performing intravenous antibiotics. In 2011, I then began a career at an inpatient psychiatric hospital setting. In 2017 I began my FNP course which I about to finish in this university. Working in the BH environment is what has motivated me to attain a future Post Master in Psychiatry.

Bottom of Form

Jamie is a 3-month-old female who presents with her mother for evaluation of “throwing up.” Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick. In fact, she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and, overall, seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle, she seems to be a very healthy, happy infant. A more precise history suggests that Jamie does not exactly throw up—she does not heave or act unwell—but rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didn’t appear to help at all, and now Mom is very concerned.

Cases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However, sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility, prompting them to change formulas rather than seeking medical care. As in the case study above, GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adults—adults may present with symptoms that have various potential causes. When evaluating patients, it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason, you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. 

To Prepare Part 1

• Review Chapter 35 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.
• Review Chapter 37 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Think about how these disorders are similar and different.
• Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor.
• Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to constructing a mind map for gastritis. Consider the epidemiology and clinical presentation of gastritis.

To Complete

Write a 2- to 3-page paper that addresses the following:

• Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.
• Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe the treatment of these disorders for a patient based on the factor you selected.
• Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.
• 3 to 4 references within 5 years

 The Following is another student post to wish I have to reply to adding other information related to what the student post, Remember APA and less than 20 % similarity. 

Chapter 55

Question:

 

Isabella, a student nurse, has just started to work in a sexual health clinic part-time where there are a large number of clients who have genital herpes. The clients, both male and female range in age from 16 to 39 years, have varying levels of education and backgrounds.

a.            What features of sexually transmitted diseases would it be important for Isabella to review?

b.            Isabella states, “Why don’t these clients just stop having sex and then their conditions wouldn’t be as bad”? If you were another nurse in the clinic, how would you respond to Isabella’s comment?

Answer:

(a)

There is a wide range of features of sexually transmitted diseases that Isabella should review. Since sexually transmitted diseases at times go unnoticed, it is necessary to diagnose early to avoid complications. The presence of sores and bumps on the genital, oral and rectal areas is one feature that is common in STD’s specifically genital herpes. Another feature to look for is the presence of vaginal discharge that is often foul-smelling which is often a symptom of trichomoniasis. Unusual vaginal bleeding, pain during sex and discharge from the penis should also be checked as they all indicate the presence of an STD (Grossman & Porth, 2014).. Other features of STD that Isabella should review include fever, lower abdominal pain, sore, swollen lymph nodes and the presence of rash on the trunk, hands and feet.

(b)

In responding to Isabella about having sex and prevention of STDs, I would point out on other possible methods through which STDs maybe transmitted. Sexually transmitted diseases including genital herpes are spread through contact with body fluids including blood, semen and vaginal fluids. They are also spread through contact with infected mucous membrane and skin (Grossman & Porth, 2014). As such, sleeping and kissing with an infected person may result in infection with STDs. Isabela should therefore not judge that the patients contacted genital herpes after having sexual contact. Secondly, Isabela should understand that sex is an important psychological and physiological need for humans and a conjugal right for married partners. Sex is also necessary for reproduction. Instead, Isabela should focus on teaching clients on how to protect themselves when having sex if a partner is feared to have an STD rather than make it mandatory for all people to avoid sex.

References

Grossman, S. & Porth, C. (2014). Porth’s Pathophysiology (9th ed). Philadelphia: Wolters Kluwer Lippincott Williams & Wilkins. ISBN 978-1451146004 

  

Based on last week’s reading, you now have an idea of the role of the APRN, and legal/professional issues in prescribing. As a future nurse practitioner, you have the authority, based on your state nurse practice act, to prescribe medications for the patients for whom you will provide care, and the responsibility of prescriptive authority is more than just simply writing a prescription correctly.

Important Links:

https://www.flsenate.gov/Committees/BillSummaries/2016/html/1424

http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html

https://floridasnursing.gov/new-legislation-impacting-your-profession/

https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioner-prescriptive-privilege

Discuss the role of advanced practice nursing in safe prescribing and 3  prescribing barriers for APRNs.