Marcia Stapleton    4 posts   Re: Topic 1 DQ 2  Another “cultural” type barrier to EBP in clinical settings is our preference for humans  as our information source. When working in a clinical setting and there are more experienced nurses around us, most nurses default to asking the more experience nurse what to do in a clinical situation.  The more experienced nurse might have experience with the situation, but is it evidence-based?  Even when textual information was accessible in a clinical situation, it was shown that nurses preferred other nurses as a resource over the textual resource (Thompson, 2004).  This is seen over and over in the patient care setting.  When we are wondering how to deal with a situation, we just ask a nurse we think has dealt with the situation, and consider them the expert or the evidence-based research.  As a clinical nurse leader, I field many questions each day.  In order to move towards an evidence based practice, I must direct the nursing staff to the research related to the question.  Reference:  Thompson, C. (2004). Nurses, information use, and clinical decision making–the real world potential for  evidence-based decisions in nursing. Evidence-Based Nursing. Retrieved from  https://ebn.bmj.com/content/7/3/68.PLEASE WORK ON THIS AND PROVIDE INTEX CITATION AND APA RERENCE MUST INCLUDE DOI OR RETRIEVED FROM 

Patient rounds involve various disciplines coming together to discuss the patient’s condition and coordinate care. They are used as an educational tool and also help keep everyone on the same page when it comes to the treatment plan. The following case is found in the textbook (Pharmacotherapy: Principles and Practices. Chisholm-Burns et al, eds.  5th edition.  McGraw-Hill.  New York 2019. ISBN-978-1-260-01944-5; Chapter 34. “Patient encounter”).

After reading the assigned chapters in the textbook, resources identified in Dynamed and Evidence based practice guidelines, please present the case to your peers in the form of a discussion. This will be your initial post. Please be sure to address all parts of the case and ensure your responses are well researched [including supporting, evidence based guidelines such those of the WHO, CDC, APS, etc.]. 

Part 1:

HPI:  A 78-year-old man who is to undergo a left above the knee amputation due to a limb abscess

PMH: Peripheral artery disease for 18 years; cardiomyopathy, benign prostatic hypertrophy for 13 years

FH: Mother had osteoporosis; father had diabetes

SH: Lives with wife; has two grown children

Meds: Aspirin 81mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; pantoprazole 40 mg daily; tamsulosin 0.4 mg daily

Pain Assessment: Patient rates pain as 8 on a scale of 0 to 10.

• Based on the type of injury, what type of pain is this patient likely to experience?
• What type of pain management regimen would you suggest in the postoperative period? Explain your answer

Part 2:

Following surgery he was placed on morphine patient-controlled analgesia (PCA). He has been using 55 mg of morphine/24 hours with adequate pain control; however, he developed redness and itching on his neck that is believed to be due to the morphine.

Current Meds:  Morphine PCA; aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily; heparin 5000 units twice daily until discharged home. He will be discharged to a skilled nursing facility for rehabilitation therapy.

You would like to convert him to a combination preparation of hydrocodone and APAP for as-needed pain relief.

• What dosing regimen would you suggest?
• What would your monitoring plan include for this patient?
• How would you assess pain response?
• The patient is concerned about the redness and itching that he developed while on morphine. Would you document this as an allergic reaction?
• What other interventions or education may be necessary at this time?

Part 3:

The patient was discharged to a skilled nursing facility and is receiving physical therapy and occupational therapy 6 days each week.

Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home, hydrocodone/acetaminophen 5/325 mg every 6 hours as needed for pain.

Pain Assessment: Patient reports pain of 7 out of 10; worse with movement.

Physical therapy notes indicate the patient is unable to complete therapy goals due to complaints of pain.

• Based on this information, what would you recommend to optimize pain control?
• Prescribers play a critical role in prescription drug misuse and abuse prevention. What steps can be taken to identify signs of dependence and abuse and what education can you provide to the patient regarding the negative effects of medication misuse?

Part 4:

The patient has been at the skilled nursing facility for 4 weeks and is making progress toward rehabilitation goals; however, he complains that his leg is throbbing and feels like pins and needles. As a result, he requests to rest several times during her therapy sessions. During unit rounds, his therapist inquires whether her previous pain medication should be reordered.

Pain Assessment: 4 out of 10

Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home,

• What additional recommendations would you have at this time regarding pain management?
• Are there any other therapeutic issues that should be addressed?

DUE 8/5 8 P.M EST

PUBLIC HEALTH 

TOPIC: HIV/AIDS

7 pages not including title and reference page APA format

PLEASE DIRECTIONS CAREFULLY

  

Overview of the sections of the Scholar-Practitioner Project:

Disease surveillance is an essential part of public health. It provides valuable information to public health officials, allowing them to detect and prevent the spread of disease. In your Scholar-Practitioner Project, you create a disease surveillance system to monitor HIV/AIDS.. The assignments in this course, including the assignment due this week (described below), all represent sections of a Scholar-Practitioner Project that you will submit in its final form in Week 10. Each week (except Week 7) you will complete a brief assignment and submit it for grading and feedback. Each component is due by Day 7 of its respective week. Be sure to use your Instructor’s feedback on each submission to revise it before incorporating it into your final Scholar-Practitioner Project.

(READ THIS SECTION BECAUSE THIS WHAT WAS INCLUDED IN PREVIOUS WORK)

In Week 1, (HISTORY OF SURVEILLANCE) you write a analyzing the influence that specific historical events have had in the evolution of disease surveillance systems. In addition, you forecast the next phase(s) in disease surveillance and explain how the changes that you predict will impact public health policy and practice.

In Week 2, (Surveillance Subject and Data Sources)   you write about identifying the disease or condition that is the focus of your surveillance system. In addition, you evaluate potential data sources and processes associated with collecting and analyzing the data you identify.

In Week 3, (Traditional vs. Syndromic Surveillance)  you write about analyzing the practical ramifications of identifying, collecting, validating, and analyzing data for syndromic surveillance. In addition, you compare your analysis to traditional disease surveillance.

In Week 4 (Algorithm)  you write about explaining the algorithm of your surveillance system, including the strengths and limitations of the algorithm to monitor disease.

In Week 5, (Digital Dashboard)  you create a mock-up of a “digital dashboard” for your disease surveillance system.

In Week 6 (System Comparison)  you write about  analyzing and comparing modern disease surveillance systems implemented at the local, state, regional, and national levels used to monitor the disease or condition you selected.

In Week 8 (Tele-health) you write about analyzing the implications of tele-health for the surveillance of the disease/condition you selected and describe how you could incorporate tele-health into your surveillance system.

In Week 9 , you write about  that provides an overview of a selected country and condition or disease.

In Week 10, you submit your completed Scholar-Practitioner Project. It will consist of sections submitted in previous weeks, revised to reflect your Instructor’s feedback, as well as several new components. 

THIS IS WHAT YOU INCLUDE IN THE PAPER

1.Table of Contents (New – Week 10)

2. Executive Summary (New – Week 10)

a. Write a 1-paragraph summary of the main points and conclusions of the Project report.

3..Research and identify two or three additional peer-reviewed articles (beyond your Learning Resources) related to evaluating disease surveillance systems.

Write a 2-page paper in which you:

i. Propose how you would evaluate the effectiveness and efficiency of the disease surveillance system you have developed throughout the course.

ii. Identify and define the criteria you will include in your evaluation.

iii. Justify the selection of evaluation criteria.

iv. Cite the two or three articles that informed your research for this section.

4)System Analysis (New – Week 10)

b. Write a 2–page paper in which you analyze the cost, functionality, timeframe, and social, political, environmental, and economic elements of your surveillance system.

5)Improving Disease Surveillance in Developing Countries (Week 9) (DON’T DO THIS SECTION)

6)Conclusion (New – Week 10)

c. Write a  2-page summary of your Project including a review of the purpose and goals of the Project, salient research findings, system features, analysis, implications, and limitations.

7)References (New – Week 10)

d. Compile your reference list of research and Project resources compiled in APA format.

Assignment: The Impact of Standardized Nursing Terminology

Among the Resources in this module is the Rutherford (2008) article Standardized Nursing Language: What Does It Mean for Nursing Practice? In this article, the author recounts a visit to a local hospital to view the recent implementation of a new coding system.

During the visit, one of the nurses commented to her, “We document our care using standardized nursing languages but we don’t fully understand why we do” (Rutherford, 2008, para. 1).

How would you respond to a comment such as this one?

To Prepare:

• Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice?
• 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:

In a 2- to 3-page paper, address the following:

• Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.
• Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples.
• Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Walden Library.

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 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)
Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

American Nurses Association. (2018). Inclusion of recognized terminologies supporting nursing practice within electronic health records and other health information technology solutions. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/Inclusion-of-Recognized-Terminologies-Supporting-Nursing-Practice-within-Electronic-Health-Records/

Macieria, T. G. R., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2017). Evidence of progress in making nursing practice visible using standardized nursing data: A systematic review. AMIA Annual Symposium Proceedings, 2017, 1205–1214. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977718/

Office of the National Coordinator for Health Information Technology. (2017). Standard nursing terminologies: A landscape analysis. Retrieved from https://www.healthit.gov/sites/default/files/snt_final_05302017.pdf 

Rutherford, M. A. (2008). Standardized nursing language: What does it mean for nursing practice? Online Journal of Issues in Nursing, 13(1), 1–12. doi:10.3912/OJIN.Vol13No01PPT05.
Note: You will access this article from the Walden Library databases.

Thew, J. (2016, April 19). Big data means big potential, challenges for nurse execs. Retrieved from https://www.healthleadersmedia.com/nursing/big-data-means-big-potential-challenges-nurse-execs

Topaz, M. (2013). The hitchhiker’s guide to nursing theory: Using the Data-Knowledge-Information-Wisdom framework to guide informatics research. Online Journal of Nursing Informatics, 17(3).  
Note: You will access this article from the Walden Library databases.

Wang, Y. Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. doi:10.1016/j.techfore.2015.12.019.
Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Executive Producer). (2012). Data, information, knowledge and wisdom continuum [Multimedia file]. Baltimore, MD: Author. Retrieved from http://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6051/03/mm/continuum/index.html

Laureate Education (Producer). (2018). Health Informatics and Population Health: Analyzing Data for Clinical Success [Video file]. Baltimore, MD: Author.

Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Vinay Shanthagiri. (2014). Big Data in Health Informatics [Video file]. Retrieved from https://www.youtube.com/watch?v=4W6zGmH_pOw.
 

 

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

1. Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.