Research children’s health issues, focusing on environmental factors and links to poverty.  The assessment of environmental processes includes agents and factors that predispose communities and populations to injury, illness, and death. What correlations did your research show between environmental and health issues in the school-aged child? Make sure to include references to the article(s) you consulted., focusing on environmental factors and links to poverty.  The assessment of environmental processes includes agents and factors that predispose communities and populations to injury, illness, and death. What correlations did your research show between environmental and health issues in the school-aged child? Make sure to include references to the article(s) you consulted.

 

1) Minimum 6 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

              Part 1: Complete the file 1

              Part 2: minimum 1 page

              Part 3: minimum 4 pages

              Part 4: minimum 3 pages

Submit 1 document per part

2)¨******APA norms, please use headers

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3) It will be verified by Turnitin and SafeAssign

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1:

See example (File 2)

Issue: Infection Control and Prevention 

Topics: Cleaning and disinfection; Standards precaution and Cross-contamination

1. Search for articles related to the problem and topics mentioned above, from the articles found, select only 2 to complete the 8 articles that this question requires  (within the last 5 years).

The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

2. Provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table.

a. Determine the level and strength of the evidence for each of the eight research articles you have selected. 

Articles:

Cohen, C. C., Choi, Y. J. & Stone, P. W. (2016). Costs of infection prevention practices in long-term care settings: A systematic review. Nursing Economics, 34(1), 16-24,45. Retrieved from https://search.proquest.com/docview/1765381619?accountid=10378

Gammon, J., Hunt, J., Williams, S., Daniel, S., Rees, S., & Matthewson, S. (2019). Infection prevention control and organizational patient safety culture within the context of isolation: Study protocol. BMC Health Services Research, 19 doi:http://dx.doi.org/10.1186/s12913-019-4126-x

Gertrude, S. A., & Nabyonga-Orem, J. (2019). The Global call for action on infection prevention and control. International Journal of Health Care Quality Assurance, 32(6), 927-940. http://dx.doi.org/10.1108/IJHCQA-03-2018-0063

Peng, M.-T. (2020). [Nurses: A Voice to Lead, Nursing the World to Health-Viewing COVID-19 Epidemic Prevention Efforts in Light of Nightingale’s Perspective on Infection Control]. Hu Li Za Zhi The Journal of Nursing, 67(3), 102–110. https://doi.org/10.6224/JN.202006_67(3).14

Qi, Z.-Y., Zhao, P.-Y., Geng, S.-H., Yi, H.-M., & Yang, L.-P. (2020). COVID-19 Epidemic: Possibility of Artificial Intelligence in Infection Control and Prevention. Journal of Epidemiology, 30(8), 371. https://doi.org/10.2188/jea.JE20200203

Trusov, A., Ismoilova, J., Tonkel, T., & Aleksandrin, A. (2016). Infection prevention and control in TB programs. Health Affairs, 35(3), 556. doi:http://dx.doi.org/10.1377/hlthaff.2016.0050

Part 2:

Issue: Infection Control and Prevention 

Topics: Cleaning and disinfection; Standards precaution and Cross-contamination

1. Write a list of five outcomes for your proposed intervention. 

 a. Below each outcome, provide a one or two sentence rationale.

Part 3:

 

Your patient is a 23-year-old female. She presents with coughing and wheezing which she stated started about three weeks ago. She is currently 25 weeks pregnant. Her last prenatal visit was one month ago in another state. She has an appointment with the prenatal care provider next week, however her respiratory symptoms brought her to your office today.

History – Chickenpox as a child. Asthma as a child, diagnosed at age 8 for which she used a SABA when needed. She has not had the need to use an inhaler since she was 19. She takes only her prenatal vitamin. No other acute or chronic problems. She advises you that she is up to date on all immunizations except she has not had a flu shot (it is October).

Social – Non-smoker, no drug use. She relocated to your state two weeks ago to get away from an abusive domestic situation. She has no support network in this area and has not yet found employment. She has no medical insurance.

HPA – Non-productive cough x 3 weeks. Wheezing audible from across the room. She states it is like this all day and wakes her from sleep every night. She reports that she is fatigued even in the morning. No other complaints.

PE/ROS – Pt appears disheveled but clean. Wheezing in all lung fields. T 98, P 82 regular, R 28 no stridor. FH 130 regular. The remainder of the exam is WNL.

Directions:

1. Construct a narrative document 

2. Diagnose the patient based on the above findings and provide your rationale for how you arrived at the diagnosis.

3. Develop a treatment plan specifically for this patient, pharmacologic and non-pharmacologic.

4. Describe community resources (using your own community) currently available in your state/city to support this patient.

5. Provide a communication plan that you will use to ensure the patient is an active participant in the treatment plan. Refer to therapeutic communication concepts.

6. Utilize national standards, your pharm and/or patho book, and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts.

Part 4:

  

Research topic: Nursing professional care in the prevention of infections associated with health care in intensive care units.

  

Problem question: What is the nursing professional’s care in preventing infections associated with health care in an adult Intensive Care Unit, according to the scientific literature review? 

1. Include a minimum of six scholarly sources- Organize in logical sections

2. Include an overview of the literature. Be unbiased in your presentation of information. Include sources and content relevant to your research questions and hypothesis

3. state the relevance in your literature review. Include a critical assessment of the sources. Do not simply include a summary of what you have read

4. A strong introduction and conclusion, including further questions for research

  

Parent Teaching Project (5%)

A critical component of pediatric nursing is teaching parents how to care for their child, particularly during an illness or after a procedure.  To develop this skill, the student will complete a parent teaching project. 

Students will be assigned a topic and developmental stage upon which to focus.  With that information, the student will need to determine what health education (AKA parent/patient teaching) needs to be conducted prior to this virtual patient being discharged.  The students will then role-play the teaching session, using a student chosen by the instructor as the “parent” and with the rest of the clinical group observing. 

The project must include:

• A 1-page      attached document discussing the assessment of a parents’ readiness to      learn and barriers to learning
• The      critical components of home care for the assigned topic
• Developmentally      appropriate instruction-
  • The       teaching reflects the developmental level of the parent and patient.       (e.g., home care instructions for an infant should include the food       appropriate for an infant rather than a school aged child).
• A      written handout that summarizes the “take home” points for the parent to      keep as a reference after the teaching session.
• A      bibliography containing no fewer than three professional journal articles      with one being a pediatric specific article.  The articles must be      less than five years old.  Use of APA format for references is      expected.  
• A      clear, creative, logical progression geared to a learner at an 8th      grade level

1)  

The final presentation topic I have chosen explores the integration of health information technology within the nurse-patient relationship and how this relationship improves quality of care at the bedside. My topic also explores how health information technology can be utilized to improve nursing clinical workflow efficiency and quality. Some conclusions I have drawn from the literature research are that utilizing technology at the point of care delivery has made a significant impact on positive patient outcomes. It is important to note that the proper utilization of this technology is paramount in safe patient outcomes and in aiding the bedside clinician to improve workflow efficiency, quality, and patient safety. I believe that this is a very relevant topic, especially as we may have all recently learned that a former nurse at Vanderbilt University Medical Center in Nashville, Tennessee was arrested and charged with reckless homicide for making a medication error that resulted in a patient’s death. A full review of the plight of this nurse, and the judgement made against her is beyond the scope of this post, but its relevance can be related to the information systems and technology at the point of care that were involved in this incident.

According to Darvish, Bahramnezhad, Keyhanian, and Navidhamidi (2014), in an ever-changing advancing healthcare system, technology plays a major role in education and nursing work. Because of the ever-increasing pace that technology develops, the literature notes the need for appropriate education technology programs. Darvish et al. (2014) notes that in order to integrate information technology to effect positive outcomes and improve quality, there needs to be educational arrangements made within an organization to create short term and long-term specialized courses to focus on target groups and their various levels of education. By focusing on these groups and identifying their needs regarding information technology education, the goal is to increase quality of care, safety, and ultimately improve clinical workflow efficiency.

In my current practice a well-designed electronic health record system (EHRS) has been implemented for years. The system we are using currently is EPIC. We currently have excellent workflow efficiency in our extremely busy practice setting. Medication administration safety is enhanced with an integrated scanning system. The only potential issue from my current practice that I can identify as problematic, is that in an extremely rushed preoperative or PACU environment it is very easy to override the scanning tool and administer a medication urgently at the clinician’s discretion. In a PACU during a post-surgical emergency this is essential but when a clinician is just rushed to keep up with the workflow, then this presents a concern.

References

Darvish, A., Barhamnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014, June 24). The role of nursing informatics on promoting quality of healthcare and the need for appropriate education. Global Journal of Health Science, 6(6), 11-18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825491/

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2)  

Working on the final presentation has brought me to a few conclusions. First is that the nurse informaticists plays a key role in linking nursing and technology. This type of nurse takes their clinical knowledge and applies it to technology to improve patient outcomes. The nurse informaticists is crucial in being the change agent when it comes to introducing new technology or changes within technology at the bedside. Second conclusion is that using change theory is important for new technology to be accepted and successfully implemented into practice. The third conclusion is that technology is expanding at a rapid rate, the incorporation of electronic health records has made improvements in patient outcomes. The future of EHR applications have unlimited possibilities, however, ethical considerations need to be addressed. Just because technology can make improvements does not necessarily mean it should. And lastly, nurses at the bedside should be involved in the process of change. They are the stakeholders in change, the ones that experience the positives and negatives of incorporating changes into healthcare.

For the final presentation I am researching the interoperability of the EHR to improve triage accuracy. My focus is using EHR clinical systems such as clinical decision support systems to process data gathered during triage to support accurate triage acuity assignment. (Hebda, Hunter, Czar, 2019) Thus far in researching literature I have concluded that it is not just my experience in witnessing inaccurate triage assignments. Tam, Chung, and Lou (2018) research describes how worldwide there are problems in assigning accurate acuity levels despite the triage algorithm used. Experience and training are key factors in triage accuracy. Applying thinking algorithms could assist the triage nurse in making the important decision of how long a patient may safely wait to be seen in the emergency room. Monga (2017) discusses how incorporating “thinking” algorithms into EHRS can be done to guide practitioners in decision making. The question is should it be done? Ethical dilemmas arise, such as what if the algorithm applies the same biases as the nurse, or use of suggested acuity level is no longer a suggestion because the nurse becomes too dependent on the system. (Char, Shah, & Magnus, 2018) This application to the triage process would not create a change in nursing practice as it should be used as a support process and not a definitive decision process.

References

Char, D. S., Shah, N. H., & Magnus, D. (2018). Implementing machine learning in health care – Addressing ethical challenges. The New England Journal of Medicine, 378(11), 981–983. doi:10.1056/NEJMp1714229

Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of Informatics for Nurses and Healthcare Professionals (6th ed.). New York, NY: Pearson.

Monga, K. (2017). Using machine learning to increase agility in HIM. Journal of AHIMA, 88(7), 30-32. Retrieved from https://search.proquest.com/docview/1912093679?accountid=34574

Tam, H. L., Chung, S. F., & Lou, C. K. (2018). A review of triage accuracy and future direction.BMC Emergency Medicine, 18(1), 58. doi:10.1186/s12873-018-0215-0

200 words for each response